MSSNY eNews: October 2, 2020 – Remain Calm and Carry On
With all that has happened in the last 6-7 months it is no wonder that that in a recent Physicians Foundation survey, half of physicians reported anger and anxiety.
COVID-19 has placed a heavy burden on physicians, and it is taking a toll on our well-being. 58% of those surveyed expressed feelings of burnout with 13% seeking mental health consultation related to the pandemic. While not unexpected given the circumstances, these survey findings are nonetheless alarming.
Adding to the stress in New York are the many increased mandates on physician practices including reporting requirements and fines for non-compliance, all proffered while physician practices are struggling to just stay afloat. Proposed legislation (S.6678-A/A.7991-A) Mandatory OPMC Signage Legislation that is sitting on the Governor’s desk is also in this category of increased stressors. This law would require every physician “practice setting” to post a sign regarding how a patient can file a misconduct complaint with the OPMC. This misguided legislation if signed into law will create unnecessary distrust in the physician-patient relationship and increase patient anxiety and confusion which would be problematic at any time but more so now with Covid-19. This legislation is unnecessary as information regarding OPMC and how to file a complaint is easily available through a simple Google search. Since nearly 10,000 complaints are filed each year with OPMC (resulting in only a few hundred actual disciplinary actions), it is clear there is already strong public awareness of how to file a complaint. This legislation unfairly singles out physicians for this requirement as opposed to any other type of professional and if passed, it will surely add to the growing problem of physician demoralization. A “Scarlet Letter” requirement like this is not the way that New York’s healthcare heroes should be treated. Please take a moment to send a letter and tweet to the Governor opposing this baffling legislation.
Peer Support in Stressful Times
On the constructive end of the spectrum, our MSSNY P2P program is up and running. If you are feeling stressed, call 1-844-P2P-PEER or email email@example.com 24/7 and we will put you in touch with a peer supporter for a confidential non-judgmental conversation to gain perspective and point you in the right direction. We also recognize that most of our physician stressors are system issues. With this is mind, the AMA and MSSNY have launched the Practice Transformation Initiative in New York with a goal to make physician burnout a thing of the past. We are happy to report that several hospitals/hospital systems around the state have joined the initiative and will be collaborating with us to effect positive change. As of today, we have received confirmation from Bassett Hospital, Ellis Hospital, Northwell Health, NY Presbyterian Hospital, Brooklyn, and St. Peter’s Health Partners.
I believe the country is correct to refer to physicians as heroes, but the fact remains that physicians are not invincible nor are they superhuman. There is a limit to how much can be imposed on them and the physician foundation poll, indicates that in many cases the limits have been reached or exceeded. We ask our government officials and our hospital leaders to be mindful of what and how much they are asking of our New York physicians and to work with MSSNY to lessen the burdens so that physicians, who are highly resilient, can “Remain Calm and Carry On.”
Bonnie Litvack, MD
Notes from Governor Cuomo’s Conference Call:
President’s COVID Diagnosis:
– Gov. said he wishes President and First Lady the best
– President reported mild symptoms
– WH briefing call for Governors today at 12:15 on healthcare related issues, President is supposed to be on the call
– Gov. said he also a call with National Governors Association today
– Day 216
– 7 fatalities
– 648 hospitalizations
– 146 ICU patients
– 65 intubations
– Hot spot zip codes are at 6.4% infection rate overall
– Outside hotspots, infection rate is 1.03% statewide
– Seeing increase in infections in Orange, Brooklyn, some spread into Queens
– DOH sending Section 16 letter to local governments, advising them of compliance laws, potential fines for poor enforcement of compliance
– 1,258 positive cases on state’s school dashboard
– State receiving questions on sparse reporting from NYC schools
– Gov. stated no specific testing being done in NYC, testing would begin on Oct. 1, and be conducted over a month
Infection Rate by Region:
– Western NY 1.2%
– Southern Tier 1.1%
– North Country 0.2%
– Mohawk Valley 0. 4%
– Mid Hudson 2.6%
– Long Island 1.3%
– Finger Lakes 1%
– Central NY 0.7%
– Capital Region 0.9%
– NYC 1.4%
– On specific parameters of fines to local governments:
– Garvey said section 16 of public health law allows DOH Commissioner to determine if any entity is willfully in violation of public health rules
– Fines can be up to $10,000 according to Section B
– DOH would need to have compliance activity info from local governments, and actions taken
– If deficient, statement of charges would be provided, and charges can be per day
– Gov. added this was done with Ebola previously, reiterated public education campaigns are not enough
– On implications of President’s positive diagnosis:
- Gov. stated this is further evidence to take virus seriously
- Gov. discussed spectrum of COVID symptoms, said if President is on 12:15 call, this would suggest a mild case
- Gov. called it “frightening” for the first family, said he wishes them the best on a personal level
New York State Launches COVID Alert NY App
New York has launched COVID Alert NY Exposure Notification App that was created by the New York State Department of Health in partnership with Google and Apple. An individual can now use the phone COVID-19 exposure alerts, without compromising privacy or personal information. This is a free smartphone app for anyone 18+ that lives and/or works in New York available for download in the Google Play Store and Apple App Store starting October 1st.
The COVID Alert NY app notifies users if they have been in close contact with someone who has tested positive for COVID-19. Upon receiving an exposure notification, the app will encourage users to contact their physician or the State Health Department hotline (1-833-227-5045) to get more information about quarantining and testing.
According to the NYS Department of Health anyone who downloads the app does not have to worry about being tracked, identified, or having their personal information shared. The app is completely anonymous and does not track location or movement. No personal data is collected. COVID Alert NY uses Bluetooth proximity-enabled exposure notification technology provided by Apple and Google which is safe and secure. To learn more about COVID Alert NY, visit http://ny.gov/covidalerts.
Congress Passes Measure to Fund Government Through December; Additional Protections for Medicare Advance Payments
This week, the US Senate completed passage of H.R. 8337, legislation to fund federal operations until December 11, 2020 and is intended to avert a potential government shutdown prior to the November elections. Among the important healthcare provisions of this legislation:
- Extends the Medicare GPCI cost index floor, important for helping to prevent Medicare cuts to the upstate New York payment locality; and
- For physicians and other health providers who had received Medicare accelerated or advance payments over the last several months, the legislation extends the period before repayment begins and the period before the balance must be repaid in full, reduces the recoupment percentage, and lowers the interest rate for payments from 9.6% to 4%.
New York DFS Regulation Requires Insures to Continuing Waiving Patient Cost-Sharing for Telehealth Services
This past Wednesday’s MSSNY e-news shared a STAT News article that detailed that some health insurers across the country, as of October 1, have stopped waiving cost-sharing for patient health services provided via telehealth. However, please be aware that the New York State Department of Financial Services has adopted a regulation that requires health insurers to continue to waive patient cost-sharing responsibilities (co-payment, coinsurance and deductibles) for telehealth services until at least November 9, for all state-regulated health insurance plans.
MSSNY also continues to strongly advocate for legislation that would require health insurers to pay for telehealth services at the same amount as the health insurer would pay for the same service were it provided in-person.
CMS Releases Snapshot of COVID-19’s Impact on Medicare Population
Today, CMS released the monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. The updated data show over 1 million COVID-19 cases among the Medicare population and over 284,000 COVID-19 hospitalizations.
Other key findings:
- The rate of COVID-19 cases among Medicare beneficiaries grew 30% since the August release to 1,562 cases per 100,000 beneficiaries.
- Similarly, the rate of COVID-19 hospitalizations among Medicare beneficiaries grew 32% since the August release to 444 hospitalizations per 100,000 beneficiaries.
- The rate of COVID-19 cases and hospitalizations grew the most among rural beneficiaries, Hispanic beneficiaries, and Medicare-only beneficiaries (those who are not dually eligible for Medicaid).
- Medicare Fee-for-Service (Original Medicare) spending associated with COVID-19 hospitalizations grew to $4.4 billion or just under $25,000 per hospitalization.
- Data on discharge status and length of stay for COVID-19 hospitalizations remained similar to previously reported figures in the August release. 31% of beneficiaries went home at the end of their hospital stay and 22% died. Nearly half of the hospitalizations lasted 7 days or less while 5% lasted more than 31 days.
The updated data on COVID-19 cases and hospitalizations among Medicare beneficiaries covers the period from January 1 to August 15, 2020. It is based on Medicare Fee-for-Service claims and Medicare Advantage encounter data CMS received by September 11, 2020.
For more information on the Medicare COVID-19 data, visit: https://www.cms.gov/research-statistics-data-systems/preliminary-medicare-covid-19-data-snapshot For an FAQ on this data release, visit: https://www.cms.gov/files/document/medicare-covid-19-data-snapshot-faqs.pdf
Actions of the 2020 MSSNY House of Delegates
The 214th MSSNY House of Delegates was held virtually on Sunday, August 23. Resolutions on Government Affairs, Public Health and Education, Socio-Medical Economics, Report of Officers and Administrative Matters, and Bylaws are detailed in the following links:
- HOD Actions on Bylaws
- HOD Actions on Governmental Affairs A
- HOD Actions on Governmental Affairs B
- HOD Actions on Socio-Medical Economics
- HOD Actions on Public Health and Education
- HOD Actions on Report of Officers and Administrative Matters
HHS Will Be Disbursing Another $20 Million in CARES Act Fund
HHS announced today that it will be disbursing another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians that have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus.
Recognizing the negative impact of the COVID-19 pandemic has increased anxiety and depression in the country and behavioral health providers have continued to provide care through telehealth and other means, HHS is also announcing that the nation’s behavioral health care providers, including psychiatrists, are now eligible for funding. Previously ineligible physicians, such as those who began practicing in 2020, will also be eligible to apply. Physicians will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding. Providers can begin applying for funds on Monday, October 5, 2020.
Teen’s Death Prompts Warning on ‘Benadryl Challenge’
The FDA issued a warning Thursday against taking diphenhydramine (Benadryl) at more than recommended doses, following accounts of at least one teen dying from overuse.
The agency is investigating reports of teens who have been hospitalized and died after taking part in the latest social media craze encouraging youth to consume a dangerous amount of antihistamine tablets.
“We are aware of news reports of teenagers ending up in emergency rooms or dying after participating in the ‘Benadryl Challenge’ encouraged in videos posted on the social media application TikTok,” the FDA stated. “We are investigating these reports and conducting a review to determine if additional cases have been reported.”
The recommended dose is generally one or two tablets every 4-6 hours for children and adults, respectively. Taking more than the recommended amount of the over-the-counter allergy medicine can lead to serious heart problems, seizures, coma, or death. Hallucinations are also possible, which appear to be the challenge’s goal.
Healthcare professionals should be on the lookout for overdose cases and report any side effects involving Benadryl and other generic forms of diphenhydramine to the FDA’s MedWatch program, the agency stated. “We also contacted TikTok and strongly urged them to remove the videos from their platform and to be vigilant to remove any additional videos that may be posted.”
Registration Now Open
October 21, 2020 @ 7:30am Medical Matters CME Webinar
Influenza 2020-2021: Vaccine Update
Learn more about dealing with flu season during a pandemic. “Influenza 2020-2021: Vaccine Update” will be presented on Wednesday October 21, 2020 at 7:30 a.m. William Valenti, MD, chair of MSSNY Infectious Disease Committee 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:
- Describe key indicators to look for when diagnosing patients presenting with flu-like symptoms
- Analyze clinical and laboratory diagnostic features and treatment specific to each flu season
- Identify recommended immunizations and antiviral medications for treatment and how best to effectively encourage patients to get vaccinated
- Evaluate seasonal influenza vaccine development and recommendations concurrent with the SARS-CoV-2 pandemic
Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at firstname.lastname@example.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.
Veterans Matters Podcast Series
Check out MSSNY’s Veterans Matters podcast series on Veterans’ healthcare topics including PTSD in Returning Veterans, TBI in Returning Veterans, Substance Use in Veterans, Suicide in Veterans, The Special Mental Health Needs of Women Veterans and Military Culture: Everything Physicians Need to Know about Veterans as Patients.
Click here to listen to Part 1 of PTSD in Returning Veterans with Dr. Frank Dowling.
Click here to listen to Part 2 of PTSD in Returning Veterans with Dr. Frank Dowling.
Click here to listen to TBI in Returning Veterans with Dr. David Podwall.
Click here to listen to Substance Use Disorders with Dr. Thomas Madejski.
Click here to listen to Suicide in Veterans podcast with Dr. Jack McIntyre.
Click here to listen to The Special Mental Health Needs of Women Veterans with Dr. Malene Ingram, Colonel, U.S. Army Reserves and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.
Click here to listen to Military Culture: Everything Physicians Need to Know about Veterans as Patients with Retired Lieutenant Colonel, U.S. Army, Lance Allen Wang and Retired Chief Master Sergeant, U.S. Air Force, Marcelle Leis.
Joyce & Duane Cady Scholarship Fund
Memorial Service for MSSNY Past President Duane M. Cady, MD held on Sept. 26
A Celebration of Life for Dr. Duane Cady was held on September 26 at the Westvale Seventh-Day Adventist Church in Syracuse. Click here to view the service.
Contributions in Dr. Cady’s memory may be made to the Duane and Joyce Cady Scholarship, AMA Foundation, 330 N. Wabash Ave., Suite 38300 Chicago, IL 6061-5885. The link for online donations is https://amafoundation.org/
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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 / email@example.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / firstname.lastname@example.org.
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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 firstname.lastname@example.org