MSSNY eNews: June 4, 2021 – Our Collective Voice Can Make a Crucial Difference
Our Collective Voice Can Make a Crucial Difference
As the end of the legislative session in Albany approaches next week, it’s more important than ever for physicians to be ready to take action through MSSNY’s Grassroots Advocacy Center. Our collective voice—the physicians of New York state—can make the crucial difference in influencing legislation that will impact physicians and our patients every day.
As we all know, anything can happen at the end of session. There are dozens of bills that MSSNY is closely following at the moment—some we support, but many more would make it much harder for physicians to deliver care to their patients. Bills that we thought were long dead could come back to life at any moment. Take liability issues, for example, which tend to appear at the end of session.
S.74-A/A.6770 would greatly expand the possible damages awardable in wrongful death actions, which, in turn, would increase already outrageously high liability insurance premiums. The bill has moved through various Committees in the Assembly and Senate. A recent actuarial estimate indicates that passage of this legislation could require a liability premium increase of nearly 50%, translating to tens of thousands of dollars in new costs for many physician practices. You can send a letter and/or tweet in opposition here.
This is just one of numerous bills where MSSNY is advocating for physicians and patients. Let’s all stand united and speak with one voice this week. Look for email alerts, tweets, and texts from MSSNY—and check our Grassroots Advocacy Center often.
MSSNY will keep you informed on the status of important legislative movement as we head into this critical final week.
Joseph Sellers, MD, FAAP, FACP
MSSNY & Patient Advocates Team Up to Pass Legislation S5299 (Rivera)/A1741 (Gottfried) to Prevent Harmful & Unfair Copay Accumulator Policies
As the Legislature enters the final week of the 2021 Legislative Session, physicians are urged to contact their Assemblymembers (End the Use of Copay Accumulators by Health Insurers) to request that they support legislation (A.1741, Gottfried) before the full Assembly that would ensure that third party financial assistance programs can count towards patient deductible and other health insurer-imposed cost-sharing requirements. The same-as bill (S.5299, Rivera) has passed the Senate.
Despite New York State’s strong record in providing affordable access to health insurance, many New Yorkers still struggle to pay for their prescription drugs and for those battling chronic illnesses like cancer, diabetes, multiple sclerosis, and others, the burden is often overwhelming. To help with high out-of-pocket costs, there are a range of copay assistance, discount, and coupon programs, that help patients pay for their medications. However, patients must also contend with what insurers refer to as “cost utilization tools”, which are used by health plans to curb spending on the more expensive drugs. These include prior authorization, step therapy and a more recent one known as “Copay Accumulators”, which prevents patients from using a copay card, or coupon, to cover their out-of-pocket expenses.
Copay Accumulators are particularly unfair to patients as any payment from a copay coupon or card goes directly to the health plan, but the amount of the support provided by the coupon/card does not count towards the patient’s maximum out of pocket limit. This unreasonable practice can be especially challenging for patients that have health insurance plans with high deductibles or high copayment requirements.
To end this policy, MSSNY together with several other patient advocacy organizations such as the American Cancer Society, New York State Bleeding Disorders Coalition and the National Multiple Sclerosis Society is pushing for passage of S5299 (Rivera)/A1741 (Gottfried). Please contact your state Assemblymember and urge them to support immediate passage of this important bill. (CARY)
Legislature Passes Multiple Health Insurer Reform Measures
The Senate and Assembly have passed multiple measures in the last few weeks to address concerns of patient and their health care providers in their dealings with health insurance plans.
Legislation (A.4668, People-Stokes/S.4111, Breslin) has passed the Assembly and Senate which would significantly limit the ability of health insurers to move medications to higher cost-sharing tiers for their prescription drug formularies during a policy year. The legislation has been revised from the version that passed both Houses 2 years ago, but vetoed by the Governor, to address concerns that had been raised in the veto message. In particular, the legislation now would prohibit the applicability of a mid-year formulary change to a patient who was on the medication at the beginning of the policy year, or suffers from a condition for which the medication is part of a treatment regimen for that condition. Other mid-year formulary changes could still occur.
Legislation (A.1677, Gottfried/S.2008, Jackson) has also passed the Assembly and Senate that would require health insurers to, within the time frames set forth under the Prompt Payment law, conspicuously state in large point type whether a claim or a bill has been partially approved or entirely denied. (AUSTER)
Please Urge Your Legislators to Reject Legislation That Would Drive Huge New Increases in Medical Liability Insurance
As we enter the final week of the 2021 Legislative Session. physicians are urged to continue to contact their legislators to request them to reject extraordinarily ill-timed legislation that could prompt untenable increases in New York’s already excessive medical liability costs by greatly expanding the types of damages awardable in wrongful death actions A letter and/or tweet can be sent from here: Reject Expansion of Recoverable Damages in Wrongful Death Actions.
This week the Assembly legislation (A.6770) advanced from the Codes Committee to the Rules Committee and the Senate legislation (S.74-A) has advanced from the Senate Judiciary Committee to the Senate Finance Committee. It could be reported to the floor and voted on at any time, so your contacts are essential!
Please remind your legislators of the severe adverse impact to patient care availability in their communities this legislation would cause, given that New York physicians and hospitals already face the highest medical liability costs in the country, by far. One recent actuarial estimate indicated that passage of legislation such as this could require a liability premium increase of nearly 50%, which translates to tens of thousands of dollars in new costs for many physicians who are already paying tens to hundreds of thousands of dollars per year in their insurance costs, which could make it impossible for many physicians to stay in practice.
Under ordinary circumstances, these kinds of increases would be unsustainable and could have hugely negative consequences on patient access to care at community hospitals and physician offices. However, with so many physician practices only beginning to recover from the huge drop in patient visits and revenue during the height of the pandemic, legislation to impose such premium increases would be unconscionable.
Please urge your legislators to reject this short-sighted proposal as well as highlighting the need for comprehensive medical liability reform instead: Reject Expansion of Recoverable Damages in Wrongful Death Actions (AUSTER)
Legislation to Require Consolidated Hospital/Physician Billing Significantly Revised
Legislation (A.3470-B/S.2521-B) which would have among many other components required hospitals and hospital-based physicians to submit consolidated bills has been significantly revised to delete this very concerning provision. This is a significant development, as MSSNY together with several other specialty societies had raised significant concerns to the Senate and Assembly that this joint billing requirement would have put non-employed physicians at the mercy of the hospitals where they practice since the legislation does not specify how payments to hospitals from this “single bill” would then be distributed to these physicians. MSSNY thanks the sponsors of this legislation for recognizing the concerns of the many physicians who took the time to send a letter or tweet regarding this far-reaching proposal.
In its place the legislation would now require notice to patients prior to hospitals, health systems and health care providers charging patients for so-called “facility fees”, including whether the patient’s health coverage will cover the facility fee (the bill specifically articulates that a “facility fee” is distinct from a “professional fee” a physician would ordinarily charge).
However, of concern with this new proposed language is a provision that would require a health care provider who enters into “a business relationship with a hospital or health system that will result in the provider’s patients being subject to facility fees”, to notify its patients of the change and that facility fees will now be applicable to services received from the health care provider. MSSNY has urged the sponsors that this required notice should be placed on the hospital or health system charging the facility fee, not the physician providing the service, as the facility fee is for the benefit of the health system. (AUSTER)
Opioid Measures Moving in the NYS Legislature
The New York State Senate passed several bills this week with the goal of addressing or reducing opioid abuse. Some of these measures are supported by MSSNY, but MSSNY has raised strong concerns with others.
- 649/A.2030, which requires the Medicaid program to cover whichever medication assisted therapy (MAT) medication is most beneficial to the patient without prior authorization, has passed the NY Senate and Assembly. Similar requirements exist for commercial health insurance plans. The Medical Society of the State of New York supported this measure.
- 2966-A/A.336-A, which requires co-prescribing of naloxone in certain instances has passed the NY Senate and Assembly. This bill requires physicians and providers, for the first opioid prescription of each year to a patient receiving 90 MME or more, to also co-prescribe an opioid antagonist with the prescription. Importantly, the bill was amended prior to passage to increase the threshold from 50 MME to 90 MME, to be applicable to a far smaller cohort of patients who are more at risk for overdose. However, MSSNY has raised concerns that this even more limited proposed co-prescribing requirement could cause some patients taking these medications to address their chronic pain to inappropriately feel stigmatized as a “drug addict”. Moreover, many physicians are already co-prescribing an opioid antagonist to certain patients based upon the physician’s clinical judgment of the risks the patient may face. Furthermore, with New York’s mandatory e-prescribing law, the co-prescription will automatically go to the pharmacy and essentially remove the choice of the patient to have the co-prescription filled, as would be the case if such prescriptions were still on paper. Certainly, such a mandate could result in significant new cost-sharing responsibilities for patients and may result in a windfall for those manufacturers of the drug.
- 4640/A.273, has passed the NY Senate and is before the full Assembly. This measure requires that physicians and other prescribers before prescribing an opioid medication to a patient for neuromuscular pain to consider, discuss with the patient and refer or prescribe alternative services such as chiropractic, massage therapy or behavioral therapy. It would not apply in situations where the patient is in hospice, is being treated for cancer, recovering from surgery, or a medical emergency. MSSNY has raised concerns that this legislation is repetitive of existing state law that requires physicians and other prescribers to use the CDC Guideline for Chronic Pain when assessing patients for opioid use. These guidelines already direct prescribers to discuss benefits and risks and the availability of non-opioid therapies with the patient. MSSNY has raised concerns that, by listing of so many possible alternatives in the legislation, it could potentially create significant new documentation requirements to demonstrate that a physician has considered each of the enumerated suggested alternatives in the legislation to prove compliance with the legislation. By creating these additional unnecessary administrative burdens, it would further disincentivize physicians from prescribing needed pain control patients to those who truly need them. (CLANCY)
Please Urge Your Legislators to Protect Physician-Led Team Care
Legislation (S.3056-A) remains before the full Senate strongly opposed by MSSNY that could jeopardize patient safety and lead to uncoordinated, siloed care by eliminating any statutory requirements for nurse practitioners to maintain collaborative arrangements with a physician practicing in the same specialty. The legislation would also eliminate the requirement for a newly practicing nurse practitioner to maintain a written collaborative agreement with a physician. MSSNY has joined with a dozen other specialty societies in a letter to Senators raising strong objections to this bill.
Physicians can send a letter urging legislators to oppose this legislation from here: Protect Physician-Led Team Care for Patients. Please let your legislators know that NPs are an essential component of our healthcare delivery system but maintaining ongoing team-based care in collaboration with a physician is essential for ensuring patients receive the highest quality care. Instead of removing these requirements, MSSNY has argued that the standards for physician-NP collaboration should be strengthened to help better recognize and treat potentially complex cases.
Same-as legislation (A.1535-A) is in the Higher Education Committee. During the recently concluded State Budget, there was a provision enacted that extended for another year – until June 30, 2022 – the existing law that permits nurse practitioners with more than 3,600 hours of experience to practice without a written collaborative agreement provided they maintain evidence of “collaborative relationships” with a physician in the same specialty practiced by the NP. (AUSTER)
Legislation to Allow Pharmacists to Provide All ACIP-Approved Immunizations Passes NYS Legislature
Legislation (S.4807A, Stavisky/ A. 6476A, Hyndman) that would allow pharmacists to administer immunizations that have been recommended by the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention, has passed the New York State Legislature. While we appreciate the increasing role that pharmacists can play in broadening patients’ ability to receive necessary protective vaccines, MSSNY has raised concerns that not only would it greatly expand the number of vaccines that pharmacists would be allowed to administer to adults it would also remove the discretion of the State Legislature in the future to add or subtract vaccinations to the list of those that can be administered by a pharmacist.
It should be noted that the legislation was amended prior to passage to require the Commissioners of Health and Education to approve additional immunizations that may be recommended by the ACIP in the future to ensure they may be safely administered by a pharmacist. MSSNY also raised concerns regarding pharmacists’ lack of reporting of these immunizations to the patient’s physicians or to the NYSIIS database. (CLANCY)
AMA Responds to AAPA’s Proposed Name Change of Physician Assistants
In response to the announcement by the AAPA that they voted to change the professional title from “Physician Assistants” to “Physician Associates”, American Medical Association (AMA) President Dr. Sue Bailey issued the following statement raising concerns about the possibility of public confusion:
“AAPA’s recent move to change the title ‘physician assistant’ to ‘physician associate’ will only serve to further confuse patients about who is providing their care, especially since AAPA sought a different title change in recent years, preferring to only use the term ‘PA’. Given the existing difficulty many patients experience in identifying who is or is not a physician, it is important to provide patients with more transparency and clarity in who is providing their care, not more confusion. Yet, AAPA’s effort to change the title of physician assistants to rebrand their profession will undoubtedly confuse patients and is clearly an attempt to advance their pursuit toward independent practice. We believe this latest effort is incompatible with state laws and are prepared to work with interested state and specialty medical societies to address any efforts to implement this title change in state or federal policy.
“We remain strongly committed to supporting physician-led health care teams that use the unique knowledge and valuable contributions of all health care professionals to enhance patient outcomes. It is also what patients want, which is why clarity in health care titles is so important. That is why the AMA has advocated in support of truth in advertising laws and stands in strong opposition to AAPA’s title change.”
It should be noted that this announcement by AAPA does not affect existing state laws. For example, in New York State, the professional title of “physician assistant” is defined under Article 131-B of the Education Law, requiring an act of the Legislature to change it. (AUSTER)
MSSNY Announces New Podcast Episodes on COVID Pandemic
MSSNY has recently published five new podcasts related to the COVID pandemic.
Newly added: COVID-19 & the Mental Health of Children and Teens is the latest podcast related to the COVID pandemic. This podcast offers insight on the mental health effects the COVID-19 pandemic has had on children and teens via a discussion with child and adolescent psychiatrist, Dr. Linda Chokroverty. Click here to listen.
Additional COVID-related podcasts include:
COVID-19 & Mental Health of Physicians provides listeners with insight from Dr. Craig Katz, vice-chair of MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response, on the impact the COVID-19 pandemic has had on the physician community. Click here to listen.
Mental Health of Patients & COVID-19 offers a discussion with Dr. Craig Katz on the mental health impact the COVID pandemic has had on patients. Click here to listen.
How to Talk to Patients About Vaccine Hesitancy includes a discussion on the history of vaccine hesitancy and offers sage advice from Dr. William Valenti to listeners on talking to vaccine hesitant patients. Listen to this podcast by clicking here.
A Discussion on COVID Vaccine for Patients is MSSNY President, Dr. Bonnie Litvack, President-elect, Dr. Joseph Sellers and Dr. William Valenti, Chair of MSSNY’s Committee on Infectious Diseases discussing vaccines currently available for COVID-19. This podcast answers many questions patients may have about the vaccines. Tell your patients to click here to listen.
MSSNY Medical Matters Program on Long COVID
Registration now open
Medical Matters: The Lingering Pandemic: Long COVID Symptoms & Treatments
Date: June 16, 2021 @ 7:30 am
A growing number of COVID survivors are experiencing a multitude of ongoing effects for months after initial recovery. Learn more about Long COVID and how to recognize and treat it by registering for Medical Matters: The Lingering Pandemic: Long COVID Symptoms & Treatments. This webinar will take place on Wednesday, June 16th at 7:30am. William Valenti, MD, chair of MSSNY’s Infectious Diseases Committee, will serve as faculty for this program. Click here to register for this webinar.
- Recognize the symptoms associated with long COVID
- Identify referral options to treat long COVID
- Examine CDC guidelines for caring for patients with long COVID symptoms
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. (HOFFMAN)
Dr. Sellers’ Interview on Vaccine Confidence to Air Statewide this Weekend
MSSNY President Dr Sellers’ interview with Empire State Weekly will air this weekend on television stations around the state, including NYC, Albany, Buffalo, Rochester, Elmira, Syracuse, Binghamton, Watertown, Utica and Plattsburgh. Dr. Sellers discussed the important role of physicians in instilling vaccine confidence in patients, encouraged parents to vaccinate younger children as they are able, and drove home the point by saying he would make sure his grandchildren get vaccinated when their age group is offered access.
Empire State Weekly will air on the following stations around the state this weekend:
WYSR SYRACUSE – Saturday @ 6:00 AM
WIVB BUFFALO Sunday @5:30 AM
WROC ROCHESTER Sunday @6:30 AM
WETM ELMIRA Sunday @7:00 AM
WPIX NEW YORK CITY Sunday @7:30 AM
WIVT BINGHAMTON Sunday @10:30 AM
WWTI WATERTOWN Sunday @10:30 AM
WPNY UTICA Sunday @10:30 AM
WTEN ALBANY Sunday @11:00 AM
WFFF PLATTSBURGH Sunday @11:00 PM
June 3rd Council Meeting Notes
The MSSNY Council met on Thursday, June 3 and approved the resolutions listed below. Additionally, Council approved changing the name of the MSSNY Health Care Disparities Committee to the Committee on Health Equity.
70.930-Automated Pharmacy Refills without Patient Authorization
The Medical Society of the State of New York (MSSNY) will support legislation and/or regulation that would limit automated medication refills by requiring that the patient request the medication prior to transmittal of the request to the prescribing providers electronic system. MSSNY will advocate pharmacists be required to review the appropriateness and validity of medication refill requests prior to transmitting the refill request to the prescribing providers electronic system.
MSSNY will support legislation to reduce unnecessary and redundant pharmacy refill requests and provide payment to the physician for pharmacy generated refill requests that occur outside the time of a patient encounter. (HOD 2020-107 and 2020-114, referred to Council, adopted 6/3/21)
155.990-Role of Private Equity in Medicine and Acquisition of Medical Practices
MSSNY will continue to work with the American Medical Association (AMA) to help educate physicians regarding the risks and considerations associated with practice affiliation with corporate or private equity investment, consistent with materials developed by the AMA to educate physicians for that purpose.
MSSNY will continue to strongly advocate for protections against corporate interference in physician decision-making which affects the care and treatment of patients and will advocate to protect continuity of care for patients which includes access to care by their physicians in the event of contract transitions, bankruptcy, or other adverse events that may arise from practice affiliation with corporate or private equity investment. (HOD 2020-100 and 2020-105, referred to Council, adopted 6/3/21)
160.962-Continued Grandfather Status for Taking Board Exams
The duly licensed physician should be the only requirement for practice of medicine and the American Board of Medical Specialties (ABMS) should keep the promise of their “grandfather” clause. MSSNY’s position is that there should be more than one pathway to participation in insurance companies, hospital privileges and other organizations (eg, ambulatory surgery centers) and encourages the ABMS to work with other societies to find what pathways ensure physician competency and pursuit of lifelong learning. (HOD 2019-214; reaffirmed HOD 2020-67 by Council 6/3/21)
235.981-Continuing Certification as a Condition of Employment or Reimbursement
The Medical Society of the State of New York will continue to work with the American Medical Association, state medical associations, and specialty societies to advocate for ensurance that requirements for maintaining board certification are not excessive in scope and are rationally related to ensuring ongoing physician competency in that specialty. (HOD 2020-67, referred to Council, substitute adopted 6/3/21)
235.986-Maintenance of Certification as Restraint of Trade
The Medical Society of the State of New York will seek legislation to prohibit board certification requirements for hospital medical staff privileges, insurer contracts and state licensure. (HOD 2016-214; reaffirmed HOD 2020-67 by Council 6/3/21)
260.887-COVID Crisis in India
MSSNY in conjunction with our AMA will urge the US government to provide all possible assistance including surplus vaccines and vaccines that have not had Emergency Use Authorization to the citizens of India and other countries in similar situations in a humanitarian crisis.
MSSNY in conjunction with our AMA will advocate for all possible assistance in the COVID-19 crisis through the World Medical Association (WMA) and World Health Organization (WHO) for government and the citizens of India and other countries in similar situations.
MSSNY in conjunction with our AMA recognizes the extraordinary efforts of many dedicated physicians and ethnic organizations assisting in the COVID-19 humanitarian crisis. (Adopted Council 6/3/21)
285.986-Racism and Intersectionality in Medicine
MSSNY affirms that racism is a public health crisis.
MSSNY will evaluate its mission statement to be clear that it supports equity in all aspects of its work.
MSSNY will systematically evaluate its policies and procedures to be clear that it supports equity in all aspects of its work, in both existing and in future policies and procedures, and that record of this process be visible to all members.
MSSNY encourages all county societies to affirm that racism is a public health crisis.
MSSNY will work with all county medical societies to ensure that their mission statements are inclusive of the needs of underrepresented minority patients and physicians.
MSSNY encourages all county societies to systematically evaluate their policies and procedures to be clear that they support equity in all aspects of their work, in both existing and in future policies and procedures, and that records of this process be visible to all members.
MSSNY will work collaboratively with all county medical societies to develop a strategic plan to improve recruitment, retention, support, and mentoring of members who are Black and Latinx, people of color (POC), indigenous people, Asian American and Pacific Islanders (AAPI), people with disabilities and/or sexual and gender minorities.
MSSNY will work with medical schools in New York to ensure that underrepresented minority students are successfully recruited and supported to reinforce the pipeline of physicians and physician leaders to be representative of the population we serve.
MSSNY will seek that all medical schools in New York will utilize appropriate culturally relevant curricula that does not propagate race-based medicine, understanding that race is a social construct and not a biological one.
MSSNY, through its Committee on Health Equity will seek to:
- Increase awareness of how discrimination based on factors such as racism, classism, cisgenderism, heterosexism, ableism, patriarchy, and xenophobia contributes to both societal and health inequities and to ensure that all New Yorkers receive the best care possible and can achieve the best health possible;
- Work with the AMA, specialty societies, Albany leadership, community groups, and other stakeholders to eliminate inequities, particularly those inequities that adversely impact the health and well-being and access to and quality of care for persons who are from historically disadvantaged populations;
- Prevent and manage diseases that are prevalent in historically disinvested populations burdened with the worse disease outcomes, including diabetes, hypertension, and cancer, through educational programming for physicians and other stakeholders;
- Reverse the troubling increases in race/ethnic-based health inequities such as maternal mortality; and
- Promote expanded funding for programs that attract a more diversified physician workforce, increasing the number of minority faculty including Black, Latinx, Native American, female, LGBTQ faculty, and faculty with disabilities teaching in medical schools and expanding medical school pipeline programs in rural and urban areas to address the shortage of physicians in medically underserved areas of New York
MSSNY will request that all New York medical specialty organizations, medical schools, non-physician healthcare organizations and hospitals adopt similar resolutions.
MSSNY stands firmly against harassment and violence against any group based on their identity, such as the recent attacks on the Asian community. (Adopted, Council 6/3/21)
312.966-Ensuring Affordability and Equity in COVID-19 Vaccine Boosters
JAMA and JAMA Network Journals Establish Priorities to Promote Diversity, Equity, Inclusion
The editors of JAMA and the JAMA Network journals have issued an editorial that outlines ongoing and new editorial priorities and key approaches for the JAMA family of journals to strive for and promote diversity, equity, and inclusion. The editors reaffirmed their commitment to improving equity and have developed 14 editorial priorities to serve as a foundation to support a comprehensive, meaningful, and sustainable strategy to achieve these goals.
According to the editors, “There is no greater calling for JAMA and the JAMA Network journals, and for all medical publications, than advancing the science and art of medicine and the betterment of public health. Today, and for the future, these goals will be accomplished by championing diversity, equity, and inclusion in all aspects of clinical care, biomedical research, health policy and society.”
Join CareClix on June 23 @ Noon for Overview of Virtual Care Management Program
MSSNY Members receive a discounted rate for implementing CareClix, a virtual telehealth platform that enables you to put your patients first.
Join CareClix for a brief overview of the platform followed by a Q&A session with CareClix’s CEO to answer any questions.
Date: June 23rd, 2021
Time: 12 pm EST
Presenter: Dr. John Korangy, MD, MPH, CEO of CareClix
CareClix’s all-in-one platform lets you deliver an exceptional patient experience that’s convenient for your patients and efficient for you. Allow patients – new and old – to chat straight from your website or mobile app. Increase appointment bookings and capture patient demand 24/7.
Key features that will be demonstrated in the webinar:
NYS Legislators Seek Campaign Support from MSSNYPAC
Your local Senator and Assemblymember seek financial support from MSSNYPAC throughout the year. Our ability to respond affirmatively to their requests with campaign contributions and physician attendance at their events affords physicians and policymakers the opportunity to develop strong rapport. These strengthened relationships are critical when healthcare policy is being formed. For physicians to be at the discussion table, we must invest in a strong, well-funded MSSNYPAC. We ask all physicians and our allies to make a contribution to MSSNYPAC online www.mssnypac.org/contribute or by phone/text 914-933-7722.
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