MSSNYeNews: IT’S TRUE: Bonding with Patients=Longevity

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
July 13, 2018
Volume 20  Number 25

MSSNYPAC

Dear Colleagues:

MSSNY advocates tirelessly for the sanctity of the patient physician relationship.  We fight against disruption of the care of our patients because we know in our hearts and minds that disruption of care by insurers, pharmaceutical benefit managers, and other third party entities leads to fragmentation of care and poorer outcomes. We have known for some time that continuity of care in primary care is associated with greater patient satisfaction,9 improved health promotion,10 increased adherence to medication, reduced hospital use, and lower hospital mortality.

Health policy researchers recently concluded that continuity of care is truly a matter of life and death in a meta-analysis published in the June 28 issue of BMJ Open. Their analysis was not limited to primary care continuity.  The same is true for specialties—particularly surgeons and psychiatrists.

The research involved 22 studies from nine countries with different cultures and healthcare systems. Overall, 82 percent of the studies showed that patients who stayed with the same physician had a lower chance of dying as compared to patients who engaged different doctors. Similarly, patients who see the same doctor are more likely to listen to our advice and they have a higher rate of following recommendations for preventing illness.

Conversely, 21 percent of Americans do not have a personal physician. Dr. Denis Pereira Gray, the lead researcher of the study, said, “ Patients talk more freely to doctors they know and doctors can then understand them better and tailor advice and treatment better.”

As the study conclusion states, “For 200 years, medical advances have been mainly technical and impersonal which has reduced attention to the human side of medicine. This systematic review reveals that despite numerous technical advances, continuity of care is an important feature of medical practice, and potentially a matter of life and death.”

Opposing Regulations that Reduces Time with Patients

A few years back, I came up with The Madejski Rule: MSSNY will vigorously oppose any legislation or regulation that reduces the quality or amount of time spent with our patients.  This principle should continue to inspire and guide us in our advocacy against unwarranted deselection by insurers, narrow networks, midyear formulary changes, government directed data collection, and retail clinics which prevent or disrupt the ability of patients to have a longitudinal relationship with a physician of their choice.

You need to be part of the solution.  Join me in Albany for our State Legislative advocacy day, Wednesday, March 6. Make sure you are a member of MSSNYPAC. Become more active in your County Medical society to create new policy which improves the care of our patients.

Excelsior!

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

eNews

DOH Now Allowing Medical Marijuana for Patients Who Are Prescribed Opioids
New York State is now allowing anyone who is prescribed an opioid the option to request medical marijuana instead. State Health Commissioner Howard Zucker MD announced details of the new policy Thursday. He said medical marijuana has been shown to be an effective pain treatment that doesn’t carry the risk of addiction that comes with opioids. Dr. Zucker said that giving people an alternative to opioids is a critical step in the fight against the opioid epidemic.

That means people suffering from severe pain, opioid dependency or other maladies will now qualify to receive medical cannabis.

“Medical marijuana has been shown to be an effective treatment for pain that may also reduce the chance of opioid dependence…Adding opioid replacement as a qualifying condition for medical marijuana offers providers another treatment option, which is a critical step in combatting the deadly opioid epidemic affecting people across the state.”

Adding severe pain and opioid dependency to the list means that 13 health conditions now qualify patients for medical marijuana in New York. Currently, more than 62,000 patients and about 1,700 practitioners are registered under the state’s medical cannabis program, according to the DOH release.

New York’s Department of Health first announced its plans to add severe pain and opioid dependency to the list of qualifying conditions last month, and is now releasing the emergency regulations to implement the decision.

Dr. Zucker said last month that “the pros outweigh the cons” when it comes to ending cannabis prohibition in the state.

Join MSSNY’s Member Perks Program and Enjoy $4,500 in Savings!
MSSNY is pleased to announce our newest member benefit!  Our new Abenity App provides members with exclusive perks and over $4,500 in savings on everything from pizza, the zoo, movie tickets, theme parks, hotels, and car rentals!

Popular Features Include:

  • Nearby Offers: Use our show and save mobile coupons to quickly access savings on the go.
  • eTickets On Demand: Save up to 40% with no hidden fees.
  • Showtimes: Find movies, watch trailers, and save up to 40% at a theater near you.
  • Monthly Giveaways: Win cash, movie tickets, electronics and more with our monthly contests.

And, with over 302,000 available discounts across 10,000 cities in the United States and Canada, you’ll never be far from savings!

REGISTER & LOG IN

Click on the following link: http://mssny.abenity.com and then create a unique user name and password. 

4 TIPS TO GET YOU STARTED

  1. Mobile Apps: For quick access to savings on the go and to receive proactive Perk Alerts of nearby offers, download our app for iPhone, Android, and Windows phones here.
  2. Quick Tour: Slide through our top features here.
  3. Monthly Emails: Subscribe to our newsletters and be the first to know about new discounts and giveaways here.
  4. Connect: Register for free giveaways, get the inside scoop, and share your savings stories on Facebook, Twitter, or Instagram using #LifeHasPerks

Download our perks flyer and email it to other MSSNY members. 

MSSNY Counsel Offers Employment Contract Review for MSSNY Members
For MSSNY members only, MSSNY Counsel Garfunkel Wild is offering a special rate for employment contract review and negotiation. Their review will focus on key provisions, including:

Compensation Models Termination Provisions; Restrictive Covenants; Professional Liability Insurance; Indemnification; Duties and Obligations; Benefits; Post-Terminations Rights; Dispute Resolution; and Outside Activities.

ARE YOU INTERESTED IN GROUP HEALTH INSURANCE? TAKE OUR SURVEY!
Do you have 90 seconds to take a brief survey? MSSNY is exploring the possibility of developing a cost-effective health plan for our members, their dependents, and their employees (not an association health plan [AHP]). Our ability to move forward will be based on the number of members that express an interest in participating with this new group. https://www.surveymonkey.com/r/GroupHealthIns

NYS County Contacts in Your County for Workers Compensation Applications
In June 2017, the NYS WCB asked MSSNY for clarity about where physicians should be referred where seeking to be authorized for treating WC injured workers and/or being authorized to provide Independent Medical Examinations (IMEs) for WC.  Attached please find the information for the NYS County Medical Society contacts for these WC applications.  If you have any additional questions, please call Regina McNally at 516-488-6100, ext. 332 or email rmcnally@mssny.org or contact your county executive from the this list.

MSSNY’s Infection Control Course Includes Newly Required Section on Sepsis
New York State law requires that all licensed health care providers—including physicians, physician assistants, nurses, nurse practitioners and dentists—receive training on infection control and barrier precautions every four years. The Medical Society of the State of New York is approved by the New York State Department of Health and the state Education Department to provide Infection Control and Barrier Precautions to all healthcare professionals.

MSSNY recently updated its course to include the newly required content on Sepsis. If your medical license is up for renewal any time after July 1, 2018, you are required to take this updated course. Every New York state physician must be in compliance by July 1, 2022. Click here to take the up-to-date Infection Control course. New participants to the MSSNY CME site must first create an account.

NY Organ Collection Agency, Nation’s Second-Largest, Threatened With Closure
In a letter last month to Live­OnNY, which recovers organs in the New York City area, the CMS said it “will not renew its agreement with LiveOnNY” when the contract is set to expire Jan. 31. The CMS rejected LiveOnNY’s request for reconsideration this past Monday.

It said the organization failed to meet two of the standards used to measure success at collecting organs. The June 4 letter, which the CMS revised on June 7 to correct the expiration date of LiveOnNY’s contract, was written during a time of upheaval in the transplant industry, which faces a perennial shortage of donor organs.

Nearly 115,000 people are on waiting lists for kidneys, livers, hearts, lungs and other organs. Many of them linger for years; about 22 die each day. More than 33,400 organs from deceased donors, a record, were transplanted in 2017. Surgeons also are using increasing numbers of kidneys and livers from live donors to fill the demand for those organs. Since 2012, the agency has required LiveOnNY to submit at least three “corrective action plans.”

LiveOnNY said it has begun an appeal process that could take as long as seven months, according to the CMS. Ultimately, LiveOnNY could go to court if the appeal is denied.

For at least the last eight years, LiveOnNY has consistently registered one of the poorest performances in the nation, records show. It ranked as the country’s second-worst OPO, according to the last full year of data.

Helen Irving, chief executive and president of LiveOnNY, said in a statement that the organization “is deeply disappointed by CMS’s decision, a decision that is informed by inherently flawed metrics that CMS uses to evaluate organ procurement organization performance. Those metrics unfairly impact New York.”

MSSNY, AAP Raise Concerns with New Standardized Student Health Form
This week, representatives of MSSNY and the NYS American Academy of Pediatrics met with the NYS Education Department to raise concerns with the recently adopted New York State standardized student health assessment form that will be required to use starting July 1.  The physicians on the call, Dr. Gail Schoenfeld and Dr. Michael Terranova, raised concerns that the form is not easily compatible with physician EHR systems, creating unnecessary administrative burdens by forcing pediatricians and their staffs to manually input data into the new form.

In response, representatives from SED noted school districts have flexibility to use alternative forms in the short term, indicating that the school districts have been notified that, “to assist with the transition, during the 2018-2019 school year schools may accept any health examination form provided”.  SED staff also indicated their interest in continuing the dialogue to find ways to reduce the administrative burden for physicians and their staff to complete the form.

The new student health assessment form is available here, and a FAQ is available here.

One-Quarter of Doctors Say They’ve Been Sexually Harassed By Patients

One in four doctors say they’ve been sexually harassed by a patient in the past three years, according to a new survey of physicians nationwide from Medscape and WebMD. Dermatologists, emergency medicine doctors, and plastic surgeons were most often harassed, though physicians in every field reported being sexually harassed by patients. More often than not, doctors told a patient to stop or made sure they were no longer left alone with that patient. But in some cases, physicians dismissed patients who had sexually harassed them from their practices.

Document Errors Common When Speech Recognition Software Used
Speech recognition software, used increasingly to document clinical encounters in electronic health records, yields errors in 7% of dictated words, suggests a study in JAMA Network Open.

The analysis included roughly 220 documents (e.g., office notes) that were dictated using one speech recognition system at two U.S. healthcare organizations. Researchers transcribed each original recording to use as the reference standard, and then examined errors in the notes at three stages:

  • the note created by the speech recognition software;
  • the speech-recognition note after it had been edited by a medical transcriptionist;
  • the transcriptionist-revised note after it had been signed by the physician.

The error rate was 7 per 100 words in the notes created by the speech recognition software, falling to below 1 per 100 after transcriptionist review and physician sign-off. In terms of clinically significant errors, 64% of the speech-recognition notes had such errors, which fell to 8% after review and sign-off.

The researchers conclude that their study “highlights the crucial role of manual editing and review” when using speech recognition software. JAMA Network Open article

AWARD NOMINATIONS

Deadline Extended to August 31 for Albion O. Bernstein, MD Award Nominations
The Medical Society of the State of New York is accepting nominations for the 2017 Albion O. Bernstein, MD Award. This prestigious award is given to: “…the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2017.”

The $2,000 award will be presented to the recipient during a MSSNY Council Meeting. Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.To request an application, please contact: Committee on Continuing Medical Education, Miriam Hardin, PhD, Manager, Continuing Medical Education, Medical Society of the State of New York, 99 Washington Avenue, Suite 408, Albany, NY 12210 or call 518-465-8085 or email mhardin@mssny.org

Doctors without Borders Information Session on July 25 in Queens
On Wednesday, July 25th, 2018 at 7:30-8:30 PM you are invited to join Doctors Without Borders/Médecins Sans Frontières (MSF) for a recruitment information session in Queens. This is your opportunity to meet our recruitment team and learn about how you can join our pool of dedicated aid workers. We’re currently recruiting for a variety of medical and non-medical positions. Recruitment Info Session will be held at Sunnyside Community Services Seminar Room, 43-31 39th St., Sunnyside, NY 11104 7:00 – 8:30 pm Register here.

CMS

Submitters of MIPS through QPP Website Can Access Performance Feedback
If you submitted 2017 Merit-based Incentive Payment System (MIPS) data through the Quality Payment Program website, you can now view your performance feedback and MIPS final score. You can access your performance feedback and final score by going to the Quality Payment Program website.

Log in using your Enterprise Identity Management (EIDM) credentials; these are the same EIDM credentials that allowed you to submit your MIPS data.

If you don’t have an EIDM account, refer to this guide and start the process now
In the coming weeks, we’ll provide additional guidance to help walk through how to review your feedback and to assist in answering your questions.

Please note: The final performance year for the Value-Based Modifier and Physician Quality Reporting System (PQRS) programs was 2016; therefore, CMS will no longer provide PQRS Feedback Reports or Quality and Resource Use Reports (QRURs). The final reports under these programs were provided in September 2017 and remain available for download through the end of this year.  

Classified

RENTAL/LEASING SPACE


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed built out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MSSNY eNews: “Take Back” Program Can Save Lives

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
June 29, 2018
Volume 20  Number 24

MSSNYPAC

Dear Colleagues:

There are many steps that can be taken to address the opioid abuse crisis in New York and across the country.

One way is to prevent opioid medications from getting into the wrong hands by providing more convenient access to medication disposal sites.

More Convenient Method for Public to Dispose of Unused Medications 

Before leaving Albany for the year, the New York State Legislature took an important step by passing legislation (S.9100, Hannon/A.9576-B, Gunther) supported by MSSNY that would create a comprehensive statewide program to better enable the collection of unused prescription medications, such as opioid medications.  This program would be paid for by the manufacturers of these medications.  The goal of this program is to assure a more convenient method for the public to dispose of these unused medications, rather than relying upon the limited number of “drop boxes”, designated collection days, or by flushing them.

We know too well the consequences of letting these medications sit in medicine cabinets.  We are hopeful that development and promotion of such a “take back” program can cut off one avenue to addiction.

I’ve had a personal interest in this issue for a number of years.  The MSSNY delegation to the AMA had suggested a study on medication recycling a number of years ago. That resolution was defeated; but I’m pleased that our continued advocacy for closing the loop of potential diversion and pollution are about to bear fruit.

Ultimately, in 2016, the MSSNY House of Delegates adopted policy calling for the enactment of such a take back program to be paid for by the manufacturers of these medications.   Our policy was then adopted by the American Medical Association during its 2016 Annual Meeting.

Urge Governor Cuomo to Sign Bill into Law 

The Legislature’s passage of this bill is not, however,  the final step.  It still must be signed into law by the Governor.  With the bill having been sent to the Governor for his consideration yesterday (he must take action by July 11), physicians are urged to contact Governor Cuomo to request that he sign this measure into law by clicking here.

The existing limited programs are helpful but must be supplemented.  In 2015, a law was enacted that permitted pharmacies and other DEA authorized collectors to collect unused controlled substances in New York.  While this was an important step in making it easier for people to take back their unused medications, voluntarily participation remains low. The Department of Environmental Conservation also operates a pilot program that provides take back receptacles at participating pharmacies, hospitals and long-term care facilities, but this program is voluntary and limited in scope.

And last year, a bill was passed to require chain pharmacies and mail-order pharmacies to participate in drug take back programs.  But that bill was vetoed by the Governor.   We believe that this legislation addresses the concerns that were raised last year by the Governor when he vetoed the bill.

Over the years, New York has developed product stewardship programs for electronic waste, rechargeable batteries, and mercury thermostats.  There is no good reason to not extend this to the pharmaceutical industry.

An Important Step in Preventing Opioid Abuse

The removal of expired, unwanted, or unused medicines can be an important step in preventing opioid abuse.  Indeed, it can save lives.  This legislation would go a long way towards making the disposal of unused medications more routine.  We applaud Senator Hannon and Assemblywoman Gunther for advancing this legislation and urge Governor Cuomo to sign it into law.

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

eNews

Legislature Completes Session with Public Health Victories
As reported last week, the NYS Legislature recently completed the scheduled portion of the 2018 Legislative Session.  As noted below, working together with many specialty societies, various patient advocacy groups and other allies, the Session produced a number of public health victories for physicians and their patients.  Moreover, hundreds upon hundreds of adverse pieces of legislation that would have added new mandates, new costs, and harmed patient access to needed care, were not enacted.

Among the measures adopted by the Legislature supported by MSSNY:

  • Creating a statewide drug “take back” program for the safe disposal of medications,
  • Requiring health insurers to provide data to the DFS for public reporting  regarding their compliance with the mental health parity/substance abuse coverage requirements (MSSNY worked closely with the NYS Psychiatric Association on this)
  • Expanded insurance coverage for prostate cancer screening without cost-sharing
  • Prohibiting use of tanning facilities for those under 18 (MSSNY worked closely with the American Cancer Society on this)
  • Provisions to extend MSSNY’s Committee for Physicians’ Health confidentiality and liability  until 2023
  • A new $100,000 grant (via a NYS Senate resolution) to provide physician education on women’s health issues.

Moreover, numerous adverse proposals that had been under serious consideration in the final weeks of Session were defeated or had objectionable provisions removed.  Though there are far too many to list off here, some of the more notable proposals would have:

  • Required physicians to report certain patients to the Department of Motor Vehicles (MSSNY worked closely with the Epilepsy Foundation and American Diabetes Association on this)
  • Required physicians to inquire and document the school attended by their school age patients (MSSNY worked closely with HANYS, GNYHA and the NYC HHC on this)
  • Expanded religious exemptions for otherwise required child immunizations (MSSNY worked closely with the NYS Academy of Family Physicians, NY-ACP and NY American Academy of Pediatrics on this).
  • Expanded the scope of practice for naturopaths, podiatrists, dieticians, estheticians, psychologists and many other non-physicians (MSSNY worked closely with each of the affected specialties societies on this)
  • Reduced the role of county medical societies in approving physicians to become authorized under Workers Compensation (MSSNY worked closely with county medical societies on this)
  • Required physicians to co-prescribe naloxone for patients for whom an opioid medication is prescribed
  • Reduced to 3 days the time frame for a physician to write an initial prescription for an opioid medication for a patient with acute pain

We thank all the physicians who took the time to communicate and/or visit with their legislators.   With a few unfinished items (not related to health care) it is still possible for the Legislature to return to Albany later in the year where various bills effecting health care delivery could be brought up again.

MSSNY, AAP Raise Concerns with New Standardized Student Health Form
This week, representatives of MSSNY and the NYS American Academy of Pediatrics met with the NYS Education Department to raise concerns with the recently adopted New York State standardized student health assessment form that will be required to be used starting July 1.  The physicians on the call, Dr. Gail Schoenfeld and Dr. Michael Terranova, raised concerns that the form is not easily compatible with physician EHR systems, creating unnecessary administrative burdens by forcing pediatricians and their staffs to manually input data into the new form.

In response, representatives from SED noted school districts have flexibility to use alternative forms in the short term, indicating that the school districts have been notified that, “to assist with the transition, during the 2018-2019 school year schools may accept any health examination form provided”. SED staff also indicated their interest in continuing the dialogue to find ways to reduce the administrative burden for physicians and their staff to complete the form.

The new student health assessment form is available here, and a FAQ is available here.

CDC: Just 23 Percent of US Adults Meet Exercise Recommendations
While the nation has surpassed the Healthy People 2020 initiative goal of just over 20 percent of U.S. adults meeting exercise recommendations by 2020, shortfalls remain in some states and among certain demographics. According to the study results, New Yorkers need to exercise more.

NYeC (NYehealth Collaborative) News: Statewide Patient Care Alerts
The NY Ehealth Collaborative recently announced the statewide expansion of patient care alerts through the Statewide Health Information Network for New York (SHIN-NY). This allows SHIN-NY participants to receive updates on their patients, regardless of where in the state care was received.

Lyme Disease Cases Significantly Underreported, CDC Says
The Wall Street Journal (6/22) reported that disparities between documented Lyme disease cases and the actual prevalence are high, according to the CDC, which says that the 30,000 cases recorded annually are a fraction of the probable 300,000 cases per year. Lyme disease, as the “most common vector-borne disease by far,” remains “underreported,” according to CDC epidemiologist Dr. Kiersten Kugeler. She added, “All reportable diseases are subject to underreporting, although we know this is particularly true for common diseases and for those often treated in an outpatient setting.”

Flu Control Pill Being Fast Tracked by FDA
A pill that helps control flu symptoms after one dose is getting fast consideration from the Food and Drug Administration, the company that makes it said Tuesday. Genentech said the FDA had granted priority review to baloxavir marboxil and would decide whether to approve it by the end of this year. If approved, baloxavir would be the first new flu drug to hit the U.S. market in years and the first with a new mechanism of action in 20 years.

“Baloxavir marboxil has been shown in clinical trials to decrease the duration of symptoms with one dose, and demonstrated a significant reduction in viral shedding in just one day,” said Dr. Sandra Horning, chief medical officer at Roche, which owns Genentech.

Influenza viruses developed resistance long ago to the first two antiviral flu drugs, amantadine and rimantadine. Newer antiviral drugs on the market include Tamiflu, a pill; Relenza, which can be inhaled; and an injectable drug called peramivir.

“The FDA is expected to make a decision on approval by December 24, 2018,” the company said.

New Shingles Vaccine in Short Supply
On Oct. 25, the CDC recommended Shingrix as the preferred vaccine for the prevention of shingles for adults aged 50 and up. The Washington Post (6/20) “To Your Health” blog reports there is a national shortage of the new shingles vaccine Shingrix, “prompting retailers to create waiting lists and the manufacturer to delay additional promotion.” The CDC now recommends Shringrix over Zostavax for people over the age of 50.

FDA Approves Chemical in Marijuana to Treat Seizures
A chemical derived from marijuana has become the first of its kind to be approved by the Food and Drug Administration and will be delivered to patients suffering from epilepsy in the form of a strawberry-flavored syrup.

The FDA announced Monday that it had approved the drug, cannabidiol, which is one of 80 active chemicals in marijuana, to treat seizures from epilepsy. It is the first time the agency has approved a purified drug substance that comes from marijuana. The drug, which is formally known as Epidiolex, will be allowed to be prescribed to infants as young as age 2 for Lennox-Gastaut syndrome and Dravet syndrome, two rare and severe forms of epilepsy. It is made by GW Pharmaceuticals, a company based in the United Kingdom.

Nominations Open for 2018 Albion O. Bernstein, MD, Award
The Medical Society of the State of New York is accepting nominations for the 2017 Albion O. Bernstein, MD Award.  This prestigious award is given to: “…the physician, surgeon or scientist who shall have made the most widely beneficial discovery or developed the most useful method in medicine, surgery or in the prevention of disease in the twelve months prior to December, 2017.”

This award was endowed by the late Morris J. Bernstein in memory of his son, a physician who died in an accident while answering a hospital call in November, 1940.

The $2,000 award will be presented to the recipient during a MSSNY Council Meeting. Nominations must be submitted on an official application form and must include the nominator’s narrative description of the significance of the candidate’s achievements as well as the candidate’s curriculum vitae, including a list of publications or other contributions.

To request an application, please contact: Committee on Continuing Medical Education, Miriam Hardin, PhD, Manager, Continuing Medical Education, Medical Society of the State of New York, 99 Washington Avenue, Suite 408, Albany, NY 12210 or call 518-465-8085 or email mhardin@mssny.org. +

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front. First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for a new tenant. Call 646-642-0700.




For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed built out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MSSNYeNews: Medical Marijuana & You

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
June 22, 2018
Number 23

MSSNYPAC

Dear Colleagues:

This week, the New York State Department of Health Commissioner Howard Zucker, MD, announced that the department will develop a regulatory amendment to add opioid use as a qualifying condition for medical marijuana.  The proposed regulations would join 12 other qualifying conditions under the state’s Medical Marijuana Program, which also were recently updated to include chronic pain and post-traumatic stress disorder.

At the same time, the New York State Legislature passed Senate Bill 8987/A.11011, sponsored by Senator George Amedore and Assemblyman Richard Gottfried, that would allow physicians to certify patients to obtain medical marijuana for “pain that degrades health and functional capability where the use of medical marijuana is an alternative to opioid use, substance use disorder.” The Medical Society of the State of New York has opposed this measure because there is limited evidence to support the recommendation of marijuana as an alternative to opioid pain medications for pain and no data on opioid use or opioid use disorder.

On a personal basis, I practice palliative medicine and deal with a number of patients with chronic pain issues, and comorbidities including substance use disorders and mental health issues.  I have had many discussions with my patients regarding marijuana as an alternative to opioid and other non-narcotic pain medicines.   We have explored their use in reducing or obviating their need for opioids.  My anecdotal, uncontrolled experience is that marijuana may be helpful in a subset of patients.  While I am open to further exploration of marijuana as an additional tool in my armamentarium for easing my patients’ suffering, I am troubled by the promotion of this complicated medication with many variations in dosage form, composition and other poorly studied parameters as a panacea without more robust study and data on the long term consequences of use.

Marijuana for 12 Indications Should Be Measured

This DOH proposal seems to be an attempt to reduce risk or harms when engaging in dangerous behavior, and while this may be an argument to be made for using medical marijuana as a harm reduction strategy, the state should be clear that this is the case.   At this time, there are no established guidelines for treatment of acute pain.  In addition, there is insufficient evidence to support the recommendation of marijuana as an alternative to opioid pain medications for pain.  Furthermore, there is insufficient evidence to support marijuana as an alternative to other treatments for acute pain, including in patients with opioid use disorder. Instead of medical marijuana, MSSNY believes that placing a patient on Medication Assisted Treatment (MAT) for opioid use disorder may be a more appropriate option for treating pain when an alternative opioid pain medication may not be appropriate for those patients that suffer from opioid use disorder.  Any action by New York State to use marijuana for the treatment of any of the 12 indications must be measured, including this one.

MSSNY has always expressed concerns about federal prosecution against a physician who certified a patient for the use of marijuana.  Action by US Attorney General Jeffrey Sessions may allow federal prosecutors to more aggressively enforce marijuana laws—a nuance that we are concerned is not being sufficiently considered.

In addition to medical marijuana, this week, Commissioner Zucker, MD said that a state-commissioned study will recommend allowing recreational use of marijuana.  The report is not yet public, but the commissioner indicated that the report’s authors reached their conclusion after a review of the legal, medical and social implication of legalization.  MSSNY looks forward to further information and will comment when we have had an opportunity to review the data and conclusions.

“Not Yes or No, But How?”

When questioned about Dr. Zucker’s comments, Gov. Andrew Cuomo said the state will at some point legalize recreational use of marijuana, but not this year. What’s more, he said, there are still many details to work out. “It’s not a yes or no, it’s the how,” Cuomo told reporters during an unrelated conference call. “The devil is in the details. What ages, what amounts, what tax rate, where do you sell it, how do you police it?”

George Santayana opined,” those who cannot remember the past are condemned to repeat it.”  Twenty years ago there were many entities which promoted opioids for more widespread usage based on limited data, which subsequently were noted to be flawed, contributing to our current desperate situation with prescription and non-prescription drug abuse.

Earlier this year, I applauded Governor Cuomo for his cautious approach to the complicated question of medicinal and recreational use of cannabinoids. History sometimes does repeat itself.  Unfortunately, it is often cunningly disguised and not recognized until the damage is done.  Truly, the devil is in the details, not only for the recreational use of marijuana but for clinical use as well.  MSSNY is concerned with additional uses for medical marijuana being legislated without adequate clinical evidence to support its use, and little knowledge of the consequences of chronic use on our patients and throughout society.

Excelsior!

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

Capital Update

Legislature Completes Session with Public Health Victories
With the New York State Senate gaveling out at 2 AM early Thursday morning, the scheduled portion of the 2018 Legislative Session came to a close.  Despite the political deadlock in the NYS Senate, working together with the many specialty societies, patient advocacy groups and other allies, the Session produced a number of public health victories for physicians and their patients, and the defeat of hundreds upon hundreds of adverse pieces of legislation that would have added new mandates, new costs, and harmed patient access to needed care.

Among the measures adopted by the Legislature supported by MSSNY:

  • Creating a statewide drug “take back” program for the safe disposal of medications,
  • Requiring health insurers to provide data to the DFS for public reporting purposes regarding how insurers are complying with the mental health parity/substance abuse coverage requirements
  • Expanded insurance coverage for prostate cancer screening without cost-sharing
  • Prohibiting use of tanning facilities for those under 18
  • Provisions to extend MSSNY’s Committee for Physicians’ Health confidentiality and liability  until 2023

Moreover, numerous adverse proposals that had been under serious consideration in the final weeks of Session were defeated or had objectionable provisions removed.  Though there are far too many to list off here, some of the more notable proposals would have:

  • Required physicians to report certain patients to the Department of Motor Vehicles
  • Required physicians to inquire and document the school attended by their school age patients
  • Required physicians to co-prescribe naloxone for patients for whom an opioid medication is prescribed
  • Reduced to 3 days the time frame for a physician to write an initial prescription for an opioid medication for a patient with acute pain
  • Expanded religious exemptions for otherwise required child immunizations
  • Expanded the scope of practice for naturopaths, podiatrists, dieticians, estheticians, psychologists and many other non-physicians
  • Reduced the role of county medical societies in approving physicians to become authorized under Workers Compensation
  • Expanded liability against physicians through expansion of wrongful death awards, removal of contingency fee limits and prohibiting ex-parte interviews.

We thank all the physicians who took the time to communicate and/or visit with their legislators.   With a few unfinished items (not related to health care) it is still possible for the Legislature to return to Albany later in the year where various bills effecting health care delivery could be brought up again. 

Legislation Passes to Require Public Reporting of Health Insurers’ Compliance with Mental Health & Substance Use Disorder Parity Laws;
The Senate and Assembly completed passage of legislation (S.1156-C, Ortt/A.3694-C, Gunther) which directs the Superintendent of the Department of Financial Services (DFS) to collect certain key data points and elements from health insurers in order to scrutinize and analyze if they are in compliance with the federal and state mental health and substance use (MH/SUD) disorder parity laws.   MSSNY working together with the New York State Psychiatric Association and other specialty societies had strongly supported this legislation, and many physicians weighed in with their legislators in support. 

If signed into law by the Governor, the information collected would be analyzed and used for the preparation of a parity compliance report that would be contained within in the annual “Consumer Guide to Health Insurers” issued by the DFS.  Although MH/SUD parity laws have been on the books for over a decade on the federal and state level, recent Attorney General settlements note that there continue to be patterns of disparity between coverage criteria imposed on MH/SUD care and treatment as compared to other covered services.  The goal of the legislation is to better ensure compliance with these laws.  (DIVISION OF GOVERNMENTAL AFFAIRS)

Bill to Establish a Statewide Drug Takeback Program Passes the NYS Legislature
Senate Bill 9100/ A9576-B, which would establish a drug takeback program, passed the New York State Legislature this week and will now go before the governor.   This measure, sponsored by Senator Kemp Hannon and Assemblymember Aileen Gunther, would require manufacturers of a covered drug to either submit, individually or jointly, a drug take back program for approval to the New York State Department or to enter into an agreement with the Department to operate a drug take back program on its behalf.  Under the bill’s provisions, manufacturers are responsible for all administrative and operational fees associated with their take back program, including the cost of collecting, transporting and disposing of covered drugs from pharmacies and other authorized collectors and the recycling or disposal, or both, of packing collected with the covered drug. This bill further requires chain pharmacies and mail-order pharmacies to provide for the collection of covered drugs by providing consumers with on-site collection, prepaid mail-back envelopes or other Drug Enforcement Agency (DEA) approved methods.  The program would accept all types of any medication in any form including prescription and nonprescription drugs, drugs in medical devices and combination products, brand and generic drugs and drugs for veterinary use.

The Medical Society of the State of New York House of Delegates had adopted policy calling for a program to allow daily access to safe, convenient, and environmentally sound medication return for sites unwanted prescription medications.  The HOD policy also calls for MSSNY to support a medication disposal program that’s fully funded by the pharmaceutical manufacturers, including costs for collection, transport and disposal of these materials as hazardous waste.                       (CLANCY)

Legislature Passes Measure to Eliminate Patient Cost-Sharing for Prostate Cancer Screening
The Senate and Assembly passed legislation this week (S.6882-A, Tedisco/A.8683-A, Gottfried) to ensure that health insurers provide coverage for diagnostic testing for prostate cancer for men 40 and over with a family history, and men 50 and over who are asymptomatic, without such care being subject to annual deductibles or coinsurance.  The bill would also require the inclusion of information regarding the availability of insurance coverage for prostate cancer screening without cost sharing in the standardized written summary prepared by the Commissioner of Health.  New York has for many years required insurance coverage for these tests, but were subject to cost-sharing.  If signed into law, this legislation would provide coverage without patient cost-sharing to a greater cohort of men for necessary prostate cancer screening than what has been recommended by the US Preventative Services Task Force.                                                                            (AUSTER, CLANCY)

Tanning Bill Prohibition For Children Under 18 Passes NYS Legislature
Legislation that would prohibit the use of tanning booths for children under 18, has passed in the NYS Legislature.  The measure, Assembly Bill 7218A/Senate Bill 8858A, is sponsored by Assemblywoman Ellen Jaffe and Senator Phil Boyle.  The Medical Society of the State of New York and several public health organizations, such as the American Cancer Society, were unanimous in their support of this measure and worked together to obtain passage of this important public health measure.   Currently, the law allows children between the ages of 17-18 years of age to use tanning booths with parental permission.  According to the American Cancer Society, skin cancer is the most diagnosed cancer in the United States. About 95,400 invasive skin cancers will be diagnosed in the US, and more than 87,000 of these will be of melanoma, the most serious form.  The bill now goes to the Governor for his consideration.                                                                              (CLANCY)

Legislation to Expand Non-Physician Care in Workers’ Compensation Does Not Pass
The Legislature left Albany without taking action on legislation (S.8812-A/A.8387-C) that would have expanded the list of eligible health care professionals allowed to treat injured workers, including acupuncturists, nurse practitioners, social workers, and physician’s assistants.  While each of these professionals can play an important role in the delivery of care to patients, MSSNY raised concerns with the possibility of care being provided to injured workers without the coordination of a physician including assessing the injured worker’s level of disability and determining causation of a patient’s injury.

MSSNY had also expressed concern over another component of the legislation that would have modified the process of how county medical societies recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.  While the provision had been improved over earlier versions, MSSNY was concerned that the phrasing of the proposal could be interpreted to enable the WCB to bypass the county medical society in approving physicians to be authorized to treat or provide IMEs under Workers’ Compensation.

Discussion on this proposal will likely continue over the year and into next year.  The legislative proposal was part of a series of WCB initiatives to expand care access to injured workers, which also included a separate WCB regulatory proposal to provide a 5% increase to the Workers Compensation medical fee schedule effective October 1.                          (AUSTER, BELMONT)

Raising the Tobacco Purchase Age Not Acted On By NYS Legislature
Legislation to increase the purchase age for tobacco products from 18 to 21, failed to be acted upon this year in the New York State Legislature.  The bill made it to the Assembly Calendar, but was not voted upon.   It had not moved from the Senate Finance Committee.  Assembly Bill 273/ Senate Bill 3978, sponsored by Assemblywoman Linda Rosenthal and Senator Diane Savino, would have allowed New York State to increase the purchase age for tobacco products from 18 to 21 years of age—there are currently 22 municipalities and counties that have increased the purchase age.  The Medical Society of the State of New York worked with  other public health associations to try to enact this legislation into law.                                                                                                        (CLANCY)

Legislation To Allow Enhanced Religious Exemptions for School Based Immunizations Defeated
Senate Bill 6141D and A. 8123B, sponsored by Senator Martin Golden and Assemblymember Richard Gottfried, which would have allowed the admission of certain unvaccinated students to public schools, did not pass the Legislature.   MSSNY opposed this measure and it worked with other public health associations and medical groups to urge that this measure not be acted upon.  There were many physicians that also sent letters to their legislators and/or made calls.   The bill did move from the NYS Senate’s Education Committee and this was the first time that this bill has been voted on by members of any Senate committee.

The bill amends the Education Law to provide the procedure for religious exemptions from vaccination requirements.  Under the bill, a parent or guardian would complete a religious beliefs vaccination exemption form to ensure a public school district does not deny admission to their unvaccinated child.  A religious exemption is currently allowable under NY State law, but the exemption allows the school institution to make a decision on whether the student should be exempt from vaccination.   This bill, if it had been passed by the Legislature, would have forced schools to accept the form and allow unvaccinated students to enter the school.                                                     (CLANCY)

Legislature Passes Bill to Call for DMV to Require Examination of Certain Patients; Does Not Contain Physician Reporting Mandate
As a result of advocacy by several patient advocacy groups along with MSSNY, the Legislature did not pass legislation (S. 3569, Young / A.10094, Carroll) that would have required a licensed physician, physician assistant or nurse practitioner to report patients that have a chronic condition which cause or may cause unconsciousness or unawareness to the Department of Motor Vehicles.  The legislation had advanced to the Senate floor, but moved no further.  In addition to MSSNY, that bill had been opposed by the Epilepsy Foundation and American Diabetes Association. 

Instead, the Legislature passed a different bill (S.8990, Young/A.11121, Carroll) which would authorize the Department of Motor Vehicles (DMV) to require driver’s license holders to submit to a DMV re-examination of their fitness to drive if the licensee experienced a loss of consciousness and was involved in a reportable accident while driving and DMV receives evidence that the loss of consciousness caused or contributed to the accident.  The bill also directs the DMV, in consultation with the Department of Health and the Division of State Police, to review its notification process by physicians to DMV including identifying the impediments of physicians, police officers and others to reporting certain patients to DMV, and report back to the Legislature within one year of enactment of this bill.                                                                                                                        (BELMONT, AUSTER)

Legislation To Mandate Collection of School Information Does Not Pass
The Senate and Assembly left Albany without taking action on legislation (S. 2113-A, Felder/A.352-A, Perry) which would have required physicians and hospitals to inquire and document the name of the school attended by school-aged patients and to include this information in their admission registration forms.    In addition to MSSNY, the bill had also been opposed by the Healthcare Association of New York State and the NYC Health and Hospitals Corporation.

The bill was on the “Debate List” on the floor of the Assembly the last 2 weeks of Session, as well as on the floor of the Senate.     However, considerable grassroots activism from physicians, as well as significant advocacy in Albany by various groups, resulted in several Senators and Assemblymembers objecting to the legislation.  MSSNY had raised concerns that New York Public Health Law Section 2101 already requires physicians to report immediately to the local health officer regarding the presence of any communicable disease. The health officer is then charged with the responsibility to investigate cases of communicable disease, to ascertain sources of infection, to seek out contacts, and to take other steps to reduce the spread of the disease.  MSSNY also raised concerns that increasing mandates take more and more time away from the ability to deliver the timely care patients expect to receive.                                                                                (AUSTER, BELMONT)

NYS Assembly Passes Single Payor Legislation; Bill Not Taken Up in the Senate
Last week, the New York State Assembly passed by a 94-46 vote legislation that would have created a single payor health care system in New York State.   The bill, which has passed the Assembly each year since 2015, was not taken up by the NYS Senate prior to leaving Albany.  While there are many physicians who support a single payor system, MSSNY has repeatedly advised legislators that it has a long-standing policy position opposing the creation of a single payor system, a policy position which was re-affirmed in the fall of 2017.

To view how each Assemblymember voted on this bill, click here.  The view the 2½ hour Assembly debate on this legislation from June 14, click here (starting at about the 1:00 mark).   (AUSTER) 

Bill to Allow Newborn Standing Orders Passes New York State Legislature
Legislation, which would authorize hospital standing orders for the care of newborns, has passed the New York State Legislature.   S. 8774B/A. 9950B, sponsored by Senator Kemp Hannon and Assemblyman Richard Gottfried, will allow a hospital to establish standing orders for the care of newborns.  The bill also allows the ability of a nurse to depart from the standing order and does require that the attending nurse shall advise the attending practitioner if the nurse becomes aware of circumstances that reasonably indicate a need to depart from the standing order.  MSSNY expressed concern that the legislation then goes on give the nurse discretion to deviate from the protocol without authorization from the attending practitioner, provided that they act within their scope of practice.

The order must also provide that the attending practitioner shall review and acknowledge in writing the care provided under the standing order.   MSSNY indicated that the tests and getting a newborn ready for admittance into a nursery pertains to a “healthy” newborn and that there is no need to deviate from the standing order.   MSSNY also indicated that if there is a medical issue that arises between the delivery room to the nursery with a “healthy” newborn then emergency protocols would be in effect and consults with a physician would be required.  However, the NYS AAP (American Academy of Pediatrics) supported this measure and the NYS Chapter, American College of Obstetricians and Gynecologists, (ACOG), District II, took no position on the measure.  The bill will now go to the Governor for his consideration.                                                                            (CLANCY)

AMA Announces Formal Opposition to CVS Takeover of Aetna
The American Medical Association (AMA) announced this week that, after conducting an exhaustive analysis on the proposed acquisition of Aetna by CVS Health, it would urge federal and state regulators to block the merger. The announcement was made by AMA President Dr. Barbara McAneny, in testimony on the proposed CVS-Aetna deal at a hearing held by the California Department of Insurance.  Earlier in the year, the AMA had presented strong concerns about the merger during a hearing of the US House of Representatives Judiciary Committee, but had stopped short of calling for an outright rejection.

According to the press release, the AMA position in opposition is based on evidence indicating the merger’s likely anticompetitive effects on Medicare Part D, pharmacy benefit management services, health insurance, retail pharmacy, and specialty pharmacy, including:

  • An expected increase in premiums due to a substantial increase in market concentration in 30 of 34 Medicare Part D regional markets.
  • An anticipated increase in drug spending and out-of-pocket costs for patients as Aetna and CVS fortify their dominant positions in the health insurance, pharmaceutical benefit management, retail and specialty pharmacy markets that already lack competition.
  • A reduction in competition in health insurance markets that will ultimately adversely affect patients with higher premiums and a reduction in the quality of insurance.
  • A foreseeable failure to realize proposed efficiencies and benefits because the merger faces enormous implementation challenges, and those efficiencies have a questionable evidence base.

Earlier this month, Immediate MSSNY Past President Dr. Charles Rothberg expressed MSSNY’s opposition to this proposed acquisition during a New York State Assembly Insurance-Health Committee hearing on this topic. Strong concerns were also expressed by consumer and pharmacy groups.

Following the conclusion of the NY Assembly hearing, Assembly Insurance Committee Chair Kevin Cahill noted, “Our State must be proactive in responding to such drastic potential changes in our health care delivery systems. The past has taught us that reactive approaches to challenges in health care could have devastating effects on consumers and our health care system. This acquisition poses serious questions for the long-term stability of the State’s insurance markets and access to health care products”.

Assembly Health Committee Chair Richard Gottfried added: “It should be of great concern to have what economists call ‘vertical integration’ – in this case a major health care provider and a major health insurer sharing the same bottom line – with dramatic effect on consumers and others in the market. It’s critical that State and Federal regulators assess and understand the potential impact on patients, insurance networks, and drug purchasing and dispensing processes.”

The AMA will file a post-hearing memorandum outlining its concerns later this month.  (AUSTER)

Legislature Rejects Scope of Practice Changes
The State Legislature left Albany this week without taking an action on a plethora of bills opposed by MSSNY together with many specialty societies which would have created or expanded the scope of practice of numerous non-physician health care providers.   Some of these bills include: 

  • Certification of Certified Registered Nurse Anesthetists  – A.442 / S.1385
  • Broadening the scope of practice of dentistry -A.4543 / S.3551
  • Expand the ability of podiatrists to provide wound care – A.1880/S.4734
  • Statutory recognition to naturopaths – 5913/S.4297
  • Psychologists Prescribing – 2851 / S.4498                          
  • Expand scope of dieticians to order lab tests – 2231-C/A.8504-B
  • Allow PAs to Operate Fluoroscopy Imaging Technology – 4716/S.8165
  • Permitting estheticians and others to do laser hair removal with limited physician oversight – S.6088-A/A.7977-A

            (DIVISION OF GOVERNMENTAL AFFAIRS)                                                                                                                                       

MSSNY Participates in New York State Lyme and Tick-Borne Disease Summit
Governor Cuomo has called upon the Department of Health, Department of Environmental Conservation, and the Office of Parks, Recreation and Historic Preservation to collaborate in order to target priority counties and public lands with the highest risk of tick exposure and Lyme disease.  On Tuesday, both public and private stakeholders met to discuss the goals of the collaboration at the New York State Lyme and Tick-Borne Disease Summit.

The goal of the working group on Lyme and other tick-borne diseases is to review New York State’s current initiatives and make policy recommendations on actions that New York State can take in the next one to three years to advance prevention, diagnostics, and other best practices. The Statewide Tick-Borne Pathogen Surveillance Initiative has been actively surveying lands across New York State and has recently launched a website displaying their findings. To view their research, click here. Tick season has started in many areas of the state and will continue through November.  To learn more about Lyme disease, prevention, and tick removal, click here.
(HARRING)

Medical Society of the State of New York Announces Veterans Matters Programs are Available on CME Website
Did you know that in a recent report, the New York State Health Foundation discovered that nearly HALF of veterans prefer to receive their care OUTSIDE of the VA system, and less than 3% of physicians outside of the VA are fully prepared to help veterans?

The Medical Society has created a free CME program series entitled Veterans Matters to assist New York State physicians in recognizing the unique health problems faced by veterans and the best way to provide care to veterans.  These programs are all available at https://cme.mssny.org 

Veterans Matters: PTSD & TBI in Veterans

Faculty: Emerald Lin, MD

Educational Objectives:

  • Identify signs and symptoms of PTSD & TBI
  • Examine evidence-based treatment modalities for PTSD & TBI
  • Explore military culture and methods to overcome unique barriers to treatment intrinsic to military culture. 

Veterans Matters: Substance Use Disorders in Veterans

Faculty: Frank Dowling, MD

Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans
  • Explore evidence-based diagnostic, intervention, and treatment options
  • Identify barriers to identification and treatment in military culture and methods to overcome them 

Veterans Matters: Suicide in Veterans

Faculty: Jack McIntyre, MD

Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans
  • Explore evidence-based diagnostic, intervention and treatment options
  • Identify barriers to identification and treatment and methods to overcome them

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                                        (HOFFMAN)

Medical Society of the State of New York Encourages You to Check out CME Website
The Medical Society of the State of New York has recently added several new emergency preparedness and Medical Matters CME programs to our CME website. You can earn FREE CME credits on a myriad of topics related to Bioterrorism and Disaster/Terrorism response.  Emergency preparedness topics include our 4-part Physician’s Electronic Emergency Preparedness Toolkit, Anthrax, Smallpox as well as Ebola and numerous others.

Additionally, all of our Medical Matters programs from the past several years have been archived at https://cme.mssny.org.  Topics range from Zika Virus, Influenza and Plague to Nuclear Radiation, Disaster Triage and Mental Health as well as a variety of other timely and relevant subjects.  For assistance, or more information, please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085.                                                (Hoffman)

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 mauster@mssny.org  pclancy@mssny.org  jbelmont@mssny.org
charring@mssny.org

eNews

Group Health Insurance Survey
Do you have a moment to take a brief survey? MSSNY is exploring the possibility of developing a cost-effective health plan for our members, their dependents, and their employees (not an associated health plan [AHP]).

Our ability to move forward will be based on the number of members that express an interest in participating with this new group.

You can access the survey here.

Thank you for your participation.

Is It OK to Charge Patients $.75 Per Page for Their Records?
Can doctors still charge 75 cents per page? NO, not automatically.

Now, practices need to do some figuring.  Copies can be provided by paper or electronically by CD or USB stick.

Then, the practice needs to do some calculations.

HIPAA requires that the charge for paper or electronic copies must reflect actual cost.  The cost may include:

  • cost of labor to copy—but not labor to review request or search and retrieve;
  • cost of certain supplies such as paper, CD or USB flash drive;
  • postage;
  • cost of labor to prepare a summary or explanation, but only if both parties agree.

Based on the results, the practice will need to ensure that whatever cost is most favorable to the patient is what can be charged.  If all else fails [or, is too cumbersome to figure out] a maximum flat rate of $6.50 can be charged.

Please be sure to see the actual HHS guidance on this link.

Notice from MLMIC to All Endorsed Partners
A public hearing has been scheduled by the New York State Superintendent of Financial Services pursuant to Section 7307 of the New York Insurance Law, to consider the Plan of Conversion adopted by the Board of Directors of Medical Liability Mutual Insurance Company, a New York mutual insurance company (“MLMIC”) on May 31, 2018, and revised on June 15, 2018.

The public hearing will be held at the offices of the New York State Department of Financial Services, One State Street, New York, NY, 10004 (6th floor in the main hearing room), beginning at 10 a.m. EST on August 23, 2018.

To view a digital copy of the entire notice of public hearing, click here.

To view a digital copy of the Plan of Conversion, click here.

For additional information about the transaction, visit  Frequently Asked Questions or call 1-888-998-7871.

Please see MLMIC’s latest news on the Berkshire Hathaway Transaction here. MLMIC policyholders should go to this link for information or to call their BH hotline 1-888-998-7871 to speak with knowledgeable staff regarding their questions.

Nurse Pleads Guilty: $60M Fraud Allegedly Involved Accelerating Patient Deaths
A nursing supervisor for Novus, a shuttered hospice provider in Frisco, Texas, has pleaded guilty to conspiracy to commit healthcare fraud for her role in a $60 million scheme that federal prosecutors say involved fatally overdosing patients for profit, according to The Dallas Morning News. Jessica Love, RN, served as Novus’ nurse case manager and regional director before the company shut down several years ago. She was one of 16 defendants charged in the healthcare fraud scheme in February 2017.

According to court documents, Ms. Love and her co-conspirators, including Novus’ owner and CEO Bradley Harris, allegedly enrolled as many people as possible in hospice care, even patients who were not eligible for the services. Once the patients were enrolled, they were given around-the-clock care, which Medicare reimbursed at a higher rate than routine care. If hospice patients were in continuous care for too long, Novus workers allegedly overmedicated them so they would die.

Ms. Love was allegedly involved in the fatal overmedication of two patients, according to the report. Documents from Ms. Love and another Novus employee, who also pleaded guilty in the case, stated Mr. Harris instructed “nurses to intentionally overmedicate beneficiaries with medications such as hydromorphone and morphine with the intent to hasten their deaths,” according to the report.

Mr. Harris has denied any wrongdoing. “We are not aware of any evidence that shows that Mr. Harris caused, hastened or otherwise contributed to the death of the hospice patients being treated by Novus,” Chris Knox, an attorney representing Mr. Harris, told The Dallas Morning News.

WHO Releases ICD-11: 5 Things to Know
After more than a decade in the making, the 11th edition of the International Classification of Diseases has been released by the World Health Organization.

The ICD serves as a foundation for identifying global health trends and statistics and is used by health insurers whose reimbursements depend on ICD coding.

Five things to know:

  1. The new edition carries about 55,000 codes for injuries, diseases and causes of death. By comparison, the 10thedition had 14,400 codes. And for the first time, the ICD is completely electronic.
  2. The new ICD will be presented at the World Health Assembly in May 2019 for adoption by member states and will go into effect Jan. 1, 2022. “This release is an advance preview that will allow countries to plan how to use the new version, prepare translations and train health professionals all over the country,” the WHO stated.
  3. In an effort to more closely reflect progress in medicine, the codes relating to antimicrobial resistance in the new ICD are more closely aligned with the Global Antimicrobial Resistance Surveillance System.
  4. The new ICD can also better capture data regarding healthcare safety, meaning it will help identify and reduce unnecessary events that may harm health, including unsafe workflows in hospitals.
  5. This ICD has new chapters, including ones on traditional medicine and sexual health. Traditional medicine has not been classified in this system until now. The chapter on sexual health brings together conditions that were previously categorized in other ways. The WHO also added gaming disorder to the section on addictive disorders. https://www.beckershospitalreview.com/finance/who-releases-icd-11-5-things-to-know.html

FDA Approves First Generic Versions of Suboxone
On June 14, the U.S. Food and Drug Administration approved the first generic versions of Suboxone (buprenorphine and naloxone) sublingual film (applied under the tongue) for the treatment of opioid dependence.

FDA Commissioner Scott Gottlieb, M.D. said, “The FDA is also taking new steps to address the unfortunate stigma that’s sometimes associated with the use of opioid replacement therapy as a means to successfully treat addiction. Patients addicted to opioids who are eventually treated for that addiction, and successfully transition onto medicines like buprenorphine, aren’t swapping one addiction for another, as is sometimes unfortunately said. They’re able to regain control of their lives and end all of the destructive outcomes that come with being addicted to opioids. When coupled with other social, medical and psychological services, medication-assisted treatments are often the most effective approach for opioid dependence. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm610807.htm

New Shingles Vaccine in Short Supply
On Oct. 25, the CDC recommended Shingrix as the preferred vaccine for the prevention of shingles for adults aged 50 and up. The Washington Post (6/20) “To Your Health” blog reports there is a national shortage of the new shingles vaccine Shingrix, “prompting retailers to create waiting lists and the manufacturer to delay additional promotion.” The CDC now recommends Shringrix over Zostavax for people over the age of 50.

+

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front. First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for a new tenant. Call 646-642-0700.




For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed built out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MSSNY eNews – Final Days to Support or Kill !

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
June 15, 2018
Number 22

MSSNYPAC

Dear Colleagues:

There has been much discussion in the media that, with the close divide in the New York State Senate, nothing much is happening in Albany. Nothing could be further from the truth. This week, the Legislature completed passage of a couple of issues of importance to New York physicians, including prohibiting those under 18 from using tanning facilities and extending for another 5 years the services of MSSNY’s Committee for Physicians Health.

As we head into the final days of the Legislative Session, there are a significant number of health care issues “below the radar” still under active consideration before the Legislature leaves Albany for the year.  Legislators and staffs will be working through the weekend and round the clock to negotiate final deals.  Among these issues under discussion:

  • Legislation supported by MSSNY and other patient advocacy groups that would prohibit health insurers from making mid-year formulary changes;
  • Legislation supported by MSSNY and other patient advocacy groups to increase the legal age to purchase tobacco;
  • Legislation supported by MSSNY and the NYS Psychiatric Association to have insurer compliance with mental health and substance abuse parity laws to be publicly disclosed in the DFS Consumer Guide to Health Insurance;
  • Legislation opposed by MSSNY and other patient advocacy groups that would mandate physicians to report certain patients to DMV;
  • Legislation opposed by MSSNY that would expand the types of providers who are permitted to treat injured workers under Workers Compensation, and reduce the involvement of county medical societies in credentialing physicians for WC participation;
  • Legislation that would expand the applicability of New York’s “surprise” bill law to hospitals;
  • Legislation that would create a Maternal Mortality Review Board

Please see below for more information on many of these issues, including in some cases requests to send letters to legislators on these items.  Please remain alert for calls to action, as the end of the Legislative Session can bring surprises that warrant immediate physician grassroots activity.

And, if you are not a member of our Physician Action Liaison (PAL) program, you can join by e-mailing jbelmont@mssny.org.

Greetings from AMA Meeting in Chicago

I’m writing while sitting at Gate A4B at Midway airport. I’m returning from Chicago and the AMA HOD where I represented MSSNY along with our great MSSNY delegation to the AMA members.

Our delegates take up to a week of their personal time to advocate MSSNY policy and confer with colleagues from throughout the country on issues affecting your practice.  We listened, learned, and discussed over 500 items that affect the practice of medicine, public health and other areas that affect the lives of our patients and families.  You can find a summary of the highlights here.

A few years back, I was elected to the AMA Council on Medical Service (CMS).  We focus on socio-medical economic issues that impact our practices and our patients.  I’m proud of the work we do on the Council and recommend you review all the reports, especially CMS on long term support services. I think we did important work on trying to create a sustainable funding stream for long term care, especially important as our population skews older.  I’m looking forward to meeting with the NY Society of Interventional Pain Physicians today to update them on current legislation in the NY Assembly and Senate.

Kira Geraci-Ciardullo

 

Congratulations to Dr. Kira Geraci-Ciardullo who was reelected to Council on Science & Public Health at the 2018 AMA House of Delegates.

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

 

Capital Update

Please Urge Your Legislators to Support Legislation to Prohibit Mid-Year Formulary Changes
With just 3 scheduled Session days left, all physicians are urged to contact their legislators to urge their support for legislation (A.2317-C, People-Stokes/S.5022-C, Serino) that would (in most cases) prohibit a health insurer from making a change to their prescription drug formulary or moving a prescription drug to a higher tier during a policy year.  The legislation has passed the Assembly unanimously, and is before the Senate Insurance Committee.  To send a letter in support, Click Here.

Earlier in the year MSSNY participated in a press conference in support of the legislation, together with the sponsors of the bill, as well as many of its supporters, including the Global Healthy Living Foundation, Lupus and Allied Diseases Association, NAACP, AARP, New Yorkers for Accessible Health Coverage, the Epilepsy Foundation, the Arthritis Foundation, the American Cancer Society, the National Association on Mental Illness-NY, the NY Chapter of the American College of Physicians, the NYS Osteopathic Medical Society, and the American College of Rheumatology.

MSSNY President Dr. Thomas Madejski stated the following for the press release:Continuation of a medication regimen prescribed by a patient’s treating physician is critical to assuring a patient’s recovery from illness, maintaining their health, or preventing worsening of their condition. Unexpected changes to a medication formulary could result in significantly higher out-of-pocket costs for patients. This could seriously interfere with their continued ability to obtain these needed medications.  Insurance company formulary changes are not made with the intimate knowledge of the patient’s personal physician.  Additionally, this legislation would help to protect consumers from unforeseen higher cost-sharing requirements.”              (AUSTER)

Tanning Bill Prohibition for Children Under 18 Passes NYS Legislature
A bill that would prohibit the use of tanning booths for children under 18 passed the New York State Senate this week.  The measure, A. 7218-A, Jaffe and S.8858-A,Boyle is sponsored by Assemblywoman Ellen Jaffe and Senator Phil Boyle.  The bill had previously passed the Assembly and will now be sent to Governor Cuomo for his signature.   The Medical Society of the State of New York and several public health organizations, such as the American Cancer Society, were unanimous in their support of this measure and worked together to obtain passage of this important public health measure.   Currently, the law allows children between the ages of 17-18 years of age to use tanning booths with parental permission.  According to the American Cancer Society, skin cancer is the most diagnosed cancer in the United States. About 95,400 invasive skin cancers will be diagnosed in the US, and more than 87,000 of these will be of melanoma, the most serious form.

Epidemiologic data suggest that most skin cancers can be prevented if children, adolescents, and adults are protected from UV radiation; however, melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for adolescents and young adults 15-29 years old.  Moreover not only is indoor tanning associated with melanoma, but new evidence demonstrates that over-use of indoor tanning beds is associated with a 69% increased risk of early-onset basal cell carcinoma (BCC), the most common form of skin cancer. Risk of developing BCC was higher in those who begin indoor tanning at earlier ages (less than 16 years old).  (CLANCY)

MSSNY Committee for Physicians’ Health Bill Completes Passage in Legislature
The New York State Assembly this week passed legislation (A.10221-A, Gottfried) supported by MSSNY that would extend until July 1, 2023 the continued operations of the MSSNY Committee for Physicians’ Health (CPH) program.  The identical Senate bill (S.8093-A, Hannon) passed the Senate last week.  While authorization for several key components of the program expired on March 31, 2018, the bill contains provisions to assure that the law is retroactive to March 31.  

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The bill must now be sent to the Governor for his signature.  However, since the bill was advanced by the NYS Department of Health, it is likely to obtain his approval.  MSSNY thanks Senator Hannon and Assemblyman Gottfried for advancing this important legislation.
(DIVISION OF GOVERNMENTAL AFFAIRS) 

Bill To Call on DFS to Evaluate Insurers & Health Plans Compliance with Mental Health & Substance Use Disorder Parity Laws
With only 3 scheduled legislative session days left, physicians are urged to contact their legislators to urge passage of S.1156-C/A.3694-C, which directs the Superintendent of the Department of Financial Services to collect certain key data points and elements from insurers and health plans in order to scrutinize and analyze if they are in compliance with the federal and state mental health and substance use (MH/SUD) disorder parity laws.  To send a letter in support, please Click Here.

The information collected would be analyzed and used for the preparation of a parity compliance report in the annual “Consumer Guide to Health Insurers” issued by Department of Financial Services.   Although MH/SUD parity laws have been on the books for over a decade on the federal and state level, recent Attorney General settlements note that there continue to be patterns of disparity between coverage criteria imposed on MH/SUD care and treatment as compared to other covered services.   This further demonstrates the need for an industry wide approach and annual evaluation of compliance. MSSNY along with NYSPA firmly believe this legislation is the next step for New York to take to assure compliance and full implementation of the federal and state MH/SUD parity laws, thereby enhancing access to care for MH/SUD care and treatment.           (CLANCY)

NYS Assembly Passes Single Payor Legislation
This week, the New York State Assembly passed by a 94-46 vote legislation that would create a single payor health care system in New York State.  To view how each Assemblymember voted on this bill, click here.  The bill, which has passed the Assembly each year since 2015, is almost certainly not going to pass the Senate this year.  The view the 2 ½ hour Assembly debate on this legislation, click here (starting at about the 1:00 mark).  (AUSTER)

Various Workers Compensation Reform Initiatives Under Discussion
Workers Compensation reform initiatives – both legislative and regulatory – continue to be in active discussion in the Legislative Session’s final days.

As part of an initiative to better ensure access to care for injured workers, the New York State Workers Compensation Board has released a proposed regulation to provide an “overall” 5% increase in the Workers Compensation medical fee schedule effective October 1, 2018.  The statement accompanying the release of the proposed rule noted that “areas with shortages of medical providers authorized to treat injured workers may see further increases.”

To review how such increase is proposed to be implemented, click here.   As comments are due to the WCB by August 5, MSSNY is reviewing the entire proposal, and has sought feedback from the members of its Workers Compensation and No-Fault committee.  MSSNY has also sought input from societies representing affected medical specialties such as Orthopedics, Anesthesiology and Osteopathy.  The proposed regulation also notes that the cost of ordering a hard copy of the fee schedule will be $100, and an electronic copy will cost $400.

Another positive development is a regulatory proposal of the WCB to increase the WC testimony fee for physicians from $400 to $450.

Distinct from these regulatory proposals, the WCB has also advanced legislation (S.8812-A/A.8387-C) in the Assembly and Senate that would expand the list of eligible providers allowed to treat injured workers.  The bill expands eligibility to include acupuncturists, chiropractors, nurse practitioners, physical therapists, physician’s assistants, podiatrists, psychologists and social workers.  MSSNY has expressed concern that the proposal would enable a nurse practitioner to assess an injured worker’s level of disability and determine causation of a patient’s injury without the involvement of a physician.

MSSNY has also expressed concern over another component of the legislation that would modify the process of how county medical societies recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.  While the provision has been improved over earlier versions, MSSNY remains very concerned that the phrasing of the proposal could enable the WCB to bypass the county medical society in approving physicians to be authorized to treat or provide IMEs under Workers’ Compensation.

MSSNY has also urged that any legislation in this area must also address the problem of Workers Compensation carriers inappropriately claiming contractual discounts to pay below the stated WC fee schedule. 

Please remain alert for further updates on these issues including the need for potential grassroots action.   (AUSTER, BELMONT)

Physicians Urged to Contact their Senators on Legislation that Imposes New Mandates on Physicians
Physicians are urged to contact their legislators to oppose S. 2113-A, Felder/A.352-A, Perry, which would require physicians and hospitals in New York City to inquire and document the name of the school attended by school-aged patients and to include this information in their admission registration forms.  New York Public Health Law Section 2101

already requires physicians to report immediately to the local health officer regarding the presence of any communicable disease. The health officer is then charged with the responsibility to investigate cases of communicable disease, to ascertain sources of infection, to seek out contacts, and to take other steps to reduce the spread of the disease.  Increasing mandates take more and more time away from the ability to deliver the timely care patients expect to receive.

The bill is on the “Debate List” of the floor of the Assembly and on the floor of the Senate.  Earlier this week the bill was to be taken up on the Senate floor.  However, considerable grassroots activism, as well as significant lobbying in Albany with other advocates, prompted several Senators to raise concerns with the bill and cause the bill to be “laid aside.”  However, the bill can still be taken up at any time throughout the next week.  (BELMONT) 

Assemblyman Abbate Introduces Legislation to Address Experts in Medical Liability Actions
Assemblymember Peter Abbate (D-Brooklyn) introduced legislation this week designed to provide some balance to the adjudication of medical liability lawsuits.  The legislation would a) require the plaintiff’s attorney to submit an “Affidavit of Merit” from a physician outlining the applicable standard of care with a description of the breach of this standard as to each defendant in lieu of the current statute that only requires a conclusory attorney affirmation; and b) establish the same rules for disclosure of expert witnesses in malpractice lawsuits that is applicable in every other jurisdiction besides New York – the ability to depose an adversary’s expert and thereby limit surprise at trial.  Identical legislation (S.7728, Hannon) had previously been introduced in the New York State Senate.  The identification of expert witnesses and reform of New York’s weak “Certificate of Merit” for medical liability actions requirement have long been policy goals of MSSNY.   (AUSTER, BELMONT)

DOH Offers New Resource on HIV Testing, Reporting and Confidentiality Update
The New York State Department of Health (NYSDOH) AIDS Institute has issued a letter and a new resource titled HIV Testing, Reporting and Confidentiality in New York State 2017-18 Update: Fact Sheet and Frequently Asked Questions.    A copy of the letter can be found HEREKey provisions related to HIV testing and confidentiality were enacted in 2010, 2014, 2015 and 2016 and comprehensive updated HIV/AIDS Testing, Reporting and Confidentiality of HIV-Related Information regulations were finalized and published in the New York State Register on May 17, 2017.

The FAQ incorporates all developments since 2010 and represents the current regulatory landscape.  The FAQ has a new user-friendly design allowing easy navigation to specific topics and links to important resources.  Some of the important topics covered include:

  • Removal of the requirement for written or oral consent;
  • Information to be provided to the patient prior to an HIV test, including informing every individual of their right to decline an HIV test;
  • Requirements to link newly diagnosed patients to HIV care;
  • HIV testing documentation requirements;
  • Expansion of minor consent for HIV treatment and prevention services;
  • Sharing of patient-specific information to promote linkage/retention in care.

The FAQ can be found HERELinks to register for two webinars to be offered on these topics and can be found in the letter.  All health and human services providers involved in HIV prevention, testing, medical care and linkage/retention services should carefully review this document to ensure implementation of these updates.  A host of resources on HIV testing, can be found on the DOH website at:

https://www.health.ny.gov/diseases/aids/providers/testing/.   If you have any questions, please contact our shared mailbox at hivtestlaw@health.ny.gov.                  (CLANCY)

Physicians Urged to Contact Legislature Requesting Action on Raising the Tobacco Purchase Age
Legislation to increase the purchase age for tobacco products from 18 to 21 is pending in the Assembly Codes and Senate Finance Committees.  Physician action is needed on this measure to ensure that the bill is acted on before the end of the 2018 Legislative Session.  Assembly Bill 273/ Senate Bill 3978, sponsored by Assemblywoman Linda Rosenthal and Senator Diane Savino, would allow New York State to increase the purchase age for tobacco products from 18 to 21 years of age—there are currently 22 municipalities and counties that have increased the purchase age.  The Medical Society of the State of New York is working with other public health associations to enact this legislation into law.  Of the 50,000 + youth who become regular smokers, half of them will eventually die from smoking-related diseases, including cancer, heart disease, emphysema, asthma and hypertension, among others.

Health care costs and lost productivity for the under aged smokers of today will cost the state over $11 billion.  Moreover, the earlier people begin to smoke, the higher their risk for developing lung cancer and other major health problems.  Preventing tobacco use among young people is a critical step in reducing growing health care costs and ensuring the health of future generations.  Physicians are encouraged to send a letter to their legislators urging action HERE.             (CLANCY)

Measure To Allow Use of Marijuana To Treat Pain Moves Forward in Legislature
Senate Bill 8987/ A. 11011-A, sponsored by Senator George Amedore and Assemblymember Richard Gottfried, would allow physicians to certify patients for the use of marijuana for medical purposes if they have “pain that degrades health and functional capability where the use of medical marijuana is an alternative to opiod use.”  The measure is in the Rules Committee in both houses and appears poised for passage.  The bill goes further than current regulations which permits medical marijuana for “chronic pain.”

The Medical Society of the State of New York is opposed to this measure as there are no established guidelines for treatment of acute pain.  In addition, there is insufficient evidence to support the recommendation of marijuana as an alternative to opioid pain medications for chronic pain.  Furthermore, there is insufficient evidence to support marijuana as an alternative to other treatments for acute pain, including in patients with opioid use disorder.   MSSNY also believes that placing a patient on Medication Assisted Treatment (MAT) for opioid use disorder may be a more appropriate option for treating pain when an alternative opioid pain medication may not be appropriate for those patients that suffer from opioid use disorder.

Of greatest concern is the changing federal landscape and risk of prosecution.  The Medical Society notes that the United States Attorney General Jeff Sessions has rescinded the Obama Administration guidelines that had for all practical purposes allowed states to authorize the use of marijuana under state law without fear of federal prosecution.  This action by AG Sessions may allow federal prosecutors to more aggressively enforce marijuana laws.   It remains unclear how this action will impact states where marijuana is legal for medical purposes.   An aggressive position taken by the AG could result in federal prosecution of any participants in medical marijuana programs such as patients, those who work at dispensaries, or physicians who certify patients to obtain medical marijuana.                        (CLANCY) 

Legislation to Create Maternal Mortality Review Board Under Serious Discussion in Session’s Final Days
Working together with the American College of Obstetricians and Gynecologist – District 2, MSSNY continues to support legislation (A.10346-A, Joyner/S.8907, Hannon) which would establish a State maternal mortality review board (MMRB).  The MMRB would be comprised of a multidisciplinary team of medical experts tasked with reviewing data on maternal deaths, identifying the root causes of these events, and disseminating evidence-based best practices to prevent them in the future. The board’s primary focus will be on quality improvement rather than punishment, reviewing outcomes of care, conducting peer reviews, and collaborating on process improvements.

Importantly, the bill provides necessary confidentiality protections to the board’s proceedings to allow for open and honest dialogue and review.  However, some are continuing to advocate to minimize these broad confidentiality protections, which MSSNY and ACOG fears would seriously undermine the quality improvement goals of the MMRB.  The bill is also supported by the Healthcare Association of New York State and the Greater New York Hospital Association.   (AUSTER, CLANCY)

Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York is proud to announce that the Bending the Diabetes Curve webinar is now available to view online! MSSNY has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has created a free CME program to educate New York State physicians on prediabetes prevention and the CDC’s National Diabetes Prevention program.

Webinar: Bending the Diabetes Curve
Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

To view this course, click here.

MSSNY is dedicated to educating the physician population on prediabetes and will be providing educational webinars and podcasts in the coming weeks. Physicians are encouraged to visit our Diabetes webpage to learn more about MSSNY’s collaboration with the AMA and the Prevent Diabetes STAT toolkit.

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at charring@mssny.org.  (HARRING)

Medical Society of the State of New York Announces June Medical Matters CME Webinar Schedule (Registration Still Open)
The Medical Society of the State of New York encourages you to register for its free Medical Matters Continuing Medical Education (CME) webinar on June 20th at 12:30pm. Participation in this webinar will earn physicians one CME credit free of charge.

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.

Faculty: Linda Chokroverty, MD
Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

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 each of these live activities 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. 

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                              (HOFFMAN)

Medical Society of the State of New York Announces Veterans Matters Programs are Available on CME Website
Did you know that in a recent report, the New York State Health Foundation discovered that nearly HALF of veterans prefer to receive their care OUTSIDE of the VA system, and less than 3% of physicians outside of the VA are fully prepared to help veterans?

The Medical Society has created a free CME program series entitled Veterans Matters to assist New York State physicians in recognizing the unique health problems faced by veterans and the best way to provide care to veterans.  These programs are all available at https://cme.mssny.org. 

Veterans Matters: PTSD & TBI in Veterans

Faculty: Emerald Lin, MD
Educational Objectives:

  • Identify signs and symptoms of PTSD & TBI.
  • Examine evidence-based treatment modalities for PTSD & TBI.
  • Explore military culture and methods to overcome unique barriers to treatment intrinsic to military culture. 

Veterans Matters: Substance Use Disorders in Veterans

Faculty: Frank Dowling, MD
Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans.
  • Explore evidence-based diagnostic, intervention, and treatment options.
  • Identify barriers to identification and treatment in military culture and methods to overcome them. 

Veterans Matters: Suicide in Veterans

Faculty: Jack McIntyre, MD
Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans.
  • Explore evidence-based diagnostic, intervention and treatment options.
  • Identify barriers to identification and treatment and methods to overcome them.

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.                                                                (HOFFMAN)

Medical Society of the State of New York Encourages You to Check out CME Website
The Medical Society of the State of New York has recently added several new emergency preparedness and Medical Matters CME programs to our CME website: https://cme.mssny.org .  You can earn FREE CME credits on a myriad of topics related to Bioterrorism and Disaster/Terrorism response.  Emergency preparedness topics include our 4-part Physician’s Electronic Emergency Preparedness Toolkit, Anthrax, Smallpox as well as Ebola and numerous others.

Additionally, all of our Medical Matters programs from the past several years have been archived at https://cme.mssny.org.  Topics range from Zika Virus, Influenza and Plague to Nuclear Radiation, Disaster Triage and Mental Health as well as a variety of other timely and relevant subjects.  For assistance, or more information, please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085. (HOFFMAN)

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   mauster@mssny.org   pclancy@mssny.org


eNews

Rare Tick-Related Powassan Virus Reported in Columbia County
A rare case of Powassan virus has been confirmed in Columbia County, county health officials report. The person who was diagnosed with the virus — a rare, but serious disease that is transmitted to humans by ticks — is “recovering well,” according to Dr. Ananthakrishnan Ramani, chief of infectious diseases and microbiology at Columbia Memorial Health and medical director for the county health department.

It’s the first such case confirmed this year in New York, and it may be the last one, according to state health officials.

Bryon Backenson, deputy director of the state Health Department Bureau of Communicable Disease Control said, “We’ve only had 29 cases ever in the state since the early 2000s when it first really became known.” There were six confirmed cases in the state last year, including three in Saratoga County. A 74-year-old man from Gansevoort died after contracting the virus last year. Nationwide, about 100 cases have been reported — largely in the Northeast and Great Lakes region, the Centers for Disease Control and Prevention reports.

Unlike Lyme and other tick-borne diseases, a tick can transmit Powassan virus while being attached to a person for as little as 15 minutes, the state Health Department reports. The disease does not, however, spread from person to person. It can also cause life-threatening encephalitis, or inflammation of the brain. Long-term neurological problems may occur.

There is no specific treatment, according to the CDC, but people with severe virus illnesses often need to be hospitalized to receive respiratory support, intravenous fluids or medications to reduce swelling in the brain.(Times Union, June 13)

AMA Endorsed Gun Control Measures at Annual Meeting
The AMA officially endorsed a variety of gun control measures on Tuesday. Here are some examples, from the AP

  • A minimum age requirement of 21 to own or buy guns and ammo
  • Licensing and safety course requirements for gun owners
  • Registration requirements for all firearms
  • Closing loopholes that allow people with a legal history of domestic abuse to buy or own guns
  • Measures that allow courts, upon a relative’s request, to remove guns from homes in which a person is imminently violent or suicidal
  • Better training of doctors on screening suicide risk

Support for the policy platform was overwhelming — with a vote of 446 to 99. In the past, the AMA has backed other gun control approaches. As the AP reported, “it has supported past efforts to ban assault weapons; declared gun violence a public health crisis; backed background checks, waiting periodsand better funding for mental health services; and pressed for more research on gun violence prevention.”

Free Garfunkel Wild Webinar: “Right to Try” Act: What You Need to Know
When: Wednesday, June 20, 2018
Time: 12:00 PM – 1:00 PM 

On May 30, 2018, a new Federal “right to try” act became effective which gives patients with life-threatening conditions the right to use experimental medications without the approval of the Food and Drug Administration. This new Federal law impacts Hospitals, Physicians, Drug Manufacturers and Patients. Join MSSNY Counsel, Garfunkel Wild, as they explore the consequences and questions of this new law. The speakers are healthcare experts Vice Chairman Andrew Blustein and Partner Lara Jean Ancona and Associate Stacey P. Klein.

Click Here To Register

Registration is limited. After registering, you will receive a confirmation email containing information about joining the webinar.

Nurse Practitioner License Suspended For Bringing 3000 Patients’ Info to New Job
A nurse practitioner who three years ago took a list of patients when she left employment at the University of Rochester Medical Center and brought the names to her new employer has been suspended from practice for one year, according to the New York State Education Department Office of the Professions. Martha Smith-Lightfoot also received 12 months stayed suspension and two years probation to begin when she returns to practice. 

The incident violated patient privacy rights under the Health Insurance Portability and Accountability Act (HIPAA) and resulted in URMC being fined $15,000 by the office of then-Attorney General Eric Schneiderman. URMC did not face any federal sanctions. On or about April 15, 2015, Smith-Lightfoot gave spreadsheets with personally identifiable information of about 3,000 patients to another health provider without the patients’ permission, according to a consent order agreed to by Smith-Lightfoot and the state nursing board Office for Professional Discipline.

Smith-Lightfoot signed the consent order last November and the Board of Regents accepted it in February. URMC learned about the breach in April 2015 from patients who received letters from Smith-Lightfoot’s new employer, Greater Rochester Neurology. Democrat Chronicle 

CMS

PAI’s QPP Tip of the Month – Check Your Eligibility!
Your practice must earn at least 15 points collectively across all four Merit-based Incentive Payment System (MIPS) categories in 2018 to avoid a -5 percent payment adjustment to your Medicare Part B fee-for-service (FFS) reimbursements in 2020. CMS has introduced new bonus points opportunities for 2018 MIPS participation to help you get closer to meeting, and even exceeding, the 15-point threshold. Evaluate whether the following categories apply to you/your practice (more than one may be applicable):

  • Small Practice – additional five points automatically earned if you are a small practice (15 or fewer clinicians) for your overall MIPS score if you submit data on at least one performance category. This means that you only need to earn an additional 10 points across the four categories to avoid a negative adjustment.
  • Complex Patients – earn up to five bonus points if your practice provides care to more complex patients, which CMS will calculate using a combination of the HCC risk scores and number of dual eligibles served by a practice.
  • Quality – additional bonus points can be earned by reporting additional high-priority measures; reporting measures electronically; and through improvement scoring.
  • Promoting Interoperability – up to 25 bonus points can be earned for reporting to additional public health agencies or clinical data registries, reporting certain improvement activities using certified electronic health record technology (CEHRT), and using 2015 CEHRT exclusively.

To learn more about category-level bonus points and scoring across all MIPS categories, please find PAI’s comprehensive resources here.

QPP Look-Up Tool Now Includes 2018 MIPS Eligibility and Predictive Qualifying APM Participant Data
This week, CMS updated its Quality Payment Program Look-Up Tool to allow clinicians to view 2018 Merit-based Incentive Payment System (MIPS) eligibility and Alternative Payment Model (APM) Qualifying APM Participant (QP) data—in one place. As you’ll see, the tool previously called the MIPS Participation Status Tool has been renamed the Quality Payment Program Participation Status Tool to reflect the improvements we’ve made.

Just enter your National Provider Identifier (NPI) in the tool to find out:

  • Whether you need to participate in MIPS in 2018
  • Your Predictive QP status

Note: The Predictive QP status is based on calculations from claims with dates of service between 1/1/17 and 8/31/17. To learn more about how CMS determined Predictive QP status, please view the Predictive QP Methodology Fact Sheet.

Clinicians Can Also Check 2018 MIPS Clinician Eligibility at the Group Level and APM Predictive QP Status at the APM Entity level:

To check your group’s 2018 QPP eligibility:

  • Log into the CMS Quality Payment Program website with your EIDM credentials
  • Browse to the Taxpayer Identification Number affiliated with your group
  • Access the details screen to view the eligibility status of every clinician based on their NPI

We are also pleased to announce that you can now download the list of all NPIs associated with your TIN. The downloaded file also includes eligibility information for each NPI. This enhancement was made in direct response to stakeholder requests for this helpful function.

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front. First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for a new tenant. Call 646-642-0700.




For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed built out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


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


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New York State Health Foundation Report


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

June 12, 2018

For Immediate Release

Statement from Thomas Madejski, MD, President, Medical Society of the State of New York (MSSNY) re: New York State Health Foundation report, “Follow the Money: Pharmaceutical Manufacturer Payments and Opioid Prescribing”

“Any physician that chooses to prescribe any medication for reasons other than patient need faces threat of significant sanction from the New York State Office of Professional Medical Conduct (OPMC) as well as potentially criminal and civil penalties.

To make an assertion that New York physicians are prescribing opioids because of payments from drug companies is completely at odds with recent statistics showing a significant decrease in opioid prescribing in New York.

New York is leading the fight against the national problem of opioid abuse. As a result of our efforts:

  • New York has had one of the lowest opioid prescribing rates in the country. New York State tied for second lowest in the country (behind Hawaii).
  • The total number of opioid prescriptions went down 20% since 2013.
  • New York has one of the lowest Medicare Part D opioid prescribing rates in the country.

Certainly more needs to be done to address New York’s heroin and opioid abuse epidemic, including increased insurance coverage to respond to those facing addiction, and addressing barriers that limit the ability of physicians and others to prescribe suboxone to address addiction.  However, these recent statistics showing a significant drop in opioid prescribing are the result of a multi-pronged and multi-year effort by many to assure greater caution in the prescribing of opioids.”

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

 

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org

 

MSSNY eNews – End of Life Care Task Force Named

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE

Thomas J. Madejski, MD
MSSNY President


MSSNY eNews
June 8, 2018
Number 21

MSSNYPAC

Dear Colleagues:

On June 6, 2018, two announcements were published in the NYS Register concerning the Workers’ Compensation Program. The first notice states that the WC Board has increased the fee for providing testimony at a WC hearing from $400 to $450.  The second notice announced the proposed update in the Official Workers’ Compensation Medical Fee Schedule which will now use the 2017 AMA-CPT coding and provide a 5% increase in the WC Conversion Factors for payment of medical care to injured workers.  In addition, physicians or their staff should explore this website for information about the DRAFT fee schedules for Workers’ Compensation.

Please note, DFS Superintendent Maria T. Vullo stated that the WC fee increase could not have been anticipated by auto insurance carriers when rates were established for policyholders.  So, to mitigate the effect of unforeseen rate increases, the Superintendent deems it necessary to delay implementation of the WC fee increase for No Fault for 18 months. If you have any questions, please contact rmcnally@mssny.org 

On the Road Again

One of the best parts of being MSSNY President is traveling throughout the Great State of New York to meet our members at their County Medical Society meetings.  So far I’ve been to Buffalo and Rochester, as well as back and forth to the Greater New York region, and out to Suffolk County.  Hearing the concerns of our members one-on-one and in small groups is instructive to me personally, and I believe helps your MSSNY executive team to hone our MSSNY’s message and deliver value to our members. This past weekend I traveled to Northern New York to meet some of our members in St. Lawrence and Franklin County.  We had a wide-ranging discussion on issues affecting public health, the current practice environment, as well as physician health and wellness. The various issues discussed reflect the diversity of our members, as well as different practice environments.  One of the challenges for our smaller counties is maintaining administrative services in the face of consolidation of practices and healthcare systems in rural environments.  Our strategic planning committee continues to look at how best to support our County Medical Societies and ensure their viability.

My thanks and congratulations to the new President of St. Lawrence county Dr. Magendra Thakur and Past President Dr. Cynthia Baltazar for their hospitality. I was also able to relax a little bit with my good friend, our Vice Speaker, Dr. Bill Latreille on the Salmon River. A splendid time was had by all on a beautiful spring Saturday, although I would have liked to catch a few more fish.

Editor’s note: Today’s Buffalo News published a profile of Dr. Madejski.

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

Capital Update

MSSNY Testifies at Assembly Hearing Examining CVS-Aetna Merger
Immediate MSSNY Past President Dr. Charles Rothberg expressed the medical community’s opposition to the proposal of CVS Health to acquire Aetna during an Assembly Insurance-Health Committee hearing in Albany this week examining this proposed acquisition.  Specifically, Dr. Rothberg noted MSSNY’s strong concerns regarding: the risk of reduced community pharmacy options for patients; the risk of even more burdensome prior authorization requirements for patient needed prescription medications; the potential impact on reduced health insurance competition, given that some smaller health plans may need to purchase drug management services from a PBM whose parent is a competitor; and the risk to medical home availability as a result of an increased push for the development of retail clinics.  Also testifying at the hearing were representatives of pharmacists and consumer advocacy groups concerned with the merger, as well as representatives of CVS and Aetna.

Following the conclusion of the hearing, in a statement Assembly Insurance Committee Chair Kevin Cahill summarized, “Our hearing today helped shine light on the impact the proposed merger will have on health care delivery in New York State. New York has a long tradition of professional and non-profit healthcare and it is critical that regulators, both at the Federal and State level, ensure that any major changes, such as this one, have unimpeded objectives of improving access and quality of care…”  He also noted that “our State must be proactive in responding to such drastic potential changes in our health care delivery systems. The past has taught us that reactive approaches to challenges in health care could have devastating effects on consumers and our health care system. This acquisition poses serious questions for the long-term stability of the State’s insurance markets and access to health care products”

Assembly Health Committee Chair Richard Gottfried added: “An acquisition like this would reshape health care delivery.  Pharmacy benefit managers, like CVS’s CareMark, and health plans have leverage over pharmacies in ways that could favor CVS’s own stores at the expense of independents and other chains. It should be of great concern to have what economists call ‘vertical integration’ – in this case a major health care provider and a major health insurer sharing the same bottom line – with dramatic effect on consumers and others in the market. It’s critical that State and Federal regulators assess and understand the potential impact on patients, insurance networks, and drug purchasing and dispensing processes. Today’s hearing, including feedback from CVS, Aetna, other health care providers, and consumer advocates, was an important step in that process.”

To view the entire 4 hour hearing, Click Here:  Dr. Rothberg’s comments begin at about the 2:20 mark.

Please Click Here to view a Capital Tonight interview with Assemblyman Cahill as he discusses his concerns with the merger proposal including the physician, pharmacy, and consumer concerns.                                                              (AUSTER)

5% Overall Increase to Workers Compensation Medical Fee Schedule Proposed
As a follow up to its announcement in April, the New York State Workers Compensation Board released a proposal this week to provide an “overall” 5% increase in the Workers Compensation medical fee schedule effective October 1, 2018.  The statement accompanying the release of the proposed rule noted that “areas with shortages of medical providers authorized to treat injured workers may see further increases.”

To review how such increase is proposed to be implemented, Click Here:   As comments are due to the WCB by August 5, MSSNY is reviewing the entire proposal, and has sought feedback from the members of its Workers Compensation and No-Fault committee.  MSSNY has also sought input from societies representing affected medical specialties such as Orthopedics, Anesthesiology and Osteopathy.

The proposed regulation also notes that the cost of ordering a hard copy of the fee schedule will be $100, and an electronic copy will cost $400.

By separate regulation, the WCB also proposed to increase the WC testimony fee for physicians from $400 to $450.

These proposals are part of a multi-pronged effort by the WCB to increase care availability for injured workers.  As reported last week, the WCB has also advanced legislation (S.8812 and A.8387-B) in the Assembly and Senate that would expand the list of eligible providers allowed to treat injured workers.  The bill expands eligibility to include acupuncturists, chiropractors, nurse practitioners, physical therapists, physician’s assistants, podiatrists, psychologists and social workers.

MSSNY has expressed concern that the proposal would enable a nurse practitioner to assess an injured worker’s level of disability and determine causation of a patient’s injury without the involvement of a physician.  MSSNY has also expressed concern over another component of the legislation that would modify the process of how county medical societies recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.  While the provision has been improved over earlier versions, MSSNY remains very concerned that the phrasing of the proposal could enable the WCB to bypass the county medical society in approving physicians to be authorized to treat or provide IMEs under Workers’ Compensation.                                                                                         (AUSTER, BELMONT)

MSSNY Opposes Requiring New Physician Mandates
MSSNY continues to advocate against various pieces of legislation that would impose more burdensome mandates on physicians.  MSSNY remains opposed to a bill, S.2113-A (Felder) / A.352-A (Perry) that would require physicians and hospitals in New York City to inquire and document the name of the school attended by school-aged patients and to include this information in their admission registration forms.  New York Public Health Law Section 2101 already requires physicians to report immediately to the local health officer regarding the presence of any communicable disease. The health officer is then charged with the responsibility to investigate cases of communicable disease, to ascertain sources of infection, to seek out contacts, and to take other steps to reduce the spread of the disease.

Increasing mandates take more and more time away from the ability to deliver the timely care patients expect to receive.  This trend is well documented.  A recent 2016 study reported in the Annals of Internal Medicine concluded, remarkably, that for every one hour of patient care delivered by a physician, two more must be spent on paperwork.                                                                               (BELMONT)

Bill to Prohibit Flavored E-liquid in E-Cigarettes Moves in the NY Assembly; On Senate Calendar for Vote
Assembly Bill 8688/S. 8610, sponsored by Assembly member Linda Rosenthal and Senator Kemp Hannon, is moving in both houses of the legislature.  This measure, if enacted, would prohibit the sale and distribution of flavored e-liquid for use in e-cigarettes.   The measure moved to the Assembly Codes Committee by a vote of 14-12 and is on the Senate calendar for a vote.  Throughout the country and New York State, the use of electronic cigarette is on the rise especially among adolescents and young adults.

E-cigarette use poses a significant health risk to young people in by increasing the possibility of addiction and long-term harm to brain development and respiratory health. E-cigarettes liquid is nicotine and most now have flavoring in them. E-cigarettes are considered tobacco products. According to a 2016 report by the U.S. Surgeon General, young adult users of e-cigarettes (ages 18 through 24) are much more likely to use flavored e-cigarettes than are users over the age of 25.

The Surgeon General also reported that the majority of youth who have tried e-cigarettes first used a flavored product. Youth are attracted to e-cigarettes due to the flavoring and a perceived lower risk than using traditional tobacco products.  Electronic cigarette companies use colorful packaging and enticing flavors to lure young people when they are at the most common age to begin smoking.  The Medical Society of the State of New York supports this measure.                                         (CLANCY)

Bill to Include Lyme Long Term Therapy Prohibition in OPMC on Assembly Floor
Assembly Bill 10930, sponsored by Assemblywomen Didi Barrett, has moved to the Assembly floor for a vote.  This legislation amends public health law to include diagnosis and long term antibiotic treatment of Lyme disease in existing standards that the Office of Professional Misconduct (OPMC) follows in relation to what a physician cannot be charged with misconduct for doing.

Under this measure, no health care professional shall be subject to professional discipline for prescribing long-term antibiotic therapy for a patient diagnosed with or treated for Lyme disease or other tick borne illness. In 2015, the New York State Legislature amended the statute by putting into place existing principles that were being followed by OPMC regarding the investigation of physicians, physician assistants and specialist assistants who use treatment modalities that are not universally accepted by the medical profession, such as the varying modalities used in the treatment of Lyme disease and other tick-borne diseases.

These principles had existed since 2005.  When this law was enacted in 2015,  according to officials from OPMC, there have only been one physician who has ever lost his or her license for misconduct related to the use of antibiotics, and that occurred in the mid- 1990s.  To MSSNY’s knowledge, there has not been any other professional who has been reviewed on antibiotic use.    The Medical Society of the State of New York has, for over last 20 years,  worked with the Department of Health and the New York State Legislature to enhance due process protections for physicians under the OPMC statute.  MSSNY believes that those protections already preserve the freedom of physicians to exercise their clinical judgment in the treatment of their patients.  MSSNY is opposed to this measure.  There is no companion measure, at this time, in the New York State Senate.                                                                        (CLANCY)

MSSNY Joins Patient Groups to Advocate to Prevent Mid-Year Formulary Changes
With just 7 scheduled Session days left, all physicians are urged to contact their legislators to urge their support for legislation (A.2317-C, People-Stokes/S.5022-C, Serino) that would (in most cases) prohibit a health insurer from making a change to their prescription drug formulary or moving a prescription drug to a higher tier during a policy year.  The legislation has passed the Assembly unanimously, and is before the Senate Insurance Committee.  To send a letter in support, Click Here.

Earlier in the year MSSNY participated in a press conference in support of the legislation, together with the sponsors of the bill, as well as many of its supporters, including the Global Healthy Living Foundation, Lupus and Allied Diseases Association, NAACP, AARP, New Yorkers for Accessible Health Coverage, the Epilepsy Foundation, the Arthritis Foundation, the American Cancer Society, the National Association on Mental Illness-NY, the NY Chapter of the American College of Physicians, the NYS Osteopathic Medical Society, and the American College of Rheumatology.

MSSNY President Dr. Thomas Madejski stated the following for the press release:Continuation of a medication regimen prescribed by a patient’s treating physician is critical to assuring a patient’s recovery from illness, maintaining their health, or preventing worsening of their condition. Unexpected changes to a medication formulary could result in significantly higher out-of-pocket costs for patients. This could seriously interfere with their continued ability to obtain these needed medications.  Insurance company formulary changes are not made with the intimate knowledge of the patient’s personal physician.  Additionally, this legislation would help to protect consumers from unforeseen higher cost-sharing requirements.                                                (AUSTER)

Bill  To Allow Superintendent of DFS to Evaluate Insurers & Health Plans Compliance with Mental Health & Substance Use Disorder Parity Laws; Physicians Urged to Contact Legislators
With only seven scheduled legislative session days left, physicians are urged to contact their legislators to urge passage S.1156-C/A.3694-C, which directs the Superintendent of the Department of Financial Services to collect certain key data points and elements from insurers and health plans in order to scrutinize and analyze if they are in compliance with the federal and state mental health and substance use (MH/SUD) disorder parity laws.  The information collected would be analyzed and used for the preparation of a parity compliance report in the annual “Consumer Guide to Health Insurers” issued by Department of Financial Services.

Although MH/SUD parity laws have been on the books for over a decade on the federal and state level, there still exists within the health insurance and health plan industry patterns of disparity between coverage criteria imposed on MH/SUD care and treatment as compared to other covered services, which is further evidence by  the settlements/agreements the office of attorney general in New York State reached over the last several years with several major insurers, health plans and managers of behavioral health benefits regarding acts of non-compliance. This further demonstrates the need for an industry wide approach and annual evaluation of compliance. MSSNY along with NYSPA firmly believe this legislation is the next step for New York to take to assure compliance and full implementation of the federal and state MH/SUD parity laws, thereby for enhancing access to care for MH/SUD care and treatment. Physicians are urged to send a letter to please Click Here.                                (CLANCY)

MSSNY Committee for Physicians Health Bill Passes Senate
The New York State Senate this week passed legislation (S.8093-A, Hannon) supported by MSSNY that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The identical Assembly bill (A.10221-A, Gottfried) advanced from the Assembly Ways & Means Committee to the Assembly Rules Committee this week, and could very well be voted on next week.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.

These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.   (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Supports Physician Protection Act
MSSNY participated in a press conference with Senator Funke, Assemblywoman Joyner, the New York State Academy of Family Physicians and the Albany County Medical Society to support legislation that would include assaults on physicians as an ‘assault in the second degree’, a class D felony charge in the state of New York. Currently it is a class A misdemeanor.

Physicians and other health care employees are exposed on a daily basis to the potential of assault or other violent situations in the course of their duties.    Assaults on the job are one of the most frequent causes of serious injuries in health care.  While current statute affords protections and increased penalties for assaults on nurses, EMTs, emergency department medical personnel, firefighters, police officers, school crossing guards, sanitation workers and other employees providing direct patient care, physicians are currently not afforded the same safeguards. Please call your legislators and tell them to support S.8055 (Funke) and A.10225 (Joyner).        (BELMONT)

Measure to Require Co-prescribing on Naloxone By All Prescribers for All Opioid Prescriptions Held in Committee
Assembly Bill 10099/Senate Bill  7801, sponsored by Assembly member Daniel O’Donnell and Senator George Amedore, was held in the Assembly Health Committee.    The measure is currently in the Senate Health Committee. This measure would authorize the New York State commissioner of health to develop guidelines to require that every time an opioid prescription is provided to a patient that co-prescribing of an opioid antagonist is required.  Additionally, the bill would  require that physicians and other health care providers identify patients at risk of an opioid-related drug overdose and prescribe an opioid antagonist to that person or to a person in a position to administer the opioid antagonist to the patient.

The Medical Society of the State of New York is opposed to this measure.   The Medical Society, a member of the AMA’s Opioid Task Force, agrees with the task force that physicians be encouraged to consider co-prescribing naloxone when it is clinically appropriate to do so.  New York State has enacted a non-patient specific script which allows for ease to do this.   The Medical Society of the State also believes that this measure will create greater stigma toward patients with pain.                                  (CLANCY)

Assembly Higher Education Committee Rejects Scope Expansion Bills
Over the last few weeks of Session, advocates for various non-physician health professions have been actively pushing their legislation to expand their scope of practice.  While many of these bills remain pending in the remaining days of Session, the Assembly Higher Education Committee, chaired by Assemblywoman Deborah Glick, voted to “hold” in Committee the following bills that had been opposed by MSSNY:

  • A.1880 (Pretlow) – Would have expanded the ability of podiatrists to provide wound care and reduced supervision requirements
  • A.5913 (Ortiz) – Would have given statutory recognition to the practice of naturopathic medicine.
  • A.5807 (O’Donnell) – would have permitted chiropractors to form professional partnerships with physicians.                                                        (DIVISION OF GOVERNMENTAL AFFAIRS)

DMV Reporting Legislation Update
With only two weeks left of the 2018 legislative session remaining, legislation, S. 3569 (Young) / A.10094 (Carroll) is still pending that would require a licensed physician, physician assistant or nurse practitioner to report patients that have a chronic condition which cause or may cause unconsciousness or unawareness to the Department of Motor Vehicles.  MSSNY staff and activists have educated members of the legislature about the ambiguity of the bill language and the fact that it encompasses a number of medical conditions where there may only be a remote chance the unconsciousness and unawareness may occur.  Such conditions may include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle. The bill is also opposed by the Epilepsy Foundation & American Diabetes Association. 

A new bill, A.11121 Rules (Carroll) was introduced this week.  This bill would authorize the Department of Motor Vehicles (DMV) to require driver’s license holders to submit to a DMV reexamination of their fitness to drive if the licensee experienced a loss of consciousness and was involved in a reportable accident while driving and DMV receives evidence that the loss of consciousness caused or contributed to the accident.  The bill would also direct the DMV, in consultation with the Department of Health and the Division of State Police to review its notification process by physicians and the methodologies by which the DMV receives information.

The bill would review the identification procedures of medical review programs and whether certain drivers should operate motor vehicles due to chronic, ongoing conditions that may cause loss of consciousness, loss of awareness or loss of body control.  MSSNY will continue to work with both houses and the various state agencies to continue to advocate that the physician’s duty to report medical conditions that would impair safe driving should be voluntary and under the physician’s discretion.                                                                                                           (BELMONT)

Health Insurer Premium Increase Requests Announced by DFS
The New York Department of Financial Services announced the proposed health insurance premium rates for the individual and small group markets for the 2019 policy year.  To read the DFS press release, Click Here:.  The chart in the press release highlights the additional premium increases insurers are seeking as a result of legislation recently enacted by Congress that repeals the previous ACA requirement for individuals to have health insurance coverage.  For the individual market, the average rate increase was 24%, with a range of a 3.2% requested decrease from Health Now to a 38.6% requested increase from Fidelis.  For the small group market, the average requested increase was 7.5%, with a range of a 0.1% requested decrease from Health Now to a 21% requested increase from Health First. Under New York, DFS must approve health insurers premium rates.                                        (AUSTER)    

NYS Program Helps to Subsidize Cost of Connecting to Regional Health Information Exchange
Did you know that New York State has a program to provide physicians with financial assistance to connect to your local Regional Health Information Exchange (RHIO)?   The Data Exchange Incentive Program (DEIP) was established by the NYS Department of Health to provide physicians and other health care providers with up to $13,000 to help offset the costs of connecting to your local RHIO. It was established in response to the concerns expressed by many physicians  – including most recently through a resolution adopted a the 2018 MSSNY House of Delegates – to reduce the sometimes exorbitant costs imposed by EHR vendors in connecting to their local RHIOs.  For more information about eligibility requirements, Click Here: or send an e-mail to deip@nyehealth.org.  Last week, the MSSNY HIT Committee received a presentation from top staff to the New York eHealth Collaborative (NYeC) about this important program to reduce the financial burden to physicians in implementing EHR systems.                                                                                               (AUSTER)

Physicians Urged to Contact Senator On Legislation to Allow Enhanced Religious Exemptions for School Based Immunizations
Physicians are urged to contact their state senator regarding Senate Bill 6141D, sponsored by Senator Martin Golden, which would allow the admission of certain unvaccinated students to public schools.  The bill is in the Senate Finance Committee.   S. 6141-D amends the Education Law to provide the procedure for religious exemptions from vaccination requirements.  Under the bill, a parent or guardian would complete a religious beliefs vaccination exemption form to ensure a public school district does not deny admission to their unvaccinated child.

A religious exemption is currently allowable under NY State law, but the exemption allows the school institution to make a decision on whether the student should be exempt from vaccination.   This bill, if passed by the Legislature, would force schools to accept the form and allow unvaccinated students to enter the school. Its companion measure, A. 8123B, sponsored by Assemblymember Richard Gottfried, chair of the Assembly Health Committee, is also pending before the Assembly’s Education Committee.  Physicians are urged to write to the members of the NYS Legislature and urge that this bill not be enacted.  To write a letter go to the MSSNY Grassroots Action Center and click on the letter here.                                                             (CLANCY)

Medical Society of the State of New York Announces June Medical Matters CME Webinar Schedule
The Medical Society of the State of New York encourages you to register for its free Medical Matters Continuing Medical Education (CME) webinar on June 20th at 12:30pm.  Participation in this webinar will earn physicians one CME credit free of charge.

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

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 each of these live activities 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. 

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at  mhoffman@mssny.org.                                                                  (HOFFMAN)

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

pschuh@mssny.orgmauster@mssny.org pclancy@mssny.org 


eNews

MSSNY Announces Members of Task Force for End of Life Care
In May, the Medical Society of the State of New York Council created a Task Force on End of Life Care.  The task force has been charged with developing a “white paper” on the physicians’ role in end of life and palliative care; and that the paper also discuss the impact of these issues on the disparate populations and the disabled community.  Ideally, the task force will generate ideas that would be brought to the MSSNY House of Delegates, and if appropriate, the AMA House of Delegates to create policies that improve access, implementation, and general approach to care as our patients approach the end of their lives.

Dr. Thomas Madejski, MSSNY President, named Jeffrey T. Berger, MD and Dr. John Maese as co-chairs of the task force.  Dr. Berger is chair of MSSNY Bioethics Committee and serves as Chief of the Division of Palliative Medicine and Director of Clinical Ethics at NYU Winthrop Hospital. He is board certified in both Internal Medicine and Hospice and Palliative Medicine; Dr. Maese, a member of the MSSNY Committee on Continuing Education, is board certified in Geriatric Medicine and Internal Medicine.  

Additionally, Dr. Madejski appointed the following MSSNY members to serve on the task force:  Bruce H. Berlin, MD; Patricia A. Bomba, MD; Clare B. Bradley, MD; Erick A. Eiting, MD, MPH; Steven M. Kaner, MD; Shail Maingi, MD; John “Jack” McIntyre, MD; Parah H.  Mehta, MD; Nancy H. Nielsen, MD, PH. D. John A. Ostuni, MD; Malcolm D. Reid, MD, MPP; Myrna Sanchez, MD; M. Monica Sweeney, MD, MPH; Rishi Kamlesh Thaker, Medical Student; Joshua Cohen, MD, Commissioner of MSSNY’s Science and Public Health Division; and Janine L. Fogarty, MD, Assistant Commissioner for Science and Public Health.                                                     

New York Insurers in Seeking Double-Digit Premium Hikes for ACA Plans
The Hill (6/4) reports that insurers which sell ACA plans in New York are seeking double-digit premium hikes for 2019, “citing recent and upcoming changes to the law.” About 14 insurers in New York want an average increase of 24 percent, and 11 in Washington State are requesting an average hike of 19.08 percent. Insurer Fidelis wants “state regulators to approve a 38.6 percent rate hike, attributing 25.9 percent of that increase to the repeal of the mandate.” For its part, Emblem, which is seeking “a 31.5 percent increase,” attributed 12 percent of that figure to the repeal of the ACA’s individual mandate.

New York’s Department of Financial Services, “Insurers have attributed approximately half of their requested rate increases to the risks they see resulting from its repeal. … Without the federal action, the average requested rate increase would be 12.1 percent.”

AG Settles with Ageless Men’s Health for Misleading PTs with Low Testosterone
Chain of “Low T” Clinics Will Reform its Practices and Provide Key Info to Patients

New York’s AG, Barbara D. Underwood, announced an agreement with Ageless Men’s Health, P.C. (“Ageless”), requiring Ageless to make complete and accurate disclosures to its patients and prospective patients concerning the diagnosis of low testosterone and the risks associated with testosterone replacement therapy (“TRT”). TRT is an increasingly common treatment for men with low levels of testosterone, sometimes called hypogonadism or “Low T.”

Ageless and its affiliates provide TRT to men at 36 clinics across the United States, including three in New York City. Ageless failed to inform patients that in diagnosing low testosterone and addressing potential side effects of treatment, it was not following evidence-based practices recommended by leading medical organizations. Additionally, Ageless prominently featured a deceptive “Low T quiz” on its website that misled patients regarding the diagnosis of low testosterone.

Medical guidelines, such as the guidelines of the Endocrine Society and the American Urological Association, recommend that two morning blood tests, on different days, should be performed to confirm a diagnosis of low testosterone before starting TRT. Ageless’ practice has been to perform only a single diagnostic blood test, at any time during business hours — more often than not in the afternoon — without informing patients that diagnosing low testosterone in this manner is contrary to these guidelines.

Instead, without informing patients, Ageless relied on different guidelines that do not contain a recommendation one way or the other concerning the time of day of testing or the number of tests that should be performed. In so doing, Ageless led patients to believe that they require treatment when they may not.

Ageless offered TRT to men whose diagnostic testosterone levels are above the thresholds for treatment set out in medical guidelines, including those collected in its own Clinical Operations Manual, without informing patients of that fact. This also led patients to believe that they require treatment when they may not.

Under the agreement, Ageless has committed to (1) remove the misleading “Low T Quiz” from its website; (2) inform patients that according to medical guidelines, blood tests for purposes of diagnosing low testosterone should be performed in the morning, and two morning tests should be performed before starting TRT; (3) inform patients about the thresholds for treatment set out in the relevant medical guidelines; and (4) inform patients in writing about the fertility-related side effects of TRT.

Addressing MSSNY Concerns Regarding eMOLST Registry
By Patricia Bomba, MD, FACP ,Vice President and Medical Director, Geriatrics Chair, MOLST Statewide Implementation Team & eMOLST Program Director and a MSSNY member

  • Doctors fear OPMC problems if they do not comply with the law.
    Do you have evidence of OPMC problems with failure to follow Family Health Care Decisions Act (FHCDA) or the Palliative Care Information Act (PCIA)? Similarly, are their concerns with OPMC enforcement issues related to physicians reporting immunizations to the New York State Immunization Information System (NYSIIS)? The reporting requirement contained in this legislation was modeled on the 2008 requirement that all practitioners enter immunizations administered to children into the NYSIIS within 14 days of administration of the immunization. To date, we are unaware of any enforcement by OPMC related to reporting to this registry.This provision is also designed to encourage the use of eMOLST, rather than the paper version, which would eliminate any concerns related to reporting within 14 days as completion on eMOLST would automatically be submitted to the Registry, requiring no additional action by the physician.
  • Doctors are concerned that the data may not be housed at the NYS DOH.
    Concern about data not being housed by NYS DOH: Under the structure of the legislation, it is envisioned that the Department of Health would contract with an entity, presumably the MOLST Program, to operate the Registry. While not “housed” at the NYSDOH, the Registry operator would be under contract with the DOH for the operation of the Registry and would be subject to significant oversight by DOH. In addition, the current eMOLST system operated by the MOLST Program is not housed by the NYS DOH, but is housed in a separate secure server, electronically stores all MOLST forms completed through the eMOLST system. The data is encrypted and separate from the application.The Registry would be operated in the same manner as the current eMOLST application. Importantly, this means that access and information transmitted through the application complies with HIPAA, Department of Health privacy rules and New York State Public Health Law. In keeping with New York State’s vision for open-system solutions, the eMOLST application was developed following open architectural principles for the benefit of the community and other Regional Health Information Organizations (RHIOs) across the state, as well as serve as a data source for the Statewide Health Information Network for New York (SHIN-NY).
    Lastly, the information contained on the MOLST is not intended to remain with the DOH, rather, it is meant to be accessed by all health care providers.
  • Doctors are concerned about multiple different documents which may have conflicting data.
    This legislation would assist in eliminating this concern by creating 2 Registries – an advance directive registry and MOLST Registry. The advance directive registry would assist in ensuring accurate documents, such as health care proxies. Patients who are appropriate for MOLST should have an up-to-date health care proxy in case MOLST orders need to be revised after the patient loses capacity. Similarly, the MOLST registry would only allow for the most recent valid MOLST to be accessible to health care providers, eliminating the concern that the form may be out of date or had been revoked.MOLST is a set of medical orders signed by the physician or nurse practitioner (as of May 28, 2018) that defines life-sustaining treatment the patient wants to receive or avoid now. Living wills are difficult for physicians to interpret and operationalize as irreversible and potentially reversible conditions coexist. A MOLST done reflecting a patient’s current health status, prognosis and goals for care is more valuable to the physician making decisions than a living will done 20 years ago, especially when the same physician is not seeing the patient in every care setting.

New Calculator for Prescribing Meds to Avoid Heart Attack, Stroke
STAT (6/4) reports that a team from Stanford University has developed a new calculator to be used to decide “whether patients might benefit from aspirin, statins, or blood pressure medications” which updates data sources, adds findings from the more recent Jackson Heart Study and Multi-Ethnic Study of Atherosclerosis, and applies newer statistical methods. The current calculator was derived in 2013 and was “endorsed by the American College of Cardiology and the American Heart Association.” The researchers claim their findings “improve the accuracy of risk estimates among multiple populations.” The results were published Monday in the Annals of Internal Medicine 

Opioids Responsible for About 20 Percent of Deaths among Young Adults
A new study published in JAMA Network Open shows that in 2016, one in 65 deaths in the US involved opioids and that among younger adults, “that number skyrocketed to one in five.” The paper used data from the CDC’s WONDER database, which tracks mortality data and causes of death in the US. According to the study, in 2016, “opioids were involved in 28,496 deaths,” and “more than 8,400 of these occurred among adults between the ages of 25 and 34, a number high enough to mean that 20% of all deaths in this age group in 2016 involved opioids.”

Researchers Examine Motivating and Deterring Factors for Stool Donors
The New York Times (6/5) reports researchers examined motivating and deterring factors for stool donors and presented their findings at Digestive Disease Week. The investigators found that stool donors were motivated by altruism and financial compensation, but deterred “by the unpleasantness that would be involved in collecting stool samples,” as well as the time required. The Times points out that there is growing demand for stool donors as fecal transplants become a more common treatment for C. difficile infections.

SOCIO-MED ECONOMICS

Important Notice Regarding Handwriting on Face of Claims Submitted to Medicare
Beginning Monday, 7/10/2018, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not a signature field, (i.e., Items 12, 13, or 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim. No more delays. 

Register for Upcoming CMS Webinars
CMS has a number of upcoming webinars scheduled to help you understand MIPS and quality measures.

Title:    MIPS Promoting Interoperability Performance Category Webinar
When: Tuesday, June 12, 2018, 1:00 – 2:00 p.m. ET
Registration: https://engage.vevent.com/index.jsp?eid=3536&seid=1111

CMS is hosting a webinar on Tuesday, June 12 at 1:00 PM ET to provide information about the Promoting Interoperability (PI) performance category (formerly the Advancing Care Information performance category) of the Merit-based Incentive Payment System (MIPS).

  • During the webinar, CMS subject matter experts will:
  • Provide a brief overview of MIPS requirements in 2018
  • Discuss the renaming of the PI performance category
  • Explain the PI performance category requirements for 2018
  • Review PI scoring

Address questions from participants at the end of the webinar, as time allows.

The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. CMS will open the phone line for the Q&A portion.

Title:   CMS Quality Measures: Development, Implementation, and You Webinar (Part 2)
When: Wednesday, June 13, 2018; 12:00-1:00pm ET and Thursday, June 14, 2018; 4:00-5:00pm ET
Registration Links: June 13; 12:00-1:00pm, ET https://battellemacra.webex.com/battellemacra/onstage/g.php?MTID=ea6790ccacf388df754e44783d623fc7f

June 14th; 4:00-5:00pm, ET
https://battellemacra.webex.com/battellemacra/onstage/g.php?MTID=eeb8a20586920854654d3d5a73bbdedba

On June 13, from 12:00-1:00pm, ET, CMS will host the second webinar, of a two-part series, that covers an introduction to quality measures, overview of the measure development process, and how providers, patients, and families can be involved. If you are unable to attend during this time, the same session will be offered again on June 14, from 4:00-5:00 pm, ET. CMS is looking for your feedback and participation in the quality measure community, so please join us during the webinar to hear updates and how you can be a part of the process!

Please note that the two opportunities listed are for the same session; we ask that you only register for one of the sessions.

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.

Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front. First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for a new tenant. Call 646-642-0700.




For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed built out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/

Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

MSSNY eNews: Workers’ Comp: Possible Fee Increase

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
June 1, 2018
Volume 18
Number 20

Greetings from St. Lawrence County!

Dear Colleagues:

On May 8, the Chair of the NYS Workers’ Compensation Board asked me for a report concerning what would be considered a fair and reasonable amount of remuneration to update the medical fee schedule.  This followed an announcement from the Chair in April of her intent to pursue measures to “increase provider participation in the workers’ compensation system and improve injured workers’ access to timely, quality medical care.” Importantly these efforts include a long-overdue fee increase, and a needed simplification in claim submission. At the same time, the announcement also reiterated the Board’s interest in the enactment of legislation to expand the various health care providers who are eligible for participation in Workers Compensation. 

With regard to recommendations for the proposed fee increase, MSSNY physician leaders came up with three values for consideration.  They were, as follows:

  1. 150% of Medicare; or
  2. 5% increase to the current WC fee schedule; or
  3. 80th percentile of Fair Health

These recommendations, along with a spreadsheet of fees for Medicare and Workers’ Compensation, for the region of Manhattan only, were shared with the 28 MSSNY physician members of the Workers’ Compensation and No-Fault Insurance Committee for a vote.  The Committee members were somewhat evenly divided between 150% of Medicare [with serious hesitation about linking to a federal fee schedule] and plus 5% for the next several years above the current WC fee schedule. Seven voted for 150% of Medicare and nine voted for 5% above the current WC fee schedule.  All members agreed that no physician or specialty should be subject to any reduction in the current WC fees.

In addition, many members urged that MSSNY seek a larger increase for the Evaluation and Management codes since these E&M codes have long been undervalued under the WC Program. I would like to personally thank Drs. Jay Weiss, Robert Goldberg and the MSSNY Committee on Workers Comp and No Fault Insurance for their hard work. We also had additional discussion with MSSNY leaders who also serve in leadership positions with some of our specialties most affected by the WC system. Thanks to Dr. John Olsewski, Dr. Jim Slaugh, and our MSSNY Vice President, Dr. Bonnie Litvak, for their thoughtful and timely contributions to the discussion.

Subsequently, our letter for a Workers’ Compensation Fee Schedule Increase was sent to the Chair of the NYS WCB on Friday, May 25, 2018 – please see this link.

Simultaneously, your MSSNY Governmental Affairs staff has also had extensive discussions with legislators and key staff about its concerns with legislation introduced in Albany that would expand the coverage of non-physicians in Workers Compensation, as well as changes to how county medical societies review physician applications to participate in Workers Compensation. MSSNY has also sought to address the problem of carriers inappropriately paying below the Workers Compensation fee schedules.

There are many issues in play, so please remain alert for further details. 

If you have any questions, please call or email Regina McNally at 516-488-6100, 332 or rmcnally@mssny.org 

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

Capital Update

AMA Opioid Task Force Releases 2018 Report
The American Medical Association Opioid Task Force has released its 2018 report and it shows significant progress being made in New York and across the country in the fight against the opioid epidemic while recognizing that more needs to be done to expand access to treatment for substance abuse disorders.   The report shows that New York State physicians and prescribers decreased opioid prescriptions between 2013-2017 by 20.3 % and that there were over 21 million checks of the state’s Prescription Monitoring Program in 2017 (up from 18 million in 2016).   The report also indicates that New York State has increased the use of naloxone and increased the use of medication assisted treatment (MAT).   The report can be found here.  The report is the continuation of an effort by the AMA Opioid Task Force and all of you to measure physicians’ progress in several quantifiable areas. This effort began during the Obama Administration and continues today.  The Medical Society of the State of New York is a member of the AMA’s Opioid Task Force and has been from the beginning of the task force formation. (CLANCY)

Workers’ Compensation Legislation Introduced
Legislation (S.8812 Akshar / A.8387-A Pretlow) has been recently introduced that would expand the list of eligible providers allowed to treat injured workers.  The bill expands eligibility to include acupuncturists, chiropractors, nurse practitioners, physical therapists, physician’s assistants, podiatrists, psychologists and social workers.  MSSNY has expressed concerned over the potential involvement of a nurse practitioner in assessing the level of disability, determining causation of a patient’s injury and treating injured workers without the involvement of a physician.

The bill would also modify the process of how county medical societies recommend physicians and providers to serve as treating providers or independent medical examiners under Workers Compensation.  While there are improvements over previous versions, MSSNY remains very concerned that the phrasing of the proposal would alter the process and authority of how county medical societies recommend physicians to serve as treating providers or independent medical examiners under Workers Compensation.  The county medical societies already ensure a timely, efficient and complete approval process of physician applications to the workers compensation board.  MSSNY also opposes the provision to delete the requirement of an arbitrator to be a member of MSSNY.

MSSNY staff continues to meet with key legislative leaders and staff to voice its very serious concerns as well as seeking other measures to reduce abusive carrier practices. (BELMONT, AUSTER)

Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians
With just a few weeks left in the legislative session, MSSNY is working together with several other patient advocacy organizations and specialty societies to advocate for numerous pieces of legislation to reduce barriers imposed by health insurance companies that interfere with patient care, and expand patient choice by limiting the ability of health insurers to narrow their networks.   These bills include:

  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill is on the Assembly floor and, this week was reported from the Senate Health Committee to the full Senate.  Please send a letter in support here.
  • 7872 (Hannon)/A.9588 (Gottfried) – would reduce prior authorization hassles by requiring health plan utilization review criteria to be evidence-based and peer reviewed; reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations); assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment; prohibiting mid-year prescription formulary changes; and assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service. Please send a letter to your legislators in support here . 
  • 5022-C (Serino)/A.2317-C (People-Stokes) – would prohibit health insurance companies from making changes to a prescription formulary or shifting a medication to a different cost-sharing tier during a policy year. The bill has passed the Assembly, and is before the Senate Insurance Committee.  (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Committee for Physicians Health Bill Advances
The Assembly Health Committee unanimously voted to advance legislation (A.10221-A, Gottfried) to the Ways & Means Committee that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The identical Senate bill S.8093-A, Hannon), has advanced to the Senate floor.  It had been on the Senate “Active List” to be passed this week, but was not brought up for a vote due to debate on an unrelated issue.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.  (DIVISION OF GOVERNMENTAL AFFAIRS) 

Partial Fill Legislation Reported to Assembly Floor
Assembly Bill 10392A, sponsored by Assemblymember John McDonald, has advanced from the Assembly Higher Education Committee to the Assembly floor.  This measure allows the prescriber to issue a  prescription for a Controlled Substance II, III or IV to the patient that can be filled partially.  It also allows them to prescribe up to a 30-day supply of Controlled Schedule II, III, IV with a notation to the pharmacist that he/she should only dispense the agreed to amount.   Each partial filling would be dispensed and recorded in the same manner as a refilling (i.e., date refilled, amount dispensed, initials of dispensing pharmacist, etc.), the total quantity dispensed in all partial fillings does not exceed the total quantity prescribed, and no dispensing occurs after six months past the date of issue.   Partial fills of prescription for Controlled Substance II are allowable under the federal law but is currently prohibited in New York State.  Its companion measure, Senate Bill 8324, sponsored by Senator Kemp Hannon, is in the Senate Health Committee.  The Medical Society of the State of New York supports this measure.  (CLANCY)

MSSNY Physician Participates In Senate Round Table On Access To Naloxone
Frank Dowling, MD, MSSNY Secretary, and a member of American Medical Association’s Task Force on Opioids, recently participated in a Senate round table on naloxone access.  The roundtable, conducted by Senator Kemp Hannon, chair of the Senate Health Committee, and the Senate’s Task Force on Heroin and Opioid Addiction, discussed issues related to availability to naloxone throughout the state.  Despite legislative efforts allows standing orders for community organizations and pharmacies to distribute Narcan without a prescription; the Good Samaritan protections and the creation of the N-Cap program, Dr. Dowling indicated that he and his office staff have called pharmacies and been told that they cannot sell or dispense Naloxone without a script or that they didn’t have naloxone in stock. 

Dr. Dowling indicated that some individual pharmacies are unaware of New York law and regulations.  Participants at the roundtable includes officials from the New York State Department of Health, the Department of Financial Services, the Office of Alcoholism and Substance Abuses Services, Albany Medical Center, regional EMS organizations, NYU Langone, the Chain Pharmacy Association of NYS, CVS Caremark Corp., ADAPT Pharma, the NYS Health Plan Association, the NYS Conference of BC/BS Plans, and the Family and Children’s Association.   To listen to a radio interview by Senator Hannon about this forum, click here(CLANCY)

Governor’s Pain Management Steering Committee Meets
Governor Andrew Cuomo has formed a Pain Management Steering Committee to gather recommendations for the appropriate treatment of pain that minimizes the risk of opioid use disorder.  Participants were asked to consider the needs of both opioid-naïve patients and patients who are in long term treatment with opioids.  The group discussed the current status of opioid prescribing in New York; acute pain prescribing and chronic pain prescribing.

The participants indicated that there is lack of awareness/understanding of the CDC Chronic Pain Guidelines; that there was a need for connecting patients from the emergency department upon discharge with a primary care physician; that clinical discretion should be continued regarding the number of days for prescribing opioids, including use of partial fill prescriptions; and the need to have emergency department check the Prescription Monitoring Program (PMP).  There was also discussion to consider the entry into the PMP from methadone clinics and the administration of naloxone to an individual.    Also discussed was coverage for non-opioid and non-pharmacologic alternatives and treatment—many alternatives are not covered by insurance; and pain management and expanding access to medication-assisted treatment.  Steering members were comprised of physicians, podiatrists, pharmacy, and representatives of treatment centers.  Several MSSNY physician leaders are steering committee members:  Nancy Nielsen, MD, PhD, Deborah Light, MD; Jose David, MD and Rose Berkun, MD. (CLANCY)     

Bill to Mandate Collection of School Information Advances in Legislature
This week the Senate Health Committee reported to the floor a bill (S.2113, Felder) that would require all hospitals and physicians to “inquire and document” as part of their patient registration process the school their “school-aged patients” attend.  The Assembly recently passed this legislation (A.352, Perry).  While well-intended, MSSNY has opposed this legislation because it creates an unnecessary risk of sanction for an inadvertent failure to comply with this law, particularly for the many physicians that do not regularly treat pediatric patients.  Moreover, MSSNY has expressed concerns with the vague terminology used in the legislation.   Physicians are urged to call their Senators to oppose this legislation 518-455-2800.                 (AUSTER, CLANCY)

Legislation To Allow Enhanced Religious Exemptions for School Based Immunizations Passed in Senate Education Committee
Senate Bill 6141D, sponsored by Senator Martin Golden, which would allow the admission certain unvaccinated students to public schools, has passed out of the NYS Senate’s Education Committee and reported to the Senate Finance Committee.   The passage of this bill is the first time that this bill has been voted on by members of any Senate committee.  S. 6141-D amends the Education Law to provide the procedure for religious exemptions from vaccination requirements.  Under the bill, a parent or guardian would complete a religious beliefs vaccination exemption form to ensure a public school district does not deny admission to their unvaccinated child.  A religious exemption is currently allowable under NY State law, but the exemption allows the school institution to make a decision on whether the student should be exempt from vaccination.

This bill, if passed by the Legislature, would force schools to accept the form and allow unvaccinated students to enter the school. Its companion measure, A. 8123B, sponsored by Assemblymember Richard Gottfried, chair of the Assembly Health Committee, is also pending before the Assembly’s Education Committee.  Voting against the bill in the Senate Education Committee were: Senators Serrano, Mayer, and Brooks.  Voting Yes, without recommendation were: Senators Peralta, Serino, Lavalle, Little, Stavisky and voting Yes were: Senators Marcellino, Gallivan, Avella, Hamiliton, Lanza, Ranzenhofer, Robach, Seward, Addabbo, Breslin.  Senator Croci was listed as excused and Senator Montgomery was absent.  Physicians are urged to write to the members of the NYS Legislature and urge that this bill not be enacted.  To write a letter go here(CLANCY)

Congress Approves Overhaul of Veterans Medical Care Options
By a 92-5 vote, the United State Senate passed legislation, The VA Mission Act to overhaul medical care options for veterans.  As the bill previously passed the US House by a 347-70 vote, the bill has been sent to President Trump for his approval.  The goal of the $52 billion reform bill is to provide veterans with more access to private doctors and hospitals.

The legislation also includes a one-year extension of the Department of Veterans Affairs’ Choice program, which provides access to veterans to be treated by non-VA physicians if they live 40 miles from a facility or need to wait for than 30 days for an appointment.   The Choice program was scheduled to run out of money at the end of the month.  As with the previous Choice Act, care would be paid for at the Medicare fee schedule, but the VA would have some flexibility to adjust the schedule for rural areas.  The legislation mandates prompt payment for providers: 30 days for electronic claims and 45 days for paper claims.

According to a summary of the legislation, the bill would require access to care outside the VA if: the VA does not offer the care or services the veteran requires; the VA does not operate a full-service medical facility in the state a veteran resides; the veteran was eligible for care in the community under the 40-mile rule in the Veterans Choice Program and meets certain other criteria, the VA is not able to furnish care within the designated access standards established by VA, or a veteran and the veteran’s referring clinician agree that furnishing care or services in the community would be in the best medical interest of the veteran after considering criteria, including:

  • The distance between the veteran and the facility that provides the care or services the veteran needs.
  • The nature of the care or services required.
  • The frequency that care or services needs to be furnished.
  • The timeliness of available appointments for the care or services the veteran needs; and
  • Whether the covered veteran faces an unusual or excessive burden to accessing care or services from the VA medical facility where the covered veteran seeks care or services.                                     (AUSTER)

NYS Program Helps to Subsidize Cost of Connecting to Regional Health Information Exchange
Did you know that New York State has a program to provide physicians with financial assistance to connect to your local Regional Health Information Exchange (RHIO)?   The Data Exchange Incentive Program (DEIP) was established by the NYS Department of Health to provide physicians and other health care providers with up to $13,000 to help offset the costs of connecting to your local RHIO.  It was established in response to the concerns expressed by many health care providers – including most recently through a resolution adopted a the 2018 MSSNY House of Delegates – to reduce the sometimes exorbitant costs imposed by EHR vendors in connecting to their local RHIOs.  For more information about eligibility requirements, click here. Or send an e-mail to deip@nyehealth.org.  The MSSNY HIT Committee received a presentation this week from the New York eHealth Collaborative (NYeC) about this important program to reduce the financial burden to physicians in implementing EHR systems.  (AUSTER)

CMS Announces 91% MIPS Participation for 2017
91% of all clinicians eligible for the Medicare Merit-Based Payment Incentive System (MIPS) participated in the first year of the Quality Payment Program, according to a blog post this week from CMS Administrator Seema Verma (click here.) The post also noted that the submission rates for Accountable Care Organizations and clinicians in rural practices were at 98 % and 94%, respectively.

The post also noted that the CMS free technical assistance received a 99.8% customer satisfaction rating by over 200,000 clinicians and practice managers.

The post also noted efforts to reduce administrative burdens for physicians.  Specifically, she noted that CMS “reviewed many of the MIPS requirements and developed policies for 2018 that continue to reduce burden, add flexibility, and help clinicians spend less time on unnecessary requirements and more time with patients.

In particular we have:

  • Reduced the number of clinicians that are required to participate giving them more time with their patients, not computers.
  • Added new bonus points for clinicians who are in small practices, treat complex patients, or use 2015 Edition Certified Electronic Health Record Technology (CEHRT) exclusively as a means of promoting the interoperability of health information.
  • Increased the opportunity for clinicians to earn a positive payment adjustment.
  • Continued offering free technical assistance to clinicians in the program.”

For more information about assistance to comply with the Medicare QPP, please find helpful information on the Physicians Advocacy Institute (PAI) website: click here.                                                                                                (AUSTER)

Medical Society of the State of New York Announces June Medical Matters CME Webinar Schedule
The Medical Society of the State of New York encourages you to register for its free Medical Matters Continuing Medical Education (CME) webinar on June 20th at 12:30pm.  Participation in this webinar will earn physicians one CME credit free of charge.

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

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 each of these live activities 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. 

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.       


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   mauster@mssny.org  pclancy@mssny.org  


eNews

New York’s New Paid Family Leave and the Important Role of Physicians
On January 1, 2018, the nation’s strongest and most comprehensive Paid Family Leave took effect. Millions of New Yorkers are now eligible for job-protected, paid time off to bond with a newly born, adopted, or fostered child, care for a family member with a serious health condition, or assist loved ones when a family member is deployed abroad on active military service.

As a health care provider, you play a critical role in certifying medical documentation in a timely manner and raising awareness of Paid Family Leave among your patients and their families. This presentation will provide an overview of Paid Family Leave and health care providers’ role in the process, and point you to some helpful resources. There will be time at the end for questions and answers as well.

Space is limited, so please register soon. When you click ‘Register here’, you will be taken to a general information page. You must click ‘Register’ on the bottom of that page to sign up.

Register

Tuesday, June 12, 12:00 p.m. – 1:00 p.m. Register here
Wednesday, June 13, 12:00 p.m. – 1:00 p.m. Register here

Additional sessions will be scheduled as needed.

More Information is Available

Complete details on Paid Family Leave are available at ny.gov/PaidFamilyLeave, including request forms and downloadable guides specifically for health care providers.

You can also call the Paid Family Leave Helpline at (844) 337-6303, Monday through Friday, 8:30 a.m. – 4:30 p.m. for more information or assistance.

From NYS Workers Comp Board Medical Director re Schedule Loss of Use
The Board has received a number of inquiries associated with Subject Number 046-1067, specifically related to the timing of the implementation of forms associated with Schedule Loss of Use evaluations.

We understand that the new forms may take some time to implement due to programming requirements. However, the guidelines are not new and the associated requirements were released and effective 1/1/18. Until such time that users can get the new forms programmed into their systems, all required elements should be captured on the existing forms and/or included in the submitted narrative.

As you are aware, new paper forms are available for use now and have been posted on the Board’s website. The revised electronic C4.3 should be available by mid-July. We ask that all users totally transition to and utilize the new forms by mid-July. Until that time no forms will be precluded as long as all the required elements are either included on the forms and/or incorporated into the narrative.

If you have any questions about the new forms, please write to

2018Guidelines@wcb.ny.gov.

ANOTHER REASON TO JOIN MSSNY!

MSSNY Instrumental in Amerigroup Policy Changes Re Ultrasounds
Your practice may have encountered significant problems relating to Amerigroup’s processing of claims.  As a result of a report given to MSSNY, their Division of Socio-Medical Economic Affairs Division began discussions with Amerigroup regarding difficulties and delays in processing claims and reimbursement issues.

Because of these efforts, as of Friday, May 18th, Amerigroup has changed their

policy on ultrasounds, non-OB ultrasounds and delivery denials.  One of our member groups has had all denials reversed and remitted!

For example:

  • CG-42 Ultrasound Policy:

Amerigroup has confirmed that coding updates have been completed to add certain diagnoses in the Z36 series to the policy.

  • Non-OB Ultrasounds:

Policy is being reviewed.  Amerigroup expects to have an update next week.  We will keep you informed!

  • Denial of Delivery Claims Reversed:

Amerigroup has reversed its denials of outstanding delivery claims (denied for “maximum benefit met”).

This is an example of our members’ dues at work!

For membership information, please contact Eunice Skelly at 516-488-6100 ext 389.

Clothing Treated With Permethrin May Stop Ticks, Study Suggests
A CDC study https://bit.ly/2HaAdik published in the Entomological Society of America’s Journal of Medical Entomology found that clothing treated with the insecticide permethrin had “strong toxic effects” on three species of ticks known to spread illnesses such as Lyme disease in the US. The permethrin on the clothing “made the ticks sluggish, impairing their movement and ability to bite.” According to the article, “After just a minute or two of contact with the treated fabric, the ticks fell off.”

Hydrochlorothiazide Associated with Melanoma Risk
High use of hydrochlorothiazide is associated with increased risk for melanoma, according to a research letter in JAMA Internal Medicine.

Using national registry data, Danish researchers matched 19,000 adults with melanoma to 190,000 controls without melanoma. Roughly 2.1% of cases and 1.8% of controls had high cumulative use of hydrochlorothiazide (50,000 mg or more).

After multivariable adjustment, high hydrochlorothiazide use was associated with significantly increased risk for melanoma (odds ratio, 1.22), as was ever-use of the drug (OR, 1.17). However, there did not appear to be a dose-response relationship. Risks were elevated for lentigo and nodular melanomas. Other antihypertensive medications studied didn’t seem to pose an increased risk.

The authors note that hydrochlorothiazide has already been linked to increased risk for lip and nonmelanoma skin cancers and say the new association is “worrying.”

JAMA Internal Medicine research letter

 Physician’s First Watch coverage of hydrochlorothiazide’s association with lip cancer

DOH

HIE Incentives Available Through Data Exchange Incentive Program (DEIP)
The New York State DOH, with support from the Centers for Medicare & Medicaid Services, established the Data Exchange Incentive Program (DEIP) to increase health information exchange (HIE) adoption across the state by building electronic health record (EHR) interfaces to New York State’s HIE, the Statewide Health Information Network for New York (SHIN-NY). The SHIN-NY connects eight regional networks, or Qualified Entities (QEs), and participating organizations are incentivized to contribute a pre-defined set of data elements to the SHIN-NY through a QE.

Eligible practices may receive up to $13,000 in incentives to offset the cost and efforts of connecting to a QE. NYeC administers the program and incentive payments on behalf of the DOH. Limited funding is available and this program is operated on a first-come, first-served basis. LEARN MORE 

CMS

Proposed Changes to Meaningful Use Programs
In late April, the Centers for Medicare & Medicaid Services (CMS) released proposed changes and a request for stakeholder feedback to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The proposed changes reflect CMS’s focus on interoperability, patient data access, and system-wide health information exchange. As a part of this effort, CMS has renamed the program, also known as Meaningful Use, to the Promoting Interoperability (PI) Programs.

In this proposed change, CMS is suggesting updates to payment, scoring, and measurement policies to reduce administrative burden and move beyond the three stages of Meaningful Use. The proposed changes will initially be applied to hospitals and critical access hospitals participating in the Medicare Program. CMS is seeking feedback on if the proposed changes should also apply to eligible professionals and hospitals that only participate in the Medicaid Program. CMS is seeking additional input on the proposed rule, specifically asking for ways to further promote interoperability.

CMS has requested feedback on the proposed rule by June 25th. NYeC is interested in stakeholder feedback to inform a comprehensive and coordinated comment as a part of our advocacy efforts. To share your comments, please submit them by Monday, June 11th to publiccomments@nyehealth.org.

Interesting Article:

Interventions to Prevent Falls in Older Adults: Updated Evidence Report and 

Systematic Review for the US Preventive Services Task Force: JAMA, April 2018

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.

Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Rare Find — Great Office Share
Wonderful office share in terrific location at great price. Choice of smaller windowed consultation room with adjoining exam room or big windowed consultation room with one or two exam rooms. Beautiful bright rooms, lovely reception area and front. First-rate building on 58th Street between Park and Lexington.  Rent by day (about $180) or by month ($5500). Front desk and office management available, along with many other amenities, including internet, ultrasound, EMG Kitchen, optional C Arm. Willing to make changes for a new tenant. Call 646-642-0700.




For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed built out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

Doctors v Pharma Pricing

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 18, 2018
Volume 18
Number 19

Dear Colleagues:

Last Friday, President Trump promised to “derail the gravy train” in the health-care system in a speech in which he unveiled his much-anticipated strategy to lower drug prices. The 44-page blueprint, called “American Patients First,” proposes a laundry list of policy ideas — but no specific timeline for implementation. He said he wanted to “promote competition; get generic drugs to market faster; lower fees paid to so-called middlemen…; and to block foreign countries from negotiating lower prices for their state-run health plans.”

A March 2018 Kaiser Family Foundation Health Tracking Poll found that 80 percent of Americans think prescription drug prices are unreasonably high. Slightly more than half responded that enacting policies to lower them should be our government’s top policy priority. One of the other hats that I wear, and welcomed in anticipation of becoming your President, is as a member of the AMA Council on Medical Service. Our Council has taken a deep dive into the escalating cost of insulin at the request of our AMA members. We have come up with some specific strategies that the practicing physician can use to help their patients now, and some suggestions to improve general affordability moving forward.

I anticipate after presentation (and hopefully, approval) at the AMA Annual meeting in June, that our Council will explore additional strategies to help make medication more available and affordable for our patients.

Additional information for your consideration:

 

• Physicians (and many patients) know that that US drug prices are the highest in the world. Americans spend $1,100 per person per year on prescription drugs. Public outrage over drug costs has been growing for years, because patients are being squeezed in a number of ways—new medicines for cancer and other life-threatening diseases often launch with prices exceeding $100,000 per year. Drugs for common ailments like diabetes and asthma routinely see price hikes around 10 percent annually. Meanwhile, some companies have been buying up once-cheap older drugs and raising prices by 1,000 percent or more.

• While private insurers and government programs pick up the biggest share of the bill, high drug costs are ultimately passed down to the public through premiums and taxes. Lawmakers have probed how they set prices, and the Justice Department is investigating possible price collusion by more than a dozen companies that make generic drugs.

• In 2016, the AMA set a new policy that established guiding principles for advocacy efforts aimed at changing the fundamentals of prescription drug pricing without compromising patient outcomes and access. The 2016 policy acknowledges the carte blanche approach to drug pricing needs to change to align with the health system’s drive for high-quality care based on value.

• Unlike other nations, the U.S. doesn’t directly regulate medicine prices. In Europe, governments negotiate directly with drugmakers to limit what their state-funded health systems pay. For most outpatient drugs reimbursed through Medicaid, drugmakers must provide the government rebates. But most medicine costs are paid for by Medicare or by private insurers. When prescription-drug benefits were added to Medicare under a 2003 law, the pharmaceutical industry successfully lobbied to prohibit the federal government from using its huge purchasing power to negotiate drug prices. Private payers typically rely on third-party pharmacy-benefit managers, such as Express Scripts, to negotiate discounts. Patients directly pay about 17 percent of prescription medicine costs out of their own pockets.

We have a crisis in drug prices in this country, where pharmaceutical companies, distributors and PBMs are able to charge whatever they want hiding their costs and legitimate profit through a labyrinth of pricing schemes, kickbacks, and special considerations.  I have remarked to my fellow Council members that looking at drug prices is like peeling an onion.  Each layer stinks and makes me cry!

We need political leaders that are willing to stand up to the power of the pharmaceutical industry.  We need physicians to call upon our elected officials to create a healthcare system that serves our patients, not middlemen and hedge fund managers, who like Don Fanucci in The Godfather, need to “wet their beak” at our patients’ expense.

Please send your thoughts to comments@mssny.org.

Thomas J. Madejski, MD 
MSSNY President


MLMIC Insurance

Capital Update

MSSNY Physician Participates in Senate Roundtable on Tick Borne Diseases—Senate Passes Package of Bills Addressing Tick Borne Diseases
Dr. William Valenti, chair of the Medical Society of the State of New York Infectious Diseases Committee, participated this week in a Senate Roundtable sponsored by the Senate’s Task Force on Lyme and Tick Borne Diseases.  The roundtable included representatives from the NYS Department of Health, SUNY at Stonybrook; Cornell University, and SUNY Adirondack.  Dr. Valenti discussed with members of the Senate the need to coordinate better laboratory testing and the need to continue to provide educational programing for physicians and other providers.   The New York State Senate also passed legislation this week which includes:

  • 2588, sponsored by Senator Susan Serino, would provide homeowners with vital and reliable information on the best way to protect their property from ticks.
  • 7242, sponsored by Senator Serino, directs the New York State Office of Parks, Recreation and Historic Preservation to install and maintain tick warning signs at all state-managed parks, including trail entryways and campgrounds.
  • 7169, co-sponsored by Senator Serino and Senator Kemp Hannon, would establish a pilot program for Lyme and tick-borne disease testing in children under the direction of the Commissioner of Health.
  • 8534, sponsored by Senator Serino, would direct the Commissioner of Education and the Commissioner of Health to promulgate and review rules and regulations related to pupils who have a tick removed from them during school or a school-sponsored activity.
  • 8539, sponsored by Senator Serino, would require the Department of Financial Services, in consultation with the DOH Commissioner, to conduct a study considering the current scope of health insurance coverage for Lyme and tick-borne diseases. The study would also examine initiatives in other states and the fiscal implications of various proposals.
  • 6926, sponsored by Senator Hannon, directs the Commissioner of Health to establish a standard protocol for the diagnosis and treatment of Lyme and other tick-borne diseases. This legislation requires the commissioner to work with health care providers and experts to develop a standard protocol process and patient notification of related symptoms, risk factors, diagnosis, and other information relating to Lyme and TBDs. During the roundtable, Dr. Valenti did discuss having a “standard protocol” but indicated that much more work needs to be done to establish what type of protocol is suitable and that work also needs to be done to develop a standard for each of the laboratories to follow.
  • 7168, co-sponsored by Senators Serino and Hannon, requires a coroner, pathologist, medical examiner or other qualified examiner that discovers Lyme and tick-borne disease infections during an examination of a deceased person to report the case to the DOH.
  • 7208, co-sponsored by Senators Serino and Hannon, would require that the Council on Human Blood and Transfusion Services review current medical research and guidance regarding the donation of blood by patients with a history of Lyme or tick-borne illnesses.
  • 3816, sponsored by Senator Kenneth LaValle, would allow Town of East Hampton to establish a tick control district.

The bills are now before the NYS Assembly for further action.                                        (CLANCY, AUSTER)

State Senate Advances DMV Reporting Mandate Legislation
The State Senate advanced a bill (S.3569 – Young / A. 10094 – Carroll) from the Transportation committee to the Senate floor that would require a licensed physician, physician assistant or nurse practitioner to report patients that have a chronic condition which cause or may cause unconsciousness or unawareness to the Department of Motor Vehicles.  The conditions include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle.  While MSSNY has adopted a comprehensive policy on impaired drivers that supports the ability of a physician to voluntarily report certain patients to DMV whom the physician believes should not operate a motor vehicle, this bill goes too far by mandating physician reporting.  MSSNY has great concerns over the ambiguity of the bill language and the fact that it encompasses a number of medical conditions where there may only be a remote chance that unconsciousness and unawareness may occur.  This bill is also opposed by the Epilepsy Foundation and the New York State Trial Lawyers Association.

Please click here to contact your legislator to express your concerns with this legislation.                                                                                 (BELMONT)

Governor Cuomo Announces Multi-agency Effort To Combat Maternal Depression
Under a directive from Governor Andrew Cuomo, the New York State Department of Financial Services will now require all New York commercial health insurance policies to cover maternal depression screenings, including screening for the mother under the child’s policy.   Additionally, the NYS Department of Health and Office of Mental Health will launch a strategic awareness campaign to provide critical information about symptoms and treatment options for maternal depression. Finally, the Office of Mental Health will open the first state-operated intensive outpatient clinic focused on maternal depression. The new regulations will require health insurance policies issued in New York to include coverage for maternal depression screenings by both adult and pediatric primary care providers, as well as speedy referrals to treatment specialists.   Insurance policies that cover the child but not the mother must provide coverage for maternal depression screening.

The new regulations will take effect 60 days after publication in the State Register.   The Department of Health and the Office of Mental Health’s awareness campaign will provide critical information about symptoms and treatment options, and to more broadly remove the stigma associated with maternal depression. There will be a joint letter to all health care providers reminding them of the seriousness of the issue as well as encouraging expansion of treatment options.                           (CLANCY)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221-A, Gottfried, S.8093-A, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The bill, amended this week to clarify its retroactive applicability to March 31, has advanced to the Senate floor, and likely will be considered at the next meeting of the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances. (DIVISION OF GOVERNMENTAL AFFAIRS)

Governor, AG Announce Potential Lawsuit Against Opioid Manufacturer
New York Governor  Cuomo and Acting Attorney General Barbara Underwood announced this week that New York State would be initiating a lawsuit against opioid drug manufacturer Purdue Pharma.  To read their joint statement, click here.

Acting AG Underwood stated “We are committed to holding opioid manufacturers and distributors accountable for the damage they’ve wrought on New York’s towns, communities, and families.  After a lengthy investigation, we are preparing a lawsuit against Purdue Pharma for its alleged deception and reckless disregard for the health and wellbeing of New Yorkers. It is clear to us that Purdue profited by deliberately exploiting New Yorkers’ addictions, and by pushing healthcare providers to increase patients’ use and dependence on these potentially fatal drugs. In addition to our impending lawsuit against Purdue, our office will continue to lead the multi-state investigation of opioid manufacturers and distributors across the country.”

Governor Andrew M. Cuomo stated: “In New York, we will not sit idly by as big corporations fuel the opioid epidemic and ignore the consequences of their actions.  We said we would sue to hold opioid manufacturers and distributors responsible, and that’s exactly what we’re doing. By taking Purdue Pharma to court, we are taking this significant step forward to hold corporations accountable and put an end to the opioid crisis once and for all. Too many innocent lives have been lost and too many families destroyed.”

As reported in numerous media outlets, Purdue Pharma responded: “We are disappointed that after months of good faith negotiations working toward a meaningful resolution to help the state of New York address the opioid crisis, the attorney general has unilaterally decided to pursue a costly and protracted litigation process.  We vigorously deny these allegations and look forward to the opportunity to present our defense.”  (AUSTER)

NYSDOH AIDS Institute Launches New Online Provider Directory
The NYSDOH AIDS Institute has launched a new online provider directory.  This new online directory will allow providers and consumers easier access to information regarding HIV, HCV, Buprenorphine, PEP, and PrEP service providers across New York State. This new directory will replace the former HIV and HCV provider directories located on the NYSDOH Health Commerce System (HCS). It will also replace the former PrEP/PEP Provider Voluntary Directory.  A copy of the directory can be found at this link: please click here.                                                                                  (CLANCY)

Medical Society of the State of New York Announces May and June CME Webinar Schedule
The Medical Society of the State of New York is pleased to announce its free Continuing Medical Education (CME) webinars for May and June.  Participation in the webinars will earn physicians one CME credit free of charge.  The webinar schedule for May and June is as follows: 

May 24th at 7:30amCurrent Concepts in Concussion for Pediatric and Adult Patients

Register for this webinar here.
Faculty: Deborah Light, MD & John Pugh, MD, PhD

Educational Objectives:

  • Identify signs and symptoms indicative of concussion as well as red flags that indicate alternate or more severe pathology;
  • Outline an appropriate management plan for a patient presenting with concussion including a return to “normal life” protocol;
  • Describe methods for the primary and secondary prevention of concussion;
  • Identify patients who would benefit from referral to a concussion specialist

June 20th at 12:30pmMedical Matters: Children’s Mental Health After Disaster

Register for this webinar here.
Faculty: Linda Chokroverty, MD

Educational Objectives:

  • Enhance physician’s understanding of the impact of disaster on children’s and family mental health
  • Improve physician skills to address potential psychiatric problems in children and families following a disaster

To view all of MSSNY’s scheduled programs, click here and select “Training Center” and “Upcoming”.

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 each of these live activities 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. 

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at  mhoffman@mssny.org.                                                                (HOFFMAN)

Ebola Webinars Available on CME Website
The Ebola outbreak in the Democratic Republic of Congo has now spread to Mbandaka city, and urban area with nearly 1.2 million residents.  There have now been 19 deaths and 39 patients infected with Ebola.  Additionally, 393 individuals are being monitored as contacts of Ebola patients.  Previous Ebola outbreaks proved stressful for healthcare providers in New York largely owing to uncertainty and media hype.  The Medical Society has two CME courses available that help to address these concerns regarding Ebola virus.

Please click here to view MSSNY’s free CME courses on this timely and relevant topic.  Ebola: A Perspective from the Field offers a firsthand description of the challenges surrounding Ebola virus.  And Viral Hemorrhagic Fevers with an Ebola Virus Update offers a comprehensive analysis of diagnosis and treatment for Ebola and other viral hemorrhagic fevers.                                                                                                  (HOFFMAN)

Bending the Diabetes Curve CME Course Available Online
Bending the Diabetes Curve webinar is now available to view online; please click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at  charring@mssny.org.                                                                                  (HARRING)

Please Join Us on July 28th for Physicians’ Day at the Races
Please join your friends and colleagues for a great event to benefit your profession.  MSSNY PAC uses its resources and mobilizes support to help elect candidates for state office who will stand and fight for us, regardless of what party they are from.  MSSNYPAC allows us to pool our resources and together, make a difference against other special interests that continue to try to undermine the delivery of quality health care.  MSSNY PAC continues to develop new fundraising opportunities for our physicians to become more active.

Please RSVP today. The Physicians’ Day at the Races will take place on Saturday, July 28, 2018 at the Saratoga Race Course in Saratoga Springs, NY.

Ticket prices are:

$500/physician,

$300/guest,

$250/guest under 21

Ticket price includes clubhouse admission, post parade programs, a gourmet buffet lunch at your own trackside table, unlimited open bar, private viewing of the horses as they bring them from the paddock and private betting windows. click here for further details.

Contact Jennifer Wilks at 518-465-8085 or by email at jwilks@mssny.org to secure tickets.  (BELMONT)


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   mauster@mssny.org  pclancy@mssny.org  


eNews

$750,000 Fine for Billing Medicaid when Physicians Were Not Enrolled in Program
Here is a cautionary New York tale –

MSSNY has recently heard from the U.S. Department of Justice that a medical practice has agreed to pay a large sum of money to settle a False Claims Act Suit for alleged improper billing practices.  The allegations were brought to the government’s attention through the filing of a complaint pursuant to the qui tam provisions (the whistleblower) of the False Claims Act.  Under the Act, private citizens can bring suit on behalf of the United States and share in any recovery.

The medical group agreed to pay $750,000.00 to resolve allegations that they billed the Medicaid Program for services provided by physicians who were not enrolled in the program.  The government’s investigation revealed that, from July 1, 2004 through December 31, 2010, the medical group employed a number of physicians who were not enrolled in the Medicaid Program who provided care to Medicaid patients.  Because the physicians were not enrolled in the program, the medical group should not have sought reimbursement from Medicaid for the services provided by these non-enrolled physicians.  Regardless, the medical group submitted requests for payment under the Medicaid provider identification numbers of the practice’s Medicaid enrolled physicians, thereby misrepresenting the identities of the individuals who were actually providing treatment to the group’s Medicaid beneficiaries.  This improper billing practice occurred at many of the medical group’s locations.

To avoid any impropriety, physicians must be enrolled in plans to treat and receive payment for a plan’s insured members. 

NY’s Acting AG to Sue Purdue Pharma for Exploiting Addictions
New York’s acting attorney general, Barbara Underwood, announced Wednesday that the state is preparing to sue the maker of the prescription painkiller OxyContin, making New York the seventh state to announce a lawsuit against Purdue Pharma this week.

In a press release, acting Attorney General Barbara Underwood said the state is readying its litigation against the opioid manufacturer for “its alleged deception and reckless disregard for the health and wellbeing of New Yorkers.”

“It is clear to us that Purdue profited by deliberately exploiting New Yorkers’ addictions, and by pushing healthcare providers to increase patients’ use and dependence on these potentially fatal drugs,” she said in a statement.

In its own statement, Purdue said the company “vigorously” denies the allegations and looks “forward to the opportunity to present our defense.”
Over the past year, the number of lawsuits filed against opioid manufacturers and distributors has substantially increased. Many of the suits claim companies aggressively marketed opioids whiledownplaying the risk of addiction and shipped suspiciously large quantities of painkillers without alerting authorities.

Three Firms Account for Over Half of All Medicare Part D Enrollees in 2018 Pending

Mergers Would Further Consolidate the Marketplace

In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55 percent) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part D enrollment, premiums and cost-sharing data.

The proposed mergers of CVS Health and Aetna, and Cigna and Express Scripts would result in further consolidation of the Part D marketplace. If these mergers go through, four firms—the two merged firms plus UnitedHealth and Humana—would cover 71 percent of all Part D enrollees and 86 percent of stand-alone drug plan enrollees, based on 2018 enrollment.

New Yorkers Do Not Eat Enough Fruits, Vegetables, Analysis Finds
The 2018 American Fitness Index analysis indicates “that while New York City ranked 52 out of 100 American cities when it comes to overall health, it is weak in key dietary areas,” particularly in that only “18.4 percent of New Yorkers eat three or more vegetables a day and 31.9 percent eat two or more fruits a day.”

FDA Names Companies “Gaming” Drug Laws to Block Competition
The FDA has followed through on its promise to publicly name companies it says may be gaming drug laws to block generic competition.

The act comes as part of the Trump administration’s recently announced effort to bring down the price of pharmaceuticals. The list  — posted on the FDA’s website May 17— includes dozens of both generic and brand-name companies that the agency said appear to have refused to give up samples of their product to generic companies seeking to make copies. Without the samples, generic manufacturers can’t conduct bioequivalence testing and apply to the agency for approval, said FDA Commissioner Scott Gottlieb, MD, in a statement.

The agency has received more than 150 pleas for help from generic drugmakers who have not been able to get samples from brand companies, said Gottlieb. “We’re also notifying the Federal Trade Commission (FTC) — the agency responsible for addressing anticompetitive business practices — about these inquiries,” he said.

According to the list, the largest numbers of inquiries have been for problems getting copies of isotretinoin (14 inquiries), bosentan (14), lenalidomide (13), thalidomide (10), and ambrisentan (10).

Among the companies that appear to be multiple offenders:

  • Actelion Pharmaceuticals, listed for potentially blocking access to macitentan (Opsumit), bosentan (Tracleer), epoprostenol sodium (Veletri), and miglustat (Zavesca);
  • Celgene, for lenalidomide (Revlimid), thalidomide (Thalomid), and pomalidomide (Pomalyst); and
  • Novartis, for everolimus (Afinitor), deferasirox (Exjade), nilotinib hydrochloride monohydrate (Tasigna), and everolimus (Zortress). 

Please Answer Physicians Foundation’s Biennial Survey
This is the Physicians Foundation’s sixth biennial physician survey. Its purpose is to examine the morale, career plans, and practice metrics of today’s physicians – and to give physicians a voice! The goal is to produce a “state of the union” of the medical profession that can have a significant impact on both policy and public perceptions. The survey is expected to take around 10 minutes to complete. It will be open through June 5th and can be accessed here.

Reminder: MSSNY is a Charter Member of the Physicians Foundation.

The Physicians Foundation will make a $5,000 contribution to the state medical society generating the most survey responses and a $5,000 contribution to the state medical society that generates that most responses per-capita.

New PTSD Definition Would Exclude Many Patients, Study Says
A proposed change in how post-traumatic stress disorder is diagnosed could exclude as many as 57% of the people with moderate—and more easily treatable—PTSD worldwide, according to a study led by researchers at NYU School of Medicine.

The study appear May 17 in the journal Psychological Medicine. It looked at almost 4,000 people from six countries to see how changes in the upcoming 11th edition of the International Classification of Diseases would affect their diagnoses.

Most of the patients studied were survivors of traffic accidents, who underwent the Clinically Administered PTSD Scale.

When patients were diagnosed using the revised code, it boosted the incidence of severe PTSD by up to 35%, but the number of moderate cases decreased by more than half.

Proposed changes in the diagnostic tool could negatively affect successful treatment for many victims of PTSD because early treatment leads to the best outcomes, said senior author Dr. Arieh Shalev, the Barbara Wilson Professor in the Department of Psychiatry at NYU School of Medicine.

Shalev also expressed concerns that insurers might not cover cases where patients clearly have symptoms consistent with PTSD but don’t meet the new criteria for diagnosis.

The revised code uses just six criteria for assessing PTSD: dissociative flashbacks, nightmares, hypervigilance, exaggerated startle response, avoidance of external reminders, and avoidance of thoughts and feelings associated with the traumatic event. The current code includes 13 conditions, including sleep disturbances and irritability, which also can be associated with other disorders.

House Passes Bill to Expand Veterans’ Healthcare Access Outside of VA
The AP (5/16) reports that on Wednesday, the US House “voted to give veterans more freedom to see doctors outside the Veterans Affairs health system” although some Democrats “cast it as a risky step toward dismantling the struggling agency.” The plan would “fulfill President Donald Trump’s promise to expand private care to veterans” who feel VA healthcare is inadequate by allowing them to seek care from private physicians. Legislators passed the $5 billion bill in a 347-70 vote.

Congressional Quarterly (5/16) reports the vote comes as “a major overhaul to a veterans’ health care program just two weeks before funds dry up.” The $5.2 billion funding will extend the Veterans Choice Program “before combining the program with other community care programs offered by the Department of Veterans Affairs in 2019.”

IPRO Hosting 34th Annual Membership Meeting at Garden City Hotel

When:   Tuesday, June 5, 2018
Time:    12:30 p.m.—3:30 p.m.
Where:  The Garden City Hotel – 45 Seventh Street, Garden City, NY

For further information, click here.

 

Classified

RENTAL/LEASING SPACE

For Sale-Outpatient Mental Health Clinic
Started in 1998 and located in the NYC metro area, this multi-location business is a well-established, highly reputable, mental health clinic providing outpatient psychotherapy and counseling services.
Revenues 2017 $1.2 mil.
Profits: 2017 $326k
Asking Price: $970k
Terms are available. The clinic’s market consists of Manhattan, Bronx, Brooklyn and Queens Counties. The 25 clinician practice specializes in group, women’s and psycho-educational therapy as well as parenting groups, court mandated services, domestic violence victims groups, anger management and supervised visitation programs. There are 250+ weekly patients and the business accepts most insurances. Buyer must be a NYS licensed physician, NYS licensed mental health consultant, NYS licensed social worker, psychologist or PhD. The owner is retiring.

Direct All Inquiries to:
Steve Epstein, V.P.
Gottesman Company
O: 201-750-9605
C: 201-704-8051


Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Beautiful NYC Medical Office — Long-term Share
Bright, big consultation room and one or two exam rooms in large,  tastefully furnished office in first-rate building. 58th Street between Park and Lexington. Near transportation.  Smaller, windowed consultation room and exam room also available. Rent by the day or week, beginning June 1 or sooner. $180 per day or $5500 per months. Perfect for internist, rheumatologist, physical medicine, ob-gyn and others. Superb front desk and office management available, along with many amenities including internet, ultrasound, EMG, kitchen, optional C-arm. Call Carol: 917-856-6402.


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

MSSNY eNews: You, Your Patients & MOLST

 

Thomas J. Madejski, MD MSSNY President
PRESIDENT’S MESSAGE
Thomas J. Madejski, MD
MSSNY President
MAY 11, 2018
Volume 18
Number 18

Dear Colleagues:

Several years ago, the New York State Department of Health approved use of a form called Medical Orders for Life-Sustaining Treatment (MOLST) that can be used statewide by health care practitioners and facilities for patients with serious health conditions who:

  • Want to avoid or receive any or all life-sustaining treatment;
  • Reside in a long-term care facility or require long-term care services; and/or
  • Might die within the next year.

The MOLST form is a way to document a patient’s wish concerning life-sustaining treatment.   This is an optional form that physicians and other health care practitioner can use–or they may choose to use other forms.  However, the MOLST form is the only authorized form in New York State for documenting both non-hospital DNR and DNI orders.  In hospitals, hospice and nursing homes, the form may be used to issue any orders concerning life-sustaining treatment and in the community setting, MOLST can be used to notify EMS personnel about a Do Not Resuscitate (DNR) and Do Not Intubate (DNI) order.

The concept for MOLST came from MSSNY member Patricia Bomba, MD, Vice President of Excellus Blue Cross Blue Shield. Dr. Bomba is a strong advocate for physicians to have “that difficult conversation” with their patients about their end of life choices. Over the years, MSSNY has supported MOLST as another “tool” in our medical toolbox and a great way to begin the difficult conversation.

Legislation (A9603), introduced by Assemblymember Joseph Morelle, would create an “eMOLST registry” that calls upon DOH to develop the registry.  If passed, physicians who use the MOLST form will then be required to report patient related information from the MOLST form to the registry within 14 days.

The problems that I see with any compulsory mandate are:

  • Doctors fear OPMC problems if they do not comply with the law
  • Doctors are concerned that the data may not be housed at the NYS DOH.
  • Doctors are concerned about multiple different documents which may have conflicting data

MSNY continues to support improving the care of all of our patients, especially when they approach the end of their lives. Our Council had extensive discussion today on end of life care and approved creation of a task force on end of life care.

What do you think? comments@mssny.org

Thomas J. Madejski, MD 
MSSNY President



MLMIC Insurance

Capital Update
MSSNY Council Approves Formation of a Task Force Death and Dying, Palliative and End Of Life Care
The Medical Society of the State of New York’s Council approved this week the formation of a task force to examine the role of physicians as it relates to death and dying, palliative and end-of-life care.  The task force was formed in lieu of a House of Delegates resolution that requested that MSSNY change its position of opposition to one of neutrality on physician-assisted suicide and euthanasia.  “These are complex issues and it is very important that we address this controversial issue in the most appropriate way,” Thomas Madejski, the society’s president, said in a release. “The Task Force will be ethnically and philosophically diverse and will include members from across MSSNY’s membership — including physicians from the Long-Term Care and Health Disparities committees.”                                                (CLANCY)


Please Urge Your Legislators to Enact Legislation to Address Prior Authorization Hassles and Expand Patient Choice of Physicians

Working together with several other patient advocacy organizations and specialty societies, MSSNY continues to advocate for numerous pieces of legislation in the final weeks of Session that would reduce barriers imposed by health insurance companies that interfere with patient care, and expand patient choice by limiting the ability of health insurers to narrow their networks.   These bills include:

  • 3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bill is in the Senate Health Committee, and the Assembly Ways and Means Committee.  Please send a letter to your legislators in support here.
  • 7872 (Hannon)/A.9588 (Gottfried) – would reduce prior authorization hassles by requiring health plan utilization review criteria to be evidence-based and peer reviewed; reducing the time frame for reviewing prior authorization requests from 3 business days to 48 hours (and to 24 hours for urgent situations); assuring that a prior authorization, once given, is enduring for the duration of the medication or treatment; prohibiting mid-year prescription formulary changes; and assuring that once a prior authorization is given, it cannot be withdrawn if eligibility is confirmed on the day of the service. We are pleased that several legislators have joined on as co-sponsors of this legislation. Please send a letter to your legislators in support here.
  • 3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract.  The bill is on the Assembly floor and in the Senate Health Committee.  Please send a letter in support here.
  • 5022-C (Serino)/A.2317-C (People-Stokes) – would prohibit health insurance companies from making changes to a prescription formulary or shifting a medication to a different cost-sharing tier during a policy year. The bill has passed the Assembly, and is before the Senate Insurance Committee.

            (DIVISION OF GOVERNMENTAL AFFAIRS)

New York Settles Lawsuit Against Federal Government to Preserve Essential Plan Funding
New York State and Minnesota settled a lawsuit this week they had filed against the US Department of Health and Human Services to protest HHS’ action to cut funding for the Basic Health programs operating in New York and Minnesota.   The settlement will result in New York receiving $151 million for its Essential Plan, and $17 million for Minnesota’s plan.  The states will continue to discuss with HHS a revised funding formula for the program.

New York’s Essential Plan provide comprehensive health insurance coverage with little cost-sharing for over 600,000 New Yorkers who earn too much to qualify for Medicaid but make less than 200% of the Federal Poverty Level.  Acting New York Attorney General Barbara Underwood released the following statement:

“The Essential Plan serves hundreds of thousands of low-income New Yorkers. We filed suit earlier this year to protect the quality, affordable health care on which New York’s families rely.  We are gratified that the federal government has agreed to make this interim payment. 

We hope and expect that, in the coming weeks, we’ll reach agreement with the federal government on a payment formula for the program, so that we can resolve this matter fairly and appropriately for all New Yorkers.”  (AUSTER)

Legislation To Require Physicians to Report Patients to DMV on Senate Transportation Committee Agenda
Legislation introduced by Senator Young would require a licensed physician, physician assistant or nurse practitioner to report patients that have chronic condition which may cause unconsciousness or unawareness to the Department of Motor Vehicles. Such conditions may include a convulsive disorder, epilepsy, fainting, dizzy spells, coronary ailments or other health conditions that may impair the ability to operate a motor vehicle.

The bill, S.3569 (Young) / A.10094 (Carroll), is on the Senate Transportation Committee agenda for Tuesday, May 15. The Medical Society understands and supports efforts to ensure pedestrian and driver safety and reduce vehicular accidents.  MSSNY policy supports the ability of physicians to voluntarily report certain patients to DMV whom the physician believes should not operate a motor vehicle.  However, a lack of well-defined medical and legal guidelines may force a physician to “over-report” which in turn could discourage patients from receiving needed medical care.  Please contact your legislators to oppose this legislation imposing burdensome and ambiguous new mandates on physicians that may jeopardize the sanctity of the doctorpatient relationship. They can be reached at 518-455-2800.                          (BELMONT)

MSSNY Urges for Extension of Committee for Physicians Health Program
MSSNY continues to advocate for legislation (A.10221-A, Gottfried, S.8093, Hannon) that would extend for an additional 5 years the continued operations of the MSSNY Committee for Physicians Health (CPH) program.  Authorization for several key components of the program expired on March 31, 2018.   The legislation was amended this week to clarify that the legislation would be retroactive to March 31 once enacted.  It has advanced to the Senate floor, and is before the Assembly Health Committee.

The CPH is a program designed to confront and assist physicians thought to be suffering from alcoholism, substance abuse or mental illness.   Since the inception of this program, CPH has assisted thousands of physicians in returning healthy to medical practice.  The work of the CPH program is an important public service both to our health care system as well as the general public. As a result, the State Budget annually includes an appropriation of $990,000 for the program, which is generated from a $30 assessment on all physicians’ biennial registration fees.

The program has traditionally been extended by the Legislature in 3 or 5 year “demonstration programs” with the most recent extension in 2013.  The recently enacted State Budget included a provision to create another “demonstration program” until 2023.  However, it omitted other provisions historically extended at the same time that are essential to its functioning that could greatly impair its operations unless immediate action is taken.  These includes provisions that set forth the CPH program’s reporting requirements to the Office of Professional Medical Conduct (OPMC), provisions to ensure liability protections for the physician Committee members for work performed in the scope of CPH, and necessary confidentiality protections for the program given the sensitivity of the work they perform.   These protections are absolutely essential to the continued functioning of the program to ensure that physicians with the appropriate expertise are willing to serve on the Committee, as well as to assure that the program has the ability to report sensitive information to OPMC when warranted by the circumstances.  (DIVISION OF GOVERNMENTAL AFFAIRS)

MSSNY Continues to Express Concerns with Cuts to Patient-Centered Medical Home Program
MSSNY continues to work with primary care associations to respond to Medicaid cuts to the Patient Centered Medical Home (PCMH) program.  As reported last week, earlier this year the NYS Health Department announced its intent to implement a huge cut in Medicaid payments to physicians participating in the PCMH program. Specifically, DOH intended to slash the current $7.50 Per Member Per Month (PMPM) payment for each Medicaid patients to $2.00 for May and June.  The amount would increase to $5 or $5.50 PMPM in July but would also have required that each PCMH participant have a Level 1 Value-Based Payment contract with a Medicaid Managed Care plan.

If permitted to go forward, these cuts and new requirements would likely have pushed many physicians away from participating in the PCMH program, which in turn would have significantly impaired access to primary care services for many patients insured through Medicaid.   As a result of these concerns, MSSNY worked together with the New York Chapters of the American College of Physicians, Academy of Family Physicians and American Academy of Pediatrics, as well as the Community Healthcare Association of New York State (CHCANYS), to successfully advocate for the Legislature to include $20 million in the State Budget to prevent these Medicaid payment cuts from being implemented.

While a NYS Assembly summary of the final State Budget noted that these funds were intended to “reject a reduction in reimbursement rates for patient centered medical home services”, that point has been disputed by the NYSDOH. Last week DOH released a letter noting payment changes to the PCMH program starting in May.  Importantly, DOH has indicated that it was not going forward with a requirement for PCMH participants to have VBP contract by July 1.  However, of significant concern, the letter indicated that there are still going to be cuts to Medicaid PCMH payment, as follows:

  1. Effective May 1, 2018 – June 30, 2018, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $5.75.
  1. Effective July 1, 2018 to the end of SFY 18-19, the MMC PCMH PMPM for providers recognized under NCQA 2014 Level 3, NCQA 2017, or NYS PCMH standards will be $6.00.
  1. Effective May 1, 2018, the PCMH incentive payments for providers recognized under NCQA’s 2014 Level 2 standards will be permanently eliminated for both MMC and FFS.

MSSNY continues to work with the ACP, AFP, AAP and CHCANYS to express significant concerns to the Legislature, DOH and Governor’s Office with these PCMH cuts, even at a reduced level, in spite of the action taken by the Legislature.  An article discussing these concerns that quoted MSSNY President Dr. Thomas Madejski appeared in Politico-NY this week.  Physicians are urged to contact the Governor and their legislators to express their concerns here.                                                             (AUSTER)

New CMS Tool for Physicians To Check Whether They Need to Comply with MIPS
The Centers for Medicare and Medicaid Services (CMS) has announced that physician practices/groups may now log into the CMS QPP website to check their 2018 eligibility for Medicare’s Merit-based Incentive Payment System (MIPS), according to an alert from the American Medical Association.

After groups log in, they will be able to click into a details screen to see the eligibility status of every clinician in the group (based on their National Provider Identifier or NPI) to find out whether they need to participate during the 2018 performance year for MIPS.  The AMA also advised that CMS will not be sending out letters to advise physicians of their eligibility status this year so checking on the QPP participation status look-up tool is the only way to determine or verify eligibility status.  Eligibility rules in 2018 are different than in 2017 so status this year may be different than last.  Also as is indicated in the look-up tool, exempt individual clinicians still will need to report if their group is eligible and chooses to report as a group.

The look-up tool can be found here.                                                 (AUSTER)

Physicians Encouraged to Take Survey; Bending the Diabetes Curve CME Course Available Online
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STAT program. The survey also serves as a platform to physicians to express what specific boundaries they have experienced or anticipate experiencing regarding the implementation of the DPP and/or Prevent Diabetes STAT. Participation in this survey is essential to the development of various educational components that will benefit both the physician and patient communities. Click here to take the one-minute survey.

Bending the Diabetes Curve webinar is now available to view online; click here. By educating physicians and connecting more patients to evidence-based lifestyle change programs, this diabetes initiative will help bridge the gap between clinical care settings and communities to reduce the incidence of type 2 diabetes.

Webinar: Bending the Diabetes Curve

Faculty: Geoffrey Moore, MD & Sarah Nosal, MD

Educational Objectives:

  • Describe the trends in Type 2 diabetes and implications for clinical practice
  • Review evidence that supports referring patients with prediabetes to lifestyle change program
  • Outline the considerations for implementing a diabetes prevention initiative in a physician practice
  • Describe NYS specific incidents of prediabetes and diabetes in adult population
  • Understand the reimbursements mechanisms for DPP

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 each of these live activities 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.

Additional information or assistance with registration may be obtained by contacting Carrie Harring at 2020 charring@mssny.org.                                       (HARRING)

Learn How You Can Help Meet the Mental Health Needs of Veterans at the Dwyer Peer Project Annual Day of Wellness
The Suffolk County United Veterans and the Suffolk County Veterans Service Agency are jointly hosting the 5th annual Joseph P. Dwyer Veterans Peer Support Project Day of Wellness. The event will take place on Saturday, June 9 at Camp Pa-Qua-Tuck, 2 Chet Swezey Road, Center Moriches, NY. It will from 9 am to 4 pm with provider demonstrations from 10 am to 3 pm. The day will include educational activities for veterans and their families with a focus on dealing with post-service transition issues as well as family-oriented entertainment by veterans. Complimentary breakfast and lunch will be served. 

To register for the live event, CLICK HERE.  Both registrants and walk-ins are accepted. 

Ebola Webinars Available on MSSNY CME Website
An Ebola outbreak has been confirmed in the Democratic Republic of Congo.  Following 17 deaths and 21 patients showing signs of hemorrhagic fever, an Ebola outbreak was declared in the Democratic Republic of Congo this week.  The Medical Society has two CME courses available that help to address these concerns regarding Ebola virus.  Go to https://cme.mssny.org to view MSSNY’s free CME courses on this timely and relevant topic.  Ebola: A Perspective from the Field offers a firsthand description of Ebola virus.  And Viral Hemorrhagic Fevers with an Ebola Virus Update offers a comprehensive analysis of diagnosis and treatment for Ebola and other viral hemorrhagic fevers.         (HOFFMAN)


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   mauster@mssny.org  pclancy@mssny.org  


eNews

Council Notes—May 10, 2018

  • MSSNY will convene a Task Force on Death and Dying to develop a white paper regarding the physicians’ role in end of life and palliative care. The paper will also discuss the impact of these issues on the disparate populations and the disabled community. Click here to read MSSNY’s press statement.
  • Dean P. McElwain, President and COO of Castle Connolly Private Health Partners, presented information about transitioning to a concierge practice model. McElwain noted that the standard concierge practice has 55-60 patients and doesn’t differ greatly from a traditional practice model, but offers both patients and physicians convenience, connectivity and care. Castle Connelly currently focuses on IM practices, but is currently in experimental stages with specialty practices. Council approved pursuing a member benefit that would assist physicians in transitioning to a concierge practice.
  • As a pilot project in participating counties, MSSNY and the county medical society will offer member benefits and services to international medical students engaged locally in New York State-approved clinical rotations free of charge until they are eligible for student or other membership. This will include invitations to county and state medical society meetings, without the right to vote unless and until formal membership is obtained.
  • MSSNY Burnout Committee will change its name to MSSNY Committee for Physician Wellness and Resilience. The mission is to increase education, awareness and recognition of stress and their effects on both the individual physician and the physician workforce and to support physicians in optimizing their physical, emotional, cognitive and psychological well-being in order to recover the intrinsic joy of the practice of medicine in a dynamic healthcare environment. The vision of the Committee for Physician Wellness and Resilience is for physicians to have a workforce and environment free of extraneous stressors and to be free from the effects of stress and their wide-ranging consequences.
  • Council discussed and approved a request from MSSNY’s General Counsel, Garfunkel Wild, to support an Amicus brief. The issue on appeal involves whether the NYS Comptroller is required to obtain a patient’s written authorization in order to subpoena patient medical records for the purpose of conducting an audit of payments made under the Empire Plan to a medical practice.

Help Patients Find You: Confirm Your Practice Info Using NYS’s New Tool
On April 25, the New York State Department of Health (NYSDOH) and the New York State of Health launched a new tool called NYS Provider & Health Plan Look-Up.

It’s an online tool that allows consumers to quickly locate information about their doctors and the health insurance plans in which their doctors participate. To make sure plan members can find you, go to the website to review and ensure your practice information is accurate.

To report an error in the listing, go to the NYS Provider & Health Plan Look-Up home page and select the Contact/Report an Error button. Then, select the health plan and the reason you are contacting them. The issue will be routed electronically to the NYSDOH and to the selected health plan(s) for review and follow-up.

Rockefeller Institute Study: Medical Marijuana v. Opioid
According to the Albany-based Rockefeller Institute of Government, some states allowing medical marijuana and recreational pot saw declines in opioid prescribing as authorities pushed urgent efforts to combat the historic American drug crisis. Medicaid patients, for example, are getting about 5.9 percent fewer prescription painkillers in medical marijuana states. Further, the opioid prescription declines are deeper where recreational pot is allowed, down nearly 6.4 percent. http://rockinst.org/blog/can-marijuana-alleviate-the-opioid-crisis-data-suggest-yes/

One high-profile National Institutes of Health study was awarded recently to researchers at Albert Einstein College of Medicine and Montefiore Health System in the Bronx. The five-year, $3.8 million grant is for the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV, the health system said.

Against that backdrop, the Rockefeller Institute report detailed a range of studies from medical journals and universities. They include:

  • Overall, patients in medical marijuana states filled fewer daily doses of opioids, University of Georgia research found. For example, they saw a 14.4 percent reduction by Medicare patients in states with access to a medical marijuana dispensary.
  • Marijuana reforms have also saved taxpayers’ money, according to recent JAMA Internal Medicine
  • Recreational marijuana laws were tied to 9.78 percent lower Medicaid spending on prescription opioids, an annual savings of $1,815 Medicaid spending per 1,000 enrollees, the study found.
Physicians’ Day at the Races 2018 – Secure Your Tickets Today!
Join your colleagues for MSSNYPAC’s Physicians’ Day at the Races on Saturday, July 28, 2018 at Saratoga Race Track in Saratoga Springs, NY.  All physicians, including non-members of MSSNY are welcome to support this state-wide fellowship event for MSSNYPAC while supporting a great cause which strengthens our profession.  Tickets are $500/physician, $300/guest and $250/guests under 21.  As it’s the day of the renowned “Jim Dandy” stakes, tickets for this event are limited. Visit www.mssnypac.org/events for details or to download an invitation.  Ticket requests and questions can be directed to Jennifer Wilks at518-465-8085.

Study: Older Adults’ Hearing Aid Use Linked To Lower Hospitalizations, ER Visits
A report published in JAMA Otolaryngology–Head & Neck Surgery suggests that older adults with hearing loss who wear hearing aids “are less likely to be hospitalized or to visit the emergency room…compared to those who don’t” wear the aids. However, the article says, “people with hearing aids also averaged 1.4 more doctor visits than those without the devices.” Researchers also published an accompanying editorial.

New York Rx Card Helps Patients Fill Their Prescriptions
The Medical Society of the State of New York (MSSNY) in partnership with New York Rx Card reminds physicians that patients who are not insured or who take prescription drugs that are not covered by their health insurance plans, can use the New York Rx Card to obtain discounts of up to 75 percent off the retail price for FDA-approved medications.

New York Rx Card has been working closely with MSSNY, as well as numerous clinics and hospitals around the state to distribute free discount prescription cards so that all New York residents will have access to this free program. The program can also be used by people that have health insurance coverage with no prescription benefits, which is common in many health savings accounts (HSA) and high deductible health plans.

Please help by encouraging your patients to print a free New York Rx Card at the MSSNY website or at www.newyorkrxcard.com.  New York Rx Card also has an available app for your iPhone and Android phones. You can visit www.newyorkrxcard.com and download the app today.  Any physicians who are interested in ordering free cards for their clinic/hospital can email Chez Ciccone, via email at fciccone@nyrxcard.com or by phone at 800-931-2297.

Five Opioid Distributor Execs: Four of Five Deny Contributing to Opioid Abuse
Five of the nation’s top opioid distributors on Tuesday told a House panel that responsibility for the opioid crisis rests with “bad actors” at pharmacies and doctors who wrote too many prescriptions, not with their companies. Executives from four of the five distributors denied contributing to widespread painkiller abuse when questioned by Energy and Commerce Oversight and Investigations Chairman Gregg Harper (R-Miss.). Joseph Mastandrea, chairman of Ohio drug wholesaler Miami-Luken, answered “yes” and blamed prior management.

Another executive, Cardinal Health Executive Chairman George Barrett, apologized for not catching bad actors faster. Several of the other executives expressed contrition for not catching large requests for opioids more quickly. Earlier this year, the committee released documents alleging that between 2006 and 2014, McKesson and Cardinal Health shipped 12.3 million pills to one pharmacy in Mount Gay-Shamrock, West Virginia, which has fewer than 2,000 residents. Likewise, over five years, AmerisourceBergen distributed 60.9 million doses of hydrocodone and 29.4 million doses of oxycodone to West Virginia.

Energy and Commerce Chairman Greg Walden (R-Ore.) recounted how one West Virginia town of about 400 people received 9 million opioid pills in two years and how a single pharmacy in a town of 1,800 people got 17 million opioid pills in a decade.

Since the 1970s, drug distributors have been responsible for flagging suspicious orders and monitoring sales — something Walden suggested has not been done.

The executives largely shifted blame, despite their role in supplying the drugs at the center of the nationwide crisis. Three of the companies that testified — McKesson, Cardinal Health and AmerisourceBergen — account for about 85 percent of the opioid drug supply, Walden said.

https://www.politico.com/story/2018/05/08/opioid-distributors-blame-pharmacies-docs-522433

MLMIC to Host Spring 2018 Network Meetings Across NYS
These programs are designed to provide risk management education to MLMIC’s insured physicians, medical directors, facility risk managers, office practice administrators, nursing staff, marketing and IT staff and other healthcare professionals. This year’s program, which can qualify participants for CME credits, focuses on “Managing Your Social Media Presence.” It will:

  • examine the use of social media in healthcare;
  • analyze the positive and negative aspects of social media;
  • describe the appropriate use of social media in marketing;
  • formulate approaches to address negative online patient reviews;
  • evaluate the potential legal implications of social media on patient privacy and confidentiality; and
  • select strategies to develop and monitor social media policies.

The program is part of MLMIC’s ongoing efforts to provide education, promote patient safety and reduce potential liability exposure for all our insured providers and entities.

MLMIC is accredited by the Medical Society of the State of New York (MSSNY) to provide CME for physicians.

MLMIC designates this live educational activity for a maximum of 2.0 AMA PRA Category I Credits™.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Click here to read the program brochure and obtain registration information for a spring Network Meeting near you. 

USPSTF: Neutral Stance on Prostate Cancer Screening in Middle-Aged Men
Prostate-specific antigen (PSA) screening for prostate cancer isn’t recommended unless men request the test after being informed of its potential benefits and risks, the U.S. Preventive Services Task Force (USPSTF) says in new guidance published in JAMA. The grade C recommendation applies to asymptomatic men aged 55 to 69. The group recommends against PSA screening in men aged 70 and older (grade D recommendation). USPSTF recommendation statement in JAMA ; JAMA Internal Medicine editorial ; USPSTF grade definitions

Geisinger Health: Now Offering DNA Sequencing to All Patients
Geisinger Health this week announced that over the next six months it will offer DNA sequencing to all of its patients as part of their “routine” preventive care in an effort to inform patients about potential genomic risk factors for cancer or heart disease. Geisinger said it plans on making DNA sequencing a “routine screening,” just like colonoscopies, cholesterol checks, and mammograms, and will have doctors work with patients on responding to any identified risk factors.

CMS

CMS’ Eight-Page Plan for Rural Health Strategy; Commitment to Telehealth
On May 8, CMS unveiled an eight-page rural health strategy, which detailed the agency’s commitment to improve access to telehealth, improve outreach to rural health care providers, and find practical solutions to improve care in those areas. The strategy marks CMS’ first focused on rural health, but it did not contain any specific policy changes.

CMS Hosting a Medicare Learning Network Call: QPP FAQs
The Centers for Medicare & Medicaid Services (CMS) is hosting a call on Wednesday, May 16 at 1:30 PM ET to discuss the most frequently asked questions (FAQs) about the Quality Payment Program that came up during the 2018 Healthcare Information and Management Systems Society (HIMSS) Annual Conference & Exhibition.

Attendees will have the opportunity to listen to 2018 programmatic updates and FAQs that were discussed at HIMSS 2018. CMS will also open the phone lines for participants to ask questions about the Quality Payment Program.

Call Details

Title: Quality Payment Program: Answering Your Frequently Asked Questions Call

Date: Wednesday, May 16, 2018

Time: 1:30-3:00 p.m. ET

Registration Link: https://blh.ier.intercall.com

Classified

RENTAL/LEASING SPACE

Thriving Internal Medicine Practice for Sale by the Physician.
Has been growing exponentially, with number of patients doubling over last two years.
Has the visits-volume and the potential space & hours to keep expanding
The physician will stay to overlap for at least one year to personally transition all the practice’s patients, to seamlessly transfer all insurance account and to assist with acquirement of hospital privileges

Well established location at street level, with dedicated handicap entrance, easy access to public transportation, a parking lot and within one mile from all three leading local hospitals.
Fully credentialed as a medical practice site with all health insurances in the market, and compliant with Americans with Disability Act requirements. Office space lease guaranteed for extended period of time. Call 917-596-8936


Are You Trying to Lease Your Medical Office or Sell Your Medical Practice? Trying to Sell New or Used Medical Equipment?
Clineeds, the new online platform designed for medical providers. With Clineeds you can lease your medical officeshared your office spacebuy and sell used medical equipment, or post healthcare job opportunities. LISTING IS FREE! Why wait? Click here to sign-up: www.clineeds.com/sign-up


Beautiful NYC Medical Office — Long-term Share
Bright, big consultation room and one or two exam rooms in large,  tastefully furnished office in first-rate building. 58th Street between Park and Lexington. Near transportation.  Smaller, windowed consultation room and exam room also available. Rent by the day or week, beginning June 1 or sooner. $180 per day or $5500 per months. Perfect for internist, rheumatologist, physical medicine, ob-gyn and others. Superb front desk and office management available, along with many amenities including internet, ultrasound, EMG, kitchen, optional C-arm. Call Carol: 917-856-6402.


For Rent – Medical Office 715 W 170 Street New York
Ground floor just completed build out 4 exam rooms with sinks and wall cabinets
Waiting and reception areas, windows throughout.
Street and private entrances, two bathrooms and storage/lab/staff room.
One block to bus and two blocks to Presbyterian Medical Center and subway.
$1900-$7900/ month for one to 4 exam rooms.
Drdese@gmail.com or 917.8618273


For Share – Plastic Surgeon’s Office Facing Central Park Ground Floor Lobby Entrance/Private exit
One to three exam rooms, consult/private office and procedure room for full or part time use.
Elegant, modern and spacious secretarial, waiting and two exam rooms.
Accredited operating rooms and recovery rooms on site.
One block to bus and 20 feet to subways.
$1275-$3750/day monthly for one to three exam rooms.
Drdese@gmail.com or 917.861.8273


Office Space – Sutton Place
Newly renovated medical office. Windows in every room looks out to a park like setting on the plaza level. 2-4 exam rooms/offices available, possible procedure room or gym. Separate reception and waiting area, use of 3 bathrooms and a shower. Central air and wireless. All specialties welcome. Public transportation nearby. Please call 212-772-6011 or e-mail: advocate@medicalpassport.org


PHYSICIAN OPPORTUNITIES


Paging Primary Care Doctors Who Love Technology
98point6 is a healthcare technology startup that needs your input.  We’re seeking practicing physicians to join our Primary Care Council to help shape the future of primary care.  If the fusion of healthcare and technology inspires you, please join us and apply today. Visit: www.98point6.com/about/pcc/


Private Multidisciplinary Medical Group Seeking Full Time or Part Time Podiatrist and Full Time or Part Time Internal Medicine/Family Practice/Allergy & Immunology Physicians.
Midtown, Union Square & Lower Manhattan locations. Attractive base salary plus comprehensive benefits package. E-mail CV to tsrgexpress@gmail.com. No recruiters please.


Chief of Medical Services
MINIMUM QUALIFICATIONS: Possession of a license and current registration to practice medicine in New York State, plus six years of experience in the practice of medicine, two years of which must be in an administrative or supervisory capacity. Appointee must be eligible for and maintain eligibility for full and unconditional participation in Medicaid and Medicare programs. Appropriate certification by an American Medical Specialty Board and one year of post certification experience in that specialty can be substituted for four years of general experience.
PREFERRED QUALIFICATIONS: Board certification in Geriatric Medicine and/or Certification as a Medical Director (AMDA), and experience in a long-term care facility.
RESPONSIBILITIES: Serve as Medical Director of a 242-bed skilled nursing facility for veterans and their dependents. Provide medical leadership and oversight ensuring the delivery of quality health care services while also ensuring compliance with clinical, statutory and regulatory standards.Send resume to:  NYS Veterans Home, Attn: Human Resources, 4207 State Highway 220, Oxford, NY 13830

The New York State Veterans Home at Oxford is a 242-bed skilled nursing facility operated by the NYS Department of Health located in Chenango County. It is an Affirmative Action/Equal Opportunity Employer. 


Family Practice Physician – Schenectady/Amsterdam, NY
Hometown Health Centers is a Federally Qualified Community Health Center in the Upstate, Schenectady and Amsterdam, NY areas. Bi-lingual in English/Spanish is a plus.  Excellent total compensation package.  No hospital rounding. Flexible and part-time schedules available.  Sign-on bonus. For additional information please send inquiries or resumes to href=”mailto:jobs@hhchc.org”>jobs@hhchc.org. www.hometownhealthcenters.org


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


 

MSSNY Will Convene Task Force on Death and Dying


MSSNY Seal
MEDICAL SOCIETY OF THE STATE OF NEW YORK
865 Merrick Avenue, Westbury, New York 11590-9007
www.mssny.org
Communications Division
Telephone: (516) 488-6100

 

For Immediate Release

MSSNY Will Convene Task Force on Death and Dying

May 10, 2018, Westbury, NY—The Council of The Medical Society of the State of New York (MSSNY) today voted to convene a Task Force on Death and Dying to develop a white paper regarding the physicians’ role in end of life and palliative care. The paper will also discuss the impact of death and dying on the disparate and the disabled populations.

“These are complex issues and it is very important that we address this controversial issue in the most appropriate way,” said MSSNY President Dr. Thomas Madejski. “The Task Force will be ethnically and philosophically diverse and will include members from across MSSNY’s membership—including physicians from the Long-Term Care and Disparities committees.”

MSSNY has a long-standing policy that opposes physicians’ participation in accelerating a patient’s natural death. 

# # #

About the Medical Society of the State of New York
Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.

 

Media Contact:
Roseann Raia

Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516.488.6100 x 302
rraia@mssny.org

 

1 2 3 4 5 22