May 6, 2016 – Strength in Numbers!


Dr. Reid
Dr. Malcolm Reid

May 6,  2016
Volume 16, Number 17

Dear Colleagues:

One of my main goals as president of MSSNY is to get our message out to more New York physicians. I am certain that if our colleagues are made aware of everything that MSSNY accomplishes on behalf of all physicians in the state, we will boost membership—and our collective voice will be strengthened.

I encourage each of you to reach out to fellow physicians with the message that MSSNY’s advocacy efforts in Albany have resulted in successes that benefit all of us. Below, I have highlighted some of MSSNY’s 2016 budget victories. Please share them with your colleagues as you encourage them to join us in our efforts:

  • Eligibility for Excess Medical Malpractice Coverage Preserved. The Legislature rejected a proposal from the Executive that would have caused over 13,000 physicians to be dropped from the Excess program.
  • Retail Clinic proposal defeated. The final budget does not include a provision that would have enabled ‘limited service’ clinics in retail stores owned by publicly traded corporations such as CVS, Walmart and Walgreens. MSSNY worked with other primary care and specialty medical societies to defeat this proposal. MSSNY will continue to oppose this proposal, should it resurface toward the end of session.
  • Changes to the Workers Compensation program rejected; role of County Medical Societies preserved! The Legislature rejected the Executive’s proposal to expand the list of providers eligible to deliver (and receive payment directly from the Workers Compensation program) to include acupuncturists, nurse practitioners, physician assistants, and social workers. Significantly, the Legislature also rejected the proposal to eliminate county medical society review and assistance for physicians looking to be authorized to deliver care. We thank the many county medical society leaders across New York State who took the time to contact their local Senators and Assembly members to express their concerns regarding this proposal.
  • Health Republic. The budget expressly articulated the establishment of a fund to be known as the “Health Republic Insurance of New York Fund” consisting of state-derived settlements funds at the discretion of the Director of the State Division of Budget. Any payments to be made from this fund would be made after distribution of Health Republic’s remaining assets in a liquidation proceeding. We are seeking further clarification regarding which monies could be potentially assigned to this fund, and will continue to work with hospital associations to assure the deposit of sufficient monies to fully reimburse physicians and other providers for care provided to patients covered by the now defunct Health Republic.
  • No Regressive Tort Measures Included in Budget. Despite renewed attention on certain regressive tort bills including a date of discovery statute of limitations and repeal of the limitations on attorney contingency fees in medical liability cases, the measures were not included as part of the budget.  It is anticipated, however, that discussion on these issues will resume as MSSNY seeks to achieve meaningful tort reforms this legislative session.
  • Elimination of prescriber prevails rejected. The Legislature rejected proposals that would have eliminated “prescriber prevails” protections for prescribing medications to all patients insured through fee for service Medicaid, as well as for several classes of medications for patients insured under Medicaid managed care.
  • E-Prescribing Exception for Low Volume Prescribers Approved. E-prescribing will not be required of prescribers who issue 25 prescriptions or less each year provided that they submit a certification to that effect to the Department of Health.   A prescriber who has made a certification on or before the expiration of the current 12-month period may do so for a maximum of three 12- month certifications.  MSSNY is continuing to advocate for legislation to reduce the onerous and burdensome requirements for physicians without waivers who issue paper prescriptions through the invocation of one of three statutory exceptions.

The time is now. We must recruit more physicians to join MSSNY and we must increase PAC contributions.  With your help, I am confident that we will succeed.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to



Please Urge Your Legislators To Reject Drastic Liability Expansion Legislation
With the Legislature’s return back to Albany for the final 7 weeks of the 2016 Legislative Session, all physicians must continue to contact their legislators to urge them 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 Statute of limitations to a “Date of Discovery” rule.   A letter to your Senator and Assemblymember can be sent from here.  If enacted, this legislation could increase your premiums by nearly 15%.  In light of the huge financial pressures prompted by excessive government mandates, abusive insurer practices, and enormous new patient cost-sharing responsibilities  that are already threatening the viability of physician practices, 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 your 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 the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an 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 ad (in has appeared in City & State, Politico New York, and the Albany Times-Union.

Also this week, MSSNY sent to the entire State Legislature a letter signed by MSSNY and over a dozen specialty medical societies urging them to reject stand-alone liability legislation that would significantly drive up premium costs, as well as an article by Deiderich Healthcare that highlighted that, once again in 2015, New York overwhelmingly led the nation in total and per capita medical liability payouts.

Legislation To Reduce E-Prescribing Exception Reporting Burden Needs Your Support
Physicians are urged to contact their legislator to urge that they support legislation (S.6779-A, Hannon/A. 9335A, Gottfried) to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription.  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 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.  This legislation has passed the Senate twice but remains stalled in the Assembly Codes Committee. Please urge your legislators to pass this bill by sending a letter located on the MSSNY grassroots action center at this link.                                                                          (DEARS, CLANCY)

AMA and CMS Resources to Better Understand CMS Medicare Value Based Payment Proposed Regulations
Following up our article from last week noting that CMS had proposed regulations to implement the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM) Value-Based Payment components of the MACRA legislation enacted by Congress in 2015, please see a detailed summary prepared by the AMA of the proposal.  Moreover, please review a high level summary of the proposed regulation from CMS.   We urge you to read these detailed summaries closely and respond back with your comments.

While payment adjustments under the MIPS and APMs will not be applied to physician Medicare payments until 2019, the positive or negative adjustments will be based upon care delivered to Medicare patients in 2017.  Under MIPS, Medicare payments could be adjusted up or down by 4% beginning in 2019, and up to +/- 9% by 2022, with additional bonus payments possible for “exceptional performance”.

Next Wednesday, May 11, at 2 PM, the US House of Representatives Ways &  Means Committee will hold a hearing to examine the implementation of the MACRA law, in which CMS Acting Administrator Andy Slavitt is expected to testify.

Comments on the proposed regulation are due to CMS by June 27.  MSSNY will be working with the AMA, specialty medical associations and other state medical associations on developing comments to CMS to address concerns with the proposal.                         (AUSTER)

FDA Announces New Rules to Regulate E-Cigarettes and Other Tobacco Products
The Food and Drug Administration (FDA) this week finalized a rule to extend its regulatory authority over tobacco products to include electronic cigarettes, cigars, pipe tobacco and water pipe tobacco, and will prohibit the sale of these products to people younger than age 18. The regulations also will require cigar and e-cigarette producers to register with FDA. In addition, the rules will require tobacco companies to include specific health warnings on packages and in advertisements for their products.

To read the FDA’s full press release setting forth the new requirements, click here.

“We have more to do to help protect Americans from the dangers of tobacco and nicotine, especially our youth. As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of addiction,” said HHS Secretary Sylvia Burwell. “Today’s announcement is an important step in the fight for a tobacco-free generation – it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions.”    

FDA Recommends Mandatory Training for Prescribers of Opioids
An advisory panel to the Food and Drug Administration (FDA) recommended this week that training for all prescribers of opioids be mandatory.  Such a mandate would require Congressional approval, however.  The FDA committee of outside experts reviewed the risk-management plans introduced nearly four years ago in an effort to reduce misuse of opioids responsible for a national crisis of abuse and death.

Since 2012, the F.D.A. has required drug companies that produce long-acting opioids to underwrite voluntary educational courses on the medications.  Entitled Risk Evaluation and Mitigation Strategies (REMS) courses, they have been offered throughout the country.   It was expected that 80,000 prescribers would take the course,but according to the FDA, less than half of this number have taken these courses.   The pharmaceutical manufacturers of these drugs have now support mandatory training for prescribers.

The recommendation supports tying Schedule II and Schedule III Narcotics DEA registration and re-registration to either completion of prescription opioid education or other attestation of prior knowledge such as board certification in pain medicine.  This would expand education to all ER/LA opioid analgesic prescribers and ensures a common base of knowledge about safe opioid prescribing, particularly around issues of abuse and misuse.                                                 (CLANCY)

Go to MSSNY’s Website To View MSSNYs Archived Opioid Education Webinars
The Medical Society has archived its opioid webinar series on its continuing medical education website at

The webinars are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems; Webinar 2 Rational Opioid Prescribing:  Is this Possible for Chronic Pain?; Webinar 3 Treatment of Opioid Use Disorders and Webinar For Pain Patients w/Substance Use Disorders.

  • 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 the webinars 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 to the top right of the page and click on “My training” to view your training page
  • The courses are listed under: A Webinar Series on Opioid Use, Treatment, and Addiction.

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 enduring 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 on all these programs may be obtained by contacting Pat Clancy at

Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-B, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  Please send a letter in support of this legislation by clicking here.

This week, an op-ed written by the sponsor of the bill headlined “Assemblyman Titone to Insurers: Stop Playing Doctor” appeared in the Staten Island Advance calling for the State Legislature to enact this common sense legislation.

We strongly encourage physicians concerned about this issue to participate in an upcoming May 23 Albany advocacy day in support of this legislation.  If you are interested in participating please e-mail  MSSNY representatives will be participating along with many other patient advocacy groups.

Scores of Members of Congress Urge CMS to Put the Brakes on Damaging Part B Medication Reimbursement Proposal
242 Members of the U.S. House of Representatives, including all 9 New York GOP members, have signed a letter to CMS urging that they put on hold a proposal to revise (and reduce) the payment methodology for in-office use medications covered through Medicare Part B.  MSSNY previously joined on with several other organizations in a letter to the New York Congressional delegation urging that they urge CMS to withdraw this damaging proposal noting that the proposal “will adversely affect the care and treatment of New York Medicare patients with complex conditions, such as cancer, macular degeneration, hypertension, rheumatoid arthritis, Crohn’s disease and ulcerative colitis, and primary immunodeficiency diseases”.  The AMA also sent a similar letter to Congressional leaders. 

Signing on to the House GOP letter included New York Representatives Chris Collins (Western NY), Dan Donovan (Staten Island), Chris Gibson (Hudson Valley), Richard Hanna (Central NY), John Katko (Central NY), Peter King (Nassau County), Tom Reed (Southern Tier), Elise Stefanik (North Country), and Lee Zeldin (Suffolk County).

Several Democrat members of the House of Representatives, including New York representatives Yvette Clark (Brooklyn), Joe Crowley (Queens), Steve Israel (Nassau/Suffolk Counties), Kathleen Rice (Nassau County) and Paul Tonko (Capital District) signed onto separate letters to CMS expressing their concerns with this proposal.

At the same time, the Republican members of the U.S. Senate Finance Committee sent a letter last week calling on CMS to “immediately” withdraw the proposal, noting that they are “perplexed” by the “unprecedented scope” of the proposal, as it could decrease the quality of beneficiary care, increase Medicare costs, and further hospital-physician practice consolidation.  The Democratic members of the US Senate Finance Committee, including New York Senator Chuck Schumer, also sent a letter to CMS expressing concerns with the proposal:.  The letter notes that “any proposed changes to the Part B program must be carefully considered to prevent any disruptions in care for Medicare beneficiaries, particularly those with serious and complex conditions”.   Moreover, the letter noted that it was essential that CMS engage with the impacted community, including directly with impacted patients.   

MSSNY thanks all the members of New York’s Congressional delegation who have demonstrated their commitment to protecting the ability of our seniors to continue to receive necessary care from the community physician of their choice.

Radiological Emergencies CME Webinar to Be Held May 18th;
Registration Now Open
Registration is now open for MSSNY’s Medical Matters webinar on  “Radiological Emergencies” to be held May 18, 2016 at 7:30 AM.  Physicians and other health care providers may register hereClick on the upcoming tab and select the webinar.

Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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

PTSD and TBI in Returning Veterans:  May – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on four dates listed below from May 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 growth

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

Thursday, May 12, 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                                                                                                                           (ELPERIN, DEARS)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:    

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MSSNY Counsel Don Moy: HR Liquidation Process to Begin on May 10
On April 22, 2016, the Superintendent of Financial Services commended a liquidation proceeding for Health Republic Insurance of New York, Corp. (HRINY) in the NYS Supreme Court, New York County.  HRINY has consented to the proceeding.

A hearing has been set for May 10, 2016 at 9:30 a.m.  At the hearing, it is expected that the judge will approve a Liquidation Order that will appoint the Superintendent as the Liquidator and allow the liquidation process to proceed.  The Liquidator will be authorized and directed to take possession and control of HRINY’s property and assets and to liquidate HRINY’s business affairs in accordance with the requirements of the N.Y. Insurance Law.

Physicians and other health care providers should have submitted claims for health care services by March 31, 2016 in accordance with the procedures and deadlines set forth in the contracts governing their provision of services to HRINY’s Members.  Claims that were submitted in accordance with the relevant contractual requirements do not need to be re-submitted.   Providers will receive Explanations of Benefit statements and information about the process for submitting any appeals as soon as available.  HRINY Members should have submitted claims for out-of-network services by March 31, 2016 in accordance with the procedures and deadlines set forth in their insurance policies.  Policy claims submitted in accordance with the relevant contractual requirements do not need to be re-submitted.

For more information regarding the Superintendent’s Order to Show cause and Verified Petition go to ; and for information regarding the  Liquidation Process and Claims Process go to 

Reminder: Open Payments Physician and Teaching Hospital Review and Dispute Period Ends May 15, 2016
Physicians and teaching hospitals have until May 15, 2016 to voluntarily review data reported by drug and medical device makers about them for calendar year 2015, and, if necessary, dispute payments, before the data is made public on June 30, 2016.

To review and dispute data, physicians and teaching hospitals must register in the Open Payments system.

If You Have Never Registered with Open Payments Before:

Make sure you have your National Provider Identifier (NPI) number, Drug Enforcement Agency (DEA) number, and State license number (SLN).  Initial registration is a two-step process and should only take 30 minutes:

  1. Register in the CMS Enterprise Identity Management System (EIDM);
  2. Register in the Open Payments system

Please remember to select the role of “Applicable Manufacturer/GPO, Physician, or Teaching Hospital”, when registering in EIDM. If any other role is requested, no access to the Open Payments System will be granted. For any additional information on registering in EIDM, refer to the EIDM Registration Quick Reference guide here.

For Users That Registered Last Year and Have Used Their Accounts in the Last 60 Days:

Physicians and teaching hospitals who registered last year do not need to reregister in the EIDM or the Open Payments system. If the account has been accessed within the last 60 days, go to the CMS Enterprise Portal, log in using your user ID and password, and navigate to the Open Payments system home page.

For Users That Registered Last Year but Have Been Inactive for More than 60 Days:

The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For Users That Registered Last Year but Have Been Inactive for More than 180 Days:

The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, contact the Open Payments Help Desk.

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website.

For assistance with the registration process, please call our live Help Desk at 1-855-326-8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays. Questions can also be submitted to the Help Desk via email, at

The U.S. Food and Drug Administration today approved the first generic version of Crestor (rosuvastatin calcium) tablets for the following uses:

  • in combination with diet for the treatment of high triglycerides (hypertriglyceridemia) in adults;
  • in combination with diet for treatment of patients with primary dysbetalipoproteinemia (Type III Hyperlipoproteinemia), a disorder associated with improper breakdown of cholesterol and triglycerides;
  • either alone or in combination with other cholesterol treatment(s) for adult patients with homozygous familial hypercholesterolemia, a disorder associated with high low-density lipoprotein (LDL) cholesterol.

In the clinical trials for Crestor, the most common side effects reported by participants taking Crestor included headache, pain in muscles (myalgia), abdominal pain, abnormal weakness (asthenia), and nausea.Rosuvastatin calcium should not be used in women who are pregnant or may become pregnant as it may cause fetal harm. Women who require treatment with rosuvastatin should be advised not to nurse their infants.

For more information, please visit: rosuvastatin.

Zika Information and Resources

  • On Thursday, the CDC reported a small study in Brazil that associated Zika with Guillain-Barre syndrome. The study did not confirm Zika infection in the patients, though according to lead author Dr. Ashley Styczynski of the CDC that data should be available in about a month. The study found that nearly 90 percent of those suffering from Guillain-Barre had also reported Zika-like symptoms earlier.
  • Onondaga County has two confirmed travel-related Zika cases, according to Syracuse (NY) Post-Standard. The county does not have the mosquitoes that spread the virus.
  • Information for Providers

For the latest information, including laboratory test instructions and forms, health alerts, and latest guidance, click here.

Latest Facts and Advisories as of 4/27/2016 [ Español (PDF)]
Reported cases of Zika in New York City: 59
·       Eight of the fifty-nine cases were pregnant at the time of diagnosis;
·       All cases contracted Zika while visiting other countries; and
·       All patients have recovered.

CMS to Host Webinars on MACRA and MIPS
On May 10, CMS will present MLN Connects National Provider Call, MACRA Listening Session: Quality Payment Program Proposed Rule. This call will be an opportunity for stakeholders, specifically Part B Fee-For-Service clinicians, and state and national associations that represent healthcare providers, to provide CMS with early feedback on the proposed policy for the Quality Payment Program. To participate, visit the MLN Connects Event Registration page. Space may be limited; please register early.

CMS also encourages you to register for:

The Merit-Based Incentive Payment System (MIPS) Overview

  • Date: Wednesday, May 11, 2016
  • Time: 12:00 p.m. – 1:00 p.m. ET
  • Details: As one path of the Quality Payment Program, MIPS streamlines three independent programs into one to ease clinician burden. MIPS also adds a fourth component to promote ongoing improvement and innovation to clinical activities. This listening session is an opportunity for stakeholders to learn about MIPS and also provide CMS with initial feedback on the proposed policy for the Quality Payment Program.
  • Register: To participate, visit the registration webpage.

Space for these webinars is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.

Please note: There will not be a Q&A period during these listening sessions. CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to send initial comments or questions using the webinars chat feature, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment. Comments are due by 5:00 p.m. ET on June 27, 2016.

For More Information
CMS encourages participants to review the proposed rule (CMS-5517-P), press release, and fact sheet prior to the listening sessions. Additional resources are also available on the website

MSSNY in the News
Lohud – Business Briefs
Briarcliff Manor’s Reid Elected President
(MSSNY President Dr. Malcom Reid mentioned)

Lohud – Business Briefs
Litvack reelected at medical society
(MSSNY Assistant Secretary Dr. Bonnie Litvack mentioned)

Greater New York Hospital Association Skyline News – 05/02/16
GNYHA, Allies Launch Med Mal Ad Campaign
(MSSNY mentioned)

Rome Sentinel – 05/02/16
Dr. Maldonado named president of state Medical Educational & Scientific Foundation
(Former MSSNY President, Dr. Joseph Maldonado, MD mentioned)

New Amsterdam News – 05/05/16
Americans need wake-up call on importance of sleep
(MSSNY mentioned) 

Valuing Episodes of Care: Expanding Transparency, Redefining Reimbursement
Join FAIR Health for a Free Webinar on Valuing Episodes of Care: Expanding Transparency, Redefining Reimbursement 

Date: Thursday, June 9, 2016
Time: 2:00 – 3:00 pm ET.

As the national healthcare system considers value-based reimbursement, stakeholders involved with everything from designing benefits plans to establishing fee schedules to equipping consumers with decision-making tools will benefit from an understanding of episodes of care—the full range of procedures and services associated with a given illness or condition. The presentation will examine how populating episodes of care with robust, reliable cost data, calibrated for risk factors, can ensure an organization’s success as the industry evolves to new and innovative reimbursement models.

Register to learn about:

  • Using bundled cost information to plan for the impact value-based reimbursement will have on your business;
  • Developing models based on group-specific claims data to identify and reduce potentially avoidable complications and, ultimately, improve outcomes and realize savings;
  • Designing and pricing benefits plans based on reimbursement for all care associated with treating a single common condition or illness;
  • Why risk profiles are critical when estimating the cost for episodes of care;
  • The value of studying variations in cost and utilization across geographic areas and over time;
  • Offering episodes of care data in user-friendly formats customized for each audience segment to promote understanding of the complete cost of care;
  • How decision-support tools fueled by complete cost data can promote sound consumer decision making, such as minimizing unnecessary ER visits; and
  • How cost information can help to improve the overall patient experience.

Sign up now. Space is limited, so RSVP today.

What is the Senate Finance Committee’s Criticism of the CMS’
Recently Announced Medicare Part B Rule?
Answer: Republican and Democratic Senators have both come out against the CMS’ proposed rule, which covers Part B drugs, such as cancer medications, that are administered in a doctor’s office or hospital outpatient department. The proposed payment model would test new ways to support physicians and other clinicians “as they choose the drug that is right for their patients,” the Centers for Medicare & Medicaid Services said in their March 11, 2016 announcement. Finance Chairman Orrin Hatch (R-Utah) and other committee Republicans wrote in a letter to the CMS that the proposed payment model would require health-care providers across the nation to engage in drastic changes in payment procedures.

The letter uses as an example the proposed average sales price (“ASP”) payment reduction in the rule as particularly problematic. The ASP would limit access to “vital drugs,” as many providers would face prescription costs which exceed the new Medicare payment amount offered under the model. This problem severely affects small physician practices and practices in rural areas where physicians who have trouble accessing drugs with the reduced ASP payment would likely refer patients to hospital outpatient departments, which are a less-convenient and more costly setting, they added. Overall, the letter argues, the ASP proposal would limit beneficiaries’ choice, increase costs and could further hospital acquisitions of physician practices.

A letter from Finance Committee Democrats also outlined concerns about reducing ASP and how doing so would affect drug access and push beneficiaries to more costly hospital outpatient departments. The medical community in large part, particularly the Community Oncology Alliance, praised the letters and hoped they would put an end to the proposed misguided and dangerous experiment. The CMS is still receiving comments on the rule (CMS-1670-P), which are being accepted until May 9, 2016.

If you have any questions, please contact Kern Augustine Conroy & Schoppmann, P.C. at 1-800-445-0954 or via email at 


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  cell 914 772-5581

Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at We take care of the rest!

Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 /

Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 Can build to suit including accredited O.R.s

NORTHERN WESTCHESTER – Psychiatric Opportunities
Part-time Psychiatrist (BC/BE/Child very desirable) wanted, to work in North Salem, N.Y., Suboxone DEA license helpful. Fax qualifications and availability to 914 669-6051 or call 914 669-5526 with questions..

Practice for Sale; North Salem, N.Y.
This is an excellent opportunity for someone wanting to purchase an established, growing practice. North Salem is a semi-rural suburban area 30 minutes north of White Plains; close to I-84, and I-684. This is an excellent place to live and practice, with excellent schools, close to malls and shopping. We treat patients of all ages, and there is a substantial Suboxone component integrated into the practice. Staffing includes several part-time psychiatrists, therapists. Patients come from Northern Westchester, nearby Putnam County and the Ridgefield-Danbury area and include children, adolescents, adults, families, Geriatric patients. Reliable office staff assist in patient and insurer management. Call 914 669-5526.

Physician Opportunities

Unique Private Pediatric Practice Opportunity
Summerwood Pediatrics is a very progressive, large community-based private practice in the Syracuse area. We provide care for over 25,000 children from birth to 21. The practice also has a satellite office in Camillus, NY. Additionally, the practice operates adjacent to an independent outpatient infusion practice, which is alsoowned and operated by our medical director. We are looking to employ a bright, energetic and enthusiastic general pediatric or subspecialty-trained physician. Presently the practice employs seven physicians, two pediatric NPs and one PA . All providers share on-call responsibilities on a one-day per week basis. Weekend coverage and office hours are performed on a rotational basis by the physicians. Our offices encompass over 28,0000sq. ft. of state-of-the- art clinical space;on-site lab services. The position, either full or part-time, includes applicable benefits inclusive of health care, malpractice insurance, CME expenditures and retirement plan. To discuss this opportunity further, contact either Dr. Robert A. Dracker or Mr. Warren Ford at 315-457-9914…9-5 EST.

Medical Director at CDPHP: Voted NYS “Best Company” by Our Employees!
CDPHP is more than a health insurer. We are a not-for-profit health value organization leading the way toward better, more affordable health care. CDPHP represents progress and innovation for more than 425,000 members throughout New York. A physician-founded and guided plan, our primary focus is the health and well-being of those we serve. While other insurers strive to create value for their shareholders, our efforts are centered on creating value for members, in part by providing employers with innovative solutions for managing health care. The Medical Director will assist the Vice President, Senior Medical Director and the SVP of Medical Affairs with the implementation of the Plan’s Medical Management, Quality Improvement and Resource Management initiatives in accordance with regulatory, accreditation, and corporate policies and strategic plan. The Medical Director will participate in the medical advisory committees, provide leadership to, and serve as a liaison between the physician community and the Plan’s management.The ideal candidate will possess the following:

  • Licensed physician with current, unrestricted license (preferably New York State); Board Certified to practice a medical specialty; ABMS specialty is required.
  • If not licensed in New York State, eligibility for New York State licensure is required.
  • Additional advanced degree(s) preferred.
  • Minimum three to five (3-5) years clinical practice experience is required.
  • Minimum of three (3) years managed care or practice management is preferred.

Please email nicole.harrington@cdphp.comEqual Opportunity Employer, females, minorities, disabled, veterans