December 18, 2015

 Dr. Joseph R. Maldonado
December 18, 2015
Volume 15, Number 47

Dear Colleagues:

If you have claims outstanding with Health Republic, please take a moment to click on this link which will bring you to MSSNY’s grassroots action center and a letter which you can send to your elected State Senator and Assemblyman to call for action to assure that physicians and other healthcare stakeholders are paid for services rendered to patients of the now defunct Health Republic.

MSSNY continues to have regular communication with key state officials regarding how the wind-down of Health Republic will occur, and at what level and when payment can expect to be received.  MSSNY also continues to share with key legislators and the media our collective concerns regarding the severe consequences to physicians’ practices as a result of the collapse of Health Republic, and advocating for a special fund to assure physician claims for care provided to HR-insured patients are fully paid.

This includes sharing the results of our survey of nearly 1,000 respondents, which has generated extensive media coverage from across New York State, including the Wall Street Journal and New York Times.  Please add your voice to these efforts to better assure that physicians are not left holding the proverbial bag!

Submit All Your Claims Now!

In the meantime, you must submit all HR claims for services rendered up to and including November 30, 2015. Although we cannot project the outcome of this debacle, it is safe to report that if your claims are not filed, they will never be considered.

Send Us Your Bounced Checks!

MSSNY has received notices from several physicians that reimbursement checks issued by HR have been returned by the bank for insufficient funds. If you have received notice from your bank that an HR check bounced, send an email to  If you can scan the check into an email that would be helpful.  If not, your email should include the date the HR check was issued, the amount of the check and whether the bank charged a fee for the transaction.

On a related matter, if you are holding reimbursement checks from HR, they will bounce if you try to deposit it.  We urge you to send us an email indicating the number of checks, the date (s), and the amount.  We will share this information with the HR monitor. Again, please email

Thank you for your patience while we continue to assist you in the process.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to

MLMIC Physianns Insurance

Alert from MSSNY General Counsel Don Moy:  NYS Court of Appeals Decision Exposes Physicians and Other Health Care Professionals to Liability to Non-Patient Members of the General Community
The majority’s decision in Davis v. South Nassau Communities Hospital must be viewed as alarming to physicians and other health care professionals.  Physicians who administer or prescribe medication to patients must be prepared to document that they advised the patient of the foreseeable side effects of the medication, and, in particular, if the medication could foreseeably impair the patient’s ability to safely operate an automobile. Physicians must be prepared to document that they advised the patient not to drive while taking the medication.

These are the facts in Davis v. South Nassau Communities Hospital (issued on December16, 2015): Patient W was treated by Dr. H at the ER of a hospital. As part of the treatment, the doctor intravenously administered to W an opioid narcotic painkiller and a benzodiazepine drug, and, allegedly, failed to warn W that such medication could impair her ability to safely operate an automobile. Shortly thereafter, W drove herself from the hospital and, while allegedly impaired by the medication administered to her, she crossed a double yellow line and struck a bus driven by plaintiff Davis.

The NYS Court of Appeals reversed an appellate court and held that under these facts, the doctor had a duty to warn the patient about the patient’s ability to drive safely, and the failure of the doctor to fulfill this duty to the patient could subject the doctor to liability to any member of the general community who is harmed as a result of the patient’s driving. The Court of Appeals opined that the “cost” of the duty  imposed upon physicians and hospitals is a “small one” because the “duty” requires the doctor to do no more than simply warn the patient of the dangers of driving. The Court emphasized that the doctor had no obligation to prevent the patient from driving.

The Court further held that its ruling does not create a new obligation on doctors because a doctor who administers prescribed medication already has a duty to advise the patient of the foreseeable side effects of the medication.  Rather, stated the Court, the ruling “merely extends” the scope of persons who may sue the doctor for failing to fulfill that responsibility to the patient.

The Court sought to limit the reach of its decision by stating that this decision should not be construed as an erosion of judicial precedent that courts need to proceed cautiously and carefully in recognizing a new “duty of care”.  Judge Leslie Stein issued a scathing dissenting opinion  and rebuked the majority decision  as  “precipitous” and contrary to the firmly established judicial precedent of the state that, in general, a physician’s duty is to the patient, and the corresponding liability may be extended to a non-patient only in rare and narrow circumstances, such as to an immediate family  member  where the physician knew or should have known  that treatment provided to the patient  could create risk of harm to immediate family members. To her knowledge, stated Judge Stein, there has been no precedent in the state that has held that a physician’s medical treatment of a patient could expose the physician to liability to an unidentified class of members of the general community.

Judge Stein stated that despite the majority’s attempt to limit the reach of its decision, she feared a “slippery slope” and that the decision could be precedent to expand liability to doctors in other areas of treatment. 

Congress Passes Year End Spending, Tax Relief Bills that Includes “Cadillac Tax” Delay, Extension of 9/11 Responder Health Coverage, and MU Hardship Provisions
The US House and Senate passed two massive legislative packages, an omnibus appropriations bill and tax revision bill, before Congress adjourned for the holidays.  Importantly, among the provisions is a 2-year delay of the so-called “Cadillac Tax” on benefit-rich health insurance plans enacted as part of the ACA that was to become effective in 2018.  Since this tax would strongly discourage employers from offering comprehensive health insurance coverage to their employees, the MSSNY House of Delegates adopted policy calling for this tax to be repealed.

The $1.1 trillion FY2016 omnibus appropriations package will fund federal agencies and programs through September 30, 2016. Many of the earlier debated policy riders, such as the proposal to “defund” Planned Parenthood, were omitted from the bill. In addition to the delay of the “Cadillac tax”, some of the other health-related provisions include the following:

  • Funds for the 9/11 emergency responder health care benefits were reauthorized and expanded;
  • A one-year delay of the health insurance tax (for 2017)
  • IPAB operational funding was cut by $15B (although the panel has never actually been established)
  • Requiring the HHS Secretary to implement an education campaign to inform breast cancer patients about the availability and coverage of breast reconstruction and other available alternatives post-mastectomy.
  • Breast cancer screening recommendations issued by the USPTF were blocked for 2 years
  • AHRQ funding was cut by $30M (earlier House version had zeroed out agency funding)
  • Funding for NIH was increased by $2B
  • Additional funds were provided for opioid prescription drug overdose prevention
  • $20M was provided for the National Diabetes Prevention Program
  • The annual ban on using CDC funding for gun violence epidemiological research was extended

A second $650B package extends a broad range of tax-related polices, including a two-year moratorium on the Medical Device Tax, also enacted as part of the ACA.

Moreover, there was a “last second” bill passed by Congress that grants CMS the authority to expedite applications for exemptions from Meaningful Use Stage 2 requirements for the 2015 calendar year through a more streamlined process, alleviating burdensome administrative issues for both providers and the agency.  In order to avoid a penalty under the meaningful use program, eligible professionals must attest that they met the requirements for meaningful use Stage 2 for a period of 90 consecutive days during calendar year 2015.  However, CMS did not publish the Modifications Rule for Stage 2 of meaningful use until Oct. 16. As a result, eligible professionals were not informed of the revised program requirements until fewer than the 90 required days remained in the calendar year.  The legislation is designed to address this flaw.

Click here for a more detailed summary from the AMA on Congress’ action.

State Supreme Court Justice Ruled Child Flu Vaccination Not Mandatory in NYC
State Supreme Court Justice Manuel Mendez ruled Thursday that the New York City Department of Health and Mental Hygiene (DOHMH) may not require that children receive a flu vaccination to attend “city-licensed preschools and day care centers, striking down one of the more ambitious public health initiatives of the Bloomberg administration.” Justice Mendez ruled that “the city had exceeded its authority” and if the city wants to require flu vaccines, the Legislature would have to vote to add it to the list. 

Physicians Dropped from Emblem Should Contact Their State and Federal Legislators To Supplement MSSNY’s Advocacy

Physicians who have been unfairly dropped from Emblem’s participating physician network are urged to contact their state and federal legislators from MSSNY’s Grassroots Action Site here and ask for them to take action to push Emblem to reverse its decision.

As has been widely reported, Emblem is dropping these physicians reportedly as part of its efforts to increase the use of value-based payment arrangements.   Because of extensive physician outrage over these arbitrary and unfair actions, MSSNY has asked for an investigation by the New York Department of Financial Services, as well as the NYS Department of Health and Attorney General’s office.

Moreover, MSSNY has written to the entire State Legislature to share the extensive media coverage of this issue affecting continuity of care for patients, and urging legislators’ assistance in reversing Emblem’s arbitrary and unfair decision.   MSSNY’s request to state legislators asked them to a) urge the New York Department of Financial Services to prevent Emblem from taking its action to drop the contracts of these 750 physicians; b)  urging the State Legislature to enact legislation (A.1212, Lavine/S.4751, Hannon) that passed the Assembly in 2015 that 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; and c) urging the adoption of legislation that would better assure more comprehensive physician networks by preventing health insurance companies from dropping physicians from its network based upon an inability to enter into a value-based payment arrangement.

Importantly, New York State Senate Health Committee Chair Kemp Hannon wrote to Emblem CEO Karen Ignani last week to ask for “further clarity on this issue.”   Senator Hannon’s letter to Emblem notes that “further information must be made available to enable the physicians you have chosen to drop from your network to properly be reconsidered.”  In particular, Senator Hannon expressed concern whether these 750 physicians “were granted an opportunity to enter value-based payment arrangements prior to them being dropped from Emblem’s network of providers” and “whether the providers will be favorably reconsidered if they are capable and willing to enter such arrangements in a timely manner, or what other factors may be taken into account upon reconsideration. “

Please continue to let us know if you have been impacted by these actions.  MSSNY and county medical societies are seeking to further identify physicians who have been impacted, as well as patients who may be willing to share their stories.  With assistance from MSSNY’s General Counsel, we have drafted a template “Dear Patient” letter for impacted physicians to customize to use for their discussions with their patients.     

MSSNY and OASAS To Conduct CME Webinars On Opioid Use; Registration Now Open
The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are pleased to present a free, four part webinar series on opioid prescribing.  Entitled,Revisiting the Role of Opioid Analgesics for Simple and Complex Patients with Chronic Pain”, the series will begin on Tuesday, January 26, 2016.

Registration is now open at here.

A copy of the flyer can be found here.

Opioid abuse is a national epidemic that physicians and other prescribers have the power to help prevent.  This series will provide information on managing pain, understanding the potential for patient addiction, and determining best practices for safe, responsible opioid prescribing.

Tuesday January 26, 2016, 12:30 p.m.

Faculty: Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN

Educational Objectives:

  • Compare and contrast the dual epidemics of chronic pain and opioid abuse and the implications on public health
  • Understand requirements of New York State laws/regulations with regard to prescribing of controlled substances.

Wednesday, February 10, 2016, 7:30 a.m.

Faculty:  Charles E. Argoff, MD

Educational Objective:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation.

Tuesday, February 23, 2016, 7:30 a.m.

Faculty:  Jeffrey Seltzer, MD

Educational Objective:

  • Describe potential for patient addiction, screening, diagnosis and subsequent treatment or referral.  

Thursday, March 10, 2016, 7:30 a.m.

Faculty: Charles E. Argoff, MD and Charles Morgan, MD, FASAM, FAAFP, DABAM

Educational Objectives:

  • Recommend tools to assist in the management of patients for whom opioids are indicated and prescribed.
  • Discuss strategies to reduce risk of treating pain in patients with substance use disorders

Physicians and other prescribers can take one or all of the webinars; each webinar has been accredited for one hour of continuing medical education credits.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.  The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For further information or assistance in registering for the program, please contact Pat Clancy at or Terri Holmes at

MSSNY Is Member of AMA’s Task Force On Opioid Abuse
The Medical Society of the State of New York is participating on the American Medical Association’s (AMA) national Task Force to Reduce Opioid Abuse.  The task force, established in 2014, consists of over 20 medical national specialty organizations and MSSNY is one of the eight state medical societies on the task force.  The goals of the task force are to:

  • Increase physicians’ use of effective PMPs
  • Enhance physicians’ education on appropriate prescribing
  • Reduce the stigma of pain and promote comprehensive assessment and treatment
  • Reduce the stigma of substance use disorder and enhance access to treatment
  • Expand access to naloxone in the community and through co-prescribing.

The task force ultimate goals are to create a behavioral shift in physicians to create a sense of urgency that they are a part of the solution to the opioid epidemic and to tap into their fundamental desire to effectively help their patients and improve their patients’ health.  The task force will also urge physicians to use PMPs to have a better—realistic—perspective about patients’ use of opioids.  Dr. Frank Dowling, MSSNY Councilor and Pat Clancy, Vice President of Public Health and Education are MSSNY appointees to the task force.

MSSNY has also developed a page entitled, “Opioids: What One Doctor Can Do.“  This page is located on the MSSNY website and is located in a blue box at the top of the home page:   The page provides information on the AMA Task Force, provides resources and best practices for physicians and also provides tools for physicians along with patient information.

NYS Connects with Other Prescription Monitoring Programs; Allows Prescribers to Assist In Reducing Doctor Shopping Across State Lines
New York State has announced that it has joined the National Association of Boards of Pharmacy PMP InterConnect hub which will allow participating states to share information from prescription monitoring programs to prevent consumers from “doctor shopping” for prescription drugs over state lines.  The New York’s Prescription Monitoring Program, (PMP) is an electronic system allows prescribers and pharmacists statewide to ensure patients do not obtain multiple prescriptions for dangerous controlled substances.  New York prescribers are required to check patient information on the PMP prior to issuing controlled substances, and this requirement was implemented under the ISTOP law.  New Jersey and Connecticut are both on the NABP PMP Interconnet hub, though other neighboring states, including Massachusetts, Pennsylvania and Vermont, are not.  MSSNY strongly supports this move and believes it will give important information to physicians about their patients.

MSSNY E-Prescribing Webinar Now Available on MSSNY CME Site
MSSNY e-prescribing webinar, entitled, “NYS Requirement for E-prescribing ALL Substances” is now available at MSSNY Continuing Medical Education site at  Faculty for this program is Sandra Knapp, Manager, Official Prescription Program, NYS Department of Health, Bureau of Narcotic Enforcement.    The requirement to e-prescribe all substances will become effective on March 27, 2016.   The Medical Society of the State of New York designates this enduring activity for a maximum of 1.0 AMA/PRA Category 1 credit™. New registrants to the site will have to register and create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the menu on “My training page” to view and take the e-prescribing course.  There are over 50 free courses that are also available.  Further information on all these programs may be obtained by contacting Pat Clancy at 

Tomorrow Is Last Day to Submit PQRS Status Questions
If you have any questions regarding the status of your 2014 PQRS reporting or are concerned about potentially receiving the PQRS negative payment adjustment in 2016, please do not hesitate to submit an informal review request. CMS will be in contact with every individual eligible professional (EP) or PQRS group practice that submits a request for an informal review of their 2014 PQRS data. Additionally, revised 2014 Annual Quality and Resource Use Reports (QRURs) are now available via the CMS Enterprise Portal.  All informal review requests must be submitted electronically via the Quality Reporting Communication Support Page (CSP) which is available now through December 16, 2015 at 11:59 p.m. Eastern Time. 

Follow these steps to submit an informal review request:

  1. Go to the Quality Reporting Communication Support Page (CSP)
  2. In the upper left-hand corner of the page, under “Related Links,” select “Communication Support Page”
  3. Select “Informal Review Request”
  4. Select “PQRS Informal Review”
  5. A new page will open
  6. Enter Billing/Primary Taxpayer Identification Number (TIN), Individual Rendering National Provider Identifier (NPI), OR Practice Site ID # and select “submit”
  7. Complete the mandatory fields in the online form, including the appropriate justification for the request to be deemed valid. Failure to complete the form in full will result in the inability to have the informal review request analyzed. CMS or the QualityNet Help Desk may contact the requestor for additional information if necessary.

For additional questions regarding the informal review process, contact the Quality Net Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information.

MSSNY Teams with CA, FL and TX Medical Societies to Urge Meaningful Use Reforms
With uncertainty surrounding whether Congress would be able agree to changes to the overly burdensome meaningful use requirements, MSSNY teamed with the medical associations of California, Florida and Texas on a letter this week to CMS Acting Administrator Andy Slavitt urging needed reforms.  In particular, the letter notes that “Physicians across this country are uniformly frustrated, angry, and demoralized by these difficult regulations.  Most physicians are working hard to meet the requirements and cannot because of the lack of specialty measures, the all-or-nothing approach, vendor problems, the lack of interoperability or other issues beyond their control.  Many physicians have been early adopters of technology and are enthusiastic about using EHR as means to improve workflow, patient care and quality outcomes.  However, the EHR incentive program must have feasible and attainable requirements to help physicians achieve these goals rather than act as a burden and hindrance to EHR use by physicians”.

Reforms to the MU program urged in the letter include: delaying implementation of MU Stage 3; giving physicians proportional credit for the measures that are successfully completed, instead of the existing “all or nothing” approach; and expanding the hardship exemptions to recognize physicians who are victims of hacking or other disruptive technology problems related to their vendors, as well as physicians who are close to retirement.

PTSD and TBI in Returning Veterans: Identification and Treatment
Live CME Seminar at Southampton Hospital
Date and time:
January 7, 8-9 AM Live at Southampton Hospital

Presenter:        Dr. Frank Dowling

Program Summary: A look into the two most common disorders facing returning veterans today, from symptoms and diagnosis to treatment and recovery, and how to overcome the unique challenges posed by military culture.

For any questions, contact: Greg Elperin at

For more information, please read our flyer.

Please register here. 

New York Ties for Top Score in Preventing and Responding to Disease Outbreaks
A December study from Trust for America’s Health (TFAH) states that New York is “tied for top billing in terms of preventing, diagnosing and responding to disease outbreaks.” The TFAH used data from the Centers for Disease Control and Prevention to create a “scoring system with metrics such as flu vaccination rates, food safety and HIV/AIDS surveillance – and then evaluated each of the 50 states to see how they stacked up.” New York is among the five states that “maxed out at 8/10 points.” Delaware, Kentucky, Maine, New York and Virginia—tied for the top score, achieving eight out of 10 indicators. Seven states—Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah—tied for the lowest score at three out of 10.

The report, from TFAH and the Robert Wood Johnson Foundation (RWJF), concluded that the United States must redouble efforts to better protect the country from new infectious disease threats, such as MERS-CoV and antibiotic-resistant superbugs, and resurging illnesses like whooping cough, tuberculosis and gonorrhea. 

Fight for Healthcare in Rural Communities

By Congressman Tom Reed (NY-23)

I care deeply about protecting access to health care and ensuring residents in rural areas have the resources and services they need. It is only fair that rural residents have equal access to quality primary and pediatric care as those living in urban areas. That is why we fought to secure funding for new health care access points across upstate New York.

Earlier this year, we introduced the Rural Hospital Access Act, which protects access to care by providing enhanced levels of Medicare funding to rural hospitals. This legislation makes permanent both the Medicare-dependent hospital program and the enhanced low-volume Medicare adjustment, which enable rural hospitals to offer the same medical services as are provided by hospitals in large cities. This is critically important because it allows seniors, veterans, and individuals with disabilities to receive quality health care right in their own communities.

The enhanced reimbursements provided by these Medicare programs have a direct impact on rural hospitals across upstate New York. An example is St. James Mercy Hospital, a central access point for residents in Steuben County. This hospital is currently undergoing a major restructuring, as part of a new vision for health care in their community. The enhanced reimbursements are critically important because they provide not only a crucial source of revenue, but also a sense of certainty and stability. This will allow rural hospitals like St. James to effectively serve local residents now and for generations to come.

Many of us depend on rural hospitals and medical facilities for health care, from pediatrics to inpatient and maternity services. It is only right we protect these services by supporting rural hospitals. We will continue fighting to ensure seniors, veterans, and individuals with disabilities have access to the care and services they need, regardless of where they live.

Congressman Tom Reed (NY-23)

2437 Rayburn House Office Building

Washington, D.C. 20515


Rep. Sarbanes:  Bill to Allow Retired Doctors to Retrain for Community Health
Rep. John Sarbanes (D-Md.) has reintroduced a bill that would allow physicians who have ceased practicing medicine to receive grants to become retrained if they pledge to work at a community health center, school health clinic or Veterans Affairs medical center for two years. This legislation would establish a grant program for medical schools, hospitals and non-profit organizations to create or expand their physician reentry programs which give physicians a streamlined process for credentialing and continuing medical education to return to medical practice after an absence. Funding could also be used to assist with credentialing fees, loan repayments and salaries. In return for this assistance, these physicians would serve at community health centers, VA medical centers or school-based health centers to help fill the shortage of primary care doctors. Participating physicians would be able to practice on a full- or part-time basis and would be covered under the Federal Tort Claims Act, which provides physicians with medical liability protection. 

MSSNY Announces 2016 Medical Matters Schedule
The Medical Society of the State of New York will begin its 2016 Medical Matters webinars on January 20, 2016 with a program entitled Immunizations During a Disaster, with Dr. William Valenti as faculty.  All programs will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials here. Go to training session and upcoming sessions tab.

Educational objectives for the January 20 program are:

  • Review recommendations for immunizations during disasters
  • Review recommendations for immunizations for responders
  • Describe best practices to avoid vaccine preventable diseases (VPD) during disasters
  • Describe the importance of herd immunity

Additional programs are: Public Health Preparedness 101 on February 17, 2016 and Radiological Emergencies on March 16, 2016.   Further information on these programs can be found here.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Further information or assistance in registering for any of these programs, may be obtained by contact Melissa Hoffman at

MSSNY Adult Immunization Podcast Now Available
William Valenti, MD, chair of MSSNY’s Infectious Disease Committee and Monica Sweeney, MD, MPH, vice chair of MSSNY Committee to Eliminate Health Care Disparities, discuss adult immunization in an effort to educate and inform patients and physicians in New York State about the importance of adult immunization.   The audio podcast can be accessed here. 

CDC Issuing Guidelines Urging Primary Care Physicians to Monitor Opioids
In a research letter in JAMA Internal Medicine, investigators “examined Medicare claims from 2013 to see which doctors prescribed opioids and how many prescriptions they filled.” The analysis revealed that “the drugs are prescribed by a broad cross-section of medical professionals – including doctors, nurse practitioners, physicians’ assistants and dentists – rather than concentrated among a small group of practitioners.”

Moreover, the analysis also revealed that on a “doctor-by-doctor level, pain management specialists and anesthesiologists handed out the most prescriptions for opioids,” but because there are more family physicians than specialists, as a group, “their number of painkiller prescriptions was higher than for any other category of health care worker.

In light of the findings, the Centers for Disease Control and Prevention issued new guidelines on December 14, urging primary-care physicians to closely monitor their patients’ use of opioids and take a more “conservative approach” to prescriptions in order to mitigate “a crippling epidemic of addiction to the powerful narcotics.”

Written comments must be received on or before January 13, 2016. You may submit comments, identified by Docket No. CDC-2015-0112 by any of the following methods:

  • Federal eRulemaking Portal: Follow the instructions for submitting comments.
  • Mail:National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE., Mailstop F-63, Atlanta, GA 30341, Attn: Docket CDC-2015-0112.

Instructions: All submissions received must include the agency name and Docket Number. All relevant comments received will be posted without change to, including any personal information provided. For access to the docket to read background documents or comments received, go to


Office Space–Sutton Place
Newly renovated medical office. Windows in every room look out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower.  Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or email:

Office Rental 30 Central Park South
Two fully equipped exam, two certified operating, bathrooms and consultation room. Shared secretarial and waiting rooms.  Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1250 for four days a month. Available full or part-time. 212.371.0468 /

Midtown Office- Rockefeller Center
Sunny, upscale office. Furnished or unfurnished. Tranquil Ambience, waterfall, well maintained building. MUST BE SEEN. If interested in renting please call 646-242-4742