October 9, 2020 – Call for Flexibility in Reporting COVID and Flu Test Results
This week, MSSNY staff and I met with New York State Department of Health and the Governor’s office to raise concerns with the new reporting requirements for COVID-19 and influenza testing. MSSNY was joined by physicians who represent urgent care practices. Under the Commissioner’s September 21 notice, positive and negative COVID-19 and flu tests results must be reported to DOH within 3 hours of the receipt of these results, along with contact information, employment and/or school information for the patient.
Your MSSNY team expressed that we share the goal of getting information to the State DOH as soon as possible to begin contact tracing and other containment efforts, but MSSNY also urged greater flexibility for reporting these results, particularly for reporting the negative tests. While there are also federal requirements to report COVID-19 test results, those results must be reported within 24 hours and do not apply to influenza testing. Complying with these mandates is a daunting, if not impossible, task for many practices. To make matters worse, the DOH notice raises the prospects of serious financial penalties for failure to comply. This is very counterproductive as it is likely to discourage practices from testing at a time when COVID-19 rates are rising in our state.
To obtain further data to back up the many individual concerns we have heard, MSSNY has initiated a physician survey regarding the challenges of complying with the requirement to report COVID-19 and flu tests – both positive and negative – within 3 hours of receiving the results. If you have not already, please take just a few minutes to complete our survey here.
Results are still coming in, but of the several hundred responses we have received so far, over 60% of those who are providing these tests have indicated that they are unable or will be unable to provide these tests if the requirements set forth in the September 21 notice are continued. In the “Comments” section of the survey, multiple physicians indicated that they agree with the importance of providing a quick turnaround for positive COVID-19 test results but urge a change in the requirements regarding reporting flu tests and negative COVID-19 tests. Also noteworthy were the comments we received in the survey concerning the difficulty of obtaining work and school information as part of this reporting mandate.
As a second surge in cases is beginning to emerge, we share the goal of providing test information as soon as reasonably possible so we can together contain the spread of the virus. However, it is counterproductive to impose measures that make it difficult, if not impossible, for physicians to provide this needed testing for our patients.
Again, please take our MSSNY survey if you provide COVID-19 or Influenza testing.
Bonnie Litvack, MD
Notes from Governor Cuomo’s Conference Call:
– Day 223
– 6 fatalities
– 779 hospitalizations
– 168 ICU patients
– 78 intubations
– 139,000 tests yesterday
– 5.4% infection rate in hotspots
– Statewide rate without hotspots included is 0.9%
– Statewide rate including hotspots is 1.1%
– Gov. stressed hotspots are being oversampled, and this skews the rate when included in statewide rate, as those regions are a small percentage of state’s population
– “misleading” to include hotspots in statewide rate
– Red zones of hotspots are 2.8% of state’s population, but 20% of state’s COVID cases
– 6.6% infection rate in red zones
– Gov. called this data evidence of state’s advanced testing capabilities
Infection Rate by Region:
– NYC – 1.2%
– Capital Region – 0.7%
– Central NY – 0.9%
– Finger Lakes – 0.8%
– Long Island – 1%
– Mid Hudson – 2.1%
– Mohawk Valley – 0.5%
– North Country – 0.3%
– Southern Tier – 1%
– Western NY – 1.3%
– Orange: 3.6%
– Rockland: 5.6%
– Broome: 3.2%
– Brooklyn: 1.9%, up from 1.7%
– 4,500 new school reported tests
– Total of 66,000 tests reported since beginning of dashboard
– 648 school districts have submitted data, which is 94% of districts
– 42 schools receiving orders for non-compliance in submitting data
– 97 new COVID cases reported in schools: 58 students, 39 faculty and staff
– Enforcement is continuing
– Gov. said clusters have always been targeted, regardless of the population involved
On Gov. Whitmer and President Trump:
– Gov. said President Trump continues to be “divisive”, “Anti-American”
– Gov. asserted President’s behavior is also driving protests in ultra-Orthodox communities in Brooklyn
– Gov. played an ultra-Orthodox robocall which claimed being in contact with Trump campaign, and being directed by the campaign to protest and hold signs saying, “Cuomo killed thousands”
– Gov. cited tweets from ultra-Orthodox leader Heshy Tischer, requesting flags be created saying, “Cuomo hates Jews” and “Cuomo killed thousands”
– Gov. called this “hurtful, disgusting, painful”, and this rhetoric is putting lives at risk
More on New OPMC Signage Requirement
As reported in Wednesday’s MSSNY e-news, despite strong MSSNY opposition, this week the Governor signed into law legislation requiring every physician’s “practice setting” to post a conspicuous sign identifying for patients the OPMC’s website for reporting suspected misconduct at https://www.health.ny.gov/professionals/doctors/conduct/.
Click here to read MSSNY President Dr. Bonnie Litvack’s statement objecting to this new requirement.
There is no specific template specified in the law or by DOH. One possible template to meet the provisions of this law as suggested by MSSNY legal counsel is to say in the signage:
“We are committed to ensuring that our patients receive appropriate medical care. You can get information regarding your rights and how to report professional misconduct at https://www.health.ny.gov/professionals/doctors/conduct“
It should be noted that, because of the section of the law that was amended by this legislation, failure to place this sign in your practice setting will NOT subject a physician to financial penalties that otherwise are applicable for other violations of the Public Health Law. However, failure to post this sign could subject the physician to discipline by the OPMC if it is shown that there was a “willful or grossly negligent” failure to comply.
MSSNY continues to have discussions with DOH staff regarding aspects of this new signage requirement, including how it will apply in settings not controlled by the physician, such as a hospital, nursing home or clinic. DOH has sent a letter to all physicians advising them of this new law, noting that these signs must be visible in areas accessed by patients and those who accompany patients to visits, such as “waiting rooms, check-in/out areas and treatment areas.”
Do You Provide COVID-19 or Flu Testing? Please Take Our Survey
To assist the State in its contact tracing efforts, the New York State Department of Health (DOH) recently sent a notice to all laboratories and all health care practitioners (including physicians) who provide in-office testing for COVID-19 and influenza to report test results, both positive and negative, within 3 hours of receiving these results. The notice further notes that practitioners or labs who do not comply with this requirement could face serious financial penalties.
Upon raising concerns to the DOH that some physicians will be unable to complete this requirement, the DOH has asked MSSNY to provide additional data regarding physicians’ ability to comply. If you haven’t already done so, please take just a few minutes to respond to this MSSNY survey.
CMS Announces New Repayment Terms for Medicare Loans Made During
The Centers for Medicare & Medicaid Services (CMS) announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress.
This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations. Under the Continuing Appropriations Act, 2021 and Other Extensions Act repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advance payment. CMS issued $106 billion in payments to providers and suppliers in order to alleviate the financial burden healthcare providers faced while experiencing cash flow issues in the early stages of combating the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE).
For more information visit the CMS website.
Flu Season is Upon Us! Vaccine Update Webinar on 10/21
Flu season is upon us! Register now to 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.
Medical Errors Increase by Nearly 20% Around Daylight Savings, Study Finds
In the days following the switch to daylight saving time, human mistakes tied to patient safety-related incidents increased by almost 20 percent, according to a study in the Journal of General Internal Medicine. Researchers analyzed voluntarily reported data from Rochester, Minn.-based Mayo Clinic that occurred seven days before and after the spring and fall time changes for 2010-17.
Patient safety-related incidents included defective systems, equipment failure or human error. Researchers did not report significant differences in overall errors in the weeks before and after the time changes. However, when analyzing human error only, they found the number of human errors increased by a statistically significant 18.7 percent after daylight saving in the spring. Most of the errors involved medications, such as administering the wrong dose or wrong drug.
ICD-10 Updated Codes: October 1, 2020 through September 30, 2021
CMS has updated the ICD-10-CM and ICD-10-PCS codes. The new ICD-10 codes are to be used from October 1, 2020 through September 30, 2021.
Some Insurers Will No Longer Waive Co-Payments for Telemedicine
The New York Times (10/3, Abelson) reported, “Some people will have to start paying more out of their own pockets for telemedicine appointments, if their virtual visits with doctors are unrelated to COVID-19 and are needed to monitor conditions like diabetes or to check out sudden knee pain.” Both Anthem and UnitedHealthcare “are no longer waiving co-payments and deductibles for some customers beginning on Oct. 1.” Patients “who have been relying on telehealth to steer clear of the emergency room or a doctor’s office during the coronavirus pandemic will need to check with their insurers to see how much they will now owe for a virtual visit.
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