MSSNY Enews: March 17, 2021 – Excess, OPMC and CPH Proposals
Assembly, Senate Advance One-House Budget Proposals that Reject Many Problematic Budget Proposals
Over the weekend, both the Assembly and the Senate introduced their respective “one-House” Budget proposals to set the stage for 3-way negotiations with the Governor to complete a State Budget before the April 1 deadline. Below is an initial summary of the most pressing Budget issues where MSSNY has been advocating. While these certainly represent significant positive developments, it is imperative that physicians continue their extensive grassroots efforts on these issues as the State Budget is finalized over the next 2 weeks.
Please take action consistent with the grassroots requests below and please be on the lookout for additional alerts based upon how negotiations are pressing on each of these issues.
Both the Assembly and Senate rejected the $51 million cut to the Excess Medical Malpractice Insurance program and 50% physician cost share imposition that had been proposed in the Executive Budget. Physicians can send a letter to legislators urging that they continue to fight to prevent this cut from being included in the Budget: Don’t Balance the Budget on the Backs of Physicians
The Assembly rejected the “OPMC Modernization Act” provisions from the Executive Budget in its entirety including several provisions that would substantially reduce physician due process rights.
The Senate rejected most of the “OPMC Modernization Act” provisions including all the proposed changes to physician due process but left in “non-OPMC” components that would:
- Require new applicants for licensure to undergo criminal background checks
- Require physicians to include on their NYS Physician profile updates office hours, whether accepting new patients, and health plan participation information (which would be based upon information already publicly available at another DOH website that is based upon information provided by the health plan)
Physicians can send a letter urging the Legislature to continue to fight to preserve due process for physicians and rejecting these proposed changes: Reject Governor’s Physician Disciplinary Proposal
The Assembly rejected in its entirety the pharmacy scope expansion provisions from the Executive Budget proposal.
The Senate rejected Executive Budget proposals to greatly expand the physician-pharmacy Collaborative Drug Therapy program and pharmacist self-ordering of lab tests, but mostly accepted the proposal to expand the immunizations that can be performed by pharmacists.
Please urge your legislators to continue to fight to reject these short-sighted proposals that would empower big box chains at the expense of community-based physician medical homes: Oppose Uncoordinated Siloed Care to be Provided by Pharmacists
Committee for Physicians Health
The Senate restored the $198,000 that had been cut in the Executive Budget proposal. While the Assembly did not appear, at first glance, to restore the cut, but there have been indications that they are supporting the restoration of this cut.
Both the Assembly and Senate rejected the Executive Budget proposal to eliminate the right of prescribers to apply for a year to year waiver of e-prescribing requirements (which apparently was still being used by over 2,000 prescribers in New York)
Medicaid Prescriber Prevails
Both the Assembly and Senate rejected the Executive Budget proposal to remove the statutory protection of the prescriber’s determination (not State Medicaid’s) to be final for a medication prescribed to a patient covered by Medicaid.
The Assembly rejected almost all of the Executive Budget telehealth Budget proposal except for a provision that expands the locations where telehealth services can be provided.
The Senate accepted the Governor’s telehealth Budget proposal, but added language supported by MSSNY that would require payment parity for telehealth services as compared to in-person services.
Nurse Practitioner Collaborative Practice
The Assembly included the Governor’s proposal to extend the existing modified nurse practitioner independent practice statute for another 6 years. The Senate did not include these provisions.
Expanded “De-Credentialing” of Physicians/Providers Under No-Fault Insurance
Both the Assembly and Senate rejected the Governor’s Budget proposal.
Both the Senate and the Assembly reject the 1% Across the Board Medicaid cut.
Recreational Use Marijuana
Effective March 17, enrolled providers other than pharmacies, may vaccinate any eligible
individual. Pharmacies must continue to vaccinate individuals age 60 and older, and
prioritize P-12 school faculty and staff, and childcare worker per federal guidance, however
are now authorized to vaccinate individuals with comorbidities or underlying conditions. All
providers must make efforts to vaccinate the most vulnerable New Yorkers, including those
with comorbidities or underlying conditions, and individuals 60+.
who provide public-facing services to New Yorkers in need, and essential in-person public-facing building service workers and providers of essential building services are eligible to be vaccinated. Read the full guidance report here.
Important Update to NYS Vaccine Tracker Reporting
Effective immediately, providers in receipt of the COVID-19 vaccine, irrespective of whether such doses are via a direct State or federal allocation or a redistribution, will now be required to report to the vaccine tracker on Mondays and Thursdays by 10 am.
This reporting will continue to be used for allocation determinations and is still required. If you have any questions regarding this change or the vaccine tracker in general, please
Please Join the NYS Department of Health Thursday, March 18th at 1 – 2 PM
for a COVID-19 update for healthcare providers To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing
immediately thereafter) on the NYSDOH COVID website for providers. Audio number and code: 844-512-2950 Access code 6542067#
Americans More Comfortable Seeking Care Amid Pandemic, Survey Suggests Americans’ comfort with visiting a hospital or physicians’ office is growing amid the COVID- 19 vaccine rollout, according to Healthgrades’ latest COVID-19 Patient Confidence Study published Feb. 18.
Healthgrades launched the study in March 2020 to assess trends in consumer behavior amid the pandemic. The report is based on a weekly survey of a random sample of 200 Americans. The most recent study represents data through Feb. 12.
- Seventy-two percent of respondents said they’d feel comfortable going to their primary care physician tomorrow, up from 40 percent in April
- Sixty-nine percent said they’d feel comfortable visiting a specialist tomorrow (up from 38 percent in April), and 63 percent said they’d be willing to visit urgent care (up from 32 percent in April).
- Fifty-four percent of respondents said they’d feel comfortable having an elective procedure at a hospital, and 64 percent said they’d undergo an in-office medical
To view the full survey, click here.
15 Recent Findings from COVID-19-Related Studies
A number of recent studies have focused on COVID-19 vaccine efficacy, hospitalization trends and variants.
Here are 15 findings from studies published since March 3:
- Pfizer said March 11 that its COVID-19 vaccine prevented 94 percent of asymptomatic cases, according to an Israeli
- Novavax’s COVID-19 vaccine candidate was 96.4 percent effective in preventing COVID- 19 in its phase 3 K. trial, the drugmaker announced March 11.
- Eli Lilly said March 10 its COVID-19 antibody cocktail reduced the risk of hospitalization and death by 87 percent during a recent phase 3
- GlaxoSmithKline and Vir Biotechnology said March 10 that their COVID-19 antibody drug was 85 percent effective at reducing virus-related hospitalizations and death in a phase 3 clinical trial.
- Despite few hospitalized COVID-19 patients having a bacterial infection, 52 percent of hospitalizations led to at least one antibiotic prescription, according to the Pew Charitable Trusts’ Antibiotic Resistance Project published March 10.
- People who have more than five symptoms of COVID-19 during the first week of illness may be more likely to develop prolonged health issues, known as “long COVID-19,” according to a study published March 10 in Nature
- Patients ages 30 and older infected with the K. coronavirus variant had a 64 percent higher death risk than those infected with previously circulating strains, according to a U.K. study published March 10 in The BMJ.
- People who received both doses of Pfizer-BioNTech’s messenger RNA vaccine and had no symptoms had an 80 percent lower risk of testing positive for COVID-19 compared to those who were unvaccinated, according to research published March 10 in Clinical Infectious The findings suggest mRNA vaccines are effective at reducing the risk of asymptomatic infection.
- Among 71,491 S. adults who were hospitalized with COVID-19, 27.8 percent were overweight and 50.2 percent were obese, according to the CDC’s latest Morbidity and Mortality Weekly Report published March 8.
- Just 0.025 percent of staff from Massachusetts General Hospital and Brigham and Women’s Hospital experienced anaphylaxis after receiving Pfizer or Moderna COVID-19 vaccines, according to a study published March 8 in JAMA.
- The COVID-19 vaccine developed by Pfizer and BioNTech was shown to be 95 percent effective in neutralizing a more contagious variant of the novel coronavirus that was discovered in Brazil, according to a study published March 8 in the New England Journal of Medicine.
- Both Pfizer’s and Moderna’s COVID-19 vaccines were at least 10 times less effective against a virus variant first found in South Africa in a small study conducted by researchers from Columbia University, Business Insider reported March 8.
- In-hospital mortality for COVID-19 patients fell 15 percentage points from March to August 2020, according to a study published March 5 in JAMA Network Open.
- Among 152 children hospitalized with COVID-19, 18, or 12 percent, developed acute kidney injury, according to a study published March 3 in Kidney International.
- The SARS-CoV-2 virus may more easily bind to the airway cells of people with Type A blood, according to a study published March 3 in Blood Advances.
NYC DOH MH Hosts Overdose Data to Action (OD2A)
Overdose death in the United States continues to climb during the ongoing COVID-19 pandemic. Recent provisional data from the Centers for Disease Control and Prevention (CDC) show that over 81,000 drug overdose deaths occurred across the country in the 12 months ending in May 2020—higher than any previously recorded 12-month period. The CDC recommends that clinicians co-prescribe naloxone to patients with high morphine milligram equivalents and those receiving opioids and benzodiazepines. Prescribers such as physicians, nurse practitioners, and physician assistants can help by optimizing how we use prescription drug monitoring programs (PDMPs) in clinical care.
Starting Tuesday, March 30, the New York City Department of Health and Mental Hygiene, in partnership with Montefiore Medical Center and NYC Health + Hospitals, will host a series of webinars with practical and current guidance for health care providers to optimize use of PDMP data in clinical care. The presentations were developed by a team of experts and include case-based discussions highlighting common and challenging case scenarios. Topics for the eight CDC Overdose Data to Action (OD2A)-funded webinars will cover: a history, overview, and importance of using PDMPs; prescribing opioids for inherited patients; equity and racial bias in opioid prescribing; prescribing for patients with complex medical histories; and more. Continuing Medical Education (CME) credits (or equivalent) will be offered with each webinar.
Key points and recommendations:
- Clinical practice guidelines encourage use of the PDMP prior to prescribing Schedule II-IV controlled substances, including opioids, benzodiazepines, other sedative-hypnotics (e.g. zolpidem), and pregabalin.
- PDMP data can help prescribers to: verify prescription fills (e.g., dates and quantity), review trends in prescription fills, identify patients at high risk for substance use disorder or overdose, guide collaboration with other prescribers and patients, and identify activity suggesting diversion or fraud.
- Incorporating PDMP data into clinical decision-making should be guided by several principles;
- PDMP data provide objective data that must be interpreted in context
- Decisions about whether and how to prescribe should consider the broader risks and benefits to the individual
- Avoid abrupt discontinuation or dose reduction of controlled substances that would result in severe withdrawal symptoms. These could lead to illicit use, overdose, seeking emergency care, dysphoric mood, and suicide risk. For some medications including benzodiazepines, it could result in seizures or
- Assess patients taking controlled substances for substance use
- Substance use disorders, including opioid use disorder, are chronic illnesses that require long-term All patients with substance use disorder should be provided or referred for evidence-based treatment. Treatment for opioid use disorder is effective, safe, and available throughout the country.
- Communication with patients about pain and substance use can take place in a way that preserves and improves the therapeutic relationship with This includes using active listening, validating, using non-stigmatizing language, and using shared decision-making.
These principles and others will be addressed in the webinar series (see accompanying information), along with practical tips for implementing them in patient care. We hope you can join us for one or more of the webinars.
Click here to register for the first webinar in the Optimizing Provider Use of Prescription Monitoring Programs series.
CDC: Most People Return for Second COVID-19 Vaccine Dose
Most people who received their first dose of a COVID-19 vaccine from either Pfizer or Moderna have gotten their second dose on time, according to research published by the CDC March 15, The Hill reported.
During the first two months of the U.S. vaccination campaign, 95 percent of people completed their two-dose vaccinations within the FDA-recommended time period, the CDC said.
But the agency noted that most people prioritized for the vaccine at that time were healthcare workers and long-term care facility residents, who likely had better access to their second doses because they’re more likely to have been vaccinated at work or their residence, The Hill reported.
“As priority groups broaden, adherence to the recommended dosing interval might decrease,” the CDC said.
The FDA authorized Pfizer’s vaccine to be given in two doses 21 days apart and Moderna’s vaccine to be given in two doses 28 days apart. But the CDC has said there can be up to 42 days between doses in emergency situations.
The CDC recommended that public health officials work to understand the causes of missed second doses, The Hill reported.
Read the full article here.
The State of COVID-19 in the US Today: 6 Stats & Why They Matter
Amid the ever-changing pandemic, it can be difficult to draw conclusions from constantly changing data, which is why Becker’s has compiled six recent statistics and provided the context for each number.
Six statistics regarding the state of the pandemic in the U.S.:
Total U.S. COVID-19 cases: 29,496,142
Context: The figure, reported at 8:30 p.m. CDT March 16 from Baltimore-based Johns Hopkins’ coronavirus dashboard, totals out to about 1 in 670 Americans having had COVID-19 at some point. As of March 16, COVID-19 cases in the U.S. account for nearly a quarter of all cases worldwide, or 24.5 percent.
Total U.S. COVID-19 deaths: 535,657
Context: A third of Americans know someone who has died from COVID-19, reports The New York Times. As of March 16, COVID-19 deaths in the U.S. account for more than a fifth of global virus deaths, or 20.1 percent.
U.S. COVID-19 case rate: 57,083 new cases reported March 15, per The New York Times.
Context: As of March 13, The number of new reported cases per day remains nearly as high as the summer record, reports The New York Times. However, daily cases are on the decline, and the average number of new cases per day has dropped more than 75 percent since the Jan. 8 peak.
U.S. COVID-19 death rate: Almost 1,500 Americans are dying from COVID-19 every day as of March 13, reports The New York Times.
Context: That number still exceeds the summer peak, though daily deaths are lower than the initial surge last spring.
Percent of U.S. population fully vaccinated: 11.5 percent
Context: As of March 15, 38,335,432 Americans have received all necessary COVID-19 vaccine doses, per the CDC. Overall, 71,054,445 Americans (21.4 percent) have received at least one COVID-19 vaccine dose. The proportion of the population that must be vaccinated against COVID-19 to reach herd immunity is still not known, according to The World Health Organization and CDC.
Vaccine Eligibility: Alaska and Mississippi are currently the only states with eligibility open to all adult residents, with everyone 16 or older eligible in Alaska and residents 18 or older in Mississippi. For a list of each state’s eligibility, click here.
CDC Considering Three Feet as Safe Distance in Classrooms
A new Harvard study suggests that sitting kids closer in the classroom doesn’t spread COVID-19 any faster.
The Centers for Disease Control and Prevention is considering reducing the distance in classrooms from 6 feet to 3 feet following the findings from the study. Students and staff members in the study wore masks.
“We are taking all of those data carefully and revisiting our guidances in that context,” says CDC Director Dr. Rochelle Walensky. Dr. Frederick Davis, of Northwell Health, says schools should wait until more adults are vaccinated before making the change. Davis says kids usually don’t get as severe a disease and sometimes are asymptomatic, but they can still bring it home and spread it to family members.
Please Submit Names of Doctors and Family Members Who Lost Their Lives During COVID-19
Doctors Day is March 30. This year, to honor our physicians and family members who died of COVID-19 in 2020-2021, MSSNY is designing a poster with the names that are submitted. Please send the names to firstname.lastname@example.org
Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine
the Centers for Medicare & Medicaid Services (CMS) is increasing the Medicare payment amount for administering the COVID-19 vaccine. This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff. At a time when vaccine supply is growing, CMS is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible.
Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.
These updates to the Medicare payment rate for COVID-19 vaccine administration reflect new information about the costs involved in administering the vaccine for different types of providers and suppliers, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.
CMS is updating the set of toolkits for providers, states and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine.
Nassau County Med Society Virtual Event: Women on the Frontlines: Stronger Together March 31st, 2021 from 6-7 PM
You’re invited to a conversation with:
Dr. Susan Bailey, President of the AMA • Dr. Elizabeth Fontana, Neurosurgeon and Chief Resident at New York Presbyterian Hospital • Dr. Bonnie Litvack, President of MSSNY • Dr. Carmen Rodriguez, FACOG, President of the LIJ, Medical Staff Society and Associate Chair of the Long Island Jewish Medical Center – Performance Improvement Coordinating Group • Dr. Aisha Terry, MPH, FACEP, Emergency Physician and Associate Professor at the George Washington University School of Medicine and Milken Institute School of Public
Health and Pandemic Advisor • Dr. Haritha Veeramachaneni, Board Certified Plastic Surgeon and recipient of the New York Times’ Super Doctors Rising Stars
In honor of Women’s History Month, we are celebrating women who have been leaders on the frontline during the pandemic. Please register here for our virtual event on Wednesday, March 31st, 2021. For further details or registration assistance, please email email@example.com or call (516) 832-2300.
- Meeting with Maria Oparal, Health Legislative Associate (LA) for Representative Joe Morelle.
- Meeting with Matt Fuentes, Health Legislative Associate for Senator Chuck Schumer.
- Meeting with Mike Demakos, Health LA for Representative Kathleen Rice
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Founded in 1988, this well-established Single Practitioner Allergy Practice has over 3500 active patients, with very positive patient reviews. The office is only one of a few in the area, but patients are seen from throughout the NYC Metropolitan Area, as well as Long Island. Potential for growth. Centrally located next to major public transportation. Retirement planned. Lease is assignable. Well-trained, extremely personable staff of three, including a Registered Nurse. Payer mix85% private, 10% Medicare 5% other. Email any questions to: firstname.lastname@example.org
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