April 2017 Update: CME Pain Management Course Now Available!

Click Here for the Compulsory Pain Management Course

Dr. Reid - MSSNY President
Dr. Malcolm Reid
January 6, 2017
Volume 17
Number 1


Dear Colleagues:

By July 1, 2017, every physician and prescriber who has a DEA registration will need to complete three hours of course work or training in pain management, palliative care, and addiction. Governor Andrew Cuomo and the New York State Legislature passed the measure in June 2016 as part of a comprehensive package to combat opioid abuse that also included extensive new requirements on health insurers to cover needed treatments (see related article below).

But where can you take this new required course?

I am pleased to report that the Medical Society of the State of New York has been working with several knowledgeable and dedicated physician members and the NYS Office of Alcoholism and Substance Abuse Services to develop a program that comports with this statute. It is anticipated that this program will begin through a series of webinars in February. Then the program will be placed on-line on the MSSNY CME website so physicians can take it at their convenience.

The statute specifically requires that prescribers need course work in the following:

  • state and federal requirements for prescribing controlled substances;
  • pain management;
  • appropriate prescribing;
  • managing acute pain;
  • palliative medicine;
  • prevention, screening and signs of addiction;
  • response to abuse and addiction;
  • and end of life care.

Officials from the Department of Health’s Bureau of Narcotic Enforcement (BNE) have indicated that— for at least the first year— prescribers would simply need to “attest” that they have taken a CME course that includes all the components. This attestation will probably be done electronically through the Health Commerce System and we are hopeful that this attestation will be forthcoming shortly.

I know some of you have asked if every physician has to take the course.  The law provides a waiver for a DEA registered prescriber who 1) clearly demonstrates to the department’s satisfaction that there would be no need for him or her to complete such course work or training or 2) that he or she has completed course work or training deemed by the department to be equivalent to the course work or training approved by the department.

MSSNY has had email correspondence with officials from BNE who have stated that:

  • Each exemption request will be reviewed by the department to determine if the requestor has clearly demonstrated to the department there would be no need for them to complete the course work.
  • Practitioners who do not have a DEA number are exempt and do not require a waiver.
  • If the candidate has completed equivalent course work or training, they can attest that they have met the requirement.  There would be no need for a waiver.

Attestation by practitioners is anticipated to be available online with an expected launch in March, 2017 and will be through the Health Commerce System (HCS).  The process for seeking an exemption will also be through the HCS and is expected to be in place in March 2017.  More information about the process will be forthcoming and MSSNY will keep you informed as we learn more details.

Once we have finalized the three-hour CME program, MSSNY will notify its members as to its availability.   If you have any questions regarding this requirement, please contact me or Pat Clancy at pclancy@mssny.org.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Save the Date:
MSSNY Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org

Legislature Returns to Albany to Begin Legislative Session
The New York State Legislature returned to Albany this week to begin the 2017 Legislative Session.  Senator John Flanagan was re-elected as Majority Leader of the New York State Senate, and Assemblymember Carl Heastie was re-elected as Speaker of the New York State Assembly.

Speaker Heastie also announced Committee Chairs in the Assembly for the 2017-18 Session.  While there were some changes from last year, the leadership of many key committees remained the same. Assemblymember Richard Gottfried will be Chair of the Health Committee, Assemblymember Kevin Cahill will be Chair of Insurance Committee, Assemblymember Deborah Glick will be Chair of the Higher Education Committee, Assemblymember Michele Titus will be Chair of the Labor Committee, Assemblymember Joseph Lentol will be Chair of the Codes Committee and Assemblymember Denny Farrell will be Chair of the Ways and Means Committee.

The Governor’s proposed budget for the 2017-18 State Fiscal Year is expected to be formally proposed by January 17.

MSSNY Lobby Day, March 8-Plan Now to Be in Albany
MSSNY’s 2017 Annual Physician Legislative Advocacy Day is Wednesday, March 8.  Please hold that day open to join hundreds of your colleagues from across the State in Albany to hear from New York State’s top policymakers and to meet with your local legislators regarding the challenging issues that are confronting our health care delivery system.  To register, click here.                                                    (DIVISION OF GOVERNMENTAL AFFAIRS)

Governor Cuomo Signs MSSNY-Supported Step Therapy Reform Legislation into Law
We are pleased to report that, on New Years Eve, Governor Cuomo signed into law legislation (A.2834-D, Titone/S.3419-C, Young) advocated for MSSNY and many other physician and patient advocacy organizations that would provide stronger regulation of health insurer step therapy prescription medication protocols.

The bill will require a health insurer to grant a physician’s override request of an insurer step therapy protocol for their patient if the physician can demonstrate that the drug required by the protocol is contraindicated, likely to be ineffective, or if the patient is stable on the medication requested by the physician.  If the physician’s request for an override of the step therapy protocol is denied, the new law would better enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.

For more specific information regarding the legislation, click here: Click Here.  The new law will apply to all New York regulated health insurance products issued or renewed January 1, 2017 and after.  Please be aware that since many New York health insurance plans for 2017 were already approved prior to the new year, the new law will not initially be applicable to all plans.

We thank Governor Cuomo for signing this legislation into law, and Senator Young and Assemblymember Titone for sponsoring this legislation.  We also thank the many other Assemblymembers and Senators who co-sponsored this legislation and advocated for its enactment.

We also thank the many physicians who took time to send letters to their legislators and Governor Cuomo in support of this legislation.  In November, MSSNY President-elect Dr. Charles Rothberg appeared in a Fios Long Island news story discussing the importance of this legislation.  In October, a letter to the editor in support of the legislation from MSSNY President Dr. Malcolm Reid () was published in the Albany Times-Union.

New Health Insurer Requirements Effective 1/1/17 to Combat Heroin and Opioid Addiction
Governor Cuomo released a statement highlighting new requirements on health insurers that went into effect January 1, 2017, aimed at combatting heroin and opioid addiction in New York.  To read the press release, click here.  The reforms were part of a comprehensive legislative package enacted in 2016. As noted in the press release, among the new requirements that apply to New York regulated health insurance products issued or renewed on or after January 1:

  • Insurers must cover necessary inpatient services for the treatment of substance use disorders for as long as an individual needs them. In addition, the legislation establishes that utilization review by insurers can begin only after the first 14 days of treatment, ensuring that every patient receives at least two weeks of uninterrupted care before the insurance company becomes involved.
  • Insurers cannot require prior approval for emergency supplies of drug treatment medications. Similar provisions that also apply to managed care providers treating Medicaid recipients who seek access to buprenorphine and injectable naltrexone took effect in June.
  • All insurers operating in New York State must use objective, state-approved criteria when making coverage determinations for all substance use disorder treatment in order to make sure individuals get the treatment they need.
  • Insurance companies must cover the costs of naloxone when prescribed to a person who is addicted to opioids and to his/her family member/s on the same insurance plan.

These important new provisions were part of an omnibus opioid abuse package enacted in 2016 that also: required most physicians and other prescribers to complete three hours of education every three years on addiction, pain management, and palliative care; limit to no more than seven days the length of an opioid prescription for an initial consultation or treatment of “acute pain”; and require pharmacists to provide educational materials to consumers about the risk of addiction, including information about local treatment services.   (AUSTER, CLANCY)

U.S. Senate Begins Debate Over ACA Repeal; MSSNY Urges Caution and Requests More Specificity
As the U.S. Senate began debate this week of a concurrent resolution introduced by Senate Budget Committee Chair Mike Enzi (R-WY) to proceed with legislation to enact a repeal of many of the funding provisions of the Affordable Care Act (ACA), MSSNY President Dr. Malcolm Reid wrote to each member of New York’s Congressional delegation to express concern with efforts to repeal  funding for coverage expansions without simultaneously specifying how it will be replaced.

Dr. Reid’s letter articulated that physicians across New York State have expressed great concerns with several ACA provisions, noting that the ACA has “encouraged and/or accelerated the proliferation of health insurance plans with huge patient cost-sharing responsibilities, prompted the narrowing of physician networks and elimination of coverage options for small businesses and sole proprietors”.  Nevertheless, the letter also states that “the ACA has provided the opportunity for hundreds of thousands of New Yorkers to obtain affordable health insurance coverage that previously was not available to them” and that “elimination of the funding currently provided to New York State through these programs could drive a huge hole in our State Budget, and prompt untenable cuts affecting millions of more New Yorkers.”

The letter urges members of New York’s Congressional delegation “to assure that any legislation that threatens the availability of affordable health insurance options for our patients simultaneously specifies how these currently available coverage options will be replaced with improved coverage options.”

The American Medical Association also sent a letter to Congressional leaders this week that requests that “before any action is taken through reconciliation or other means that would potentially alter coverage, policymakers should lay out for the American people, in reasonable detail, what will replace current policies.” The AMA letter was accompanied by a listing of key health system reform objectives including:

  • Assure that individuals currently covered do not become uninsured and take steps toward achieving coverage and access for all Americans.
  • Maintain key insurance market reforms, such as coverage for pre-existing conditions, guaranteed issue and parental coverage for young adults;
  • Stabilize and strengthen the individual insurance market;
  • Ensure that low and moderate income patients are able to secure affordable and adequate coverage;
  • Ensure that Medicaid, CHIP, and other safety net programs are adequately funded;
  • Reduce regulatory burdens that detract from patient care and increase costs;
  • Provider greater cost transparency throughout the health care system; and
  • Incorporate common sense medical liability reforms.

Liability Expansion Bills Re:Introduced
Among the first bills introduced by the legislature are several bills being pushed by the trial lawyers.  The bills include:

Prohibiting ex-parte interviews of plaintiff’s treating physician (S.243)
This bill 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. 

Expansion of Wrongful Death Damages (S.411)
This bill would expand the categories of damages which a plaintiff may recover in a wrongful death action to include emotional as well as economic loss. The categories for recovery would be expanded to include grief or anguish caused by the decedent’s death as well as loss of love, loss of society, loss of protection, loss of comfort, loss of companionship, and loss of consortium.

Recoveries against Third Parties (S.412)
This bill permits a plaintiff to recover directly against a third party defendant when the judgment against the original defendant has not been satisfied after thirty days.  It would also allow a plaintiff to recover against a third party against which it did not litigate, and with which it has no privity.

MSSNY Advocates to Address Physician Shortages
For the past several years, MSSNY has been advocating for funding to expand the Doctors across New York (DANY) program. This week, MSSNY participated in a meeting with other physician and hospital advocates to discuss strategies to provide additional resources in this year’s budget toward the DANY program.  MSSNY will continue to work with legislators in the upcoming legislative session to find ways to attract and retain physicians in underserved areas of the state.                                                                              (BELMONT)

Register Now for a January 26 Lunchtime Program to Discuss the Medicare MIPS Program
The Medicare MACRA/MIPS program has now gone into effect.  Do you and your staff want to learn more regarding what you need to know to comply with this new program that could have a significant impact on your revenue from Medicare?  Please join us for a webinar on Thursday January 26, from 12:30 – 1:30, where you will hear from Frank Winter of New York Regional Office for CMS present important information about this new program for physicians and their staffs.  To register Click Here.

Upon your registration, you will receive a confirmation e-mail with instructions for joining this session either by webinar or conference call.  (AUSTER) 

MSSNY Veterans’ Matters Upcoming Grand Rounds on Substance Use Disorders; Physicians Strongly Urged to Attend
Following a positive response to 2016’s expansion of Veterans’ Matters to include programming on substance use disorders, a live grand rounds presentation will be held on Friday, January 13th. Frank Dowling, MD, will present at Brookhaven Memorial Hospital, 101 Hospital Rd., Patchogue, NY at 8 am.

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 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

To register for the live program, click on the link below

Substance Use Disorders: Live at Brookhaven Memorial Hospital – 1/13/17 at 8 am

Information and the educational objectives for the program can be found here

Substance Use Disorders: Live at Brookhaven Memorial Hospital – 1/13/17

If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg Elperin at gelperin@mssny.org or call (518)465-8085.                      (CLANCY, ELPERIN)

Medical Matters CME Webinar Series Continues in 2017; Registration now open
The Medical Society of the State of New York will continue its Medical Matters webinars on January 18, 2017 at 7:30 a.m. with Triage in a Disaster Event.   Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here. Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well. February’s webinar will be: The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team.  This program will be held on Wednesday, February 15, 2017 at 7:30 a.m. Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here

The educational objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event.  2) Identify means by which members of the healthcare team can address  stress before,  during and after an active shooter/bombing event.  3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team. A copy of the flyer can be accessed here.  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) 

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

enews large

Analysts Say VA Has Failed To Provide Rehabilitation to Opioid-Addicted Veterans
In a nearly 6,000-word story, the Wall Street Journal (12/29) reports that the Department of Veterans Affairs admits that the large population of opioid-addicted veterans is due in part to its over prescription of painkillers for injuries and PTSD and says it is working to fix the damage. However, analysts say budgetary and bureaucratic hurdles have prevented the Department from building a rehabilitation that can handle the treatment needs of the tens of thousands of veterans with opioid addiction, and many veterans are left to their own devices to find resources to combat the condition.

NYS Group Wants Constitutional Amendment to Guarantee Clean Air and Water
AP (12/29) reports Environmental Advocates of New York and are calling for an amendment to the New York state constitution “that would guarantee residents a right to clean air and water.” The two groups are promoting the proposed amendment with online videos that feature “children from Hoosick Falls, where water wells have been contaminated by an industrial chemical. At a state Senate hearing in August, Health Commissioner Howard Zucker said the state followed federal guidelines in addressing the issue.

“In 2016, we saw communities in New York struggling with clean drinking water and clean air,” Environmental Advocates executive director Peter Iwanowicz said. “What was missing was clear language in the state constitution giving people the right to drink water that won’t make them sick and breathe air that’s safe.”


January 20th, 2017, from 6 to 8.30 pm & January 21st, 2017 from 5 to 7.30 pm 

Enhance your perceptual and communication skills and strengthen your clinical practice! Open to all physicians, physician assistants, psychiatrists, residents, nurses, medicals students, and healthcare professionals across disciplines

January 20th from 6 to 8.30 pm: Enhancing Presence and Observation

January, 21st from 5 to 7.30 pm: Increasing Self-Awareness and Empathic Intelligence 

Cost: $285 (includes 1/20/17 and 1/21/17 + museum entrance fee) $185 for students

Art experience is welcome but not necessary–Location: The MET Museum in NYC

Space is limited to insure interactivity! For more information check out our website  and to register go here.

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

Come to YPs, Resident and Fellow Meeting in Westbury on February 11
Save the Date for the Annual Joint Meeting of the Young Physicians, Residents, Fellows, and Medical Student Sections: Saturday, February 11, 2017 at the Marriott Courtyard, 1800 Privado Road, Westbury NY 11590.

Presentations will include “Telemedicine/Telehealth:Tools for Clinical Practice and Patient Engagement.” Gain a better understanding of and appreciation for the use of telemedicine as part of a patient management strategy that will improve and increase access to treatment, lower costs, and more effectively engage patients.

We will also present important financial planning strategies and tips specifically for younger physicians, including Student Loan Management, Main Financial Issues to Address in Residency and as you Transition to Practice, Asset Protection Strategies and Risk Management, and more.

Policy will be created, elections will be held.

YPS and RFS register at sbennett@mssny.org; MSS register at mreyes@mssny.org.

MSSNYPAC – The Political Voice for New York’s Physicians
The 2017 session of the NYS Legislature has convened!  For the next several months, many health policy proposals will be offered and perspectives from many stakeholders will be considered as policy is formulated.  It is critically important for the physician to have a meaningful seat at the table in shaping these proposals.  Physicians have experienced many victories and the legislative session offers opportunity for further reforms and administrative simplifications yet it is also fraught with danger in the form of expansions of medical liability and scope of practice of non-physicians that we must oppose.Through MSSNYPAC, physicians are a force for change in New York State healthcare policy.Join or increase your support and participation today at www.mssnypac.org

Former Anesthesiologist with Addiction Problem Helps Others to Recover
The Syracuse Post-Standard published an interesting story about a former anesthesiologist who changed specialties and went into addiction medicine after recovering from drug addiction. http://www.syracuse.com/empire/index.ssf/2017/01/follette.html#incart_river_home 

Now Accepting Abstracts for Student Poster Symposium at April 21 HOD
We are accepting abstracts for consideration for our 12th Annual Resident/Fellow/Medical Student Poster Symposium to be held on:

Friday, April 21, 2017
Westchester Marriott
Tarrytown, New York
2 pm – 4:30 pm

In the words of past participants, the MSSNY symposium is an “excellent networking opportunity,” a place to “meet fellow residents and attendings” and “learn from other presentations” that they “would highly recommend.” 

Click here for detailed guidelines.

Deadline for abstract submission is 4 pm, Tuesday, January 31, 2017. Check out last year’s Abstract Book here.

We welcome your participation!

Improving Payment for Chronic Care, Behavioral Health and Diabetes Prevention
Improving payment for chronic care management and behavioral health, enhancing diabetes prevention, and a data collection strategy for global services will significantly reduce burden on practitioners compared to the proposal are key focus areas of the 2017 Medicare Physician Fee Schedule (PFS) that CMS released on Nov. 2, 2016. CMS says that the new policies will improve Medicare payment for those services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment conditions.

A few highlights of the final rule include:

  • Reimbursement for chronic care management (CCM), complex chronic care management, and care plan development— The 2017 Medicare PFS includes several revisions to the billing code set to more accurately recognize the work of primary care and other cognitive specialties to accommodate the changing needs of the Medicare patient population, and the value of care management and care coordination.
  • Expansion of the Medicare Diabetes Prevention Program (MDPP) ―The 2017 Medicare PFS finalizes policies including the definition of the MDPP benefit, beneficiary eligibility criteria, and supplier eligibility and enrollment criteria that will enable organizations, including those new to Medicare, to prepare for enrollment into Medicare as MDPP suppliers. Learn more in CMS’ fact sheet. CMS said that future rulemaking will address policies related to payment, virtual providers, and other program integrity safeguards.
  • Behavioral Health Integration– CMS will pay for the care collaboration for beneficiaries with behavioral health issues. Payment is based on the collaborative care model, and is meant to foster discussion, information sharing and planning between the PCP and the behavioral health care specialists
  • Reimbursement for Non Face-to-Face Prolonged Evaluation & Management Services (E/M) – CMS will pay for additional time spent by the physician or non-physician practitioner beyond the direct patient care visit.
  • Data collection within surgical global period— The 2017 Medicare PFS finalizes a data collection strategy that aims to significantly reduce the burden on practitioners by requiring reporting of post-operative visits only for high-volume/high-cost procedures, using existing CPT code 99024 instead of the proposed G-codes.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to gather data on visits in the post-surgical period that could be used to accurately value these surgical services. CMS is hopeful that use of the existing CPT code for reporting these services will be significantly less burdensome than the proposal to require time-based reporting using the G-codes.

For more information:

EHR Incentive Programs Attestation Programs Open January 23 to February 28
In 2016, the EHR reporting period was a minimum of any continuous 90 days between January 1, 2016 and December 31, 2016. There is also a 90-day reporting period for CQMs for providers that choose to report CQMs by attestation. The EHR Incentive Programs attestation system will be open from January 3, 2017 to February 28, 2017. Providers must attest by the attestation deadline to avoid a 2018 payment adjustment. In preparation for attestation, CMS encourages providers to review the 2016 program requirements webpage on the EHR Incentive Programs website.

Columbia’s Mailman School of Public Health: Marijuana Use up in Pregnant Women
More pregnant women are using marijuana than were a decade ago, according to a study from Columbia University’s Mailman School of Public Health published in JAMA. Researchers found that the percentage of pregnant women who used marijuana in the past month increased from 2.37 percent in 2002 to 3.85 percent in 2014. Pregnant women between 18 and 25 years old had the highest use rate, with 7.47 percent of them using the drug within the past month. http://jamanetwork.com/journals/jama/fullarticle/2594398

New: DrFirst Rcopia® Prescribers Receive Notice of Failed e-Prescriptions via Mobile Device
Have you ever issued an e-prescription for a patient, and then found hours later that the transmission failed to reach the pharmacy?  Many docs have. According to Surescripts, e-prescription failures occur 3% to 6% of the time. Failure is typically not a result of a problem with your prescribing software; the error is more likely to be somewhere between the network and the target pharmacy.

DrFirst’s Rcopia e-prescribing software mitigates failed transmissions through the use Notification of Undelivered Scripts or “NUS.” NUS, delivered through DrFirst’s Backline® secure communications software, sends a secure message directly to your mobile device within minutes of any patience prescription failing to reach the pharmacy. That means you can be notified and correct the problem before your patient arrives at the pharmacy.

To activate this service, individual physicians can sign-up for a complementary Backline account for NUS support. Once you register, DrFirst will connect your Backline account with your Rcopia account to transmit NUS messages. You can also use the Backline software to secure text with other colleagues in the Backline community.

DrFirst is a MSSNY member benefit.

For more information, MSSNY Members should visit this link: http://www.drfirst.com/mssny 

New Legislation Re Emergency 5-Day Supply of Drugs Used to Treat Substance Use Disorders in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care
As a result of changes to Insurance Law section 3216 paragraph 31-a, effective January 1, 2017, insurance carriers will be required to provide at least 5 days’ coverage for emergencies, without prior authorization, for medications used to treat substance use disorders. This includes medication associated with the management of opioid withdrawal and/or stabilization as well as medication used for opioid overdose reversal. Additionally, no policy shall impose an additional copayment or coinsurance on an insured who received an emergency supply of medication and then received up to a thirty day supply of the same medication in the same thirty day period in which the emergency supply of medication was dispensed.

Medicaid Fee-for-Service (FFS)

A pharmacist can initiate an emergency 5-day supply of a non-preferred medication for the treatment of a substance use disorder by calling the clinical call center at 1-877-309-9493. The clinical call center is available 24 hours per day, 7 days per week.

To obtain FFS preferred medication listings and criteria see also the following website: Medicaid FFS Preferred Drug List and Pharmacy Prior Authorization Programs.

If a prescriber initiates a subsequent prescription for the same medication for the treatment of a substance use disorder within 30 days of the initial 5-day emergency supply, and the pharmacist is notified and/or confirms this upon reviewing the patient’s prescription history or utilizing ProDUR editing, the following may be used to exempt the copayment for the subsequent prescription:

  • In NCPDP field 461-EU, enter a value “04” (Exempt Copay and/or Coinsurance)
  • Please refer to the NCPDP Companion Guide at: https://www.emedny.org/HIPAA/5010/transactions/NCPDP_D.0_Companion_Guide.pdf and the ProDUR Manual at: https://www.emedny.org/ProviderManuals/Pharmacy/ProDUR-D.0-ECCA_Provider_Manual/Pro%20DUR%20ECCA%20Provider%20Manual%20(D.0).pdf

This process will be utilized until such a time the Department is able to systematically address the exemptions of copayment(s) on eligible subsequent prescription(s) within the 30 day period.

Managed Care plans will develop and communicate their own processes/procedures to comply with this law.

DEA Reverses Decision re Registration Renewal Process
The good news is that registration numbers will not automatically be retired if renewal applications are filed within the one-month grace period after the expiration date. However, there are a few issues that need clarification from the DEA, including whether the filing of a renewal application during the one-month grace period automatically reinstates the registration number or whether DEA must adjudicate the renewal application before the number becomes valid.  It also is not clear whether a registration number remains valid if the registrant files a renewal application during the grace period and DEA fails to adjudicate the application before the end of the month. The AMA will be following up with DEA staff

We recently alerted physicians to a notice from the Drug Enforcement Administration (DEA) that effective January 1, 2017, the DEA was changing its long-standing policy of allowing a grace period for registrants who failed to file a timely renewal application. The revised announcement states the following: 

At this time, DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows:

  • If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application.
  • DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required.
  • Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration.

If you want to check your registration expiration date, please contact the DEA Registration Service Center at 1-800-882-9539 or email DEA.Registration.Help@usdoj.gov and include your DEA Registration number in your email.  For questions about this alert, please contact Debra Cohn, Senior Washington Counsel, at (202) 789-7423 or debra.cohn@ama-assn.org.


Prime Astoria Medical Office for Rent or Lease
23-15 Astoria Boulevard, Astoria, New York
Customizable Lower Level
7,500 Sq Feet Gross For Lease
Prime Location Close To Hospital and Other Medical Facilities.
Direct Street Access Private Elevator plus Direct Access From  
Street Level Stairs.
AB Building Management LLC
George Miltiadou
718-482- 7262

Upper East Side Medical Office for Sale
Suitable for a solo practice or shared multi- specialist group. Large unit, about 1100 Sq Ft, located on the ground floor of a cooperative building with own entrance to office, 2 or 3 equipped exam rooms with exam tables and work station areas, front waiting room with reception area with storage unit of shelves for medical charts, a consultation office, 1 and a half bathrooms and kitchenette. Lots of shelves throughout exam rooms, 2 EKGs, one PC computer that comes equipped with a PFT machine and operating software, an operating X-ray machine suitable for chest X-rays with film processor. No brokers, call office manager, Diana Peron @ 212-861-9012

State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space (preview images of space can be seen on www.instagram.com/dermroom). $8,000-$11,500/month. For details contact (212)–583–2966 or email Hefderm@outlook.com, no brokers.

Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

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

Physician Opportunities

Executive Director – Bronx County Medical Society
Bronx County Medical Society, a leader in promoting excellence in Clinical Care, Education & Public Policy, is seeking an executive director. Candidates should have either a bachelor degree and/or three years of work experience with non-profit medical groups. The Executive Director should be knowledgeable on healthcare policy and nonprofit compliance. Candidate must demonstrate strength in event planning and fundraising, member recruitment and retention, community outreach, and possess strong communication skills. We offer a competitive salary and benefits package. Please send resume and cover letter to Diane Miller, Executive Director at bxcms@msn.com

A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.