January 26, 2018 – Allscripts Ransomware Attack!

Governor Cuomo Issues Executive Order to Allow Pharmacists to Immunize Children Under 18 for Influenza
Governor Andrew Cuomo this week issued an executive order outlining several steps to respond to the latest flu epidemic including to allow pharmacists to immunize children under the age of 18.  The Executive Order, effective today, suspends the section of state education law that limits the authority of pharmacists to administer immunizing agents to anyone under age 18 to allow vaccines to be administered to anyone age two and up. Parents and guardians are also encouraged to call pharmacies ahead of their visit, to ensure they are ready to receive patients in this age group.   Parents and guardians with children between the ages of six months and 24 months are still encouraged to see their primary care provider for the vaccination.  This action by the governor has occurred in prior years when the influenza outbreak has been severe.  The Executive Order encompasses a disaster declaration by the Governor and the order will remain in effect until the disaster is over with.  Additionally, the Governor also took the following steps to combat the influenza outbreak:

• Issuance of Department of Financial Services guidance to health insurers to ensure that prior authorization is not a barrier to the prescribing of antiviral medications within the first 48 hours of illness.
• Direct engagement with all New York State county health commissioners to review the four key strategies of influenza control- vaccination, rapid antiviral treatment, isolation of sick individuals, and good hand hygiene-and promote local vaccination awareness efforts.
• Ongoing communication with all New York State hospitals and nursing homes to review capacity management strategies and the actions available to expand capacity to handle patient surge.
• Continued monitoring of hospital capacity through survey and direct outreach to hospital leadership.

A copy of the Executive Order can be found here.  (CLANCY)

Congress Passes Long-Term CHIP Extension and Delays Cadillac Tax
The short-term continuing Budget resolution agreed to by Congress and President Trump earlier this week importantly included 6 years of federal funding for the Children’s Health Insurance Program (CHIP) that provides coverage to nearly 9 million children across the country, including hundreds of thousands of children in New York State.  The Continuing resolution, which funds the federal government through February 8, also contains a 2-year delay on implementation of the “Cadillac Tax” on comprehensive health insurance coverage and the medical device tax.  MSSNY has adopted policy that calls for elimination of the “Cadillac Tax”, since it would disincentivize employers from offering generous health insurance policies to their employees.

Federal funding for the CHIP program had expired last fall, placing this program in jeopardy for many states, including New York.  Last week, MSSNY joined with several other patient and health care provider advocacy associations in a letter to New York’s Congressional delegation to work to continue funding for CHIP program as well as other key health subsidy programs, such as continued health insurance subsidies for lower and middle-income patients, as well as funding for community health centers and Disproportionate Share Hospitals.  Funding for these other programs will be discussed in the context of the next Continuing Budget Resolution.                                                        (AUSTER)                      

Legislation Introduced by Assembly Health Committee Chair to Reduce Prior Authorization Hassles Based on AMA Prior Authorization Principles
Legislation (A.9588, Gottfried) was introduced this week by Assembly Health Committee Chair Richard Gottfried to help reduce insurer-imposed administrative hassles consistent with the recently released document entitled Prior Authorization and Utilization Management Reform Principles.  These principles were developed by the American Medical Association, American Hospital Association, Medical Group Management Association, American Pharmacists Association, and Arthritis Foundation along with several other health and patient advocacy associations including MSSNY.    Assemblyman Gottfried’s legislation would enact into law several of the suggested reforms that were articulated in these Prior Authorization principles, including:

• Requiring health plan utilization review criteria to be evidence-based and peer reviewed ;
• Reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations)
• Assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment.
• Prohibiting mid-year prescription formulary changes; and
• Assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service.

MSSNY together with NY Academy of Family Physicians & the NY chapter of The American College of Physicians advocated for the introduction of this legislation. Legislation to reduce prior authorization hassles is more important than ever.  For example, a recent study by Milliman noted that insurers’ use of burdensome prior authorization and step therapy requirements for many prescription medications nearly doubled between 2010 and 2015. And a recent Annals of Internal Medicine study reported that physicians spend two hours on administrative work for every hour with a patient.                                               (AUSTER)

A.G. Schneiderman Announces $1.15 Million Settlement with Aetna for Patient Privacy Breach
New York Attorney General Eric Schneiderman announced a settlement this week with Aetna to resolve alegations that Aetna revealed the HIV status of nearly 2,500 New York patients through a July 2017 mailing, according to the press release, in which the envelopes’ oversize transparent address window revealed text confirming the members’ HIV status.  According to the press release, as part of the settlement, Aetna will pay a $1.15 million civil penalty; develop and maintain enhanced operating procedures with regard to privacy protections of personal health information and personally identifiable information in mailings; and hire an independent consultant to monitor and report on the settlement’s injunctive provisions.

To read the press release, click here. 

To read the full settlement, click here.

According to the press release, Aetna has agreed to implement and maintain a series of enhanced privacy protections, including modifications to its Standard Operating Procedure for Print/Mailing Quality-Prevention of PHI/unwanted disclosure(s), and Use of Protected Health Information in Litigation – Best Practices Policy to provide enhanced safeguards to protect from negligent disclosure of personal health information and personally identifiable information through mailings.

“Through its own carelessness, Aetna blatantly violated its promise to safeguard members’ private health information,” stated Attorney General Schneiderman. “Health insurance companies handle personal health information on a daily basis and have a fundamental responsibility to be vigilant in protecting their members. We won’t hesitate to act to ensure that insurance companies live up to their responsibilities to the New Yorkers they serve.”   (AUSTER)

MSSNY Partners with AMA to Educate Physicians & Patients on Diabetes Prevention
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York. MSSNY has created two free CME programs to educate New York State physicians on prediabetes prevention and the CDC’s National Diabetes Prevention program.

Live Webinar: Bending the Diabetes Curve
Tuesday, February 20^th at 7:30am
Register for this webinar HERE.
Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

• Describe the trends in Type 2 diabetes and implications for clinical practice
• Review evidence that supports referring patients with prediabetes to lifestyle change program
• Outline the considerations for implementing a diabetes prevention initiative in a physician practice
• Describe NYS specific incidents of prediabetes and diabetes in adult population
• Understand the reimbursements mechanisms for DPP

House of Delegates Live Seminar: Bending the Diabetes Curve
Thursday, March 22^nd, 2-3pm
Adams Mark Hotel, Buffalo, NY, Grand B
Pre-Register for this live seminar HERE.
Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

* Must attend in person at the House of Delegates.

Educational Objectives:

• Describe the trends in Type 2 diabetes and implications for clinical practice
• Review evidence that supports referring patients with prediabetes to lifestyle change program
• Outline the considerations for implementing a diabetes prevention initiative in a physician practice
• Describe NYS specific incidents of prediabetes and diabetes in adult population
• Understand the reimbursements mechanisms for DPP

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at charring@mssny.org. (HARRING)

Medical Society of the State of New York Announces its January CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its January free Continuing Medical Education (CME) webinars.  Participation in the webinars will earn physicians one CME credit free of charge.  The January schedule is as follows: 

January 30^th at 7:30am – Veterans Matters:  PTSD & TBI in Veterans
Register for this webinar here.
Faculty: Emerald Lin, MD

Educational Objectives:

• Identify signs and symptoms of PTSD & TBI
• Examine evidence-based treatment modalities for PTSD & TBI
• Explore military culture and methods to overcome unique barriers to treatment intrinsic to military culture

To view all of MSSNY’s scheduled programs, click here and select “Upcoming”.

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.  (HOFFMAN, CLANCY)

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   mauster@mssny.org  pclancy@mssny.org  

jbelmont@mssny.org charring@mssny.org