March 18, 2016 – DOH’s Exceptions to E-Prescribing

drmaldonado PRESIDENT’S  MESSAGE
 Dr. Joseph R.  Maldonado
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March 18,  2016
Volume 16, Number 10

Dear Colleagues:

In lieu of my weekly introduction, New York State Commissioner of Health Dr. Howard Zucker issued a very important letter on March 15th outlining “12 Exceptions” to the E-Prescribing Law that is looming over us and goes into effect in 10 days.

“This letter is to inform you of a blanket waiver with respect to the electronic prescribing requirements, pursuant to Public Health Law (PHL) § 281 and Education Law § 6810, that goes into effect on March 27, 2016, for exceptional circumstances in which electronic prescribing… Read More

Joseph Maldonado, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


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Legislature Puts in One House Budget Bills; Negotiations to Begin in Earnest
The Senate and Assembly one house bills were posted over the weekend. While DGA staff continues to analyze the provisions of the bills, below are highlights of what we have read thus far.

  1. After strenuous advocacy by MSSNY and other advocacy groups, each House added $25M in their one House budget bills to restore funding for the Excess program. In addition they included language to continue the Excess program as is and to continue the Superintendent’s authority to set medical malpractice rates. Physicians should thank their elected officials for proposing to restore this funding and continue to urge restoration of this cut as the final Budget is being negotiated. Go to the this link for a letter you can send to your elected representatives.
  1. After proactive advocacy by MSSNY and other advocacy groups, both Houses articulated a desire that “funding or settlement funds be identified in  addition  to  remaining  assets  to   reimburse   hospitals, physicians and producers pro-rata for losses associated with the demise of Health  Republic  upon  completion  of  the  formal liquidation process” (Senate language). Importantly, several key legislators (Senators Hannon, Rivera, and Valesky and Assemblymembers Cahill and Walter) articulated this goal in the first meting of the Health Budget Conference Committee this week.  In addition, the Senate bill would eliminate the requirement for prior approval of health insurance premium rates and would establish a requirement that within thirty days deeming an insurer insolvent, the superintendent must apply for a liquidation order.

ALL PHYSICIANS SHOULD IMMEDIATELY GO TO THE FOLLOWING LINK TO CONTACT THEIR ELECTED REPRESENTATIVES TO URGE THE INDENTIFICATION OF A POOL OF MONIES TO REIMBURSE HEALTHCARE PROVIDERS FOR THE SERVICES RENDERED TO PATIENTS PREVIOUSLY INSURED BY HEALTH REPUBLIC.  http://cqrcengage.com/mssny/app/onestep-write-a-letter?5&engagementId=151313

  1. The Senate included the Governor’s retail clinic language which would allow publicly traded corporations to own and operate limited service clinics in retail space they own without regard for public need. The Assembly advanced language which would, importantly, not allow publicly traded corporations to own and operate retail clinics but which seeks to regulate practices that rent space in retail establishments by, among other things, requiring them to be accredited; limit the type of services which can be provided and prohibit them from delivering care to children under the age of two. The corporately owned retail clinic language remains in play.  Go to the this link to send a letter of opposition to this proposal to your legislators.
  1. After strenuous advocacy by MSSNY and other advocacy groups, neither House included any of the workers’ compensation language we opposed. While this is a very positive development, we must keep the pressure on by reaching out to your elected representatives if you haven’t yet done so by sending a letter found at this site.
  1. The Senate bill includes language to require the commissioner of health to develop an elder abuse screening tool. Physicians, PAs and NPs are permitted (not required) to use the tool to identify abuse or maltreatment of their patients. The language also calls for the establishment of an interagency clearinghouse for reported cases involving physical abuse, sexual abuse, emotional abuse, active, passive or self-neglect, financial exploitation or other hazardous situations which could jeopardize the health and wellbeing of an individual and calls for the creation of multidisciplinary teams for the purpose of investigating reports of suspected elder abuse. The proposal would also authorize a financial institution to disallow a transaction if it believes that financial exploitation of a vulnerable adult is occurring.
  1. The Senate bill included legislation strongly supported by MSSNY which would exempt low volume providers from the eRx mandate and allow prescribers invoking an exception to the mandate to make a notation in the patient’s medical record instead of calling DOH (currently required by law).  Please send in support letter here:
  1. Senate bill sets aside an additional $12M in new funding for 100 new loan forgiveness/practice support slots as part of the Doctors Across New York. The bill would reduce from five to three the number of years of service associated with the support and would allow for $40,000 in loan forgiveness/practice support each year up to $120,000 for each new recipient.
  1. Each House would restore existing ”prescriber prevails” protections in the Medicaid and Medicaid Managed Care program.
  1. Each House devotes a significant amount of new money ($26M (Senate) and $32M (Assembly)) to address substance abuse with significant money flowing for prevention and treatment services, recovery support services and recovery community centers. In addition, the Assembly would require OASAS to: develop educational materials for schools and require schools to make Substance Use Disorder (SUD) treatment referrals; develop materials for pharmacies to distribute regarding drug addiction, treatment and disposal of drugs; develop SBIRT materials; develop SUD materials for physicians for voluntary distribution to patients and require hospitals to establish policies regarding referral of individuals in need of SUD treatment.
  1. The Senate included language in its one House bill that MSSNY opposes that would allow chiropractors and physicians to partner in LLPs/LLCs.
  1. Importantly, the Senate one House repeals action taken in last year’s budget to eliminate Medicaid reimbursement for services provided to patients dually eligible for Medicaid and Medicare thereby restoring the 20% of the co-insurance. Please send a letter in support here.

The conference committees are expected to continue meeting next week.

We will keep you informed of discussions which ensue throughout the next couple of weeks.

Best Regards,
Liz. Moe, Pat and James

NYS DOH Commissioner Issues 12 Additional Exemptions to the E-Prescribing Requirment
NYS Health Commissioner Howard Zucker, MD issued a statement this week providing 12 exemptions to the e-Prescribing mandate going in effect March 27th.   In a March 16th letter, the Commissioner said that exceptional circumstances existed in which electronic prescribing cannot be performed due to limitations in software functionality.   In a letter to prescribers, the Commissioner listed the 12 additional exceptions to the e-prescribing requirement.   Those exceptions are as follows:

  • any practitioner prescribing a controlled or non-controlled substance, containing two (2) or more products, which is compounded by a pharmacist;
  • any practitioner prescribing a controlled or non-controlled substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  • any practitioner prescribing a controlled or non-controlled substance that contains long or complicated directions;
  • any practitioner prescribing a controlled or non-controlled substance that requires a prescription to contain certain elements required by the federal Food and Drug Administration (FDA) that are not able to be accomplished with electronic prescribing;
  • any practitioner prescribing a controlled or non-controlled substance under approved protocols under expedited partner therapy, collaborative drug management or in response to a public health emergency that would allow a non-patient specific prescription;
  • any practitioner prescribing an opioid antagonist that would allow a non-patient specific prescription;
  • any practitioner prescribing a controlled or non-controlled substance under a research protocol;
  • a practitioner prescribing a controlled or non-controlled substance either through an Official New York State Prescription form or an oral prescription communicated to a pharmacist serving as a vendor of pharmaceutical services, by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law. The Assembly and Senate have passed similar legislation (A.9334/S6778)
  • a pharmacist dispensing controlled and non-controlled substance compounded prescriptions, prescriptions containing long or complicated directions, and prescriptions containing certain elements required by the FDA or any other governmental agency that are not able to be accomplished with electronic prescribing;
  • a pharmacist dispensing prescriptions issued under a research protocol, or under approved protocols for expedited partner therapy, or for collaborative drug management;
  • a pharmacist dispensing non-patient specific prescriptions, including opioid antagonists, or prescriptions issued in response to a public health emergency issued; and
  • a pharmacist serving as a vendor of pharmaceutical services dispensing a controlled or non-controlled substance through an Official New York State Prescription form or an oral prescription communicated by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined in section twenty-eight hundred one of the public health law.

The the above-listed exceptional circumstances will be effective until March 26, 2017. According to an email that MSSNY received on March 17, 2016 from the NYS Bureau of Narcotics Enforcement, any use of these the exceptions does not require physicians to notify the Department of Health that they are using the exception.

Additionally, on March 17, 2016, Governor Cuomo issued a press statement about e-prescribing, noting that the “requirement is a key component of New York’s I-STOP initiative that is focused on helping curb the abuse of prescription medication throughout the state”.   He reminds prescribers that e-prescribing will become effective on March 27, 2016.   A copy of the Governor’s press release is here.

A copy of the Commissioner’s letter can be found here.                                (CLANCY, DEARS)

Continue to Urge your Legislators to Reduce Liability Insurance Costs, Not Raise Them!
Last week physicians and medical students from across New York State came to Albany to remind their legislators that, in light of the huge financial pressures threatening the viability of physician practices and our health care delivery system, no further liability increases can be tolerated.  Please continue to urge  your legislators (http://cqrcengage.com/mssny/app/write-a-letter?4&engagementId=105729) to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.

MLMIC’s estimate is that this bill could increase physician liability premiums by nearly 15%!   New York physicians continue to pay liability premiums that are among the very highest in the country.  By way of example, a neurosurgeon practicing on Long Island must pay an astounding $338,252 for just one year of insurance coverage and an OB/GYN practicing in the Bronx or Staten Island must pay $186,639.   New York far surpasses all other states in terms of total medical liability payouts, per capita payments, and medical liability awards above $1 million.

MSSNY joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.

To make matters even worse, trial lawyers are aggressively pushing the Legislature to consider additional liability expansion bills such as legislation that would eliminate the statutory limitation on contingency fees in medical liability actions, legislation that MLMIC has estimated could have the effect of raising your premiums by over 10%.   Please tell your legislators to enact comprehensive liability reform to bring down these costs, not legislation that increases them!                                                                                                  (AUSTER, DEARS)

MSSNY Joins Many Other Group in Expressing Strong Concerns with Changes to Payment for Medicare Part B Drugs
MSSNY joined numerous patient advocacy groups, specialty societies and state medical societies in a letter to HHS, CMS and Congressional leaders expressing strong concerns with proposed changes to the methodology for paying for medications covered under Medicare Part B, such as chemotherapy and ophthalmological medications.   CMS is proposing to change the reimbursement methodology of Part B drugs from the current 6% add-on to the “Average Sales Price (ASP)” to 2.5% plus a flat fee.  CMS also proposed a second phase that would implement value-based purchasing tools similar to those employed by commercial health plans, pharmacy benefit managers, hospitals, and other entities that manage health benefits and drug utilization. 

Broad concerns with this proposal were expressed by several groups and members of Congress in a New York Times article last week.  The American Society of Clinical Oncology released a statement condemning the proposal noting that “it is inappropriate for CMS to manipulate choice of treatment for cancer patients using heavy-handed reimbursement techniques…..Physicians did not create the problem of drug pricing and its solution should not be on their backs.”  More here.

To read the CMS press release and other materials describing CMS’ proposal, click here.                                                                                                            (AUSTER)


Assembly Passes Stand-Alone Ethics Reform Bill
On Tuesday, March 15th, the Assembly passed a bill (A.9535) that was introduced by Speaker Heastie and includes over 85 assembly sponsors. The bill proposes to limit outside earned income, close the LLC loophole, place restrictions on legislator-lawyers, and prohibit ownership interests in any company with matters before the state. The bill would limit outside earned income of legislators to no greater than 40% of the annual salary of the state justices of the New York State Supreme Court. And it places restrictions on legislator-lawyers by prohibiting the sharing of legal fees between legislator-lawyers and other lawyers who are not a member of the same law firm, unless the legislator-lawyer actually performs legal work, and the fee is in proportion to the services performed.

Legislators, without a legislative ethics commission written opinion, would be prevented from earning income from ownership interests in any firm, corporation, LLC, or partnership engaged in any lobbying activity (directly or indirectly), representing litigants against the state, contracting with the state, or appearing to have matters before the state. Within 30 days of taking offices, legislators would also be required to submit records of all ownership interests in any company to the legislative ethics commission.                                              (MCPARTLON)


PTSD and TBI in Returning Veterans:  March – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on seven dates listed below from March through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic grow

To register for this webinar, click on a date below and fill out the registration form

Tuesday, March 22, 6-7 PM
Thursday, April 7, 6-7 PM
Tuesday, April 12, 7:30-8:30 AM
Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                                   (DEARS, ELPERIN)

298 Participants View Zika Webinar; Program Archived on MSSNY’s CME Site
Nearly 300 physicians and other healthcare providers participated in this month’s MSSNY Medical Matters program, entitled “Zika—An Evolving Story”.    The webinar was conducted by MSSNY and the New York State Department of Health and featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Dr. Elizabeth Dufort,  medical director, Division of Epidemiology from the New York State Department of Health.   This program has been archived to the MSSNY CME website and physicians and other health care providers can view this program free of charge by logging into the MSSNY CME Website.

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online programs have varying numbers of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY)

Live Seminar on Ebola at MSSNY House of Delegates; Physicians Can Also Participate by Web
The April session of Medical Matters will take place at the MSSNY House of Delegates and is entitled,

“Ebola: A Perspective from the Field”.  The program will be held on Thursday, April 14, 2016 at 2:00pm. Physicians may attend the session at the Westchester Marriott, 670 White Plains Road, Tarrytown, NY 10591 or by webinar.  Registration is limited at the Tarrytown, so physicians are encouraged to register for the live session as soon as possible.   Registration for the live session or by webinar is now open here. Click on the upcoming tab and select the program.

The program will be conducted by Dario Gonzalez, MD, FACEP, Associate Medical Director, Fire Department City of New York/Office of Medical Affairs.  Dr. Gonzalez was deployed for nine weeks by Americares to Liberia, West Africa as part of the US response to the Ebola epidemic.  The educational objective is: Offer perspective and lessons learned from an individual who treated Ebola patients firsthand.

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 mhoffman@mssny.org.
(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 ldears@mssny.org      mauster@mssny.org  
pclancy@mssny.org jmcpartlon@mssny.org    

 

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JAMA: Physicians’ EHR-Inboxes Are Overloaded
A research letter published online March 14 in JAMA Internal Medicine suggest “some physicians receive more than 100 notifications per day via electronic health record (EHR)-based inboxes, and dealing with this electronic burden requires more than an hour every day.” Researchers arrived at these conclusions after evaluating “the electronic logs of 276,207 notifications received from January 1 through June 30, 2015, by 92 physicians at three large practices (one multispecialty and two primary care practices) in Texas.

“Information overload is of emerging concern because new types of notifications and “FYI” (for your information) messages can be easily created in the EHR (vs in a paper-based system). Furthermore, the additional workload to read and process these messages remains uncompensated in an environment of reduced reimbursements for office-based care. Conversely, EHRs make it easier to measure the amount of information received. We quantified the notifications that physicians received via inboxes of commercial EHRs to estimate their burden.”


THIS WEEK: MSSNY in the News
New York Times – 03/14/16
The End of Prescriptions as We Know Them in New York
(MSSNY President Dr. Joseph Maldonado quoted)
Also picked up in:
Times Union – 03/14/16

State rewrites medical practice
(MSSNY President, Dr. Joseph Maldonado quoted)

The Buffalo News – 03/14/16
In New York, paper prescriptions out, computers in
(MSSNY President, Dr. Joseph Maldonado quoted

 

The Oneida Daily Dispatch (AP) – 3/13/16
NY mulls legalizing doctor-assisted suicide
(MSSNY mentioned)

The Daily Freeman(AP)  03/13/16
NY Legislature mulling doctor-assisted suicide bills
(MSSNY mentioned)

The Troy Record (AP) 03/13/16
New York lawmakers eye assisted suicide law
(MSSNY mentioned)

The Saratogian (AP) – 03/13/16
New York lawmakers eye assisted suicide law
(MSSNY mentioned)

Private Officer Breaking News – 03/14/16
New York to Discard Prescription Pads, and Doctors’ Handwriting, in Digital Shift
(MSSNY President Dr. Joseph Maldonado quoted)

Utica Observer – 03/15/16
E-scripts: Is everyone ready?
(MSSNY President Dr. Joseph Maldonado quoted)

New York State Osteopathetic Medical Society – 3/15/2016
NYSOMS joins MSSNY in Powerful Day of Advocacy
(MSSNY mentioned)

Thefix.com – – 03-17/16
New York State Is Doing Away With Paper Prescriptions
(MSSNY President Dr. Joseph Maldonado quoted)

Crain’s Health Pulse – 03/18/16
As e-prescribing deadline looms, DOH issues waivers
(Elizabeth Dears, MSSNY’s senior vice president for legislative and regulatory affairs quoted)


Are You a Pre-residency IMG looking for Experience?  Are You a Physician Who Can Help?
MSSNY’s IMG Committee, through its Clearinghouse of Opportunities Program, seeks to place IMG candidates seeking externship and internship opportunities.

Contact us if you are an IMG looking for a meaningful experience to help you become familiar with the US healthcare system and help prepare you for residency training. Past participants have worked as scribes, entering notes into electronic medical records; performed chart audits for preventive care as a quality improvement measure; educated patients; coordinated with insurance and healthcare providers; helped with research and special projects, etc.

If you are looking for a way to stay connected to medical practice as you pursue residency training, or if you have a position to offer an unlicensed medical graduate, please contact Ruzanna Arsenian (rarsenian@mssny.org). Graduates should include a CV, and those with previous experience in their home countries as faculty members, practicing physicians, or researchers, should be sure to mention that.  Let us know where you are located, how far you would be able to travel, and whether or not you require a paid position or if you could accept a role as a volunteer.

Physicians who are willing to help familiarize an unlicensed medical graduate with medical practice in the US are asked to describe the role they would ask the graduate to fill and include any specific requirements in terms of hours or duties.  Please indicate if the position will include observership experience with a formal evaluation leading to a possible letter of recommendation, or will offer payment for office work performed.


Commit to Pursuing Your Leadership Potential
Join the American Association for Physician Leadership from April 13-15 in Washington, D.C. for the 2016 Spring Institute and engage with health care’s influencers to find solutions to today’s toughest challenges. Register today for leadership courses from the American Association for Physician Leadership®, formerly ACPE, and earn up to 35 CME credits.

Recommended courses:

  • Physician in Management Series (35 CME/Credits)
    Gain a solid foundation to succeed in your new leadership role.
  • Managing Physician Performance (24 CME/Credits)
    Learn to effectively hire, engage and manage physicians within your organization.
  • Election 2016 and Health Policy for Physician Leaders (11 CME/Credits)
    Get insight from health policy experts and learn how to communicate with policymakers.

Register today for leadership courses from the American Association for Physician Leadership®, formerly ACPE, and earn up to 35 CME credits.
View All Courses
Hurry! Hotel group rate expires March 28. 


Zika Virus Update from NYSDOH
New York officials announced a new plan to combat Zika on Thursday. The state of New York plans to “monitor and target a type of mosquito that officials fear could spread the Zika virus,” in addition to distributing “prevention kits to pregnant women.” Thus far the state has reported 49 cases of Zika, all from people who have recently traveled to affected areas, the AP says. Gov. Andrew Cuomo said Thursday that officials “expect that number to go up” but are unsure “how high.”

Health Advisory: Expansion of Zika Virus Testing to Pregnant Women Who Had Unprotected Sex With A Partner Who Traveled to An Area With Active Mosquito-borne Transmission of Zika Virus – March 10, 2016


NYU Med Offerings: Dietary Strategies in Cardiovascular Risk Reduction
Thursday, May 19, 2016, 12:30 PM – 5:30 PM
To Register and for more information: http://www.med.nyu.edu/cme/diet_cardiovascular
The NYU Post-Graduate Medical School designates this live activity for a maximum of 4.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ​

The course will cover topics such as the Mediterranean Diet, the Vascular Biology of Eating, Plant Based Nutrition and explore the evidence and controversies surrounding saturated fat, cholesterol, sugar and salt.  Attendees will also be instructed in dietary assessment and dietary counseling with the latest innovations in counseling—motivation/technology. The course will also offer a unique lecture on the link between the human microbiome and cardiovascular disease.

Advances in Cardiovascular Risk Reduction
Friday, May 20, 2016, 8:30 AM – 3:45 PM
To register and for more information: http://www.med.nyu.edu/cme/cardiovascular
The NYU Post-Graduate Medical School designates this live activity for a maximum of 7.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This one-day course will cover state-of-the-art management of patients with cardiovascular risk factors, with a focus on prevention. This year’s program focuses on recent clinical trial results with implications in the management of cardiovascular disease risk factors, such as diabetes, hypertension and ischemia. Additional topics include new developments in PCSK9 treatments for familial hypercholesterolemia, the use of aspirin in cardiac prevention and weight loss surgery insights.


CLASSIFIED

Physician Opportunities

Family & Internal Medicine Opportunity Just 50 miles North of NYC
Top $$ AND potential partnership with large multi-specialty physicians’ group + the balance of work & personal life you have been seeking. Perfect suburban area just 50 miles north of NYC. This is a growth position with the right person moving into a partnership opportunity within two to three years. You will enjoy a salary of $175K+ as well as:
• A monthly bonus potential
• Health, Dental, Vision and prescription insurance
• 3 weeks’ paid vacation time off annually
• 6 federal Holidays off with pay
• A $2500 CME reimbursement
• A 401K plan with company match
• Company pays 75% of a single premium life insurance policy at twice your annual salary
• Paid malpractice insurance, plus paid DEA and license renewals
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
• Active NYS license
• Current DEA #
• Experienced as well as New Grads welcome to apply
**Relocating physicians are welcome and relocation assistance will be offered to the right candidate!**
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.

Neurologist & Pain Management Physician Needed
A growing multi-specialty group in Orange County is looking for both a Neurologist and Pain Management Physician to join their group. This position will work with the headache center Neurologist/Pain Management Specialist. All subspecialties are welcome.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
   • Experience in procedures and utilizing an integrated comprehensive approach to pain management.
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.


OB/GYN Opportunity in the Hudson Valley
Are you looking for a great work/life balance? We are looking for an OB/GYN to join the team. We are looking for a provider to provide comprehensive primary health care to a select population of essentially healthy women, participate in the care of women with complications & responsible for providing a full range of agency approved antepartum, intrapartum, postpartum, gynecological and family planning service.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
       • Active NYS license
       • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review
.


Pediatrician Opportunity in Orange County, New York
A prestigious multi-specialty physicians’ group seeks a family driven
Pediatrician to join their group.
The ideal candidate will possess the following:
• BE/C in Family Medicine or Internal Medicine
   • Active NYS license
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review. 
.


Psychiatry Opportunity in New York’s Beautiful Hudson Valley
Our client, a prestigious multi-specialty physicians’ group who has been recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance, seeks a Psychiatrist to join their group.
The ideal candidate will possess the following:
• BE/C in Psychiatry
   • Active NYS license preferred
   • Experienced as well as New Grads welcome to apply
For immediate consideration and additional information on position details please contact Laura Rappleyea at 845-344-3434 or lrappleyea@hereshelp.com and send CV’s for review.



Join Well Established Solo Female OB/GYN Physician Practice in New York City
Quality oriented, looking for MD for long term career opportunity. New graduates welcome to apply. Affiliated with Lenox Hill Hospital. The current office has a AAAA certified operating room and an AIUM accredited ultrasound service. Looking to establish another location. Great opportunity to balance personalized practice with quality lifestyle. Please summit CV to obgynpractice130@gmail.com


Jerome I. Sager – Attorney at Law
The health care law experts representing medical professionals for more than 25 years.  See us for Professional Medical Conduct Defense, Medicaid and Medicare Fraud Cases, DEA and Controlled Substance Issues, Third party insurance issues. We can handle most legal matters. Call us for a free consultation. 212-685-2333 / 917-312-6631, jeromesager@cs.com

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