MSSNY eNews: November 3, 2021 – 11 Physician Specialties Ranked by Female Representation

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11 Physician Specialties Ranked by Female Representation
Obstetrics and gynecology is the physician specialty with the greatest female representation, while orthopaedic surgery has the least, according to the Accreditation Council for Graduate Medical Education.

The organization released its 2020-2021 Data Resource Book, the most comprehensive resource on data for graduate medical education in the U.S.

Researchers gathered data between July 1, 2020, and June 30, 2021. There are 12,420 accredited programs in the U.S., with 149,200 active fellows and residents in the programs.

Here is how 11 specialities stacked up in terms of female representation in 2021:

1. 1. 1. 1. Obstetrics and gynecology – 84.6 percent
         2. Pediatrics – 71.1 percent
         3. Child neurology – 68.7 percent
         4. Medical genetics and genomics – 55.9 percent
         5. Psychiatry – 49.1 percent
         6. Nuclear medicine – 33.3 percent
         7. Radiation oncology – 30.5 percent
         8. Urology – 28.5 percent
         9. Interventional radiology (integrated) – 22.0 percent
         10. Neurological surgery – 20.4 percent
         11. Orthopaedic surgery – 16.7 percent

Read more here.

–Gleeson, Becker’s Hospital Review

2022 Medicare Payment Rule Sets Forth Huge Cuts to Conversion Factor: Contact Your Representatives Today
This week, CMS released its final rule for the 2022 Medicare physician fee schedule.  While AMA and MSSNY continue to thoroughly analyze the 2400+ page rule, of significant consequence is the 2022 Medicare conversion factor that will be reduced by approximately 3.75% from 34.8931 (2021) to 33.5983.

This is largely a result of the expiration of a 3.75% increase to the conversion factor at the end of calendar year 2021, as averted by Congress last December.  In addition, there is a 2% cut as a result of the previously delayed Medicare sequester provisions scheduled to go back into effect in 2022, and imposition of a 4% Statutory PAYGO sequester resulting from passage of the American Rescue Plan Act. Should lawmakers fail to act, it will result in a cumulative Medicare payment cut of nearly 10%.

Physicians are urged contact their member of Congress to prevent these cuts. Tell Congress to cancel Medicare cuts today!

In the face of this looming threat Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) circulated a “Dear Colleague” letter highlighting the financial uncertainty within the Medicare payment system and the dangers facing the physician community if Congress fails to enact legislation to address these problems. Within a matter of weeks 245 of their colleagues showed their support for fixing the problem of these extreme Medicare cuts by co-signing the letter, including many of the members of the New York Congressional delegation.

The 2022 payment rule also finalized provisions that extend coverage of services that were added to the Medicare telehealth list on an interim basis in response to the COVID-19 public health emergency until the end of 2023 and eliminated geographic barriers, allowing patients in their homes to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders. In addition, CMS announced plans to permanently increase payment for immunization administration, beyond COVID vaccines, and relied on information from the AMA and the RUC in developing the improved payment rates. CMS is also moving forward with the first round of seven MIPS Value Pathways (MVPs) that will be available, beginning with the 2023 performance year.

The text of the proposed rule can be accessed at:  https://www.federalregister.gov/public-inspection/current

Link to the CMS Press Release: https://www.cms.gov/newsroom/press-releases/cms-physician-payment-rule-promotes-greater-access-telehealth-services-diabetes-prevention-programs

Link to the Physician Fee Schedule Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2022-medicare-physician-fee-schedule-final-rule

Link to the QPP Fact Sheet and related material: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1654/2022%20Quality%20Payment%20Program%20Final%20Rule%20Resources.zip

MSSNY in the News
WCNY Capital Pressroom – 11/01/21
New York Readies to Vaccinate Kids
President Dr. Joseph Sellers Interviewed

Politico – 11/01/21
Weekly New York Healthcare
New York Readies to Vaccinate Kids
(MSSNY President Dr. Joseph Sellers interviewed)

Niagara Gazette – 11/01/21
Top New York doctor discusses pediatric vaccines following federal approval
(MSSNY President Dr. Joseph Sellers quoted)
Also ran in:
Press Republican
Oneonta Daily Star

Poughkeepsie Journal – 11/01/21
Court upholds religious exemption ban in NY medical worker vaccine mandate. What to know
(MSSNY President Dr. Joseph Sellers quoted)
Also ran in:

Star-Gazette

Genesee Country Express

Wayne Post

Daily Messenger

Observer-Dispatch

Times Telegram

The Steuben Courier Advocate

The Evening Tribune

Wellsville Daily Reporter

The Journal News – lohud.com

The Leader

Rochester First / News 8 WROC (CBS) – 11/01/21
CDC: Vaccine-induced COVID-19 immunity better protects than infection-induced immunity
(MSSNY President Dr. Joseph Sellers interviewed)

WROC-8 TV (CBS) / Rochester First – 10/26/21
FDA advisers back Pfizer’s COVID-19 vaccine for young kids
(MSSNY President Dr. Joseph Sellers interviewed)

Times News Network – 10/26/21
NYC Shares Timeline for Kids Age 5-11 1st COVID Vaccine Doses Pending Federal OK
(MSSNY President Dr. Joseph Sellers quoted)
Also ran in News Nation USA

MSSNY Testifies at Assembly Health Committee Hearing to Make Improvements to Medicaid Program
Kings County Medical Society Assistant Treasurer and MSSNY Delegate Dr. Nriaj Acharya delivered testimony at a New York State Assembly Health Committee hearing this week examining New York’s Medicaid global cap and Medicaid Managed Care programs.  An internist, Dr. Acharya’s testimony focused on the challenges he sees treating patients covered by Medicaid in his practice, including the difficulties in referring patients to specialists given the shockingly low reimbursement and excessive hassles in claims submission to Medicaid managed plans.

He noted that, despite New York’s historical efforts to ensure robust coverage for patients insured by Medicaid, community physician care has always been a marginalized aspect of the Medicaid program, noting a recent Kaiser Family Foundation Report demonstrating that New York remains having one of the lowest Medicaid to Medicare physician payment ratios in the country, with payment for health care services ranked at 46^th in the country (56% of Medicare, compared to 72% nationally).

Exacerbating these concerns are the various claims authorization and payment hassles imposed by managed Medicaid health insurance plans.  To improve the Medicaid program for patients, these problems must be addressed.  He also noted MSSNY’s support for efforts to carve pharmacy back into the state Medicaid fee for service, where there would be one statewide prescription formulary to be navigated instead of the dozens of various formularies he has to navigate now. He also urged an end to the Medicaid global cap, which puts even more pressure to cut payments for care delivery.

Dr. Nriaj Acharya delivers testimony at New York State Assembly Health Committee hearing

What You Need to Know About Pediatric Vaccine and Boosters
Join the New York State Department of Health for an informational webinar on pediatric vaccine and boosters on Thursday, November 4th at 7:30 – 8:30 PM.

To accommodate the large number of participants, the webinar will stream via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers: https://coronavirus.health.ny.gov/weekly-healthcare-provider-update

Audio number and code: 844-512-2950 Access code 5789808#

*Questions can be sent in advance to Covid19Vaccine@health.ny.gov*

Association Between the Physician Quality Score in the Merit-Based Incentive Payment System and Hospital Performance in Hospital Compare in the First Year of the Program
JAMA released a study in August investigating the scientific validity of the MIPS quality score as a measure of hospital-level patient outcomes. Specifically, this study looked at whether better physician performance on the MIPS quality scores is associated with improved hospital outcomes. Linear regression was used to examine this association (measuring postoperative complications, failure to rescue, individual postoperative complications, and readmission). This study had a cohort of 38,830 clinicians and included a number of surgical specialties. A major takeaway from this analysis is that high physician MIPS scores may not translate into better hospital outcomes or be great indictors of clinical quality. Key results included:

• Overall, better performance on the physician MIPS quality score was associated with better hospital surgical outcomes for some physician specialties during the first year of the MIPS program. However, the MIPS quality score was not associated with the hospital composite rate of postoperative complications.
• MIPS quality scores for a percentage of vascular surgeons were associated with higher hospital rate of failure to rescue. MIPS quality scores for some cardiac surgeons were associated with higher hospital coronary artery bypass graft (CABG) mortality rate.

MIPS quality scores for some cardiac surgeons were associated with higher hospital CABG readmission rates.

Physician Advocacy Urged to Pushback Against HHS’ Insurer-Biased Interpretation of “No Surprises Act”
MSSNY thanks the several members of the New York Congressional Delegation who have added their names to a letter co-authored by Rep. Tom Suozzi (D-Long Island) and others to Xavier Becerra, Secretary of Health and Human Services (HHS), Janet Yellen, Secretary of Treasury, and Martin J. Walsh, Secretary of Labor, regarding an Interim Final Rule (IFR) that was released on September 30, 2021 entitled, “Requirements Related to Surprise Billing; Part II”. The letter urges Congress to amend the IFR to synchronize the law’s implementation with the legislation Congress passed in 2020. Instead of following the statutory language included within the No Surprises Act enacted by Congress last December, HHS and other federal agencies designed an Independent Dispute Resolution (IDR) process for resolving out of network surprise medical bills that heavily favors health insurance companies in payment disputes.

See below for the full list of New York Delegation members that signed on to the letter.

MSSNY President Dr. Joseph Sellers recently issued a statement (Surprise Billing Legislation Interim Final Rule: MSSNY Calls for Prioritizing Patient Care Over Insurance Profits) in which he said, “In implementing the Independent Dispute Resolution (IDR) process for resolving patient surprise medical bills – a process that New York physicians have strongly supported for many years – HHS has clearly sought to put its thumb on the scale in favor of multi-billion-dollar insurance companies.”

The rule has also been criticized by numerous national medical organizations, including the AMA, the American Hospital Association (AHA), Federation of American Hospitals and numerous specialty societies. The Congressional intent articulated in the “No Surprises Act” was to create an IDR process to protect patients that was appropriately balanced and did not favor either the insurer or the physician in claims disputes. Specifically, the final language adopted by Congress required that numerous factors be considered, including patient acuity or complexity of services, demonstrations of previous good faith efforts to negotiate in-network rates and previously contracted rates, in addition to the insurers’ median in-network rate, without specifying that one factor take precedence over another.

With the law scheduled to take effect January 1, 2022, MSSNY intends to work with the AMA, and other allied groups, to advocate for needed changes to the regulation to ensure that the IDR process is implemented in a way that better achieves balance in the IDR process, to protect care availability in hospital emergency departments.

MSSNY members can also help by sending a letter to Senators Schumer and Gillibrand, as well as their respective member of Congress, from here: Urge Congress to Urge HHS to Revise Independent Dispute Resolution Regulations 

Additionally, last week the Texas Medical Association (TMA) filed a lawsuit in federal district court in Tyler, Texas, arguing that the Biden administration improperly failed to follow direction from Congress about how to implement the dispute resolution process set forth in the No Surprises Act,

The lawsuit also alleges a violation of the Administrative Procedure Act, which requires a formal notice and comment period in advance of finalizing such a rule. The agencies failed to solicit and incorporate comments from stakeholders, crucial step of implementing the law.  MSSNY will continue to keep physicians updated on the status of this lawsuit.

We thank the following NY Delegation Members who Signed On to the Suozzi-Wenstrup Letter:

1. Representative Yvette Clarke (D- Brooklyn)
2. Representative Adriano Espaillat (D- Manhattan)
3. Representative Brian Higgins (D- Buffalo)
4. Representative Chris Jacobs (R- Western New York)
5. Representative John Katko (R- Central New York)
6. Representative Nicole Malliotakis (R- Staten Island)
7. Representative Carolyn Maloney (D- Manhattan)
8. Representative Sean Maloney (D- Newburgh)
9. Representative Grace Meng (D- Queens)
10. Representative Joe Morelle (D- Rochester)
11. Representative Tom Reed (R- Corning)
12. Representative Kathleen Rice (D- Long Island)
13. Representative Elise Stefanik (R- Plattsburgh)
14. Representative Tom Suozzi (D- Long Island)
15. Representative Ritchie Torres (D- Bronx)

Obituaries
ABEND, Sander Morton; New York, NY.  Died October 02, 2021, age 89.  Bronx County Medical Society

BECKER, Jerrold Melvin; Encinitas, CA.  Died August 01, 2021, age 95.  Nassau County Medical Society

CARROLL, William E.; Greenwich, NY.  Died July 24, 2021, age 84.  Medical Society County of Washington

CHIEN, Yin Chu; Brooklyn, NY.  Died March 16, 2021, age 87.  Medical Society County of Kings

CHOW, To-Fei P.; Northville, MI.  Died July 21, 2016, age 81.  Nassau County Medical Society

COHEN, David Edward; Great Neck, NY.  Died July 02, 2021, age 84.  Nassau County Medical Society

GORDON, Myron; Albany, NY.  Died December 06, 2020, age 94.  Medical Society County of Albany

HOSLEY, Henry Franklin; Castleton on Hudson, NY.  Died January 03, 2021, age 92.  Medical Society County of Albany

IRA, Felix S. Jr.; Albany, NY.  Died March 20, 2021, age 91.  Medical Society County of Albany

JONES, Basil Clinton; Vineyard Haven, MA.  Died February 03, 2021, age 93.  Medical Society County of Kings

KAUFMAN, Ira H.; Houston, TX.  Died August 21, 2020, age 91.  Nassau County Medical Society

KENT, Donald Seymour; West Palm Beach, FL.  Died February 24, 2021, age 100.  Nassau County Medical Society

KLIBANOFF, Edward; Wykagyl, NY.  Died December 24, 2020, age 93.  Bronx County Medical Society

ROWLEY, Joseph F.; Cohoes, NY.  Died October 12, 2021, age 94.  Cayuga County Medical Society

RUDDY, Patrick Joseph; Vero Beach, FL.  Died September 20, 2021, age 93.  Broome County Medical Society

TANNER, John Stetson; Plattsburgh, NY.  Died October 01, 2020, age 91.  Clinton County Medical Society

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