December 9, 2016 – Last Chance to Write the Gov on Step Therapy!
Dr. Malcolm Reid
|December 9, 2016
There are only a few days left for physicians to send a letter to Governor Cuomo requesting that he sign into law a bill (A.2834-D/S.3419-C) that would establish specific criteria for physicians to request an override of an insurer’s step therapy medication protocol when it is in the best interest of their patients’ health. The bill has already passed in the State Legislature. We know the insurers are strongly fighting this bill, so the Governor’s office needs to hear your support.
The bill is one of few remaining bills that has not yet been delivered to the Governor, but should be sent within a few days.
MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations and specialty societies to achieve passage of this legislation.
A few weeks back, MSSNY President-elect Dr. Charles Rothberg appeared in a FIOS Long Island news story discussing the importance of this legislation. In October, my letter to the editor in support of the legislation appeared in the Albany Times-Union. I was responding to an inflammatory op-ed attacking this common sense legislation written by a representative of health insurance industry.
The bill would require a health insurer to grant a physician’s override request of an insurer step therapy protocol if the drug required by the insurer 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, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.
This has been a heck of a fight. Let’s not give up now.
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 firstname.lastname@example.org
NYS DOH Announces Expansion of Medical Marijuana to Include Chronic Pain
The New York State Department of Health announced this week that it will proposed regulations to include “chronic pain” as a qualifying condition for patients who have been certified to use medical marijuana. DOH also announced that regulations will also allow wholesaling of medical marijuana products, removing the cap on the number of products available to patients, making it easier for hospitals to allow certified patients to self-administer medical marijuana.
In a press release issued by the Department of Health, Commissioner Howard Zucker, MD, said, “These are major steps forward for New York’s Medical Marijuana Program and the thousands of patients who are benefiting from it every day. These enhancements will continue to strengthen the program and improve patient access by making medical marijuana available to patients suffering from chronic pain and making more products available at dispensing facilities across the state.”
The department has filed a proposed regulatory amendments to add chronic pain as a qualifying condition and defines chronic pain as “any severe debilitating pain that the practitioner determines degrades health and functional capability; where the patient has contraindications, has experienced intolerable side effects, or has experienced failure of one or more previously tried therapeutic options; and where there is documented medical evidence of such pain having lasted three months or more beyond onset, or the practitioner reasonably anticipates such pain to last three months or more beyond onset.” The amendment will be published in the New York State Register on December 21, 2016. It will then be subject to a 45-day comment period before it can be adopted.
Last week, the Department authorized nurse practitioners to certify patients for medical marijuana. The department also filed a proposed rulemaking that was published to enable physician assistants to register with the Department to certify patients for medical marijuana, as long as their supervising physicians are also registered to certify patients. This amendment will not take effect until it is filed for adoption after the public comment period.
In a letter to the DOH Commissioner, MSSNY President Malcolm Reid, MD, expressed concerns over the chronic pain expansion at a time when there is likely an enhanced risk of federal prosecution with the upcoming change in the federal administration. A copy of the letter can be found HERE.
Medicaid to Cover Gender-Transition Care for Minor Children in NY as of Dec. 7
The Wall Street Journal (12/6) reports the New York Health Department announced December 6 that New York State Medicaid will start covering gender-transition care for youths under a new regulation that went into effect December 7 .The department noted that all medically necessary hormone treatments and surgeries for transgender youths will now be covered by Medicaid.
CDC Wants to Interview Primary Care Physicians Re Fall Prevention
The Centers for Disease Control and Prevention (CDC) will be conducting a series of individual interviews with primary care physicians (and other health care professionals) to better understand fall prevention among older adults. CDC’s STEADI Initiative. Flyer available here.
- Only 30 minutes
- Conducted over the phone
- Flexible scheduled
Participants receive a $25 Amazon gift card
Physicians who are NOT eligible include:
- Providers who work exclusively in a hospital setting with inpatients
- Geriatricians who have completed a geriatrics fellowship
Attn: YPs, Residents, Fellows and Medical Students: Meeting in Westbury Feb. 11
Save the Date for the Annual Joint Meeting of the Young Physicians, Resident and Fellow, 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.
Free Publicity For MSSNY Members
ClearDoc Video is FREE to MSSNY Members who reserve their spot by Monday, Dec. 12th
ClearDoc shoots the videos in under an hour right from your office. Click Here to see some MSSNY Member Videos. ClearDoc is a video educational platform for patients and a great way to generate new patients. ClearDoc is going live in January and already has:
- 100’s of NY doctors recording answers
- 1000+ Videos
- 21 Specialties
- Dozens of MSSNY Members
- Multiple State Level Association Endorsements
We are only providing the free videos and placement offer on ClearDoc until Monday, Dec. 12th. Please reserve your spot today.
If you have interest or just want to check out some current MSSNY members doing video, go to MSSNY.GetClearDoc.com
Urban Institute: Over 1M New Yorkers Could Be Uninsured if ACA Is Repealed
More than 1.1 million New Yorkers could become uninsured by 2019 under a partial repeal of the ACA, according to a report issued this week by the Urban Institute which examines the implications of a partial repeal of the Affordable Care Act (ACA). The report also concluded:
- New York would lose more than $10 billion by 2028 in premium tax credits and cost-sharing reductions, which help make health insurance more affordable for individuals and families; and
- New York would lose approximately $47 billion by 2028 in funding for Medicaid and the Children’s Health Insurance Program (CHIP).
IMG Symposium on December 14 at Jacobi Hospital, Bronx
The IMG symposium:
When: December 14, Wednesday
Where: Jacobi Medical Center, 1400 Pelham Parkway South, Bronx NY 10461
Building #4, 2nd Floor Conference Room
Time: 5.30 pm
John P. Belmont Named Vice President of Legislative and Regulatory Affairs
John P. Belmont has been named Vice President of Legislative and Regulatory Affairs for MSSNY. He replaces Moe Auster, who was recently promoted to the position of Senior Vice President for Legislative and Regulatory Affairs for MSSNY.
“John brings to MSSNY a tremendous amount of knowledge of the New York State legislative process,” said MSSNY President Dr. Malcolm Reid. “We believe he will be a great advocate for needed improvements to New York’s healthcare system to address the many challenges faced by New York’s dedicated physicians who are working to assure their patients can receive the quality and timely care they need.”
Before joining MSSNY, Mr. Belmont was a Legislative Representative for the Civil Service Employees Association’s influential Legislative and Political Operations arm since December 2006. The Civil Service Employees Association is one of the largest unions in the United States representing 300,000 active and retired, public and private employees.
As a Legislative Representative, Mr. Belmont developed and analyzed proposed legislation and lobbied members of the Assembly, Senate and the Governor’s office on issues of interest to CSEA. He also participated in planning and conducting member education and training for CSEA membership.
Prior to CSEA, Mr. Belmont worked for the New York State Assembly as a researcher for the Communication and Informational Services Department, where he researched legislation and legislative programs for assigned regions and provided support for member outreach programs including all media outreach and demographic research.
A political science graduate of the College of Saint Rose, Mr. Belmont holds a Trade Union Program Certificate in trade union management and executive leadership from Harvard University. He lives in Colonie, New York.
MSSNY Veterans’ Matters Upcoming Programs on Substance Use Disorders; Physicians Strongly Urged To Attend
The Medical Society of the State of New York has expanded its Veterans’ Matters mental health training initiative by including additional programming on substance use among returning veterans alongside programs on PTSD and TBI as well as Suicide. Veterans’ Matters is conducted through webinars and live grand rounds presentations all over the state.
Presenting faculty for Veterans’ Matters will be Frank Dowling, MD who will present a substance use disorders webinar on Thursday, December 15th at 8 a.m. On January 13th, a live grand rounds presentation of the same program will be conducted at 8 a.m. by Dr. Dowling at Brookhaven Memorial Hospital, 101 Hospital Rd, Patchogue, NY. 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
Information and the educational objectives for each webinar can be found here:
If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg Elperin at email@example.com or call (518)465-8085.
Alert from HHS: Phishing Email Disguised as Official OCR Audit Communication
It has come to our attention that a phishing email is being circulated on mock HHS Departmental letterhead under the signature of OCR’s Director, Jocelyn Samuels. This email appears to be an official government communication, and targets employees of HIPAA covered entities and their business associates. The email prompts recipients to click a link regarding possible inclusion in the HIPAA Privacy, Security, and Breach Rules Audit Program. The link directs individuals to a non-governmental website marketing a firm’s cybersecurity services. In no way is this firm associated with the U.S. Department of Health and Human Services or the Office for Civil Rights. We take the unauthorized use of this material by this firm very seriously.
OCR would like to further share that this phishing email originates from the email address OSOCRAudit@hhs-gov.us and directs individuals to a URL at http://www.hhs-gov.us.
This is a subtle difference from the official email address for our HIPAA audit program, OSOCRAudit@hhs.gov but such subtlety is typical in phishing scams.
Covered entities and business associates should alert their employees of this issue and take note that official communications regarding the HIPAA audit program are sent to selected auditees from the email address OSOCRAudit@hhs.gov. In the event that you or your organization has a question as to whether it has received an official communication from our agency regarding a HIPAA audit, please contact us via email at OSOCRAudit@hhs.gov.
Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!
Seminars: Triage in a Disaster and Impact of Shooter/Bombing on Healthcare
MSSNY 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.
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.
Know Your Provider Enrollment Revalidation Due Date to Protect Your Bottom Line!
Revalidate before your due date to avoid a hold on your Medicare payments and a possible deactivation or lapse in your Medicare billing privileges.
There are several ways to find your revalidation due date.
- Internet Based Provider Enrollment, Chain and Ownership System (PECOS)
- Sign in with user ID and password
- Medicare Revalidation List – Search Tool
- Lookup by NPI or name
- Revalidation notice mailed by National Government Services
- Mailed in yellow envelope
Generally, the due date will remain with the provider/supplier throughout subsequent revalidation cycles. So you will not have to wonder about the due date the next time you need to revalidate.
NOTE: Unsolicited applications received 6 months prior to the revalidation due date will be returned to the provider.
Need assistance? Providers/Suppliers can register for our provider enrollment revalidation webinars by either using the following links, Part A / Part B or by visiting the NGSMedicare.com website. The webinars below can be found under the Education Tab by selecting Webinars, Teleconference and Events.
- Provider Enrollment Revalidation
- Getting Connected to PECOS
- Submitting Revalidation via PECOS Application
- Submitting Revalidation via Paper Application for a Part A providers
- Submitting Revalidation via Paper Application for a Part B providers
Let’s Chat about Provider Enrollment Revalidation
RSVP now at firstname.lastname@example.org or by calling (929) 239-4160.
AMPAC Announces Dates for 2017 Candidate Workshop
Ever wonder how Doctors get elected to Congress or your state legislature? Considering a run for office for yourself? Join us February 17-19 at the AMPAC Candidate Workshop in Washington, DC and we’ll teach you how to run a winning political campaign, just like we taught many of your colleagues over the years!
The Candidate Workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office.
US Health Spending Averaged Nearly $10,000 Per Person In 2015
The New York Times (12/2) reports the Department of Health and Human Services announced on Nov. 30 that healthcare spending in the US “increased last year at the fastest rate since the 2008 recession, reaching $3.2 trillion, or an average of nearly $10,000 a person.” The HHS report, which was published online in the journal Health Affairs, attributed “the increase in federal spending…mainly [to] the expansion of Medicaid eligibility and enrollment.” The Wall Street Journal (12/2) reports spending also grew faster than expected, with national health expenditures increasing 5.8 percent compared with the Centers for Medicare and Medicaid Services’ projected growth of 5.5 percent.
Morris Park-Van Nest, Bronx. Brand New Construction at Highly Desirable Intersection. 2,350 sq. ft. + Ground Level + 1,300 sq. ft. Lower Level; Open Floor Plan. Please Call Anthony Mameli 347-387-9768 or Email to: email@example.com. Charles Rutenberg Realty – Exclusive.
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.
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
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 firstname.lastname@example.org
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 email@example.com. No recruiters please.
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 firstname.lastname@example.org. No recruiters please.