Debate Begins on Single Payer

 drmaldonado PRESIDENT’S MESSAGE

Dr. Joseph R.Maldonado, President

Dear Colleagues:

In the coming weeks, you will be reading more about MSSNY’s progress in moving or stalling numerous legislative bills pertaining to healthcare delivery in New York State.  We anticipate Assemblyman Richard Gottfried’s bill on the New York Health Plan (a single payer plan initiative) will move to the floor of the Assembly for debate next week.

Our country and state are both divided on how best to remedy the complex problems associated with our present multi-payer healthcare system.  These problems are so wicked that many have looked to other countries for alternative models of healthcare delivery.  The vision of a single payer that can obviate the problems inherent in a multi-payer system is enticing.  The ease of access and the administrative attraction of dealing with one payer is appealing.  However, in studying many of these single payer systems, it is clear that physicians are unhappy and frustrated in these systems—albeit for different reasons.

A single payer system may not be the panacea some think it to be.

Several weeks ago, MSSNY’s House of Delegates expressed its views when it declined to support the concept of a single payer system.  As New Yorkers, we find ourselves in tremendous turmoil as our state leadership advances healthcare reform initiatives that will fundamentally change how we practice medicine in New York State.  MSSNY has been engaged in these efforts at the level of DSRIP, SHIP, PHIP and the SHIN-NY.  We are proud of our work in collaborating with the state to implement changes in a manner that will advance healthcare delivery improvements for decades to come.  The disruption of these efforts with the addition of another payment methodology threatens to undermine the physician workforce environment and the state’s efforts in healthcare delivery improvement.  Accordingly, the Society is opposing the New York Health Plan bill currently in the Assembly.

I will continue to support the dialogue within our profession and this state that explores improvements to our healthcare delivery system.  However, at this time, support for a single payer system threatens the viability of thousands of small practices throughout the state that are focused on preparing for ICD-10, e-prescribing, SHIP, SHIN-NY and DSRIP.  Let’s give the profession the opportunity to meet the immediate challenges facing our profession in the coming year before embarking on another megaproject such as transforming NY into a single payer state.

We will continue to work with Governor Cuomo, Assemblyman Richard Gottfried and Senator Kemp Hannon to better define the legislative and regulatory environment in which physicians operate in NY, thus improving the health of our state’s residents.

Joseph Maldonado, M.D, MSc, MBA, DipEBHC 

MSSNY President

Please send your comments to comments@mssny.org

CapitalUpdate

ASSEMBLY WILL VOTE ON SINGLE PAYER BILL
Despite significant opposition from Republican and Democratic Assemblymembers, the Assembly Codes and Ways & Means Committees reported Assemblyman Gottfried’s single payer bill (A.5062/S.3525) to the floor of the Assembly. It can be voted on as early as Wednesday of next week.

Many physicians support this bill as a means to create health system efficiencies while reducing insurer control and influence over the practice of medicine. A significant number of physicians, however, feel that they will lose clinical autonomy under a single payer system. Moreover, based upon their experience with the Medicare and Medicaid systems, they are also concerned that a single payer system will result in a significant and unwarranted reduction in payment for the services they render.

At MSSNY’s most recent House of Delegates held earlier this month, a resolution which called upon MSSNY to support legislation to implement a single payer system was passionately debated by the physician delegates. While there was significant support among the physician delegates there was also overwhelming opposition. The Resolution was not adopted.

All physicians are encouraged to let your perspective be known to your Assembly representative by calling 1-518-455-4100, and asking to speak to your Assemblymember.  (DEARS, AUSTER)

PLEASE CONTACT YOUR LEGISLATORS IN SUPPORT OF HEALTH INSURANCE REFORM LEGISLATION
With just a few weeks left to go in the New York State legislative session, MSSNY continues to strenuously advocate for a number of critically needed health insurer reforms to better assure patients can receive coverage for the care they need from the physician of their
choice, and to reduce the extraordinary administrative burden imposed on physicians and their staff to assure patients can receive the care and medications they need.   Next week, Thursday, May 28, MSSNY President Dr. Joseph Maldonado will participate in a press conference with a number of patient advocacy groups, Assembly Health Committee Chair Richard Gottfried and Assemblymember Matthew Titone to urge the passage of legislation (A.2834-A, Titone/S.3419-A, Young) that would provide physicians with an expeditious method to override a health insurer step therapy/Fail-first protocol when prescribing needed medications for their patients.   To send a letter, click here.

In addition, physicians are urged to send letters to their legislators in support of these bills:

  • A.336 (Gottfried)/S.1157 (Hannon) – permits independently practicing physicians to collectively negotiate patient care contract terms with health insurers under close state supervision.  In the Senate Finance and Assembly Ways & Means Committees.  To send a letter in support, click here.
  • A.3734 (Rosenthal)/S.1846 (Hannon) – requires health insurers to offer Out of network coverage in New York’s Health Insurance Exchange.  In Assembly and Senate Insurance Committees.  To send a letter in support, click here(AUSTER, DEARS)

CME MANDATE BILL ON PAIN MANAGEMENT ON THE FLOOR OF BOTH HOUSES; CAN BE VOTED ON AT ANY TIME
Legislation that would require physicians to take three hours of continuing education on pain management, palliative care, and addiction is now on the floor of both houses in the New York State Legislature and can be voted on at any time.

Senate Bill 4348 passed out of the Senate Health Committee and has gone to the Senate floor.  Its companion measure, Assembly Bill 355 is also pending on the Assembly floor.   Immediate physician action is needed to stop this measure from passing.   Physicians are urged to send a letter urging defeat of this measure.

Assembly Bill 355, sponsored by Assemblywoman Linda Rosenthal, and Senate Bill 4348, sponsored by Senator Kemp Hannon would require three hours of course work every two years for physicians and other healthcare workers.   Under the bill’s provisions, the course work would include each of the following topics:  I-STOP and drug enforcement administration requirements for prescribing controlled substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; prevention, screening, and signs of addiction; responses to abuse and addiction; and end-of-life care.  Given the success of New York’s I-Stop law and the wide variety of educational tools that prescribers are already using to educate themselves regarding the risks and benefits of various controlled medications, MSSNY remains opposed to the measure.        (CLANCY, DEARS)

SCOPE OF PRACTICE BILLS STATUS AT END OF SESSION
The following are among many scope of practice bills that MSSNY is opposing as the Legislative Session draws to a close for 2015:

  • 816 (Libous)/ A.3329 (Morelle) – a bill that would permit certain dental surgeons to perform a wide range of medical surgical procedures involving the hard or soft tissues of the oral maxillofacial area. This could include cosmetic surgery, such as face lifts, rhinoplasty, bletheroplasty, and other procedures, and would allow them to do these procedures in their offices, although they are not included in the office-based surgery law that govern office-based surgery for physicians.  This bill is in the Higher Education Committee in both the Senate and Assembly.
  • 5805 (McDonald)/ S.4857 (LaValle) – a bill that would expand the definition of “collaborative drug therapy management” to include patients being treated by PAs and NPs, not just physicians, and extend collaboration to unspecified disease states. It allows a pharmacist to prescribe in order to adjust or manage a drug regimen, and adds a non-patient specific protocol.  The bill includes nursing homes in the definition of facility.  This bill is in the Higher Education Committee in the Senate and Assembly.
  • 123 (Paulin)/ S.4739 (Hannnon) – a bill that would authorize pharmacists to, in addition to those immunizations currently allowed to be administered by pharmacists, administer immunizations to prevent tetanus, diphtheria, pertussis, acute herpes zoster, and meningococcal pursuant to a patient specific or non-patient specific order, and would remove the sunset provisions currently in the law. Pharmacists are currently allowed to administer influenza, pneumococcal, acute herpes zoster and meningococcal pursuant to a patient specific order from a physician.   This bill is in the Higher Education Committee in both the Senate and Assembly.
  • 719 (Pretlow)/ S.4600 (Libous) – a bill that would expand on a bill enacted in 2012, and would allow podiatrists to care for up to the knee. This would include diagnosing, treating, operating or prescribing for cutaneousconditions of the ankle up to the level of the knee, which could include skin cancers or diabetic wounds.  It does not have to be a wound that is “contiguous with”, but only has to be “related to” a condition of the foot or ankle.  It would eliminate the requirement for direct supervision of podiatrists training to do this additional work, and would allow them to basically train themselves.

This bill is in the Higher Education Committee in the Senate and Assembly.

  • 7035 (Perry)/ S.4917 (LaValle) – a bill that would license naturopaths and create a scope of practice for them that could be interpreted in many ways, and is not clear as to their limits of practice. It would allow them to practice as primary care providers, call themselves naturopathic doctors, claims that they cannot do invasive procedures, yet allows them to immunize and perform cryotherapy.  This bill is in the Higher Education Committee in the Senate and Assembly.
  • 2063 (Libous)/ A.2803 (Paulin) – a bill that would authorize optometrists to use and prescribe various oral therapeutic drugs, which have a systemic effect on the body, which they are not trained to deal with. Most of the requested drugs are rarely, if ever, used by ophthalmologists, and are unnecessary for optometrists to use.  This bill is in the Higher Education Committee in the Senate and Assembly.
  • 215-A (Martins)/ A.4391 (O’Donnell) – a bill to permit chiropractors to form LLCs with physicians as partners. This bill could allow chiropractors, who own a controlling interest in the LLC to tell employed physicians, or even a minority partner, how to practice and what tests to conduct.  This bill is on 3rd reading in the Senate, and is in the Higher Education Committee in the Assembly. (ELLMAN)

HEARING AID ACCESS BILL GAINS MOMENTUM IN ASSEMBLY
A.127 (Buchwald)/ S.4080 (Murphy) is gaining momentum in the Assembly, with twenty-five co-sponsors and signing on to the bill, and many memos in support being sent to Legislators from physicians and groups.  The bill is in the Consumer Affairs and Protection Committee in the Assembly and in the Consumer Protection Committee in the Senate.  Physicians are urged to contact their Assembly Member and Senator to support the bill, which would allow an audiologist or hearing aid dispenser, employed in an ENTs office, to sell hearing aids at fair market prices, and calls for a report after two years to show the impact of the bill.  This can be done by clicking on the following link.

New York is currently one of only two states in which physicians are not allowed to sell hearing aids for profit.  (ELLMAN)

MSSNY URGES PHYSICIANS AND PATIENTS TO ADVOCATE IN SUPPORT OF SCHOOL BASED MENINGOCOCCAL IMMUNIZATION
The Medical Society of the State of New York is urging physicians and their patients to advocate in legislation requiring school-based immunizations against the meningococcal disease.  Assembly Bill 791/Senate Bill 4324, sponsored by Assemblywoman Aileen

Gunther and Senator Kemp Hannon, would require that every person entering 6th grade and 11th grade shall have been immunized against meningococcal disease.   This recommendation is consistent with the Advisory Committee on Immunization Practices.  Meningococcal disease is caused by bacteria and is a leading cause of bacterial meningitis.  The bacteria are spread through the exchange of nose and throat droplets, coughing, sneezing or kissing.  Young people, between the ages of 10-25 years of age, are most at risk for this disease.   If not treated quickly, it can lead to death within hours or lead to permanent damage to the brain and other parts of the body.  Physicians are encouraged to go to MSSNY’s Grassroots Action Center to send a letter to their legislators and urge support of this bill:

MSSNY has also developed a patient support letter that patients can use to urge support of this legislation:

The bills are in the respective health committees in each house of the legislature.  (CLANCY)

CADILLAC TAX REPEAL LEGISLATION INTRODUCED IN CONGRESS
Legislation (HR 2050) to repeal the so-called “Cadillac Tax” on comprehensive health insurance coverage contained in the Affordable Care Act was recently introduced by Rep. Joe Courtney (D-CT).  Eight members of New York’s Congressional delegation representing many regions of New York State have joined as co-sponsors, including Representatives
Chris Gibson, Brian Higgins, Hakeem Jeffries, Nita Lowey, Sean Patrick Maloney, Jerrold Nadler, Jose Serrano, and Paul Tonko.  The “Cadillac tax” refers to an excise tax on high-premium health insurance plans that will be implemented in 2018.  It will be a 40% tax on health premiums above a threshold of $10,200 a year for individuals and $27,500 for families.

At its 2013 House of Delegates, MSSNY adopted a policy calling for to repeal of this tax, which will particularly hurt high cost states like New York and dis-incentivize employers from offering their employees comprehensive health insurance benefits.  The negative impact of this tax on patient care access in New York State was recently the subject of a forum where Assembly Health Committee Chair Richard Gottfried and Senate Health Committee Chair Kemp Hannon each expressed their concerns with this tax. For more information about this forum, please see the linked article from Capital New York (AUSTER)                                                                                                    

BILL TO DELAY ICD-10 IMPLEMENTATION INTRODUCED
The AMA recently sent a letter to Rep. Ted Poe (R-TX) in support of his legislation, HR 2126, introduced in the US Congress to postpone the ICD-10 code sets required to be used by physicians in claim submissions as of October 1, 2015.  MSSNY has urged support for a
further delay of the ICD-10 mandate, though prospects for the bill’s passage remain unclear given the commitment of the leaders of the House Energy & Commerce Committee to permitting ICD-10 to be implemented as planned given the support of many healthcare stakeholders including health plans and hospitals.  The letter notes that “the differences between ICD-9 and ICD-10 are substantial, and physicians are overwhelmed with the prospect of the tremendous administrative and financial burdens of transitioning to ICD-10. ICD-10 includes 68,000 codes—a five-fold increase from the approximately 13,000 diagnosis codes currently in ICD-9. Implementation will not only affect physician claims submission; it will impact most business processes within a physician’s practice, including verifying patient eligibility, obtaining pre-authorization for services, documentation of the patient’s visit, research activities, public health reporting, and quality reporting. This will require education, software, coder training, and testing with payers.”

Physicians can send a letter in support of this legislation here. (AUSTER)                                                                                                                         

MSSNY OFFERS FREE PATIENT BROCHURE ON DIABETES FOR USE WITHIN PHYSICIANS OFFICE
The Medical Society of the State of New York Committee’s on Preventive Medicine and Family Health and the Committee to Eliminate Health Care Disparities, has developed a patient brochure that physicians can offer within their office.  The patient brochure discusses risks associated with pre-diabetes and diabetes and is available in English and Spanish.  If you would like copies of this brochure, please contact the Medical Society of the State of New York at (518) 465-8085 or email Terri Holmes at tholmes@mssny.org and request copies of the Diabetes brochure.  The development of the brochure was made possible from a grant from AstraZeneca.  (CLANCY, ELLMAN)

FINAL MEDICAL MATTERS CME WEBINAR TO BE HELD JUNE 9TH; PHYSICIANS URGED TO REGISTER
The Medical Society’s final webinar for the spring will be conducted on June 9, 2015 at 7:30 a.m. William Valenti, MD, chair of MSSNY Infectious Disease Committee will present “Emerging Infections 2015-A look at EV-D68 and Chikunguya”. Physicians are encouraged to register by clicking on https://mssny.webex.com . Click on “Training Center” and then on the “Upcoming” tab to register.

The educational objectives are:

  • Recognize and describe Enterovirus D68 (EV D68)
  • Recall the importance of continued immunizations
  • Recognize symptoms of Chikungunya and describe measures for reporting

Physicians may also contact Melissa Hoffman at mhoffman@mssny.org or at 518-465-8085 to register.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

It is anticipated that Medical Matters programming for fall/spring 2015-2016 will be announced shortly.  (CLANCY)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:          

pschuh@mssny.org ldears@mssny.org     mauster@mssny.or
pclancy@mssny.org bellman@mssny.org  

Enews May 2015 550x150

Medicare Eligible Professionals: Take Action by July 1 to Avoid 2016 Medicare Payment Adjustment
Payment adjustments for eligible professionals that did not successfully participate in the Medicare EHR Incentive Program in 2014 will begin on January 1, 2016. Medicare eligible professionals can avoid the 2016 payment adjustment by taking action by July 1 and applying for a 2016 hardship exception.

The hardship exception applications and instructions for an individual and for multiple Medicare eligible professionals are available on the EHR Incentive Programs website, and outline the specific types of circumstances that CMS considers to be barriers to achieving meaningful use, and how to apply.

To file a hardship exception, you must:

  • Show proof of a circumstance beyond your control.
  • Explicitly outline how the circumstance significantly impaired your ability to meet meaningful use.

Supporting documentation must also be provided for certain hardship exception categories. CMS will review applications to determine whether or not a hardship exception should be granted.

You do not need to submit a hardship application if you:

  • are a newly practicing eligible professional
  • are hospital-based: a provider is considered hospital-based if he or she provides more than 90% of their covered professional services in either an inpatient (Place of Service 21) or emergency department (Place of Service 23), and certain observation services using Place of Service 22; or
  • Eligible professionals with certain PECOS specialties (05-Anesthesiology, 22-Pathology, 30-Diagnostic Radiology, 36-Nuclear Medicine, 94-Interventional Radiology)

CMS will use Medicare data to determine your eligibility to be automatically granted a hardship exception. The application must be submitted electronically or postmarked no later than 11:59 p.m. ET on July 1, 2015 to be considered. 

If approved, the exception is valid for the 2016 payment adjustment only. If you intend to claim a hardship exception for a subsequent payment adjustment year, a new application must be submitted for the appropriate year.

In addition, providers who are not considered eligible professionals under the Medicare program are not subject to payment adjustments and do not need to submit an application. Those types of providers include:

  • Medicaid only
  • No claims to Medicare
  • Hospital-based

CDC Report Shows Most Distinct Causes Of Death In Each State
The CDC published a report this week in the journal Preventing Chronic Disease: Public Health Research, Practice and Policy that showed the most distinct causes of death in each state from 2001 to 2010. The report labels each state with a cause of death higher on
average than the rest of the country. Pelvic inflammatory disease (PID) is the number 1 unusual cause of death in New York State. The lead author, Francis Boscoe, a research scientist at the New York State Health Department, told ABC News that “they looked for outliers in each state to determine the most distinctive cause of death.”

YouTube Video: What Medicare Professionals Need to Know in 2015
A video recording of the “PQRS/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015” presentation has been posted to the CMS MLN Connects® page on YouTube.  This presentation is the same as the webinars that were delivered on March 31, 2015 and April 7, 2015.  A link to the video can be found here.

Last Call for GME Task Force Members|
The GME task force will be charged with making recommendations to MSSNY as to how best address the growing shortage of residency training positions. It will make recommendations to the Council regarding how to advance solutions that address the problem while minimizing the onerous consequences of one-sided solutions.

MSSNY welcomes inquiries from those interested in serving on the taskforce; please contact Eunice Skelly at eskelly@mssny.org 516-488-6100 ext.389.

Take a CME Cruise to Everywhere!
New York physicians are again being offered the chance to sail the Mediterranean while updating their practice skills through a series of onboard CME programs offered through Continuing Education, Inc. Based in Tampa, Florida the organization had just announced
15 cruises with CME programs focused on such topics as cardiology, family medicine, pulmonology, palliative medicine, pediatrics, gastroenterology and a host of other clinical topics. In addition, the company has a variety of other CME cruises available to Alaska, Northern Europe, Hawaii and the Caribbean. Working in concert with major cruise lines, each onboard program is scheduled while the individual ship is at sea to enable physicians and families to enjoy the ports on the ship’s itinerary. For further information, click here.

 

Legislation Introduced re Unfair RAC Audit – May 28, 2015 –


Dr. Joseph R. Maldonado
MSSNY President
May 28, 2015
Weekly Update for New York State Physicians
Volume 16, Number 20
Christina Cronin Southard, Editor
Julie Vecchione DeSimone, Assistant Editor
mssnye-news@mssny.org  www.mssny.org

Colleagues:

Representative George Holding of North Carolina recently introduced legislation (HR 2568) entitled “The Fair Medical Audits Act of 2015.” This legislation reflects several MSSNY-supported provisions and addresses many concerns that physicians have with regard to the extraordinary lack of transparency and expensive, time-consuming and often unfair processes that plague the current Medicare audit program.

Currently, Medicare pays recovery audit contractors or “RACs” on a contingency basis to find overpayments to health care providers, providing these contractors with undue monetary incentives to audit doctors. The five regional firms contracted by the government are paid up to 12.5 percent of all claims they successfully identify as invalid. The burden this places on physicians from both a resource, financial liability and record-keeping standpoint is significant, as the RAC auditors can go back as far as three years.

This legislation would establish incentives for RACs to make more accurate audit findings and increase educational efforts to help physicians avoid common mistakes.  Since 2006, MSSNY has worked closely with the Physicians Advocacy Institute to advocate for more fair and transparent medical audits.

It is time to address fundamental problems that have contributed to the backlog of audit appeals and caused a great deal of unnecessary expense and confusion for physicians in New York. We commend Congressman Holding for his leadership on this critically important issue. Rep. Holding is a member of the House Ways and Means Subcommittee on Health, which has jurisdiction to consider legislation to reform the RAC program.

MSSNY has contacted each of the members of New York’s Congressional delegation to urge them to co-sponsor this important legislation, and we urge you contact your local Representative as well.

Joseph R. Maldonado, Jr, M.D, MSc, MBA, DipEBHC
MSSNY President

Please send your comments to comments@mssny.org


 

PHYSICIAN ACTION URGED TO DEFEAT DISASTROUS LIABILITY EXPANSION BILL

All physicians must contact their respective Assemblymembers to urge that they oppose legislation (A.285, Weinstein/S.911, Libous) that would drastically increase medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.  The bill will be considered by the Assembly Codes Committee at its Tuesday, June 2 meeting.  The letter can be sent here:   http://cqrcengage.com/mssny/app/write-a-letter?1&engagementId=105729.  Physicians are also encouraged to contact individual members of the NYS Assembly Codes Committee to express their opposition to this one-sided disastrous legislation.   A list of the members with links to their contact information is provided here: http://assembly.state.ny.us/comm/?sec=mem&id=7.  As New York physicians continue to pay liability premiums that are among the very highest in the country and face reduced payments from Medicare and commercial insurers, as well as rapidly increasing overhead costs to remain in practice, no liability increases can be tolerated.

List of members of the Assembly Codes Committee:

Joseph Lentol, Chair(AD 50)         518-455-4477            718-383-7474

Robin Schimminger (AD 140)        518-455-4767            716-873-2540

Helene Weinstein    (AD 41)          518-455-5462            718-648-4700

James Brennan       (AD 44)          518-455-5377            718-788-7221

Keith Wright              (AD 70)         518-455-4793            212-866-5809

Gary Pretlow             (AD 89)         518-455-5291            914-667-0127

Vivian Cook              (AD 32)          518-455-4203           718-322-3975

Steven Cymbrowitz (AD 45)           518-455-5214            718-743-4078

Michele Titus            (AD 31)          518-455-5668            718-327-1845

Daniel O’Donnell     (AD 69)           518-455-5603            212-866-3970

Charles Lavine         (AD 13)          518-455-5456            516-676-0050

Nick Perry                  (AD 58)        518-455-4166            718-385-3336

Kenneth Zebrowski (AD 96)           518-455-5735            845-634-1091

Thomas Abinati        (AD 92)          518-455-5753            914-631-1605

David Weprin            (AD 24)          518-455-5806           718-454-3027

Walter Mosley           (AD 57)          518-455-5325           718-596-0100

Alfred Graf                 (AD 100)       518-455-5355           845-794-5807

Joseph Giglio           (AD 148)         518-455-5241           716-373-7103

Thomas McKevitt     (AD 17)           518-455-5341           516-228-4960

Michael Montesano (AD 15)            518-455-4684            516-937-3571

Edward Ra                (AD 19)          518-455-4627           516-535-4095

ClaudiaTenney        (AD 101)         518-455-5334            315-736-3879

(DIVISION OF GOVERNMENTAL AFFAIRS)

ASSEMBLY PASSES SINGLE PAYER BILL

Earlier this week, by a vote of 92-52, the NYS Assembly passed Assemblyman Gottfried’s Single Payer bill (A.5062/S.3525). Click on the here to see how your Assembly representative voted on the bill.

Well in advance of this vote, MSSNY sent its respectful letter of opposition to Assemblyman Gottfried and the entire NYS Assembly

All sources have indicated to MSSNY representatives that this is a one-house bill which will not be taken up by the NYS Senate.  See article here wherein the passage of the bill was characterized  as a “largely symbolic step toward universal health insurance.”                        (DEARS, AUSTER)

HEALTHCARE PROFESSIONAL TRANSPARENCY BILL ON SENATE HIGHER EDUCATION COMMITTEE AGENDA

PLEASE CONTACT YOUR ELECTED REPRESENTATIVES.

MSSNY, working closely with several state and national specialty societies including the NYS Society of Anesthesiology and the NYS Society of Dermatology and Dermatologic Surgery, is aggressively pursuing legislation (S.4651-A, Griffo/A.7129-A, Stirpe) to assure that health care professionals are appropriately identified in their one-on-one interaction with patients and in their advertisements to the public.  Importantly, this bill will require that advertisements for services to be provided by health care practitioners identify the type of professional license held by the health care professional.  In addition, this measure would require all advertisements to be free from any and all deceptive or misleading information.  Ambiguous provider nomenclature, related advertisements and marketing, and the myriad of individuals one encounters in each point of service exacerbate patient uncertainty.  Further, patient autonomy and decision-making are jeopardized by uncertainty and misunderstanding in the health care patient-provider relationship.  Importantly, this measure would also require health care practitioners to wear an identification name tag during patient encounters that includes the type of license held by the practitioner.  The bill would also require the health care practitioner outside of a general hospital to display a document in his or her office that clearly identifies the type of license that the practitioner holds.

Physicians are encouraged to contact their elected representatives in both houses of the Legislature to ask that the bill be passed this year.                                           (DEARS, ELLMAN)

MSSNY JOINS PATIENT ADVOCACY ORGANIZATIONS IN EFFORT TO LIMIT INAPPROPRIATE INSURER DRUG STEP THERAPY PRACTICES

MSSNY President Dr. Joseph Maldonado this week participated in a press conference with several patient advocacy organizations in support of legislation (A.2834-A/S.3419-A) to permit physicians to have an expeditious method to override a health insurer drug step therapy protocol so that patients can timely receive the medications best able to treat their particular conditions.   Assembly Health Committee Chair Richard Gottfried and Assembly bill sponsor Matthew Titone also participated in the press conference.  The event garnered significant media coverage from across the state, including quotes from Dr. Maldonado in Crains’ Health Pulse and the Albany CBS Affiliate.  Meetings were held with key legislative leaders thereafter.  The bill is currently before the Assembly and Senate Insurance Committees.  All physicians are urged to express their support for this legislation by sending an e-mail from MSSNY’s Grassroots Action Center.     (AUSTER, DEARS)

CME MANDATE BILL ON PAIN MANAGEMENT ON THE FLOOR OF BOTH HOUSES; CAN BE VOTED ON AT ANY TIME

Legislation that would require physicians to take three hours of continuing education on pain management, palliative care, and addiction is now on the floor of both houses in the New York State Legislature and can be voted on at any time. Senate Bill 4348 passed out of the Senate Health Committee and has gone to the Senate floor.  Its companion measure, Assembly Bill 355, is also pending on the Assembly floor.   Immediate physician action is needed to stop this measure from passing.  Physicians are urged to send a letter urging defeat of this measure.

Assembly Bill 355, sponsored by Assemblywoman Linda Rosenthal and Senate Bill 4348, sponsored by Senator Kemp Hannon would require three hours of course work every two years for physicians and other healthcare workers.   Under the bill’s provisions, the course work would include each of the following topics:  I-STOP and drug enforcement administration requirements for prescribing controlled substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; prevention, screening, and signs of addiction; responses to abuse and addiction; and end-of-life care.  MSSNY remains oppose to the measure.                 (CLANCY, DEARS)

SCHOOL BASED MENINGOCOCCAL IMMUNIZATION LEGISLATION MOVES FORWARD IN BOTH HOUSES

Assembly Bill 791B and Senate Bill 4324, sponsored by Assemblywoman Aileen Gunther and Senator Kemp Hannon, were advanced from the Assembly and Senate Health committees this week.  Assembly Bill 791B will now go the Assembly Codes Committee and Senate Bill 4324 will go to the Senate floor for a vote. The Medical Society of the State of New York has been working with a number of provider and patient advocacy organizations in support of this legislation and is urging physicians and their patients to advocate in support of legislation requiring school-based immunizations against the meningococcal disease.  Assembly Bill 791B/Senate Bill 4324 would require that every person entering seventh grade and 11th  grade shall have been immunized against meningococcal disease.   Physicians are encouraged to go to MSSNY’s Grassroots Action Center to send a letter to their legislators and urge support of this bill.

MSSNY has also developed a patient support letter that patients can use to urge support of this legislation.

This bill is consistent with the Advisory Committee on Immunization Practices.  Meningococcal disease is caused by bacteria and is a leading cause of bacterial meningitis.  The bacteria are spread through the exchange of nose and throat droplets, coughing, sneezing or kissing.  Young people, between the ages of 10-25 years of age, are most at risk for this disease.   If not treated quickly, it can lead within hours to death or to permanent damage to the brain and other parts of the body.  Organizations in support of this measure include GMHC, the American Academy of Pediatrics NYS Chapter, District II, Latino Commission on AIDS, Kimberly Coffey Foundation, March of Dimes, Meningitis Angels, National Meningitis Association, the Nurse Practitioner Association New York State, New York State Academy of Family Physicians, and the New York Chapter of the American College of Physicians.                  (CLANCY)

STANDARDIZING PRESCRIPTION PRIOR AUTHORIZATION LEGISLATION ADVANCESLegislation to standardize the processes for insurer-required prior authorization of prescription medications is advancing in the New York State Legislature.  This week, legislation (S.4721, Hannon) supported by MSSNY to require the New York State DFS and DOH to develop a standardized form for requesting prior authorization for prescription medications was reported from the Senate Health Committee to the Senate floor.  Similar legislation (A.6983-A, McDonald) is before the full Assembly.  However, the Assembly bill was amended this week.  Instead of requiring the development of a uniform prior authorization form, the Assembly bill has been broadened to require DFS and DOH to develop “standards for prior authorization requests of prescription medications to be utilized by all health care plans for the purposes of submitting a request for a utilization  review  determination  for  coverage  of prescription  drug  benefits under this article”, including standards developed by the National Council for Prescription Drug Programs (NCPDP).  MSSNY is currently reviewing the amended bill.                         (AUSTER, DEARS)

MSSNY OFFERS FREE PATIENT BROCHURE ON DIABETES FOR USE WITHIN PHYSICIANS OFFICE

The Medical Society of the State of New York Committee’s on Preventive Medicine and Family Health and the Committee to Eliminate Health Care Disparities, has develop a patient brochure that physicians can offer within their office.  The patient brochure discusses risks associated with pre-diabetes and diabetes and is available in English and Spanish.  If you would like copies of this brochure, please contact the Medical Society of the State of New York at (518) 465-8085 or email Terri Holmes at tholmes@mssny.org and request copies of the Diabetes brochure.  The development of the brochure was made possible from a grant from AstraZeneca.                                                                                                                                                (CLANCY, ELLMAN)

ADVOCACY MATTERS CME WEBINAR JUNE 9, 2015

The next “Advocacy Matters” CME webinar will be held on Tuesday, June 9, 2015, from 12:30 to 1:30 PM.  The faculty will include David Whitlinger, CEO of NYeC, New York e-Health Collaborative (NYeC), Inez Sieben, COO, and Lisa Halperin Fleischer, NYeC CMO, presenting on the topic “SHIN-NY Statewide Patient Record Look-Up.”

 

Course objectives:

  • Provide an update and overview of the Statewide Healthcare Information Network of New York (SHIN-NY) and its value to healthcare providers
  • Give Healthcare Providers Information on how they will be able to access and share patient records through the SHIN-NY
  • Provide an overview of what capabilities will be available for healthcare providers this year and what they may already be able to access.

To register for this webinar, click here and fill out registration form.  (DEARS, HARDIN)

FINAL MEDICAL MATTERS CME WEBINAR TO BE HELD JUNE 9TH; PHYSICIANS URGED TO REGISTER

The Medical Society’s final webinar for the spring will be conducted on June 9, 2015 at 7:30 a.m. William Valenti, MD, chair of MSSNY Infectious Disease Committee will present “Emerging Infections 2015-A look at EV-D68 and Chikungunya”. Physicians are encouraged to register by clicking on https://mssny.webex.com . Click on “Training Center” and then on the “Upcoming” tab to register.

The educational objectives are:

  • Recognize and describe Enterovirus D68 (EV D68)
  • Recall the importance of continued immunizations
  • Recognize symptoms of Chikungunya and describe measures for reporting

Physicians may also contact Melissa Hoffman at mhoffman@mssny.org or at 518-465-8085 to register.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

It is anticipated that Medical Matters programing for fall/spring 2015-2016 will be announced shortly.                                                                                                                     (CLANCY)

For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:       

pschuh@mssny.org ldears@mssny.org   mauster@mssny.or  
pclancy@mssny.org bellman@mssny.org    

 

 

Step Therapy or Fail Therapy?

Controversy is heating up over a state bill to limit step therapy, the insurance process that requires patients to try less expensive drugs to treat their conditions before their plans will cover more expensive ones recommended by their doctors. The bill (S.2711-A /A.5214-A) would increase pharmaceutical costs while exposing patients to less proven treatments, said the New York Health Plan Association in a statement Thursday. But Dr. Joseph Maldonado, president of Medical Society of the State of New York, said the measure may cut hospital costs incurred when patients are treated with the wrong medication. “There are many instances in which step therapy is very appropriate, but there are instances when this is the medication the patient needs, and they shouldn’t have to jump through unnecessary hoops to get it,” said Dr. Maldonado, who spoke at an Albany press event yesterday hosted by supporters of the legislation.

HANYS Offers Ready. Set. Code!  ICD-10-CM by Specialty.
This series of coding workshops helps physician practices understand the structure of the International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) and successfully assign diagnosis codes for their specialty.

These two-hour workshops are being held from 1 to 3 p.m. on multiple dates, and are led by American Health Information Management Association certified ICD-10 trainers.  The registration fee for each workshop is $150.

Specialties are grouped as follows:

  • Workshop 1: Cardiology/Vascular/Respiratory
  • Workshop 2: Orthopedic/Podiatry/Spine
  • Workshop 3: OB-GYN/Pediatrics/Urology
  • Workshop 4: Internal Medicine/Family Practice
  • Workshop 5: General Surgery/Gastro/ENT/Plastic Reconstructive/Colon
  • Workshop 6: Mental Health/Neurology/Neuro Surgery/Ophthalmology

Ready. Set. Code!  ICD-10-CM by Specialty has been approved for two American Academy of Professional Coders continuing education units (CEUs) and is eligible for two American Health Information Management Association CEUs.

Registration is available online or by mail by downloading the program information and registration form. Contact: Terry August 

Boston Children’s Hospital Buys Westchester Physician Group
Children’s and Women’s Physicians of Westchester agreed to be acquired by Boston Children’s Hospital, an unusual deal for New York. The 280-doctor practice, which largely focuses on pediatrics, has offices in New York, New Jersey, and Connecticut. It is based in Valhalla, down the road from Westchester Medical Center and the New York Medical College. Both those institutions also are in negotiations with the Boston hospital, said Dr. Leonard Newman, CWPW’s president. (Crain’s 5/26)

If the deal goes through this summer as projected, CWPW will continue to refer to Maria Fareri Children’s Hospital at Westchester Medical Center and NYMC, where its staff has academic faculty appointments. Boston Children’s affiliate is Harvard Medical School, which does not allow faculty appointments outside Massachusetts.

AG: Alzheimer Drug Namenda Will Be Available for 30 Days after Patent Expires
A federal appeals court has rejected a drug manufacturer’s appeal and affirmed a judge’s order that Actavis PLC keep distributing its widely used Alzheimer’s medication until after its patent expires this summer. New York Attorney General Eric Schneiderman, who sought the order, calls the Court of Appeals ruling a victory for consumers. His office says the drug Namenda should remain on shelves 30 days after the patent expires July 11. He alleged anti-trust and state law violations by Actavis in an effort to push patients to its new patented drug and avoid losses from cheaper generics. Dublin-based Actavis says its new drug Namenda XR—taken once daily instead of twice—is better and demand is growing. 

Too Many Women Who Need Bone Screening Aren’t Getting It
Too few women at high risk for osteoporosis are being tested for the bone-depleting condition, while too many women at low-risk are being screened, a new study suggests.

A team led by Dr. Anna Lee Amarnath of the University of California, Davis, examined the medical records of nearly 51,000 women, aged 40 to 85, living in the Sacramento area.

The researchers looked at whether or not women were getting a dual-energy X-ray absorptiometry (DXA) test, which measures bone mineral density.( Journal of General Internal Medicine, news release, May 19, 2015)

The result: Osteoporosis screening rates jumped sharply at age 50, despite guidelines suggesting that screening only begin at age 65, unless a woman has certain risk factors.

However, the study also found that those risk factors — a small body frame, a history of fractures, or taking medications that could thin bones — had only a slight effect on a woman’s decision to get her bones tested.

Over seven years, more than 42 percent of eligible women aged 65 to 74 were not screened, Amarath’s team found, nor were nearly 57 percent of those older than 75.

However, nearly 46 percent of low-risk women aged 50 to 59 were screened, as were 59 percent of low-risk women aged 60 to 64.

The study was published online May 19 in the Journal of General Internal Medicine.

“DXA screening was underused in women at increased fracture risk, including women aged 65 years and older. Meanwhile, it was common among women at low fracture risk, such as younger women without osteoporosis risk factors,” Amarnath said in a journal news release.

What to do? Reminder notes to doctors and patients might help, one expert said.

“Health systems should invest in developing electronic health records systems that prompt providers at the point-of-care when screening is needed and when it can be postponed,” study senior author Joshua Fenton, an associate professor of family and community medicine at UC Davis, said in the news release. 

Medicine Considers What Defines Professionalism
Physicians take an oath to uphold ethical standards, but rapid changes in the health care system may have begun to blur lines across the practice of medicine. What measures should physicians be held accountable to, and who should regulate the profession?

The May 12 issue of JAMA takes a deep dive into professionalism, including viewpoints from scholars and academic leaders about the responsibility and accountability of medicine to self-govern, self-regulate and ensure the highest degree of professionalism.

Prominent physicians among the authors include AMA Executive Vice President and CEO James L. Madara, MD; Ezekiel J. Emanuel, MD, vice provost for global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania; Thomas J. Nasca, MD, CEO of the Accreditation Council for Graduate Medical Education; and Lois Margaret Nora, MD, president and CEO of the American Board of Medical Specialties.

The issue examines the key roles and responsibilities of modern governing and accrediting bodies and of professional organizations and societies. Find out what these entities are doing—and what they should do differently—to enhance self-governance, safeguard self-regulation and foster professionalism. 

On a related note, this month’s issue of the AMA Journal of Ethics tackles this topic. The issue examines where professional boundaries start and stop, and how far physicians may go to assist patients with nonclinical matters. Learn about key areas where establishing boundaries with patients may be challenging and issues outside the patient-physician relationship where boundaries are essential.

 

 

 

 

 

 

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