September 22, 2017 – Graham-Cassidy: No Good for NY

Charles Rothberg, MD
September 22, 2017
Volume 17
Number 36

Dear Colleagues:

Graham-Cassidy Proposal Is Not Good for New York
This week, MSSNY joined with numerous other New York healthcare provider associations in a letter to New York’s Congressional delegation expressing its strong objections to the Cassidy-Graham proposal before the US Senate. This proposal could be coming up for a vote in the US Senate week next week.

As MSSNY has  stated regarding earlier proposals to profoundly restructure the Affordable Care Act (ACA), we are very concerned with the possibility that hundreds of thousands of New Yorkers could lose access to insurance programs that currently provide “first dollar” coverage.  We are also very concerned about the potentially huge adverse budgetary impacts to the State of New York.   One report has New York losing over $50 billion as a result of this bill. 

New York’s Senators Charles Schumer and Kirsten Gillibrand, are strongly opposed to it.  Moreover, some of the Republican members of New York’s Congressional delegation who supported earlier “ACA repeal and replace” proposals are now expressing strong objections to Cassidy-Graham, including Reps. John Faso, Peter King and Claudia Tenney. 

What we need are targeted reforms to fix the flaws of the ACA, instead of proposals that strip away coverage to New Yorkers who rely upon this availability to help pay for their health care needs.  We need to assure more comprehensive physician networks for our patients and to reduce the exorbitant insurer-imposed deductibles they face.   Therefore, we are also very concerned with the increasing attention being placed on “single payor” proposals as the primary alternative to these faulty ACA “repeal and replace” proposals, at a time when enactment of such a proposal in Washington is highly unlikely. 

We badly need compromise, not a further digging in of our heels.   Republicans and Democrats need to come together to find common ground and work towards the enactment of legislation that enhances rather than reduces affordable and comprehensive coverage options for our patients.”

MSSNY has signed onto the following letter:

Charles Rothberg, MD
MSSNY President

Please send your comments to

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New Law to Prohibit Medical Record Charges When Needed to Support a Patient’s Government Benefit Application
As reported last week, the Governor has signed into law legislation (S.6078, Valesky/A.7842, Gottfried) that now expressly prohibits health care providers and facilities from charging patients for copies of medical records when such records are needed “for the purpose of supporting an application, claim or appeal for any government benefit or program.”

While the previous law had already prohibited charging for medical records when a patient was unable to pay, the purpose of this new law is to respond to numerous complaints lodged by patients where they were charged for medical records necessary to assist applications and appeals for government programs assisting lower income patients such as Social Security Disability Insurance (SSDI) and the Supplemental Nutritional Assistance Program (SNAP), or other government benefit program such as those for 9/11 first responders.

While noting that it did not condone the actions of health care providers who were charging low-income patients for medical records, MSSNY did express concerns that the terminology “any government benefit or program” in the legislation was too broad, and suggested that the bill be amended to specifically enumerate in the law those low-income government benefit programs to which this fee charge prohibition should apply.  However, that change was not made.

Multiple Op-Eds this Week Urge Gov. to Veto One-Sided Medical Malpractice Expansion Legislation
Physicians are again reminded that, if they have not done so, to contact Governor Cuomo to urge that he veto legislation that would trigger double digit increases in liability premiums by significantly expanding the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer”.  Physicians can send a letter here  and by calling 518-474-8390.

This past week, Orange County Medical Society President Dr. Stephanie Zeszutek had a letter published in the Middletown Times-Herald urging the Governor to veto this bill.   Dr. Zeszutek’s letter noted that “The state has a dangerous doctor shortage and future doctors are already being deterred from certain specialties or medicine altogether due to malpractice liability concerns. This bill sets a dangerous precedent for liability across the country. We urge Gov. Cuomo to reject this bill in favor of more sensible legislation.”

Moreover, Adam Morey of the Lawsuit Reform Alliance of New York had a lengthy op-ed published in the Albany Times Union  noting that  “Before any drastic changes are made to the statute of limitations, Gov. Cuomo and the Legislature should instead work with all stakeholders to overhaul the entire medical liability apparatus. New York’s current system is in dire need of reform.”

Numerous other letters to the editor and op-eds have appeared in papers across the State over the last few months urging Governor Cuomo to veto this bill, including in the Buffalo News, Poughkeepsie Journal, Rochester Business Journal and Syracuse Post-Standard.

While many physicians have weighed in, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is signed into law without also provided needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

The Physician Advocacy Liaison Network
Do you want to play a critical role in protecting the future of medical care delivery?

MSSNY is building an even more powerful grassroots infrastructure to increase physicians’ contacts to their local legislators.  To reach and energize our membership, we are expanding the ways by which we communicate with physicians to greatly increase our activist network, which is critical to our grassroots activity.  We must mobilize physicians to better assure the enactment of favorable legislation and the defeat of proposals that will adversely impact the care that you provide to your patients.  We must make certain that our elected officials remain committed to championing the issues that matter most to MSSNY members and their patients.

There has never been a greater need for physicians to become active.  With so many changes occurring in our health care system, and other opposition interests seeking to marginalize the physician’s role as leader of the health care team, we must make up for it with an overwhelming presence in grassroots activity that will make it impossible for legislators to ignore.

PAL responsibilities include:

  • Educating other members on issues facing physicians, such as at local county medical society or medical staff meetings
  • Working as appropriate with your county medical society, be available to meet with your members of the legislature at least twice a year
  • Being responsible for calling or writing letters to members of the legislature on issues that impact physicians
  • Attend training programs in regard to legislative issues
  • Enlisting other member to support our action plans and mobilize them to action
  • Joining and recruiting others to join MSSNYPAC

Click here to sign up! 

Thank you to the many physicians who have already answered the call and added their name to the list!

Promo Code: MSSNY

Please Urge Your Legislators to Support Due Process Protections for Physicians Dropped from Health Insurer Networks
Emblem Health Plan’s latest dropping of hundreds of physicians from its network without any due process for these physicians is a clarion call to legislators of the need to enact legislation (A.2704, Lavine/S.3943, Hannon) that assures physicians have some ability to appeal when their contracts are non-renewed.

These due process protections are required for Medicare managed care networks but not similarly required for commercial health insurance plans.  There is no good reason for this discrepancy.  This legislation passed the Assembly overwhelmingly earlier this year, but died on the floor of the State Senate.  Please take the time to contact your legislators to urge that they enact this legislation when they return to Albany in January.

Medical Matters: “Herd Community” Protects Vulnerable Populations
MSSNY will begin its 2018 Medical Matters continuing medical education (CME) webinar series with “The Importance of Herd Immunity” on Wednesday, October 18, 2017 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.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at

Educational objectives are:

  • Review the epidemiology of vaccine-preventable infectious disease and role of herd immunity.
  • Describe how herd immunity protects vulnerable populations such as newborns, the elderly and those who are too sick to be vaccinated.
  • Discuss the percentage(s) of a population who need to be vaccinated to allow herd immunity to be effective.

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. 

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

What Is the Constitutional Convention?
Every 20 years, New Yorkers have the chance to vote whether they want to hold a constitutional convention to amend or change the New York State Constitution.  Voters will decide on whether they want to hold a convention on November 7, 2017.  In 1997, voters overwhelmingly rejected a convention.  The last constitutional convention held in 1967.  If voters approve a convention, delegates would be elected in 2018, with the convention held the next year.

The New York State AFL-CIO, CSEA, NYSUT and many other unions and elected officials have come out in opposition of a constitutional convention fearing that pensions could be cut and workers’ rights could be in danger.  Various nonprofit good government groups like Citizens Union have come out in favor of a convention in hopes of fixing campaign finance laws and ethics reform.  Additionally, the New York State Bar Association have also come out in support of holding a constitutional convention.
Please click below to see who is opposing the constitutional convention?
Constitutional Convention Oppose List
Please click below to see who is supporting the constitutional convention?
Constitutional Convention Support List

Emblem Signs Major City Medical Group
EmblemHealth has agreed to a new value-based contract with Corinthian Medical IPA, the two sides jointly announced Thursday. With the deal Emblem adds to its network Corinthian’s 1,750 “providers,” many of them serving immigrant communities in Brooklyn, the Bronx, Queens and Upper Manhattan. Corinthian, led by Dr. Ramon Tallaj, has demonstrated a willingness to manage patients’ health through value-based contracts. That approach matches Emblem’s shifting of more of its business in that direction. If the physicians keep patients’ costs low, through preventive care and management of chronic diseases, Corinthian can share in Emblem’s savings.

Dr. Tallaj is also chairman of Advocate Community Providers, one of the state’s largest DSRIP Performing Provider Systems.

Radiologists: “New Anthem Imaging Policy Will Harm Patient Access to Care”
The new Anthem cost-cutting policy of not covering computed tomography (CT) and magnetic resonance imaging (MRI) performed in hospital outpatient departments is arbitrary and unwise.

Economically motivated steerage of patients compromises the physician-patient relationship and undercuts integrated health care efforts.

Denying patients covered access to care at such a vast number of facilities will delay care, increase wait times and force many patients to travel outside of their communities to get advanced imaging. The policy may particularly impact patients in inner city and rural areas. In many areas, the local hospital outpatient setting may be the only immediate access point for advanced imaging outside of the main hospital.

The ACR is concerned that Anthem’s policy will force patients to locate an ever-declining number of freestanding imaging centers and/or physician’s offices to access imaging services. If patients do find local, freestanding imaging centers, such facilities may not be immediately prepared to care for an influx of patients now denied covered access to hospital outpatient imaging. Also, by steering all patients out of the hospital, odds of these facilities caring for a patient that may experience complications is increased.

Forcing all advanced imaging out of hospital outpatient departments may prompt many of these facilities to cut back on standard imaging (X-ray, etc.) or close altogether. This may be particularly true in areas where hospitals care for many indigent patients. Moreover, this policy will impact negatively the ability to train the next generation of radiologists. The preponderance of radiology training programs occur in hospitals and hospital-owned imaging facilities.

We urge Anthem to reconsider their approach and work with providers and hospitals to achieve better coverage policy.

Students/Residents Can Submit Abstracts for 13th Annual Poster Symposium at HOD
MSSNY is very pleased to announce the 13th Resident/Fellow/Medical Student Poster Symposium to be held on Friday, March 23, 2018 at the Adam’s Mark Hotel in Buffalo, from 2:00 pm – 4:30 pm. Deadline for abstract submission is 4:00 pm, Friday, January 5, 2018. Participants must be MSSNY members. Membership is free for first-time resident members and nominal for medical students. Join online.

Detailed guidelines can be found here.

Please pass this on to any New York State residency program directors you may know, or anyone involved with a NYS medical school. 

MSSNY Travel Discount Program
MSSNY is pleased to offer an exclusive worldwide travel discount service to our members. Savings average 10-20% below-market on all hotels and car rental suppliers around the world.
Save time and money. Let us negotiate the best deals and comparison price for you.
Any hotel, any car, anywhere, anytime.
Click here to save on your next trip.

State Offers Loan Repayments for Primary Care Clinicians
The state Department of Health is requesting applications for its Primary Care Service Corps Loan Repayment Program, which aims to increase the supply of clinicians in underserved areas.

The program will pay back up to $60,000 in education loans for physicians and other health practitioners In return, the program requires that these primary-care clinicians commit to work for at least two years in a state-designated Health Professional Shortage Area or at a state correctional facility.

This is the third funding round for the program. The state has allocated up to $1 million for fiscal 2017 to 2018 for renewals of existing contracts and for new awards.

Practitioners must demonstrate that they are or will be working in primary care or behavioral health and in an outpatient or other eligible setting. Applications get higher scores based on their site’s HPSA score. Applicants also get extra points for practicing in sites that encourage a diverse work environment and support patients of diverse ethnicities, people with disabilities and other underserved populations. Assuming funding continues, practitioners can extend their contract for three renewal periods of one year each. Questions must be submitted by 4 p.m. Sept. 28, and final applications are due at 4 p.m. Nov. 1.>/span>

AMA Webinar: Thriving Under MIPS – Where to start? Breaking down the complexity of MIPS
With many feeling overwhelmed by the complexity of the Quality Payment Program (QPP), physicians struggle to answer one key question – Where do I start? To help assuage this issue, the AMA has released a new customizable resource – the MIPS Action Plan – that breaks down the complexity of the Merit-based Incentive Payment System (MIPS) track of QPP into specific actionable steps. In this 1-hour webinar, attendees will learn how to use this tool to create and/or validate their strategies for MIPS implementation in 2017. Chris Botts, AMA Care Delivery and Payment Manager will be the presenter. Click here to register.

When: Wednesday, October 18, 2017
1:00PM to 2:00PM ET

Attention Managed Care Network Physicians: Medicaid Provider 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. To check on your enrollment status, please call CSRA at 1-800-343-9000. Practitioners may also check the Enrolled Practitioners Search function here:  If you are already enrolled as a  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 to: 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. Providers who are not enrolled with New York State Medicaid by January 1, 2018 will not be able to provide services for Medicaid managed care program members. For additional information, please see the May 2017 NYS Medicaid Update available online.


Great Neck – Medical Zoned Condo
2690 Sqft – $699,000 – quick easy access to North Shore University Hospital, Long Island Expressway and Long Island Rail Road. 10 Exam rooms plus waiting room & large secretary area . Call Chris Pappas, LAB 516-659-6508

Beautiful, Fully-Equipped Medical Suite for Rent or Share – Glen Oaks, NY
For Rent or Share – Glen Oaks, NY
(border of Queens & Long Island)
Available for full or half-days.
Beautiful, recently renovated office
available for part-time share
OR available for rent.
Centrally located /Close to expressways.
The practice is 5 minutes from LIJ/Northwell Hospital.
8 exam rooms/procedure rooms. Waiting room, break room and
personal office with private bathroom.
(~2500 sqft) Free WIFI.
6 parking spots for patients and 2 for doctor.
The previous tenant, a full-time primary care
physician with a part-time cardiologist coming
in turned it over to an associate a year ago
but has been here for about 10 years. He needed more space
and bought a building about 20 minutes away. Our building gets a lot of drive-by traffic and pedestrian traffic from the mall across the street. Weekly we have patients walk in inquiring about the practice.
The dental practice next door sees over 2500 patients per year and refers actively to the medical suite.Follow the link for a video of the space (all furnishings, exam tables, chairs, oxygen, orthoscope included in lease – about $500k in value): Haresh at or 516-220-3297

Upper East Side Medical Office for Rent
East 68th Street full or part-time, 1 consult room, 2 exams rooms, large waiting room, high ceilings, central A/C, carpeted throughout , window in every room, X-Ray facility in-house.  Also for Rent- Large furnished room ideal for Psychiatrist/Psychologist. Please call 212-639-1800

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
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

Child and Adolescent Psychiatrist – Lockport, New York, Eastern Niagara Hospital
Eastern Niagara Hospital is seeking a Full Time Medical Director for its 12 bed Child and Adolescent Psychiatric Unit.  Responsibilities include inpatient care, shared on-call responsibilities and Medical Director duties.  Competitive compensation package.  For more information, please contact David DiBacco at 716-514-5501 or email to