Dr. Malcolm Reid
June 3, 2016
It seems that every day we read or hear about another opioid related death. In fact, more than 78 people die each day due to opioid misuse and overdose, including heroin. Many of these individuals are our patients. As physicians, we can—and must—help to end the opioid abuse epidemic.
The Governor and New York State Legislature are currently discussing and negotiating an Opioid Prevention Package that will likely be voted on before the end of session. This comprehensive package includes provisions to require coverage for inpatient treatment for substance abuse for a period of time and eliminating utilization review and prior authorization requirements that has served as obstacles for necessary treatment to combat substance abuse. The proposal also would establish specific day limitations on the amount of Schedule II and Schedule III prescriptions for acute pain; a requirement that all prescribers of schedule II, III or IV controlled substances counsel and make available information relating to the risk of addiction and a requirement for all prescribers to take a 3 hour course on pain management, addiction, palliative and end of life care which will be tied to licensure. The MSSNY Council and its leadership, along with our Division of Governmental Affairs, are responding to these proposals.
At the recent MSSNY Council meeting, the Council supported two very important proposals to address the opioid issue. MSSNY supports legislation to allow patients to have access to Medication Assisted Therapy (MAT) and psychosocial strategies for substance use disorders covered by insurance including services provided in the primary care setting. MSSNY also continues to support insurance coverage for inpatient substance use treatment and increasing funding for more available treatment beds.
MSSNY Council also supported federal legislation to allow “partial fill” of Schedule II Controlled Substance medications. Partial fills for Schedule II controlled substances are currently prohibited under the Drug Enforcement Agency’s (DEA) regulation. This bill, part of the Congressional opioid discussion, would allow physicians/prescribers, in consultation with their patient, to prescribe up to a 30 day supply of Controlled Schedule II with a notation to the pharmacist that he/she should only dispense the agreed to amount. The DEA allows partial fill for Controlled III and IV.
Since 2014, MSSNY has been an active participant of the American Medical Association’s Task Force to Reduce Opioid Abuse. The task force, comprised of over 25 states, specialty and other health care associations was formed in an effort to reduce the nation’s burden from the inappropriate prescribing of opioids, and the growing crisis of heroin overdose and death.
One of the goals of the task force is to increase physicians’ registration and use of effective prescription monitoring programs (PMP). Here, in New York State, physicians who wish to prescribe a Schedule II, III or IV controlled substance are required to consult the PMP—and since the implementation of this requirement, doctor shopping has been reduced by over 85% and prescriptions for opioids are down!
And, every state in the country saw a decrease in the number of opioid analgesic prescriptions filled in 2015 according to new data from IMS Health. This information, which reflects the activity of physicians and other healthcare professionals, shows that nationally, there was a 6.8 percent decrease in the total number of prescriptions for opioid analgesics in 2015 compared to 2014. For New York State, there has been a 10.5% reduction in opioid analgesics prescriptions since 2013!
We should be very proud of our collective efforts to reduce “doctor-shopping.”
MSSNY has, and will continue to support expanded access to naloxone through New York State’s Opioid Prevention Program. As a result, 3,500 overdose reversals have been documented, and over 1,500 lives were saved in 2015.
Another goal of the task force is to enhance physicians’ education on effective, evidence-based prescribing. This year, The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, jointly provided a free, four part webinar series on Opioid Use, Treatment, and Addiction. This program is now available on line here.
MSSNY has also developed and placed on its website information on best practices, physicians’ resources and educational programs that are currently available to physicians. Please click this link.
Let me be clear—78 patients dying EVERY DAY from this epidemic is unacceptable. This is not a problem that physicians created; but physicians are needed to effectuate the remedy. And while we have concerns regarding some of the proposals under consideration, we stand ready to participate in negotiations to assure that patients can continue to have access to medically indicated treatment for acute and chronic pain. This will likely mean that we—both the prescriber and the patient—will need to be better educated as to appropriate pain management for all patients including those with addiction so that we can arrest the wide ranging and persistent scourge affecting our patients throughout New York and across the nation. MSSNY is committed to assisting the state and, indeed, the nation in ending the opioid misuse and overdose epidemic.
We will need every physician in this state to do his/her part in this effort!
Malcolm Reid, MD, MPP
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Governor Advances Draft Legislation to Curb Opioid Epidemic
Governor Cuomo, fresh from a listening tour that has transpired across all communities through the state, has advanced draft legislation that would address issues that have arisen in New York communities with regard to the burgeoning epidemic of opioid abuse and addiction. Based upon MSSNY’s conversations with the Legislature, the draft proposal would attempt to attack the problem comprehensively by proposing the following:
- Establishment of insurance law changes that enhance coverage for substance abuse diagnosis and treatment opportunities and reduce obstacles such as utilization review and prior authorization requirements that insurers impose to restrict access to medically necessary substance abuse treatment, including: (1) a requirement to use the OASAS clinical review tool in making UR decisions; required coverage for at least fourteen days of inpatient care for diagnosis and treatment of substance abuse; and elimination of prior authorization for buprenorphine;
- Attacking the problem in our schools by requiring teachers to take continuing education on drug addiction and response; requiring students to receive education on heroin and opioid abuse; requiring the establishment of recovery high schools; and requiring substance abuse free living beds in colleges;
- Establishing a seven day limit on the initial prescription of opioids for acute pain (that does not include chronic pain, cancer pain, pain that is addressed by palliative care practices or pain that is a normal consequence of a surgery that is performs on an inpatient basis) and
- Establishing a requirement that all prescribers (physicians, physician assistants, nurse practitioners, nurse midwives and podiatrists) complete a three hour continuing education course before each re-registration on pain management, addiction and palliative care; and
- Establishing a requirement that prescribers of any schedule II, III or IVcontrolled substance offer counseling and make available information relating to the risk of addiction and available local resources for addiction and have a patient sign a form acknowledging that he or she has been offered consultation related to the prevention, mitigation and treatment of such addiction.
MSSNY lobby staff met this week with the Lieutenant Governor and Commissioner of Health to discuss the perspective of organized medicine on these issues. MSSNY lobby staff has also met with members of the Senate and Assembly and is working toward addressing many of the concerns raised by MSSNY leadership concerning these proposals. (DEARS, CLANCY, AUSTER)
Do Not Wait – Contact Your Legislators to Prevent Legislation to Increase Lawsuits and Liability Premiums
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) under consideration that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule. A letter to your Senator and Assemblymember can be sent from here.
There are just two weeks left in the legislative session, and anything can happen. In light of the huge financial pressures already facing physicians prompted by excessive government mandates, reduction in insurer payments and networks, and rapidly rising patient cost-sharing responsibilities, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients.
In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers. MSSNY together with numerous other specialty medical societies have joined GNYHA and HANYS in an print and radio ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature. The print ads (http://www.nymedmalreform.org/) have appeared in City & State, Politico New York, and the Albany Times-Union. Moreover, MSSNY’s concerns about the impact of this legislation on New York’s fragile health care system were documented extensively in an AP article this week. (AUSTER, DEARS)
Legislation to Enable Physician Override of Insurer “Fail First” Medication Protocols Moving
With just 7 schedule Session days remaining in the 2016 Legislative Session, physicians are urged to send a letter in support of legislation (A.2834-C, Titone and S.3419-B, Young) to articulate a process for physicians to request and be granted an override of an insurer medication step therapy protocol when it is in the best interest of their patients’ health. MSSNY has been working with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers in support of this legislation.
This week, A.2834-C was overwhelmingly advanced from the Assembly Insurance Committee to the Rules Committee. The bill has been substantially modified from earlier versions to more clearly delineate the circumstances when an override must be granted, and the time frames within which a health insurer must grant such override request.
Specifically, a health insurer would be required to grant a physician’s override request if one of the following factors are present: 1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; 2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; 3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; 4) the patient is stable on the medication requested by the physician; 5) the medication is not in the best interests of the patient’s health. While the legislation would generally require the health insurer to make its decision within 3 days of the override request of the physician, the insurer would be required to grant the override request within 24 hours of the request if the patient has a medical condition that places the health of such patient in serious jeopardy if they do not receive the requested medication. Perhaps most importantly, if the physician’s request for an override is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal. Similar legislation S.3419-B is currently before the Senate Insurance Committee.
Last week, MSSNY representatives joined representatives of many other physician and patient advocacy groups in a press conference and lobby day in support of this critically needed legislation. The activities generated significant press activity regarding this legislation, including articles in the Albany Times Union, Politico New York, CBS 6 Albany, and Time Warner Cable News.
Legislation to Reduce E-Prescribing Exception Reporting Passes the Assembly
Legislation (A.9335-B, Gottfried) overwhelmingly passed the Assembly this week by a 132-2 vote to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing. Identical legislation (S.6779-B, Hannon) is before the full Senate and poised for passage.
In March, the Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because: their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription. DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription.
This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions. In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state. In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.
A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions. It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing requirements went into effect, do not require reporting to the DOH. The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply. Please urge your Senators to pass this bill by sending a letter located on the MSSNY grassroots action center.
(DEARS, CLANCY, AUSTER)
Bill to Limit Pain Medication Will Be Voted on By Assembly Codes Committee; Physicians Urged to Act
S6091-B/A.8601-A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald, will be voted on by members of the Assembly Codes Committee, next week. The bill would limit the initial prescription by a physician or other prescriber of Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain. While the bill was originally to be considered by the Committee this week, the meeting was postponed until next week. MSSNY strongly opposes this legislation.
Physician action is needed to prevent this bill from becoming law. Physicians are urged to call their state Assembly members today and indicate opposition to this measure.
Assemblymembers can be found here. Members of the Assembly Codes Committee are listed here.
Physicians can also send a letter to their members by logging onto MSSNY’s Grass Roots Action Center.
This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient by imposing an arbitrary standard not developed by any medical authority. Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine. A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.
The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address a patient’s medical condition. Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.
(CLANCY, DEARS, AUSTER, MCPARTLON)
Senate Finance Committee to Consider Collective Negotiation Legislation
The Senate Finance Committee will consider legislation (S.1157-A, Hannon) next week that would permit independently practicing physicians to collectively negotiate patient care contract provisions with health insurance companies under close state supervision. The bill had been favorably reported to the Finance Committee from the Health Committee earlier this year. MSSNY strongly supports this legislation as a means to enable patients and physicians to be able to negotiate fairly with those health insurance companies that have huge market power dominance in many regions across New York State. It is more important than ever given the push on insurers to impose often untested value-based payment strategies. Identical legislation (A.336-A, Gottfried) recently advanced from the Assembly Health Committee to Assembly Ways & Means Committee. All physicians are urged to contact their Senators and Assemblymembers to urge support for this legislation. A letter can be sent from MSSNY’s Grassroots Action Center here. (AUSTER, DEARS)
DOH Provides Certification Process For Low Volume Prescribers to Receive One Year Exemption From E-Prescribing Requirment
The New York State Department of Health has announced its certification procedures for prescribers who write less than 25 prescriptions a year. This process will enable prescribers to write paper prescriptions rather the e-prescriptions.
The Medical Society of the State of New York secured this provision within the 2016-17 New York State Budget and the certification process can either be done electronically or by paper application. Prescriptions in both oral and written form for both controlled substances and non-controlled substances are included in determining whether the practitioner will reach the limit of twenty-five prescriptions. A certification is valid for one year. Should the practitioner exceed twenty-five prescriptions within the twelve-month period, he or she is required to issue prescriptions electronically or obtain from the Department a waiver from the requirement to electronically prescribe.
Certifications postmarked or submitted to the Department by July 1, 2016, may be specified to begin as of March 27, 2016. Such certifications remain valid through March 26, 2017.
Instructions for filing a certification through the Health Commerce System (HCS) can be found here.
The paper certification form can be found here and can be either emailed, mailed or faxed back to the NYS DOH Bureau of Narcotic Enforcement.
ZIKA CME Webinar to Be Held June 8 at 6 P.M.; Physician Registration Now Open
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the “Zika Virus: An Evolving Story–UPDATE” on Wednesday June 8th at 6 p.m. Registration for this program is now open here. Click on the upcoming tab and select the programs.
MSSNY conducted the original program in March 2016, but this program will provide updates to the ever changing story of Zika. The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection; 2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection. 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 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 contacting Melissa Hoffman at firstname.lastname@example.org.
MSSNY Participates in New York Kicks Butts Campaign
The Medical Society of the State of New York has joined with the American Cancer Society, the American Lung Association, and Tobacco Free Kids and a variety of other affiliated health organizations and businesses to encourage New York City residents to quit smoking. The New York Kick Butts campaign is being held this week, and New York City physicians are asked to discuss with patients smoking cessation treatment options. By offering medication and counseling, physicians can help patients to double their quit rates.
Helpful tools can be found on line at PlanMyQuit.com/NYC or by calling the New York State Smokers’ Quit line at 1-866-NY-QUITS (697-8487) or by just dialing 311. Additional resources can also be found at NYSmokeFree.com. Physicians can find an information flyer here.
Patient information here.
For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:
BNE: Low Prescribers Do Not Have to Issue Scripts Electronically
The Bureau of Narcotic Enforcement (BNE) announced that the process for a practitioner to certify that he or she will not issue more than twenty-five prescriptions during a twelve-month period is now available. A practitioner submitting a certification will not be required to issue prescriptions electronically.
A practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System or by submitting a paper certification form to BNE.
Below is a list of Frequently Asked Questions (FAQ’s) related to “Certifications” that will be included in the Electronic Prescribing FAQ document on our website.
—VP Socio-Med Regina McNally
Q: How does a practitioner certify that he or she will not issue more than 25 prescriptions during a twelve-month period?
A: A practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System or by submitting Certification form, DOH-5221, to the Bureau of Narcotic Enforcement.
Complete the steps below to submit a certification online in HCS:
- Log into the HCS here
- Under “My Content” click on “All Applications”
- Click on “E”
- Scroll down to Electronic Prescribing Waivers 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.
- Select the practitioner name from the list. If the name appears more than once, select the option that starts with the profession (i.e., Medicine-###### Doe John).
- Provide contact information for the person who should be contacted regarding the Certification.
- Click on “Submit Certification”
- Enter in the “Begin Date” of the twelve-month certification period.
- Enter in the Mailing Address of the practitioner submitting the certification.
- Click “Submit”
- Click “Certify”
- You will be returned to the “Waiver Requests and Certifications Summary” screen. The certification period will be displayed.
Q: Can a practitioner submit a certification with an effective date prior to the date of submission?
A: During the first year of the certification process, certifications postmarked or submitted to the Department by July 1, 2016, may specify a begin date as early as March 27, 2016. Certifications submitted to the Department after July 1, 2016, cannot be backdated.
Q: Can a practitioner submit a certification with a future effective date?
A: Yes, up to 3 months in the future.
Q: Does the 25 count script limit include all prescriptions?
A: Prescriptions in both oral and written form for both controlled and non-controlled substances must be included in determining whether the practitioner will reach the limit of twenty-five prescriptions.
Q: What should a practitioner do if he or she exceeds twenty-five prescriptions within the twelve-month certification period?
A: The practitioner is required to issue prescriptions electronically or obtain a waiver from the requirement to electronically prescribe. Please see information related to electronic prescribing waivers here.
Q: Does my certification need to be approved?
A: There is no review and approval process for certifications.
Q: Who can submit the certification for a practitioner?
A: Each individual practitioner must certify independently. A hospital or group practice organization cannot submit a certification on behalf of the practitioner.
Q: How long is the certification valid?
A: A certification is valid for one year from the begin date.
Q: Does a practitioner need to submit a certification each year?
A: Yes. A practitioner must recertify each year.
Q: Can a practitioner submit a certification for a period that begins prior to the end date of its current certification period?
A: No. The certification periods can’t overlap. The begin date of a new certification period must be after the end date of the previous certification.
Q: Does a practitioner who already has an approved waiver from the requirement to electronically prescribe also need to submit a certification?
A: No. The practitioner is covered by the waiver until March 26, 2017.
Q: Does a practitioner who issues less than 25 prescriptions per year and already has an approved waiver from the requirement to electronically prescribe also need to submit a certification?
A: No. The practitioner is covered by the waiver until March 26, 2017.
Fidelis: Pain Management Provider Access Crisis in Erie County, NY:
On 5/18/2016 MSSNY contacted CMS regarding a crisis in Erie Co concerning access to pain management providers as alerted by members of Fidelis (The New York State Catholic Health Plan). After learning that Dr. Eugene Gosy, a participating pain management provider, was indicted on 114 counts by the United States’ Attorney for the Western District, Fidelis suspended this provider who operated a large pain management practice. Concurrently, and perhaps unrelated, another large pain management practice has closed, leaving large numbers of patients in Erie Co. without access to pain management services. On 5/24/2016 Fidelis advised CMS that it is actively recruiting providers to fill this gap. However, since some may not meet credentialing standards, Fidelis is allowing its members to receive care out of network. In addition it is working with local anesthesiologists to contract with them, as they would be qualified.
CMS Baltimore has been apprised of the situation and the Account Manager was advised that since pain management is not a specialty subject to time and distance standards, this case would not justify running the network through the Network Management Module (NMM) for a review. However, we can address the issue from the perspective of accuracy of provider directories and closely monitor the plan’s progress in providing appropriate provider access.
Before this incident came to light, Fidelis had already been subject to a review of its online provider directory by CMS Baltimore. Since this issue is not limited to Fidelis, other Account Managers who have plans with service areas in Erie County have been notified to review with their plans. (Socio-Med VP Regina McNally)
Council approved the following:
- MSSNY will support development of a comprehensive stroke system within New York State and will support development of either statewide or regional stroke protocols for New York State’s EMS agencies.
- MSSNY will support the New York State Pathology Association’s efforts in seeking a repeal of the New York State regulation that prohibits pathologists from speaking directly to patients about test results.
- MSSNY will support legislation/regulations allowing partial fill of Schedule II Controlled Substance medications similar to partial prescription fills permitted under regulations for Schedule III and IV medications.
- MSSNY will support legislation/regulation to allow access to Medication Assisted Therapy and psychosocial strategies for substance use disorders and that insurance companies be required to provide coverage for these programs including in the primary care non-psychiatric non –addiction specialist setting.
- MSSNY Task Force on Physician Stress and Burnout will continue in its efforts to promote wellness efforts as a way of prevention of the consequences of burnout. Next steps will include assigning a subcommittee to review survey options; outreach to liability companies to discuss partnering options; and outreach to NYS resident education leadership regarding opportunities for collaboration.
- The 2016 House of Delegates Resolutions that were referred to Council by the HOD were approved to go back to committees for further discussion. The resolutions will then be brought back to Council.
NY Law: Can Register as Organ Donors When Buying Insurance through Exchange
On June 1, Gov. Andrew Cuomo signed a bill into law that will require the state’s health insurance exchange to “ask anyone signing up for coverage…if they’d like to register as [an organ] donor.” The article points out that the state has the second lowest organ donation participation rate in the US. Currently, only one in four eligible New Yorkers is registered. That’s the second lowest participation rate in the nation. The law’s sponsor, Sen. Kemp Hannon, says nearly 10,000 people in the state are now on a waiting list for available organs or tissue. AP (5/26)
United Healthcare Will Offer Exchange Plans in Only Three States
On May 31, UnitedHealthcare disclosed on a website dedicated to insurance brokers that it plans to offer on-exchange plans in only three states — New York, Nevada, and Virginia. A company spokeswoman confirmed that it will withdraw from the Illinois exchange.
Preliminary CDC Report: Long Decline In US Death Rates Has Reversed Course
The Centers for Disease Control and Prevention reports preliminary numbers indicate that “the long decline in Americans’ death rates has reversed course.” Factors contributing to the “turnaround” include “a rise in deaths from firearms, drug overdoses, accidental injuries, suicides, Alzheimer’s disease, hypertension and stroke.” Still, “‘there’s no smoking gun here,’ said Farida Ahmad, mortality surveillance lead for the CDC’s National Center for Health Statistics.” Ahmad called “the increase in mortality ‘unusual,’ noting that it’s the first time since 2004-2005 that the rate went up rather than down.”
First-Ever Addiction Implant
FDA last week approved a first-of-its-kind implantable device that emits a drug used to treat opioid-related substance use disorders. The device over a six-month period releases buprenorphine, a medication used to treat opioid-related substance use disorders. Expanding the use and availability of medication-assisted treatment (MAT) options like buprenorphine is an important component of the FDA’s opioid action plan and one of three top priorities for the U.S. Department of Health and Human Services’ Opioid Initiative aimed at reducing prescription opioid and heroin related overdose, death and dependence.
Medical Office Space For Sale in Prime Bay Ridge Co-op Building
Bay Ridge, Brooklyn You will be sure to impress your patients with this move-in condition over 2500 square foot professional space in a prime Bay Ridge Coop Building. Office space has a separate private entrance. Low maintenance of $866.67 includes heat, water and real estate taxes. Currently set up as a medical office so little work to do. You have two reception areas; large waiting room; four large offices/exam rooms and plenty of extra work areas. The outer rooms have windows facing Shore Road. Easy to park and accessible by bus. Go to the link below to see the virtual tour of this great space. Asking $675,000.00.
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Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.
Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email firstname.lastname@example.org cell 914 772-5581
Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week. Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.
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Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.
The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.
Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services
Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.
New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=