June 10, 2016 – Don’t Stop Now!

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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June 10,  2016
Volume 16, Number 21

Dear Colleagues:

As legislators seek to close down the Legislative Session for the year, please be warned that anything can happen at the end of Session.  Proposals thought to be “dead” or languishing often come back to life.

For example, many years ago, legislation to completely eliminate the statutory limitation on attorney fees for medical malpractice lawsuits seemingly came out of nowhere to be passed on one of the last calendars of the Assembly and Senate.  Thankfully, newspapers across the State editorialized just how bad that bill was and it was vetoed by then-Governor Pataki.

This is why we need you.

I thank the many of you who have answered our call over the last few months to contact your legislators and the Governor to express your strong opposition to a bill that would greatly increase the length of time for a medical malpractice suit to be brought.   We are pleased many newspaper and TV articles about this issue have prominently highlighted our concerns that you cannot bestow new rights to sue doctors and hospitals without taking corresponding action to bring down the exorbitant cost of medical liability insurance in New York.  There could be serious consequences to the availability of patient care.

So far, neither the Assembly nor the Senate have passed the bill this year.

But like I said, anything can happen in the last days of a Legislative Session, particularly when we are but a few months away from an election.  Controversial issues are often among the last bills taken up.  And the trial lawyers and their allies are putting enormous pressure on the Legislature.

Therefore, it is absolutely critical that you continue to contact your lawmakers and remind them of the huge problems to patient care in your community that will occur if they enact liability expansion legislation in a “vacuum.”  Remind them of just how dysfunctional and expensive New York already is.  Remind them that we need comprehensive reform of our medical malpractice adjudication system.  And remind them of the many health services that may not be provided by hospitals and doctors because resources will instead be spent instead on increased malpractice coverage costs.

In addition to calling your local legislators, you can send a letter to your legislators from here.

And make sure your colleagues do the same. You’ve stepped up for your profession— make sure they do so too.

I know many physicians think the “game is rigged” and that these contacts don’t make a difference. Let me assure you – it does make a difference.  The key, however, is generating a critical mass of physicians to weigh in simultaneously with their legislators to give them a stronger sense of the breadth of our concerns.

So please make these contacts NOW.  It’s essential to protect ourselves, our colleagues and, most importantly, to preserve the availability of timely quality patient care in our communities.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


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One Week Left – Please Urge Your Legislators to Prevent Legislation to Increase Lawsuits and Liability Premiums
With just a few days left in the 2016 Session, all physicians must continue to call and write their legislators to urge that they reject legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule.   A letter can be sent from here. The bill was placed on the Debate List in the Assembly this past Wednesday, June 8, indicating action by the Assembly could be imminent, and it is under active consideration by the State Senate.

Therefore, you must let your legislators know that the cost impact of this legislation is unsustainable to New York’s fragile health care system.  Any premium increases, let alone the premium increase that would be imposed as a result of this bill, are not assumable by physicians and hospitals given the cuts in payment being imposed by health insurers and from Medicare, as well as the huge costs to comply with burdensome state and federal mandates.  Let your legislators know that New York physicians already pay in many instances among the highest premiums in the country and that New York was recently ranked by WalletHub.com as the worst state to practice medicine in the country.  And most importantly, let them know the harmful consequences to patient access to care in your community if this legislation were to be enacted without also enacting reforms to reduce the cost of liability coverage.

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined GNYHA and HANYS in an print and radio ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.   The print ads (http://www.nymedmalreform.org/) have appeared in City & State, Politico New York, and the Albany Times-Union.  Moreover, MSSNY’s concerns about the impact of this legislation on New York’s fragile health care system were documented extensively in a recent AP article.
(AUSTER, DEARS)

Governor and Legislature Negotiations on Opioid Package Continue
MSSNY President Malcolm Reid, MD, MPP met this week with Paul Francis, Deputy Secretary for Health and Human Services and other Governor’s health policy staff to put forward MSSNY’s concerns with several issues imbedded in the opioid package now being negotiated by the Governor and Legislative leaders to address the burgeoning epidemic of opioid abuse and addiction. This week the Governor’s Task Force released a report making 25 recommendations to combat this epidemic.  A copy fo the report can be found at this link.

Specifically, Dr. Reid weighed in on four issues of concern including: (1) how often and whom should take mandatory continuing education on effective pain management; (2) whether to establish a day limit on the initial prescription of opioids for acute pain, for how long, and the need for physicians to maintain some discretion to prescribe longer than the limit; (3) whether the exception from the duty to consult the state prescription monitoring database currently granted for emergency room physicians should be repealed; and (4) whether to mandate counseling of patients for whom a prescription is being written for a schedule II, II or IV opioid/narcotic on the addictive nature of opioids.  Discussions on these issues remain fluid. To read a copy of MSSNY’s letter to Mr. Francis, please go here.(DEARS, AUSTER, CLANCY)

Legislation to Reduce E-Prescribing Exception Reporting on Senate Floor; Physician Action Needed
Physicians are urged to contact their elected State Senator to urge that the Senate take up and pass legislation (S. 6779, Hannon/A.9335-B, Gottfried) before they leave town next week to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.  The Assembly counterpart was overwhelmingly approved the Assembly last week by a 132-2 vote.

In March, the Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because:  their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription.  DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription. This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions. In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate.

This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state.  In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.

A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.   It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing requirements went into effect, do not require reporting to the DOH.   The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply. Please urge your Senators to pass this bill by sending a letter located on the MSSNY grassroots action center at this link.
 (DEARS, AUSTER)


Previously Vetoed “Title Bill” for Certified Registered Nurse Anesthetists on Assembly Floor.   Urge Your Elected Representatives to Vote Against A.140 (Paulin)/S.7166 (Gallivan)
Physicians are urged to immediately contact their elected Assembly representatives to urge defeat of legislation (A.140 (Paulin)/S.7166 (Gallivan), currently on the 3rd reading rules cal. 150 on the Assembly floor, where if passed would statutorily recognize the title of certified registered nurse anesthetists (“CRNA”).   A letter can be sent from MSSNY’s Grassroots Action Center here.

Passage of this legislation is cause for great concern because it will empower CRNAs to encourage the State to apply to the Centers for Medicaid and Medicare Services (CMS) for CMS approval of an exemption from the requirement for physician supervision of CRNAs, thereby poetentially allowing for CRNA independent practice.

While this bill purports to be a “title protection” for CRNAs it actually establishes the certification necessary for CRNAs to be directly reimbursed by health insurance companies, as would be provided in legislation currently before both the Senate & Assembly Insurance Committees. 
(
DEARS, MCPARTLON)         


Legislation to Enable Physician Override of Insurer “Fail First” Medication Protocols Moving
With just 3 scheduled Session days remaining in the 2016 Legislative Session, physicians are urged to send a letter and call their legislators in support of legislation (A.2834-D, Titone and S.3419-C, Young) to articulate a process for physicians to request and be granted an override of an insurer medication step therapy protocol when it is in the best interest of their patients’ health.    MSSNY has been working with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers in support of this legislation.

Last week, A.2834-D was overwhelmingly advanced from the Assembly Insurance Committee to the Rules Committee.  The bill has been substantially modified from earlier versions to more clearly delineate the circumstances when an override must be granted, and the time frames within which a health insurer must grant such override request.  Specifically, a health insurer would be required to grant a physician’s override request 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.  S.3419-C is currently before the Senate Insurance Committee, and its sponsor Senator Young is pushing hard for its passage.                                                                                                                                       (AUSTER, DEARS)

Bill to Limit Pain Medication Passes Assembly Codes Committee
A6091-B/A.8601-A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald, passed the Assembly Codes Committee this week by a vote of 14-6. Voting against the measure were: Assemblymembers Robin Schimminger;  Charles Lavine; Thomas McKevitt; Michael Montesano; Edward Ra; and Claudia Tenney.  The bill would limit the initial prescription by a physician or other prescriber of a Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain.   MSSNY strongly opposes this legislation because it fails to allow for a prescriber to exercise professional medical judgement in prescribing based upon the patient’s medical condition. The bill is now is in the Assembly Rules Committee and can be voted on at any time.

Physicians can send a letter to their members in opposition by logging onto MSSNY’s Grass Roots Action Center here.

This issue is being heavily discussed in the context of the opoid/heroin abuse package under negotiation (See related article.)

This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient by imposing an arbitrary standard not developed by any medical authority.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.   A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.

The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address a patient’s medical condition.  Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.
(CLANCY, DEARS, AUSTER, MCPARTLON)


Physician Collective Negotiation Legislation AdvanceThe Senate Finance Committee this week advanced to the Senate Rules Committee critically important legislation (S.1157-A, Hannon) that would permit independently practicing physicians to collectively negotiate patient care contract provisions with health insurance companies under close state supervision.      MSSNY strongly supports this legislation as a means to enable patients and physicians to be able to negotiate fairly with those health insurance companies that have huge market power dominance in many regions across New York State.  

It is more important than ever given the push on insurers to impose often untested value-based payment strategies.   Earlier this session, identical legislation (A.336-A, Gottfried)   advanced from the Assembly Health Committee to the Assembly Ways & Means Committee.  With just a few days left in the Legislative Session, all physicians are urged to contact their Senators and Assemblymembers to urge support for this legislation.  A letter can be sent from MSSNY’s Grassroots Action Center here.
(AUSTER, DEARS)


Renewed Effort to Address Ethics Reform
On Wednesday, Governor Cuomo visited Fordham University in the Bronx and delivered an address outlining his renewed agenda for ethics reform. In the address, Governor Cuomo announced he would take “first-in-the-nation action to curb the power of independent expenditure campaigns.” Governor Cuomo lambasted the standing 2012 U.S. Supreme Court decision which prohibits government from restricting people and corporations from making unlimited independent political expenditures on behalf of candidates—effectively undoing provisions of state and federal campaign finance law which existed at that time. While leaders of both houses of the state legislature have indicated that ethics reform remains a priority, differences remain over the breadth of potential changes and exactly which provisions are ripe for reform.                        (MCPARTLON)   

PTSD and TBI in Returning Veterans:  June Webinar
MSSNY will be holding the last in a series of CME webinars on PTSD and TBI in returning veterans on Monday, June 20. The faculty presenter will be Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic growth

To register for this program, click on the date below and fill out the registration form

Monday, June 20, 6-7 PM                                                                                (ELPERIN, DEARS)

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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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Our Message Is Everywhere
A message from Doctors and Hospitals: New York is home to many of the world’s finest doctors and hospitals, but they spend billions annually on medical malpractice costs—by far the nation’s highest. Let’s make sure Albany doesn’t make things worse by passing bills that will raise those costs even higher and damage patient care. Learn more here.


Info You Need: Medicare’s Mail-Order Program for Diabetes Testing Supplies
If you treat patients with Original Medicare who use diabetes testing supplies, you should know that Medicare is continuing its National Mail-Order Program. This program includes all parts of the US, and it requires Medicare beneficiaries who want diabetes testing supplies delivered to their homes to use a national mail-order supplier that has a contract with Medicare. The program is designed to help beneficiaries get quality supplies while also saving money.

This website contains the latest information about the national mail-order program.

EPaces: Do Not Share Your User ID and Password
As a result of recent security improvements to the ePACES log-in process, eMedNY is aware that some ePACES users are sharing their log-in credentials with their co-workers in order to facilitate daily processing of eligibility checks, among other functions.
We would like to remind all ePACES users of the following policy stated in the Medicaid Confidentiality Regulations under “ePACES Access Control.”

Warning: As per the Health Insurance Portability and Accountability Act (HIPAA), CSC or the on-site ePACES Administrator is required to assign unique user IDs and passwords for identifying and tracking user’s identity [Ref: § 164.312(a)(2)(i)]. Users that share their ePACES user id and password are in violation of the HIPAA Security Regulation. If this practice is detected, the user’s access will be revoked and other sanctions may apply.

HOW TO SET UP ePACES USER IDs:
Fortunately, there are only 3 steps needed for your ePACES Administrator to create and define roles for ePACES user IDs – click, create, assign!

Read all about them in the ‘ePACES – Setting Up User Accounts’ Quick Reference Guide. No Call Center tokens required!



SPECIAL OFFER:  Sign up for the “New York State Practitioner Education – Medical Use of Marijuana Course” today and get free admission to the CWCBExpo Exhibits at the Javits Center.
The “New York State Practitioner Education-Medical Use of Marijuana Course” created by TheAnswerPage.com[1] is the sole required course for physicians seeking to register with the NYSDOH to certify patients for medical marijuana.  We also offer a legal educational course, written by the Medical Marijuana Law Group of Abrams Fensterman, which addresses the common legal concerns of physicians who are interested in certifying patients for the New York Medical Marijuana Program.

Sign up today at www.TheAnswerPage.com and receive:

  • Complimentary admission to all of the exhibits at the Cannabis World Congress & Business Expo (CWCBExpo), June 16-17, 2016, Javits Convention Center
  • Up to a year to complete the “New York State Practitioner Education-Medical Use of Marijuana Course” and earn 4.5 AMA PRA Category 1 CME Credits™
  • Access to legal educational guidance written by the Medical Marijuana Law[2] Group of Abrams Fensterman


Differences in Incomes of Physicians by Race and Sex
“The median annual income of white male doctors between 2010 and 2013 was $253,042, compared with $188,230 for black male doctors, according to a study published in the BMJ. Both groups of men far out-earned female doctors of both races, although the pay gap between white and black women was modest and not statistically significant.”



FDA Warns Overdosing on Anti-Diarrhea Drugs Can Cause Fatal Heart Problems
The FDA warned on June 7 that common anti-diarrhea drugs, such as prescription Imodium (loperamide) and related over-the-counter drugs, “can cause potentially deadly heart problems when taken at higher-than-recommended levels.” According to the agency, abusers try to achieve highs by taking up to 300 milligrams at once, far in excess of the recommended 8 to 16 milligrams per day. The agency has received 31 reports of people hospitalized due to the heart problems, including 10 deaths over the last 39 years. 

Please Take Physicians Foundation Survey: NY Should Be Heard
We need your support to make the 2016 Physicians Foundation Biennial Physician Survey a success! Your participation is essential for generating awareness about the key challenges facing the physician community today as well as for helping policymakers formulate efficient and effective policies that improve patient care. We would greatly appreciate you taking 10 minutes to complete the survey.

USPSTF Reaffirms Syphilis Screening Guidelines as Cases Increase
The US Preventive Services Task Force reaffirmed their 2004 guidelines on syphilis screening, which recommend that “men who have sex with men, people living with HIV and others at an increased risk of the sexually transmitted disease” be screened for syphilis. The United States Preventive Services Task Force made this recommendation in a JAMA article published online, the first update to the syphilis screening recommendation since 2004 (JAMA. 2016;315[21]:2321-2327. doi: 10.1001/jama.2016.5824). The article points out that the number of new syphilis cases in the US was almost 20,000 in 2014 compared to only 5,979 in 2005, according to the CDC.

Albany County Executive to Sign Law to Raise Tobacco Purchase Age
The Albany (NY) Times Union (6/8) reports that on Wednesday, Albany County Executive Dan McCoy is expected to sign a law that would raise the age to buy tobacco products to 21. Lawmakers have pushed this legislation “in hopes of preventing young adults from ever taking up a tobacco habit.” Albany would become the third county in New York to pass this legislation. 


MSSNY in the News

Associated Press – 06/02/16
New York Bill Extends Deadline for Medical Malpractice Suits
(MSSNY Senior VP, Liz Dears quoted)

Also ran in:

McDowellNews.com
New York bill extends time for medical malpractice lawsuits                                    

The Observer-Dispatch (AP)
NY bill extends time for medical malpractice lawsuits                                              

ObserverToday.com
NY bill would extend deadline for medical malpractice suits

TheIndyChannel.com
New York bill extends deadline for medical malpractice suits                                   

KMTV
New York bill extends deadline for medical malpractice suits                                   

The Denver Channel
New York bill extends deadline for medical malpractice suits                                   

FOX 4 Now
New York bill extends deadline for medical malpractice suits                                   

WPTV NewsChannel 5
New York bill extends deadline for medical malpractice suits                                   

KTNV ABC Channel 13
New York bill extends deadline for medical malpractice suits                                   

Kivi Tv
New York bill extends deadline for medical malpractice suits                                   

Newsnet5.com
New York bill extends deadline for medical malpractice suits                                   

Columbia Missourian
New York bill extends deadline for medical malpractice suits                                   

PostBulletin.com (AP)
New York bill extends deadline for medical malpractice suits                                   

Pantagraph.com
New York bill extends deadline for medical malpractice suits                                   

Olean Times Herald
New York bill extends deadline for medical malpractice suits                                   

Journal Gazette & Times-Courier
New York bill extends deadline for medical malpractice suits                         

Dailyamerican.com
New York bill extends deadline for medical malpractice suits                                     

The Daily Star (AP)
New York bill extends deadline for medical malpractice suits                                     

KDWN
New York bill extends deadline for medical malpractice suits                                     

The Leader Herald
New York bill extends deadline for medical malpractice suits                                     

Adirondack Daily Enterprise
New York bill extends deadline for medical malpractice suits                                     

ObserverToday.com
New York bill extends deadline for medical malpractice suits                                     

Westfield Republican
New York bill extends deadline for medical malpractice suits                                     

Elkhart Truth
New York bill extends deadline for medical malpractice suits                                     

WKBW
Bills extends time for medical malpractice suits                                                       

Fox Carolina
New York bill extends deadline for medical malpractice suits

Albany Times Union – 06/02/16
New York opioid pill bill would limit prescriptions
(MSSNY mentioned)

Also ran in:

San Antonio Express News

Newsday – 06/05/16
Medical malpractice lawsuit bill stalls in state Senate 

WCBS-TV New York  – 06/03/16
N.Y. State Lawmakers Push For Change To Limitations On Medical Malpractice Suits
(MSSNY President, Dr. Malcom Reid interviewed) 

Black Daily News – 06/03/16
N.Y. State Lawmakers Push For Change To Limitations On Medical Malpractice Suits
(MSSNY President, Dr. Malcom Reid quoted)

Examiner.com – 06/06/16
NY Senate sits on malpractice bill passed by Assembly
(MSSNY mentioned)

Newsday – 06/05/16
Medical malpractice lawsuit bill stalls in state Senate
(MSSNY Mentioned)


CLASSIFIEDS



Medical Office Space For Sale in Prime Bay Ridge Co-op Building
Recently renovated Medical Office
Bay Ridge, Brooklyn You will be sure to impress your patients with this move-in condition over 2500 square foot professional space in a prime Bay Ridge Coop Building.  Office space has a separate private entrance. Low maintenance of $866.67 includes heat, water and real estate taxes.  Currently set up as a medical office so little work to do.  You have two reception areas; large waiting room; four large offices/exam rooms and plenty of extra work areas.   The outer rooms have windows facing Shore Road. Easy to park and accessible by bus.  Go to the link below to see the virtual tour of this great space. Asking $675,000.00.
http://tours.tourfactory.com/tours/tour.asp?t=1512876&guid={4A6DD20B-CF78-432D-B56F-19CF4BC55DF6}

Liz Hammann                                                Keller Williams Realty Empire                    Licensed Associate Real Estate Broker
Cell:    646-773-2785      lizhamm15@gmail.com
www.lhammann.kwrealty.com   
                           
 Michelle Epstein, CBR  Keller Williams Realty Empire
Licensed Associate Real Estate Broker
Cell:    917- 359-0721
michellerealestate1@gmail.com
www.epstein.kwrealty.com                        


121 EAST 60TH ST – 6TH FL OFFICE ROOM FOR RENT
Professional Co-op office in an established part time Doctors office. Recently re-done, waiting area with a full time receptionist for your clients. The elegant lobby is attended 24-hours and offers live operator answering service for your clients, and more. Available Monday through Sunday (Monthly $2,000). Please call to schedule an appointment. 212-355-7017121 E 60thst


Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581


Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!


Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities

Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.

The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.

Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services 

Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.


New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=


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

 

 

 

 

 

 

 

 

 

 

 

 

 

June 3, 2016 – Let’s End Opioid Abuse

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

June 3,  2016
Volume 16, Number 20

Dear Colleagues:

It seems that every day we read or hear about another opioid related death. In fact, more than 78 people die each day due to opioid misuse and overdose, including heroin. Many of these individuals are our patients. As physicians, we can—and must—help to end the opioid abuse epidemic.

The Governor and New York State Legislature are currently discussing and negotiating an Opioid Prevention Package that will likely be voted on before the end of session. This comprehensive package includes provisions to require coverage for inpatient treatment for substance abuse for a period of time and eliminating utilization review and prior authorization requirements that has served as obstacles for necessary treatment to combat substance abuse. The proposal also would establish specific day limitations on the amount of Schedule II and Schedule III prescriptions for acute pain; a requirement that all prescribers of schedule II, III or IV controlled substances counsel and make available information relating to the risk of addiction and a requirement for all prescribers to take a 3 hour course on pain management, addiction, palliative and end of life care which will be tied to licensure. The MSSNY Council and its leadership, along with our Division of Governmental Affairs, are responding to these proposals.

At the recent MSSNY Council meeting, the Council supported two very important proposals to address the opioid issue. MSSNY supports legislation to allow patients to have access to Medication Assisted Therapy (MAT) and psychosocial strategies for substance use disorders covered by insurance including services provided in the primary care setting.  MSSNY also continues to support insurance coverage for inpatient substance use treatment and increasing funding for more available treatment beds.

MSSNY Council also supported federal legislation to allow “partial fill” of Schedule II Controlled Substance medications.  Partial fills for Schedule II controlled substances are currently prohibited under the Drug Enforcement Agency’s (DEA) regulation. This bill, part of the Congressional opioid discussion, would allow physicians/prescribers, in consultation with their patient, to prescribe up to a 30 day supply of Controlled Schedule II with a notation to the pharmacist that he/she should only dispense the agreed to amount. The DEA allows partial fill for Controlled III and IV.

Since 2014, MSSNY has been an active participant of the American Medical Association’s Task Force to Reduce Opioid Abuse. The task force, comprised of over 25 states, specialty and other health care associations was formed in an effort to reduce the nation’s burden from the inappropriate prescribing of opioids, and the growing crisis of heroin overdose and death.

One of the goals of the task force is to increase physicians’ registration and use of effective prescription monitoring programs (PMP).  Here, in New York State, physicians who wish to prescribe a Schedule II, III or IV controlled substance are required to consult the PMP—and since the implementation of this requirement, doctor shopping has been reduced by over 85% and prescriptions for opioids are down!

And, every state in the country saw a decrease in the number of opioid analgesic prescriptions filled in 2015 according to new data from IMS Health.  This information, which reflects the activity of physicians and other healthcare professionals, shows that nationally, there was a 6.8 percent decrease in the total number of prescriptions for opioid analgesics in 2015 compared to 2014. For New York State, there has been a 10.5% reduction in opioid analgesics prescriptions since 2013!

We should be very proud of our collective efforts to reduce “doctor-shopping.”

MSSNY has, and will continue to support expanded access to naloxone through New York State’s Opioid Prevention Program.  As a result, 3,500 overdose reversals have been documented, and over 1,500 lives were saved in 2015.

Another goal of the task force is to enhance physicians’ education on effective, evidence-based prescribing. This year, The Medical Society of the State of New York, the New York State Office for Alcoholism and Substance Abuse Service and the NYS Department of Health’s Bureau of Narcotic Enforcement, jointly provided a free, four part webinar series on Opioid Use, Treatment, and Addiction. This program is now available on line here.

MSSNY has also developed and placed on its website information on best practices, physicians’ resources and educational programs that are currently available to physicians.  Please click this link.

Let me be clear—78 patients dying EVERY DAY from this epidemic is unacceptable. This is not a problem that physicians created; but physicians are needed to effectuate the remedy.  And while we have concerns regarding some of the proposals under consideration, we stand ready to participate in negotiations to assure that patients can continue to have access to medically indicated treatment for acute and chronic pain. This will likely mean that we—both the prescriber and the patient—will need to be better educated as to appropriate pain management for all patients including those with addiction so that we can arrest the wide ranging and persistent scourge affecting our patients throughout New York and across the nation. MSSNY is committed to assisting the state and, indeed, the nation in ending the opioid misuse and overdose epidemic.

We will need every physician in this state to do his/her part in this effort!

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


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Governor Advances Draft Legislation to Curb Opioid Epidemic
Governor Cuomo, fresh from a listening tour that has transpired across all communities through the state, has advanced draft legislation that would address issues that have arisen in New York communities with regard to the burgeoning epidemic of opioid abuse and addiction.  Based upon MSSNY’s conversations with the Legislature, the draft proposal would attempt to attack the problem comprehensively by proposing the following:

  • Establishment of insurance law changes that enhance coverage for substance abuse diagnosis and treatment opportunities and reduce obstacles such as utilization review and prior authorization requirements that insurers impose to restrict access to medically necessary substance abuse treatment, including: (1) a requirement to use the OASAS clinical review tool in making UR decisions; required coverage for at least fourteen days of inpatient care for diagnosis and treatment of substance abuse; and elimination of prior authorization for buprenorphine;
  • Attacking the problem in our schools by requiring teachers to take continuing education on drug addiction and response; requiring students to receive education on heroin and opioid abuse; requiring the establishment of recovery high schools; and requiring substance abuse free living beds in colleges;
  • Establishing a seven day limit on the initial prescription of opioids for acute pain (that does not include chronic pain, cancer pain, pain that is addressed by palliative care practices or pain that is a normal consequence of a surgery that is performs on an inpatient basis) and
  • Establishing a requirement that all prescribers (physicians, physician assistants, nurse practitioners, nurse midwives and podiatrists) complete a three hour continuing education course before each re-registration on pain management, addiction and palliative care; and
  • Establishing a requirement that prescribers of any schedule II, III or IVcontrolled substance offer counseling and make available information relating to the risk of addiction and available local resources for addiction and have a patient sign a form acknowledging that he or she has been offered consultation related to the prevention, mitigation and treatment of such addiction.

MSSNY lobby staff met this week with the Lieutenant Governor and Commissioner of Health to discuss the perspective of organized medicine on these issues. MSSNY lobby staff has also met with members of the Senate and Assembly and is working toward addressing many of the concerns raised by MSSNY leadership concerning these proposals.                                                                                           (DEARS, CLANCY, AUSTER)

Do Not Wait – Contact Your Legislators to Prevent Legislation to Increase Lawsuits and Liability Premiums
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) under consideration that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule.   A letter to your Senator and Assemblymember can be sent from here.

There are just two weeks left in the legislative session, and anything can happen.  In light of the huge financial pressures already facing physicians prompted by excessive government mandates, reduction in insurer payments and networks, and rapidly rising patient cost-sharing responsibilities, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients.

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined GNYHA and HANYS in an print and radio ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.   The print ads (http://www.nymedmalreform.org/) have appeared in City & State, Politico New York, and the Albany Times-Union.  Moreover, MSSNY’s concerns about the impact of this legislation on New York’s fragile health care system were documented extensively in an AP article this week.                                                                                       (AUSTER, DEARS)

Legislation to Enable Physician Override of Insurer “Fail First” Medication Protocols Moving
With just 7 schedule Session days remaining in the 2016 Legislative Session, physicians are urged to send a letter in support of legislation (A.2834-C, Titone and S.3419-B, Young) to articulate a process for physicians to request and be granted an override of an insurer medication step therapy protocol when it is in the best interest of their patients’ health.    MSSNY has been working with a wide array of patient advocacy organizations, specialty societies, hospitals, and pharmaceutical manufacturers in support of this legislation.

This week, A.2834-C was overwhelmingly advanced from the Assembly Insurance Committee to the Rules Committee.  The bill has been substantially modified from earlier versions to more clearly delineate the circumstances when an override must be granted, and the time frames within which a health insurer must grant such override request.

Specifically, a health insurer would be required to grant a physician’s override request 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.  Similar legislation S.3419-B is currently before the Senate Insurance Committee.

Last week, MSSNY representatives joined representatives of many other physician and patient advocacy groups in a press conference and lobby day in support of this critically needed legislation.  The activities generated significant press activity regarding this legislation, including articles in the Albany Times Union, Politico New York, CBS 6 Albany, and Time Warner Cable News.
(AUSTER, DEARS)

Legislation to Reduce E-Prescribing Exception Reporting Passes the Assembly
Legislation (A.9335-B, Gottfried) overwhelmingly passed the Assembly this week by a 132-2 vote to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.    Identical legislation (S.6779-B, Hannon) is before the full Senate and poised for passage.
In March, the Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because:  their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription.  DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription.

This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions. In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state.  In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.

A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.   It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing requirements went into effect, do not require reporting to the DOH.   The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply. Please urge your Senators to pass this bill by sending a letter located on the MSSNY grassroots action center.
(DEARS, CLANCY, AUSTER)

Bill to Limit Pain Medication Will Be Voted on By Assembly Codes Committee; Physicians Urged to Act
S6091-B/A.8601-A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald, will be voted on by members of the Assembly Codes Committee, next week. The bill would limit the initial prescription by a physician or other prescriber of Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain. While the bill was originally to be considered by the Committee this week, the meeting was postponed until next week. MSSNY strongly opposes this legislation.

Physician action is needed to prevent this bill from becoming law.  Physicians are urged to call their state Assembly members today and indicate opposition to this measure.

Assemblymembers can be found here.  Members of the Assembly Codes Committee are listed here.

Physicians can also send a letter to their members by logging onto MSSNY’s Grass Roots Action Center.

This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient by imposing an arbitrary standard not developed by any medical authority.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.   A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.

The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address a patient’s medical condition.  Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.
(CLANCY, DEARS, AUSTER, MCPARTLON)


Senate Finance Committee to Consider Collective Negotiation Legislation
The Senate Finance Committee will consider legislation (S.1157-A, Hannon) next week that would permit independently practicing physicians to collectively negotiate patient care contract provisions with health insurance companies under close state supervision.   The bill had been favorably reported to the Finance Committee from the Health Committee earlier this year.  MSSNY strongly supports this legislation as a means to enable patients and physicians to be able to negotiate fairly with those health insurance companies that have huge market power dominance in many regions across New York State.   It is more important than ever given the push on insurers to impose often untested value-based payment strategies.   Identical legislation (A.336-A, Gottfried) recently advanced from the Assembly Health Committee to Assembly Ways & Means Committee.  All physicians are urged to contact their Senators and Assemblymembers to urge support for this legislation.  A letter can be sent from MSSNY’s Grassroots Action Center here.                      (AUSTER, DEARS)


DOH Provides Certification Process For Low Volume Prescribers to Receive One Year Exemption From E-Prescribing Requirment
The New York State Department of Health has announced its certification procedures for prescribers who write less than 25 prescriptions a year.  This process will enable prescribers to write paper prescriptions rather the e-prescriptions.

The Medical Society of the State of New York secured this provision within the 2016-17 New York State Budget and the certification process can either be done electronically or by paper application. Prescriptions in both oral and written form for both controlled substances and non-controlled substances are included in determining whether the practitioner will reach the limit of twenty-five prescriptions.  A certification is valid for one year. Should the practitioner exceed twenty-five prescriptions within the twelve-month period, he or she is required to issue prescriptions electronically or obtain from the Department a waiver from the requirement to electronically prescribe.

Certifications postmarked or submitted to the Department by July 1, 2016, may be specified to begin as of March 27, 2016.  Such certifications remain valid through March 26, 2017.

Instructions for filing a certification through the Health Commerce System (HCS) can be found here.

The paper certification form can be found here and can be either emailed, mailed or faxed back to the NYS DOH Bureau of Narcotic Enforcement.
(CLANCY, DEARS)


ZIKA CME Webinar to Be Held June 8 at 6 P.M.; Physician Registration Now Open
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story–UPDATE” on Wednesday June 8th  at 6 p.m.   Registration for this program is now open here. Click on the upcoming tab and select the programs.

MSSNY conducted the original program in March 2016, but this program will provide updates to the ever changing story of Zika. The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection; 2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)


MSSNY Participates in New York Kicks Butts Campaign
The Medical Society of the State of New York has joined with the American Cancer Society, the American Lung Association, and Tobacco Free Kids and a variety of other affiliated health organizations and businesses to encourage New York City residents to quit smoking.  The New York Kick Butts campaign is being held this week, and New York City physicians are asked to discuss with patients smoking cessation treatment options.  By offering medication and counseling, physicians can help patients to double their quit rates.

Helpful tools can be found on line at PlanMyQuit.com/NYC or by calling the New York State Smokers’ Quit line at 1-866-NY-QUITS (697-8487) or by just dialing 311.   Additional resources can also be found at NYSmokeFree.com.  Physicians can find an information flyer here.

Patient information here.

There is also a new 5 Steps to Quit Smoking flier in both ENGLISH and SPANISH found on the resources page of nykicksbutts.org.  Additional information can also be found here.
(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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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BNE: Low Prescribers Do Not Have to Issue Scripts Electronically
The Bureau of Narcotic Enforcement (BNE) announced that the process for a practitioner to certify that he or she will not issue more than twenty-five prescriptions during a twelve-month period is now available.  A practitioner submitting a certification will not be required to issue prescriptions electronically.

A practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System or by submitting a paper certification form to BNE.

Below is a list of Frequently Asked Questions (FAQ’s) related to “Certifications” that will be included in the Electronic Prescribing FAQ document on our website.

VP Socio-Med Regina McNally 

Q: How does a practitioner certify that he or she will not issue more than 25 prescriptions during a twelve-month period?

A: A practitioner can either submit a certification online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System or by submitting Certification form, DOH-5221, to the Bureau of Narcotic Enforcement.

Complete the steps below to submit a certification online in HCS:

  1. Log into the HCS here
  2. Under “My Content” click on “All Applications”
  3. Click on “E”
  4. Scroll down to Electronic Prescribing Waivers and double click to open the application. You may also click on the “+” sign to add this application under “My Applications” on the left side of the Home screen.
  5. Select the practitioner name from the list. If the name appears more than once, select the option that starts with the profession (i.e., Medicine-###### Doe John).
  6. Provide contact information for the person who should be contacted regarding the Certification.
  7. Click on “Submit Certification”
  8. Enter in the “Begin Date” of the twelve-month certification period.
  9. Enter in the Mailing Address of the practitioner submitting the certification.
  10. Click “Submit”
  11. Click “Certify”
  12. You will be returned to the “Waiver Requests and Certifications Summary” screen. The certification period will be displayed.

Q: Can a practitioner submit a certification with an effective date prior to the date of submission?

A: During the first year of the certification process, certifications postmarked or submitted to the Department by July 1, 2016, may specify a begin date as early as March 27, 2016.  Certifications submitted to the Department after July 1, 2016, cannot be backdated.  

Q: Can a practitioner submit a certification with a future effective date?

A: Yes, up to 3 months in the future.

Q: Does the 25 count script limit include all prescriptions?  

A: Prescriptions in both oral and written form for both controlled and non-controlled substances must be included in determining whether the practitioner will reach the limit of twenty-five prescriptions.

Q: What should a practitioner do if he or she exceeds twenty-five prescriptions within the twelve-month certification period?  

A: The practitioner is required to issue prescriptions electronically or obtain a waiver from the requirement to electronically prescribe.  Please see information related to electronic prescribing waivers here.

Q: Does my certification need to be approved?   

A: There is no review and approval process for certifications.

Q: Who can submit the certification for a practitioner?   

A: Each individual practitioner must certify independently.  A hospital or group practice organization cannot submit a certification on behalf of the practitioner.

Q: How long is the certification valid?   

A: A certification is valid for one year from the begin date.

Q: Does a practitioner need to submit a certification each year?   

A: Yes. A practitioner must recertify each year.

Q: Can a practitioner submit a certification for a period that begins prior to the end date of its current certification period?   

A: No.  The certification periods can’t overlap.  The begin date of a new certification period must be after the end date of the previous certification.

Q: Does a practitioner who already has an approved waiver from the requirement to electronically prescribe also need to submit a certification?   

A: No.  The practitioner is covered by the waiver until March 26, 2017.

Q: Does a practitioner who issues less than 25 prescriptions per year and already has an approved waiver from the requirement to electronically prescribe also need to submit a certification?   

A: No.  The practitioner is covered by the waiver until March 26, 2017.


Fidelis: Pain Management Provider Access Crisis in Erie County,  NY:
On 5/18/2016 MSSNY contacted CMS regarding a crisis in Erie Co concerning access to pain management providers as alerted by members of Fidelis (The New York State Catholic Health Plan).  After learning that Dr. Eugene Gosy, a participating pain management provider, was indicted on 114 counts by the United States’ Attorney for the Western District, Fidelis suspended this provider who operated a large pain management practice.  Concurrently, and perhaps unrelated, another large pain management practice has closed, leaving large numbers of patients in Erie Co. without access to pain management services.  On 5/24/2016 Fidelis advised CMS that it is actively recruiting providers to fill this gap.  However, since some may not meet credentialing standards, Fidelis is allowing its members to receive care out of network.  In addition it is working with local anesthesiologists to contract with them, as they would be qualified.

CMS Baltimore has been apprised of the situation and the Account Manager was advised that since pain management is not a specialty subject to time and distance standards, this case would not justify running the network through the Network Management Module (NMM) for a review.  However, we can address the issue from the perspective of accuracy of provider directories and closely monitor the plan’s progress in providing appropriate provider access.

Before this incident came to light, Fidelis had already been subject to a review of its online provider directory by CMS Baltimore. Since this issue is not limited to Fidelis, other Account Managers who have plans with service areas in Erie County have been notified to review with their plans. (Socio-Med VP Regina McNally) 


Council Notes—June 2, 2016

Council approved the following:

  • MSSNY will support development of a comprehensive stroke system within New York State and will support development of either statewide or regional stroke protocols for New York State’s EMS agencies.
  • MSSNY will support the New York State Pathology Association’s efforts in seeking a repeal of the New York State regulation that prohibits pathologists from speaking directly to patients about test results.
  • MSSNY will support legislation/regulations allowing partial fill of Schedule II Controlled Substance medications similar to partial prescription fills permitted under regulations for Schedule III and IV medications.
  • MSSNY will support legislation/regulation to allow access to Medication Assisted Therapy and psychosocial strategies for substance use disorders and that insurance companies be required to provide coverage for these programs including in the primary care non-psychiatric non –addiction specialist setting.
  • MSSNY Task Force on Physician Stress and Burnout will continue in its efforts to promote wellness efforts as a way of prevention of the consequences of burnout.  Next steps will include assigning a subcommittee to review survey options; outreach to liability companies to discuss partnering options; and outreach to NYS resident education leadership regarding opportunities for collaboration.
  • The 2016 House of Delegates Resolutions that were referred to Council by the HOD were approved to go back to committees for further discussion. The resolutions will then be brought back to Council.


NY Law: Can Register as Organ Donors When Buying Insurance through Exchange
On June 1, Gov. Andrew Cuomo signed a bill into law that will require the state’s health insurance exchange to “ask anyone signing up for coverage…if they’d like to register as [an organ] donor.” The article points out that the state has the second lowest organ donation participation rate in the US. Currently, only one in four eligible New Yorkers is registered. That’s the second lowest participation rate in the nation. The law’s sponsor, Sen. Kemp Hannon, says nearly 10,000 people in the state are now on a waiting list for available organs or tissue. AP (5/26)


United Healthcare Will Offer Exchange Plans in Only Three States
On May 31, UnitedHealthcare disclosed on a website dedicated to insurance brokers that it plans to offer on-exchange plans in only three states — New York, Nevada, and Virginia. A company spokeswoman confirmed that it will withdraw from the Illinois exchange.


Preliminary CDC Report: Long Decline In US Death Rates Has Reversed Course
The Centers for Disease Control and Prevention reports preliminary numbers indicate that “the long decline in Americans’ death rates has reversed course.” Factors contributing to the “turnaround” include “a rise in deaths from firearms, drug overdoses, accidental injuries, suicides, Alzheimer’s disease, hypertension and stroke.” Still, “‘there’s no smoking gun here,’ said Farida Ahmad, mortality surveillance lead for the CDC’s National Center for Health Statistics.” Ahmad called “the increase in mortality ‘unusual,’ noting that it’s the first time since 2004-2005 that the rate went up rather than down.” 


First-Ever Addiction Implant
FDA last week approved a first-of-its-kind implantable device that emits a drug used to treat opioid-related substance use disorders. The device over a six-month period releases buprenorphine, a medication used to treat opioid-related substance use disorders. Expanding the use and availability of medication-assisted treatment (MAT) options like buprenorphine is an important component of the FDA’s opioid action plan and one of three top priorities for the U.S. Department of Health and Human Services’ Opioid Initiative aimed at reducing prescription opioid and heroin related overdose, death and dependence.


CLASSIFIEDS



Medical Office Space For Sale in Prime Bay Ridge Co-op Building
Recently renovated Medical Office
Bay Ridge, Brooklyn You will be sure to impress your patients with this move-in condition over 2500 square foot professional space in a prime Bay Ridge Coop Building.  Office space has a separate private entrance. Low maintenance of $866.67 includes heat, water and real estate taxes.  Currently set up as a medical office so little work to do.  You have two reception areas; large waiting room; four large offices/exam rooms and plenty of extra work areas.   The outer rooms have windows facing Shore Road. Easy to park and accessible by bus.  Go to the link below to see the virtual tour of this great space. Asking $675,000.00.
http://tours.tourfactory.com/tours/tour.asp?t=1512876&guid={4A6DD20B-CF78-432D-B56F-19CF4BC55DF6}

Liz Hammann                                                Keller Williams Realty Empire                    Licensed Associate Real Estate Broker
Cell:    646-773-2785      lizhamm15@gmail.com
www.lhammann.kwrealty.com   
                           
 Michelle Epstein, CBR  Keller Williams Realty Empire
Licensed Associate Real Estate Broker
Cell:    917- 359-0721
michellerealestate1@gmail.com
www.epstein.kwrealty.com                        


121 EAST 60TH ST – 6TH FL OFFICE ROOM FOR RENT
Professional Co-op office in an established part time Doctors office. Recently re-done, waiting area with a full time receptionist for your clients. The elegant lobby is attended 24-hours and offers live operator answering service for your clients, and more. Available Monday through Sunday (Monthly $2,000). Please call to schedule an appointment. 212-355-7017121 E 60thst


Recently renovated Medical Office Space available June, 2016 in desirable midtown Manhattan building located between Park and Madison Avenues.Please Call Mr Mel Farrell at 212. 696.7107 for further information.


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581


 

Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!


Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities

Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.

The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.

Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services 

Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.


New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=


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

 

 

 

 

 

 

 

 

 

 

 

 

 

Council June 2, 2016

 

       AGENDA
         MSSNY Council Meeting
            Thursday, June 2, 2016, 9:00 a.m.
                  Long Island Marriott
                     101 James Doolittle Blvd.
                  Uniondale, NY  11553

A.    Call to Order and Roll Call

B.    Approval of the Council Minutes of April 17, 2016

C.    New Business (All New Action & Informational Items) 

1.   President’s Report
a. 2016 HOD Resolutions referred to Council
    (For Council Approval)

 

b. Presidential Appointments to the Executive Committee of the Council are:
Joshua M. Cohen, MD, MPH
Parag H. Mehta, MD

 

c. Minutes of he MSSNY Task Force on Physician Stress and Burnout

 

2.  Board of Trustees Report – No Report Submitted.  Council met prior to the Board of Trustees at the HOD.

 

3.  Secretary’s Report – Nominations for Life Membership and Dues Remissions.

 

4. MLMIC Update  –  Mr. Donald Fager, Esq. will present a verbal report

 

5. AMA Delegation Update – Dr. Kennedy will present a verbal
report

 

6. MSSNYPAC Report – (Handout at Council)

 

7. Commissioners  (All Action Items, For Council Approval )
Commissioner of Science & Public Health, Frank G. Dowling, MD
1. Preventive Medicine & Family Health Committee:
a. Request to support a three-tiered system of stroke centers in NYS  and repeal of prohibition preventing pathologists from speaking directly to patients about test results

 

  2. Addiction & Psychiatric Medicine Committee
a. Support of partial fill of Schedule II Controlled Substance and Support to allow access to Medication Assisted Therapy

(MAT)

8.  Councilors  (All Action Items from County Societies
and District Branches)
     No reports submitted

 

D.  Reports of Officers (Verbal Reports)

1. Office of the President – Meetings attended:
  • Suffolk County Legislative Breakfast
  • MLMIC Cocktail Dinner & Board of Directors
  • Erie County Annual Meeting
  • Annual Bangladesh Convention
  • Specialty Society Fundraiser & Lobby Day
  • Kings County Annual Meeting
  • Nassau County Annual
  • Richmond County Legislative Brunch
  • Round Table Meeting with Senator Flanagan

2. Office of the President Elect – Charles Rothberg, MD
3. Office of the Vice President – Thomas J. Madejski, MD
4. Office of the Treasurer – Joseph R. Sellers, MD, Financial Statement for the period 1/2/16 to 4/30/16
5. Office of the Secretary – Arthur C. Fougner, MD – Discussion re Eisenhower Park walk to boost community health
6. Office of the Speaker –  Kira A. Geraci-Ciradullo, MD, MPH

E. Reports of Councilors  (Informational)

1 .     Kings and Richmond Report – Parag H. Mehta, MD, Verbal
Report  on ABIM First Community Exploration Day Meeting
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
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
12.    Ninth District Branch Report  –  Thomas T. Lee, MD
13.    Medical Student Report – Christina Kratschmer
14.    Organized Medical Staff Report – Richard Ritter, MD
No written report submitted
15.    Resident/Fellow Report Robert A. Viviano, DO
16.   Young Physician  Report – L. Carlos Zapata, MD

F. Commissioners (Committee Informational Reports/Minutes)

1. Commissioner of Communications,
Joshua M. 
Cohen, MD, MPH
     Report of the Division of Communications

 

2. Commissioner of Science & Public Health,
Frank G. Dowling, MD

a. Bio Ethics Minutes Committee , April 1, 2016
b. Preventive Med and Family Health Minutes, May 12, 2016

G. Report of the Executive Vice President
Membership Dues Revenue Schedule

 

HReport of the General Counsel
No written report submitted

 

I. Report of the Alliance  
Alliance Report

 

J.   Other Information/Announcements

 

K.  Adjournment

 

 

May 27, 2016 Capital Update

Dr. Reid
Dr. Malcolm Reid
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MLMIC


Capital_Update_Banner


Do Not Wait – Tell Your Legislators That Patient Access to Care Will be Harmed By Legislation to Increase Lawsuits and Liability Premiums!
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) under consideration that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations.

This week MSSNY President Dr. Malcolm Reid participated in a “roundtable” discussion with Senate Majority Leader Flanagan, Senate Deputy Majority Leader DeFrancisco and Senate Health Committee Chair Hannon to have a frank discussion regarding the implications of this proposal on New York’s health care system.   Other participants in the roundtable included representatives of the New York State Trial Lawyers Association, Greater New York Hospital Association, HANYS, MLMIC, PRI, NY-ACOG, the NYS Society of Plastic Surgeons and other specialty societies.

Dr. Reid emphasized the extremely difficult practice environment that New York physicians already face in light of already exorbitant medical liability premiums, and rapidly transitioning and dwindling payments from insurers and Medicare.  He specifically noted a recent Wallet Hub study concluding that New York is the worst state in the country in which to practice medicine, a practice environment that will only get far worse if this bill was permitted to pass.  Hospital representatives highlighted that New York’s hospitals have the second worst operating margins in the country.

In light of the huge financial pressures already facing physicians prompted by excessive government mandates, reduction in insurer payments and networks, and rapidly rising patient cost-sharing responsibilities, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients.

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined GNYHA and  HANYS in an ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.   The ads  have appeared in City & State, Politico New York, and the Albany Times-Union.

Please remind your legislators of the seriously adverse consequences to patient care should this legislation be enacted!   (AUSTER, DEARS)


Legislation to Make Reasonable Changes to ERX Law on Senate Floor; Physician Action Needed
Legislation (S. 7801, Hannon) to address several issues which have arisen as part of the implementation of the e-prescribing law is on the Senate floor and is poised for passage. Physicians should send in a letter to urge their representative’s support for the bill by clicking on the this link.

Specifically, the bill would enable a pharmacy that receives an electronic prescription for a non-controlled substance to transfer the prescription to an alternative pharmacy at the request of the patient when the pharmacy receiving the prescription is unable to fill it. The bill would also prohibit pharmacies from requesting a physician to renew a patient’s prescription in a manner that is inconsistent with the e-prescribing law.

This is meant to address misleading pharmacy fax-back forms that haven’t been amended to reflect current law that prohibits a prescriber from faxing or calling in a prescription unless a statutory exception is being invoked. Importantly, the bill would also eliminate exposure to criminal penalty in the event that a prescriber fails to adhere to the requirements of the e-prescribing law.  It is anticipated that similar legislation will be introduced in the Assembly next week.
(DEARS, AUSTER)


Legislation to Reduce E-Prescribing Exception Reporting Burden Needs Your Support; Bill on Floor in Both Assembly and Senate
Physicians are urged to contact their legislators  to urge that they support legislation (A. 9335A, Gottfried/S. 6779B, Hannon)  to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription.    The bill was reported from the Assembly Codes Committee to the full Assembly this week, and identical legislation is before the full Senate.  It is poised for passage.

The Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because:  their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription.  DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription. This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions.

In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state.  In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.

A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.   It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing requirements went into effect, do not require reporting to the DOH.   The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply. Please urge your legislators to pass this bill by sending a letter located on the MSSNY grassroots action center at the this link.
(DEARS, CLANCY)


Lobby Day Generates Strong Support for Legislation to Enable Override of Insurer “Fail First” Medication Coverage Policies
Concerned about health insurance protocols requiring your patients to “fail first” on certain prescription medications before they are able to take the most medically appropriate medication?  Please send a letter to your legislators in support of legislation (A.2834-B, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.

This week, MSSNY representatives joined representatives of many other physician and patient advocacy groups in a press conference and lobby day in support of this critically needed legislation.  The activities generated significant press activity regarding this legislation, including articles in the Albany Times Union, Politico New York, CBS 6 Albany, and Time Warner Cable News.                                                (AUSTER, DEARS)


Aid in Dying Legislation Passes NYS Assembly Health Committee
By a vote of 14-11, legislation that would enable a terminally ill patient to request and use medication passed out of the Assembly Health Committee.  A. 10059/ S. 7579, sponsored by Assemblywoman Amy Paulin and Senator Diane Savino, has been referred to the Assembly’s Codes Committee.  The measure is still in the Senate Health Committee.  David C. Leven, Executive Director of End of Life Choices New York, an organization who is advocating for the legislation, indicated in a statement following the Assembly Health Committee vote,  that the legislation would not be acted on before the end of session in June.   The Medical Society of the State of New York issued a memo of opposition to this legislation based on its position on physician assisted suicide.                                                          (CLANCY)


CME Mandate Bill Passes Assembly Health Committee; Now on Assembly Floor for Action
Senate Bill 4348/Assembly Bill 355, sponsored by Senator Kemp Hannon and Assemblywoman Linda Rosenthal and which would create a continuing medical education mandate for practitioners with prescribing privileges has passed the Assembly Health Committee and is now before the full Assembly and can be voted at any time.  The measure has already been approved by the full Senate.

Under the bill’s provisions, every two years, physicians would need to complete three hours of continuing medical education that involves pain management. The curricula must include but is not limited to: I-STOP and drug enforcement administration requirements for prescribing control substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; preventative, screening and signs of addiction; responses to abuse and addiction; and end-of-life care.

MSSNY has strongly opposed this measure in previous legislative sessions. While continuing medical education is valuable to physicians in keeping up-to-date on new clinical information, and physicians throughout the state voluntarily take continuing medical education for continued professional development in those areas that pertain to their individualized practice, this bill fails to recognize that the Medical Society of the State of New York, the specialty societies, the American Board of Medical Specialties, and the American Osteopathic Association have all been aggressively promoting voluntary CME on pain management and that there is other course work that addresses many of the above issues.  Moreover, this mandate could potentially apply to many physicians who do not regularly prescribe opioid medications.                      (CLANCY, DEARS)


Bill to Limit Pain Medication in Assembly Codes Committee; Physicians Urged to Act
S. 6091-B/A.8601 – A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald,has moved from the Assembly Health Committee to the Codes Committee. This measure passed the New York State Senate last week. The bill would limit the initial prescription by a physician or other prescriber of Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain.   MSSNY strongly opposes this legislation.

Physician action is needed to prevent this bill from becoming law.  Physicians are urged to call their state Assembly members today and indicate opposition to this measure.

Assemblymembers can be found http://assembly.state.ny.us/mem/

Members of the Assembly Codes Committee are listed here. 

Physicians can also send a letter to their members by logging onto MSSNY’s Grass Roots Action Center here.

This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient by imposing an arbitrary standard not developed by any medical authority.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.   A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.

The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address a patient’s medical condition.  Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.

Furthermore, the development of guidance for pain management must be addressed from the broadest spectrum and be generally applicable to all physician practices without being too specific or proscriptive as to how pain should be treated.                                                   (CLANCY, DEARS, AUSTER, MCPARTLON) 


Lobby Day Advances Efforts to Include E-Cigarettes Under the Clean Indoor Air Act
Yesterday, May 24th, health care organization from across the state and country, including the Medical Society of the State of New York, held a press event and met with legislators to advocate for placing E-Cigarettes under the New York State Clean Indoor Air Act.

Sponsors of the legislation (A.5955/S.2202), Republican Senator Kemp Hannon and Democratic Assemblywoman Linda Rosenthal, spoke in support of bill at the press event; along with teenage members of Reality Check Youth organization, who shared their insights on rampant use among youth populations in both schools and public places across New York State.

The Food and Drug Administration (“F.D.A.”) recently announced regulations that, when in effect, will regulate the manufacture, import, packaging, labeling, advertising, and sale of e-cigarettes and liquid nicotine. Among the new regulations, e-cigarettes must contain a warning label and manufactures must submit a list of ingredients and information on harmful or potentially harmful ingredients to the F.D.A. for consideration during the products approval process.

To send a letter in support of legislation to place E-Cigarettes under the New York State Clean Indoor Air Act click here.                                                                                                                   (MCPARTLON, CLANCY)  


Senate Seeks to Require Fingerprinting and FBI Background Checks For Physician Licensure
Amid recent reports of deficient monitoring and sanctioning of the licensed professions, specifically nurses, with regards to professional misconduct or criminal convictions, Senator Ken LaValle has introduced a bill (S.7791) that would require all Title 8 licensed professions, including physicians, to undergo mandatory FBI background checks and fingerprinting for licensure.

The legislation also seeks to establish a unit within the state Education Department’s Office of the Professions specifically tasked with monitoring and sanctioning the licensed professions.  What’s missing from the legislation is a carve out for physicians and physicians assistants, whose professions are already subject to strict compliance of professional conduct standards through oversight by the Office of Professional Medical Conduct (“OPMC”) within the State Health Department.  Established in 1977, the OPMC is statutorily mandated to investigate every complaint and monitor any legal action taken against a NYS-licensed physician.

With New York State earning marks as the worst state in the country to practice medicine, now is not the time to force a duplicative sanctioning body upon physicians; or to mandate FBI criminal background checks and fingerprinting for licensure—a measure even our neighboring states, including Massachusetts, Vermont, and Pennsylvania do not currently required.  The Medical Society of the State of New York strongly opposes this legislation. (MCPARTLON)


Previously Vetoed Legislation in Assembly and Senate Higher Education Committees
The purported “Title Bill” for certified registered nurses (“CRNA”), which was previously vetoed by Governor Cuomo in 2012,  is back again for consideration in both houses’ higher education committees (A. 140-A, Paulin/ S.7166-A, Gallivan). Worse yet, the language is nearly identical to language from a bill vetoed last year and once more contains no provisions on scope of practice, and supervision/oversight requirements by physicians. CRNA’s have sought for years to be able to practice independently of physicians, and when viewed in conjunction with other legislation which seeks to permit direct reimbursement to CRNA’s for anesthesia services, this bill is a major step in that direction. The Medical Society of the State of New York strongly opposed this legislation.                      (MCPARTLON)


Ensuring Medicare Home Health Eligibility: The Shared Responsibility Across the Continuum of Care – Webinar Hosted By National Government Services (Ngs)—June 2nd From 10-11:30am
A free webinar on Medicare home care eligibility and documentation requirements for all settings of care will be held June 2, from 10 to 11:30 a.m., by Medical Society of the State of New York, HANYS, Home Care Association of New York State, and National Government Services (NGS).

REGISTER HERE

CMS requires that establishing patients’ Medicare eligibility and supplying supporting medical record documentation for post-acute home care services be a shared responsibility between referring providers—hospital, nursing home, and practitioners—and the receiving home care agency.

The referring entity—hospital or nursing home—and ordering practitioner must review and document the patient’s status at the time of discharge in the context of Medicare’s home care eligibility criteria, and provide that information as part of the patient transition to the receiving home care agency.

All staff involved with planning and implementing a patient’s transition to post-acute home care services are urged to attend this valuable program.
(MCPARTLON) 


Physician Action Urged to Oppose Federal VA Rule Change to Permit Independent Nurse Anesthetist Practice in the VA Health System
The Veterans Administration this week issued a proposed rule that would allow Advanced Practice Nurses (APRNs) (nurse anesthetist, nurse practitioner, nurse midwife, clinical nurse specialist) to practice independently within the VA health system.  The proposed rule would not change state law on APRN practice outside of VA facilities.

AMA Board Chair Dr. Stephen Perlmut issued a statement expressing great disappointment in the proposal by the VA including noting that “While the AMA supports the VA in addressing the challenges that exist within the VA health system, we believe that providing physician-led, patient-centered, team-based patient care is the best approach to improving quality care for our country’s veterans. We feel this proposal will significantly undermine the delivery of care within the VA. With over 10,000 hours of education and training, physicians bring tremendous value to the health care team. All patients deserve access to physician expertise, whether for primary care, chronic health management, anesthesia, or pain medicine.”  To read the full AMA statement, click here.

The American Society of Anesthesiologists has set up a webpage to give physicians the opportunity to let the VA and their federal legislators know of its concern with this proposed rule. Physicians are encouraged to do two things to help ensure that we maintain safe care for our nation’s veterans:

  • Go here and click on the text that reads “Take action today …” This will allow you to send your legislators a message urging them to protect VA care.
  • Go here  to submit a comment. Pre-drafted text is available, but you are encouraged to include personal stories about your experiences in the operating room, including the crucial role of the physician anesthesiologist in an environment where seconds count. After completing the contact information, click “Submit.” When the proposal is entered into the Federal Register, your comments are automatically entered.

Take action now, for yourself, your profession, and, most importantly, for our veterans! 
(AUSTER, DEARS)


New York Kicks Butts Campaign to Be Held May 31-June 6th
The Medical Society of the State of New York has joined with the American Cancer Society, the American Lung Association, and Tobacco Free Kids and a variety of other affiliated health organizations and businesses to encourage New York City residents to quit smoking.  The New York Kick Butts campaign will be held May 31-June 6th and New York City physicians are asked to discuss with patients smoking cessation treatment options.  By offering medication and counseling, physicians can help patients to double their quit rates.

Helpful tools can be found on line at PlanMyQuit.com/NYC or by calling the New York State Smokers’ Quit line at 1-866-NY-QUITS (697-8487) or by just dialing 311.   Additional resources can also be found at NYSmokeFree.com.  Physicians can find an information flyer here.

Patient information here.

There is also a new 5 Steps to Quit Smoking flier in both ENGLISH and SPANISH found on the resources page of nykicksbutts.org.  Additional information can also be found here.
(CLANCY)


Zika CME Webinar to Be Held June 8 At 6 P.M.; Physician Registration Now Open
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story–UPDATE” on Wednesday June 8th  at 6 p.m.   Registration for this program is now open here.

Click on the upcoming tab and select the programs.

MSSNY conducted the original program in March 2016, but this program will provide updates to the ever changing story of Zika. The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection; 2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)


PTSD and TBI in Returning Veterans:  June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on two remaining dates listed below from May through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic growth

To register for this program, click on a date below and fill out the registration form

Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                         (ELPERIN, DEARS)

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.org
pclancy@mssny.org jmcpartlon@mssny.org

 

 

 

 

 

 

 

 

 

 

 

 

 

 

May 20, 2016 – Date of Discovery on Table NOW!

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
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May 20,  2016
Volume 16, Number 19

Dear Colleagues:

This week, I was in Albany with almost 100 other physicians representing their specialty medical societies together with MSSNY.  We walked the halls of the State Capitol to advocate on issues near and dear to all New York physicians, regardless of specialty, location of practice, or region.

Of significant importance was our collective advocacy against a date of discovery exception to our statute of limitations. Actuarial analysis of such a bill shows that it will increase medical liability premiums by as much as 15%.

Given that our medical liability premiums far exceed premiums paid by our colleagues anywhere in the nation, and that New York leads the rest of the country in the amount of total medical liability payouts, we physicians and hospitals simply cannot absorb higher premium costs.  Many of the legislators with whom we met had not yet made a decision on whether to support the bill.

As I wrote last week, that’s why it is imperative that we all let our legislators know the huge adverse impact to our health care system if this legislation is enacted.

You can send a letter from right here.

As a group, we also urged support for meaningful changes to the e-prescribing law and urged the defeat of legislation that would inappropriately expand the scopes of practice of many non-physician health professionals.  With so much happening at the end of a legislative session, we urge that you take the time to read our MSSNY Enews carefully, follow our Twitter and Facebook posts, and contact your legislators immediately where we request it.

There are thousands of bills under consideration by lawmakers in Albany, many of which we oppose.

Please remember that your action can really be the difference between a bill passing or not, and is absolutely critical to our success!

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


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Do Not Wait – Tell Your Legislators to Reject the 15% Medical Liability Tax Proposal
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule.   A letter to your Senator and Assemblymember can be sent from here.  In light of the huge financial pressures already facing physicians prompted by excessive government mandates, reduction in insurer payments and networks, and rapidly rising patient cost-sharing responsibilities, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients.

This message was reiterated to legislators in the State Capitol this week as many physicians representing MSSNY and different specialty societies came to Albany to advocate to address concerns shared across the profession.

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.   The ads have appeared in City & State, Politico New York, and the Albany Times-Union.

Please remind your legislators of the seriously adverse consequences to patient care should this legislation be enacted!

Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  Several patient and physician advocacy organizations including MSSNY representatives will be participating in a press conference (along with the bill sponsors) and lobby day this Monday, May 23 to generate action on this legislation before the Session ends in four weeks.  To send a letter in support of this legislation click here.                                  (AUSTER, DEARS)

Legislation to Reduce E-Prescribing Exception Reporting Burden Needs Your Support; Bill on Assembly Codes Committee this Tuesday
Physicians are urged to contact their legislators to urge that they support legislation (A. 9335A, Gottfried) to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription.  The Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because:  their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription.  DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription. This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions. In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state.  In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.

A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.   It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing went into effect, do not require reporting to the DOH.   The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply.  This legislation has passed the Senate twice but remains stalled in the Assembly Codes Committee.

Please urge your legislators to pass this bill by sending a letter located on the MSSNY grassroots action center.                                              (DEARS, CLANCY)

CME Mandate Bill Passes NYS Senate; on Health Committee
Senate Bill 4348/Assembly Bill 355, sponsored by Senator Kemp Hannon and Assemblywoman Linda Rosenthal and which would create a continuing medical education mandate for practitioners with prescribing privileges passed the New York State Senate this week and is on Assembly Health Committee for Monday. It is important for physicians to contact their elected representative to urge that they vote against this mandate! Call and send an email through MSSNY’s Grassroots Action Center by going here.

Under the bill’s provisions, every two years, physicians would need to complete three hours of continuing medical education that involves pain management. The curricula must include but is not limited to: I-STOP and drug enforcement administration requirements for prescribing control substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; preventative, screening and signs of addiction; responses to abuse and addiction; and end-of-life care.

MSSNY has strongly opposed this measure in previous legislative sessions. While continuing medical education is valuable to physicians in keeping up-to-date on new clinical information, and physicians throughout the state voluntarily take continuing medical education for continued professional development in those areas that pertain to their individualized practice, this bill fails to recognize that the Medical Society of the State of New York, the specialty societies, the American Board of Medical Specialties, and the American Osteopathic Association have all been aggressively promoting voluntary CME on pain management and that there is other course work that addresses many of the above issues.  Moreover, this mandate could potentially apply to many physicians who do not regularly prescribe opioid medications.                                        (CLANCY, DEARS)

Bill to Limit Pain Medication Passes NYS Senate; Moves Out of Assembly Health Committee;

  1. 6091b/A.8601-A, sponsored by Senator Kemp Hannon and Assemblymember John McDonald, passed the New York State Senate this week. The bill would limit the initial prescription by a physician or other prescriber of Schedule II or III Controlled Substances, to a 5-day supply for patients suffering acute pain. MSSNY strongly opposes this legislation.

Despite substantial opposition, the bill was reported from the Assembly Health Committee to the Codes Committee.  MSSNY thanks the following members of the Health Committee for voting against the bill:

Edward Braunstein (D-Queens); Janet Duprey (R-Clinton County); Andrew Hevesi (D-Queens); Charles Lavine (D-Nassau County); David McDonough (R-Nassau County); Crystal People-Stokes (D-Erie County); Andrew Raia (R-Suffolk County); Robin Schimminger (D-Erie County); Phil Steck (D-Albany/Schenectady counties); Matthew Titone (D-Staten Island); Ray Walter (R-Erie/Niagara Counties)

Physician action is needed to prevent this bill from becoming law.  Physicians are urged to call their state assembly members today and indicate opposition to this measure.

Assemblymembers can be found here.
Members of the Assembly Codes Committee are listed here.

Physicians can also send a letter to their members by logging onto MSSNY’s Grass Roots Action Center.

This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient.   Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.   A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.

The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address a patient’s medical condition.  Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.

Furthermore, the development of guidance for pain management must be addressed from the broadest spectrum and be generally applicable to all physician practices without being too specific or proscriptive as to how pain should be treated.                                                    (CLANCY, DEARS, AUSTER, MCPARTLON)

NYS Senate Issues Opiate Report and Passes Numerous Legislative Proposals; Governor’s “Listening Tour” on Opioid Abuse To Continue Through Next Week
The New York State Senate Joint Task Force on Heroin and Opioid Addiction on May 17, 2016 released its report legislative recommendations to address shortcomings in the state’s existing opioid prevention and treatment-delivery strategies. There were 35 legislative proposals that the task force recommended that the Senate take action.  The majority of these proposals passed the Senate on the same day that the report was issued.

While the recommendations contained a number of important initiatives to address the opioid abuse epidemic, it also called for the enactment of several measures opposed by MSSNY including:

  • An across the Board pain management CME mandate;
  • A 5-day limit on an initial prescription for a Schedule 2 or 3 controlled substance to address acute pain;
  • Statutorily mandating, prior to prescribing a Schedule 2 controlled substance, that physicians document that they advised their patients the risks of taking such medications

For a review of the report and the legislative proposal go here.

Additionally, a series of “listening tours” have been held throughout the week and are expected to go through next week across by Governor’s Andrew Cuomo’s Task Force.   It is expected that the Governor will release his findings by June and it is expected that it will contain legislative proposals to address the opioid issue. (CLANCY)


Health Care Organizations Urge Inclusion of E-Cigarettes in Clean Indoor Air Act—Advocacy Day To Be Held May 24th
A group of health care organizations, including the Medical Society of the State of New York, have come together to advocate for the placement of E-Cigarettes under the New York State Clean Indoor Air Act. The group, comprised of national and state organizations includes the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Roswell Park Cancer Institute, New York State Association of County Health Officials, Campaign for Tobacco-Free Kids, New York State Public Health Association, and the Medical Society of the State of New York, among others.

While New York State has prohibited the sale of E-Cigarettes to minors under the age of 18, indoor use of E-Cigarettes in public places is still permitted. MSSNY supports legislation and urges its members to support legislation (A.5955, Rosenthal/S.2202, Hannon) to place E-Cigarettes under the New York State’s Clean Indoor Air Act.

To send a letter in support of this legislation click here.                                  (CLANCY, MCPARTLON)


New York Kicks Butts Campaign to Be Held May 31-June 6th
The Medical Society of the State of New York has joined with the American Cancer Society, the American Lung Association, and Tobacco Free Kids and a variety of other affiliated health organizations and businesses to encourage New York City residents to quit smoking.  The New York Kick Butts campaign will be held May 31-June 6th and New York City physicians are asked to discuss with patients smoking cessation treatment options.  By offering medication and counseling, physicians can help patients to double their quit rates.

Helpful tools can be found on line at PlanMyQuit.com/NYC or by calling the New York State Smokers’ Quit line at 1-866-NY-QUITS (697-8487) or by just dialing 311.   Additional resources can also be found at NYSmokeFree.com.  Physicians can find an information flyer here.

Patient information here.

There is also a new 5 Steps to Quit Smoking flier in both ENGLISH and SPANISH found on the resources page of nykicksbutts.org.  Additional information can also be found here.
(CLANCY)


CMS Administrator Seeks to Allay Concerns About Disparate Impact of Medicare VBP Programs on Smaller Physician Practices
CMS Acting Administrator Andy Slavitt testified before the US House Ways and Means Committee to address concerns raised by many Representatives regarding the impact to small physician practices of the proposed rule to implement the MIPS value-based Medicare payment program enacted by Congress last year. 

Slavitt was responding to concerns expressed by many physician organizations, including MSSNY, regarding the chart on p.676 of the proposed regulation that concluded that the overwhelming majority of solo and small physician practices would face cuts under the MIPS program.  Specifically, he noted that    “Despite what the table shows, data shows that physicians in small and solo practices can do just as well as in practices larger than that”.  Moreover, he noted that the now infamous p.676 chart was skewed because it was based upon Medicare reporting data from 2014, when many small practice physicians did not even report on quality measures, but that “reporting will get far easier going forward”.  This includes the “opportunity to report in groups and in a more automated way”.

In conjunction with the testimony, last week CMS also released a “fact sheet” that details the flexibility and support available to assist small and rural physician practices in participating in the MIPS and APM Medicare value-based payment components of the MACRA law passed by Congress in 2015, and which will be applicable to patient care delivered in 2017.  The “fact sheet” is available here.

The CMS fact sheet  highlighted the proposed exemptions from the MIPS payment adjustment for physicians who have less than or equal to $10,000 in Medicare charges and less than or equal to 100 Medicare patients, as well as changes to the existing PQRS and Meaningful Use reporting requirements to reduce some of the hassles smaller practice physicians have experienced.  Furthermore, CMS staff reiterated these points in a conference call convened by the AMA with state medical societies this week.

To read a brief, but detailed, AMA summary of the proposed regulations, click here.

And to view a high level summary of the proposed regulation from CMS, click here.

Please take the opportunity to review these documents and share with us your comments and concerns.

While payment adjustments under the MIPS and APMs will not be applied to physician Medicare payments until 2019, the positive or negative adjustments will be based upon care delivered to Medicare patients in 2017.  Beginning in 2019 under MIPS, Medicare payments could be adjusted up or down by 4%, and up to +/- 9% by 2022, with additional bonus payments possible for “exceptional performance”.

Comments on the proposed regulation are due to CMS by June 27.  MSSNY will be working with the AMA, specialty medical associations and other state medical associations on developing comments to CMS to address concerns with the proposal.
(AUSTER)


Ensuring Medicare Home Health Eligibility: The Shared Responsibility Across The Continuum of Care 

WEBINAR HOSTED BY NATIONAL GOVERNMENT SERVICES (NGS)—JUNE 2ND FROM 10-11:30AM

REGISTER HERE

A free webinar on Medicare home care eligibility and documentation requirements for all settings of care will be held June 2, from 10 to 11:30 a.m., by Medical Society of the State of New York, HANYS, Home Care Association of New York State, and National Government Services (NGS).

CMS requires that establishing patients’ Medicare eligibility and supplying supporting medical record documentation for post-acute home care services be a shared responsibility between referring providers—hospital, nursing home, and practitioners—and the receiving home care agency.

The referring entity—hospital or nursing home—and ordering practitioner must review and document the patient’s status at the time of discharge in the context of Medicare’s home care eligibility criteria, and provide that information as part of the patient transition to the receiving home care agency.

All staff involved with planning and implementing a patient’s transition to post-acute home care services are urged to attend this valuable program.

Online registration for this June 2 webinar is provided by NGS. Registrants are invited to email their pre-webinar questions for speakers to jmcpartlon@mssny.org before May 26.

REGISTER HERE.
(MCPARTLON)


Zika CME Webinar to Be Held June 8 at 6 P.M.; Physician Registration Now Open
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story–UPDATE” on Wednesday June 8th  at 6 p.m.   Registration for this program is now open here. Click on the upcoming tab and select the programs.

MSSNY conducted the original program in March 2016, but this program will provide updates to the ever changing story of Zika.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD, Medical Director, Division of Epidemiology from the New York State Department of Health will conduct this presentation.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)


PTSD and TBI in Returning Veterans:  June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on two remaining dates listed below from May through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic growth

To register for this program, click on a date below and fill out the registration form

Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                          (ELPERIN, DEARS)

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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

enews large

Majority of Patients Happy with Primary Care Physicians
The physician-patient relationship remains strong, with nine out of 10 U.S. adults noting high levels of satisfaction with their primary care physician (PCP). This is according to a new national patient survey commissioned by the Physicians Foundation, of which MSSNY is a charter member. However, patients cite increasing concern and frustration with their ability to manage rising healthcare costs and medical debt, with many indicating that they have avoided treatment plans, routine or specialty check-ups, or prescriptions as a result. These behaviors have far reaching implications relative to healthcare access, costs, resource utilization and overall patient health outcomes.

According to the research, 95 percent of patients surveyed are satisfied or very satisfied with their PCP’s ability to explain information in a manner they understand, while 96 percent feel their physicians are respectful of them. Moreover, 93 percent were satisfied or very satisfied with how well their PCP listened to them during their most recent exam, with 92 percent noting high levels of satisfaction relative to how well their doctor knew their medical history.

However, the findings show that patients who saw a primary care physician for their most recent routine exam are not fully adhering to treatment plans, avoiding routine check-ups or opting not to take prescription medication due to rising healthcare costs. Sixty-two percent of U.S. adults are concerned with being able to pay for medical treatment if they get sick or injured. Almost half (48 percent) are not confident they could afford care should they become seriously ill. In addition, more than a quarter of U.S. adults (28 percent) have skipped a medical test, treatment or follow-up or avoided a visit to the doctor for a medical problem in the past 12 months because of costs. Twenty-seven percent of patients have avoided filling a prescription in the past 12 months, noting costs as a primary factor.

More Physicians Participating In Direct Primary Care Model
The AP (5/19) reports more and more physicians “have begun to provide subscription-like service to patients, a model known as direct primary care,” which allows patients to pay a fixed monthly fee, and receive unlimited visits. Like “concierge medicine for the rich, direct primary care can appeal to middle and low-income patients who struggle with high deductibles or can’t afford insurance at all.” The article mentions a Virginia physician who charges a monthly fee of $60 for people over 31, $30 for adults 30 and under, and $15 for children whose parents participate in his program.


Trial Supports Intensive BP Lowering in Nondiabetic Elders
Intensive blood-pressure reduction lowers cardiovascular events and mortality in nondiabetic older adults, according to a prespecified subanalysis from SPRINT. The findings were published in JAMA and presented at the American Geriatrics Society’s annual meeting.

In SPRINT, roughly 2600 adults aged 75 and older with increased CV risk but without diabetes or histories of stroke were randomized to intensive BP control (systolic target,

The researchers calculated that 25% of cancers in women and 33% in men might not have occurred if everyone adopted the healthy lifestyle. Similarly, 48% of cancer deaths in women and 44% in men might have been averted. When comparing the healthy group to the U.S. white population in general, the reductions were even greater. Lung and esophageal cancers saw the greatest reductions.

Editorialists write: “As a society, we need to avoid procrastination induced by thoughts that chance drives all cancer risk or that new medical discoveries are needed to make major gains against cancer, and instead we must embrace the opportunity to reduce our collective cancer toll by implementing effective prevention strategies and changing the way we live.”

JAMA Oncology article (Free)

JAMA Oncology editorial (Free) 


Marijuana Licensees Looking to Expand Prescribers to PAs and NPs
The five companies awarded licenses to grow and sell medical marijuana in New York have joined forces to lobby lawmakers for changes to the state’s Compassionate Care Act.

“We’re going around giving an update to the program [and] sharing some of our impressions and talking about ways that we think the program can be improved,” said Ari Hoffnung, chief executive officer of Vireo Health, one of the five companies that have formed the Medical Cannabis Industry Association.

The four others are PharmaCann, Etain, Columbia Care and Bloomfield Industries.

One of the changes to the law the group will lobby for is to allow nurse practitioners and physician assistants to certify seriously ill patients to be eligible for medical marijuana. As it’s written, the law only allows physicians to certify patients. (Politico, 5/18)


CMS Offering YouTube Program for Innovation Day on Tuesday, May 24

Transforming Clinical Practice Initiative

Are you a clinician or health care professional who wants to:

  • Maximize your understanding of Medicare reimbursement changes?
  • Utilize quality measures and use the data for practice improvement?
  • Optimize the health outcomes of your patients?
  • Strategize with like-minded health care professionals on practice efficiencies?

If you answered “yes” to any of these questions, then you need to be at Innovation Day on May 24th to learn from leaders in practice transformation!

Click here to register.

  • Date: May 24, 2016
  • Time: 10 a.m. – 3:45 p.m. ET (Registration opens at 9 a.m.)
  • Presenters:
  • CMS
  • American College of Physicians
  • Health Partners of Delmarva
  • National Nursing Centers Consortium
  • QIN-QIO Telligen
  • VHQC
  • Vizient Alliance

Join on YouTube

For more information on the TCPI, click here.


NYC Pharmacy Offers Two- Hour Delivery Just for Prescription Drugs
The New York Post (5/17, Covert) reports that even though there is “a Duane Reade seemingly on every corner,” Capsule, a new pharmacy startup, “believes there is a better, faster and cheaper way to deliver prescription drugs.” The company is launching in New York City today, “promising free, two-hour delivery for prescriptions anywhere in the city except Staten Island.” The company will operate from one location in Manhattan, “a strategy that will not only slash its rent but help prevent out-of-stock medications, co-founder and CEO Eric Kinariwala told The Post.” In addition, the company will only offer prescription drugs, rather than also offering other “drugstore staples.”


JAMA: 30% of Top Women Clinician-Researchers Experienced Sexual Harassment
A research letter published in JAMA on Tuesday in which researchers discussed a survey that found that up to “30 percent of top women clinician-researchers have experienced blatant sexual harassment on the job.” The researchers also found that 66 percent of women who responded to the survey recount personal experiences of gender bias, and 70 percent say they perceived gender bias in the field. Among the 1,700 male and female participants, only 10 percent of men reported gender bias. Prescription Medicine Delivery Service Launches Today In New York City.


CLASSIFIED


121 EAST 60TH ST – 6TH FL OFFICE ROOM FOR RENT
Professional Co-op office in an established part time Doctors office. Recently re-done, waiting area with a full time receptionist for your clients. The elegant lobby is attended 24-hours and offers live operator answering service for your clients, and more. Available Monday through Sunday (Monthly $2,000). Please call to schedule an appointment. 212-355-7017
121 E 60thst

Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581


Recently Renovated Medical Office Space Available June, 2016
Desirable Midtown Manhattan Building located between Park and Madison Avenues. Please Call Mr. Mel Farrell At 212. 696.7107 for further information.


Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!


Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities

Columbia University – Associate Vice President for Health Services
Reporting to the Vice President for Campus Services, the Associate Vice President for Health Services (AVP) provides leadership for health policy, programs, outreach, facilities, finances, and health programming on the Morningside Campus of Columbia University. Serving the total health, health information, disability, sexual assault, sexual misconduct, and wellness needs of over 25,000 students, the AVP serves as a principal advisor on health affairs to the Vice President for Campus Services, the Executive Vice President for Facilities & Operations, and the Senior Executive Vice President.

The position requires a minimum of 10 years experience in health/human services or a related setting with at least five years of senior leadership at a director level or above. MD, DO, PhD, or equivalent clinical degree in a health related field is required. Additional requirements include: experience in crisis management coupled with ability to manage confidential information in a sensitive manner and use of sound judgment; ability to manage and lead collaboration with diverse constituencies, including traditionally underserved communities; demonstrated ability to provide leadership in complex institutions and to work with health providers and a wide range of University and contracted personnel; and evidence of strong customer service orientation with proven methods of soliciting, responding to, and managing feedback.

Review of applications will begin June 6, 2016, and will continue until the position is filled. The full position announcement, including application instructions, is available on the Spelman Johnson website at http://www.spelmanandjohnson.com/position/associate-vice-president-health-services 

Columbia University is an equal opportunity/affirmative action — Race/Gender/Disability/Veterans employer.


New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=


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

 

 

 

 

 

 

 

 

 

 

 

 

 

May 13, 2016 – Want Higher Premiums? Do Nothing!

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

May 13,  2016
Volume 16, Number 18

Dear Colleagues:

As you may have seen in our MSSNY E-news publications, we face a threat like never before from the State Legislature which is weighing whether to pass a bill (A.285-A/S.6596) to greatly lengthen the medical malpractice Statute of Limitations. We have been informed that this bill, if enacted, could increase our already outrageously high premiums by another 15%.

Just imagine the impact that an increase of that nature will have on the ability of your practice or your hospital to be able to continue to deliver the care your patients expect.

Will you be able to invest in or afford needed upgrades to your electronic medical record system?

Will you be able to make other technological investments to enhance the services or treatments you can provide to your patients?

Will you even be able to continue to pay your staff?

Given New York’s already difficult practice environment, this bill will unquestionably drive many physicians out of New York.  Additionally, it could greatly exacerbate the already tenuous financial situation that faces many New York hospitals. 

We Are Waging War

To counter this threat, we have been waging an aggressive public relations and advocacy campaign along with specialty societies, hospitals, and even other provider groups, to remind legislators of the already overwhelming costs our health care system face – far more than other states – and why enactment this bill could have a dramatically negative impact on the ability of our patients to obtain timely needed care.  Our ads have appeared in numerous publications regularly read by legislators and other health care policy thought leaders.

But we really need you to actively join us in this fight.

I thank the many of you who have already answered our call to contact your Senators and Assemblymembers to urge them to oppose this bill, and to instead enact comprehensive medical liability reform.  However, we need many more physicians to call and write their legislators in overwhelming numbers to be sure these legislators truly understand the gravity of this legislation and the impact to patients in the communities they represent were this legislation to be enacted.

Please continue to send letters from the MSSNY Grassroots site here.

But do not stop there.  You must also take the time to call your legislators.  A personal conversation can often be more powerful and resonate more loudly than a letter. If you need more information to assist you when making these calls, you can go to this page on the MSSNY website to help you.

Our campaign will not only involve “grassroots” but also “grasstops.”  In this regard, we will be working with county medical society leaders to contact physicians across the State whom we know have close relationships with key legislators.

Please make these contacts as soon as possible.  Our ability to continue to be able to be there for our patients is directly tied to the extent to which we are willing to stand up for our patients and profession.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


Capital_Update_Banner

Tell Your Legislators; We Can’t Tolerate Any Further Increases to Our Outrageously High Liability Premiums!
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could increase by another 15% your already exorbitant medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule.   A letter to your Senator and Assemblymember can be sent from here.

In light of the huge financial pressures already facing physicians prompted by excessive government mandates, reduction in insurer payments and networks, and rapidly rising patient cost-sharing responsibilities, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients.

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.   The ad  has appeared in City & State, Politico New York, and the Albany Times-Union.

Please remind your legislators of the seriously adverse consequences to patient care should this legislation be enacted!  (AUSTER, DEARS)

Governor Establishes Task Force to Combat Heroin
Governor Andrew M. Cuomo has established a statewide heroin task force charged with ending the heroin and opioid crisis in New York. The group, comprised of a broad coalition of experts in healthcare, drug policy, advocacy, education, and parents and New Yorkers in recovery, will build on the state’s previous efforts and use their expertise and experience to develop a comprehensive action plan to combat the state’s opioid epidemic.

Members of the task force include: Kathy Hochul, Lieutenant Governor, co-chair; Arlene Gonzalez-Sanchez, NYS OASAS Commissioner, co-chair; Maria Vullo, Acting NYS DFS Superintendent; Dr. Howard Zucker, NYS DOH Commissioner; Joshua Vinciguerra, NYS DOH, Bureau of Narcotic Enforcement Director; Michael Green, NYS DCJS Executive Commissioner; Lt. Colonel Frank Kohler, Lead on Heroin/Opioids, NYS State Police; Tino Hernandez, President, Samaritan Village; Daniel Raymond, Policy Director, Harm Reduction Coalition; Charles Brack, Peer/Family Support Specialist, United Healthcare;  Patrice Wallace-Moore, CEO of Arms Acres; Michael McMahon, Richmond County District Attorney; Adrienne Abbate, Executive Director, SI partnership for Community Wellness; Kym Laube, Executive Director, Human Understanding & Growth Services; Dr. Jeffrey Reynolds, President and CEO of Family and Children’s Association; Anne Constantino, CEO of Horizon Health Services; Cortney Lovell, Director, Wrise Consulting; Susan Salomone, Executive Director of Drug Crisis in Our Backyard; Patrick Seche, Director of Services, Addiction Psychiatry, University of Rochester Medical Center; Jerald Woolfork, VP for Student Affairs at SUNY Oswego; Tom O’Brien, Roxbury Schools Superintendent’ Terrence Murphy, NYS Senate; Linda Rosenthal, NYS Assembly.

The task force is expected to go on a “listening tour”  as early as next week.  The task will identify ways to expand awareness of heroin and opioid addiction; enhance statewide prevention efforts; increase access to treatment; and improve support for those in recovery.     (CLANCY, DEARS)

Bill to Limit Pain Medication on The Assembly Health Committee; Moving in Senate
A.8601-A, sponsored by Assemblymember John McDonald, is on the Assembly Health Committee agenda this Tuesday, May 17.  The bill would limit the initial prescription by a physician or other prescriber of Controlled Substances, Schedule II or III, to a 5-day supply for patients suffering acute pain.   The Medical Society of the State of New York is opposed to this measure.  Its companion measure, S.6091B, sponsored by Senator Kemp Hannon, is on the Senate calendar and can be voted on at any time.   This legislation would effectively prevent a physician from exercising his/her clinical judgement on behalf of the patient.

Moreover, this action would set a dangerous precedent in New York State and represents an enormous encroachment of the New York State Legislature into the practice of medicine.   A physician’s clinical judgment in addressing the unique needs of the individual patient should always prevail to ensure that patients receive the most appropriate and effective medication in a timely manner.

The Medical Society agrees with the concerns expressed by some that there have been instances when prescribers have authorized doses for opioid medications in excess of what was needed to address that  patient’s medical condition.  Therefore, to address this concern, MSSNY has been working with the American Medical Association and other state medical societies across the country to urge Congress to pass legislation that would enable a physician to authorize a “partial fill” of a controlled substance prescription, thereby reducing the likelihood of unused medications being left in medicine cabinets.

Furthermore, the development of guidance for pain management must be addressed from the broadest spectrum and be generally applicable to all physician practices without being too specific or proscriptive as to how pain should be treated.

Physician action is needed to prevent this bill from becoming law.  Physicians are urged to call their state senators and assembly members today and indicate opposition to this measure.

Senators can be found here.

Assemblymembers chttps://www.nysenate.gov/senators-committees.an be found here.

Members of the Assembly Health Committee are listed here.(CLANCY, DEARS, AUSTER, MCPARTLON)


Bill to Expand Athletic Trainer Scope of Practice Pending on Senate Higher Education Committee Agenda
Senate Bill 4499B/Assembly Bill 1266B, sponsored by Senator Rich Funke and Assemblymember Charles Lavine, would require licensure of athletic trainers and significantly expand their scope of practice to and allow athletic trainer to exam, evaluate, assess, manage, treat and rehabilitate a neuromusculoskeletal injuries.  It is on the Senate Higher Education Committee’s Agenda on May 17th.  The bill would also allow for the management and treatment of neurological conditions such as concussions, spinal cord injuries or nerve injuries resulting from participation in an athletic event or in individuals involved in adaptive athletics.   The bill requires an athletic trainer to achieve a master’s level of education by 2025 and would also require continuing education.

The Medical Society of the State of New York believes that athletic trainers have a role in a physician led health care team.   However, scope limitations exist and to ensure that there will not be any harm to patients.  The Medical Society believes that any expansion as articulated in this bill will significantly reduce the quality of care, and potentially cause harm to patients.  Physicians are urged to call members of the Senate Higher Education Committee and urge defeat of this measure.  Committee members may be reached here.(CLANCY, DEARS, MCPARTLON


May 23 Lobby Day in Support Legislation to Enable Override Of Insurer “Fail First” Medication Policies
MSSNY will be participating with a number of other patient advocacy groups in a May 23 Albany Lobby Day in support of legislation (A.2834-B, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override a health insurer “fail first” or “step therapy” protocol when it is in the best interest of their patients’ health.   We strongly encourage physicians concerned about the difficulties their patients face as a result of these “fail first” prescription protocols to come to Albany to participate in this event.

A 2014 MSSNY survey reported that 90% of the responding physicians indicated that health insurer “fail first” protocols for prescription medications “sometimes” adversely affected their patients and 45% indicated that it “frequently” adversely affected patients.

If you are interested in participating in this May 23 event please e-mail mauster@mssny.org.

Last week, an op-ed written by the sponsor of the bill headlined “Assemblyman Titone to Insurers: Stop Playing Doctor” appeared in the Staten Island Advance calling for the State Legislature to enact this common sense legislation.  To send a letter in support of this legislation click here. 
(AUSTER, DEARS)


NYS Assembly Passes Bill to Address Price Gouging of Medications Deemed to Be in Short Supply
The New York State Assembly passed legislation (A.6731, Crespo) this week to add drugs or medical products, publicly listed by the FDA as being “subject to a shortage”, to the list of goods and services that can be subjected to the state’s price gouging laws.  Such designation would empower the New York Attorney General to prosecute cases when these drugs or medical products subject to a shortage are being sold for an “unconscionably excessive” price.  The bill permits the courts to determine when the price for a drug in short supply is “unreasonably excessive” and establishes the criteria for making such determinations.

To read Assembly Speaker Carl Heastie’s press release hailing the passage of the legislation, click here.  The release notes that the bill is seeking to respond to the “many media reports that have documented the impact of ‘gray market’ vendors who purchase from small wholesalers or pharmacies quantities of scarce generic drugs that are then re-sold at prices many times higher than their initial price point”.  Identical legislation (S.4508, Lanza) is before the Senate Consumer Protection Committee.                                                       (AUSTER)

CMS Releases Fact Sheet to Address Concerns About Disparate Impact of Medicare VBP Programs on Smaller Physician Practices
This week CMS released a “fact sheet” that details the flexibility and support available to assist small and rural physician practices in participating in the MIPS and APM Medicare value-based payment components of the MACRA law passed by Congress in 2015, and which will be applicable to patient care delivered in 2017.  The “fact sheet” is available here.

The goal of the fact sheet is to respond to concerns expressed by many physician organizations, including MSSNY, regarding the chart on p.676 of the proposed regulation that concluded that the overwhelming majority of solo and small physician practices would face cuts under the MIPS program.

MSSNY had contacted several key members of New York’s Congressional delegation, including Senator Charles Schumer and House Ways & Means Committee member Tom Reed, to urge them to express concerns to CMS that this could not have possibly been the intention when Congress passed MACRA.

Specifically addressing this concern, CMS noted that it “is sensitive to the unique challenges that small practices face in different types of communities, and the Quality Payment Program as proposed would provide accommodations for various practice sizes and configurations. In addition, CMS is sensitive to the concerns expressed by the proposed rule’s regulatory impact analysis, which was perceived to show that the Quality Payment Program would negatively impact small practices. This regulatory impact analysis is based on 2014 data when many small and solo practice physicians did not report their performance. It also does not reflect the accommodations in the proposed rule that are intended to provide additional flexibility to small practices. This paper details the flexibility and support available to small practices and practices in rural or health professional shortage areas in the proposed rule. CMS is committed to a continued dialogue regarding the obstacles and challenges these practices encounter, both during the rulemaking period and throughout the implementation of the Quality Payment Program.”

The CMS fact sheet also highlights the exemptions from the MIPS payment adjustment for physicians who have less than or equal to $10,000 in Medicare charges and less than or equal to 100 Medicare patients, as well as changes to the existing PQRS and Meaningful Use reporting requirements to reduce some of the hassles smaller practice physicians have experienced.

As reported last week, the AMA has prepared a detailed summary of the proposed regulations, which you can review here.  And to view a high level summary of the proposed regulation from CMS, click here.

Please take the opportunity to review these documents and share with us your comments and concerns.

While payment adjustments under the MIPS and APMs will not be applied to physician Medicare payments until 2019, the positive or negative adjustments will be based upon care delivered to Medicare patients in 2017.  Under MIPS, Medicare payments could be adjusted up or down by 4% beginning in 2019, and up to +/- 9% by 2022, with additional bonus payments possible for “exceptional performance”.

Comments on the proposed regulation are due to CMS by June 27.  MSSNY will be working with the AMA, specialty medical associations and other state medical associations on developing comments to CMS to address concerns with the proposal.   (AUSTER)


US House Passes Several Bills to Address Opioid Abuse
The United States House of Representatives passed 18 separate bills this week to address the opioid addiction crisis in the country.  The bills that passed will now need to be reconciled with measures passed by the United States Senate earlier this year.  Among the bills passed by the House include:

  • R. 4641 which would establish an inter-agency task force to review, modify, and update best practices for pain management and how pain medication is prescribed;
  • HR 4599, to reduce unused medications by enabling a physician to authorize a pharmacy to “partially fill” a prescription for opioid medications;
  • HR 4976, to require the FDA, as part of its evaluation of the Extended-Release/Long-Acting Opioid Analgesics Risk Evaluation and Mitigation Strategy, to develop recommendations regarding education programs for prescribers of opioids. It would also require FDA to finalize the draft guidance entitled “General Principals for Evaluating the Abuse Deterrence of Generic Solid Oral Opioid Drug Products.”
  • HR 5046, to authorize the Department of Justice (DOJ) to award grants to state and local governments to provide opioid abuse services, including: enhancing collaboration between criminal justice and substance abuse agencies; developing, implementing, or expanding programs to prevent, treat, or respond to opioid abuse; train first responders to administer opioid overdose reversal drugs; and investigate unlawful opioid distribution activities.

The full list of bills passed by the House this week to address this issue is available here.
(AUSTER, CLANCY)


NYS Society of Anesthesiology Requests Physician Action Against Department of Veterans Affairs (VA) Rule Change
The NYS Society of Anesthesiology has requested MSNSY physicians to take action to protect your patients and profession. The Department of Veterans Affairs (VA) is about to propose a rule change to allow nurse practitioners to practice independent of physician supervision; nurse anesthetists are included in this group.

Physicians are encouraged to do two things to help ensure that we maintain safe care for our nation’s veterans (please act now);

  1. Go to here and click on the text that reads “Take action today …” This will allow you to send your legislators a message urging them to protect VA care.
  1. Go to this page to submit a comment. Pre-drafted text is available, but we encourage you to include personal stories about your experiences in the operating room, including the crucial role of the physician anesthesiologist in an environment where seconds count. After completing the contact information, click “Submit.” When the proposal is entered into the Federal Register, your comments are automatically entered.

Please encourage your spouse, children, siblings, parents and friends to take this action. Numbers count in our effort to protect the women and men who have sacrificed so much to protect our freedom and safety. Anyone with an e-mail address can comment.

Take action now, for yourself, your profession, and, most importantly, for our veterans!
(DEARS, AUSTER)


AG Offers Assistance to Overcome Insurance Barriers to Needed Substance Abuse and Mental Health Treatment
Attorney General Eric Schneiderman this week announced that his office is offering assistance to address insurance barriers for individuals and families seeking substance abuse and/or mental health treatment.  To read the full press release, click here.

Specifically, the alert encourages those seeking treatment who are facing barriers with their health insurer to call his office’s Health Care Helpline at 1-800-428-9071.  The press release notes that the Helpline has addressed numerous complaints about health plan coverage of mental health care, and has succeeded in many cases with obtaining approval of medically necessary care, or reimbursement where the consumer has paid for mental health care out-of-pocket.  It further notes that any person who is denied substance abuse treatment should:

  • Check the denial letter for accuracy and inform plan of mistakes;
  • Ask the health provider to submit a letter of medical necessity, including facts that show that the patient meets the relevant medical necessity criteria, point-by-point.
  • Request a written, detailed explanation of the denial from the health insurance company.
  • Look for common improper denial flags, such as “fail first” requirements, reduced payments for out-of-network providers, insufficient or incorrect information in denial letters, refusing to provide medical necessity criteria or using criteria that do not match the health condition, and failure to consult with the health provider or consider medical evidence supplied.

The press release further noted that, over the past 2 years, the AG’s Health Care Bureau has signed agreements with five major companies (Cigna, MVP, EmblemHealth, ValueOptions/Beacon, and Excellus), after determining that these companies were not in compliance with federal and state mental health parity laws. It noted that the AG’s investigation found that the companies were improperly denying patients who were seeking mental health and substance abuse treatment. The settlements required the companies to implement a host of reforms to comply with state and federal law, and gave members the opportunity to appeal medical necessity denials. These efforts resulted in $2.9 million in penalties, and $1.6 million in consumer reimbursements for out-of-pocket treatment costs.
(AUSTER)


Go to MSSNY’s Website to View MSSNY’S Archived Opioid Education Webinars
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org .

The webinars are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems; Webinar 2 Rational Opioid Prescribing:  Is this Possible for Chronic Pain?; Webinar 3 Treatment of Opioid Use Disorders and Webinar Four Pain Patients w/Substance Use Disorders.

  • The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.
  • New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.
  • Click on the tool bar menu located at the to the top right of the page and click on “My training” to view your training page
  • The courses are listed under: A Webinar Series on Opioid Use, Treatment, and Addiction.

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 enduring 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.

Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY, DEARS)


MSSNY to Conduct CME Medical Matters Webinar on Zika Virus on June 8 At 6 P.M.
The Medical Society, in conjunction with the New York State Department of Health will conduct a Medical Matters webinar on the  “Zika Virus: An Evolving Story–UPDATE” on Wednesday June 8th  at 6 p.m.   Registration for this program is now open here.

Click on the upcoming tab and select the programs.

MSSNY conducted the original program in March 2016, but this program will provide updates to the ever changing story of Zika.

The educational objectives for this program are: 1) Describe the epidemiology of Zika Virus infection;

2) Understand the modes of transmission; 3) Understand how to advise patients; and 4) Learn methods for prevention of infection.  William Valenti, MD, chair of MSSNY’s Infectious Disease Committee, and Elizabeth Dufort, MD,  Medical Director, Division of Epidemiology from the New York State Department of Health, will conduct this presentation.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.       
(CLANCY, HOFFMAN)


Radiological Emergencies CME Webinar to Be Held May 18th; Registration Now Open
Registration is now open for MSSNY’s Medical Matters webinar on  “Radiological Emergencies” to be held May 18, 2016 at 7:30 AM.  Physicians and other health care providers may register here.
Click on the upcoming tab and select the webinar.

Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN)


PTSD and TBI in Returning Veterans:  May – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on three dates listed below from May through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic growth

To register for this program, click on a date below and fill out the registration form 

Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM
(ELPERIN, DEARS)

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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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DOH Study: 20% of Female Medicaid Recipients 15-44 Were Prescribed Opioids
timely study by researchers at the New York State Department of Health, just published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, documents how widespread the use of prescription opioids has become in recent decades.

Focusing on the state’s female Medicaid recipients of reproductive age (15 to 44), the study found that fully 20 percent had been prescribed opioids at least once between 2008 and 2013.

That figure included 9.5 percent of the women who gave birth the same year, which is a particular concern because opioid use during pregnancy can cause birth defects and other health problems for newborns.

The authors–Brian Gallagher, Yejee Shin and Patrick Roohan of the Health Department’s Office of Quality and Patient Safety–noted previous studies involving other states had found even higher rates. They suggest that New York regulations, including the four-year-old Internet System for Tracking Overprescribing (I-STOP), “might contribute to the lower proportion of opioid prescribing in New York compared with opioid prescribing in most other states and the United States overall.”


NY Doctors Are Not Complying with MOLST Regulations
“Too many doctors are still not completing the MOLST form with their patients,” said David Leven, executive director of End of Life Choices New York. MOLST stands for Medical Orders for Life-Sustaining Treatment and includes provisions for whether or not a patient should be resuscitated. (Crains’s 5/12)

In 2011, New York enacted the Palliative Care Information Act, which requires doctors and nurse practitioners to inform patients of the likely course of their disease, their end-of-life options (including forgoing treatment) and their “legal rights to comprehensive pain and symptom management at the end of life.” That year, the state also enacted the Palliative Care Access Act, directed at hospitals, long-term care facilities and home-care agencies.

Columbia University Medical Center also has been putting in place new palliative care protocols, said Dr. Kenneth Prager, the hospital’s director of clinical ethics speaking at a panel on dying last week hosted by the Jonas Center and the New York Academy of Medicine. For instance, a doctor must ask patients about their values and quality-of-life standards prior to putting in certain medical devices.

But even with more protocols in place, deciding whether to keep a patient alive is never easy, said Dr. Prager. As medical technology becomes more sophisticated, he said, the considerations become more complex.


Addicts May Turn To Anti-Diarrhea Drugs When Unable To Get Painkillers
In a 1,100-word article, The New York Times (5/10, Louis, Subscription Publication) reports that addicts without access to “painkillers are instead turning to Imodium and other anti-diarrhea medications.” The study at http://bit.ly/1TtnRAP published online in the Annals of Emergency Medicine (4/29), “described two deaths in New York after loperamide abuse.” Additionally, “overdoses have been linked to deaths or life-threatening irregular heartbeats in at least a dozen other cases in five states in the last 18 months.”


Revalidation Information for PART B
Every five years, CMS requires you to revalidate your Medicare enrollment record information. As part of this process, you need to update or confirm all the information in your record, including your practice locations and reassignments. The next cycle of Revalidation has started, and you will be receiving an official Revalidation notice 2 to 3 months prior to the revalidation due date.

Attached is a list of providers asked to revalidate in the state with due dates in the next 5 months.

Be on the look-out for your notification as it will direct you on next steps for submission and completion of your Revalidation process.

National Government Services offers information and resource tools for understanding Revalidation on our website.

Go to: www.ngsmedicare.com

  • Enrollment tab
  • Obtain Revalidation Instructions

Determine if you are due to revalidate by the Medicare Revalidation Lookup Tool on the CMS website here . For more general revalidation information, visit CMS website here.

Provider Revalidation Interactive Tool: (click for direct link)

This tool is designed to assist with general revalidation instructions submitting via PECOS (Provider Enrollment Chain and Ownership System) or Paper Application.

The preferred method to submit an application is electronically via Internet-based PECOS (Provider Enrollment Chain & Ownership System).

A few advantages include:

  • Faster application process
  • Automatic selection of proper enrollment form(s)
  • Tailored application process
  • Fewer submission errors/omissions

Educational Webinars: (click for direct link to view dates and times to select opportunities)

  • Getting Connected to PECOS
  • Provider Enrollment Revalidation
  • Submitting Revalidation via PECOS
  • Submitting Revalidation via Paper Application

Application Fee Decision Tree: (click for direct link)

The tool assists in understanding if an application fee is required.

Thank you

National Government Services

CDC: Test Urine and Blood for Accurate Zika Virus Diagnosis
In a report released on May 11, the CDC said an analysis of blood and urine tests conducted by Florida’s health department found rates of virus detection from urine were higher than from blood. Florida, with 95 confirmed cases, is the state with the most number of Zika infections on the U.S. mainland.

In a study of 53 patients, 92% of urine samples “tested positive for Zika, compared to 81% of saliva samples and 51% of blood samples, according to the CDC.”


Restaurants Cannot Refuse to Serve Pregnant Women
New York City is explicitly prohibiting restaurants and bars from refusing alcoholic drink orders to mothers-to-be, with new guidelines that say doing so would represent discrimination under the city’s Human Rights Law.

“While covered entities may attempt to justify certain categorical exclusions based on maternal or fetal safety, using safety as a pretext for discrimination or as a way to reinforce traditional gender norms or stereotypes is unlawful,” the guidance released by the Commission on Human Rights on Friday says.

That would also apply to foods deemed risky during pregnancy, such as raw fish or soft cheese. According to the C.D.C., about 10 percent of pregnant women drink alcohol.


CLASSIFIED

Recently Renovated Medical Office Space Available June, 2016
Desirable Midtown Manhattan Building located between Park and Madison Avenues.
Please Call Mr. Mel Farrell At 212. 696.7107 for further information.

Office to Share/Rent
Medical Co-op Building located on East 60th Street, NYC. Includes one consult room and 2 examination rooms, waiting room, 2 bathrooms, plus 2 medical assistants. Space for one secretary. Available 2.5 days per week.  Free internet and Wi-Fi. For more information, contact mamdocs9B@gmail.com or (212) 230-1144.

Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581


Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!

Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Physician Opportunities


Northern Westchester – Psychiatric Opportunities
Part-time Psychiatrist (BC/BE/Child very desirable) wanted, to work in North Salem, N.Y., Suboxone DEA license helpful. Fax qualifications and availability to 914 669-6051 or call 914 669-5526 with questions..

New York Life Seeks Experienced Medical Director
New York Life is seeking an experienced Medical Director. Full time physician (M.D. or D.O.) needed for our underwriting department in Manhattan. At least 3-5 years Internal Medicine or Family Practice required. Competitive industry salary, excellent benefits, outstanding culture. Visit: https://career8.successfactors.com/sfcareer/jobreqcareer?jobId=30244&company=NYLPRD&username=



Unique Private Pediatric Practice Opportunity
Summerwood Pediatrics is a very progressive, large community-based private practice in the Syracuse area. We provide care for over 25,000 children from birth to 21. The practice also has a satellite office in Camillus, NY. Additionally, the practice operates adjacent to an independent outpatient infusion practice, which is alsoowned and operated by our medical director. We are looking to employ a bright, energetic and enthusiastic general pediatric or subspecialty-trained physician. Presently the practice employs seven physicians, two pediatric NPs and one PA . All providers share on-call responsibilities on a one-day per week basis. Weekend coverage and office hours are performed on a rotational basis by the physicians. Our offices encompass over 28,0000sq. ft. of state-of-the- art clinical space;on-site lab services. The position, either full or part-time, includes applicable benefits inclusive of health care, malpractice insurance, CME expenditures and retirement plan. To discuss this opportunity further, contact either Dr. Robert A. Dracker or Mr. Warren Ford at 315-457-9914…9-5 EST.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

May 6, 2016 – Strength in Numbers!

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

May 6,  2016
Volume 16, Number 17

Dear Colleagues:

One of my main goals as president of MSSNY is to get our message out to more New York physicians. I am certain that if our colleagues are made aware of everything that MSSNY accomplishes on behalf of all physicians in the state, we will boost membership—and our collective voice will be strengthened.

I encourage each of you to reach out to fellow physicians with the message that MSSNY’s advocacy efforts in Albany have resulted in successes that benefit all of us. Below, I have highlighted some of MSSNY’s 2016 budget victories. Please share them with your colleagues as you encourage them to join us in our efforts:

  • Eligibility for Excess Medical Malpractice Coverage Preserved. The Legislature rejected a proposal from the Executive that would have caused over 13,000 physicians to be dropped from the Excess program.
  • Retail Clinic proposal defeated. The final budget does not include a provision that would have enabled ‘limited service’ clinics in retail stores owned by publicly traded corporations such as CVS, Walmart and Walgreens. MSSNY worked with other primary care and specialty medical societies to defeat this proposal. MSSNY will continue to oppose this proposal, should it resurface toward the end of session.
  • Changes to the Workers Compensation program rejected; role of County Medical Societies preserved! The Legislature rejected the Executive’s proposal to expand the list of providers eligible to deliver (and receive payment directly from the Workers Compensation program) to include acupuncturists, nurse practitioners, physician assistants, and social workers. Significantly, the Legislature also rejected the proposal to eliminate county medical society review and assistance for physicians looking to be authorized to deliver care. We thank the many county medical society leaders across New York State who took the time to contact their local Senators and Assembly members to express their concerns regarding this proposal.
  • Health Republic. The budget expressly articulated the establishment of a fund to be known as the “Health Republic Insurance of New York Fund” consisting of state-derived settlements funds at the discretion of the Director of the State Division of Budget. Any payments to be made from this fund would be made after distribution of Health Republic’s remaining assets in a liquidation proceeding. We are seeking further clarification regarding which monies could be potentially assigned to this fund, and will continue to work with hospital associations to assure the deposit of sufficient monies to fully reimburse physicians and other providers for care provided to patients covered by the now defunct Health Republic.
  • No Regressive Tort Measures Included in Budget. Despite renewed attention on certain regressive tort bills including a date of discovery statute of limitations and repeal of the limitations on attorney contingency fees in medical liability cases, the measures were not included as part of the budget.  It is anticipated, however, that discussion on these issues will resume as MSSNY seeks to achieve meaningful tort reforms this legislative session.
  • Elimination of prescriber prevails rejected. The Legislature rejected proposals that would have eliminated “prescriber prevails” protections for prescribing medications to all patients insured through fee for service Medicaid, as well as for several classes of medications for patients insured under Medicaid managed care.
  • E-Prescribing Exception for Low Volume Prescribers Approved. E-prescribing will not be required of prescribers who issue 25 prescriptions or less each year provided that they submit a certification to that effect to the Department of Health.   A prescriber who has made a certification on or before the expiration of the current 12-month period may do so for a maximum of three 12- month certifications.  MSSNY is continuing to advocate for legislation to reduce the onerous and burdensome requirements for physicians without waivers who issue paper prescriptions through the invocation of one of three statutory exceptions.

The time is now. We must recruit more physicians to join MSSNY and we must increase PAC contributions.  With your help, I am confident that we will succeed.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

MLMIC


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Please Urge Your Legislators To Reject Drastic Liability Expansion Legislation
With the Legislature’s return back to Albany for the final 7 weeks of the 2016 Legislative Session, all physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the Statute of limitations to a “Date of Discovery” rule.   A letter to your Senator and Assemblymember can be sent from here.  If enacted, this legislation could increase your premiums by nearly 15%.  In light of the huge financial pressures prompted by excessive government mandates, abusive insurer practices, and enormous new patient cost-sharing responsibilities  that are already threatening the viability of physician practices, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for your patients.

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.   The ad (in http://www.nymedmalreform.org/) has appeared in City & State, Politico New York, and the Albany Times-Union.

Also this week, MSSNY sent to the entire State Legislature a letter signed by MSSNY and over a dozen specialty medical societies urging them to reject stand-alone liability legislation that would significantly drive up premium costs, as well as an article by Deiderich Healthcare that highlighted that, once again in 2015, New York overwhelmingly led the nation in total and per capita medical liability payouts.
(AUSTER, DEARS)


Legislation To Reduce E-Prescribing Exception Reporting Burden Needs Your Support
Physicians are urged to contact their legislator to urge that they support legislation (S.6779-A, Hannon/A. 9335A, Gottfried) to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription.  The Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because:  their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription.

DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription. This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions.

In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6 million to 15 million e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state.  In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.

A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.   It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing went into effect, do not require reporting to the DOH.   The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply.  This legislation has passed the Senate twice but remains stalled in the Assembly Codes Committee. Please urge your legislators to pass this bill by sending a letter located on the MSSNY grassroots action center at this link.                                                                          (DEARS, CLANCY)

AMA and CMS Resources to Better Understand CMS Medicare Value Based Payment Proposed Regulations
Following up our article from last week noting that CMS had proposed regulations to implement the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM) Value-Based Payment components of the MACRA legislation enacted by Congress in 2015, please see a detailed summary prepared by the AMA of the proposal.  Moreover, please review a high level summary of the proposed regulation from CMS.   We urge you to read these detailed summaries closely and respond back with your comments.

While payment adjustments under the MIPS and APMs will not be applied to physician Medicare payments until 2019, the positive or negative adjustments will be based upon care delivered to Medicare patients in 2017.  Under MIPS, Medicare payments could be adjusted up or down by 4% beginning in 2019, and up to +/- 9% by 2022, with additional bonus payments possible for “exceptional performance”.

Next Wednesday, May 11, at 2 PM, the US House of Representatives Ways &  Means Committee will hold a hearing to examine the implementation of the MACRA law, in which CMS Acting Administrator Andy Slavitt is expected to testify.

Comments on the proposed regulation are due to CMS by June 27.  MSSNY will be working with the AMA, specialty medical associations and other state medical associations on developing comments to CMS to address concerns with the proposal.                         (AUSTER)


FDA Announces New Rules to Regulate E-Cigarettes and Other Tobacco Products
The Food and Drug Administration (FDA) this week finalized a rule to extend its regulatory authority over tobacco products to include electronic cigarettes, cigars, pipe tobacco and water pipe tobacco, and will prohibit the sale of these products to people younger than age 18. The regulations also will require cigar and e-cigarette producers to register with FDA. In addition, the rules will require tobacco companies to include specific health warnings on packages and in advertisements for their products.

To read the FDA’s full press release setting forth the new requirements, click here.

“We have more to do to help protect Americans from the dangers of tobacco and nicotine, especially our youth. As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of addiction,” said HHS Secretary Sylvia Burwell. “Today’s announcement is an important step in the fight for a tobacco-free generation – it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions.”    
(AUSTER, CLANCY)


FDA Recommends Mandatory Training for Prescribers of Opioids
An advisory panel to the Food and Drug Administration (FDA) recommended this week that training for all prescribers of opioids be mandatory.  Such a mandate would require Congressional approval, however.  The FDA committee of outside experts reviewed the risk-management plans introduced nearly four years ago in an effort to reduce misuse of opioids responsible for a national crisis of abuse and death.

Since 2012, the F.D.A. has required drug companies that produce long-acting opioids to underwrite voluntary educational courses on the medications.  Entitled Risk Evaluation and Mitigation Strategies (REMS) courses, they have been offered throughout the country.   It was expected that 80,000 prescribers would take the course,but according to the FDA, less than half of this number have taken these courses.   The pharmaceutical manufacturers of these drugs have now support mandatory training for prescribers.

The recommendation supports tying Schedule II and Schedule III Narcotics DEA registration and re-registration to either completion of prescription opioid education or other attestation of prior knowledge such as board certification in pain medicine.  This would expand education to all ER/LA opioid analgesic prescribers and ensures a common base of knowledge about safe opioid prescribing, particularly around issues of abuse and misuse.                                                 (CLANCY)


Go to MSSNY’s Website To View MSSNYs Archived Opioid Education Webinars
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org.

The webinars are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems; Webinar 2 Rational Opioid Prescribing:  Is this Possible for Chronic Pain?; Webinar 3 Treatment of Opioid Use Disorders and Webinar For Pain Patients w/Substance Use Disorders.

  • The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.
  • New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.
  • Click on the tool bar menu located at the to the top right of the page and click on “My training” to view your training page
  • The courses are listed under: A Webinar Series on Opioid Use, Treatment, and Addiction.

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 enduring 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. 

Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY, DEARS)


Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-B, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  Please send a letter in support of this legislation by clicking here.

This week, an op-ed written by the sponsor of the bill headlined “Assemblyman Titone to Insurers: Stop Playing Doctor” appeared in the Staten Island Advance calling for the State Legislature to enact this common sense legislation.

We strongly encourage physicians concerned about this issue to participate in an upcoming May 23 Albany advocacy day in support of this legislation.  If you are interested in participating please e-mail mauster@mssny.org.  MSSNY representatives will be participating along with many other patient advocacy groups.
(AUSTER, DEARS)


Scores of Members of Congress Urge CMS to Put the Brakes on Damaging Part B Medication Reimbursement Proposal
242 Members of the U.S. House of Representatives, including all 9 New York GOP members, have signed a letter to CMS urging that they put on hold a proposal to revise (and reduce) the payment methodology for in-office use medications covered through Medicare Part B.  MSSNY previously joined on with several other organizations in a letter to the New York Congressional delegation urging that they urge CMS to withdraw this damaging proposal noting that the proposal “will adversely affect the care and treatment of New York Medicare patients with complex conditions, such as cancer, macular degeneration, hypertension, rheumatoid arthritis, Crohn’s disease and ulcerative colitis, and primary immunodeficiency diseases”.  The AMA also sent a similar letter to Congressional leaders. 

Signing on to the House GOP letter included New York Representatives Chris Collins (Western NY), Dan Donovan (Staten Island), Chris Gibson (Hudson Valley), Richard Hanna (Central NY), John Katko (Central NY), Peter King (Nassau County), Tom Reed (Southern Tier), Elise Stefanik (North Country), and Lee Zeldin (Suffolk County).

Several Democrat members of the House of Representatives, including New York representatives Yvette Clark (Brooklyn), Joe Crowley (Queens), Steve Israel (Nassau/Suffolk Counties), Kathleen Rice (Nassau County) and Paul Tonko (Capital District) signed onto separate letters to CMS expressing their concerns with this proposal.

At the same time, the Republican members of the U.S. Senate Finance Committee sent a letter last week calling on CMS to “immediately” withdraw the proposal, noting that they are “perplexed” by the “unprecedented scope” of the proposal, as it could decrease the quality of beneficiary care, increase Medicare costs, and further hospital-physician practice consolidation.  The Democratic members of the US Senate Finance Committee, including New York Senator Chuck Schumer, also sent a letter to CMS expressing concerns with the proposal:.  The letter notes that “any proposed changes to the Part B program must be carefully considered to prevent any disruptions in care for Medicare beneficiaries, particularly those with serious and complex conditions”.   Moreover, the letter noted that it was essential that CMS engage with the impacted community, including directly with impacted patients.   

MSSNY thanks all the members of New York’s Congressional delegation who have demonstrated their commitment to protecting the ability of our seniors to continue to receive necessary care from the community physician of their choice.
(AUSTER)


Radiological Emergencies CME Webinar to Be Held May 18th;
Registration Now Open
Registration is now open for MSSNY’s Medical Matters webinar on  “Radiological Emergencies” to be held May 18, 2016 at 7:30 AM.  Physicians and other health care providers may register hereClick on the upcoming tab and select the webinar.

Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAM)


PTSD and TBI in Returning Veterans:  May – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on four dates listed below from May through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them
  • Outline the process of recovery and post-traumatic growth

To register for this program, click on a date below and fill out the registration form.

Thursday, May 12, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                                                                           (ELPERIN, DEARS)

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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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MSSNY Counsel Don Moy: HR Liquidation Process to Begin on May 10
On April 22, 2016, the Superintendent of Financial Services commended a liquidation proceeding for Health Republic Insurance of New York, Corp. (HRINY) in the NYS Supreme Court, New York County.  HRINY has consented to the proceeding.

A hearing has been set for May 10, 2016 at 9:30 a.m.  At the hearing, it is expected that the judge will approve a Liquidation Order that will appoint the Superintendent as the Liquidator and allow the liquidation process to proceed.  The Liquidator will be authorized and directed to take possession and control of HRINY’s property and assets and to liquidate HRINY’s business affairs in accordance with the requirements of the N.Y. Insurance Law.

Physicians and other health care providers should have submitted claims for health care services by March 31, 2016 in accordance with the procedures and deadlines set forth in the contracts governing their provision of services to HRINY’s Members.  Claims that were submitted in accordance with the relevant contractual requirements do not need to be re-submitted.   Providers will receive Explanations of Benefit statements and information about the process for submitting any appeals as soon as available.  HRINY Members should have submitted claims for out-of-network services by March 31, 2016 in accordance with the procedures and deadlines set forth in their insurance policies.  Policy claims submitted in accordance with the relevant contractual requirements do not need to be re-submitted.

For more information regarding the Superintendent’s Order to Show cause and Verified Petition go to http://healthrepublicny.org ; and for information regarding the  Liquidation Process and Claims Process go to http://www.healthrepublicny.org/providers.php 


Reminder: Open Payments Physician and Teaching Hospital Review and Dispute Period Ends May 15, 2016
Physicians and teaching hospitals have until May 15, 2016 to voluntarily review data reported by drug and medical device makers about them for calendar year 2015, and, if necessary, dispute payments, before the data is made public on June 30, 2016.

To review and dispute data, physicians and teaching hospitals must register in the Open Payments system.

If You Have Never Registered with Open Payments Before:

Make sure you have your National Provider Identifier (NPI) number, Drug Enforcement Agency (DEA) number, and State license number (SLN).  Initial registration is a two-step process and should only take 30 minutes:

  1. Register in the CMS Enterprise Identity Management System (EIDM);
  2. Register in the Open Payments system

Please remember to select the role of “Applicable Manufacturer/GPO, Physician, or Teaching Hospital”, when registering in EIDM. If any other role is requested, no access to the Open Payments System will be granted. For any additional information on registering in EIDM, refer to the EIDM Registration Quick Reference guide here.

For Users That Registered Last Year and Have Used Their Accounts in the Last 60 Days:

Physicians and teaching hospitals who registered last year do not need to reregister in the EIDM or the Open Payments system. If the account has been accessed within the last 60 days, go to the CMS Enterprise Portal, log in using your user ID and password, and navigate to the Open Payments system home page.

For Users That Registered Last Year but Have Been Inactive for More than 60 Days:

The EIDM locks accounts if there is no activity for 60 days or more. To unlock an account, go to the CMS Enterprise Portal, enter your user ID and correctly answer all challenge questions; you’ll then be prompted to enter a new password.

For Users That Registered Last Year but Have Been Inactive for More than 180 Days:

The EIDM deactivates accounts if there is no activity for 180 days or more. To reinstate an account that has been deactivated, contact the Open Payments Help Desk.

For more information about the registration process, visit the physician and teaching hospital registration page on the Open Payments website.

For assistance with the registration process, please call our live Help Desk at 1-855-326-8366, Monday through Friday, from 8:30 a.m. to 7:30 p.m. (ET), excluding Federal holidays. Questions can also be submitted to the Help Desk via email, at openpayments@cms.hhs.gov.

The U.S. Food and Drug Administration today approved the first generic version of Crestor (rosuvastatin calcium) tablets for the following uses:

  • in combination with diet for the treatment of high triglycerides (hypertriglyceridemia) in adults;
  • in combination with diet for treatment of patients with primary dysbetalipoproteinemia (Type III Hyperlipoproteinemia), a disorder associated with improper breakdown of cholesterol and triglycerides;
  • either alone or in combination with other cholesterol treatment(s) for adult patients with homozygous familial hypercholesterolemia, a disorder associated with high low-density lipoprotein (LDL) cholesterol.

In the clinical trials for Crestor, the most common side effects reported by participants taking Crestor included headache, pain in muscles (myalgia), abdominal pain, abnormal weakness (asthenia), and nausea.Rosuvastatin calcium should not be used in women who are pregnant or may become pregnant as it may cause fetal harm. Women who require treatment with rosuvastatin should be advised not to nurse their infants.

For more information, please visit: rosuvastatin.


Zika Information and Resources

  • On Thursday, the CDC reported a small study in Brazil that associated Zika with Guillain-Barre syndrome. The study did not confirm Zika infection in the patients, though according to lead author Dr. Ashley Styczynski of the CDC that data should be available in about a month. The study found that nearly 90 percent of those suffering from Guillain-Barre had also reported Zika-like symptoms earlier.
  • Onondaga County has two confirmed travel-related Zika cases, according to Syracuse (NY) Post-Standard. The county does not have the mosquitoes that spread the virus.
  • Information for Providers

For the latest information, including laboratory test instructions and forms, health alerts, and latest guidance, click here.

Latest Facts and Advisories as of 4/27/2016 [ Español (PDF)]
Reported cases of Zika in New York City: 59
·       Eight of the fifty-nine cases were pregnant at the time of diagnosis;
·       All cases contracted Zika while visiting other countries; and
·       All patients have recovered.


CMS to Host Webinars on MACRA and MIPS
On May 10, CMS will present MLN Connects National Provider Call, MACRA Listening Session: Quality Payment Program Proposed Rule. This call will be an opportunity for stakeholders, specifically Part B Fee-For-Service clinicians, and state and national associations that represent healthcare providers, to provide CMS with early feedback on the proposed policy for the Quality Payment Program. To participate, visit the MLN Connects Event Registration page. Space may be limited; please register early.

CMS also encourages you to register for:

The Merit-Based Incentive Payment System (MIPS) Overview

  • Date: Wednesday, May 11, 2016
  • Time: 12:00 p.m. – 1:00 p.m. ET
  • Details: As one path of the Quality Payment Program, MIPS streamlines three independent programs into one to ease clinician burden. MIPS also adds a fourth component to promote ongoing improvement and innovation to clinical activities. This listening session is an opportunity for stakeholders to learn about MIPS and also provide CMS with initial feedback on the proposed policy for the Quality Payment Program.
  • Register: To participate, visit the registration webpage.

Space for these webinars is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.

Please note: There will not be a Q&A period during these listening sessions. CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to send initial comments or questions using the webinars chat feature, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment. Comments are due by 5:00 p.m. ET on June 27, 2016.

For More Information
CMS encourages participants to review the proposed rule (CMS-5517-P), press release, and fact sheet prior to the listening sessions. Additional resources are also available on the website


MSSNY in the News
Lohud – Business Briefs
Briarcliff Manor’s Reid Elected President
(MSSNY President Dr. Malcom Reid mentioned)

Lohud – Business Briefs
Litvack reelected at medical society
(MSSNY Assistant Secretary Dr. Bonnie Litvack mentioned)

Greater New York Hospital Association Skyline News – 05/02/16
GNYHA, Allies Launch Med Mal Ad Campaign
(MSSNY mentioned)

Rome Sentinel – 05/02/16
Dr. Maldonado named president of state Medical Educational & Scientific Foundation
(Former MSSNY President, Dr. Joseph Maldonado, MD mentioned)

New Amsterdam News – 05/05/16
Americans need wake-up call on importance of sleep
(MSSNY mentioned) 


Valuing Episodes of Care: Expanding Transparency, Redefining Reimbursement
Join FAIR Health for a Free Webinar on Valuing Episodes of Care: Expanding Transparency, Redefining Reimbursement 

Date: Thursday, June 9, 2016
Time: 2:00 – 3:00 pm ET.

As the national healthcare system considers value-based reimbursement, stakeholders involved with everything from designing benefits plans to establishing fee schedules to equipping consumers with decision-making tools will benefit from an understanding of episodes of care—the full range of procedures and services associated with a given illness or condition. The presentation will examine how populating episodes of care with robust, reliable cost data, calibrated for risk factors, can ensure an organization’s success as the industry evolves to new and innovative reimbursement models.

Register to learn about:

  • Using bundled cost information to plan for the impact value-based reimbursement will have on your business;
  • Developing models based on group-specific claims data to identify and reduce potentially avoidable complications and, ultimately, improve outcomes and realize savings;
  • Designing and pricing benefits plans based on reimbursement for all care associated with treating a single common condition or illness;
  • Why risk profiles are critical when estimating the cost for episodes of care;
  • The value of studying variations in cost and utilization across geographic areas and over time;
  • Offering episodes of care data in user-friendly formats customized for each audience segment to promote understanding of the complete cost of care;
  • How decision-support tools fueled by complete cost data can promote sound consumer decision making, such as minimizing unnecessary ER visits; and
  • How cost information can help to improve the overall patient experience.

Sign up now. Space is limited, so RSVP today.


What is the Senate Finance Committee’s Criticism of the CMS’
Recently Announced Medicare Part B Rule?
Answer: Republican and Democratic Senators have both come out against the CMS’ proposed rule, which covers Part B drugs, such as cancer medications, that are administered in a doctor’s office or hospital outpatient department. The proposed payment model would test new ways to support physicians and other clinicians “as they choose the drug that is right for their patients,” the Centers for Medicare & Medicaid Services said in their March 11, 2016 announcement. Finance Chairman Orrin Hatch (R-Utah) and other committee Republicans wrote in a letter to the CMS that the proposed payment model would require health-care providers across the nation to engage in drastic changes in payment procedures.

The letter uses as an example the proposed average sales price (“ASP”) payment reduction in the rule as particularly problematic. The ASP would limit access to “vital drugs,” as many providers would face prescription costs which exceed the new Medicare payment amount offered under the model. This problem severely affects small physician practices and practices in rural areas where physicians who have trouble accessing drugs with the reduced ASP payment would likely refer patients to hospital outpatient departments, which are a less-convenient and more costly setting, they added. Overall, the letter argues, the ASP proposal would limit beneficiaries’ choice, increase costs and could further hospital acquisitions of physician practices.

A letter from Finance Committee Democrats also outlined concerns about reducing ASP and how doing so would affect drug access and push beneficiaries to more costly hospital outpatient departments. The medical community in large part, particularly the Community Oncology Alliance, praised the letters and hoped they would put an end to the proposed misguided and dangerous experiment. The CMS is still receiving comments on the rule (CMS-1670-P), which are being accepted until May 9, 2016.

If you have any questions, please contact Kern Augustine Conroy & Schoppmann, P.C. at 1-800-445-0954 or via email at info@DrLaw.com. 


CLASSIFIED


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581

Want to Rent your Medical Office? Need to Lease Space to Expand your Practice?
Clineeds is an online platform designed to help physicians find or rent medical office space. Listing is completely FREE! Sign up today at http://clineeds.com/signup. We take care of the rest!

Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


NORTHERN WESTCHESTER – Psychiatric Opportunities
Part-time Psychiatrist (BC/BE/Child very desirable) wanted, to work in North Salem, N.Y., Suboxone DEA license helpful. Fax qualifications and availability to 914 669-6051 or call 914 669-5526 with questions..

Practice for Sale; North Salem, N.Y.
This is an excellent opportunity for someone wanting to purchase an established, growing practice. North Salem is a semi-rural suburban area 30 minutes north of White Plains; close to I-84, and I-684. This is an excellent place to live and practice, with excellent schools, close to malls and shopping. We treat patients of all ages, and there is a substantial Suboxone component integrated into the practice. Staffing includes several part-time psychiatrists, therapists. Patients come from Northern Westchester, nearby Putnam County and the Ridgefield-Danbury area and include children, adolescents, adults, families, Geriatric patients. Reliable office staff assist in patient and insurer management. Call 914 669-5526.


Physician Opportunities

Unique Private Pediatric Practice Opportunity
Summerwood Pediatrics is a very progressive, large community-based private practice in the Syracuse area. We provide care for over 25,000 children from birth to 21. The practice also has a satellite office in Camillus, NY. Additionally, the practice operates adjacent to an independent outpatient infusion practice, which is alsoowned and operated by our medical director. We are looking to employ a bright, energetic and enthusiastic general pediatric or subspecialty-trained physician. Presently the practice employs seven physicians, two pediatric NPs and one PA . All providers share on-call responsibilities on a one-day per week basis. Weekend coverage and office hours are performed on a rotational basis by the physicians. Our offices encompass over 28,0000sq. ft. of state-of-the- art clinical space;on-site lab services. The position, either full or part-time, includes applicable benefits inclusive of health care, malpractice insurance, CME expenditures and retirement plan. To discuss this opportunity further, contact either Dr. Robert A. Dracker or Mr. Warren Ford at 315-457-9914…9-5 EST.

Medical Director at CDPHP: Voted NYS “Best Company” by Our Employees!
CDPHP is more than a health insurer. We are a not-for-profit health value organization leading the way toward better, more affordable health care. CDPHP represents progress and innovation for more than 425,000 members throughout New York. A physician-founded and guided plan, our primary focus is the health and well-being of those we serve. While other insurers strive to create value for their shareholders, our efforts are centered on creating value for members, in part by providing employers with innovative solutions for managing health care. The Medical Director will assist the Vice President, Senior Medical Director and the SVP of Medical Affairs with the implementation of the Plan’s Medical Management, Quality Improvement and Resource Management initiatives in accordance with regulatory, accreditation, and corporate policies and strategic plan. The Medical Director will participate in the medical advisory committees, provide leadership to, and serve as a liaison between the physician community and the Plan’s management.The ideal candidate will possess the following:

  • Licensed physician with current, unrestricted license (preferably New York State); Board Certified to practice a medical specialty; ABMS specialty is required.
  • If not licensed in New York State, eligibility for New York State licensure is required.
  • Additional advanced degree(s) preferred.
  • Minimum three to five (3-5) years clinical practice experience is required.
  • Minimum of three (3) years managed care or practice management is preferred.

Please email nicole.harrington@cdphp.comEqual Opportunity Employer, females, minorities, disabled, veterans


 


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

 

 

 

 

 

 

 

 

 

 

 

 

 

April 29, 2016 – MOC Opposition Is Strong!

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

April 29,  2016
Volume 16, Number 16

Dear Colleagues:

In the good old days, physicians took one board examination in their specialty and they were “grandfathered” for life.

Over a period time since 1990, the various ABMS boards changed the rules and physicians have had to recertify every 10 years. MOC additionally requires practice assessment and patient-safety activities every two years. Now, the whole recertification process has become a big business that we have to feed. The exams are expensive and time consuming. In 2014, ABIM declared that physicians who did not participate would be identified as “not meeting MOC requirements.” The main physician complaints are that these specialty boards control who can practice and they misuse their muscle to force compliance by charging exorbitant fees.  Now, boards are threatening to link test results to hospital employment.

According to Dr. Paul Tierstein’s JAMA article (1/8/2015), his frustration in fulfilling requirement led him to create a web-based petition that has more than 20,000 signatures against MOC requirements www.nomoc.org.

Internists and Internal Medicine subspecialists have been the most ardent critics saying that the MOC program of the ABIM is a waste of time and money and does nothing to contribute to better patient care.

Many physicians across the country report that the examinations are forcing some of their colleagues into early retirement.

In two 2015 studies, JAMA evaluated quality and medical costs who were certified before 1990 and those who certified just after 1990. The studies showed that patient outcomes were no better and costs were only marginally lower in the recertifying group. However, a 2.5 percent decrease in Medicare billings by the group who recertified.

This past week, Oklahoma enacted a law aimed to remove MOC as a requirement for physicians to obtain a license or secure admitting privileges. A few days earlier, Kentucky signed a measure that prohibits making MOC a condition of licensure. Michigan is considering a measure that forbids hospitals from denying privileges solely on the basis of MOC.

What the AMA Says

At the 2014 AMA Interim Meeting in Dallas, physicians voted to update the AMA’s policy on maintenance of certification (MOC) during. The adopted policy outlines principles that emphasize the need for an evidence-based process that is evaluated regularly to ensure physician needs are being met and activities are relevant to clinical practice.

The MOC principles include:

  • MOC should be based on evidence and designed to identify performance gaps and unmet needs, providing direction and guidance for improvement in physician performance and delivery of care.
  • The MOC process should be evaluated periodically to measure physician satisfaction, knowledge uptake, and intent to maintain or change practice.
  • MOC should be used as a tool for continuous improvement.
  • The MOC program should not be a mandated requirement for licensure, credentialing, payment, network participation or employment.
  • Actively practicing physicians should be well-represented on specialty boards developing MOC.
  • MOC activities and measurement should be relevant to clinical practice.
  • The MOC process should not be cost-prohibitive or present barriers to patient care.

MSSNY Actively Pursuing Actions to Protect Physicians

MSSNY is very active in opposing any certification linkage to employment and at the 2016 House of Delegates, the following resolutions were voted upon:

  • MSSNY will continue to work with the appropriate organizations to ensure the MOC process does not disrupt physician practice or reduce the capacity of the overall physician workforce.
  • MSSNY will oppose any effort by NYS to require certification by any medical specialty board as a condition of obtaining or renewing the registration of a medical license in New York.
  • MSSNY should ask the AMA to reaffirm the AMA’s policy regarding Maintenance of Certification and Maintenance of Licensure programs and provide an amicus brief or other support when the opportunity arises to defend physicians against any attempt to use recertification of Maintenance of Certification as a condition of employment, licensure or reimbursement.
  • MSSNY should file an amicus brief in support of the American Association of Physicians and Surgeons lawsuit regarding board certification requirements as antitrust and MSSNY should take this resolution to the 2016 Annual meeting of the American Medical Association House of Delegates.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

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Physicians – Let Your Legislators Know that Legislation to Substantially Increase Your Liability Risk Could Be Detrimental to Patient Access to Care!
All physicians must continue to contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.    The letter can be sent from here. If enacted, this legislation could increase your premiums by nearly 15%.  In light of the huge financial pressures prompted by excessive government mandates and abusive insurer practices that are already threatening the viability of physician practices, it is essential that you express to your elected representatives that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients. 

We anticipate the Trial Lawyers and their allied front groups will be making an out all out push to enact this legislation when the Legislature returns to Albany on May 3 for the final 7 weeks of the Legislative Session.  It is imperative that you make these contacts to your legislators NOW!

In response to this threat, MSSNY and other groups have publicly highlighted the huge and unsustainable liability burden already assumed by New York physicians, and the threat this legislation poses to the already precarious stability of many New York hospitals and medical liability insurers.  MSSNY together with numerous other specialty medical societies have joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad campaign highlighting the disastrous consequences to our healthcare system should such a large expansion in the right to sue be permitted by the State Legislature.  An ad will be in the upcoming May 2 City & State.   Earlier this year, MSSNY joined GNYHA and HANYS in ads in the Albany Times-Union and City & State calling for reduction in these exorbitant costs. (AUSTER, DEARS)

DFS Commences Health Republic Liquidation Process
The New York State Department of Financial Services (DFS) announced that it has commenced a liquidation proceeding for Health Republic in the New York State Supreme Court.

The DFS announcement notes that “Providers should continue to submit any outstanding claims against Health Republic in accordance with the procedures and deadlines set forth in the contracts that governed their provision of care to Health Republic members. Claims previously submitted in this manner do not need to be re-submitted. Information for consumers who paid for covered services out-of-pocket and are owed money by Health Republic can be found at www.HealthRepublicNY.org.

The press release also notes that “the amount of assets available to satisfy the outstanding claims against Health Republic will not be known for some time given claims that the Liquidator may have against third parties, including as to the “3R” payments Health Republic had expected to receive from the federal government. The 3R programs – risk adjustment, reinsurance and risk corridors – were established by the federal government specifically to help protect health insurance companies, like Health Republic, from larger-than-expected losses during the first few years of operation. In addition, the Liquidator will pursue, under the supervision of the Court, any available third party claims and legal actions that may be warranted in order to maximize the assets available for distribution.”

Initiation of liquidation proceedings is an important first step towards providing some clarity to physicians and hospitals regarding any assets Health Republic will have to pay claims.  Filing of liquidation is also a necessary step towards defining the monies that will be needed to be allocated to the “Health Republic Insurance of New York Fund” that MSSNY and others advocated to be created in the recently enacted State Budget to pay outstanding HR claims that cannot be paid out of HR’s remaining assets. MSSNY will continue to monitor the liquidation process and will provide updates to physicians as they develop.       
(AUSTER, DEARS)


CMS Releases Proposed Regulations to Implement Medicare Value-Based Payment Initiatives
The US Department of Health and Human Services this week formally proposed a regulation to implement the value-based payment programs contained in the MACRA legislation enacted by Congress in 2015 that repealed the Medicare SGR methodolgy.  While payment adjustments under the Merit Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) are not applied until 2019, it will be based upon care delivered to Medicare patients in 2017.  The regulation has a 60-day comment period.

To read the HHS summary, click here.

To read AMA comments, click here.  AMA President Dr. Steven Stack stated in an AMA Viewpoints post that “While we have not yet digested the entire 962-page regulation, it appears on our initial review that CMS Acting Administrator Andy Slavitt and his senior management team have listened.”

Under MIPS, Medicare payments could be adjusted up or down by 4% beginning in 2019, and up to +/ – 9% by 2022, with additionial bonus payments possible.  Among other issues, the proposed rule addresses questions about elements of MIPS, including:

  • Quality: In this category, clinicians would choose to report 6 measures, rather than the current requirement of 9 measures, from among a range of options that accommodate differences among specialties and practice settings.
  • Advancing care information: For this category, clinicians would choose to report customizable measures that reflect how they use technology in their day-to-day practice. Importantly, unlike the existing EHR meaningful use program, this category would not require all-or-nothing EHR measurement or redundant quality reporting.
  • Clinical practice improvement activities: This category would reward physicians for clinical practice improvements, such as activities focused on care coordination, patient engagement and patient safety. Clinicians would select activities that match their practices’ goals from a list of more than 90 options.

The AMA noted that, since MACRA was passed in 2015, it has been providing extensive physician feedback on what should be included in the regulations under development. This has included numerous comment letters on specific aspects of MACRA implementation, as well as 10 overall principles that the AMA many other medical associations urged the agency to follow.  The post also noted that the AMA had also responded to CMS’ requests for information that provided advice on the agency’s proposal for a quality measure development plan and episode groups. Other activities have included hosting listening sessions with CMS for different medical specialties and other stakeholders.  MSSNY will be reviewing the proposed regulation and working with the AMA and other state medical and specialty associations on developing comments in response.                                                                                                                                    (AUSTER)


Health Care Organizations Urge Inclusion of E-Cigarettes in Clean Indoor Air Act—Advocacy Day to Be Held May 24th
A group of health care organizations, including the Medical Society of the State of New York, have come together to advocate for the placement of E-Cigarettes under the New York State Clean Indoor Air Act. The group, comprised of national and state organizations includes the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Roswell Park Cancer Institute, New York State Association of County Health Officials, Campaign for Tobacco-Free Kids, New York State Public Health Association, and the Medical Society of the State of New York, among others.

Despite containing carcinogens and toxic chemicals, including those found in anti-freeze, E-Cigarettes are currently unregulated by the FDA, and are not subject to tobacco laws as they do not contain tobacco. While New York State has prohibited the sale of E-Cigarettes to minors under the age of 18, indoor use of E-Cigarettes in public places is still permitted. MSSNY supports legislation and urges its members to support legislation (A.5955, Rosenthal/S.2202, Hannon) to place E-Cigarettes under the New York State’s Clean Indoor Air Act.
(CLANCY, MCPARTLON)


New York Kicks Butts Campaign To Be Held May 31-June 6tH
The Medical Society of the State of New York has joined with the American Cancer Society, the American Lung Association, and Tobacco Free Kids and a variety of other affiliated health organizations and businesses to encourage New York City residents to quit smoking.  The New York Kick Butts campaign will be held May 31-June 6th and New York City physicians are asked to discuss with patients smoking cessation treatment options.  By offering medication and counseling, physicians can help patients to double their quit rates.     Helpful tools can be found on line at PlanMy Quit.com/NYC or by calling the New York State Smokers’ Quitline at 1-866-NY-QUITS (697-8487) or by just dialing 311.   Additional resources can also be found at NYSmokeFree.com.  Physicians can find an information flyer here or patient information here.                       (CLANCY)


Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.

We strongly encourage physicians concerned about this issue to participate in an upcoming May 23 Albany advocacy day in support of this legislation.  If you are interested in participating please e-mail mauster@mssny.org.  MSSNY representatives will be participating along with many other patient advocacy groups.                          (AUSTER, DEARS)


DFS Reminds Insurers Of Requirements To Cover Screening For Maternal Depression
Governor Cuomo announced this week that the Department of Financial Services issued guidance to remind health insurers of their responsibility to provide health insurance coverage for maternal depression screenings. The guidance follows the United States Preventive Services Taskforce recommendations made earlier this year that group health plans and insurers offering group or individual health coverage must provide, with no copayment, coinsurance or deductible, preventative services such as depression screenings in pregnant and postpartum women.

“We took this action to make sure that all pregnant and postpartum women can receive the full treatment services to which they are entitled,” said Governor Cuomo. “Health insurers have an obligation to cover charges for essential preventative services, and our administration will not hesitate to hold them accountable to that responsibility. This will help mothers and newborn New Yorkers across the state lead safe, healthy lives.”

To read the Circular Letter sent by DFS to insurers, click here.(AUSTER)


Scores of Members of Congress Urge CMS to Put The Brakes on Damaging Part B Medication Reimbursement Proposal
Hundreds of members of Congress have signed varying joint letters to CMS urging that they put on hold a proposal to revise (and reduce) the payment methodology for in-office use medications covered through Medicare Part B.  As reported last week, MSSNY joined several other organizations in a letter to the New York Congressional delegation (urging that they urge CMS to withdraw this damaging proposal.  The AMA also sent a similar letter to Congressional leaders.

The Republican members of the Senate Finance Committee sent a letter calling on CMS to “immediately” withdraw the proposal, noting that they are “perplexed” by the “unprecedented scope” of the proposal, as it could decrease the quality of beneficiary care, increase Medicare costs, and further hospital-physician practice consolidation. The Members also state their “dismay” that CMS did not indicate how it will assess the Part B Payment Model’s impact on the quality of beneficiary care, stating that this “glaring omission” deprives stakeholders from providing meaningful comments.

The Democratic members of the US Senate Finance Committee, including New York Senator Chuck Schumer, also sent a letter to CMS expressing concerns with the proposal.  The letter notes that “any proposed changes to the Part B program must be carefully considered to prevent any disruptions in care for Medicare beneficiaries, particularly those with serious and complex conditions”.   Moreover, the letter noted that it was essential that CMS engage with the impacted community, including directly with impacted patients.  Specifically, the letter requested that CMS resolve the following issues before moving forward with any proposal:

  • Beneficiaries access to Part B medications, particularly in response to concerns raised by many that the combined effect of the proposal and sequestration cuts could result in some physicians facing acquisition costs that exceed the Medicare reimbursement;
  • Potential impact on site of service, because community-based physicians could respond to this proposed cut by referring patients to Hospital outpatient departments, which according to the letter “would result in higher overall costs for both beneficiaries and the Medicare program”
  • Interaction with existing delivery and payment reform models, given other programs such as the Oncology Care Model and payment reforms enacted under MACRA.

In the House, over 170 GOP members, including New York representatives Chris Collins (Western NY), Dan Donovan (Staten Island), John Katko (Central NY), Tom Reed (Southern Tier) and Lee Zeldin (Suffolk County) have signed a letter to CMS initiated by Rep. Dr. Tom Price (GA), Rep. Dr. Charles Boustany (LA), and Rep. John Shimkus (IL), asking that CMS withdraw the proposed regulation.  A House Democrat letter initiated by Rep, Neal (MA) is also circulating that, so far, Rep. Paul Tonko (Capital District) has signed.
(AUSTER)


HHS Issues Final Rules on Medicaid Managed Care-Potentially Opening The Door for More Telemedicine
On April 25, 2016, the US Department of Health and Human Services (HHS) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP); the first overhaul of its kind in more than ten years. The final rules will be implemented in phases over the next three years, beginning on July 1, 2017.

To read the HHS summary, click here.

Notable changes in the final rules include passing to the states the duty to establish “network adequacy standards”. In the past, federal standards required in-person access. The change leaves open the question for individual states to decide whether telemedine access is adequately appropriate.  In the Federal Register, CMS commented that the change, “encourages states to consider how current and future technological solutions could impact their network adequacy standards. Therefore, we agree with adding these criteria to the list of elements that states should consider when developing network adequacy standards.” Included in the list of elements states must consider is the “availability of triage lines or screening systems, as well as the use of telemedicine, e-visits, and/or other evolving and innovative technological solutions.”

The final rules, in their entirely, are designed  to: (1) support states’ efforts to advance delivery system reform and improvements in quality of care for Medicaid and CHIP beneficiaries; (2) strengthen the consumer experience of care and key consumer projections; (3) strengthening program integrity by improving accountability and transparency; and (4) align rules across health insurance coverage programs to improve efficiency and help consumers who are transitioning between sources of coverage.

To read all 1,425 pages of the final rules, click here.
(MCPARTLON)


Workers Comp Board Gives Update on Implementation of Medical Portal
The New York State Workers Compensation Board recently released an Update regarding several aspects of its Business Process Re-engineering (BPR) program designed to reduce delays in the processing of Workers Compensation claims.  In particular, the Update reported that the much-anticipated medical portal will go live later this year, which will reduce administrative hassles by enabling physicians to submit medical authorization and variance requests (C-4Auth, MG-1 and MG-2) electronically directly to the payer for review.   The Update further notes that the WCB held 20 WebEx sessions this past winter to demonstrate the portal’s functionality which   cumulatively had over 1,000 attendees.  The presentation can be viewed here.
(AUSTER)


Radiological Emergencies CME Webinar to Be Held May 18th; Registration Now Open
Registration is now open for MSSNY’s Medical Matters webinar on  “Radiological Emergencies” to be held May 18, 2016 at 7:30 AM.  Physicians and other health care providers may register here.

Click on the upcoming tab and select the webinar.

Faculty for this session will be Cham Dallas, PhD.  Dr. Dallas is a professor in the Department of Health Policy and Management at the College of Public Health, University of Georgia.  He is also the Director of the Institute for Disaster Management at the University of Georgia and a Board Member of the National Disaster Life Support Foundation (NDLSF).  Dr. Dallas has a national/international reputation in toxicology and emergency preparedness and response, including over 30 years of experience.

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.

Further information or assistance in registering for any of these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                                                (CLANCY, HOFFMAN)


Capital District Regional Health Emergency Preparedness Coalition to Host Pediatric Emergency Preparedness Training Seminar On May 24th
The Capital District Regional Health Emergency Preparedness Coalition will host a pediatric training seminar on May 24, 2016 from 9-4 at the University at Albany East Campus, 1 University Place. Rensselaer, NY 12144.  The one day emergency preparedness training seminar will provide a broad overview of potential care needs for the pediatric patient involved in an emergency/disaster situation.  The training seminar will include information for medical, trauma, and crisis response specific to the most vulnerable population in any emergency—children.

Registration is available through the NYS DOH learning management system at: www.nylearnsph.com

Search: CDR Pediatric Training Seminar 2016 under calendar.             (CLANCY)


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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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Seven New York Health Insurers Required to Expand Coverage Of Hepatitis C Treatments
Under agreements made with New York State Attorney General Eric Schneiderman’s office, seven New York health insurers, including Affinity Health Plan, Empire BlueCross BlueShield, Excellus BlueCross BlueShield, HealthNow New York Inc., Independent Health Association Inc., Oxford Health Plans, and MVP Health Care, will be required to provide coverage for Hepatitis C medicines for almost all patients with this disease, not just for those in more advanced stages. The insurers also cannot deny treatment to patients with a history of substance or alcohol use. According to Schneiderman’s office, now nearly all commercial health insurance plans in the state also won’t deny coverage for those who use alcohol or drugs or whose authorizing physician isn’t a specialist.  New drugs can cost more than $83,000, but drug makers have maintained that their medicines offer good value because they lower the potential for long-term costs of liver disease, liver cancer and transplantations.  To read the Attorney General’s press release, visit http://www.ag.ny.gov/press-release/ag-schneiderman-announces-major-agreement-seven-insurers-expand-coverage-chronic

How to Register for the 2016 PQRS Group Practice Reporting Option Call
Wednesday, May 4 from 3 to 4:30 pm ET
To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

This call gives a walkthrough of the Physician Value – Physician Quality Reporting System (PV-PQRS) Registration System, an application that serves the PQRS and Value-Based Payment Modifier (Value Modifier) programs. Learn how to meet the satisfactory reporting criteria through the PQRS group practice reporting option (GPRO), avoid the CY 2018 PQRS negative payment adjustment, and CY 2018 Value Modifier automatic downward payment adjustment. A question and answer session follows the presentation.

The PV-PQRS Registration System is open through June 30 for groups to select a GPRO reporting mechanism. See the PQRS GPRO Registration webpage for more information.

Agenda:

  • PQRS and Value Modifier: Incentives and adjustments for CY 2018
  • 2016 PQRS reporting criteria for group practices reporting via the GPRO, including the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for PQRS survey
  • How to obtain an Enterprise Identity Management (EIDM) account
  • How to register for the PQRS GPRO in the PV-PQRS Registration System
  • Where to call for help and resources
  • Target Audience: Physicians, Medicare individual eligible professionals and group practices, therapists, medical group practices, practice managers, medical and specialty societies, payers, and insurers.
  • This MLN Connects Call is being evaluated by CMS for CME and CEU continuing education credit (CE). Refer to the call detail page for more information.


CMS Eliminates the Two-Midnight Rule: What is the Impact and When Will it Take Effect?
CMS recently announced that it will be dropping the much maligned two-midnight rule.  The rule, which was introduced in 2014, allowed for a hospital to receive inpatient payment under Medicare Part A only if the patient’s hospital stay was expected to span two midnights. If the patient’s stay was expected to be less than two midnights, the care was to be billed as outpatient services. Originally, CMS anticipated that the two-midnight rule would actually lead to an increase in reimbursements; therefore the final rule implemented a 0.2 percent cut to hospital inpatient reimbursements, which resulted in a national reduction of approximately $220 million.

The new proposed rule, which would go into effect in 2017, will permanently eliminate the 0.2 percent payment reduction. Additionally, CMS proposed to increase 2017 payments by 0.8 percent in order to offset the two-midnight rule payment cuts experienced by hospitals in 2014, 2015, and 2016. CMS estimates that this increase will result in an additional $539 million in payments in 2017 to acute care hospitals.

In a statement accompanying the announcement of the new rule, the CMS defended its 0.2 percent cuts and reiterated the decision to cut payment was reasonable when made.  Industry experts note that the CMS was no doubt strongly motivated after the order issued by the District Court for the District of Columbia in Shands Jacksonville Medical Center v. Burwell, which instructed CMS to reconsider and address the 0.2 percent cuts.

If you have any questions, please contact Kern Augustine Conroy & Schoppmann, P.C. at 1-800-445-0954 or via email at info@DrLaw.com.


Bank of America Announces Enhancement  to Affinity Card Program
Bank of America will be adding a new bonus earn category that will provide customers 2% bonus earn on Wholesale Club purchases (along with the current 2% on groceries and 3% on gas).  In addition, the quarterly bonus earn cap will be increased from $1,500 to $2,500 in combined gas/grocery/wholesale club purchases. The target implementation date is June 1st, which will be around the time that Visa cards will begin to be accepted at Costco.  With these enhancements, customers will enjoy bonus earn at all Wholesale Club merchants, including BJ’s Wholesale and Sam’s Club, as well.


CLASSIFIED


Spacious, Newly Renovated Medical Office to Sublet Near the United Nations
Handicapped accessible, Wi-Fi ready, separate reception area 1 to 3 rooms rooms available, 1 to 7 days per week Ideal for ophthalmologist/optometrist with onsite optical dispensary Could easily suit other specialties Excellent value, long-term lease available if desired Contact Dr. Scott Weissman email scott.weissmanmd@gmail.com  cell 914 772-5581

Commercial Co-op For Sale Lynbrook $129,000
Corner Of Hempstead Ave And Peninsula Blvd
880 sq ft Ground Floor Fully Renovated
Perfect For Doctor’s Office, Health Care, Accountant, Attorney,
Insurance, Real Estate, And General Office
AC, Parking Lot For Employees And Patients
3 Offices, Kitchen, Bath, Receptionist & Waiting Area
(516) 362-1828 | Leatherman Homes

Office Rental 30 Central Park South 
Two fully equipped exam rooms, two certified operating rooms, bathrooms and consultation room. Shared secretarial and waiting rooms. Elegantly decorated, central a/c, hardwood floors. Next to Park Lane and Plaza hotels. $1300 for four days a month. Available full or part-time. 212.371.0468 / drdese@gmail.com


Medical Office For Rent – 715 West 170 Street
Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s

Central Park South Medical Office Available to Share
Central Park South medical office, next to Plaza Hotel. Gorgeous Central Park view. Recent beautiful high–end renovation. Share part time with cosmetic dermatologist. Fully equipped for in–office surgery. Two exam rooms for you, shared waiting room and personal office. Free WiFi. Available part time, full or half days. Suits plastic/cosmetic surgeons/ENT/OBGYN etc. Contact Judith Hellman, MD, at jhderm@gmail.com or (212) 755–5482


NORTHERN WESTCHESTER – Psychiatric Opportunities
Part-time Psychiatrist (BC/BE/Child very desirable) wanted, to work in North Salem, N.Y., Suboxone DEA license helpful. Fax qualifications and availability to 914 669-6051 or call 914 669-5526 with questions..

Practice for Sale; North Salem, N.Y.
This is an excellent opportunity for someone wanting to purchase an established, growing practice. North Salem is a semi-rural suburban area 30 minutes north of White Plains; close to I-84, and I-684. This is an excellent place to live and practice, with excellent schools, close to malls and shopping. We treat patients of all ages, and there is a substantial Suboxone component integrated into the practice. Staffing includes several part-time psychiatrists, therapists. Patients come from Northern Westchester, nearby Putnam County and the Ridgefield-Danbury area and include children, adolescents, adults, families, Geriatric patients. Reliable office staff assist in patient and insurer management. Call 914 669-5526.


Physician Opportunities

Unique Private Pediatric Practice Opportunity
Summerwood Pediatrics is a very progressive, large community-based private practice in the Syracuse area. We provide care for over 25,000 children from birth to 21. The practice also has a satellite office in Camillus, NY. Additionally, the practice operates adjacent to an independent outpatient infusion practice, which is alsoowned and operated by our medical director. We are looking to employ a bright, energetic and enthusiastic general pediatric or subspecialty-trained physician. Presently the practice employs seven physicians, two pediatric NPs and one PA . All providers share on-call responsibilities on a one-day per week basis. Weekend coverage and office hours are performed on a rotational basis by the physicians. Our offices encompass over 28,0000sq. ft. of state-of-the- art clinical space;on-site lab services. The position, either full or part-time, includes applicable benefits inclusive of health care, malpractice insurance, CME expenditures and retirement plan. To discuss this opportunity further, contact either Dr. Robert A. Dracker or Mr. Warren Ford at 315-457-9914…9-5 EST.

Medical Director at CDPHP: Voted NYS “Best Company” by Our Employees!
CDPHP is more than a health insurer. We are a not-for-profit health value organization leading the way toward better, more affordable health care. CDPHP represents progress and innovation for more than 425,000 members throughout New York. A physician-founded and guided plan, our primary focus is the health and well-being of those we serve. While other insurers strive to create value for their shareholders, our efforts are centered on creating value for members, in part by providing employers with innovative solutions for managing health care. The Medical Director will assist the Vice President, Senior Medical Director and the SVP of Medical Affairs with the implementation of the Plan’s Medical Management, Quality Improvement and Resource Management initiatives in accordance with regulatory, accreditation, and corporate policies and strategic plan. The Medical Director will participate in the medical advisory committees, provide leadership to, and serve as a liaison between the physician community and the Plan’s management.

The ideal candidate will possess the following:

  • Licensed physician with current, unrestricted license (preferably New York State); Board Certified to practice a medical specialty; ABMS specialty is required.
  • If not licensed in New York State, eligibility for New York State licensure is required.
  • Additional advanced degree(s) preferred.
  • Minimum three to five (3-5) years clinical practice experience is required.
  • Minimum of three (3) years managed care or practice management is preferred.

Please email nicole.harrington@cdphp.comEqual Opportunity Employer, females, minorities, disabled, veterans



Relieve Physician Burnout through Yoga Science (30 CMEs)
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Change your perspective––change your experience. The 8th annual
American Meditation Institute Heart and Science of Yoga conference
is uniquely designed to offer you a refreshingly new, clearer and kinder
perspective on yourself and every personal and professional responsibility you face. This comprehensive training in Yoga Science as Holistic Mind/Body Medicine will provide easy-to-use, practical tools to prevent and reverse the debilitating causes and effects of physician burnout. Topics include: mantra meditation, diaphragmatic breathing, easy-gentle yoga, Yoga psychology, neuroplasticity, PTSD, trauma, resilience, the chakra system as a diagnostic tool, epigenomics, mind function optimization, Ayurveda, nutrition, functional medicine, and lymph system detoxification. Through engaging lectures by an accomplished faculty, instructive practicums and ongoing Q&A, you’ll gain experiential knowledge that will integrate Yoga Science into a dynamic self-care program. As a result of attending this conference, you’ll return home with a set of practical tools that can empower you to make conscious, discriminating and reliable choices to enhance your creativity, well-being, happiness and success. Regardless of how
challenging your circumstances might feel today, Yoga Science can help. Delicious gourmet vegetarian food(always including special dietary needs).
americanmeditation.org/cme
.

 


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

 

 

 

 

 

 

 

 

 

 

 

 

 

April 22, 2016 – Let’s Build New Alliances Together

 

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
asset.find.us.on.facebook.lgTwitter_logo_blue1

April 22,  2016
Volume 16, Number 15

Dear Colleagues:

I became an active member of MSSNY soon after I graduated from medical school in 1987. I became engaged in organized medicine at the national level by going to the AMA on my own when I was a resident. Many of the issues that plagued us then are the ones we have now. We beat them back, and like crabgrass and weeds, they come back every year no matter how many times we try to kill them.

The perennial issues of tort reform, malpractice rates and frivolous lawsuits and regressive liability are still with us. Insurance company abuses, insurance giants taking over lesser giants, unfunded mandates, and regulatory interference in the practice of medicine are on MSSNY agenda in Albany every year.

All these issues, vexing as they are, have not killed us yet. While there is much wrong with the state of medicine today, there is also much that is right with medicine. We still have the joy of healing patients and we have more and more patients than ever to treat.

If physicians can rise above their denial, anger and lethargy and join together to fight for their profession and their patients, we can overcome these challenges. We must be at the table when decisions are being made, not after we have been forced to swallow the outcome. Clearly, to avoid being victims, we must arm ourselves with numbers—data, a larger membership and more funding.

As our very effective Government Affairs Division tells us, they can only do so much. Legislators want to hear directly from the doctors. They really do want to talk to you, especially in your own districts. You are not just a voter but you are also a business owner, employer, community leader and patient advocate. Legislators will listen.

The truth is that we have had many tort reform victories. I believe that we can obtain collective negotiation and meaningful tort reform and I will work toward those goals. We will hammer away at the big issues. We need to be out in front of the issues and bring the fight to them, and not just punch wildly when we are on the ropes.

On the Agenda

With their help and yours, here are some of the other things I hope to accomplish:

  • Improve the outreach to MSSNY members, non-members, patients and government
  • Increase membership and income of MSSNY. I challenge each of you to bring in at least ONE new member. (I have had many mentors to whom I gave tribute at my inauguration—you can and should mentor a fellow physician, too.)
  • Increase our PAC funding and focus support on our allies.
  • We have to unite specialties, collaborate with other professions, hospitals and insurance companies whenever possible.
  • We must build new alliances and help physicians in private practice.

Physicians have to give more to our PAC. We have to turn words into action. We have to turn conflict into collaboration and self-interest into mutual cooperation. Unity of purpose will strengthen all of us.

Whether you are a new physician, mid-career or retiring, we need you and you need us.

The message for you and your colleagues—Get active and stay active in MSSNY.

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

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Physicians – Let Your Legislators Know that Legislation to Increase Your Liability Risk Could Be Detrimental to Patient Access to Care!
All physicians must contact their legislators to urge them to oppose legislation (A.285-A, Weinstein/S.6956, DeFrancisco) that could drastically increase New York’s already exorbitantly high medical liability premiums by changing the medical liability Statute of limitations to a “Date of Discovery” rule.   The letter can be sent from here.

If enacted, this legislation could increase your premiums by nearly 15%.  In light of the huge financial pressures prompted by excessive government mandates and abusive insurer practices that already are threatening the viability of physician practices, it is essential that you express to your elected representatives  that “stand-alone” legislation driving further liability increases cannot be tolerated and could seriously impact access to care for patients. 

We anticipate the Trial Lawyers and their allied front groups will be making an out all out push to enact this legislation when the Legislature returns to Albany on March 3 for the final 7 weeks of the Legislative Session.  It is imperative that you make these contacts to your legislators NOW!

In response to this threat, MSSNY and other groups have publicly highlighted the huge liability burden already assumed by New York physicians.  Recently, the Lawsuit Reform Alliance of NY wrote to the Syracuse Post Standard in support of badly needed medical liability reform to preserve access to specialized physician care.  And MSSNY has joined the Greater New York Hospital Association (GNYHA) and Healthcare Association of New York State (HANYS) in an ad in the Albany Times-Union and City & State calling for reduction in these exorbitant costs.
(AUSTER, DEARS)


Physicians Must Send Letter to Their Elected Representatives to Urge Elimination of Requirement to Electronically Inform DOH Concerning the Issuance of a Paper Script
Physicians are encouraged to send a letter accessible through MSSNY’s grassroots action center to urge that they support legislation (S.6779, Hannon/A. 9335A, Gottfried) to ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription.

The Bureau of Narcotics Enforcement announced that when a physician invokes one of the three statutory exceptions and write a paper script because:  their technology or power has failed; the prescription will be filled outside of New York; or it would be impractical for the patient to obtain medications in a timely manner, they must electronically submit to the department an onerous amount of information about the issuance of the paper prescription.  DOH asks that each time a paper prescription is written, the prescriber must electronically inform the DOH of their name, address, phone number, email address, license number, patient’s initials and reason for the issuance of the paper prescription (referencing the appropriate section of law.)   This creates an onerous burden for all physicians, particularly in situations where there is a protracted technological failure, and the physician needs to report dozens upon dozens of paper prescriptions. In fact, Surescripts has stated publicly that there is a 3-6% e-prescription transmission failure rate. This means that in the state of New York anywhere between 7.6M to 15M e-prescriptions will fail every year and each prescriber involved with these failures who subsequently write a paper prescription will need to file this information with the state.     In some small communities, even the patient’s initials can convey information that will enable others who access this information to identify the patient who will receive the medication.

A much more preferable alternative is to allow physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions.   It is important to know that the 12 exceptions released by the DOH Commissioner 10 days before e-prescribing went into effect, do not require reporting to the DOH.   The same should hold true for the issuance of paper prescriptions when one of the three statutory exemptions apply.  This legislation has passed the Senate twice and remains stalled in the Assembly Codes Committee. In order to re-invigorate legislative interest in this proposal physicians must send the letter located on the MSSNY grassroots action center.                        (DEARS, AUSTER)


Urge Passage of Legislation to Enable Override of Insurer “Fail First” Medication Policies
Concerned about health insurer policies that require your patients to “fail first” on certain prescription medications before they are able to take the medication that you believe is most medically appropriate to improve their health?  MSSNY is working together with a number of patient advocacy groups in support of legislation (A.2834-A, Titone/S.3419-B, Young) to provide physicians with an expeditious manner to override an insurer “fail first” policy when it is in the best interest of their patients’ health.  To send a letter in support of this legislation click here.

We strongly encourage physicians concerned about this issue to participate in an upcoming May 23 Albany Advocacy Day in support of this legislation.  MSSNY representatives will be participating along with many other patient advocacy groups.  Moreover, MSSNY Immediate Past-President Dr. Joseph Maldonado recently appeared on the YNN Statewide news program Capital Tonight along with National Alliance on Mental Illness’ Matthew Shapiro to discuss the importance of the legislation.  To watch the broadcast, click here.      (AUSTER, DEARS)


Health Care Organizations Urge Inclusion of E-Cigarettes In Clean Indoor Air Act—Advocacy Day to Be Held May 24th
A group of health care organizations, including the Medical Society of the State of New York, have come together to advocate for the placement of E-Cigarettes under the New York State Clean Indoor Air Act. The group, comprised of national and state organizations includes the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Roswell Park Cancer Institute, New York State Association of County Health Officials, Campaign for Tobacco-Free Kids, New York State Public Health Association, and the Medical Society of the State of New York, among others.

Despite containing carcinogens and toxic chemicals, including those found in anti-freeze, E-Cigarettes are currently unregulated by the FDA, and are not subject to tobacco laws as they do not contain tobacco. While New York State has prohibited the sale of E-Cigarettes to minors under the age of 18, indoor use of E-Cigarettes in public places is still permitted. MSSNY supports legislation and urges its members to support legislation (A.5955, Rosenthal/S.2202, Hannon) to place E-Cigarettes under the New York State’s Clean Indoor Air Act.                                                                                                                (CLANCY, MCPARTLON)

Physicians Invited to Particpate In Medical Specialties Lobby Day – May 17, 2016
Physicians from all localities will join forces in the State Capital on May 17th to advocate for their patients and profession during the annual Medical Specialties Lobby Day. Collectively, MSSNY and the specialty societies participation in this event represent physicians in specialty practices across New York State and together we stand committed to battling inappropriate allied health provider expansion legislation and advancing bills of importance to all of medicine.

The day will kick off with a breakfast, legislative briefing and Q&A session in the Empire State Plaza. Immediately following, physicians will meet with their elected representatives in the Senate and Assembly.

Attendees will be paired with physicians of other specialties and provided with easy to understand talking points so they can effectively present their arguments and positions.

We hope that you will reaffirm your commitment to your colleagues, your profession and your patients by joining us in Albany on May 17. To register here. 

All registrants will be emailed a confirmation and additional details closer to the event.


NYS Medical Specialties Lobby Day Organizations
Medical Society of the State of NY — NYS Ophthalmological Society — NYS Society of Physical Medicine and Rehabilitation — NYS Society of Plastic Surgeons — NYS Society of Orthopaedic Surgeons — NYS Society of Otolaryngology – Head and Neck Surgery — American College of Surgeons of NYS — NYS Psychiatric Association — NYS Society of Anesthesiologists
(MCPARTLON)


MSSNY AMA Urge Congress to Push CMS to Withdraw Proposed Revisions to Part B Medications Payment
MSSNY together with 20 other health advocacy organizations have written to the entire New York Congressional delegation urging that they request CMS to withdraw a proposed rule that would implement a new Medicare Part B medication payment model.  The proposal would change the reimbursement methodology of Part B drugs from the current 6% add-on to the “Average Sales Price (ASP)” to 2.5% plus a flat fee.

The letter to the New York Congressional delegation highlights that these proposed payment changes could have a serious adverse impact on the care and treatment of New York Medicare patients with complex conditions, such as cancer, macular degeneration, hypertension, rheumatoid arthritis, Crohn’s disease and ulcerative colitis, and primary immunodeficiency diseases.   The American Medical Association has also written a detailed letter to Congressional leadership urging that they request CMS to withdraw the proposed rule, noting in particular that “the proposal could threaten Medicare beneficiaries’ continued access to care in their local community and lower cost delivery sites depending on where they live”.   The proposal has also generated strong opposition from the American Society of Clinical Oncology.      (AUSTER)


PTSD and TBI in Returning Veterans: May – June Webinars
MSSNY will be holding a series of CME webinars on PTSD and TBI in returning veterans on five dates listed below from April through June. The faculty presenters will be Frank Dowling, MD and Joshua Cohen, MD.

Course objectives:

  • Explore the two most prevalent mental disorders facing American veterans today, their causes, symptoms, and comorbidities;
  • Outline treatment options including evidence-based psychotherapy and pharmacotherapy;
  • Discuss barriers to treatment, including those unique to military culture, and how to overcome them;
  • Outline the process of recovery and post-traumatic growth.

To register for this program, click on a date below and fill out the registration form.

Thursday, May 5, 6-7 PM
Thursday, May 19, 7:30-8:30 AM
Thursday, June 2, 6-7 PM
Thursday, June 9, 7:30-8:30 AM                                                                                  (ELPERIN, DEARS)


NYS DOH To Conduct Zika Virus Webinar: An Update on Microcephaly for Healthcare Providers on April 27th
The New York State Department of Health will conduct a Zika Virus webinar on April 27, 2016 from 12-1 p.m. to discuss the relationship between prenatal Zika virus infection and microcephaly and other serious brain abnormality.  Registration is required. Physicians are strongly encouraged to participate.

Presenters will be Deborah Campbell, MD, FAAP, Professor of Clinical    Pediatrics, Albert Einstein College of Medicine, Chief, Division of Neonatology, Children’s Hospital at Montefiore and Deborah Fox, MPH, Director, Congenital Malformations Registry, New York State Department of Health. The  webinar will discuss other factors that can cause microcephaly in a fetus, describe how to determine if a fetus or newborn is microcephalic, and describe how your efforts and reporting to the NYSDOH’s Congenital Malformations Registry will help to accurately document the prevalence of microcephaly in New York State and Zika virus infection’s contribution to it.
(CLANCY)


MSSNY’s Opioid Webinars Are Now Available On Its CME Online Site
The Medical Society has archived its opioid webinar series on its continuing medical education website at http://cme.mssny.org/

The webinars are:  Webinar 1 Pain Management at the Crossroads:  A Tale of Two Public Health Problems; Webinar 2 Rational Opioid Prescribing:  Is this Possible for Chronic Pain?; Webinar 3 Treatment of Opioid Use Disorders and Webinar 4 Pain Patients w/Substance Use Disorders  

Physicians and other prescribers can earn up to one hour of continuing medical credits by viewing this webinar and completing the test.    The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.     MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course.

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.  MSSNY’s online continuing medical education sites has numerous programs of varying length, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
(CLANCY)


View Zika Webinar; Program Archived on MSSNY’s CME Site
The Medical Matters program, entitled “Zika Virus—An Evolving Story” is now archived to the MSSNY CME website and physicians and other health care providers can view this program free of charge by logging into http://cme.mssny.org.

The webinar was conducted by MSSNY and the New York State Department of Health and featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee, and Dr. Elizabeth Dufort, Medical Director, Division of Epidemiology from the New York State Department of Health.

The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses.  MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. 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 online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.
(CLANCY, HOFFMAN) 


Please Join Us – MSSNY to Have Team at the 2016 CDPHP Workforce Race
For the first time, MSSNY will have a team at the CDPHP Workforce Team Challenge!  May 6 is the deadline to register for the 2016 CDPHP Workforce Team Challenge.  This year’s 3.5-mile race is on Thursday, May 19, 2016, and both runners and walkers are highly encouraged to participate.   The race begins at 6:25 PM at Empire State Plaza in Albany.  MSSNY members who would like to join the team are invited to sign up at http://www.cdphpwtc.com/; please choose “Medical Society of the State of New York” from the team drop-down list.  Registration is $22.00, and a portion of the registration fees go to this year’s “Charities of Choice,” Girls on the Run and Schenectady ARC.  For more information, please contact Miriam Hardin (mhardin@mssny.org).
(HARDIN)

 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.org  
pclancy@mssny.org jmcpartlon@mssny.org    

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CMS Publishes Data for 2015 Open Payments
Since 2013, CMS Open Payments program (also known as the Sunshine Act) has collected data from drug and device manufacturers and group purchasing organizations (GPOs) about payments they make to physicians and teaching hospitals. The program also collects information about ownership and investment interests of physicians and their immediate family members in drug and device manufacturers and GPOs. CMS publishes this data on its website, so it is important for physicians and teaching hospitals to check and confirm the accuracy of the financial transactions reported about them.

Last June, CMS published payments and ownership records for more than 607,000 physicians and 1,122 teaching hospitals valued at $6.45 billion for 2014.  Payments were attributed to medical research, conference travel and lodging, gifts and consulting. CMS has collected data for all of Calendar Year 2015 and will publish it on its website on June 30, 2016.

To review any payments attributed to them, physicians—including doctors of medicine or osteopathy, dentists, chiropractors, optometrists and podiatrists—and teaching hospitals need to register on the Open Payments website.

CMS encourages physicians to review data reported about them so applicable manufacturers and GPOs can resolve any disputes before the data is published. There are instructions and quick reference guides located on the Resources Page to help. The review period for the June 30, 2016 publication opened on April 1, 2016, and will end May 15, 2016. 

CMS Launches Largest-Ever Multi-Payer Initiative for Primary Care
          New Affordable Care Act initiative, designed to improve quality
and cost
This week, CMS announced its largest-ever initiative to transform and improve how primary care is delivered and paid for in America. The effort, the Comprehensive Primary Care Plus (CPC+) model, will be implemented in up to 20 regions and can accommodate up to 5,000 practices, which would encompass more than 20,000 doctors and clinicians and the 25 million people they serve. The initiative is designed to provide doctors the freedom to care for their patients the way they think will deliver the best outcomes and to pay them for achieving results and improving care.

“Strengthening primary care is critical to an effective health care system,” said Dr. Patrick Conway, CMS deputy administrator and chief medical officer. “By supporting primary care doctors and clinicians to spend time with patients, serve patients’ needs outside of the office visit, and better coordinate care with specialists we can continue to build a health care system that results in healthier people and smarter spending of our health care dollars. The Comprehensive Primary Care Plus model represents the future of health care that we’re striving towards.”

Building on the Comprehensive Primary Care initiative launched in late 2012, the five-year CPC+ model will benefit patients by helping primary care practices:

  • Support patients with serious or chronic diseases to achieve their health goals
  • Give patients 24-hour access to care and health information
  • Deliver preventive care
  • Engage patients and their families in their own care
  • Work together with hospitals and other clinicians, including specialists, to provide better coordinated care

Primary care practices will participate in one of two tracks. Both tracks will require practices to perform the functions and meet the criteria listed above, but practices in Track 2 will also provide more comprehensive services for patients with complex medical and behavioral health needs, including, as appropriate, a systematic assessment of their psychosocial needs and an inventory of resources and supports to meet those needs.

CPC+ will help practices move away from one-size-fits-all, fee-for-service health care to a new system that will give doctors the freedom to deliver the care that best meets the needs of their patients. In Track 1, CMS will pay practices a monthly care management fee in addition to the fee-for-service payments under the Medicare Physician Fee Schedule for activities. In Track 2, practices will also receive a monthly care management fee and, instead of full Medicare fee-for-service payments for Evaluation and Management services, will receive a hybrid of reduced Medicare fee-for-service payments and up-front comprehensive primary care payments for those services. This hybrid payment design will allow greater flexibility in how practices deliver care outside of the traditional face-to-face encounter.

To promote high-quality and high-value care, practices in both tracks will receive up-front incentive payments that they will either keep or repay based on their performance on quality and utilization metrics. The payments under this model encourage doctors to focus on health outcomes rather than the volume of visits or tests.

Practices in both tracks also will receive data on cost and utilization. Optimal use of Health IT and a robust learning system will support them in making the necessary care delivery changes and using the data to improve their care of patients. Track 2 practices’ vendors will sign a Memorandum of Understanding (MOU) with CMS that outlines their commitment to supporting practices’ enhancement of health IT capabilities. These partnerships will be vital to practices’ success in the care delivery work and align with the Office of the National Coordinator for Health IT priority to ensure electronic health information is available when and where it matters to consumers and clinicians.

Under the CPC+ model, Medicare will partner with commercial and state health insurance plans to support primary care practices in delivering advanced primary care. Advanced primary care is a model of care with five key components:

  • Services are accessible, responsive to an individual’s preference, and patients can take advantage of enhanced in-person hours and 24/7 telephone or electronic access.
  • Patients at highest risk receive proactive, relationship-based care management services to improve outcomes.
  • Care is comprehensive and practices can meet the majority of each individual’s physical and mental health care needs, including prevention. Care is also coordinated across the health care system, including specialty care and community services, and patients receive timely follow-up after emergency room or hospital visits.
  • It is patient-centered, recognizing that patients and family members are core members of the care team, and actively engages patients to design care that best meets their needs.
  • Quality and utilization of services are measured, and data is analyzed to identify opportunities for improvements in care and to develop new capabilities.

CMS will select regions for CPC+ where there is sufficient interest from multiple payers to support practices’ participation in the initiative. CMS will enter into a Memorandum of Understanding (MOU) with selected payer partners to document a shared commitment to align on payment, data sharing, and quality metrics in CPC+.

CMS will accept payer proposals to partner in CPC+ from April 15 through June 1, 2016. CMS will accept practice applications in the determined regions from July 15 through September 1, 2016.

In March 2016, the Administration estimated that it met the ambitious goal – eleven months ahead of schedule – of tying 30 percent of Medicare payments to quality and value through alternative payment models by 2016. The Administration’s next goal is tying 50 percent of Medicare payments to alternative payment models by 2018. The Health Care Payment Learning and Action Network established in 2015 continues to align efforts between government, private sector payers, employers, providers, and consumers to broadly scale these gains in better care, smarter spending, and healthier people.

For more information about the CPC+ model, including a fact sheet, please click here.

How to Apply

Payer solicitation and practice applications will be a staggered process. First, CMS will solicit payer proposals to partner with Medicare in CPC+ (April 15-June 1, 2016). The choice of up to 20 CPC+ regions will be informed by the geographic reach of selected payers.

Next, CMS will publicize the CPC+ regions, and solicit applications from practices within these regions (July 15-September 1, 2016). Practices will apply directly to the track for which they believe they are ready; however, CMS reserves the right to offer practice entrance into Track 1 if they apply to, but do not meet the eligibility requirements for Track 2.

Practices applying to Track 2 will need to submit a letter of support from their Health IT vendor(s) that outlines vendors’ commitment to supporting the practice with advanced health IT capabilities. CMS will sign a Memorandum of Understanding with those health IT vendors supporting Track 2 practices selected to participate in CPC+.


CMS releases Medicare Advantage Quality Data for Racial and Ethnic Minorities
CMS Office of Minority Health released data detailing the quality of care received by people with Medicare Advantage by racial or ethnic group.

The database presents HEDIS and CAHPS scores for different racial and ethnic groups at the level of individual Medicare contracts and is intended to be used to improve quality and accountability. The information provided by this database is not used to evaluate care through the star ratings program Medicare Advantage and Part D Star Ratings program nor is not it used for payment purposes.

A report summarizing the data accompanied the release. Analysis of the quality of care delivered to beneficiaries showed that Asians and Pacific Islanders typically received care that is similar to or better than the care received by Whites, whereas African Americans and Hispanics typically received care that is similar to or worse than the care received by Whites. African Americans and Hispanics also reported their health care experiences as being similar to or worse than the experiences reported by Whites. This data help to highlight the racial and ethnic disparities that occur within healthcare.

The data and summary report can be viewed here.


MSK Reports $28M Health Republic Debt
Memorial Sloan Kettering reported $169.2 million in operating income last year, but still 30.3% less than it earned in 2014. MSK attributed the lower profit in part to bad debt related to the failure of Health Republic Insurance of New York, as well as to rising drug costs. The hospital wrote off $28.3 million in bad debt from patients who were insured by Health Republic, and said it would “continue to pursue collection for these charges.” That bad debt contributed to an 11.4% increase in operating expenses, to $3.5 billion. (Crains, 4/15)


CAQH CORE National Education Event
Save Time and Money using EFT/ERA Transactions – CAQH CORE and AMA Guidance on Implementing the Phase III CAQH CORE Operating Rules

Thursday, April 28, 2016 | 2:00 – 3:00 pm ET

Register for this event HERE for free

Are you interested in faster payment and remittance advice processing? Reductions in phone calls to health plans? Want to eliminate lost or stolen checks? The answer to all these questions is undoubtedly yes and the easiest way to do it is to switch from paper checks and EOBs to healthcare electronic funds transfers (EFT) and electronic remittance advice (ERA). CAQH CORE and the American Medical Association (AMA) will discuss the benefits of going paperless in healthcare financial transactions, highlighting available resources to help your organization with implementation efforts. The webinar will also showcase a real-world case study from the largest integrated healthcare system in the U.S., the Veteran’s Health Administration, and how they have benefitted from moving to electronic payments and remits.


Please Take Physicians Foundation Survey—MSSNY is a Charter Member
Merritt Hawkins, on behalf of The Physicians Foundation, biennially conducts one of the largest and most widely referenced physician surveys undertaken in the United States. The survey is intended to provide a “state of the union” of the medical profession and to give physicians a voice with policy makers and the public. Much of the information gathered in the past will be shared with your members during our presentation in May.

Take the survey here.

At this time, we only have 284 responses from New York. By encouraging more physicians from the state to complete the survey, we will acquire better insights into the practice patterns and perspectives of New York physicians, which we will be able to pass along to you. Also, a $5,000 grant will go to the state medical society with the most responses.


Bank of America Announces Enhancement  to Affinity Card Program
Bank of America will be adding a new bonus earn category that will provide customers 2% bonus earn on Wholesale Club purchases (along with the current 2% on groceries and 3% on gas).  In addition, the quarterly bonus earn cap will be increased from $1,500 to $2,500 in combined gas/grocery/wholesale club purchases. The target implementation date is June 1st, which will be around the time that Visa cards will begin to be accepted at Costco.  With these enhancements, customers will enjoy bonus earn at all Wholesale Club merchants, including BJ’s Wholesale and Sam’s Club, as well. 


AG Lawsuit Accuses CDPHP of Unlawfully Denying Coverage of HepC Treatment
This week, Attorney General Eric T. Schneiderman announced a lawsuit against CDPHP. The insurer has approximately 450,000 members in New York State and provides service to 24 counties throughout the Capital Region, North Country, Hudson Valley, Central New York, and the Southern Tier.  The lawsuit, filed in New York Supreme Court, alleges that CDPHP unlawfully restricted coverage of treatment for chronic Hepatitis C infection, a potentially life threatening condition. Several medications are currently available that can completely cure Hepatitis C. The lawsuit alleges that CDPHP denied coverage for such treatment unless the member demonstrated advanced disease – such as moderate to severe liver scarring. Members diagnosed with early-stage chronic Hepatitis C infection must monitor their disease and wait until they develop liver scarring or other advanced disease before their treatment will be covered by CDPHP.

“When consumers purchase health insurance, they rightfully expect that if they are diagnosed with a serious, potentially life threatening disease like Hepatitis C, treatment will be considered ‘medically necessary’ and covered by their insurance,” said Attorney General Schneiderman. “Forcing patients to wait for care, risking internal organ damage, is unconscionable and, as we allege in our lawsuit, violates the law and the company’s own policies.”

Effective January 1, 2014, New York State has required medical providers to offer Hepatitis C screening to patients born between 1945 and 1965 and to provide or make a referral for follow-up health care to patients with a positive test result.

While the Food and Drug Administration has approved several medications to cure Hepatitis C, CDPHP has limited coverage of those medications to only those members with an advanced stage of the disease. This approach is, and has been, inconsistent with the prevailing treatment guidelines, which recommend treatment of nearly all individuals diagnosed with chronic Hepatitis C.

According to the lawsuit, CDPHP restricted coverage of Hepatitis C treatment, including but not limited to requiring advanced liver scarring, in a manner that is inconsistent with its own policies. The Complaint further alleges that CDPHP may have restricted coverage of Hepatitis C treatment because of the potential expense to CDPHP, yet its plan documents never disclosed to current or potential members that it considered cost when deciding whether treatment for a disease would be covered by the plan  By failing to disclose that cost is a consideration in making determinations as to whether and when treatment is deemed “medically necessary,” and by failing to cover treatment for Hepatitis C even when it meets the plans’ definitions of “medically necessary,” the lawsuit alleges that CDPHP is misleading its members about the scope of their coverage. The lawsuit further alleges that by failing to fully disclose the definition of “medically necessary” used in determining when benefits will be covered, CDPHP is violating the New York State Insurance Law and Public Health Law.

The lawsuit is part of a continuing investigation into numerous health insurers for improperly restricting coverage of Hepatitis C treatments and misleading their members about the scope of their coverage.


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Two to five examination rooms available plus Reception,secretarial areas. Two bathrooms and entrances. Ethernet and cable ready. $4000 – $9500/ month. 917.861.8273 drdese@gmail.com Can build to suit including accredited O.R.s


Central Park South Medical Office Available to Share
Central Park South medical office, next to Plaza Hotel. Gorgeous Central Park view. Recent beautiful high–end renovation. Share part time with cosmetic dermatologist. Fully equipped for in–office surgery. Two exam rooms for you, shared waiting room and personal office. Free WiFi. Available part time, full or half days. Suits plastic/cosmetic surgeons/ENT/OBGYN etc. Contact Judith Hellman, MD, at jhderm@gmail.com or (212) 755–5482

L.I. PSYCHIATRIC PRACTICE FOR SALE
                    Huntington, NY
Currently 20 hrs./wk – no evenings or weekends.
$100K/yr. gross. Low overhead.
Office available for rent or move to your location.
Details on request: 631-784-7704

Physician Opportunities

Unique Private Pediatric Practice Opportunity
Summerwood Pediatrics is a very progressive, large community-based private practice in the Syracuse area. We provide care for over 25,000 children from birth to 21. The practice also has a satellite office in Camillus, NY. Additionally, the practice operates adjacent to an independent outpatient infusion practice, which is alsoowned and operated by our medical director. We are looking to employ a bright, energetic and enthusiastic general pediatric or subspecialty-trained physician. Presently the practice employs seven physicians, two pediatric NPs and one PA . All providers share on-call responsibilities on a one-day per week basis. Weekend coverage and office hours are performed on a rotational basis by the physicians. Our offices encompass over 28,0000sq. ft. of state-of-the- art clinical space;on-site lab services. The position, either full or part-time, includes applicable benefits inclusive of health care, malpractice insurance, CME expenditures and retirement plan. To discuss this opportunity further, contact either Dr. Robert A. Dracker or Mr. Warren Ford at 315-457-9914…9-5 EST.


NORTHERN WESTCHESTER – Psychiatric Opportunities Part-time Psychiatrist (BC/BE/Child very desirable) wanted, to work in North Salem, N.Y., Suboxone DEA license helpful. Fax qualifications and availability to 914 669-6051 or call 914 669-5526 with questions..


Practice for Sale; North Salem, N.Y. This is an excellent opportunity for someone wanting to purchase an established, growing practice. North Salem is a semi-rural suburban area 30 minutes north of White Plains; close to I-84, and I-684. This is an excellent place to live and practice, with excellent schools, close to malls and shopping. We treat patients of all ages, and there is a substantial Suboxone component integrated into the practice. Staffing includes several part-time psychiatrists, therapists. Patients come from Northern Westchester, nearby Putnam County and the Ridgefield-Danbury area and include children, adolescents, adults, families, Geriatric patients. Reliable office staff assist in patient and insurer management. Call 914 669-5526.

Medical Director at CDPHP: Voted NYS “Best Company” by Our Employees!
CDPHP is more than a health insurer. We are a not-for-profit health value organization leading the way toward better, more affordable health care. CDPHP represents progress and innovation for more than 425,000 members throughout New York. A physician-founded and guided plan, our primary focus is the health and well-being of those we serve. While other insurers strive to create value for their shareholders, our efforts are centered on creating value for members, in part by providing employers with innovative solutions for managing health care. The Medical Director will assist the Vice President, Senior Medical Director and the SVP of Medical Affairs with the implementation of the Plan’s Medical Management, Quality Improvement and Resource Management initiatives in accordance with regulatory, accreditation, and corporate policies and strategic plan. The Medical Director will participate in the medical advisory committees, provide leadership to, and serve as a liaison between the physician community and the Plan’s management.

The ideal candidate will possess the following:

  • Licensed physician with current, unrestricted license (preferably New York State); Board Certified to practice a medical specialty; ABMS specialty is required.
  • If not licensed in New York State, eligibility for New York State licensure is required.
  • Additional advanced degree(s) preferred.
  • Minimum three to five (3-5) years clinical practice experience is required.
  • Minimum of three (3) years managed care or practice management is preferred.

Please email nicole.harrington@cdphp.comEqual Opportunity Employer, females, minorities, disabled, veterans



Relieve Physician Burnout through Yoga Science (30 CMEs)
Layout 1
Change your perspective––change your experience. The 8th annual
American Meditation Institute Heart and Science of Yoga conference
is uniquely designed to offer you a refreshingly new, clearer and kinder
perspective on yourself and every personal and professional responsibility you face. This comprehensive training in Yoga Science as Holistic Mind/Body Medicine will provide easy-to-use, practical tools to prevent and reverse the debilitating causes and effects of physician burnout. Topics include: mantra meditation, diaphragmatic breathing, easy-gentle yoga, Yoga psychology, neuroplasticity, PTSD, trauma, resilience, the chakra system as a diagnostic tool, epigenomics, mind function optimization, Ayurveda, nutrition, functional medicine, and lymph system detoxification. Through engaging lectures by an accomplished faculty, instructive practicums and ongoing Q&A, you’ll gain experiential knowledge that will integrate Yoga Science into a dynamic self-care program. As a result of attending this conference, you’ll return home with a set of practical tools that can empower you to make conscious, discriminating and reliable choices to enhance your creativity, well-being, happiness and success. Regardless of how
challenging your circumstances might feel today, Yoga Science can help. Delicious gourmet vegetarian food(always including special dietary needs).
americanmeditation.org/cme
.

 


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

 

 

 

 

 

 

 

 

 

 

 

 

 

April 17, 2016 – Council

 AGENDA
Council Meeting – HOD
Sunday, April 17, 2016
Westchester Marriott, Tarrytown, NY

A. Call to Order and Roll Call

B. APPROVAL of the Council Minutes of March 7, 2016

C. New Business (All New Action & Informational Items)

1. President’s Report:

Dr. Reid – Please welcome our MSSNY Officers, Councilors,  Trustees, County Execs, MSSNY Staff and the following new  MSSNY Councilors:

Maria A. Basile, MD, MBA, Suffolk County Medical
Society  Councilor
Brian P. Murray, MD, Third District Branch Councilor
Richard A. Ritter, MD, Organized Medical Staff Section Councilor
Christina E. Kratschmer, Medical Student Section Councilor

 

a. APPROVAL – 2016/2017 New MSSNY Meeting Schedule
b. APPROVAL – 2016/2017 New Committee Selections 
c. APPROVAL – MSSNY’s Recommendations to improve EHR satisfaction: Based on findings from New York Physician’s survey on EHR


2. Board of Trustees Report
– No report – Board meets after Council

D. Commissioners (All Committee & Sub-Committee Informational
Reports/Minutes

  1. Commissioner of Governmental Relations, Gregory Pinto, MD
    a. HIT Committee Minutes, March 29, 2016
    b. AD HOC Subcommittee on EHR Functionality Minutes, March 15, 201
  1. Commissioner of Socio Medical Economics, Howard H. Huang, MD
    a. Interspecialty Committee Minutes, February 25, 2016
  1. Commissioner of Science and Public Health, Frank G. Dowling, MD
    a. Addiction and Psychiatric Medicine Committee Minutes, January 22, 2016
    b. Bio Ethics Committee Minutes, February 5, 2016
    c. Bio Ethics Committee Minutes, April 1, 2016
    d. Eliminate Health Care Disparities Committee Minutes, February 19, 2016
    e. Heart, Lung Cancer Committee Minutes, January 27, 2016
    f. Infectious Diseases Committee Minutes, January 14, 2016
    g. Infectious Diseases Committee Minutes, October 27, 2016
    h. Preventive Medicine and Family Health Committee Minutes, February 11, 2016

E. Reports of Officers (Verbal Reports)

  1. Office of the President – Malcolm D. Reid, MD, MPP
  2. Office of the President-Elect – Charles Rothberg, MD
  3. Office of the Vice President – Thomas J. Madejski, MD, FACP
  4. Office of the Treasurer – Joseph R. Sellers, MD, FAAP, FACP – Financial Statement for the period  1/1/16 to 02/29/16
  5. Office of the Secretary – Arthur C. Fougner, MD
  6. Office of the Speaker – Kira A. Geraci-Ciardullo, MD, MPH

F. Reports of Councilors (Informational)

1.Manhattan/Bronx Report – Joshua M. Cohen, MD, MPH
2. Third District Branch Report – Brian P. Murry, MD
3. Fifth District Branch Report – Howard H. Huang, MD
4. Seventh District Branch Report – Mark J. Adams, MD
5. Ninth District Branch Report – Thomas T. Lee, MD
6. Queens County Report – Saulius J. Skeivys, MD
7. Kings / Richmond Report – Parag H. Mehta, MD


G. Report of the Executive Vice President

 1. Membership Revenue Schedule

H. Other Information/Announcements
1. Part B Drugs Sign-On Letter
2
Testimony of Joseph Sellers, MD – NYS Assembly Health and Insurance
Committees

I. Adjournment

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