MSSNY eNews: January 20, 2021 – Gov.‘s Budget Proposes New Costs on Doctors, Expand Pharm Scope and Reduce Due Process
New York: 6.3
New daily cases: 12,721
Tests per 100,000: 1,190.7
It is not only Inauguration Day: Today also marks a full year since the first known coronavirus patient in the United States was admitted to the hospital.
Governor Cuomo Releases State Budget Proposal – Contains a Number of Problematic Proposals to Impose New Costs on Doctors, Expand Pharmacy Scope, and Reduce Due Process
Governor Cuomo released his proposed 2021-22 State Budget to address a 2-year $14.9 billion deficit and a 4-year $39 billion deficit. The presentation identified that the Budget submission was based upon the likely receipt of additional $6 billion from the federal government but noted that $15 billion was needed to avoid the combination of Budget cuts and revenue increases in the Budget he proposed.
As has been previously discussed, new revenue sources included $500 million through mobile sports betting and $350 million through the sale of adult use cannabis (when fully implemented), as well as higher taxes for those making more than $5 million per year. The Governor further noted that while he was hopeful to receive additional funding from the federal government, they would examine the possibility of litigation to ensure New York receives it fair share.
The Budget does include some positive items including:
- a call once again to require state oversight over Pharmacy Benefit Managers (PBMs),
- to significantly expand the manufacturing of personal protective equipment (PPE) and
- additional funding to increase reimbursements to providers in the state’s Essential Plan program, and to cover premiums to ensure those enrolled stay enrolled if they are eligible.
However, the Executive Budget contains a number of significantly problematic initiatives, including several rejected by the State Legislature in previous Budget cycles. These include:
- requiring the 16,000 or so physicians insured through the Excess Medical Malpractice Insurance program to bear 50% of the cost of a policy. This proposal was a recommendation from the Medicaid Redesign Team last spring, and was advanced during State Budget negotiations last March, but rejected by the State Legislature. You can send a letter/tweet in opposition to your state legislators here: Don’t Balance the Budget on the Backs of Physicians (p2a.co)
- A comprehensive “OPMC modernization” proposal which would have the effect of significantly reducing due process for physicians for whom a complaint is filed with the OPMC. It would permit the Commissioner the discretion to public identify a physician against whom a complaint has been filed prior to the conclusion of an investigation and hearing, and greatly increase the authority to impose a “summary suspension” prior to the conclusion of an investigation and hearing. This was also proposed in last year’s Executive Budget and rejected by the State Legislature. You can send a letter/tweet in opposition to your state legislators here: Reject Governor’s Physician Disciplinary Proposal (p2a.co)
- Permitting pharmacists to act as a “referring healthcare provider” for providing to patient’s asthma and disease self-management, and permitting them to order various lab tests
- Greatly expanding the existing physician-pharmacist collaborative drug therapy program to permit pharmacists to “prescribe” and inclusion of nurse practitioners. This was also proposed in last year’s State Budget and rejected by the State Legislature.
- Continuation of the authority for an additional 6 years for certain nurse practitioners to practice without a written collaborative agreement of a physician provided there is proof of “collaborative arrangements” with physicians in that specialty of practice. Cutting the appropriation of MSSNY’s successful Committee for Physicians Health by 20%
We are still continuing to go through the thousands of pages of Budget language, but we will be coordinating with the specialty societies and developing grassroots materials to assist physicians in fighting back to push the Legislature to reject these initiatives when the final Budget is enacted on March 31. It is important than ever as well that physicians plan to participate in MSSNY’s virtual Physician Advocacy Day on March 2. You can register here: Webinar Registration – Zoom
Nearly 40% Still Hesitant to Visit Physician’s Office Due to COVID-19
Nearly 40 percent of Americans said they still feel unsafe visiting a physician’s office during the COVID-19 pandemic, according to research published Jan. 13 from the Society for Cardiovascular Angiography and Interventions.
The society conducted three surveys in late December 2020 to better understand Americans’ COVID-19 fears. The first survey included responses from a nationally representative group of 1,005 U.S. adults. The second included insights from a sample of 1,023 LatinX adults, and the third featured responses from 1,041 Black adults.
Four survey findings:
- More than 30 percent of respondents said they have not had a routine checkup since the pandemic started, and 38.4 percent said they still feel unsafe going to a physician’s office.
- Overall, 51 percent said they do not feel comfortable scheduling a medical procedure during the pandemic. Twenty-five percent of Black respondents and 29 percent of LatinX respondents said the same.
- Thirty-three percent of Black respondents and 34 percent of Latinx respondents said they would feel comfortable going to a hospital for emergency care during the pandemic, compared to 58 percent of the general population.
- More respondents said they were afraid of COVID-19 (58 percent) than having a heart attack
Medicare Part B 2021 Important Update from Anthem
When: Friday, January 22, 2021, 12:00 – 2:00 PM EST
MSSNY will be partnering with National Government Services to conduct a webinar on important changes for the Medicare Program in 2021.
Agenda Topics to include:
- COVID-19 Public Health Emergency (PHE)
- Evaluation & Management coding Changes in CY2021
- 2021 Medicare Physician Fee Schedule (MPFS)
- Final Policy, Payment, and Quality Provisions Changes to the MPFS for Calendar Year 2021
- Quality Payment Program
- Contact Information/Resources
James D. Bavoso
Provider Outreach & Education, Manager
CMS is Working to Expand COVID-19 Vaccine Outreach
CMS is working to expand our COVID-19 vaccine outreach efforts in the community with the goals of building vaccine confidence, preparing people to be vaccinated, and slowing the spread of the virus. We want to help reach membership and Medicare beneficiaries with information and resources about the COVID-19 vaccine. I know that MSSNY is already communicating with its members about COVID-19, but I hope that you can use some of the resources we will be making available, and that we can be helpful to your efforts.
We/HHS will have communication toolkits soon to help you do that and as those are developed, we will share them and hope that you will share on your website and in your newsletters if possible. The toolkits will include talking points to speak accurately and confidently about COVID-19 prevention measures, videos, customizable social media messages, a standard PowerPoint presentation, content for community webinars, blog content, blurbs for newsletters and websites, fact sheets, and flyers.
Right now, our key messages for Medicare beneficiaries are:
- Vaccines are approved but are in limited supply. Medicare beneficiaries should check with their state or jurisdiction for when and where to receive the vaccine. Look for updates from your state and local officials as more doses of the vaccine become available for additional priority groups.
- Do not give out your Medicare number and don’t pay for the vaccine. It will be at no cost to you. You cannot pay to get quicker access.
- Remember that you need 2 doses for the COVID-19 vaccine to be effective, so be sure to schedule your second dose when you receive your first one. Be on the lookout for COVID-19 vaccine scam efforts.
- The vaccine will help keep you from getting COVID-19. Learn more about the benefits of the vaccine.
- Unfortunately, there are some myths about the COVID-19 Vaccine and vaccination in general. Here is more information to bust COVID-19 vaccine myths.
In February 2021, CMS Local Engagement Staff will join HHS to promote and distribute to specific partner groups tailored toolkits that include talking points to speak accurately and confidently about COVID-19 prevention measures, culturally relevant videos, customizable social media messages, a standard PowerPoint presentation, content for community webinars, blog content, blurbs for newsletters and websites, and fact sheets. We will continue to engage these partners to reach vulnerable populations, adapting to new messaging as needed.
Please keep an eye out for the toolkits and continue to share the links I mentioned as you see fit. Also, let me know if there is anything we can do to assist you and your membership, and whether it would be good to touch base by phone/conference call or Zoom sometime soon.
NEJM Covid-19 Vaccine Resource Center
A collection of resources on Covid-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.
All information and resources on the Covid-19 Vaccine Resource Center will be updated on an ongoing basis as medical science evolves and will remain freely available to all.
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