MSSNY eNews: November 13, 2020 – Survey: 66% Have Difficulty Obtaining PPE

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Colleagues:

Over the last few weeks amid the rising number of COVID 19 cases in NYS and rising COVID-19 hospital admissions, MSSNY heard anecdotal reports of increasing PPE supply chain disruption from members. A MSSNY survey was conducted last week to ascertain the scope of the problem.  Highlights of the survey show:

  • Nearly 2/3 of the physician respondents indicated that they are at least “sometimes” finding it difficult to obtain needed PPE 
  • Over 40% of the physician respondents have indicated that it takes them at least 4 weeks to get their PPE from when they order it; Nearly 20% said it takes at least 6 weeks. 
  • 53% of the physician respondents said the cost of PPE has gone up by at least 25% compared to pre-pandemic levels, and nearly 1/3 have said the cost has gone up by more than 50% 
  • 1/3 of the physician respondents indicated that the lack of available/affordable PPE has impacted their ability to care for patients; and 
  • Only 6% of the physician respondents said that health insurers were at least “sometimes” helping to cover the increased cost. 

MSSNY has shared these results with the NYS DOH and has reiterated our need for additional state assistance on this front. We have also sought to share our concerns with the media and the public to have them be more aware of the consequence of these challenges to patient care delivery.  NYS must heed the lessons learned this spring. Our NYS community physicians are our first line of defense in the fight against COVID. Our community physician offices must remain open to take care of patients and help fend off the rise in hospital admissions.  To stay open, they need a ready supply of affordable, reliable PPE and they need the state government to help provide that PPE.  Models exist that have worked in states like California and Texas that helped to procure millions of dollars’ worth of PPE for their State Medical Societies to distribute to their community-based physicians.

Second Wave

As cases begin to surge in NYS, our physicians are not only concerned about PPE but also their ability to keep their doors open for patients amid a second wave. With this in mind, your MSSNY member benefits committee has been actively looking for products and partnerships to enhance your bottom line. MSSNY is excited to present such an offer to our members– a GPO (Group Purchasing Organization) member benefit through Premier Inc, one of the largest group purchasing companies.  There are no fees and no minimums, just savings for you and your practice.  The savings in most cases are significant and will more than cover the cost of MSSNY membership.  Enrollment is simple and employed physicians can also sign up (as long as their employer does not belong to a different GPO). You can save on PPE, office supplies from companies such as Staples, Fed Ex, cell phone contracts, vaccines, office equipment, laboratory supplies and much more.  The pricing is transparent and not dependent on purchasing volume.  Stay tuned for details on sign up which will be sent in emails, communications from county societies and on our MSSNY website.

COVID-19 Vaccine Update

Things are progressing rapidly with the vaccine and it is anticipated that the first supply of Pfizer’s vaccine will arrive in the state in December. Plans call for the initial supply to be disbursed to the healthcare workforce in hospitals and local health departments. As vaccine supplies become available, the plan calls for it to be dispersed to healthcare workers and patients in long term care facility, federally qualified health centers, urgent care centers, pharmacies, state institutional settings, ambulatory care providers, including independent private practices and clinics, and home health/hospice care.

For any private practice or clinic to provide the COVID-19 vaccine to patients, they MUST BE ENROLLED in the New York State Immunization Information System (NYSIIS) or in New York City’s Citywide Immunization Registry (CIR). The New York State Department of Health has informed us that enrollment in the NYSDOH COVID-19 Program for ambulatory care providers, including independent private practices and clinics, is expected to open on December 21, with a webinar slated for December 22 to answer questions. A recorded webinar will be available earlier in December to review at your convenience. Additional written material, including an enrollment instructions guide, will also be provided. MSSNY will provide you with this information as soon as it is available. ​

The next few weeks will be filled with some uncertainty but one thing you can be certain of is that your MSSNY will be looking out for you and your patients.

Bonnie Litvack
MSSNY President


MSSNY, AMA Part of Team Efforts to Prevent Steep Medicare Cuts for 2021
This week the AMA joined together with several other national specialty society to send a letter to Congressional leaders urging action to prevent steep Medicare cuts to many specialties in 2021.  Last week, MSSNY also joined with several other northeastern state medical societies in a joint letter to Congress urging action to prevent these cuts, and MSSNY issued a statement on Thursday on this issue:

To supplement these efforts, physicians are urged to send a letter to their respective members of the House of Representatives and Senators Schumer and Gillibrand here.

Joining MSSNY on its letter to Congress were the medical societies of Connecticut, Delaware, Maryland, Massachusetts, New Hampshire, New Jersey, Pennsylvania and Ohio.   The letter notes that: “the CMS MPFS Proposed Rule would increase payments for Evaluation and Management (E/M) codes—increases that are sorely needed, and which we support. However, in doing so, CMS is bound by statute to remain budget neutral—to offset any increases by making corresponding decreases.

To meet these requirements, CMS has proposed a drastic, nearly 11% decrease to the conversion factor that determines all Medicare payment rates. These cuts will be harmful to primary care physicians (PCPs) and other medical specialty types. For example, while the positive E/M changes were meant to give PCPs a significant increase, having a conversion factor decrease of 11% means that those benefits are diminished—especially in face of increased cost and decreased reimbursements during the COVID-19 pandemic.”


Notes from Governor Cuomo’s Conference Call

COVID:

– Day 258
– 200,000 tests conducted yesterday, all-time high
– Statewide rate is 2.6% with hotspots included, down from 2.9%
– Statewide rate without hotspots included is 2.2%
– Rate in micro-clusters is 4.5%, down from 4.8%
– 24 fatalities
– 1,700 hospitalizations, up 60 from yesterday
– 331 in ICU
– 137 intubations

COVID Restrictions:
– Rockland will go from orange to yellow zone
– Gov. said he will speak with Governors of neighboring states this weekend to align policies, believes additional measures will need to be taken in addition to recent restrictions to restaurants, bars, and gyms

Q&A:

On Mayor de Blasio’s comments on closing schools on Monday:
– Gov. said infection rate in schools is low
– State has general parameters for schools: less than 5% to open, 9% requires closure
– Local districts were to specify their own parameters within these, NYC agreed on 3%
– Mayor de Blasio is correct that 3% would trigger closure, but Gov. suggests schools remain open, saying schools “are not the problem” right now

On long waits for testing in NYC:
– Gareth Rhodes (DFS Deputy Supt.) said over 1,200 test sites statewide, 425 in NYC
– Rhodes said some sites may have delays, but many have open appointments daily
– coronavirus.health.ny.gov lists sites, residents can see where openings are near them

On COVID in schools upstate and why yellow zone schools are required to conduct testing as opposed to “problem areas”
– Gov. said yellow zone is considered a problem area, just to a lesser degree than red or orange zones

On why de Blasio is being allowed to close NYC schools when Gov. has previously asserted it is within the state’s jurisdiction to mandate school closures:
– Gov said state overrides all localities on closures, however, schools could set their own parameters for closure
– NYC’s parameters are within compliance of state regulation, infection rates were based on geographic area, not the infection rate within the school district


 

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Department of Financial Services (DFS) Extends COVID-19 Telehealth Policy
The New York Department of Financial Services (DFS) announced on November 9th that it had extended its existing, critically important policy for requiring New York State health insurance plans to cover Telehealth services without patient cost-sharing for another 60 days:

Earlier this year, the DFS had issued a circular letter noting its requirements for insurers to a) waive cost-sharing requirements for services delivered via telemedicine b) permit coverage for health care services delivered via audio-only mechanisms and c) enabling delivery of telemedicine services through basic smartphone and video technologies.

MSSNY is also working with the American Medical Association (AMA) to advocate for making permanent Medicare policies to help cover telemedicine services for patients and is seeking permanent policy changes at the state level that will provide parity in payment for physicians for health care services delivered via video, as well as required insurer coverage for delivering care for audio-only visits with patients. MSSNY will continue its work with outside partners, and key lawmakers during the 2021 legislative session to make these temporary policies permanent, as well as legislation to require health insurers to ensure “payment parity” between telemedicine visits and in-office visits. Additionally, Governor Cuomo signed legislation, early this summer, that requires Medicaid coverage for “audio-only” telemedicine.

Some physicians across the state had integrated Telemedicine into their practices prior to the onset of the pandemic, but the COVID19 crisis forced physicians and other health care providers to quickly increase their capacity to provide care remotely. A May MSSNY survey showed that 83% of the physician respondents indicated they had incorporated telemedicine into their practice, with nearly half the respondents noting that they were treating at least 25% of their patients remotely. Moreover, a recent Fair Health study showed that, for the northeastern part of the country, use of Telehealth went from 0.08% of claim submissions in May 2019 to 12.5% of claims submitted in May 2020.

Even though two of the many vaccines in clinical trials have shown great promise, none have received final approval from the Food and Drug Administration (FDA) and public health experts anticipate that COVID-19 will remain a public health threat for the foreseeable future, even once they are approved. Therefore, it is reasonably likely that this expanded Telehealth coverage policy will be extended beyond January.


NY: Positive Tests Climb to 2.9% from Less than 1%
On Wednesday, New York reported 4,820 additional virus cases and 21 deaths. At the beginning of September, it was reporting between 700 and 800 daily cases and less than 10 daily fatalities. The rate of positive tests has climbed to 2.9%, from less than 1%. The state has 1,628 people hospitalized for COVID, twice as many as a month ago. (Bloomberg, 11/11)


HHS Secretary Azar: Predicted “Enough Vaccine for General Public Vaccination”
HHS Secretary Alex Azar predicted “there would be enough COVID-19 vaccine for general public vaccination campaigns by spring 2021.” He “outlined what he said would be the distribution schedule for Pfizer’s and other companies’ experimental vaccines, none of which are approved, but Pfizer said Monday its vaccine is over 90 percent effective at preventing coronavirus infection.”

Azar said “there would be enough of the vaccine to inoculate at-risk nursing home residents, health care workers and first responders by the end of January and that there should be ‘enough for all Americans by the end of March to early April to have general vaccination programs.’”


Young People with Coronavirus Often Asymptomatic Can Still Transmit Virus
Young, healthy people who contract the coronavirus are often asymptomatic, very rarely need hospital care and can transmit the virus to a roommate unwittingly even when following strict quarantine orders, according to two new studies” published in the New England Journal of Medicine. These “findings support the need for strong measures, like daily testing, that go beyond the temperature checks and symptom reporting now commonly deployed to prevent transmission in offices, dormitories and other group settings, the authors said.”  One study examined the spread of the virus among Marine recruits, while the other examined the outbreak on the USS Theodore Roosevelt.


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AMA Calls on State Medical and Pharmacy Boards to Review Walmart’s Admitted Interference into The Practice of Medicine and Pharmacy
It has come to our attention that Walmart may have sent you a letter regarding its recent lawsuit against the U.S. Department of Justice. A copy of the complaint is attached for your reference. While we do not have any comment at this time on the legal arguments made by Walmart in its complaint against the U.S. Department of Justice, there are several factual matters of concern.

First, it is concerning that Walmart says it has denied prescriptions to hundreds of thousands of patients and thousands of physicians and other health care professionals. The concern stems from the fact that these denials likely result from an inappropriate corporate policy built on arbitrary prescribing restrictions that the U.S. Centers for Disease Control and Prevention says should not be used to create hard policy thresholds.

The AMA is further concerned that Walmart describes a type of back-room investigatory body at its corporate headquarters that decides whether individual patient care decisions are appropriate or not—using some unknown algorithm to approve or deny a patient’s prescription for controlled substances. If a Walmart—or any other pharmacist—has a question about a prescription, the AMA has full faith in the physician-pharmacist-patient therapeutic triad to resolve questions. As it is, Walmart’s corporate policy results in no due process for physicians, handcuffs its pharmacists and harms patients.

Whether Walmart wins or loses its lawsuit is for the courts to decide, but the AMA once again calls on state medical and pharmacy boards to meaningfully review Walmart’s admitted interference into the practice of medicine and pharmacy. State medical and pharmacy boards are the appropriate venue to ensure the safe, ethical practice of medicine and pharmacy, respectively. A corporate entity should not be permitted to take these wide-ranging actions that have harmed health care professionals and the patients they care for.


Starting Monday!
OnBoard: Limited Release Informational Webinars for Health Care Providers
This is a reminder that starting Monday, the Workers’ Compensation Board will be presenting informational webinars about OnBoard: Limited Release and how it will benefit you as a health care provider. Each one-hour webinar will cover an overview and timeline for OnBoard: Limited Release, the efficiencies it will bring to your processes, what you can do now to prepare, and how we will be training you to use the new system.

Registration is required and you can register for the session that works best for you.

November 16, 2020, 9:30 a.m. – 10:30 a.m. (Session is full)
November 17, 2020, 1:00 p.m. – 2:00 p.m.


REGISTER NOW

Registration Open; November 18, 2020 @ 7:30 am Medical Matters CME Webinar
COVID-19: Stories from the Frontline

Learn more about the COVID-19 timeline, best practices, and adaptive measures.  Register now for: “COVID-19: Stories from the Frontlineon Wednesday November 18, 2020 at 7:30 a.m.  Erick Eiting, MD, MPH, MMM, vice-chair of MSSNY Committee to Eliminate Healthcare Disparities and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here

Educational objectives are:

  • Examine the timeline of the COVID-19 pandemic
  • Discuss best practices and need vs. supply for personal protective equipment (PPE)
  • Outline adaptive measures taken to remedy shortfalls in staffing and equipment

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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. 


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Registration Now Open: Veterans Matters: Suicide in Veterans Webinar
Monday, November 23rd @ 7:30 am
The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: Suicide in Veterans live webinar on Monday, November 23, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!

When:             November 23, 2020 at 7:30 am
Faculty:           Jack McIntyre, MD

Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans
  • Explore evidence-based diagnostic, intervention, and treatment options
  • Identify barriers to identification and treatment in military culture and methods to overcome them.

Register here.

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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.




Registration Now Open for Steps to Physician Wellness and Resiliency
Registration is now open for Steps to Physician Wellness and Resiliency on December 10th from 7:30-8:30 am.

Frank Dowling, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety, or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here.  Please click here to view the flyer for this program.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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.


 

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The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.

UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at drfox.903parkave@gmail.com.

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Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com


OBGYN Physician for Our Upper East Side Practice
Gynecology office setting only – No Obstetrics. Please contact the office at 212-772-3722 Email: olarugabriela@aol.com. Office Location: VCARE OBGYN 328 East 75th St. Suite 4 New York NY 10021 REQUIREMENTS: Doctor of Medicine degree. New York Medical License. DEA Board Certified OBGYN

 

 

 

 

 

 

 

 

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