MSSNY eNews – Final Days to Support or Kill !
PRESIDENT’S MESSAGE Thomas J. Madejski, MD MSSNY President MSSNY eNews June 15, 2018 Number 22 |
Dear Colleagues:
There has been much discussion in the media that, with the close divide in the New York State Senate, nothing much is happening in Albany. Nothing could be further from the truth. This week, the Legislature completed passage of a couple of issues of importance to New York physicians, including prohibiting those under 18 from using tanning facilities and extending for another 5 years the services of MSSNY’s Committee for Physicians Health.
As we head into the final days of the Legislative Session, there are a significant number of health care issues “below the radar” still under active consideration before the Legislature leaves Albany for the year. Legislators and staffs will be working through the weekend and round the clock to negotiate final deals. Among these issues under discussion:
- Legislation supported by MSSNY and other patient advocacy groups that would prohibit health insurers from making mid-year formulary changes;
- Legislation supported by MSSNY and other patient advocacy groups to increase the legal age to purchase tobacco;
- Legislation supported by MSSNY and the NYS Psychiatric Association to have insurer compliance with mental health and substance abuse parity laws to be publicly disclosed in the DFS Consumer Guide to Health Insurance;
- Legislation opposed by MSSNY and other patient advocacy groups that would mandate physicians to report certain patients to DMV;
- Legislation opposed by MSSNY that would expand the types of providers who are permitted to treat injured workers under Workers Compensation, and reduce the involvement of county medical societies in credentialing physicians for WC participation;
- Legislation that would expand the applicability of New York’s “surprise” bill law to hospitals;
- Legislation that would create a Maternal Mortality Review Board
Please see below for more information on many of these issues, including in some cases requests to send letters to legislators on these items. Please remain alert for calls to action, as the end of the Legislative Session can bring surprises that warrant immediate physician grassroots activity.
And, if you are not a member of our Physician Action Liaison (PAL) program, you can join by e-mailing jbelmont@mssny.org.
Greetings from AMA Meeting in Chicago
I’m writing while sitting at Gate A4B at Midway airport. I’m returning from Chicago and the AMA HOD where I represented MSSNY along with our great MSSNY delegation to the AMA members.
Our delegates take up to a week of their personal time to advocate MSSNY policy and confer with colleagues from throughout the country on issues affecting your practice. We listened, learned, and discussed over 500 items that affect the practice of medicine, public health and other areas that affect the lives of our patients and families. You can find a summary of the highlights here.
A few years back, I was elected to the AMA Council on Medical Service (CMS). We focus on socio-medical economic issues that impact our practices and our patients. I’m proud of the work we do on the Council and recommend you review all the reports, especially CMS on long term support services. I think we did important work on trying to create a sustainable funding stream for long term care, especially important as our population skews older. I’m looking forward to meeting with the NY Society of Interventional Pain Physicians today to update them on current legislation in the NY Assembly and Senate.
Congratulations to Dr. Kira Geraci-Ciardullo who was reelected to Council on Science & Public Health at the 2018 AMA House of Delegates. |
Please send your thoughts to comments@mssny.org.
Thomas J. Madejski, MD
MSSNY President
Please Urge Your Legislators to Support Legislation to Prohibit Mid-Year Formulary Changes Earlier in the year MSSNY participated in a press conference in support of the legislation, together with the sponsors of the bill, as well as many of its supporters, including the Global Healthy Living Foundation, Lupus and Allied Diseases Association, NAACP, AARP, New Yorkers for Accessible Health Coverage, the Epilepsy Foundation, the Arthritis Foundation, the American Cancer Society, the National Association on Mental Illness-NY, the NY Chapter of the American College of Physicians, the NYS Osteopathic Medical Society, and the American College of Rheumatology. MSSNY President Dr. Thomas Madejski stated the following for the press release: “Continuation of a medication regimen prescribed by a patient’s treating physician is critical to assuring a patient’s recovery from illness, maintaining their health, or preventing worsening of their condition. Unexpected changes to a medication formulary could result in significantly higher out-of-pocket costs for patients. This could seriously interfere with their continued ability to obtain these needed medications. Insurance company formulary changes are not made with the intimate knowledge of the patient’s personal physician. Additionally, this legislation would help to protect consumers from unforeseen higher cost-sharing requirements.” (AUSTER) Tanning Bill Prohibition for Children Under 18 Passes NYS Legislature Epidemiologic data suggest that most skin cancers can be prevented if children, adolescents, and adults are protected from UV radiation; however, melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for adolescents and young adults 15-29 years old. Moreover not only is indoor tanning associated with melanoma, but new evidence demonstrates that over-use of indoor tanning beds is associated with a 69% increased risk of early-onset basal cell carcinoma (BCC), the most common form of skin cancer. Risk of developing BCC was higher in those who begin indoor tanning at earlier ages (less than 16 years old). (CLANCY) MSSNY Committee for Physicians’ Health Bill Completes Passage in Legislature The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness. Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice. The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees. The bill must now be sent to the Governor for his signature. However, since the bill was advanced by the NYS Department of Health, it is likely to obtain his approval. MSSNY thanks Senator Hannon and Assemblyman Gottfried for advancing this important legislation. Bill To Call on DFS to Evaluate Insurers & Health Plans Compliance with Mental Health & Substance Use Disorder Parity Laws The information collected would be analyzed and used for the preparation of a parity compliance report in the annual “Consumer Guide to Health Insurers” issued by Department of Financial Services. Although MH/SUD parity laws have been on the books for over a decade on the federal and state level, recent Attorney General settlements note that there continue to be patterns of disparity between coverage criteria imposed on MH/SUD care and treatment as compared to other covered services. This further demonstrates the need for an industry wide approach and annual evaluation of compliance. MSSNY along with NYSPA firmly believe this legislation is the next step for New York to take to assure compliance and full implementation of the federal and state MH/SUD parity laws, thereby enhancing access to care for MH/SUD care and treatment. (CLANCY) NYS Assembly Passes Single Payor Legislation Various Workers Compensation Reform Initiatives Under Discussion As part of an initiative to better ensure access to care for injured workers, the New York State Workers Compensation Board has released a proposed regulation to provide an “overall” 5% increase in the Workers Compensation medical fee schedule effective October 1, 2018. The statement accompanying the release of the proposed rule noted that “areas with shortages of medical providers authorized to treat injured workers may see further increases.” To review how such increase is proposed to be implemented, click here. As comments are due to the WCB by August 5, MSSNY is reviewing the entire proposal, and has sought feedback from the members of its Workers Compensation and No-Fault committee. MSSNY has also sought input from societies representing affected medical specialties such as Orthopedics, Anesthesiology and Osteopathy. The proposed regulation also notes that the cost of ordering a hard copy of the fee schedule will be $100, and an electronic copy will cost $400. Another positive development is a regulatory proposal of the WCB to increase the WC testimony fee for physicians from $400 to $450. Distinct from these regulatory proposals, the WCB has also advanced legislation (S.8812-A/A.8387-C) in the Assembly and Senate that would expand the list of eligible providers allowed to treat injured workers. The bill expands eligibility to include acupuncturists, chiropractors, nurse practitioners, physical therapists, physician’s assistants, podiatrists, psychologists and social workers. MSSNY has expressed concern that the proposal would enable a nurse practitioner to assess an injured worker’s level of disability and determine causation of a patient’s injury without the involvement of a physician. MSSNY has also expressed concern over another component of the legislation that would modify the process of how county medical societies recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation. While the provision has been improved over earlier versions, MSSNY remains very concerned that the phrasing of the proposal could enable the WCB to bypass the county medical society in approving physicians to be authorized to treat or provide IMEs under Workers’ Compensation. MSSNY has also urged that any legislation in this area must also address the problem of Workers Compensation carriers inappropriately claiming contractual discounts to pay below the stated WC fee schedule. Please remain alert for further updates on these issues including the need for potential grassroots action. (AUSTER, BELMONT) Physicians Urged to Contact their Senators on Legislation that Imposes New Mandates on Physicians already requires physicians to report immediately to the local health officer regarding the presence of any communicable disease. The health officer is then charged with the responsibility to investigate cases of communicable disease, to ascertain sources of infection, to seek out contacts, and to take other steps to reduce the spread of the disease. Increasing mandates take more and more time away from the ability to deliver the timely care patients expect to receive. The bill is on the “Debate List” of the floor of the Assembly and on the floor of the Senate. Earlier this week the bill was to be taken up on the Senate floor. However, considerable grassroots activism, as well as significant lobbying in Albany with other advocates, prompted several Senators to raise concerns with the bill and cause the bill to be “laid aside.” However, the bill can still be taken up at any time throughout the next week. (BELMONT) Assemblyman Abbate Introduces Legislation to Address Experts in Medical Liability Actions DOH Offers New Resource on HIV Testing, Reporting and Confidentiality Update The FAQ incorporates all developments since 2010 and represents the current regulatory landscape. The FAQ has a new user-friendly design allowing easy navigation to specific topics and links to important resources. Some of the important topics covered include:
The FAQ can be found HERE. Links to register for two webinars to be offered on these topics and can be found in the letter. All health and human services providers involved in HIV prevention, testing, medical care and linkage/retention services should carefully review this document to ensure implementation of these updates. A host of resources on HIV testing, can be found on the DOH website at: https://www.health.ny.gov/diseases/aids/providers/testing/. If you have any questions, please contact our shared mailbox at hivtestlaw@health.ny.gov. (CLANCY) Physicians Urged to Contact Legislature Requesting Action on Raising the Tobacco Purchase Age Health care costs and lost productivity for the under aged smokers of today will cost the state over $11 billion. Moreover, the earlier people begin to smoke, the higher their risk for developing lung cancer and other major health problems. Preventing tobacco use among young people is a critical step in reducing growing health care costs and ensuring the health of future generations. Physicians are encouraged to send a letter to their legislators urging action HERE. (CLANCY) Measure To Allow Use of Marijuana To Treat Pain Moves Forward in Legislature The Medical Society of the State of New York is opposed to this measure as there are no established guidelines for treatment of acute pain. In addition, there is insufficient evidence to support the recommendation of marijuana as an alternative to opioid pain medications for chronic pain. Furthermore, there is insufficient evidence to support marijuana as an alternative to other treatments for acute pain, including in patients with opioid use disorder. MSSNY also believes that placing a patient on Medication Assisted Treatment (MAT) for opioid use disorder may be a more appropriate option for treating pain when an alternative opioid pain medication may not be appropriate for those patients that suffer from opioid use disorder. Of greatest concern is the changing federal landscape and risk of prosecution. The Medical Society notes that the United States Attorney General Jeff Sessions has rescinded the Obama Administration guidelines that had for all practical purposes allowed states to authorize the use of marijuana under state law without fear of federal prosecution. This action by AG Sessions may allow federal prosecutors to more aggressively enforce marijuana laws. It remains unclear how this action will impact states where marijuana is legal for medical purposes. An aggressive position taken by the AG could result in federal prosecution of any participants in medical marijuana programs such as patients, those who work at dispensaries, or physicians who certify patients to obtain medical marijuana. (CLANCY) Legislation to Create Maternal Mortality Review Board Under Serious Discussion in Session’s Final Days Importantly, the bill provides necessary confidentiality protections to the board’s proceedings to allow for open and honest dialogue and review. However, some are continuing to advocate to minimize these broad confidentiality protections, which MSSNY and ACOG fears would seriously undermine the quality improvement goals of the MMRB. The bill is also supported by the Healthcare Association of New York State and the Greater New York Hospital Association. (AUSTER, CLANCY) Bending the Diabetes Curve CME Course Available Online Webinar: Bending the Diabetes Curve Educational Objectives:
To view this course, click here. MSSNY is dedicated to educating the physician population on prediabetes and will be providing educational webinars and podcasts in the coming weeks. Physicians are encouraged to visit our Diabetes webpage to learn more about MSSNY’s collaboration with the AMA and the Prevent Diabetes STAT toolkit. 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 each of these live activities 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. Additional information or assistance with registration may be obtained by contacting Carrie Harring at charring@mssny.org. (HARRING) Medical Society of the State of New York Announces June Medical Matters CME Webinar Schedule (Registration Still Open) June 20th at 12:30pm – Medical Matters: Children’s Mental Health After Disaster Register for this webinar here. Faculty: Linda Chokroverty, MD
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 each of these live activities 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. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. (HOFFMAN) Medical Society of the State of New York Announces Veterans Matters Programs are Available on CME Website The Medical Society has created a free CME program series entitled Veterans Matters to assist New York State physicians in recognizing the unique health problems faced by veterans and the best way to provide care to veterans. These programs are all available at https://cme.mssny.org. Veterans Matters: PTSD & TBI in Veterans Faculty: Emerald Lin, MD
Veterans Matters: Substance Use Disorders in Veterans Faculty: Frank Dowling, MD
Veterans Matters: Suicide in Veterans Faculty: Jack McIntyre, MD
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 each of these live activities 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. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. (HOFFMAN) Medical Society of the State of New York Encourages You to Check out CME Website Additionally, all of our Medical Matters programs from the past several years have been archived at https://cme.mssny.org. Topics range from Zika Virus, Influenza and Plague to Nuclear Radiation, Disaster Triage and Mental Health as well as a variety of other timely and relevant subjects. For assistance, or more information, please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085. (HOFFMAN) Rare Tick-Related Powassan Virus Reported in Columbia County It’s the first such case confirmed this year in New York, and it may be the last one, according to state health officials. Bryon Backenson, deputy director of the state Health Department Bureau of Communicable Disease Control said, “We’ve only had 29 cases ever in the state since the early 2000s when it first really became known.” There were six confirmed cases in the state last year, including three in Saratoga County. A 74-year-old man from Gansevoort died after contracting the virus last year. Nationwide, about 100 cases have been reported — largely in the Northeast and Great Lakes region, the Centers for Disease Control and Prevention reports. Unlike Lyme and other tick-borne diseases, a tick can transmit Powassan virus while being attached to a person for as little as 15 minutes, the state Health Department reports. The disease does not, however, spread from person to person. It can also cause life-threatening encephalitis, or inflammation of the brain. Long-term neurological problems may occur. There is no specific treatment, according to the CDC, but people with severe virus illnesses often need to be hospitalized to receive respiratory support, intravenous fluids or medications to reduce swelling in the brain.(Times Union, June 13) AMA Endorsed Gun Control Measures at Annual Meeting
Support for the policy platform was overwhelming — with a vote of 446 to 99. In the past, the AMA has backed other gun control approaches. As the AP reported, “it has supported past efforts to ban assault weapons; declared gun violence a public health crisis; backed background checks, waiting periodsand better funding for mental health services; and pressed for more research on gun violence prevention.” Free Garfunkel Wild Webinar: “Right to Try” Act: What You Need to Know On May 30, 2018, a new Federal “right to try” act became effective which gives patients with life-threatening conditions the right to use experimental medications without the approval of the Food and Drug Administration. This new Federal law impacts Hospitals, Physicians, Drug Manufacturers and Patients. Join MSSNY Counsel, Garfunkel Wild, as they explore the consequences and questions of this new law. The speakers are healthcare experts Vice Chairman Andrew Blustein and Partner Lara Jean Ancona and Associate Stacey P. Klein. Registration is limited. After registering, you will receive a confirmation email containing information about joining the webinar. Nurse Practitioner License Suspended For Bringing 3000 Patients’ Info to New Job The incident violated patient privacy rights under the Health Insurance Portability and Accountability Act (HIPAA) and resulted in URMC being fined $15,000 by the office of then-Attorney General Eric Schneiderman. URMC did not face any federal sanctions. On or about April 15, 2015, Smith-Lightfoot gave spreadsheets with personally identifiable information of about 3,000 patients to another health provider without the patients’ permission, according to a consent order agreed to by Smith-Lightfoot and the state nursing board Office for Professional Discipline. Smith-Lightfoot signed the consent order last November and the Board of Regents accepted it in February. URMC learned about the breach in April 2015 from patients who received letters from Smith-Lightfoot’s new employer, Greater Rochester Neurology. Democrat Chronicle
PAI’s QPP Tip of the Month – Check Your Eligibility!
To learn more about category-level bonus points and scoring across all MIPS categories, please find PAI’s comprehensive resources here. QPP Look-Up Tool Now Includes 2018 MIPS Eligibility and Predictive Qualifying APM Participant Data Just enter your National Provider Identifier (NPI) in the tool to find out:
Note: The Predictive QP status is based on calculations from claims with dates of service between 1/1/17 and 8/31/17. To learn more about how CMS determined Predictive QP status, please view the Predictive QP Methodology Fact Sheet. Clinicians Can Also Check 2018 MIPS Clinician Eligibility at the Group Level and APM Predictive QP Status at the APM Entity level: To check your group’s 2018 QPP eligibility:
We are also pleased to announce that you can now download the list of all NPIs associated with your TIN. The downloaded file also includes eligibility information for each NPI. This enhancement was made in direct response to stakeholder requests for this helpful function. |
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Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to: NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830
The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer.
CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355