October 23, 2015 – Social Media Is Pow! Pow! Powerful

 Dr. Joseph R. Maldonado
October 23, 2015
Volume 15, Number 40

Dear Colleagues:

This week, we followed the story of the near closing down of the family practice residency program at Columbia University/New York Presbyterian Hospital.  The reports indicate that the closures were not due to financial constraints but rather to “strategic priorities.”  The event serves as an excellent case study for health policy, communications and business school students.

I will be delving more into some of the valuable insights offered by this real-time case in my November News of New York column.  Today, I would like to focus on the power of social media.  Most of us are familiar to some extent of its value and power.  For the least engaged of us, we may participate for social purposes; most of have family members who are fully immersed in social media.  Yet, in the case of the residents and faculty in the family practice residency program, social media was used not as a social tool but rather as a powerful tool for action.

Social media as a power tool for action is a concept well known to younger physicians and medical students.  They use it not only for social purposes but also for change management.  It is not merely a “keeping you up-to-date” tool.  Rather, it is an informational tool used expressly to effect action and change.  Therein, lies the key difference in how social media is used by younger physicians versus older physicians.  If older physicians engage in social media professionally, it is to disseminate knowledge.  When younger physicians engage social media, they disseminate knowledge AND seek to effect change.  It is not merely a cerebral tool—rather, it is a tool to effect change.

The speed with which Columbia University/Presbyterian Hospital reversed its decision regarding the family practice program and the power of the individuals and entities that weighed in on the decision to reverse change attests to the value of social media to effect change.  It is a tool for organizing stakeholders and entities that can effect change when individuals, by themselves, are incapable of effecting change.

While many organized medicine organizations have captured the power of social media as a tool for disseminating knowledge, I believe most have not fully captured or harnessed the capabilities to the extent that the residents in the Family Practice Program at Columbia did when they managed a reversal of the program’s closure.  It is time we as a state society and amalgam of county and specialty societies begin to explore how we, too, can convert our use of social media from merely knowledge dissemination to a  powerful action tool for effective change.

Decision can be reversed!

While I laud the residents and faculty that used these tools to effect change, I think there is a larger brilliant teaching moment to be gained from this event.

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

Please send your comments to comments@mssny.org


DOH Bureau of Narcotic Enforcement Information on Medical Marijuana Program
The New York State Department of Health’s Bureau of Narcotic Enforcement announces the availability of the required four-hour medical use of marijuana course. Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must complete this course. The Compassionate Care Act, signed into law on July 5, 2014, authorized the Department of Health to implement a Medical Marijuana Program in New York State. Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must:

  • be qualified, by training or experience, to treat patients with one or more of the serious conditions eligible for medical marijuana;
  • be licensed, in good standing as a physician and practicing medicine, as defined in article one hundred thirty one of the Education Law, in New York State;
  • possess a Health Commerce System (HCS) Medical Professions Account user ID and password;
  • possess an active Drug Enforcement Administration (DEA) registration number; and
  • complete the four hour Department-approved medical use of marijuana course.

Departmental officials anticipate that the four hour department approved online course is available to practitioners through the TheAnswerPage, an established online medical education provider here.

The course will include the following topics, which are required in the regulations: the pharmacology of marijuana; contraindications; side effects; adverse reactions; overdose prevention; drug interactions; dosing; routes of administration; risks and benefits; warnings and precautions; and abuse and dependence.  The cost to take the course is $249, and practitioners will earn 4.5 hours of CME credit upon successful completion of the course. Additional information regarding the practitioner registration process is available on the Department’s Medical Marijuana Program webpage, which can easily be accessed via the this link.

Please monitor this webpage frequently for updates and the department may be contacted with any questions: New York State Department of Health, Bureau of Narcotic Enforcement,

Medical Marijuana Program, Riverview Center,50 Broadway, Albany, NY 12204; Call 866-811-7957 or email mmp@health.ny.gov for more information. 

MSSNY Joins Physician Leaders in our Nation’s Capital to Advocate for Administrative Simplification
This week, Saratoga Springs ENT and MSSNY Board of Trustees member Dr. Robert Hughes joined MSSNY staff and physician leaders from other states in Washington DC to advocate for legislation to reduce some of the overwhelming bureaucratic hassles physicians are facing in various aspects of the Medicare program.  Joint advocacy meetings with representatives of the California, Florida and Texas medical associations were held with numerous Senators and Representatives who serve on key health care policy committees in support of legislation to:

  • Reduce the hassles associated with complying with onerous federal regulations governing the use of electronic medical records (HR 3309, Ellmers);
  • Restore some fairness in the conducting of audits by Medicare Recovery Audit Contractors (HR 2568, Holding);
  • Repeal the excise tax on comprehensive health insurance plans (“Cadillac Tax”) that was contained within the ACA scheduled to go into effect in 2018 (several bills including: S.2075, Brown; S.2045, Heller; and HR 2050, Courtney).

There was wide support for many of the provisions contained within each of these proposals, and substantial efforts are being made to incorporate elements of these proposals into various end of year “must do” bills under development by Congress.  Meetings were held with the offices of Senator Charles Schumer, Rep. Tom Reed (Ways & Means Committee) and Rep. Chris Collins (Energy & Commerce Health Subcommittee) from New York; Senator John Cornyn, Rep. Dr. Michael Burgess and Rep. Kevin Brady (Chair, W&M Health Subcommittee) from Texas; Senator Bill Cassidy (Senate HELP Committee) from Louisiana; Rep. Dianne Black (W&M Health Subcommittee) and Rep. Marsha Blackburn (E&C Health Subcommittee) from Tennessee; and Rep. Dr. Tom Price (W&M Health Subcommittee) of Georgia.


Foster Gesten, MD to Focus on State Health Innovation PLAN (SHIP)

Foster Gesten, MD, Medical Director for the Office of Health Insurance Programs for the Department of Health, will present on the State’s Health Innovation Plan on MSSNY’s November 10th  Advocacy Matters program. The program will run from 12:30- 1:30PM.  

The Centers for Medicare and Medicaid Services’ State Innovation Models Initiative is providing support to states for the development and testing of state-based models for multi-payer payment and health care delivery system transformation with the aim of improving health system performance for residents of participating states. New York State has received a grant to pursue the implementation of its Health Innovation Plan, centered on statewide implementation of an Advanced Primary Care (APC) model, which will facilitate integrated care delivery and which will rely on emerging health information technologies and primary care workforce to promote the objectives of population health. For more information on the State’s Health Innovation Plan, please go to the following this link.

The objectives of November 10th Advocacy Matters program are as follows:

  1. Describe the fundamental components of the State Health Innovation Initiative and its core objectives.
  2. Describe the Advanced Primary Care (APC) model and how physician practices can achieve this status.
  3. Describe the five strategic pillars and three enablers of system transformation.
  4. Describe how the Plan will promote meaningful, value-based payment arrangements across the State’s payers and insurers and how physician practices will be affected.

Physicians interested in participating in the coming November 10th program may register for Advocacy Matters. Please go to https://mssny.webex.com and click on the “Upcoming” tab.  A “Register” link appears to the right of the program name.    

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 CreditsTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Advocacy Matters is a CME series held on the second Tuesday of every month. It is sponsored by MSSNY’s Legislative and Physician Advocacy Committee. It is intended to enhance communication with physicians concerning issues of the moment. Elected officials, agency officials, and key legislative/agency staff will be invited to discuss regulatory and legislative matters.

Disclosure Statement: The Medical Society of The State of New York relies upon planners and faculty participants in its CME activities to provide educational information that is objective and free of bias. In this spirit and in accordance with the guidelines of MSSNY and the ACCME, all speakers and planners for CME activities must disclose any relevant financial relationships with commercial interests whose products, devices or services may be discussed in the content of a CME activity, that might be perceived as a real or apparent conflict of interest. Any discussion of investigational or unlabeled uses of a product will be identified.

The planners and faculty participants do not have any financial arrangements or affiliations with any commercial entities whose products, research or services may be discussed in these materials.

NY Judge Rules Against Lawsuit that Makes Assisted Suicide a Crime
On October 19, a state civil judge ruled against a lawsuit that makes assisted suicide a felony. Judge Joan Kenney ruled that while she was sympathetic to the patients’ plight, the US Supreme Court has already found that New York state laws prohibiting assisted suicide do not violate civil rights.

Attorney General Eric Schneiderman argued against assisted suicide because of New York’s “longstanding commitment to the preservation of life,” he said. In her decision, released on October 19, Judge Kenney quoted a 1997 ruling by former US Supreme Court Chief Justice William Rehnquist that states laws barring lethal medication do not “infringe on fundamental rights.”

The patient plaintiffs, a 55-year-old former FedEx worker with AIDS, an 81-year-old retired attorney with bladder cancer and a 60-year-old philanthropist with Lou Gehrig’s disease — are appealing the decision.

Currently, assisted suicide is legal in Montana, Washington, New Mexico, Oregon and Vermont.

AMA Expresses Concerns with NAIC Proposal to Enhance Network Adequacy
The AMA has written to the National Association of Insurance Commissioners (NAIC) to express concerns with several aspects of its proposal to revise its Managed Care Plan Network Adequacy Model Act, which has not been updated since 1996.  The purpose is to develop template legislation for consideration by State Legislatures.  While states are certainly not required to enact these model acts, they are often given strong consideration.  To view a copy of the letter, click here.

The letter does reference several positive aspects of the NAIC proposal, including: stronger regulation and transparency of provider directories; a shift away from using accreditation as a “deeming” tool; a focus on access to appropriate specialty care, including pediatric specialty care; and transparency in carriers’ selection standards have been included in the draft model act.

However, the letter also sets forth several concerns with the template proposal that have been highlighted to AMA by specialty societies and state medical societies from across the country, including MSSNY.  These include:

  • The draft legislation fails to require prior approval by regulators of health plan networks;
  • The draft legislation fails to require that tiered networks be sufficiently comprehensive to meet insured’s needs;
  • While the draft legislation outlines several types of quantitative measurements that may be used to measure network adequacy, it fails to require the use of these quantitative standards;
  • The draft legislation could be construed to permit health insurers to use telemedicine technologies to meet network adequacy requirements; and
  • The draft legislation would greatly undermine the incentive for health insurers to establish comprehensive physician networks by permitting insurers to only have to pay their woefully inadequate in-network rates or Medicare rates, for care by out of network physicians in a hospital.  This element of the Model Act revisions would give enormous new powers to health insurance companies, far different than the very carefully crafted compromise law enacted in New York State in 2014 that balanced the need for patients to avoid facing sometimes very large “surprise” medical bills with the need to assure that physicians are paid fairly for providing this needed care in often life-threatening situations.

MSSNY is also developing its own letter to the NAIC that will raise similar concerns. 

From NGS: Claims Submitted for Hepatitis/Pneumococcal Vaccines Denied in Error
Description of the Problem

National Government Services has identified a claims processing issue in which claims for the following immunization and administration procedures codes incorrectly denied due to an incorrect diagnosis code. Codes: G0010, G0009, 90630, 90669, 90670, 90732, 90739, 90740, 90743, 90744, 90746, 90747

What This Means to You

A system error impacted providers who submitted claims for these services in which they reported ICD-10-CM diagnosis code Z23.The system issue has caused these claims to deny

in error as having an invalid diagnosis code.

                                              Current Status of Problem

A mass adjustment will be made to claims that denied in error; adjustments will be completed soon. It is unnecessary to resubmit the claim or to request an appeal. No provider action is needed.
Please watch the Production Alerts section of our website and Email Updates for additional information regarding this issue. We apologize for any inconvenience this may have caused. 

Register Now For E-Prescribing CME Webinars
MSSNY is hosting two free continuing medical education webinars on E-prescribing on November 9 and December 9 at 7:30 a.m. for MSSNY members.

Registration is now open to MSSNY physicians by clicking here.

Select training center and the upcoming tabs.   A copy of the flyer can be found here. The webinars will be held on Monday, November 9, 2015 and Wednesday, December 9, 2015 at 7:30 a.m.

The program, entitled, “New York State Requirement for E-prescribing of All Substances,” includes the following educational objectives are:

  • Describe the e-prescribing mandate, to whom it applies, when it becomes effective, and how physicians can comply with its requirements.
  • Describe the practitioner electronic prescribing of controlled substances registration process, to whom it pertains, and the information required to be provided by physicians in order to register eRX software with the Bureau of Narcotics Enforcement.
  • Describe the exceptions to the e-prescribing mandate and any additional requirements associated with those exceptions.
  • Describe the application process and criteria for a waiver from the e-prescribing mandate.
  • Describe what rules pertain to physicians who only prescribe non-controlled substances

Further information can be obtained by contacting Terri Holmes at tholmes@mssny.org.

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.

E-prescribing of all substances will be required in New York State by March 27, 2016.   The ISTOP legislation enacted in 2012 required e-prescribing of ALL substances. Regulations pertaining to the E-prescribing requirements were adopted on March 27, 2013. The Medical Society of the State of New York was successful in obtaining a delay in the e-prescribing requirements for all substances to March 27, 2016.  

Members Only: Your Patients Can Save Up to 75% on Prescriptions
With the rising cost of generic and name brand medications, your patients could all use some help these days.  The New York RX Card, MSSNY’s newest Member Benefit, is a 100% Free and 100% confidential point of sale prescription discount card that can save your patients up to 75% on prescription medications!  It is free to everyone with no minimum nor maximum uses, no age or income requirements, no enrollment or approval process and it is accepted at over 68,000 pharmacies, nationwide.

This card will provide you with Rx medication savings of up to 75% at more than 68,000 pharmacies across the country including CVS/pharmacy, Duane Reade, A&P, Hannaford, Kinney, Kmart, Pathmark, Stop and Shop, Target, Tops, Waldbaums, Walgreens, Walmart, Wegmans and many more. We encourage you to give cards to friends and family members. This card is pre-activated and can be used immediately.

The NYRX Card works on lowest price logic, to guarantee the best prices on medications.  It won’t lower co-pays or replace existing insurance, but in some cases the New York Rx price is even lower than your patients’ co-pay.  It can be used during the deductible periods in Health Savings Accounts and High Deductible Plans, lowering out-of pocket-expense on prescriptions. Medicare Part D recipients can use the card to discount their prescriptions not covered on their plan as well as receive discounts on medications not discounted when in the “donut hole.”

The NYRX Card is pre-activated and ready to go with no personal information taken or given. NYRX will mail as many cards you desire, directly to your office, with display stands. The cards typically are placed at the patient check out area. Some doctors also place them at the check in area. Contact rraia@mssny.org for your cards. 

  MSSNY’s Amazing Doctors

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Dr. Amar Atwal, Dr. Ephraim Atwal and Dr. Ken Anthone 

Three surgeons, Drs. Kenneth D. Anthone, Amar Atwal and Ephraim Atwal offered free cataract surgeries on October 16 at their clinic, Atwal Eye Care in Cheektowaga (Erie) for non-insured and low income area residents as well as military veterans, and recent immigrants. Dr. Anthone has donated 150 cataract surgeries locally with the Eyes On America Foundation. Dr. Amar Atwal is the Founder and Medical Director of Atwal Eye Care/ Buffalo Care Associates and Buffalo Ambulatory Surgery Center. Dr. Ephraim Atwal specializes in Laser Vision Correction including LASIK and PRK. This was the group’s seventh year providing free surgery to people in need.

Five MSSNY Members Will Be Honored at Westchester Doctors of Distinction
The Third Annual Westchester Doctors of Distinction Award will be held on October 29 at the Bristal in Armonk. The honorees are:

  • Craig Zalvan, MD for the Humanitarian Award
  • Scott D. Hayworth, MD for the Lifetime Achievement Award
  • Andrew Kleinman, MD for Leadership in Medical Advocacy Award
  • Robert Gary Josephberg, MD for Excellence in Medical Research
  • Mark Russakoff, MD for Leadership in Medical Advocacy

For more information, call 914-949-2990



3 exam rooms; one consulting room;  large secretarial/admin area. Shared waiting room. All specialties welcome. Three bathrooms in office suite. Large free parking lot. Call Dr. Howard Yudin 914-251-1261.