October 27, 2017 – Drugs: Everyone’s Problem

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE
Charles Rothberg, MD
October 27, 2017
Volume 17
Number


Dear Colleagues:

Today, as a guest, I will be attending the NYS and NJ Societies of Interventional Pain Physicians Conference in Jersey City. These doctors already have a target on their back.

When drug addiction became everyone’s problem— kids, adults, law and drug enforcement—not just ours, New York stepped up in a meaningful way with ISTOP. We did not like it and thanks to our Government Affairs division, we were able to make the process less draconian than what was proposed. Most of the complaints about using the DOH’s system have died down. Many doctors reported that, to their surprise, yes, some of their patients were doctor shopping because they were either addicted to or diverting their prescribed opioids. Other states have used our comprehensive ISTOP program as a model to treat their own epidemics.

In reality, the epidemic is a failure of public health, public policy, and law enforcement. Blame and remedies should be shared. What about the role various national organizations promoting pain as a vital sign? What about the role of Congress in limiting DEA enforcement of diversion? What about drug makers that misstated the safety of opioids?  What about the role of insurers and PBMs in disfavoring alternatives to opioids? Many drug companies claimed that the opioids they manufactured were not addictive.

This week, President Trump addressed the problem in a somber press conference. His long-awaited public health emergency declaration on the opioid epidemic does not yet contain any new funding to combat the problem. However, federal health agencies will be able to reallocate existing resources and hire educated personnel. The declaration disappointed state officials and public health experts who maintain that a lot more money is needed to respond and confront this deadly epidemic. One of President Trump’s intentions is to break a logjam preventing doctors from treating opioid addiction through telemedicine consults as a way to reach addicts living in rural areas.

The CDC Has released guidelines on how to treat Chronic Pain which includes best practices.  This speaks to something that is often lost when discussing the opioid epidemic—there are still many patients who need pain medication, and there are some concerns that because of new prescribing limits and the fear of feeding addiction, they will have no access.

President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis is set to release its final recommendations on Nov. 1. I expect that they will map out solid short and long term solutions.

Our President stated, “As Americans, we cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction…..We can be the generation that ends the opioid epidemic. We can do it.”

As physicians, I am confident that we are up to the challenge, too.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org



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MSSNY’s Statement Re Merger of CVS and Aetna Insurance Company
“The proposed purchase of Aetna by CVS, as reported by the Wall Street Journal, demands an immediate investigation by the federal Departments of Justice and Federal Trade Commissions. Physicians and patients are already often powerless to push back against barriers imposed by market dominant health insurance behemoths that interfere with needed medical care, such as limited choice of doctors and burdensome pre-authorization rules.

At the same time, corporate pharmacy interests are increasingly trying to take away prescribing and health care decision making authority from physicians, thereby interfering with continuity of care for our patients.  These companies need to prove why these problems will not become even worse for our patients if this proposed conglomeration were permitted to go forward.”

NYS Senate Releases Report on Lyme and Tick-Borne Disease
The New York State Senate’s Task Force on Lyme and Tick-Borne Diseases has released a report,” Ticking Time Bomb: An Update on the Lyme and Tick-Borne Disease Epidemic in New York State”.  This report recommends that there be established a comprehensive action plan, developed by the NYS Department of Health, in 2018 to implement a comprehensive approach to surveillance, prevention and detection in Lyme and other tick borne diseases.

Additionally, the report calls for the development of a specific medical protocol and notification for diagnosis and treatment;  that a comprehensive assessment of insurance practices related to tick borne disease; calls for increased testing for children and the use of informational technical technology to inform the public about the dangers of tick-borne diseases.  A copy of the report may be found HERE.

Concerns with Anthem’s New Prior Authorization Policy for Imaging Services
This past week, MSSNY staff joined representatives of the New York State Radiological Society to meet with the New York Department of Financial Services to express strong concerns with Anthem’s new policy imposing new prior authorization requirements as a precondition of patients receiving hospital-based imaging services.  In particular,

MSSNY expressed concerns regarding the additional administrative hassles imposed on referring physicians seeking to assure their patients can receive needed MRIs or CTs in a timely manner.  Moreover, concerns were expressed regarding the likely continuity of care issues for some patients, as well as the fact that such additional criteria for accessing these services of particular radiologists may not be clearly identified when a patient is looking at which physicians participate in a particular health insurer’s network.

To aid in its investigation, DFS representatives asked MSSNY and NYSRS for examples of instances where patients have been unable to receive the care they need, or have had their care unduly delayed, as a result of this new prior authorization requirement.   Please contact rmcnally@mssny.org if you would like to share your story.

Similar prior authorization requirements have been imposed in other states by Anthem.  As a result, the American Medical Association EVP Dr. James Madara wrote a letter to Anthem EVP Dr. Craig Samitt urging Anthem to reconsider this policy given the “potential adverse impact on patients’ timely access to medically necessary care”, and concerns that the “new policy interferes with the patient-physician relationship and may disrupt ongoing care coordination”.

AMA Action Item: IPAB Repeal Moving Ahead in Congress; Be Heard
Legislation to repeal the Independent Payment Advisory Board (IPAB) is moving on Capitol Hill, but Congress needs to hear from America’s physicians in order to push it over the finish line.

The “Protecting Seniors’ Access to Medicare Act of 2017” (H.R. 849) would permanently repeal the IPAB; a panel that puts significant health care payment and policy decisions in the hands of an unelected body with far too little accountability.  Unless the IPAB is repealed, access to care for millions of Medicare patients could be threatened by arbitrary cost-cutting targets year after year.

Getting rid of IPAB will allow physicians and policymakers to focus on long-term efforts to improve care quality, improve health outcomes and make Medicare more sustainable while preserving access to care for seniors now and in the future. Please urge your legislators to support H.R. 849 to repeal the arbitrary and flawed IPAB by calling our toll-free grassroots hotline: (800) 833-6354 or emailing them today! Click this link to log in and send your message.


Promo Code: MSSNYCorporate-Huddle-uQAB4IbD?promo”>


About New York’s New Step Therapy Override Law
This week, MSSNY President-Elect and Medina internist/geriatrician Dr. Thomas Madesjki and MSSNY Senior Vice President Moe Auster participated in a webinar to discuss the provisions of New York’s new law to better regulate health insurers’ use of “step therapy” or “fail first” protocols. The forum was sponsored by the National Psoriasis Foundation.

A “step therapy protocol” is a policy that establishes a specific sequence in which prescription drugs for a medical condition are approved for coverage by a health insurance plan for a patient.  The new law provides that all NY-regulated health insurers shall grant an override of that insurer’s step therapy protocol upon receipt of information from the physician “that includes supporting rationale and documentation” which demonstrates that the drug(s) being required by the health insurer:

  • Is contraindicated or will likely cause an adverse reaction by physical or mental harm to the patient;
  • Is expected to be ineffective based on the known clinical history and conditions of the patient and his/her drug regimen;
  • Has been tried by the patient or another prescription drug(s) in the same pharmacologic class or with the same mechanism for action and such drug(s) was discontinued due to a lack of efficacy or effectiveness, diminished effect or an adverse event;
  • Should not be required because the patient is stable on a drug other than the drug being required by the insurer; or
  • Is not in the best interest of the patient because it will likely cause a significant barrier to a patient’s adherence with his/her plan of care, will likely worsen a comorbid condition of a the patient, or will likely decrease the patient’s ability to achieve or maintain reasonable functional ability in performing daily activities.

Health insurers must respond to a step therapy override request within 72 hours of the request.  A health insurer is required to respond within 24 hours if the request is for a patient with a medical condition that places the health of the patient in serious jeopardy without the prescription drug or drugs prescribed by the patient’s physician.  If the health insurer fails to act within these 72 or 24-hour time periods, the request will be granted in favor of the patient.

The new law also requires that health insurers’ step therapy protocols be based upon evidence-based and peer-reviewed clinical criteria that also takes into account the needs of atypical patients.  These criteria must be made available to physicians upon request.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here  or here. 

Governor Signs Bill into Law to Regulate Biosimilar Substitutions
Governor Cuomo signed into law this week a bill (S.4788-A/A.7509-A) passed by the State Legislature   that would establish rules regarding the substitution of interchangeable biological products.  While New York State law regulates the substitution by pharmacists of generic drugs for their branded counterparts, the existing law has not been updated to set forth the circumstances under which a biologic product can be substituted with a FDA approved interchangeable biologic.

Importantly, it would prohibit a pharmacist from substituting an interchangeable biological product (as defined by the FDA) prescribed by a physician if the physician affirmatively requests that the product be “dispensed as written”.  If the physician does not specify on the prescription that the biological medication should be “dispensed as written”, then the pharmacist may substitute an interchangeable biological product but only if the pharmacist provides notice to the physician within 5 days of the substitution.  The new law provides that this notice from the pharmacist to the physician be conveyed by:

·        making an entry that is electronically accessible to the prescriber through an interoperable electronic medical records system, an electronic prescribing technology or a pharmacy record; ·        using fax, electronic transmission or other electronic means, or ·        by telephone if an electronic means is not available to the pharmacist at the time of communication.  It would also establish a 5-year sunset on all these provisions.


Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!


Urge Gov. Cuomo to Veto Disastrous Liability Bill; Instead Work for Reform
Physicians are urged to continue to contact Governor Cuomo to request that he veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.   If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.   You can send a letter here and call 518-474-8390.

While many physicians have made these contacts, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Significant pressure is being placed on the Governor to sign the bill by trial lawyers, and by some consumer groups and media outlets.  For example, this past week, a consumer group representative appeared on a statewide political show to urge the Governor to sign the bill. There was also an article in the New York Daily News, which has engaged in a multi-year crusade for this bill, regarding the significant number of groups that supported the bill.  The article did reference concerns from several groups, including MSSNY, the Lawsuit Reform Alliance, and the New York State Radiological Society.  MSSNY President Dr. Charles Rothberg stated “We’re in favor of comprehensive reform. We want to make sure any reforms protect the public, but also that they are reasonable and don’t unfairly burden our hospitals and physicians.”

In response, physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Last week Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

There was also a lengthy article in the New York Law Journal this week highlighting the problems with this bill that included a quote from MSSNY’s Dr. Rothberg. 

NYS/NYC Department of Health Report Increase in Hepatitis A Infections
The New York State and New York City Departments of Health are reporting recent increases in hepatitis A infections in men who have sex with men (MSM) in New York City and that state DOH has documented a similar risk profile among individuals with hepatitis A who reside in NYS outside of NYC. Western Europe is also experiencing outbreaks of hepatitis A among men that have sex with men.

The state DOH has sent a letter to all physicians and health care providers requesting that  efforts be intensified to implement existing recommendations for completion of a hepatitis A vaccine series in all men and transgender individuals who have sex with men who are either not previously immunized or who do not know their vaccination or disease status.  There is also information in the letter that physicians can provide to their patients.  A copy of the letter can be found here.

Asian New Yorkers Face Barriers to Mental Health Care
New York City’s diverse and growing Asian population needs dedicated resources to increase access to mental health care, according to a report released by the Asian American Federation.

Suicide was among the 10 leading causes of death for Asian New Yorkers every year between 1997 and 2015, but that was not the case for other racial groups, according to stats from the city’s Department of Health and Mental Hygiene.

Through a series of roundtable discussions, focus groups and interviews conducted with mental health providers and others working with Asian New Yorkers, the federation identified key barriers to accessing mental health care in Asian communities. These include a shortage of providers that are culturally and linguistically competent, a lack of awareness and understanding of mental health issues in some Asian communities, less access to health insurance and a lack of research on alternative services that bear less stigma.

In addition to highlighting the need to develop more culturally appropriate models for addressing mental health issues, the federation faulted the city for not dedicating enough social-services dollars to Asian New Yorkers.

Physicians Needed for Martial Arts Tournament November 4-5 SUNY Old Westbury
The US Muay Thai Open will take place on November 4 and 5, 2017 at SUNY College at Old Westbury. The tournament will feature approximately 400 amateur Muay Thai athletes from around the nation and world. The physicians’ duties will be to observe each bout, permanently stop bouts if in the physicians’ opinion, the competitor is no longer medically fit to compete, and to perform post-bout interviews to assess the competitors’ condition.  They will need physicians for the following dates:

Saturday, November 4, 2017
7:30 a.m. – 1:30 p.m.
7:30 a.m. – 7:30 p.m.

Sunday, November 5, 2017
7:30 a.m. – 1:30 p.m.
7:30 a.m. – 7:30 p.m.

Compensation will be $100/hr for physician services. Call 480-245-0094 or 917-318-7988

MEDICARE/MEDICAID INFORMATION

Tip of the Week
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc. 

Q: What is all this buzz about new Medicare audits?
A:  In an effort to “reduce appeals, decrease provider burden and improve the medical review and education process,” Medicare has expanded the Targeted Probe and Educate (TPE) pilot program to all their Medicare Administrative Contractors (MACs) for Part A, B, HHH and DME.

The TPE program went into effect on Oct. 1, 2017 and it applies to all medical reviews for all MAC lines of business. It is very similar to a pre-payment audit only the TPE has a definitive time line.

The providers/suppliers will have one (1) to three (3) pre- or post-payment rounds of review. After or during each review, the healthcare provider /supplier will be educated based on MACs findings. The educational sessions are offered via webinar or telephone conference by a nurse reviewer. Other educational methods are available if necessary. If the healthcare provider is found to be non-compliant with Medicare, they will be reviewed again.

Failing the third round of reviews can result in dire consequences such as a referral to the Centers of Medicare and Medicaid services (CMS) for additional action. These actions may include “extrapolation, referral to Zone Program Integrity Contractor(ZPIC) or Unified Program Integrity Contractor (UPIC), referral to the RAC or 100% pre-pay review,” etc. (i.e. audit).

If you are targeted the best advice is to take advantage of the education provided by your MAC as well as additional education from an outside certified coder with experience with these types of reviews.

Remember the sooner you get it right, the sooner you will be removed from the TPE.

Sources:
Targeted Probe and Educate (TPE), http://ow.ly/JB5N30fDG7u
CMS PUB 100-20 One-Time Notification, Transmittal 1919, SUBJECT: Targeted Probe and Educate, http://ow.ly/sf9A30fDGjQ
NGS Compliance & Audits, Targeted Probe and Educate http://ow.ly/IshY30fDGyM
Noridian Healthcare Solutions, Targeted Probe & Educate http://ow.ly/s6HN30fDGLX
If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

Medical Provider Direct Deposit FAQs

  • How do I start?
    Visit nysif.com and log in to your online account. If you do not have one, please create a NYSIF account by clicking Login >> Create an Account and choosing “medical provider” as the account type. Visit our Medical Provider Portal page for more information on registration.
    You will need a check received from NYSIF within the last 12 months and a valid email address to begin. When you’ve completed your registration, log into your account and choose “Enroll/Manage Direct Deposit.”
  • What do I need to enroll?
    A valid checking or savings account, the name of your financial institution, your bank routing number and your bank account number. Foreign bank accounts cannot be enrolled in NYSIF direct deposit.
  • How will NYSIF verify my identity?
    Once the application is completed, you will be redirected to DocuSign to authenticate your identity and sign electronically.
  • When will my direct deposit begin?
    Once NYSIF receives a completed direct deposit application, it will take several business days to verify your bank information. Until that time, you will receive your payments by mail.
  • Will I be notified by NYSIF when payments are deposited?
    Once direct deposit begins, you will receive an email every time NYSIF deposits a payment to your account. You can then log in to the medical provider portal to review the associated Explanation of Benefits (EOB) by using the draft number in the payment notification email to “Search Payments by Check Number.” Each direct deposit can contain payment for up to 25 separate bills.
  • Will funds be available on a holiday?
    If your payment date falls on a bank holiday, your payment will post on the next business day.
  • What if I want to change bank accounts?
    If you need to change the bank account for your direct deposit, please log in to your account and choose “Manage/Enroll Direct Deposit” to provide your new bank account information. Please note, you will be directed to DocuSign again to verify your identity. Once NYSIF approves your new application, it will take several business days to process the change to the new account. If a payment is due in the interim, it will be sent by mail.
  • What if I want to cancel direct deposit?
    Log in to your NYSIF online account, visit your Account Management page and click “Unsubscribe” to cancel direct deposit at any time. It may take another cycle of payments to stop this transaction, after which your next scheduled payment will be sent by mail.
  • What if I move?
    Always notify NYSIF if your address changes. However, moving will not affect your direct deposit unless you close or change bank accounts.

Please carefully review the Medical Provider’s Rights and Authorizations, applicable to any NYSIF provider payments.

Attention Managed Care Network Providers: Medicaid Enrollment Requirement
Section 5005(b)(2) of the 21st Century Cures Act amended Section 1932(d) of the Social Security Act (SSA) and requires that effective January 1, 2018, all Medicaid Managed Care and Children’s Health Insurance Program providers must enroll with state Medicaid programs.

The SSA requires that the enrollment include providing identifying information including name, specialty, date of birth, social security number, National Provider Identifier (NPI), federal taxpayer identification number, and the state license or certification number.

For example, if a physician currently participates in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid.

Common Enrollment Questions:

  • To check on your enrollment status, please call CSRA at 1-800-343-9000. Practitioners may also check the Enrolled Practitioners Search function at: https://www.emedny.org/info/opra.aspx
  • If you are already enrolled as a Medicaid fee-for-service (FFS) provider and are listed as active, you will not have to enroll again.
  • If at one time you were a FFS provider, and your enrollment has lapsed (no longer actively enrolled), you may be able to keep your original Provider Identification Number (PID), also known as MMIS ID, by reinstating.
  • Practitioners who do not wish to enroll as a Medicaid FFS billing provider may enroll as a non-billing, Ordering/Prescribing/Referring/Attending (OPRA) provider.
  • Enrollment in Medicaid FFS does not require providers to accept Medicaid FFS patients.

If you are not actively enrolled, please go here  and navigate to your provider type. Print the Instructions and the Enrollment form. At this website, you will also find a Provider Enrollment Guide, a How Do I Do It? Resource Guide, FAQs, and all forms related to enrollment in New York State Medicaid. 

As a point of information, under 42 CFR 455.104 defines the following providers as excluded from the definition of “disclosing entity”:

  • Solo practitioners such as an individual physician, psychologist, or chiropractor.
  • Group of individual practitioners, such as a group of cardiologists, or a group of radiologists.”



Therefore, physicians do not need to complete Section 5.

If you have questions, please contact Regina McNally at 516-488-6100 ext 332.

SEMINARS

Rebuild Puerto Rico Health Symposium in NYC TOMORROW
The Puerto Rican Studies Association (PRSA) and the Center for Puerto Rican Studies will host several concurrent panels that will discuss various health topics related to rebuilding Puerto Rico.

When:  Saturday, October 28, 2017, 11:30-12:45
Where: Silberman School of Social Work, Hunter College, 2180 Third Avenue (at 119th St)

The panelists will include Irwin Redlener, MD, Director of the National Center for Disaster Preparedness, Columbia University; Sarah Schuyler, Director of Operations, The Afya Foundation; Jodie Roure, JD, PhD, Associate Professor, St. John’s University School of Law. In addition, physicians who have volunteered in Puerto Rico will share their experiences.

If you’re unable to attend in person, click here for the zoom webinar link.

DOH Commissioner Zucker to Speak on Pain Management and Medical Marijuana
As a partner with the New York State Department of Health Medical Grand Rounds Committee, the enclosed information on the first session of the 2017-2018 Commissioner’s Medical Grand Rounds series: Pain Management and Medical Marijuana at Flushing Hospital

Who:     Hosted by DOH Commissioner Howard A. Zucker, MD, JD
When:   Monday, October 30th, 2017
Time:    6:30 PM – 8:30 PM
Where: Flushing Hospital Medical Center – Medical Science Building, 5th Floor, Auditorium
4500 Parsons Blvd (at the corner of 45th Ave and Burling Street)      Flushing, NY 11355

The purpose of this presentation is to enhance the learner’s knowledge of cannabinoids and their pharmacology, demonstrate how medical marijuana may fit into medical practice for pain management, explain safety, potential risks and benefits of medical marijuana use, provide information on the effect marijuana may have on opioid use and opioid related risks, and discuss the regulatory requirements of the Medical Marijuana Program in New York State. Practitioners will have the opportunity to ask questions of the Department and physicians currently using these treatments to help patients.

This session will be streamed as a live webcast for those unable to attend in person, and it will also be offered on the New York State Department of Health webpage as an archived webinar. This is a free event and participation is encouraged from providers all over the state of New York. Participants are eligible for CME credits whether they view in-person, via the live webcast, or via the archived webcast. Please;

Buprenorphine Training to be held in Sullivan County December 2nd
The NYSDOH AIDS Institute and the Sullivan County Public Health Department are hosting a free Buprenorphine Eligibility Waiver Training for Clinical Providers on Saturday, December 2nd, 2017 from 8:00AM to 1:00PM at Catskill Regional Medical Center, 68 Harris-Bushville Rd, Board Room, Harris, NY 12742. This training is for physicians, nurse practitioners, physician assistants, pharmacists, and medical residents. Sullivan County has some of the highest rates of opioid overdose in New York State. In just the first seven months of 2017, Sullivan County has experienced a reported 20 overdose deaths.  From 2013-2016, there were approximately 75 reported opioid overdose deaths.

DOH is seeking to increase the volume of providers in and around the county that are able to offer medication assisted treatment (MAT) to people using opioids whom could benefit from buprenorphine (or “suboxone”).  Attached is a flyer with further information, including location, online registration, and more details. Further information will be sent out to confirmed attendees. Light refreshments will be provided. Registration closes on November 29th at 5pm.

Trainers: Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY; Bruce Trigg, MD, Harm Reduction Coalition, New York, NY

Please Note: CME Credits will be made available. This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training. Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2).
For more information about buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.

An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician” CME Webinar on December 6; Registration Now Open
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician”.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Elizabeth DuFort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.  Register for this webinar here

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

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures

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. 

Physicians Encouraged to Attend AMA Webinar Re Preventing Diabetes in Patients
November is National Diabetes Awareness Month and the American Medical Association (AMA) and the Medical Society of the State of New York (MSSNY) has partnered to provide educational information to New York State physicians on how to initiate clinical practice change and prevent diabetes in patient population.  Physicians can participate in a webinar on November 15 from 1-2 p.m.  Click here to register.

The session will review the evidence base for clinical approaches to diabetes prevention and describe how physicians and care teams can implement a diabetes prevention initiative within their practice. Kate Kirley, MD, MS, Director of Chronic Disease Prevention and Janet Williams, MA, Senior Program Manager will be presenters.  Dr. Kirley is director of Chronic Disease Prevention at the American Medical Association.  Prior to joining the AMA, she was a practicing family physician and health services researcher at NorthShore University Health System, and a clinical assistant professor in the Department of Family Medicine at the University of Chicago.  Janet Williams is senior manager of physician and health system engagement at the American Medical Association.  She has more than 30 years public health program and policy development experience.   She manages the AMA’s prediabetes initiative to develop and test clinical tools and resources for engaging health systems, clinicians and health departments in diabetes prevention.

New Alzheimer’s Association Continuing Medical Education (CME) Course Now Available
The Alzheimer’s Association is offering Challenging Conversations about Dementia, a free five-module online CME course intended to meet the educational needs of primary care clinicians — including internists, family physicians, nurse practitioners and physician assistants — who are seeking additional education in the assessment, diagnosis and ongoing health care of patients with cognitive impairment and dementia.

The course takes approximately 75 minutes and upon completion, participants will be able to:

    • Recognize the signs indicative of dementia and mild cognitive impairment versus normal aging.
    • Identify and explain the benefits of early detection and diagnosis of mild cognitive impairment and/or dementia.
    • Discuss next steps in the diagnostic process with patients who fail a cognitive screen in a clinical setting and prompt them to complete the process.
    • Evaluate the behavioral, safety and functional needs of patients with AD as part of the care planning process.

  • Assess patients’ fitness to drive.

CLASSIFIEDS


Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.


Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069

Medical Family Practice For Sale – Long Beach, NY
Established 14 years. Newly renovated. Fully equipped ground floor premises. 3 exam rooms. Must see! Call Carol – 516-238-3422


For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
or 631-318-4008

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at  http://www.clineeds.com/sign-up

PHYSICIAN OPPORTUNITIES


Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.


To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026


CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355