September 16, 2016 – What Is Really Discussed at Council?

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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September 16, 2016
Volume 16, Number 32

MLMIC

Dear Colleagues:

Yesterday, the Council meeting to plan for 2016-2017 activities met in Westbury. The six meetings we convene in a year’s time are usually quite lively in spite of the fact we always have an ambitious agenda. Yesterday’s was 127 pages.

The following items were deliberated and voted upon:

  • Council voted to sign-on to the Pennsylvania Medical Society MOC letter making the official declaration of No Confidence in the ABIM. The voting was preceded by an informative presentation by Dr. Parag Mehta outlining the case against the necessity of MOC requirements and highlighting the growing protest over the MOC process.
  • Council approved the following resolution as amended: Whereas CMS is permitting a process of “seamless conversion” wherein seniors are transitioned from traditional MCR insurance products into Medicare Advantage options with seniors having little understanding of the implications, MSSNY will prepare a simple, easy to read modifiable model letter for physician members to provide their Medicare enrollees this month as well as a poster for physicians to post. Additionally, MSSNY will work with appropriate stakeholders to collaborate with senior groups to raise awareness among physicians and seniors on the implications of the practice of seamless conversion and will work with appropriate stakeholders to advocate with legislators and CMS to implement an immediate moratorium on the practice of seamless conversion. MSSNY will bring the resolution to the AMA.
  • Council approved an in-person, rather than a virtual meeting, for the January 2017 Council meeting.
  • Council approved the Congressional, State Senate and State Assembly candidates for MSSNYPAC endorsement http://bit.ly/2cPkoUb
  • The 2017 House of Delegates will be held April 21-23 at the Westchester Marriot in Tarrytown. Speaker of the House Dr. Geraci-Ciardullo announced the Resolution deadlines for the 2017 House of Delegates: February 17, 2017 and March 17, 2017 (final deadline).

Your Councilors make a concerted effort to attend these meetings on their own time and take their posts very seriously. Your interests as a practicing physician are utmost in their minds when issues come up for discussion. You can read your county report that was submitted on behalf of your geographic area. You might want to call your Councilor to discuss your issues and concerns about your practice. You might even want to thank your Councilor for their service to your county and the personal time spent on our pressing issues. They are:

  1. Kings/Richmond Report– Parag H. Mehta, MD
  2. Manhattan/Bronx Report – Joshua M. Cohen, MD, MPH
  3.  Nassau County Report – Paul A. Pipia, MD
  4. Queens County Report – Saulius J. Skeivys, MD
    (no written report submitted)
  5. Suffolk County Report – Maria A. Basile, MD, MBA
  6. Third District Branch Report – Brian P. Murray, MD
  7. Fourth District Branch Report – John J. Kennedy, MD
  8.  Fifth District Branch Report –Howard H. Huang, MD
  9. Sixth District Branch Report – Robert A. Hesson, MD
  10.  Seventh District Branch Report – Mark J. Adams, MD
  11. Eighth District Branch Report – Edward Kelly Bartels, MD
    (no written report submitted)
  12. Ninth District Branch Report – Thomas T. Lee, MD
  13.  Medical Student Section Report –Christina Kratschmer
  14.  Organized Medical Staff Section Report –Richard A. Ritter, MD (no written report submitted)
  15. Resident & Fellow Section Report – Robert A. Viviano, DO
  16. Young Physician Section Report – L. Carlos Zapata, MD(no written report submitted)
  17. Resident & Fellow Section Report– Robert A. Viviano, DO16.
  18. Young Physician Section Report – L. Carlos Zapata, MD (no written report submitted) 

We are all working hard for you and your practice.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


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MSSNY Makes Endorsements For The November Elections
At the September 15, 2016 meeting of the MSSNY Council, the following legislators/candidates were endorsed for election by the Medical Society of the State of New York.   Each has demonstrated themselves to be champions of issues to preserve the ability of patients to continue to receive needed and timely physician care. 

NEW YORK STATE ASSEMBLY

  • Kevin Cahill (D, 103rdAD – Dutchess and Ulster counties)
  • Michael Cusick (D, 63rd AD- Richmond County)
  • Deborah Glick (D, 66th AD, NY County)
  • Richard Gottfried (D, 75th AD, NY County)
  • Charles Lavine (D, 13th AD, Nassau County)
  • Joseph Morelle (D, 136thAD, Monroe County
  • Robin Schimminger (D, 140th AD, Erie and Niagara counties)

NEW YORK STATE SENATE

  • Tom Croci (R, 3rdSD, Suffolk County
  • Kemp Hannon (R, 6th SD, Nassau County)
  • Robert Ortt (R, 62ndSD, Monroe, Niagara and Orleans Counties)
  • Michael Ranzenhofer (61stSD, Erie, Genesee and Monroe Counties)
  • James Seward (51stSD, Cayuga, Chenango, Cortland, Delaware, Herkimer, Otsego, Schoharie, Tompkins and Ulster counties)
  • James Tedisco (Candidate For 49thSD, Fulton, Hamilton, Herkimer, Saratoga and Schenectady Counties)
  • Catherine Young (57thSD, Allegany, Cattaraugus, Chautauqua and Livingston Counties)

US CONGRESS

  • Chris Collins (R, 27thCD – Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans and Wyoming Counties)
  • Joseph Crowley (D, 14thCD – Bronx and Queens counties)
  • Elise Stefanik (R, 21stCD – Clinton, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, St. Lawrence, Saratoga, Warren and Washington counties)
  • Paul Tonko (D, 20thCD – Albany, Montgomery, Rensselaer, Saratoga, and Schenectady counties)  

NEW YORK STATE ASSEMBLY

Assembly Member Kevin Cahill 103rd AD (Ulster and Dutchess counties)  Chairs the Assembly Insurance Committee, and a member of the Health, Higher Education and Ways & Means Committee. Assemblyman Cahill works closely with MSSNY staff and has a strong record of taking action consistent with MSSNY’s positions.  This past legislative session, he led efforts to assure that the Assembly rejected cuts to the Excess Medical Malpractice program proposed in the Executive Budget, which preserved coverage for 13,000 physicians across New York who otherwise would have been dropped from the program.  He also was a forceful vocal opponent to legislation rejected by the Assembly proposed in the State Budget and on a “stand-alone” basis that would have permitted corporate-owned retail clinics.  Moreover, as Chair of the Assembly Insurance Committee, he was integral in helping to shape legislation supported by MSSNY and passed by the Legislature that provides physicians with a mechanism to override a health insurer step therapy medication protocol.  He is also one of the principal co-sponsors of legislation to permit physicians to collectively negotiate with health insurers.

Assembly Member Michael Cusick 63rd AD (Richmond County) Sits on the Assembly Higher Education and Ways & Means Committees. Assemblyman Cusick works closely with MSSNY staff and has a strong record of taking action consistent with MSSNY’s positions.   He was chief sponsor of legislation that passed the Legislature to hasten the time for insurers to complete review of applications for physicians to participate in the insurer’s network.  Despite his sponsorship of the I-STOP legislation, hHis efforts were critical in helping to greatly improve the final version bill of the I-STOP bill over earlier versions, including working to assure a physician could delegate the “duty to consult” to staff.  He also was very helpful in efforts to help shape legislation so as to reduce the hassles to physicians associated with required CME for pain management, and limitations on specific opioid medications. In 2015-16, he supported a number of bills of importance to MSSNY in floor votes, including legislation to require health insurers to use similarly trained physicians before denying patient care, and legislation to assure due process protection for physicians when health plans do not renew physician participation contracts with them.   He is also a co-sponsor of legislation to permit physicians to collectively negotiate with health insurers.

Assembly Member Deborah J. Glick (D) 66th AD New York County) Assemblywoman Glick chairs the Assembly’s Higher Education Committee.   She has been tenacious in opposing legislation to permit corporate owned “retail clinics” and has been a strong advocate in opposition to CME mandates.    She has been a fierce opponent to inappropriate scope of practice expansion bills, including those that the Senate had passed in recent years such as the podiatric, athletic trainer and a bill to allow chiropractors to co-own medical practice in contravention of the corporate practice of medicine doctrine.  She and her staff have an outstanding working relationship with MSSNY.

Assembly Member Richard Gottfried 75th AD (New York County). Chairs Assembly Health Committee and sits on the Assembly Higher Education Committee. In that capacity, Assemblyman Gottfried has introduced and secured passage of legislation to protect physician and patient concerns with e-prescribing.  He also the long time sponsor of numerous MSSNY priority bills, including legislation to provide peer review confidentiality protections and to permit physician collective negotiations. He also opposed changes to the Excess Medical Liability Insurance program. He works closely with MSSNY staff and has a good record of taking action consistent with MSSNY’s positions.

Assembly Member Chuck Lavine 13th AD (Nassau County). Sits on the Assembly Codes, Health, Higher Education, Insurance, and Judiciary Committees. Assemblyman Lavine works closely with MSSNY staff and has a strong record of taking action consistent with MSSNY’s positions.  In 2015-16, he sponsored multiple bills to address concerns raised by physicians, including legislation (which passed the Assembly) to assure due process protection for physicians when health plans do not renew physician participation contracts with them, and legislation that would prohibit health insurers from using extrapolation when they audit physicians (which also passed the Assembly). In 2015-16, he supported a number of bills of importance to MSSNY in committee and floor votes, including legislation to permit physicians to collectively negotiate with health insurers (he is a co-sponsor), and legislation to require health insurers to use similarly trained physicians before denying patient care.  He also voted against multiple bills opposed by MSSNY, including stand-alone legislation to require physicians to take pain management CME and legislation that would have imposed a 5-day limit on medications to treat acute pain.

Assembly Majority Leader Joseph Morelle 136th AD (Monroe County). Assembly Majority Leader. Assemblyman Morelle was instrumental in efforts to delay passage of an overbroad pain management CME mandate and helped to assure that the final opioid legislation enacted addressed many concerns raised by physicians.  He was also helpful in efforts to prevent passage of legislation to permit corporate owned retail clinics. He is also opposed to most scope of practice changes and supports legislation to provide additional protections for physicians and patients to prevent insurers from denying or delaying necessary medical care. He opposed proposed changes to the Excess program and opposed changes to the workers compensation program that would have added certain non-physician providers to provide care to injured workers and a proposal to eliminate the county medical society role in review of applications to the workers’ compensation program.

Assembly Member Robin Schimminger 140th AD (Erie and Niagara counties) Sits on the Assembly Health, Codes and Ways and Means Committees.  Assemblyman Schimminger works closely with MSSNY staff and has a strong record of taking action consistent with MSSNY’s positions.    He is the long-time sponsor of the Medical Liability Reform Act, legislation which contains a number of provisions to address the high cost of medical liability insurance, including:

  • A cap on non-economic damages
  • Reducing joint and several liability
  • Identification of expert witnesses in medical liability cases
  • Identification of physician providing certification for Certificate of Merit

Assemblyman Schimminger also sponsored legislation to prohibit hospitals from requiring board certification as a condition of staff privileges, and health insurers from requiring board certification as a condition of participation. In 2015-2016, he supported a number of bills of importance to MSSNY in committee and floor votes, including the Collective Negotiation legislation, and legislation to assure due process protection for physicians when health plans do not renew physician participation contracts with them.   He also voted in opposition to a number of bills also opposed by MSSNY, including legislation to extend the medical liability statute of limitations, legislation to require physicians to complete CME for pain management, and legislation that would have imposed a 5-day limit on medications to treat acute pain

NEW YORK STATE SENATE

Senator Tom Croci (R) 3rd SD (Suffolk County). Chairs Senate Ethics, Veterans and Homeland Security & Military Affairs. In his capacity as chairman of the Senate Veterans Committee, Senator Croci worked with the Committee on Mental Hygiene to secure for MSSNY, NYSPA and NASW a grant to assist in the development and presentation of continuing medical education programming on the diagnosis and treatment of PTSD and TBI in returning veterans.

Senator Kemp Hannon (R) 6th SD (Nassau County). Chairs Senate Health Committee. Senator Hannon has, at the request of MSSNY, carried and successfully passed a number of bills including three bills to address issues with e-prescribing, standard prior authorization request forms, physician collective negotiation (2011) and has introduced medical liability reform legislation including a cap on noneconomic loss and peer review confidentiality legislation while advocating within his conference on behalf of MSSNY against the date of discovery bill.

Senator Robert Ortt (R) 62nd SD (Monroe, Niagara, Orleans Counties). Chairs Senate Mental Hygiene & Developmental Disabilities Committee. In his capacity as chair of the Mental Hygiene Committee, Senator Ortt, worked with the Committee on Veterans to secure for MSSNY, NYSPA and NASW a grant to assist in the development and presentation of continuing medical education programs on the diagnosis and treatment of PTSD and TBI in returning veterans.

Senator Michael Ranzenhofer (R) 61st SD (Erie, Genesee, Monroe Counties), is the Deputy Majority Leader for Economic Development and Chairs the Corporations, Authorities & Commissions Committee, and is a member of the Senate Finance Committee.  During the Senate caucus on the Date of Discovery Statute of Limitations bill in the final hours of session, Senator Ranzenhofer is reported to have stridently argued against the bill thereby aiding in its defeat.

Senator James Seward (R) 51st SD (Cayuga, Chenango, Cortland, Delaware, Herkimer, Otsego, Schoharie, Tompkins and Ulster counties), is the Chair of the Senate Insurance Committee, and member of the very powerful Senate Finance, Health and Rules Committees.  Senator Seward has long been a champion of medical liability reform and staunch opponent of liability expansion legislation.   He has also been a regular participant at MSSNY’s Annual Albany Physician Advocacy Day.  This year, as Chair of the Senate Insurance Committee, he was integral in helping to shape legislation supported by MSSNY and passed by the Legislature that provides physicians with a mechanism to override a health insurer step therapy medication protocol.

Jim Tedisco (R) Running to fill vacant 49th SD (Fulton, Hamilton, Herkimer, Saratoga and Schenectady Counties). Assemblyman Tedisco has represented voters in Schenectady and Saratoga Counties since 1982. He is very well known in his District and has been a long-time friend of medicine. He served as Minority Leader of the Assembly from 2005 to 2009. He has had a long and very good working relationship with MSSNY DGA staff and MSSNY physicians. He supported the step therapy override bill and legislation that would eliminate the requirement for physicians to report to the State each time they write a prescription in lieu of an e-prescription.

Senator Catherine Young (R) 57th SD (Allegany, Cattaraugus, Chautauqua, and Livingston Counties). Senator Young chairs the Finance Committee, as well as the Senate Republican Campaign Committee. As Chair of the Senate Finance Committee, working with the Chair of the Senate Health Committee, Senator Young steadfastly opposed the Governor’s proposal to reduce funding of the Excess program substantially reducing the number of physicians eligible for such coverage, opposed the retail clinic proposal and opposed the workers compensation proposal to add certain non-physician providers to provide care to injured workers and a proposal to eliminate the county medical society role in review of applications to the workers’ compensation program. She also sponsored legislation that would empower physicians to override step therapy protocols to assure that their patients have timely access to medically necessary medication.

US CONGRESS

Representative Chris Collins (R) CD 27 (Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Wyoming) Representative Chris Collins is running for his 3rd term.  He serves on the very powerful House Energy & Commerce Health Subcommittee. Representative Collins and his staff work closely with local physicians and MSSNY staff, and he has a strong record of advocating for policies consistent with the concerns of physicians and patients.  He is a co-sponsor of the Fair Medical Audits Act of 2015 which would restore some fairness in the conducting of audits by Medicare Recovery Audit Contractors.  He also signed unto a letter to CMS that expressed strong opposition with a CMS proposal that would significantly cut the payments to physicians for medications administered to patient under Medicare Part B.  Moreover, at a Congressional hearing last December, he aggressively questioned CMS Acting Administrator Slavitt regarding CMS response to the collapse of Health Republic and its impact on local physicians.

Representative Joe Crowley (D) 14th CD (Bronx and Queens Counties) Congressman Crowley is running for his 10th term. He serves on the very powerful House Ways & Means committee, which has jurisdiction over much of the health care policy considered by Congress. Representative Crowley and his staff work closely with local physicians and MSSNY staff, and he has a strong record of advocating for policies consistent with the concerns of physicians and patients. He is lead sponsor of legislation that would significantly increase the number of residency slots to address doctor shortages in New York and across the country. He was also very vocal in support of efforts that ultimately led to a repeal of the flawed Medicare Sustainable Growth Rate formula, including leading a bi-partisan effort to use the Overseas Contingency Operations (OCO) funds to pay for its repeal.  Moreover, he recently signed unto a letter to CMS that expressed strong concerns with a CMS proposal that would significantly cut the payments to physicians for medications administered to patient under Medicare Part B. 

Representative Paul D. Tonko (D) CD 20 (Albany, Schenectady and parts of Montgomery, Rensselaer and Saratoga Counties) He is serving his fourth term, and is one of New Yorkers on the very powerful House Energy and Commerce Committee – one of the Committees with health care jurisdiction.  Congressman Tonko served for over 20 years in NYS Assembly prior to running for Congress, and was the sponsor of the Mental Health Parity bill.    He has carried his advocacy for mental health parity to Congress.  He has also been a strong advocate to expand opioid treatment capacity for community caregivers – legislation that in May, passed the U.S. House of Representatives. Congressman Tonko is the vice co-chair of the Congressional Addiction, Treatment and Recovery Caucus.  He has an excellent working relationship with local physicians and with MSSNY staff.

Representative Elise Stefanik (R) 21st SD (Clinton, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, St. Lawrence, Saratoga, Warren, Washington). Running for second term, the Congresswoman serves on the House Armed Services Committee and the Committee on Education and the Workforce.   She authored the Be Open Act – legislation that was signed into law by the President to fix a flaw in ObamaCare by repealing the auto-enrollment mandate that reduces choices in health coverage and has created confusion that can lead to significant tax penalties on both the employer and employee. She also signed onto a House Republican Delegation letter to CMS in opposition to a Medicare Demonstration program that would significantly impair seniors’ access to care by reducing physician reimbursement for injectable medications.   She has worked closely with many local physicians, including several MSSNY leaders.

Urge Governor Cuomo To Sign Step Therapy Override Bill
All physicians are urged to send a letter to Governor Cuomo requesting that he sign into law a bill (A.2834-D/S.3419-C) that would establish specific criteria for physicians to request an override of a health insurer step therapy medication protocol when it is in the best interest of their patients’ health.

The bill has not as of yet been delivered to the Governor.

MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers to achieve passage of this legislation.      We know the insurers are strongly fighting this bill, so the Governor’s office needs to hear your support.

Over the summer, MSSNY representatives and several other patient advocacy groups met with the Governor’s office to urge that this bill be signed into law.  Moreover, in Augusts, dozens of patient advocates rallied at the State Capitol in support of this bill.

The bill would require a health insurer to grant a physician’s override request of an insurer step therapy protocol if one of the following factors are present: 1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; 2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; 3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; 4) the patient is stable on the medication requested by the physician; 5) the medication is not in the best interests of the patient’s health.

While the legislation would generally require the health insurer to make its decision within 3 days of the override request of the physician, the insurer would be required to grant the override request within 24 hours of the request if the patient has a medical condition that places the health of such patient in serious jeopardy if they do not receive the requested medication.  Perhaps most importantly, if the physician’s request for an override is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.

Gov. Signs Laws to Improve Voluntary Organ Donation
New York State has the third highest need for donors – with 10,000 residents currently waiting for organ transplants – but the lowest number of registered donors. Governor Cuomo has now signed three laws that will help improve voluntary organ donation in New York.

  • Lauren’s Law, which requires individuals who apply for a New York State Driver’s License to affirmatively decide whether or not to participate in the state’s organ donor registry, was extended for four years.
  • The Organ Donor Registration Opportunity/Health Benefit Exchange law requires applications for insurance coverage through the State’s Health Benefit Exchange to include an opportunity for individuals to participate in New York’s Donate Life Registry.
  • Another new law lowers the minimum age for organ donation designation to 16 years old. The law, taking effect February 14, 2017, allows individuals age 16 and older to enroll in the New York State Donate for Life Registry and to consent to making lifesaving organ and tissue donations. The vast majority of other states have this law. 


Empire Bluecross/Blueshield to Participate in CMS Multi-Payer Initiative
Empire BlueCross BlueShield has been selected to participate in the Centers for Medicare and Medicaid Services’ Comprehensive Primary Care Plus program, a five-year multi-payer model.

The program, according to CMS, is designed to bolster primary care through regionally-based multi-payer payment reform by bringing different payers, like CMS, commercial insurance plans and state Medicaid agencies, together to make changes to health care delivery.

CPC+ will have two primary care tracks with “incremental advanced care delivery requirements” and payment options, in the hopes each will have better infrastructure to deliver care to patients, according to CMS. Practices will be centered on certain functions, like access and continuity, care management, comprehensiveness and coordination, patient and caregiver engagement and planned care and population health, according to CMS.

Providers that want to participate in CPC+ need to apply through CMS and will be announced later this year.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


NYSDOH Offering “A September 2016 Series of Zika Virus Webinars”

  • Zika Virus: An Update for Obstetric and Neonatal Providers and the Birth Facility Team
    When: Tuesday, September 20, 12 – 1 p.m.
    Speakers: Lou Smith, MD, MPH, Medical Director, Bureau of Communicable Disease                       

Control

  • Zika Virus: An Update for the NYS Healthcare Provider             When: Wednesday, September 21, 12 – 1 p.m.
    Speakers:
    P. Bryon Backenson, MPH, Director of Vector-Borne Diseases and   Elizabeth Dufort, MD, FAAP, Medical Director, Division of Epidemiology, NYSDOH
  • Zika Virus: An Update on Transplant Associated Concerns             When: Thursday, September 22, 12 – 1 p.m.
     Host: NYSDOH and the NYS Transplant Council
    Speakers: Kirsten St. George, MAppSc, PhD, Chief Viral Diseases, Wadsworth Center,                                                                        NYSDOH; Lewis Teperman, MD, FACS, Vice Chair of Surgery & Director of Organ Transplantation at Northwell Health, Manhasset NY and Region 9 Councillor to the United Network for Organ Sharing (UNOS); Marian Michaels, MD, MPH, Professor of Pediatrics and Surgery, University of Pittsburgh School of Medicine, Disease Transmission Advisory Committee (DTAC) Vice Chair, United Network for Organ Sharing (UNOS)
  • Zika Virus: An Update for the Pediatric Provider
    When: Wednesday, September 28th 2016, 12 – 1 p.m.

Please click here for more information and to register.

UnitedHealthcare Physician Advocacy Council: Any Questions to Ask Them?
As part of the last legal settlement with United that was concluded in 2015, United agreed to the formation of a Committee referred to as the PAC – Physician’s Advisory Council.  The Medical Society of the State of New York has 4 physician members who are on the UHC PAC.  The Committee meets 4 times a year with similarly named physicians from United.  One criteria for being on this group is that the physician must be participating with United.

The Committee is charged with addressing any issue of contention, either operational or administrative, that might be encountered in dealing with United. While issues are discussed at length, the agreement stipulates that UHC is there to listen and report back to the UHC leadership on items discussed.  United does not present new policy matters to the PAC.  However, the group could discuss United policy issues that cause concern and these concerns would then be taken back the leadership for their thoughts and/or action.  The spirit of the settlement agreement is that MSSNY could share subject matters at a high level to garner a better relationship with UHC.

In this spirit, MSSNY is asking members if they have specific issues with United that we can address and advocate for your behalf.  If you have a concern, please send an email to Regina McNally, VP, Socio-Medical Economics.  Please state the subject as UHC PAC Item and send your email to rmcnally@mssny.org  MSSNY email is not HIPAA-secure, so please do NOT include any PHI!

Many Seniors Wrongly Denied Medicare Coverage
The New York Times (9/13,) reports that beneficiaries are often told Medicare will no longer cover physical therapy or nursing home stays because they are “stable and chronic,” or have reached “maximum functional capacity,” or they have plateaued.

Seniors “with chronic and progressive diseases – dementia, Parkinson’s, heart failure” – are typically given this incorrect assessment, even though a 2013 settlement of a class-action suit mandated that Medicare “cover skilled care and therapy when they are ‘necessary to maintain the patient’s current condition or prevent or slow further deterioration.’”

In addition, last month, a Federal judge ordered CMS “to do a better job of informing health care providers and Medicare adjudicators that the so-called improvement standard was no longer in effect.” The judge said that while CMS does not have to further update its manuals, it must do a better job of educating the medical community about these changes. 

YP/Resident Leadership Seminar Slated for Syracuse Oct 21-22
Following an exciting Leadership Seminar for downstate physicians in April, MSSNY’s Medical Educational and Scientific Foundation (MESF) has now slated a Leadership program for upstate physicians in Syracuse from late afternoon Friday, Oct 21 through Saturday, Oct 22.

The program is scheduled for the Doubletree Inn at Syracuse Thruway exit 36. A renowned faculty from Brandeis and Harvard University will lead the program, which is focused on management techniques needed by physicians in an integrated health care environment.

Attendees at the April downstate Leadership Seminar gave the program rave reviews. The program is limited to 40 physician attendees aged 40 and under with all costs covered under a grant from The Physicians Foundation.  For further information, contact MESF Executive Director at Tom Donoghue tdonoghue@mssny.org. 

“When Is the Flu Not the Flu?” CME Webinar on Nov. 16; Registration Now Open
MSSNY will begin its 2017 Medical Matters continuing medical education (CME) webinar series with “When Is the Flu Not the Flu?” on Wednesday, November 16, 2016 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.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are: 1). Recognize the distinction between influenza virus infections and other similarly presenting illnesses.  2). Describe strategies for prevention, diagnosis and management of patients presenting with flu-like symptoms. 

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 Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Additional programs are will be conducted in January-May 2017, and topics include: Triage in a Disaster Event; The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team; and Mosquito Borne Diseases.  Program dates for Medical Matters will be announced shortly.

22% of Generic Drugs Billed to Part D Had 100% Increase between 2010-2015
About 22 percent of generic drugs billed to Medicare Part D had at least one price increase of 100 percent or more between 2010 and 2015, states a new GAO report titled, “Generic Drugs Under Medicare Part D Generic Drug Prices Declined Overall, but Some Had Extraordinary Price Increases.”  http://www.gao.gov/assets/680/679022.pdf

Exercise in Self-Assessment of Your Orthopaedic Knowledge: Preparation for MOC
The 2016 Annual New York State Society of Orthopaedic Surgeons Symposium will take place on Saturday, September 24, 2016 from 7:00am – 4:30pm at the NYU Langone Medical Center – Hospital for Joint Diseases in the Loeb Auditorium (301 East 17th Street, NY NY 10003).

NYSSOS is committed to designing programs that help orthopaedists achieve and comply with educational requirements. This one-day event features presentations on topics including sports, pediatrics, trauma, adult reconstruction, spine, geriatrics, metabolic bone disease, upper extremity, foot & ankle and hand surgery.

Participants who purchase and pass the AAOS OKU 11 exam will receive up to 20 SAE credits. Participants who review the AAOS OKU 11 educational material and complete and pass the AAOS OKU 11 exam will be eligible to receive up to 70 CME credits. AAOS OKU 11 products will be available for purchase at the time of registration.  Pre-registration is required to attend.

Residents and Fellows are encouraged to attend. Three discounted registration packages are available. Register Online or download the Brochure. 

 “Light the Path” Walk at LI’s Sunken Meadow State on October 6
The Long Island Health Collaborative is hosting a “Light the Path” walk for Behavorial Health Awareness on Thursday, October 6 at 4:00PM at Sunken Meadow State Park, Rte. 25A and Sunken Meadow Parkway, Kings Park, NY 11754. Parking is available in Field 2. Register to receive updates here. For questions or more information visit www.LIHealthCollab.org


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Physician Opportunities

A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.



A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).

If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.



Crown Medical PC Needs a New Internist and Pediatrician to Join Our Team! Salary $200,000 + plus benefits.
As a part of our continued growth, we are searching for a new Internist and Pediatrician to join our team. Salary is $200,000 + plus benefits.
Primary Responsibilities:
Examines, diagnoses and treats patients for acute injuries, infections, and illnesses
Counsels and educates patients and families about acute and chronic conditions or concerns
Documents items such as: chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan
Formulates diagnostic and treatment plans
Prescribes and administers medications, therapies, and procedures
Orders lab and imaging tests to determine and manage an immediate treatment plan and provides advice on follow up
Responsible for the coordination of care with specialists and appropriate ancillary services
Completes all documentation and paperwork in a timely manner
Maintains quality of care standards as defined by the practice
Required Qualifications:
Active and unrestricted New York medical license
Board certified in Internal Medicine or Pediatrics
Current and unrestricted DEA certificate
Effective communication skills
Outstanding organization skills and ability to multi-task
Takes Initiative, creative, has problem solving ability, is adaptable, and flexible
Ability to work without direct supervision and practice autonomously
Ability to work in fast-paced environment
Crown Medical, PC / ER Medical, PC
Contact: Michael Furman
Practice Administrator
718-208-1215
e: michael@crownmd.com


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777

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