June 2, 2017 – VW Does EHR?


PRESIDENT’S MESSAGE
Charles Rothberg, MD
June 2, 2017
Volume 17
Number 21

Dear Colleagues:

This week, when the news broke about eClinicalWorks’ misdeeds, the phrase that immediately came to mind was “Volkswagen Does Electronic Health Records.”

The real story is EHR vendor eClinicalWorks has agreed to pay $155 million to resolve a False Claims Act lawsuit that alleged it gave customers kickbacks for publicly promoting its products. The fine stemmed from a whistleblower suit alleging that it falsely obtained certification for meeting certain criteria as part of the meaningful use EHR reimbursement program.

EClinicalWorks disputes the charges but said it settled anyway to avoid the “cost and uncertainty inherent in protracted litigation.”  Really?

This sounds fishy to me. Why would someone pay out a $155 million fine if they were not guilty? This outcome is an outrage. If a physician attempted such a scam, they would not be fined. They would go directly to jail and would never be able to reclaim their medical license.

The DOJ alleges that eClinicalWorks opted to add the 16 drug codes necessary for certification into its software rather than enable the product to access those from a complete database; failed to accurately record user actions with audit log functionality; did not always accurately record diagnostic imaging orders or conduct drug-drug interaction checks; and, finally, eClinicalWorks did not satisfy data portability requirements designed to enable doctors to transfer patient data over to other vendor’s EHRs.

“As a result of these and other deficiencies in its software, ECW caused the submission of false claims for federal incentive payments based on the use of ECW’s software,” the Vermont DOJ said.

Why do we try to privatize when firms are self-serving and do not hold public trust with sanctity? All they have to do is pay a fine when accused of willful wrongdoing.

By the way, the lawsuit was originally filed by whistleblower Brendan Delaney, who at the time was a software technician at the New York City Division of Health Care Access and Improvement. He will receive approximately $30 million as part of the resolution.

The vendor accepted terms in a 5-year settlement agreement that the Office of the Inspector General called innovative.  “eClinicalWorks must allow customers to obtain updated versions of their software free of charge and to give customers the option to have eClinicalWorks transfer their data to another EHR software provider without penalties or service charges,” the notice said. “eClinicalWorks must also retain an Independent Review Organization to review eClinicalWorks arrangements with healthcare providers to ensure compliance with the Anti-Kickback Statute.”

“This resolution demonstrates that EHR companies will not succeed in flouting the certification requirements,” said Acting U.S. Attorney for the District of Vermont Eugenia Cowles.

I think one already did succeed.

Sincerely,
Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


Crunch Time as the End of the Legislative Session Nears
The legislature will return to Albany next week.  With only three weeks left of session, we need to remain active in the legislative process.  The end of session usually brings a lot of negotiations and deals on various bills and regularly includes surprises. While it’s hard for us to predict the unpredictable, there are ways to get involved and tip the odds in our favor.  As we monitor bill introductions and meet with every legislator, our physicians must keep up on the most up- to-date information and important material to boost our efforts.  Our grassroots action network click here is filled with informational materials and ways to contact your legislators.  Please call, write and meet with your legislators before the end of session which is scheduled for June 21st.
(BELMONT)

Physicians Urged to Continue to Oppose Liability Expansion Bills
All physicians are urged to continue to contact their legislators (click here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated.  MSSNY has been working closely with hospital associations and specialty societies to demonstrate the health care community’s  shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted.

The timing of these bills could not be worse.  We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending.    Please urge you elected officials to oppose the following bills:

  • Lengthening the Medical Liability Statute of Limitations (3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals.  If enacted this bill could increase your liability premiums by 15%.  This bill is on the Assembly floor and can be voted on at any time.
  • Expansion of Wrongful Death Actions (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action.  Actuarial studies have predicted that this bill could increase liability premiums by over 50%.  This bill is on the Assembly Codes Committee next week.
  • Direct Actions Against a Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.
  • Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
    (DIVISION OF GOVERNMENTAL AFFAIRS)


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just a few weeks left in the Legislative Session, physicians are urged to contact their legislators to ask them to support legislation strongly supported by MSSNY to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks.  These bills include:

  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill has passed the Assembly and was recently reported to the Senate floor. Please send a letter in support click here.
  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support click here.
  • 5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers.  The bills are in the Senate Health and Assembly Insurance Committee. Please send a letter to your legislators in support click here.    (DIVISION OF GOVERNMENTAL AFFAIRS)

Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!




Support Legislation to Repeal Arbitrary Limits on Compensation Arrangements with Billing Vendors
At the April MSSNY House of Delegates meeting, a resolution was adopted calling on MSSNY to “work for repeal of the New York State law barring percentage-based payment arrangements between physicians and their billing agents” and, to “oppose efforts by state government officials to demand refunds from physicians based upon allegations that claims were submitted to Medicaid using percentage-based arrangements between physicians and their billing agents”.  Legislation (A.193, Buchwald/S.2247, Hannon) has been introduced that would accomplish one of the goals of the resolution by eliminating the “one of a kind” New York law that prohibits health care practitioners from entering into contracts with practice management companies that use percentage-based billing arrangements.  The legislation has advanced from the Senate Health Committee to the Senate floor, and in the Assembly has been referred to the Health Committee.  Physicians are urged to send a letter to their legislators in support of this legislation click here.
(AUSTER)


Physicians Can Still Participate in NYS Meaningful Use Program Under Medicaid
The NYS Department of Health has sent out a notice that the deadline to register and report for Meaningful Use in the New York State Medicaid Electronic Health Records (EHR) Program is September 15, 2017.  This will be the last opportunity for physicians and other eligible professionals to join the program. Incentive payments to Eligible Professionals (EPs) are disbursed over the course of six participation years. EPs may receive up to $21,250 for the first participation year and $8,500 for each remaining participation year.   To participate in the EHR Incentive Program, you must have a certified EHR system, be enrolled as a fee-for-service New York Medicaid provider, and be registered with CMS.   Further information and to register may be obtained here.

MSSNY is seeking information from the DOH regarding the number of physicians participating in the Medicaid EHR program as well as the reasons why some physicians started in the program but did not continue.  
(CLANCY)


Need to Meet Your Pain Management CME Requirement?  MSSNY Pain Management, Palliative Care and Addiction Online Program Available
The Medical Society of the State of New York Pain Management, Palliative Care and Addiction modules are now available on-line here.

These modules are being offered free of charge to all MSSNY members.  Physicians who are new users to the MSSNY CME site will be required to register as a new user.  As a new user, physicians and non-physicians will be required to enter fields that include: position; name (the name should be what you want to appear on the CME certificate); email address; and then create a password.  MSSNY members who encounter a payment page or have difficulty registering, please email cme@mssny.org for technical support.  Directions for creating a new account/or logging in can be found here.   Non-MSSNY physicians will be charged $50 per module.

The MSSNY CME is a new site and while many MSSNY members have an account with mssny.org a MSSNY member may not necessary have an account with cme.mssny.org   If in doubt, try to create an account and if it tells you that the email address is unavailable or in use,  an account exists.   Passwords can be reset if you don’t know it.  Physicians who have previously had an account at the MSSNY CME site will need to log into the site using their email and password. The MSSNY CME site provides the ability for physicians and other prescribers to view the archived webinar at their leisure, take the required test, and download their certificate.

The online program covers all eight topics required in the New York State statute. MSSNY developed the program with the NYS Office of Alcoholism and Substance Abuse Services (OASAS).  MSSNY is listed as an accrediting organization by the NYS DOH Bureau of Narcotic Enforcement.   Information on the three CME modules is available here.  Additional information or technical support may be obtained by contacting cme@mssny.org .
(CLANCY)

 DOH Attestation Process for Pain Management CME Must Be Completed by July 1, 2017
The New York State Department of Health has announced the attestation process for prescribers required to complete Pain Management CME. Prescribers must attest to the completion of the pain management, palliative care and addiction course work or training by July 1, 2017, and again every three years thereafter. The prescriber should only attest after completion of at least three hours of course work or training covering all eight topics. A prescriber with a Health Commerce System (HCS) account will attest online using the Narcotic Education Attestation Tracker (NEAT) application.  Complete the steps to access the NEAT (Narcotic Education Attestation Tracker) application in the NYS Health Commerce System (HCS):

  1. Log into the HCS
  2. Under “My Content” click on “All Applications”
  3. Click on “N”
  4. Scroll down to NEAT (Narcotic Education Attestation Tracker) and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.

Complete the steps to ATTEST to the completion of the education requirement.   A full set of instructions can be found here.

Prescribers that do not have access to a computer can request a paper attestation form by calling the Bureau of Narcotic Enforcement (BNE) toll-free at 1-866-811-7957. They may then complete the form and return it by mail to the address provided in the form. The Bureau of Narcotic Enforcement has also released a Frequently Asked Questions (FAQs) on the prescriber mandate.   A copy of the FAQs can be found here.

In certain limited circumstances, the New York State Department of Health may grant an exemption to the required course work or training to an individual prescriber who clearly demonstrates to the department that there is no need to complete such training.  Exemptions will be granted only in very limited circumstances, and not solely on the basis of economic hardship, technological limitations, prescribing volume, practice area, specialty, or board certification.  Prescribers may apply for an exemption through the Health Commerce System. Further information may be obtained by contacting BNE at 1-866-811-7957 or narcotic@health.ny.gov.             (CLANCY)

MSSNY & NYSDOH Podcast: Current Concepts in Concussion for Pediatric and Adult Patients
MSSNY’s Continuing Medical Education pre-recorded podcast on Current Concepts in Concussion for Pediatric and Adult Patients is now available on the MSSNY CME webpage for your participation. Listen in on a discussion between Dr. John Pugh, assistant professor of Neurology at Albany Medical Center and Dr. Deborah Light, Director of the Sports Medicine Fellowship at Albany Medical Center while they share their expertise on topics including identifying symptoms indicative of concussion, outlining appropriate management plans, and methods for primary and secondary prevention of concussion.  Click here to listen to the podcast and fulfill the requirements to receive a certificate awarding 1 hour of CME.                                                                                           (HARRING)


Paid Family Leave Benefits Begin in 2018; Payroll Deductions Begin in July 2017
All physician employers should be aware that, beginning January 1, 2018, their employees who have worked for 26 or more consecutive weeks (or part-time for at least 175 days) will be eligible for Paid Family Leave (PFL), as a result of legislation enacted last year as part of the 2016-17 State Budget. Employees will be eligible to receive up to 8 weeks of paid leave in 2018, with this amount going up to ten weeks in 2019 and 12 weeks in 2021.   Premiums for the PFL program are fully funded through employee payroll contributions.

Employees are eligible for PFL benefits for a) maternity or paternity leave for birth of a child, b) caring for a close relative with a serious health condition or c) when a spouse, child, domestic partner or parent of the employee is on active duty or has been notified of an impending call or order of active duty.

Employers may begin to withhold the weekly employee contribution beginning July 1, 2017, for the coverage that begins on January 1, 2018.

For more information from New York State about this new program: click here.  For additional online summaries about this new law, you can review (click here) and (click here).                                                             (AUSTER)

Encourage your patients to listen to MSSNY’s podcast: “What Patients Need to Know About Zika”
The Medical Society of the State of New York has produced an audio podcast entitled “What Patients Need to Know About Zika”.  This audio podcast is available to individuals free of charge and provides New York State patients with important information on the Zika virus.  Individuals may listen to the podcast here:

Developed by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response, the podcast has Dr. William Valenti, an infectious disease specialist, and Dr. Elizabeth Dufort, medical director, Division of Epidemiology, NYS Department of Health, discussing the Zika virus.  Topics covered in the podcast include general information about Zika, symptoms and treatment; sexual transmission; pregnancy risks; travel to countries where the virus is prevalent and prevention steps.

MSSNY Committee on Emergency Preparedness and Disaster/Terrorism Response has been developing educational programming on emergency preparedness for physicians and the health care community since 2001.  Partnering with the New York State Department of Health, MSSNY has conducted various educational webinars and online programs on topics ranging from Zika virus to pandemic flu.   Arthur Cooper, MD, MS is chair of the committee and Lorraine Giordano, MD is vice chair.   Physicians’ education is available on the MSSNY CME site at:  http://cme.mssny.org/

Additionally, MSSNY has also developed for physicians and health care providers an audio podcast discusses the epidemiology of Zika virus. It also provides information on disease transmittal, diagnosis and the measures that the New York State Department of Health has taken to guide and protect all New Yorkers.   This podcast is available here.
(HOFFMAN, CLANCY)


Register Now For The Next Medical Matters 2017 CME Webinar
The next “Medical Matters 2017” webinar is entitled “Mosquito Borne Diseases”.  On June 14, 2017, at 7:30am, MSSNY will present an update on Zika virus along with several other prominent mosquito-borne diseases.  Please register here.

William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

The educational objectives for this live webinar are: 1) Identify the most prominent mosquito borne diseases, including chikungunya, dengue, West Nile virus, yellow fever and zika.  2)  Describe the epidemiology of mosquito borne diseases.  3)  Review modes of transmission and methods of prevention of infection.

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.                                                    (CLANCY, HOFFMAN)

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

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New Medicare Cards Will No Longer Contain Social Security Numbers
CMS is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019.

Health care professionals and beneficiaries will both be able to use secure look up tools that will support quick access to MBIs when they need them. There will also be a 21-month transition period where providers will be able to use either the MBI or the HICN further easing the transition.

CMS will assign all Medicare beneficiaries a new, unique MBI number which will contain a combination of numbers and uppercase letters. Issuance of the new MBI will not change the benefits a Medicare beneficiary receives.

CMS has a website dedicated to the Social Security Removal Initiative (SSNRI) where providers can find the latest information and sign-up for newsletters. CMS is also planning regular calls as a way to share updates and answer provider questions before and after new cards are mailed beginning in April 2018.

For more information, please visit here.


New Powerful Mobile ePrescribing App Available to MSSNY Members

The Medical Society of the State of New York (MSSNY) has partnered with DrFirst to offer MSSNY members a free one-year license of DrFirst’s  new mobile e-prescribing app, iPrescribe®.Optimized for mobile experiences on small screens, iPrescribe brings you the full power of e-prescribing in an intuitive interface that allows you to e-prescribe from anywhere.

  • Faster e-prescribing
    Prescribe legend drugs and controlled substances with just a few taps on your phone.
  • Smarter e-prescribing
    Access patients’ health insurance formulary and co-pay costs as you e-prescribe.
  • Safer e-prescribing
    Receive clinical alerts and consult the most robust medication history available in the industry.
  • Better e-prescribing
    Exchange secure messages with patients and your care team.

Sign up here by July 31st to receive a one-year free trial for iPrescribe. Enter MSSNY when prompted for a promo code. As part of this special offer for MSSNY members, DrFirst is waiving all costs associated with ID proofing and the cost of obtaining the two-factor authentication token required for controlled substance prescribing (EPCS). As an additional courtesy to MSSNY members, DrFirst will also facilitate the upload of patient data into the app.
To learn more about this limited-time offer visit our iPrescribe page.


NYS DOH Launches “Provider & Health Plan Look Up:” Check ASAP for Errors
The New York State Department of Health, together with the NY State of Health, this week announced the launch of the NYS Provider & Health Plan Look-Up, an online tool that consumers can use to research those health insurance plans with which a physician (and other health care practitioners) participates. It also lists practice locations for each physician.  Previously, a consumer would have to go to the website of each health insurance company to determine if a physician participated with a particular plan. 
Physicians should take the opportunity to go to the website to see with which health plans they are listed to participate to determine if there are inaccuracies in their listings.

According to a recent MSSNY survey, over 50% of responding physicians indicated that they were inappropriately listed as a participating provider on a health insurer’s website.  One physicians who contacted us reported that he as listed as having 167 practice locations! The most efficient way to report an error is for the physician or someone on his or her behalf to select the Contact Us button on the website. Then select the health plan and the reason for the contact. The issue will be routed electronically to the DOH and to the selected health plan(s) for review and follow-up.

This newly created DOH website is strictly limited to those physicians who have contracts to participate in a health plan’s network. If you participate in ONLY traditional fee for service Medicare/Medicaid or only in academia, this website is not for you! If you cannot locate your name on your initial search, please be sure to enter the county where you practice.

NY’s Medical Marijuana Program: Free Webinar June 20th, 2017 12-1pm
What all healthcare providers should know!

Please join the Garfunkel Wild law firm for a complimentary webinar and hear from two former high-ranking New York Department of Health (NYDOH) attorneys James E. Dering, former NYSDOH General Counsel and Sandra M. Jensen, former NYSDOH Acting Director of Bureau of House Counsel, both of whom who were involved with the implementation of the Medical Marijuana program.

With the growth and expansion of New York’s Medical Marijuana Program, its highly regulated nature, and recent changes to the program’s regulations, it is important for all healthcare providers to have an understanding of how the program works and its restrictions. This is important not only for practitioners who are considering registering with the program but those already registered so that they are aware of restrictions and rules on resident or patient use – – including new regulations with provisions specific to hospitals. Space is limited. Register here:


More Deaths from Alzheimer’s and More Occurring at HomeU.S. death rates from Alzheimer’s disease rose by about 55 percent between 1999 and 2014—with a growing percentage of such deaths occurring at home, according to a CDC report released last week. CDC said Alzheimer’s is the sixth leading cause of death in the United States, accounting for 3.6 percent of all deaths in 2014.

Medicaid Questions

    1. How do I reactivate Medicaid billing? Should I if I’m not doing Medicaid billing? 

Visit https://www.emedny.org/info/ProviderEnrollment/ If you are going to write scripts for a traditional fee-for-service Medicaid recipient or refer them for labs or x-rays, you need to have a Medicaid fee-for-service provider number so that you can Order & Refer.  Please understand that the pharmacy, lab, radiologist, etc. lists your number on their claim submission to Medicaid to show that their service was Ordered or Referred by you.  If your number is not active/valid, they will not get paid.

  1.    Do I need it for all of my Medicaid managed care billing?
    With Medicaid Managed Care (MMC), you are enrolled/contracted with a specific MMC plan(s).  Based on your enrollment/contract with that plan, you would have the plan’s active provider number.  So this would not affect those contract(s)/plan(s).


New Quality Payment Program Resources Available – and New Site Look
CMS has recently revamped the look of the Quality Payment Program website, and also posted new resources to help clinicians successfully participate in the first year of the Quality Payment Program.CMS encourages clinicians to visit the website to review the following new resources:

Note: Final approval of these organizations is dependent on satisfactory completion of CMS training and submission of a Quality Assurance Plan. A final list of the CAHPS for MIPS Survey vendors approved by CMS to administer the 2017 survey will be made publicly available this summer.

  • Medicare Shared Savings Program and Quality Payment Program Fact Sheet: Explains how the Shared Savings Program and the Quality Payment Program align reporting requirements for participating Accountable Care Organizations (ACOs) and MIPS clinicians, and how certain tracks in Shared Savings Program ACOs meet Advanced Alternative Payment Model (APM) criteria under the Quality Payment Program.
  • MIPS APM Fact Sheet: Provides an overview of a specific type of APM, called a “MIPS APM,” and the special APM scoring standard used for those in MIPS APMs.


CMA Hosting June 15 5PM Webinar to Avoid Payment Adjustments under QPP
CMS will be hosting a webinar on June 15th at 5pm to provide an overview of some of the upcoming deadlines practices are facing to avoid payment adjustments under QPP and other CMS payment programs, and to provide an overview of the CMS-funded technical assistance available to assist them in successfully participating in QPP and in transforming their practices.  As you know, those practices that are successful can receive significantly higher reimbursement from CMS in the future, but many clinicians still have questions and concerns about this program, and are unsure where to go for help.

The webinar will include CMS grantees and contractors that are funded to assist clinicians with QPP, and we will be sharing information about other available resources. The link for the webinar and dial-in information will be emailed to those who register a few days before the call.

https://www.eventbrite.com/e/macra-quality-payment-program-deadlines-and-resources-in-new-york-tickets-35012449178

For More Information

To get the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center can also be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.

What is the Status of the New CMS Primary Care Payment Initiative?
Last summer, the CMS announced a new initiative intended to improve payment for primary care. The program, called “Comprehensive Primary Care Plus” (“CPC+”), was begun in 14 regions, including 11 whole states. In this area, it included all of New Jersey,
the North Hudson Valley in New York
and the Greater Philadelphia area in Pennsylvania.

These areas were selected on the basis of density and interest shown by providers and payers. Under CPC+, providers are to be paid a monthly fee for primary care visits.
The new markets to be added include the Greater Buffalo Region in New York, encompassing Erie and Niagara Counties
, as well as Louisiana, Nebraska and North Dakota. No reasons have been given for the apparent lack of interest in this initiative, which resulted in it being rolled out in fewer new markets than anticipated. The four new markets for the initiative, to begin in January, 2018.

The initiative is intended to improve outcomes and lower costs. The initiative has two tracks – under track one, providers receive a monthly fee for specific services, in addition to fee-for-service payments. Under track two, providers will receive an upfront monthly care management fee and reduced fee for service payments.

This is intended to allow providers to offer care outside of traditional face to face encounters. Depending upon the volume of patients, providers could potentially earn an additional $100,000 to $250,000 per year under the model. The model was supposed to launch in up to 20 regions, but CMS saw less interest than was expected, and this pattern has held when the program was recently expanded.

CMS does have a number of events coming up that might be of interest; dates, times and registration information can be found here: https://innovation.cms.gov/Files/x/cpcplus-calendarevents.pdf

CMS also has two short videos that provide helpful information about the model:

CMS has stated that if any of the organizations would like to talk directly about the model, they would be happy to set up some time.  Please let me know if you would like to arrange a meeting/talk with some CMS subject matter experts. I, Regina McNally, can reached by email at rmcnally@mssny.org or call me 516-488-6100 ext. 332.

Weekly Charting Tip:

What can be the cause of a False Claim Act being filed against you by the Federal Government?

  • Up-coding procedures
  • Unbundling procedures
  • Filing multiple claims for the same procedure
  • Billing for medically unnecessary procedures
  • Violating the Anti-Kickback Statute
  • Putting down the incorrect place where the service was rendered
  • Putting down the incorrect health care provider that claimed to have rendered the services
  • Oh yes, and a disgruntled former employee to call the government so that he or she can claim a piece of the action!

Be forewarned.

Until next week, Larry Kobak, Partner, Kern Augustine, PC questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.



CLASSIFIEDS


Manhasset Suite
Medical Suite to share- located at 1201 Northern Blvd, Manhasset. The medical space includes 4 exam rooms and consultation rooms. Direct access to office-  NO STEPS. Conveniently located between St.Francis Hospital and NS/LIJ Hospitals. For more information, please call 516-365-4616 or email RSwe777@aol.com

Medical Practice for Sale in Upscale Westchester Community
Successful well established (1984) and actively growing Internal Medicine/ Primary Care Practice conveniently located only 45 minutes from midtown Manhattan. Great Opportunity for established physician to expand his patient base or for entrepreneurial new graduate.  Lease assignable with option to renew.

Facilities / Business Details

Well known Professional Building with convenient free parking; ground/first floor location, handicap accessible. Contemporary office recently built and painted. Two large exam rooms; one consultation room/doctor’s office, lab, spacious receptionist area and large waiting room. As an independent practice, it provides an extremely appealing option for the patient that does not want to go to a huge impersonal multi-specialty group. Approximately 80% commercial payers; 20% Medicare. Doctor retiring but willing to stay on to introduce new physician to patients and assist in transition.

Asking Price: 
$175,000

Contact: rpcdb51@yahoo.com


Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
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

Physician Opportunities


Paging Primary Care MDs Who Love Technology
98point6 is a Seattle startup who wants your input. We’re seeking practicing physicians to join our council and help shape the next generation of primary care. If the fusion of health care and technology inspires you, please apply here.


Ophthalmologist Part Time
Ophthalmologist needed to work at multiple nursing homes in all 5 boros except Staten Island. Part time or full-time position available.  Generous salary and incentives.Ttech provided. Opportunity to perform surgery, but not required. Please email cv to privacyssw@gmail.com


Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training. OSH focuses on child health, asthma prevention, obesity and nutrition, vision screening, dental care, mental health, reproductive health, and childhood disability. We collaborate with various city and community based agencies to provide social and academic services to address the needs of all New York City school children, especially those facing the most significant social, economic, and health challenges.

The Office of School Health is currently undergoing expansion. There is an immediate need for physicians with an expertise in pediatric, adolescent, or family medicine, with the capacity to utilize primary care skills set through a public health lens. OSH is also  interested in public health and preventive medicine graduates with programmatic, analytic, and social medicine skills.

The NYC DOHMH is reaching out to identify candidates for this recruitment. We are enlisting your help to nominate medical professionals who are committed to contributing their talents to improve health and academic outcomes in our schools. Please consider applying for these positions or passing these opportunities on to talented physicians among your own personal networks.

Attached are the American Academy of Pediatrics position statements on the role of the School Physician as well as the job description and recruitment flyers:

  • Adolescent School Health Physician, Family and Child Health/SH Reproductive/City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 277208
  • Field Doctor, Bureau of School Health/SH Medical (pre-K-8 Programs or High School) City Medical Specialist, Level: 01/Part-time/Flexible Work Schedule (20-35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to:https://a127-jobs.nyc.gov/ In the Job ID search bar enter: Job ID: 265869
  • Supervising Medical Doctor,Bureau of School Health/SH Reproductive Health, City Medical Specialist, Level: 02/Part-time (35 hrs/week) To learn more about this position & apply, please submit your resume & cover letter to: https://a127-jobs.nyc.gov/ Job ID:  277026

Please list in your cover letter how you heard about this position (including name of the professional association, website, or individual who referred you). If you have questions, please contact Caroline Volel, MD, MPH at OSH@health.nyc.gov.


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