December 2, 2016 – What You Need to Know Re: PTSD

PRESIDENT’S MESSAGE Dr. Malcolm Reid

December 2, 2016 Volume 16, Number 42

Dear Colleagues:

I can state with confidence that all physicians agree that our veterans deserve the best and  timely medical care available to them.

The Veteran’s Choice Program now allows veterans to receive medical care in the community if the VA cannot schedule an appointment within 30 days of the veteran’s preferred date, or the date determined medically necessary by their physician, or if the veteran resides more than 40 miles from their closest VA medical facility. It was authorized under the Veterans Access, Choice, and Accountability Act of 2014 and provides $10B for non-VA medical care to eligible Veterans.

MSSNY has expanded its Veterans’ Matters mental health training initiative by including additional programming on substance use disorders and suicide in returning veterans.  Veterans’ Matters is conducted through webinars and live grand rounds presentations all over the state.

Frank Dowling, MD, a board-certified psychiatrist, will be presenting a PTSD and TBI webinar on Wednesday, December 7th at 7:30 am. An active member of MSSNY, Dr. Dowling currently serves as Commissioner for Science and Public Health. Previously, he served as co-chair of the Addiction and Psychiatric Medicine Committee, chair of the Task Force on Alcohol and Health and vice chair of the Committee on Bioterror and Emergency Preparedness. In addition, he serves on the Advisory Committee and as faculty for the Veteran’s Mental Health Training Initiative, a collaborative effort by MSSNY, NYSPA and NASW-NY to train NY practitioners to assist warriors and veterans with post-traumatic stress and TBI.  

On December 15th, a Substance Use Disorders webinar will also be conducted at 8 am by Dr. Dowling.  Each program is accredited for one-credit hour of continuing medical education.  Registration is required. 

To register for a webinar, click on a date below

PTSD and TBI – Wednesday, 12/7/16 at 7:30 am
Substance Use Disorders – Thursday, 12/15/16 at 8 am

Information and the educational objectives for each webinar can be found here

PTSD and TBI – 12/7/16
Substance Use Disorders –12/15/16

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.

If you wish to become a physician who treats veterans, for more details about the Veterans Choice Program, visit http://www.va.gov/opa/choiceact/for_providers.asp

You must accept Medicare rates and have a full, current and unrestricted license in New York.

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

Please send your comments to comments@mssny.org

Gov. Signs MSSNY-Supported Legislation to Permit Pharmacy to Pharmacy Transfer of eRx
Governor Cuomo has signed into law legislation advocated for by MSSNY that would permit an e-prescription to be forwarded from one pharmacy to another pharmacy.  The law takes effect March 1, 2017. The purpose of the legislation is to address situations where a patient must request a physician to issue a new e-prescription if the pharmacy to whom an e-prescription was originally submitted does not have the medication in stock. Instead, the pharmacy can forward the e-prescription to another pharmacy requested by the patient. It is another “administrative simplification” measure signed into law this fall that was strongly advocated for by MSSNY and other specialty societies. Other measures signed into law include:

• Eliminating the requirement for physicians to report to DOH when a written prescription must be issued in lieu of an e-prescription;

• Requiring the DOH and DFS to create uniform standards for how health insurers impose prescription prior authorization protocols
• Reducing from 90 to 60 days the time within which a health plan must review a physician’s application to be included in the plan’s network

We thank the hundreds of physicians who contacted their legislators and the Governor to urge that this measure be signed into law. 

Gov. Vetoes Legislation to Enable Pharmacists to Change Length of Prescription Fills
Governor Cuomo has vetoed legislation that would have permitted pharmacists to increase the supply of a non-controlled drug prescription up to a 90-day supply, provided it did not exceed the total amount prescribed by the physician. Basically, it would have permitted a pharmacy to issue a 90-day supply of a medication with 3 refills, instead of following the physician’s prescription for a 30-day supply of a medication with 11 refills. In vetoing the bill the Governor noted that it a) would promote the unnecessary filling of larger quantities of prescription medication, “which could increase the amount of unused drugs in circulation and heighten concerns about safe disposal” and b) “unnecessarily infringes on the doctor-patient prescribing relationship…by allowing pharmacists to unilaterally determine that an additional supply of a drug refill is warranted without first obtaining the practitioner’s approval”.

Nurse Practitioners Can Now Certify Patients for Medical Marijuana
Nurse practitioners will now have the ability to certify patients for the use of medical marijuana under recent regulatory rules changes. Statutorily, the Commissioner of Health, Howard Zucker, MD, had the authority to seek an expansion under the law to allow nurse practitioners to certify patients for use of medical marijuana. In order for nurse practitioners to register with DOH to issue certifications for patients, the practitioner must take the required four-hour course.

Recent press reports have also indicated that the New York State Department of Health will seek to allow physicians assistants to certify patients for the use of medical marijuana if their supervising physicians have been authorized to certify patients. Additionally, the department officials have announced that it is considering allowing the use of medical marijuana for the treatment of chronic pain and also indicated that regulations will be developed to allow for this. MSSNY leadership and its committees are currently reviewing these proposals. Approximately 750 physicians have taken the required course on medical marijuana and have registered with the Department of Health to be able to certify that patients are eligible to receive medical marijuana. 

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

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 am. 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.

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. 

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.

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.

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

Deadline for Informal Review of Potential Penalties Extended
Physicians who want to contest potential payment penalties associated with the Physician Quality Reporting System (PQRS) and/or the Value Modifier (VM) now have until December 7 to file a request for an informal review of their data.  Previously, the deadline to request a review was November 30 but the Centers for Medicare and Medicaid Services announced yesterday that the deadline will be extended by one week.

The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act.  Failure to successfully complete required PQRS reporting will result in a 2% penalty.  Value Modifier penalties can range from 1% to 4% depending on the size of the practice and its performance on cost and quality measures.  PQRS penalties were communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS web site.  Value Modifier penalties and bonuses can be found in Quality and Resource Use Reports (QRURs) posted on the web site only.

Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review.  Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data.

• To File A Request for PQRS Informal Review:

Go to the Quality Reporting Communication Support Page (CSP), select “related links” in communication support page in the upper left-hand corner, then select “informal review request” followed by “”PQRSs informal review” and fill out requested information when new page opens.

If you have not already done so, 2015 PQRS feedback reports can be accessed on the CMS Enterprise Portal using an Enterprise Identity Management (EIDM) account. See PQRS Analysis and Payment webpage for more information.

For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or TIN, in e-mail inquiries to the QualityNet Help Desk.

• To File A Request for VM Informal Review:

For information on how to file, see the 2017 Value Modifier Informal Review Request Quick Reference Guide.

For More Information, see: How webpage and/or  2015 QRUR and 2017 Value Modifier webpage.

Help Desk Information: For EIDM, contact the QualityNet Help Desk at qnetsupport@hcqis.org or 866-288-8912 (TTY 877-715- 6222);  For QRURs or the Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3)

Residents and Fellows: Register for Poster Symposium; Jan. 31 Deadline
MSSNY is very pleased to announce the 12^th Resident/Fellow/Medical Student Poster Symposium:

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

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. Participants must be MSSNY members, and membership is free for first-time resident members. Join online. 

Student News: USMLE Step 2: Determine the Cause of Morbidity and Death
If you’re preparing for the United States Medical Licensing Examination® (USMLE®) Step 2 exam, you might want to know which questions are most often missed by those taking the practice test. Check out this example from Kaplan Medical, and view an expert video explanation of the answer. This USMLE® Step 2 practice test question deals with a 68-year-old man whose complaints include headache, dizziness and fatigue. Read more at AMA Wire.

For Your Patients: FREE Rx Cards for Discounted Drugs
MSSNY has teamed up with the New York Rx Card program to provide FREE discount prescription drug cards to your employees and patients.  The New York Rx Card can be used for savings of up to 75 percent on prescription drugs at over 68,000 pharmacies nationwide.  The New York Rx Card discounts brand names and generics as well as non-covered medications for those patients who may have prescription coverage.  The program has no membership restrictions, no income requirements, no age limitations and there are no applications to complete.

Please encourage your patients to print a free New York Rx Card at  www.newyorkrx.com.

Patients also can secure the discount by simply walking into any CVS pharmacy in the state and asking for the New York Rx Card discount even if they do not have a card.

The drug cards also can be mailed to your clinic at NO COST by contacting the drug card’s program director, Chez Ciccone, via email at cc@nyrxcard.com or by phone at 800.931.2297.

We believe this is an easy and innovative way to help your patients get the prescription drugs they need to be treated effectively.

WSJ: Hospital Construction in New York City Booming Since 2013
The Wall Street Journal reports: “Hospitals in the city spent more than $6 billion on construction from 2013 through 2015 and are expected to spend $8.2 billion from 2016 through 2018, according to a survey and analysis from the New York Building Congress, an industry group.” (WSJ 12/1/)

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