February 5, 2016 – Come on March 8th or Retire

drmaldonado PRESIDENT’S MESSAGE
 Dr. Joseph R. Maldonado
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February 5, 2016
Volume 16, Number 5

Dear Colleagues:

Reschedule Your Schedule for March 8 or Go Ahead and Take Early Retirement

It is IMPERATIVE that Doctors across New York who are not providing critically necessary medical services to patients be in ALBANY on March 8, 2016.  The medical malpractice crisis with the almost certain lengthening of the Statute of Limitations will adversely affect every physician in the state.  The failure to address the Health Republic debacle will cost millions of dollars to doctors across the state.  Unfunded mandates and radical changes in how we are reimbursed will change the practice of medicine like nothing in the past century.  IF YOU ARE NOT IN ALBANY on MARCH 8th, 2016 you may as well retire from medicine.  Most of us in this society will find the looming threats too onerous to remain in solo or small independent practices.  MSSNY CAN NOT BRING ABOUT THE NECESSARY CHANGES WITH A FEW DOCTORS.  New York’s PHYSICIANS MUST RISE UP AND COME TO ALBANY AND CONVEY OUR POSITION TO THE LEGISLATOR AND THE GOVERNOR.  Contact your county society to make plans to be present that date.  RESCHEDULE your patients.  Be in Albany on March 8, 2016.

Follow-up on last week’s column

Last week’s President’s column evoked the greatest response to date for my column.  Before elaborating further on the response, I want to thank you all for reading my column, and especially to those who took time from their busy schedules to share their views.  For all readers, it should be clear that the column reflects my personal views on issues I believe to be relevant to New York physicians.  On occasion, they may reflect MSSNY policy and in those instances, I state it.

While most applauded the idea of reframing the discussion to de-politicize the issue in the context in which it is currently debated, a few felt the reframe raised other concerns.  These included most importantly, those raised by colleagues in the mental health community who are concerned that I have advanced the notion that individuals with mental illness perpetrate violent crimes.  I do not believe nor do I in anyway support the notion that individuals with mental illness are more prone than members of the general population to commit violent crimes.  However, I do hold the belief that many individuals who commit violent crimes have untreated mental illness which may have in addition to other factors, contributed to their perpetration of acts of violence.  The nuances of this complex discussion can be better understood by carefully reading the Position Statement of the American Psychiatry Association   the press release by the American Psychological Association at:

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

Please send your comments to comments@mssny.org


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MSSNY Lobby Day Scheduled for March 8th – Physicians Urged to Attend And Wear Your White Lab Coats
MSSNY’s “Physician Advocacy Day” will be held on March 8th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza in Albany, New York.  If you plan to attend, please register here.

A full slate of legislators and top Administration officials have been invited to dialogue with Advocacy Day participants including:

  • Donna Frescatore, Executive Director, NYS Health Benefit Exchange;
  • Troy Oechsner, Executive Deputy Superintendent, Department of Financial Services;
  • Legislative Panel: Senate Health Chair Kemp Hannon; Assembly Health Chair, Richard Gottfried; Senate Insurance Chair, James Seward; Assembly Insurance Chair Kevin Cahill.

 

In addition, Assembly Speaker Carl Heastie, Assembly Majority Leader Joe Morelle and Senate Majority Leader John Flanagan have been invited.  A brief informal luncheon to which members of each House are invited to dine and speak with their constituents will follow the morning program.   County Medical Societies will be scheduling appointments for physicians to meet with their elected representatives.

Given the wide range of threats physicians face including legislation that would expand the statute of limitations with a broad date of discovery exception potentially increasing physician premiums by 14.5%; legislation to repeal the Trial Lawyers contingency fee limits, potentially increasing premiums by over 10%; significant reductions in eligibility of the Excess Program; legislation that will mandate physicians to take a 4-hour Pain Management CME course every two years; and a move to effectuate statutory and regulatory changes to implement a value-based payment structure under Medicaid and potentially to Medicare and commercial products as well. 

PHYSICIANS ARE ENCOURAGED TO IMMEDIATELY REGISTER THROUGH THE LINK BELOW TO ATTEND THE MARCH 8TH LOBBY DAY IN ALBANY.   

http://goo.gl/forms/Mw7CX8JfzL                                                                            (GOVERNMENTAL AFFAIRS STAFF)


Contact Your Legislators to Support a Health Republic Guarantee Fund; Senator Valesky Introduces Legislation

With the failure of the Executive Budget to include a Guarantee or other fund to cover the likely   hundreds of millions in payments due to Health Republic contracted providers, all physicians are urged to continue to contact their legislators and demand that the State Legislature take action to create such Guarantee or other fund to cover these costs.

This week Senator David Valesky (D-Onondaga County) and fellow Independent Democratic Conference member David Carlucci (D-Rockland County) introduced legislation (S.6667) to create such a Guarantee Fund.  Senator Valesky’s press release announcing the introduction of this legislation

(http://www.nysenate.gov/newsroom/press-releases/david-j-valesky/senator-valesky-proposes-guaranty-fund-rx-consumer-and) included a statement from MSSNY President Dr. Joseph Maldonado that “Physicians thank Senator Valesky for introducing legislation to assure that Physicians can receive payment for services rendered to their patients who had health insurance coverage through the now defunct Health Republic. Physicians and other healthcare stakeholders should not bear the losses associated with the demise of this company. The failure to address this problem will have a de-stabilizing effect on our already fragile health care system at a time changes are being demanded of by policymakers on physicians to accept far greater insurance risk”.  The press release also included statements in support by the Healthcare Association of New York State and the Greater New York Hospital Association, groups MSSNY has been working with to support such a fund.

Urging the Legislature to enact a Guarantee fund as part of the State Budget process was a major component of the testimony that MSSNY recently to a joint hearing of the Assembly Ways & Means and Senate Finance Committees.  For more information, see here.

Remind your legislators that, with physicians facing so many other challenges in seeking to keep their doors open to deliver patient care, including high liability costs, expensive electronic medical record equipment, employee costs, insurance companies dropping physicians from their networks and declining payments from insurers, failure to assure payment for these claims would have serious negative consequences for patient care and employment in your community.                                                                                                (AUSTER, DEARS)


Physicians Urged to Oppose Huge Cuts to Excess Medical Liability Insurance Program
Physicians are urged to continue to contact their legislators  to object to the huge cuts contained in the Executive Budget to the Excess Medical Malpractice Insurance program.      MSSNY’s strong opposition to these cuts was a major component of MSSNY’s recent testimony to the Assembly Ways & Means and Senate Finance Committees, as well as in meetings with legislators and key legislative staff.  For more information, click here.

Specifically, the proposal would cut funding by $25 million, with the effect that 55% of physicians who currently receive this essential coverage being dropped from the program.  Across much of upstate New York, only neurosurgeons, bariatric surgeons and OB-GYNs would keep this coverage. That means that in the Capital District, in Northern New York, in Central New York, in western New York and in the Southern Tier every family physician, internist, pediatrician, ophthalmologist, emergency room physician, vascular surgeon, cardiologist, radiologist, pathologist, otolaryngologist, dermatologist and allergist would be automatically dropped.  And downstate, many primary care physicians, ophthalmologists, otolaryngologists, pathologists, dermatologists and allergists would be dropped.

The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level.  The program was created over 30 years ago as a result of the liability insurance crisis of the mid-1980’s to address concerns among physicians that their liability exposure far exceeded available coverage limitations.  Absent meaningful liability reform, with verdicts and physician liability premiums continuing to be far out of proportion compared to the rest of the country, full funding for the Excess program is absolutely essential in today’s very challenging practice environment.

At a time when the state is seeking to attract and retain physicians, this proposal deters physicians from wanting to practice in New York State for fear of putting themselves and their families in financial jeopardy for judgements and settlements exceeding the limits of their primary coverage.  Please urge your legislators to reject these cuts and restore full funding for the program!
(AUSTER, DEARS)


Disastrous Liability Expansion Bill Back on Assembly Calendar and Now Re-Introduced in Senate; Physicians Must Contact Their Legislators to Oppose Now!
All physicians must continue to contact their Senators and Assembly members to urge that they oppose legislation (A.285, Weinstein, S. 6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   The letter can be sent here.

With the bill having passed the Assembly in 2015, but not the Senate, it resumed a place on the Assembly Calendar, where it could be voted on by the full Assembly at any time.   The bill was brought up for initial consideration on Monday 1/11, but was “laid aside” by the Assembly Republican Conference.

At the conclusion of the 2015 Legislative Session, Senate Majority Leader Flanagan noted in response to a question from a Daily News reporter that issues like malpractice reform “have never been done in isolation” and that they would be working with representatives on both sides of this issue.  Since that time, MSSNY working together with MLMIC and hospital associations have met with top Senate staff to discuss comprehensive medical liability proposals to work towards legislation that would reduce the outrageous cost of physician medical liability premiums.

As these discussions ensue, you need to let your legislators know that no liability increases can be tolerated!  MLMIC’s estimate is that A.285/S.6596 could increase physician liability premiums by an untenable 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  They also face rapidly increasing overhead costs to remain in practice such as the huge costs associated with implementing expensive and cumbersome electronic medical record systems.  At the same time, they face reduced payments from Medicare and commercial insurers, and many practices face losses of tens of thousands, hundreds of thousands and in some cases millions of dollars in losses due to the collapse of Health Republic.

And to make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Physicians need liability reform to bring down these costs, not legislation that increases them!                                                                                                                                                                                 (AUSTER, DEARS)

Physicians Urged to Continue to Oppose One-Sided Workers Compensation Reform Proposals
All physicians should continue to contact their State Senators and Assemblymembers here to express their strong opposition to sweeping Workers’ Compensation reform proposals contained in the Executive Budget.

MSSNY recently gave testimony to the Senate Finance and Assembly Ways & Means Committees raising significant concerns with Budget proposals that would:

  • Enable treatment of injured workers and direct payment for care by various non-physicians without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery when specialized care is needed; whether new funds will be allocated or whether existing fees will need to be cut to cover this expanded list of care providers; and whether a non-physician can perform an IME of an injured worker to review the care provided by a physician to an injured worker;
  • Expand the circumstances when a physician or other health care provider can have their authorization removed and empowers the Board to impose significant fines on a physician or any other Board-authorized health care provider for violating a Workers Compensation rule;
  • Remove the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation, which is currently an important peer review function provided by county medical societies to assure physician applications are complete and physician applicants are appropriately qualified to deliver this needed care to injured workers;
  • Reduce choice for injured workers by prohibiting an injured worker not subject to a collective bargaining agreement from seeking medical treatment from outside a Workers Compensation PPO before 120 days after his or her first visit to a PPO provider; and
  • Remove the requirement for a referral by a physician for an injured worker as a pre-condition to receive psychological care;

Exacerbating these concerns is that the proposal also does not meaningfully address the many excessive administrative hassles and payment delays that have caused many physicians to be unable to participate in the Workers Compensation program.   While there have been some modestly positive actions taken by the WCB in recent years to encourage physician participation in the WC program through removal of arbitration fees and development of an electronic portal for facilitating authorizations from carriers, these one-sided Budget proposals, if enacted, could further chase physicians away from the program.

MSSNY has reached out to labor organizations and attorneys for injured workers to coordinate its advocacy in opposition to these adverse proposals.  MSSNY has also been working closely with county medical society leadership from across the State to encourage their outreach to their local Senators and Assemblymembers to request that these proposals be jettisoned from the Budget.
(AUSTER, DEARS)


MSSNY Testifies Before Joint Senate Finance and Assembly Ways & Means Committee
Last week, MSSNY submitted its testimony of the proposed budget for fiscal year 2016-17.  Noting the fact that many physician practices are struggling to remain viable with the significantly decreasing compensation and increasing overhead costs, including medical liability premium costs, they must bear, MSSNY representatives advocated that the Legislature take action to assure that we create and preserve an economically sensible health care delivery system.

First and foremost, in the testimony MSSNY focused on the financial hardship that has been created as a result of the collapse of Health Republic and the need for the creation of a Guarantee Fund or other pool of monies to assure that physicians and other stakeholders will be made whole. MSSNY also encouraged the Legislature to reject the programmatic changes to the Excess program proposed in the budget which would result in the dropping of 55% of physicians who currently have the extra $1M layer of coverage from the program. MSSNY urged the restoration of the $25M funding cut to the historic $127.4M level. MSSNY continues to oppose the establishment by publicly traded corporations of limited-services clinics in pharmacies and other retail establishments, particularly at a time when MACRA and other transformational payment structures reward physicians only if they provide same day access to care, provide for care collaboration and enhanced quality of care. MSSNY expressed its opposition to the sweeping Workers’ Compensation reform proposal contained in the Executive Budget including provisions which would removes the authority of county medical societies to recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation and enable treatment of injured workers and direct payment for care by nurse practitioners and physician assistants, without clarity as to: how non-physicians treating patients with serious health conditions will coordinate patient care delivery with physicians and no new funds to cover this expanded list of care providers. MSSNY also opposed proposed language that would eliminate existing “prescriber prevails” protection for prescriptions for Medicaid patients.

Most importantly, MSSNY urged comprehensive reform of our flawed medical liability adjudication system including reforms which would: place reasonable limits on non-economic damages, which 30 other states have enacted; identifying and assuring qualified expert witnesses; eliminating joint and several liability; strengthening our weak Certificate of Merit requirement; and assuring statements of apology are immunized from discovery.  Other important measures we support include alternative systems for resolving Medical Liability claims such as Medical Courts or a Neurologically Impaired Infants Fund that applies to physicians.   A copy of the Testimony can be accessed through the following link.
(DEARS, AUSTER) 


To Physicians in Long Island, NYC, Hudson Valley, and Capital District: Please Complete Survey Regarding Impact of Proposed Cigna-Anthem Merger
As many physicians know, Anthem, the parent of Empire Blue Cross/Blue Shield, has filed paperwork to acquire CIGNA.   MSSNY has written to the New York State Department of Financial Services and Attorney General’s office to express its concerns about the impact to patient care as a result of further health insurer consolidation.

State and federal regulators are very interested in knowing the prospective effects of these possible mergers on your practice and patient care.  In this regard, MSSNY working together with the American Medical Association Advocacy Resource Center have developed a survey seeking physician input on the potential impact on these proposed mergers.

Last fall, the AMA released a report articulating the significant potential anticompetitive effects that would occur in numerous regions all across the country as a result of this merger.  Among the identified regions of concern in New York State were Long Island, New York City, the Hudson Valley, the Capital District and the Glens Falls area.  Therefore, physicians practicing in these regions are asked to complete the Survey!

This survey, and any information collected in response, will be used by the Medical Society solely for the purpose of petitioning state and federal government concerning the antitrust issues raised by Anthem’s proposed acquisition of Cigna. The antitrust laws prohibit the state medical association from using any information collected pursuant to this survey for any anticompetitive purposes, including, but not limited to, using that information in discussions with health insurers and other payers in an effort to raise physician payment or otherwise increase physician compensation. The state medical society will also not disclose any information received in response to this survey to its physician members without first consulting experienced antitrust Counsel.                                                                         (AUSTER)


Rescheduled Webinar on Opioid Prescribing to be Held Feb. 9th; Second Webinar in Series to be Held Feb 10
The first webinar in the opioid series will be held Tuesday, February 9th at 7:30 a.m. followed on February 10, 2016 with the second webinar at 7:30 a.m.   Physicians and other prescribers are encouraged to register for the entire webinar series at the following link. Click on the upcoming tab and select the programs.

Physicians will need to register for each webinar; each webinar has different topics described below. Physicians and other prescribers are allowed to register up to ½ hour before the webinar.

The Medical Society of the State of New York and New York State Office for Alcoholism and Substance Abuse Services are jointly providing this 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, February 9, 2016 at 7:30 a.m.,  and will be conducted by Charles Morgan, MD, FASAM, FAAFP, DABAM and Patricia Bruckenthal PhD, APRN-BC, ANP, FAAN and the educational objectives are:

  • 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.

The second webinar will be held on Wednesday, February 10, 2016, 7:30 a.m. Faculty:  Charles E. Argoff, MD.  The educational objective is to:  Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessment and documentation. 

The remaining webinars in the series are scheduled for:

Tuesday, February 23, 2016, 7:30 a.m.  Faculty:  Jeffrey Selzer, MD and the 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 and the 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.
(CLANCY)


Please Complete the New Health Republic Survey!
As MSSNY continues its advocacy in support of a special fund to pay for the unpaid claims as a result of the Health Republic demise, we need you to take the time to complete a MSSNY survey to provide us with updated information regarding the amounts you are due from Health Republic.  To complete the survey, click here: https://www.surveymonkey.com/r/HRepublic2This data is critical to our advocacy efforts!  We thank the many of you who provided data in November detailing the amounts you are owed, but we need to obtain updated and more precise numbers since many legislators have asked us for this data.
(AUSTER, DEARS)

NYS Department of Health Issues Protocals for Zika Virus
The New York State Department of Health has issued new protocols for Zika virus which now include the collection of a urine sample in addition to blood samples.   The health advisory and guidelines for pregnant women may be found at the department website.

The World Health Organization has declared a global emergency due to the Zika virus and NY state officials have indicated that guidelines may change.   DOH Commissioner Howard Zucker indicated that the state will be monitoring mosquitoes closely as the weather gets warmer.  The Department of Health conducted a webinar on Zika and the webinar is now available at the department’s website.
(CLANCY)

 


MSSNY to Sponsor Free CME Webinar on Public Health Preparedness on Feb. 17th
Public Health Preparedness 101 will be the topic of MSSNY’s Medical Matters webinar on Wednesday, February 17, 2016 with. Kira Geraci-Ciardullo, MD, MPH and Arthur Cooper, MD, MS serving as faculty.  This program is designed to help physicians and staff on how to prepare professionally and personally for a public health emergency.  The program will begin at 7:30 a.m.   Registration is now open to physicians and other public health officials.  Go to training session and click on the upcoming sessions tab.

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 mhoffman@mssny.org.                                                                                                     (CLANCY, HOFFMAN) 


Assembly Gottfried Seeks to Double the Number of In-State Med. Marijuana Dispensaries
With only several hundred physicians currently registered to certify the use of medical marijuana for their patients, Assemblyman Gottfried introduced legislation (A.9151) last Friday to double to number of marijuana manufacturers and dispensaries in the state. Under the current program, 49 counties with an aggregate population of 7.5 million lack access to a medical marijuana dispensary in their county. With counties underserved and “978,500 New Yorkers for every medical marijuana dispensary”, Assemblyman Gottfried’s legislation would allow for five additional manufacturers, each permitted to operate up to four dispensaries. Currently, the legislation is a one-house bill, without a Senate same-as.
(MCPARTLON) 


NYU Arthur Caplan – It’s Time to Cancel the Summer Olympics
In Wednesday’s Forbes Sport Money section, Arthur Caplan, PhD, of NYU Langone Medical Center, presents the case for evaluating whether the 2016 Summer Olympic Games in Rio de Janiero should to be cancelled. Caplan argues that it is irresponsible to allow the games to take place in an area under a wide-spread outbreak of the Zika virus, which the WHO recently declared an “explosively spreading” “public health emergency of international concern”.            (MCPARTLON)

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 ldears@mssny.org            mauster@mssny.org  
pclancy@mssny.org jMcPartlon@mssny.org    

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Physicians and Zika Virus
Commissioner of Health Howard Zucker, MD, JD NYS has placed on the DOH website, “Zika Virus What New York State Clinicians Need to Know” dated February 1, 2016.


Resolutions for the 2016 House of Delegates
The deadline for resolutions is 5:00pm on February 19; or for resolutions resulting from our Lobby Day, 5:00 on March 11 is the deadline. Send all resolutions to lmayer@mssny.org
 


New York State Earns Mixed Reviews in New Tobacco Report
In a report from the American Lung Association (ALA) titled “State of Tobacco Control 2016,” reports, New York earned an “A” in 2015 “on policies that promote smoke-free air.” However, the ALA “called on New York officials to increase funding for the state’s tobacco control programs by $10 million to $52 million per year and expand New York’s Clean Indoor Air Act to restrict the use of electronic cigarettes.”

The smoking rate among the state’s high school students has dropped to 7.3 percent, while the adult smoking rate has dropped to 14.5 percent, below the national average of 17.8 percent, according to figures released by the state last year.

The lung association raised concerns, however, about an increase in the use of products like e-cigarettes and hookahs. And it gave the state failing grades for funding and providing access to programs that help people quit smoking.

The advocacy group called on New York officials to increase funding for the state’s tobacco control programs by $10 million to $52 million per year and expand New York’s Clean Indoor Air Act to restrict the use of electronic cigarettes.


From Socio-Med VP Regina McNally: Go with Dr. First for
E-Prescribing
I have been receiving many calls from physicians regarding the upcoming NYS e-prescribing mandate of March 27, 2016 and you might be getting calls, too. We endorse DrFirst as a “stand-alone” e-prescribing product.  I believe software would be added to the physician’s existing computer.  This stand-alone product will help those physicians who have an EMR or EHR that might not be ready by the 3/27/16 deadline.  Please see the following:  http://www.drfirst.com/mssny/mssny-lp/

MSSNY members get a discount!  DrFirst’s MSSNY hotline number is (866)980-0553.

If a physician member can document either financial or technical limits, s/he can apply for a waiver from electronic prescribing.  The application for the waiver would apply for both controlled and non-controlled prescription drugs.  Note, there’s no guarantee that the waiver will be granted.  Please see the attached for waiver information.

As a point of physician protection, a medical record for the patient (spouse, family, friends, etc.) must be maintained (even if it is on an index card) for every prescription written in either paper or electronic mode. 

E-prescribing of both controlled and non-controlled substances is currently permissible in New York. Practitioners must ensure compliance with the requirement, including working with their software vendors to implement the additional security requirements needed for e-prescribing of controlled substances, and registering their certified software applications with the Bureau of Narcotic Enforcement

Below are highlights/key points that may be of particular interest to prescribers and pharmacists:

  • A prescription generated on an electronic system that is printed out to the Official New York State Prescription form or faxed is NOT an electronic prescription.
  • After March 27, 2016, a pharmacist is NOT required to verify that a practitioner properly falls under one of the exceptions from the requirement to electronically prescribe. Pharmacists may continue to dispense medications from valid written, oral, or fax prescriptions that are consistent with current laws, regulations, and Medicaid policies.

A comprehensive list of FAQs can be found here.

The FAQs provide an explanation of the laws and regulations, pharmacy registration forms, registration for official prescriptions and e-prescribing systems (ROPES), software and data requirements, waivers and exceptions, and resource information and contacts.

Questions? Please contact the Bureau of Narcotic Enforcement at

1-866-811-7957 or via e-mail to narcotic@health.ny.gov


Poster Symposium Seeks Judges on April 15 in Tarrytown
If you’re coming to the House of Delegates in Tarrytown – or just live in the neighborhood – and are free on Friday afternoon, April 15, from 2 – 4 pm, please consider participating as a judge at the MSSNY Resident and Fellow Section Poster Symposium. It’s always an exciting, lively event! Please contact sbennett@mssny.org or 516-488-6100 extension 383 if you’re interested. Thank you.


AMA: All Physicians Subject to 2015 Medicare MU Program Should Apply for Hardship
Prior to adjourning for the holidays, Congress passed the Patient Access and Medicare Protection Act (PAMPA), which directed CMS)to make AMA-supported changes to the Medicare EHR Incentive Program hardship exception process that allows physicians to avoid a Meaningful Use (MU) penalty in 2017.

CMS has stated that it will broadly accept hardship exemptions because of the delayed publication of the program regulations. Applying for the hardship will NOT prevent a physician from earning an incentive. It simply protects a physician from receiving an MU penalty. Therefore, physicians who believe that they met the MU requirements for the 2015 reporting period should still apply for the hardship protection. Note that the program operates on a two-year look-back period, meaning that physicians who are granted an exception for the 2015 program will avoid a financial penalty for 2017.

Step-by-step instructions for completing the hardship exception application are attached.

The new applications and instructions for a hardship exception from the Medicare Electronic Health Records Incentive Program 2017 payment adjustment are available here.

This new, streamlined application process is the result of PAMPA, which established that the Secretary may consider hardship exceptions for “categories” of EPs, eligible hospitals, and CAHs that were identified on CMS’ website as of December 15, 2015. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.

Importantly, EPs, eligible hospitals, and CAHs that wish to use the streamlined application must submit their application according to the timeline established in PAMPA:

  • Eligible Professionals: March 15, 2016
  • Eligible Hospitals & CAHs: April 1, 2016

Please note:

Following Congress’ efforts in PAMPA, we have reviewed our administrative authorities and determined that groups of providers may apply for a hardship exception on a single application. Under the group application, multiple providers and provider types may apply together using a single submission. The hardship exception categories are the same as those applicable for the individual provider application. 


NEJM: Surgical Residents’ Long Shifts May Have No Impact on Patient Outcomes
Research published online in the New England Journal of Medicine indicated that “allowing surgeons in training to work extremely long shifts without breaks had no effect on patient outcomes and created only minor dissatisfaction among the young” physicians. http://bit.ly/1P9tCnV Investigators “looked at how many patients died or had serious complications in the month after surgery and found the same low rate – about 9 percent – in both groups.” Meanwhile, “residents’ self-rated dissatisfaction with their education and with their well-being were similarly low – 11 percent and roughly 13 percent respectively in each group.” In an accompanying editorial at http://bit.ly/1VRjodv, Dr. John Birkmeyer “wrote the experiment’s results ‘effectively debunks concerns that patients will suffer as a result of increased handoffs and breaks in continuity of care.’”


Nat’l Center on Addiction/Substance Abuse Releases Report on Food Addiction
The National Center on Addiction and Substance Abuse announced the release of a report that lays out the characterizing symptoms, risk factors and underlying neurobiological characteristics of food addiction, and how these features overlap with those of obesity, eating disorders and substance addiction. This report, Understanding and Addressing Food Addiction: A Science-Based Approach to Policy, Practice and Research, highlights how the knowledge and experience gained from years of substance use research and work in substance prevention, intervention and policy might be applied to controlling unhealthy eating and the food environment that contributes to it. It offers evidence-based recommendations for policy, prevention, health care practice and research to help reduce the deadly and costly health consequences of unhealthy eating.
Highlights of the report include:

  • Evidence regarding the prevalence of food addiction and its co-occurrence with obesity, binge eating disorder and other health conditions
  • The risk factors, characterizing symptoms and biological mechanisms of food addiction and related disorders and how these overlap with other eating disorders and with substance addiction
  • Recommendations for policy, prevention, health care practice and research, and resources for additional information

The report is available for download at no cost and can be found here.

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Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.

 

 



Classifieds


OFFICE SPACE – Sutton Place
Newly renovated medical office. Windows in every room looks 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 e-mail: advocate@medicalpassport.org

Office Rental 30 Central Park South
Two fully equipped exam rooms, two certified operating rooms, 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. 212.371.0468drdese@gmail.com.


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. 212-685-2333 / 917-312-6631, jeromesager@cs.com.



CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355