MSSNYeNews: March 13, 2020 – Triskaidekacovid Phobia

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
March 13, 2020

Vol. 23  Number 11


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Colleagues:

Our Kevin Bacon Strategy is not working. While it’s probably too late for containment to hold off the spread of COVID-19, the goal shifts to mitigation – sufficient social distancing to slow down the virus and prevent overwhelming our medical resources. Testing, while not sufficiently scaled, is becoming increasingly available via health systems throughout the state. Some states, CT, CO, and WA are setting up “Drive Thru” testing facility, similar to New York State which initiates its first driving facility in New Rochelle. The Gates Foundation is funding a home test kit delivered by Amazon that could be mailed in. This is currently a pilot in the Seattle area but could be widely available soon. More information on SARS CoV2 and COVID-19 can be found here.

Every day, more cases are being found, especially now that testing is increasingly available. Our local health systems realized the importance of social distancing a while ago as medical staff meetings are now choosing Facetime over face time. As more large scientific meetings are canceled, our own House of Delegates has come under increasing scrutiny.  While further discussion and final decision is planned for early next week, it is far more likely than not that the House as we know it will not be held. The business of the House, however, will not be ended. It is the business model that will change. MSSNY’s Long Term Planning Committee has been working on a trial of virtual reference committees. What was once long-term planning may quickly become short term planning.

I’ve found humor to be a great salve for the worried brow. So, in that vein, on this Friday the 13th, take a few deep breaths and be of good cheer. We will get through this. This is a virus, not Ragnarok. We must be the adults in the room. While this is only Round 3 in a 12-round fight, we can do this. We have no choice. Our families, our colleagues and our patients are counting on us.  Fear is the mind killer. As former NY governor Franklin Roosevelt observed, “The only thing we have to fear is fear itself.”

Your Medical Society of the State of New York has taken the following steps to provide you with information:

  • Create a COVID-19 section on the MSSNY website
  • Participate in weekly conference calls with the New York State                    Department of Health
  • Create a physician resource page of valuable links to get information
  • Has created two podcasts on COVID 19 for physicians and patients—          both of which can be found on our website
  • Will conduct a COVID-19 webinar on March 18, 2020 for physicians.

All information can be found in the various articles below.

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President


Capital Update


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WHO Declares COVID-19 Pandemic; Important Information Physicians Need to Know
The World Health Organization (WHO) has declared COVID-19 as a pandemic.  There are 421 cases of confirmed COVID-19 in New York State as of March 13, 2020.  According to Governor Andrew Cuomo, 50 patients have been hospitalized which is about a 12% hospitalization rate.  He also announced the approval of the federal government for New York labs to conduct up to 6,000 COVID-19 tests per day.  The governor on Thursday also banned gatherings of 500 or more in the state and any gathering under 500 individuals in attendance will be required to cut capacity by 50%.  There are also new limits on visitations to nursing homes – Only medically necessary visits will be allowed to protect the most vulnerable.  

The Medical Society of the State of New York has gathered information to aid physicians and has also developed communication tools for your patients on COVID-19.  MSSNY strongly recommends that physicians utilize the New York State Department of Health which has up-to-date information on COVID-19 and includes and includes information on known cases of COVID-19, cleaning and disinfection guidance, help for childcare providers and schools, and guidelines for individuals who have recently traveled internationally.

Since COVID-19 is a reportable disease, please ensure that you and your staff have the number of your local department of health.  Contact information can be found here.

MSSNY now has a Physician Resource Page on its website of important links and it can be accessed here.

Additionally, MSSNY has put together a physicians’ podcast on COVID-19 accessible here.

MSSNY has also provided for patients a podcast on COVID-19 here.

MSSNY has also developed patient specific information page that you can provide to patients and it can be accessed here.

Physicians are also encouraged to go to the MSSNY CME website and take the Physicians’ Emergency Tool Kit modules which contain educational programs on Office Surge, Crisis Communication and responding to public health emergencies.

The Governor has also indicated his hope to find retired physicians and other healthcare personnel to help at their former hospitals in the event they are needed to help with exceeded capacity at the facility.   (CLANCY, HOFFMAN)


State Agencies Sent Out Reminder that New York Law Covers Telemedicine
Both the New York State Department of Financial Services (DFS) and Department of Health (DOH) have sent out notifications relating to the Covid-19 outbreak reminding health insurers, physicians and hospitals that New York law requires coverage for telemedicine in the same manner as if care had been provided in an office setting.  To read the DFS circular letter, click here  () and to read the Medicaid guidance click here.  Moreover, Congress passed a law last week that reduces current restrictions on Medicare coverage for telemedicine but we are awaiting guidance from CMS as to how it will be implemented.                                            (AUSTER)



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DFS Announces Emergency Regulation to Prevent Insurer Cost-Sharing for Covid-19 Testing
The New York Department of Financial Services (DFS) today announced an emergency regulation that prohibits New York health insurers from imposing cost-sharing on emergency room visits, in-network outpatient physician office visits, in-network urgent care center visits, in-network telehealth visits, and in-network laboratory tests when the purpose of the visit or test is to diagnose novel coronavirus (COVID-19).   To read the regulation click here.

This emergency regulation also requires that insurers notify their in-network health care providers not to collect any deductible, copayment, or coinsurance for diagnostic testing for COVID-19.

This regulation follows guidance issued on March 2nd, 2020 that outlined a series of other actions that New York health insurers are required or advised to take, including keeping New Yorkers informed regarding available benefits; offering, where possible, telehealth medical advice and treatment; preparing insurers to cover the costs of a COVID-19 immunization should one become available; and guaranteeing access to out-of-network providers at the in-network cost-sharing when no in-network provider can treat the insured.

The DFS Press release noted that Copayments, coinsurance, or annual deductibles may be imposed in accordance with the applicable policy for any follow-up care or treatment for the novel coronavirus (COVID-19), including an inpatient hospital admission, as otherwise permitted by law.         (AUSTER) 


MSSNY Governmental Affairs Team Prepares for Phase 2 in Budget Process
Since Governor Cuomo released his proposed budget for FY 2020 on January 21st, the MSSNY Governmental Affairs team has been working hard to build support in the legislature for the organization’s position on proposals that will have the greatest impact on physicians and public health. Included among these are:

  1. A ban on vaping products like flavored liquids used with e-cigarettes.
  1. Regulation of Pharmacy Benefit Managers (PBMs).
  1. Protecting funding for the state Excess Medical Malpractice Insurance Program.
  1. Opposing unnecessary, proposed changes to the physician disciplinary process administered by the Office of Professional Medical Conduct (OPMC), which could significantly curtail physician due process rights.
  1. Rejecting a steep across the board cut in reimbursements for physicians participating in the state Medicaid program.

As is traditionally done, the Assembly and Senate are expected to pass their own one house resolutions on March 18th, which will outline their budget priorities for FY 2020, followed by three-way negotiations between the Governor and leaders in the Assembly and Senate. The statutory deadline for lawmakers to have final agreement on a new budget is April 1st. However, it is possible this deadline could be delayed due to the COVID19 outbreak, which has hit New York state particularly hard, which may prevent the Legislature from meeting this deadline.

The Division of Governmental Affairs team will continue to push MSSNY’s budget priorities and monitor discussions between the Governor and legislative leaders in the coming weeks.                                                            (CARY, AUSTER)


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Medicaid Redesign Team II (MRT II) Discusses Possible Reform Proposals Including Several of Concern
The MRT II held its second public meeting this past week where it discussed the over 2,200 proposals that were submitted to the group, and which could be part of its final list of recommendations next week, March 19.   The MRTII is charged with finding $2.5 billion in savings to the Medicaid program as part of the State Budget that is scheduled to be finalized by April 1, just a few weeks away.

MSSNY continues to be concerned by a range of the MRT II proposals under consideration, chief among them:

  1. Eliminating or reducing funding for the Excess Medical Malpractice Insurance Program. Please send a letter to your legislators to oppose this cut here.
  1. Permitting nurse-anesthetists to deliver anesthesia care without adequate anesthesiologist supervision. Please send a letter to your legislators to oppose this policy change.
  1. A further Medicaid cut in addition to the 1% across-the-board cut to achieve desired Budget savings and what that means for physician reimbursements. Please send a letter to your legislators to oppose further Medicaid cuts here.
  1. Elimination of “Prescriber Prevails” policy in the Medicaid pharmacy benefit.
  1. Changes to the Patient Centered Medical Home (PCMH) program that may further tie payments to certain quality performance metrics. The Department of Health (DOH) has stated that patients enrolled in PCMH had significantly lower health costs overall than non-PCMH enrollees.

MSSNY’s Governmental Affairs team will continue to share our concerns with policymakers behind the scenes and will provide an update as new details become available. (CARY, AUSTER)


Registration Now Open for CME Series on Pain Management, Palliative Care & Addiction; NYS Requires Every Prescriber to Take 3 Hour Course By July 1, 2020
The Medical Society of the State of New York announces an updated series of three one-hour CME webinars on pain management, palliative care and addiction.  New York State statute requires all prescribers, holding a DEA license, to complete three hours of coursework every three years.  Coursework must include the following:

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

These webinars are being offered FREE OF CHARGE to MSSNY members. A discount code was emailed to members on February 24, 2020. Please contact Melissa Hoffman at mhoffman@mssny.org if you did not receive this discount code.

The Medical Society of the State of New York has worked with the New York State Office for Alcoholism and Substance Abuse Services (OASAS) in the development of these programs.  Following the webinars, the courses will be offered on-line on the MSSNY CME site.   The programs will be offered to MSSNY members free of charge and there is a non-member fee of $50 per session.

The three webinars cover all issues required in the New York State statute and participation is only by computer, or with the Webex app.

Two Remaining Webinars will be held on:

Tuesday March 17, 2020—7:30-8:30am
When to Consider Opioid Therapy for Chronic Non-Cancer Pain & in Palliative Care

Faculty: Charles Argoff, MD
Educational Objectives:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation
  • Describe palliative medical care and end-of-life care

Register for this webinar here 

Tuesday March 24, 2020—7:30-8:30am
Patients with Opioid Use Disorders: Identification, Treatment, and Management of Co-occurring Pain

Faculty: Jeffrey Selzer, MD, Marc Manseau, MD, MPH, NYS OASAS Medical Director
Educational Objectives:

  • Describe the Potential for Addiction, Patient Screening, Diagnosis and Subsequent Treatment or Referral
  • Recommend Tools to Assist in the Identification of High-Risk Patients for Whom Opioids are Indicated and Prescribed
  • Describe Strategies for Treating Pain in Patients with Substance Use Disorders

Register for this webinar here. 

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

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

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or 518-465-8085

(HOFFMAN)


This Week’s Legislative Podcast


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“Coronaviruses 2020: COVID-19 An Evolving Story” CME Webinar on March 18th Registration Now Open
Included in MSSNY’s response to the COVID-19 outbreak is Matters: Coronaviruses 2020: COVID-19 An Evolving Story on March 18th at 7:30am.  Faculty for this program are William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee along with Elizabeth DuFort, MD, Medical Director in the Division of Epidemiology at the New York State Department of Health will serve as faculty for this program. And Marcus Freidrich, MD, MBA, Chief Medical Officer – Office of Quality of Patient Safety – New York State Department of Health will be present to answer questions.

Registration is now open for this webinar. Click here to register

Educational objectives are:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role int eh public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

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

For more information prior to this webinar, be sure to go to https://cme.mssny.org and view Principles of Isolation and Quarantine: Epidemiology as a Decision Maker for more information on the public health response to infectious diseases.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

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


Veterans Matters: The Special Mental Health Needs of Women Veterans Live Seminar in Saratoga
The Medical Society of the State of New York and the Saratoga County Medical Society are hosting a CME live seminar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Wednesday, March 18, 2020 at 6:45 pm.

Where:
Nove Restaurant
707 Saratoga Road
Wilton, NY  12831

When:                  Sign-in/Reception at 6:00pm – Program begins at 6:45pm
Faculty:                Malene Ingram, MD & Colonel, U.S. Army Reserves

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify the barriers that women veterans face in getting the specific care they need

Reservations can be made by contacting Gregory Pinto, MD at gregory685@aol.com or (518) 587-0772. Dinner charge for non-MSSNY member is $35.00 and no charge for MSSNY members and their spouses.

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.      (SHERPA)     


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pschuh@mssny.org mauster@mssny.org pclancy@mssny.org zcary@mssny.org rali@mssny.org

 

eNews

Gov. Andrew Cuomo is banning all gatherings of 500 people or more as of 5 p.m yesterday.  All businesses or facilities with capacities up to 500 — including restaurants and bars — must also reduce their occupancy by 50 percent. The state is also allowing schools that close to provide up to two meals per day to low-income students. The Trump administration also announced this morning that the FDA will allow New York state to authorize public and private labs to begin testing.

Today, Gov. Andrew Cuomo said New York state could be dealing with virus response for six months or more, during the opening of a New Rochelle drive-thru facility that will test for Covid-19. He said that could mean six, seven, eight or nine months that the state will be responding to the outbreak.

The governor said the facility, operated by Northwell Health, will have six lanes and will be able to process 200 people today with plans to increase its capacity to 500 in the next few days.

The state is working with BioReference Laboratories with the aim of processing 5,000 tests per day by next week. It has contracted with 28 public and private labs in New York as well as out-of-state labs to increase the number of samples it can process. Some are still waiting on federal approval to begin testing.

Testing will be done by appointment-only, with priority given to people in New Rochelle and to vulnerable populations, such as those with underlying illnesses, particularly respiratory diseases. Appointments can be made by calling 888-364-3065. The governor said the logjam in testing is not related to a lack of test kits but limited approvals for labs conducting testing. The state Health Commissioner said Thursday afternoon that about 2,300 people had been tested in the state.

There had been 328 people diagnosed with Covid-19 in New York as of Thursday afternoon, with 95 of those individuals living in New York City.

New Rochelle has been a focal point for the outbreak, with more than 100 people testing positive there.

Information Centers for Physicians

Current CDC Info for Professionals:

CMS News

CMS Emergency Info

CDC Travel Info


 


COVID-19 MAC Test Pricing
Today, CMS is posting a fact sheet to the CMS.gov website to aid Medicare providers with information relating to the pricing of both the CDC and non-CDC tests.  You can find the fact sheet here.


Clinical: Dr. Anthony Fauci on Talking with Patients About COVID-19
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, talks with Clinical Conversations about novel coronavirus disease (COVID-19). Listen in here.


EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2

http://www.mssnyenews.org/wp-content/uploads/2020/03/EPAs-list-products-for-use-against-COVID-19-031320.pdf


NYSDOH Issues Special Edition of Medicaid Update Re Corona Virus
The New York State Department of Health issued a special edition of the Medicaid Update on March 10 featuring New York State Medicaid Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID–19).  This Medicaid Update can be found here.


FDA Approves Generic Version of Asthma Inhaler
The FDA has approved a generic version of albuterol sulfate inhalation aerosol, the asthma inhaler marketed as ProAir HFA. The drug is indicated to treat reversible obstructive airway disease and prevent exercise-induced bronchospasm in both adults and children aged 4 years and older.

This is the first generic metered-dose inhaler to be approved in almost two decades and should be available in late 2020. FDA news release


Ways to Deal With Sleep Deprivation in Residents and Early-Career Clinicians
Endocrine News examined “ways to help” medical residents and early-career clinicians “cope with sleep deprivation so” they can give their “patients the best care possible, as well as take care of” their own personal health. The article interviewed Fariha Abbasi-Feinberg, MD, FAASM, FAAN, “board member of the American Academy of Sleep Medicine (AASM) and a practicing sleep medicine physician and medical director of Sleep Medicine with Millennium Physician Group, and board certified in sleep medicine and neurology, in Fort Meyers,” FL, and Timothy P. Brigham, MDiv, PhD, “the chief of staff and chief education and organizational development officer for the” Accreditation Council for Graduate Medical Education.


Q4 2019: 50% Increase in Ransomware Attacks Against Healthcare Providers
HealthIT Security (3/9) reports “ransomware attacks against healthcare providers increased a whopping 350 percent during the last quarter of 2019 with the rapid pace of attacks already continuing throughout 2020, according to a new report from Corvus.” The “findings mirror similar reports, which also noted that these numbers are likely lower than the actual number of attacks – as some ransomware victims do not report the incidents to the public.” The research found “one of the most common exposure types is through the remote desktop protocol, which is associated with a 37 percent greater likelihood of a successful ransomware attack.


HHS: In 2022, Patients Can Download Electronic Health Records
On March 9, Federal officials released groundbreaking rules that will let patients download their electronic health records and other health care data onto their smartphones. “Patients should have control of their records, period. Now that’s becoming a reality,” said Health and Human Services Secretary Alex Azar. “These rules are the start of a new chapter in how patients experience American health care.”

Many of the provisions are set to take effect in 2022.

“The days of patients being kept in the dark are over,” said Centers for Medicare & Medicaid Services Administrator Seema Verma. “In today’s digital age, our health system’s data-sharing capacity shouldn’t be mired in the Stone Age.” Yet the new rules also have raised concerns about privacy as technology companies, such as Google, Microsoft, Apple and Amazon, open up new markets for providing medical records through mobile apps. Major EHR vendor Epic, for instance, has warned that freer flow of medical records could spur the unwanted sale of data or other unauthorized uses.

Verma said the nation’s health care system remains “hugely expensive and inefficient as repeat tests drive up costs and, perhaps most importantly, doctors are forced to provide care with an incomplete clinical picture, especially at a time when the health care systems could be under stress…With the handling of the COVID virus, the urgent need for coordinated integrated care could not be clearer,” she said. (March 10, KHN)


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if youThank you. (WILKS)


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MSSNYeNews: Lobby Day in the Time of Coronavirus – March 6, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
March 6, 2020

Vol. 23  Number 10


MSSNYPAC Seal

 


Colleagues:

As I arrived in Albany, the city was abuzz with Coronavirus talk. Representatives of HANYS were preparing to leave. They had just canceled their lobby activity, needing to get back to their respective hospitals. At an event that night, I greeted State Senate Health Committee Chair Sen. Gustavo Rivera with a forearm bump and soon he had the whole room fist bumping, forearm bumping and air high fiving as he pointed me out and laughed. The message, however, was clear. MSSNY was in the house.

The following day 200 physicians – attendings, staff and yes, medical students filed into the auditorium in “The Egg” for the morning program, packed with COVID19 updates and a review of our legislative agenda. I cannot thank NY Society of Addiction Medicine, NY Osteopathic Medical Society, NY Society of Plastic Surgeons and ACOG enough for their participation. Appearances by Senate Minority Leader John Flanagan and DFS’ outgoing chief Troy “Surprise Bills” Oeschner (who received an award) and panel discussion followed, featuring Assembly Insurance Chair Kevin Cahill, Senate Insurance Chair Neil Breslin, and Assembly Health Committee Chair Richard “The Dean” Gottfried who all answered questions about our legislative concerns. Finally, outgoing Sen. James Seward received our commendation for years of service.

During the lunch that followed, we all agreed this was the most cordial session we had ever witnessed. Whether it was Coronavirus or a moment of clarity, our doctors went off for appointments with legislators on a real high note to deliver our message that our Medical Society stands ready to work with our state government to insure the health of all New Yorkers.

By the way, keep your fingers crossed— the news was encouraging on the OPMC issue.

As I write this, I’m struck by the dedication of NY physicians who heard the call, left their practices, and traveled to Albany to deliver our message. You all have my thanks and gratitude.

Oh, and the title above? Well, I riffed on Gabriel Garcia Marquez’ Love in the Time of Cholera.

I’m out.

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President


Coronavirus Update with Anthony Fauci, MD – March 2020


There is an order of priority for testing, defined below (1 through 5):

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Capital Update

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This Week’s Legislative Podcast


Physician Advocacy Day – A Great Success!
Thank you to the hundreds of physicians, medical students and other physician advocates who took the time to come to Albany this week to participate in MSSNY’s Physician Advocacy Day at the State Capitol.    We would also like to give a special thanks to Assemblymember Kevin Cahill, Assemblymember Richard Gottfried, Senator Neil Breslin and Senate Minority Leader John Flanagan for educating the physicians in attendance about the health Budgetary issues that are being faced in Albany, and for responding to the many questions posed by physicians regarding various legislative proposals.

Physicians from across the State met with many of the members of the Assembly and Senate that represent the regions where they practice, and MSSNY physician leaders met with (or the top staff to) Senate Majority Leader Andrea Stewart-Cousins, Assembly Speaker Carl Heastie, Senate Deputy Majority Leader Michael Gianaris and Assembly Minority Leader Will Barclay as well as key health staff to the Governor.

They emphasized the physician community’s strong concerns with proposed Medicaid cuts, proposed elimination of the Excess Medical Liability Insurance Program, and seriously problematic changes to the physician disciplinary process, while also urging support for items such as regulating PBMs and a flavored tobacco/vaping ban.  Direct physician advocacy is an essential component of legislative success and helped in great part by your contributions on days like this.  We look forward to continuing to work with you on the many legislative issues that impact physicians and healthcare in general. (DIVISION OF GOVERNMENTAL AFFAIRS)


COVID-19 Cases Continue to Rise in NYS
New York State has 22 confirmed cases of COVID-19 with 122 cases under investigation as of March 6th.  Coronavirus is now a reportable disease and physicians are required to report suspected cases to their local department of health. There are 2,733 under quarantine in New York City.  Physicians are urged to stay informed by going to the New York State Department of Health website for healthcare providers here or the New York State Department of Health NYC physicians here.

NYS also has a coronavirus hotline at 1-888-364-3065.  The latest guidance from the NYS Department of Health can be found here.

MSSNY also has the latest updates from the state on its website at www.mssny.org   Please see information located in the blue boxes labeled COVID-19.

MSSNY will also conduct a webinar on COVID-19 at March 18, 2020 at 7:30 a.m.   Registration is now available here.    (CLANCY)



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Governor, DFS Announce Steps to Ensure Coverage for COVID-19 Testing and Treatment
As one of the many steps being taken to respond to the coronavirus outbreak, Governor Andrew Cuomo announced this week a new directive by the NYS Department of Financial Services requiring New York health insurers to waive cost sharing associated with testing for coronavirus including emergency room, urgent care and office visits, and ensuring health insurers cover care related to the testing and treatment for coronavirus.

In addition to prohibiting the imposition of patient cost-sharing, the guidance issued by DFS to health insurers regarding actions they should take in relation to the potential impact of COVID-19 on New York includes:

  • Directing insurers to develop robust telehealth programs with their participating providers where appropriate, particularly for individuals who may have difficulty making an office visit and where a phone call with a medical professional can alleviate the need for a hospital visit.
  • Directing insurers to verify that their provider networks are adequately prepared to handle a potential increase in the need for health care services, including offering access to out-of-network services where appropriate and required, in the event more COVID-19 cases are diagnosed in New York. In addition, DFS is reminding insurers that lifetime or annual limits cannot be placed on in-patient care.
  • In the event an immunization becomes available for COVID-19, DFS is reminding insurers that they must cover the cost of vaccination for children under 19. For adults, DFS’s guidance states that all insurers should be prepared to cover the immunization immediately at no cost-sharing.
  • Directing insurers to provide insurance coverage for off-formulary prescription drugs if there is not a formulary drug available to treat the insured, through a formulary exceptions process.
  • Reminding insurers that coverage for emergency services in hospital facilities is required at the in-network cost-sharing even if the hospital is out-of-network or overseas, and that no insurer may require a patient to seek preauthorization prior to seeking emergency care, including for ambulance service.

Directing insurers that they are required to hold harmless insureds who receive surprise medical bills for health care services, including those related to testing and treatment of COVID-19.                                                                   (AUSTER)


“Coronaviruses 2020” CME Webinar on March 18th Registration Now Open
With the number of Covid-19 cases and quarantines growing significantly this week, please sign up for MSSNY’s Medical Matters: Coronaviruses 2020 scheduled for March 18th at 7:30am.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar: please click here   

Educational objectives are:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role in the public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

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

For more information prior to this webinar, be sure to go to https://cme.mssny.org and view Principles of Isolation and Quarantine: Epidemiology as a Decision Maker for more information on the public health response to infectious diseases.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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


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Please Continue to Urge Your Legislators to Protect Physician Due Process
With Part L of Governor’s proposed Health/Mental Hygiene Budget bill containing extremely troubling measures to bypass important due process protections for physicians when a complaint has been filed against them with the OPMC, all physicians are urged to continue to contact their legislators contact here to urge that the Legislature reject this unfair proposal.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation.  It would also permit the OPMC to summarily suspend a physician without the typical due process requirements with only a minimal finding of “risk to the public”, as opposed to the much stronger “imminent danger” standard now required for bypassing these essential due process protections.  It would also give the OPMC much greater powers to seize physician records and record systems, even that which is necessary for physicians to deliver care to their patients.

That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career. 

MSSNY has joined with 18 state specialty societies and the NYS Society of Physician Assistants in a communication to the Legislature setting forth our concerns in greater detail. Memo   Moreover, thousands of physicians from across the State have contacted their local legislators to express their severe concerns with this grossly unfair proposal.  Have you?

Please urge your legislators to reject this proposal from the Budget. (AUSTER)


Legislators Urged to Preserve Excess Liability Program
Physicians are urged to contact their legislators to request that the Excess Medical Malpractice Insurance Program be extended.  Unfortunately, the Excess program has become a “political pawn” in discussions regarding ways to address the State’s huge budget deficit.   A letter to your legislators can be sent here.

This program, which provides nearly 17,000 physicians across the State with an additional $1 million/$3 million of liability coverage above the primary $1.3M/$3.9M layer, is being proposed to be eliminated after June 30.  This is despite the fact that this coverage is needed more than ever due to New York’s excessive and growing liability costs that far exceed all other states.  Without this protection, many physicians will be unable to continue to practice. Indeed, those who would be dropped would be personally exposed to financial ruin in the event that a judgment or award exceeded the limits of the primary layer.  If anything, the program actually needs to be expanded, not diminished.

Let your legislator know that, in the absence of comprehensive medical liability reform, physicians need this secondary layer of liability insurance to protect against New York’s excessive verdicts and settlements.  please click here (AUSTER)


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Physicians Meet With Legislators to Discuss Flavored Vaping Ban
Physicians, parents and members of other health care organizations were in Albany on Tuesday to discuss with legislators the need to prohibit flavored nicotine products for use in e-cigarette or vaping products.  Participating from the Medical Society were Gregory Threatte, MD, president of the Albany County Medical Society and Roy Korn, MD, president of the Schoharie County Medical Society and members of MSSNY governmental affairs staff.  Along with meeting with members and staff of the NYS Legislature, the physicians also joined with Lt. Governor Kathy Hochul and Health Commissioner Howard Zucker, MD at an early morning strategy session on vaping and at a press conference with Lt. Governor Hochul in the afternoon.

MSSNY supports the proposal put forth by Governor Andrew Cuomo to prohibit the sale of flavored nicotine devices within the context of his 20-21 New York State Budget.  MSSNY also supports legislative efforts in the New York State Legislature.  Statistics show that youth vaping using flavored e-cigarettes has increase in NYS from seven percent to 27% percent over the last five years and 40% of all NYS high school seniors “vape” every day.

Please assist us in the efforts by sending a letter to legislators here.
(CLANCY, AUSTER, CARY, ALI)


MSSNY Testifies at NYC MRT2 Forum
MSSNY President Dr. Art Fougner delivered comments to the New York City meeting of the Medicaid Redesign Committee this week.  You can see his comments here: please click here (at the 11 minute mark).  The MRT2 is charged with arriving at recommendations to achieve $2.5 billion in State Budget savings for the State Budget due April 1.

Similar to MSSNY Vice President Dr. Joseph Sellers’ comments at the Albany MRT forum and Monroe County Medical Society Executive Director Chris Bell’s comments at the Rochester MRT forum, his recommendations included: expansion of Medicaid coverage for in-home physician care visits and telemedicine to help reduce rising transportation costs, expansion of the Patient-Centered Medical Home program (which according to DOH has demonstrated itself to reduce patient medical costs), and long overdue liability medical liability reform (since the State must subsidize the excessive liability costs in New York that are much less in other states).        (AUSTER)


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Care Delivery Mandate Bills Begin to Pile Up in Albany
MSSNY continues to raise serious concerns with the numerous bills advancing in Albany that, while well-intended, would place substantial new mandates on patient care delivery at a time when physicians are already drowning in administrative tasks diverting time away from treating patients.  A recent Annals of Internal Medicine study concluded that physicians already spend 2 hours on administrative tasks for every hour they spend actually delivering patient care.  These bills unfairly place the physician at risk of financial penalty by DOH or even license sanction by the OPMC if the physician fails to document even one time that they performed the mandated task.  These proposals include:

  • Mandated conspicuous posting in a physician’s office of a patient’s ability to file a complaint with the Office of Professional Conduct (A.7991-A/S.6678-A). Assembly Floor/Senate Floor
  • Mandated notification to epileptic patients of the risk of sudden death due to epilepsy (S.5397-A/A.7807-A). On Assembly Floor/On Senate Floor
  • Mandated co-prescribing of naloxone for patients: a) taking 50 mmg per day b) with a history of substance use disorder or c) concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics (S.5150-B/A.5603-B). Passed Senate.  In Assembly Ways & Means
  • Mandated reporting of rescue inhaler prescriptions to the statewide immunization system (S.7337). On Senate floor
  • Mandated dissemination of a pamphlet prior to performance of a pelvic exam (S.7544/A.9600). On Senate floor/In Assembly Health
  • Mandated procedure for a maternal health care provider to provide written notification to patients regarding the risks of a C-section (A.318-A/S.2888-A). Passed Assembly/In Senate Women’s Issue Committee
  • Mandated proof of completion of CME on cultural competency, including paying for an additional fee to SED on top of the biennial $600 registration fee (S.2406-A). Passed Senate/In Assembly Higher Education Committee
  • Mandated seeking of a detailed patient/family member consent for a nursing home resident prior to the receipt of a psychotropic medication, or detailed documentation of the need to provide such medication without consent (A.1033/S.5441). Passed Assembly/In Senate Health Committee
  • Mandated completion of additional questions for the NYS Physician Profile including office hours, whether accepting new patients and an unknown number of practice demographic questions. Contained in Part K of the Governor’s proposed Health/Mental Hygiene Budget bill.

            (DIVISION OF GOVERNMENTAL AFFAIRS)


One-Sided Surprise Bill Proposals Advance in Congress
Contact Your Representatives Today
All physicians are urged to continue to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative to express strong concerns with the various proposals before Congress that would substantially limit insurer responsibility for coverage of out of network emergency and surprise medical bills.  A letter can be sent here: please click here

While MSSNY supports the goals of legislation to prevent surprise medical bills, most proposals advanced so far are steered heavily to the benefit of insurance companies, and do not have the balance of New York’s law.  Recently the House Ways & Means Committee and Education & Labor Committee advanced separate proposals.  While the Ed & Labor proposal was very similar to Energy & Commerce proposal advanced last year strongly opposed by MSSNY and many other physician organizations, the W&M proposal did make some modest improvements including rejecting a benchmark payment and permitting the consideration of many factors.

However, the IDR mechanism identified in the legislation would also prohibit the consideration of physician charge data and require the consideration of median in-network data, which in all certainty will skew the results towards the insurance companies.  In fact, when the proposal was scored by the Congressional Budget Office (CBO), it was noted that “in facilities where surprise bills are likely, average payment rates for both in- and out-of-network care would move toward the median in-network rate.  Moreover, the proposal only provides for a minimal review of insurer networks, which is the major contributing factor to the problem of surprise bills.

Please take the opportunity to contact your federal legislators today, urging a fair solution to this issue similar to New York’s law. Please click here            (AUSTER, CARY)


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Registration Now Open for CME Series on Pain Management, Palliative Care & Addiction; NYS Requires Every Prescriber to Take 3 Hour Course By July 1, 2020
The Medical Society of the State of New York announces an updated series of three one-hour CME webinars on pain management, palliative care and addiction.  New York State statute requires all prescribers, holding a DEA license, to complete three hours of coursework every three years.  Coursework must include the following:

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

These webinars are being offered FREE OF CHARGE to MSSNY members. A discount code was emailed to members on February 24, 2020.  Please contact Melissa Hoffman at mhoffman@mssny.org if you did not receive this discount code.

The Medical Society of the State of New York has worked with the New York State Office for Alcoholism and Substance Abuse Services (OASAS) in the development of this program.  Following the webinars, the course will be offered on-line on the MSSNY CME site.  The program will be offered to MSSNY members free of charge and there is a non-member fee of $150 for the on-line series.

The three webinars cover all issues required in the New York State statute and participation is only by computer, or with the Webex app.
Webinars will be held on:

Tuesday March 10, 2020—7:30-8:30am
Understanding the Current Legal Landscape in New York State for Prescribing Controlled Substances
Faculty: Patricia Bruckenthal, PhD, APRN-BS, FAAN & Robert Kent, Esq., NYS OASAS General Counsel
Educational Objectives:

  • Understand New York State and Federal Requirements for Prescribing Controlled Substances
  • Discuss Guidelines for Chronic Pain

Register for this webinar here.

Tuesday March 17, 2020—7:30-8:30am
When to Consider Opioid Therapy for Chronic Non-Cancer Pain & in
Palliative Care
Faculty: Charles Argoff, MD
Educational Objectives:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation
  • Describe palliative medical care and end-of-life care

Register for this webinar here

Tuesday March 24, 2020—7:30-8:30am
Patients with Opioid Use Disorders: Identification, Treatment, and Management of Co-occurring Pain
Faculty: Jeffrey Selzer, MD, Marc Manseau, MD, MPH, NYS OASAS Medical Director
Educational Objectives:

  • Describe the Potential for Addiction, Patient Screening, Diagnosis and Subsequent Treatment or Referral
  • Recommend Tools to Assist in the Identification of High-Risk Patients for Whom Opioids are Indicated and Prescribed
  • Describe Strategies for Treating Pain in Patients with Substance Use Disorders

Register for this webinar here.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or 518-465-8085       (HOFFMAN)


Veterans Mental Health Training Initiative – Save the Date!
The Medical Society of the State of New York, along with the New York Psychiatric Association and the National Association of Social Workers-NYS will hold a two-day Veterans Healthcare Training Initiative with interactive seminars and panel discussions on the health and mental health care needs of veterans. Continuing Medical Education (CME) credits will be offered for various programs.

The event will be held on Friday, May 1st and Saturday, May 2nd at the HNA Palisades Premier Conference Center, 334 Route 9W, Palisades, NY 10964.

Registration details coming soon!    (SHERPA)


Veterans Matters: The Special Mental Health Needs of Women Veterans Live Seminar in Saratoga
The Medical Society of the State of New York and the Saratoga County Medical Society are hosting a CME live seminar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Wednesday, March 18, 2020 at 6:45 pm.

Where:
Nove Restaurant
707 Saratoga Road
Wilton, NY  12831

When:     Sign-in/Reception at 6:00pm – Program begins at 6:45pm
Faculty:   Malene Ingram, MD & Colonel, U.S. Army Reserves

Educational Objectives:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify the barriers that women veterans face in getting the specific care they need

Reservations can be made by contacting Gregory Pinto, MD at gregory685@aol.com or (518) 587-0772. Dinner charge for non-MSSNY member is $35.00 and no charge for MSSNY members and their spouses.

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          (SHERPA) 

pschuh@mssny.org mauster@mssny.org pclancy@mssny.org zcary@mssny.org rali@mssny.org

MSSNY ADVOCACY DAY WAS A GREAT SUCCESS WITH OVER 200 PHYSICIANS COMING TO ALBANY ON WEDNESDAY, MARCH 4

MSSNY President Art Fougner, President Elect Bonnie Litvack and Vice
President Joseph Sellers discuss New York’s malpractice problems and
New York’s highest per capita payment.

Dr. Daniel Choi (Suffolk), MSSNY EVP Phil Schuh, Dr. Thomas Lee (Westchester)
and Suffolk County Executive Director Dr. Aaron Kumar.

 

DFS Deputy Superintendent Troy Oeschner was honored for his many years
of assisting MSSNY in resolving several physician payment issues was presented
a plaque by Dr. Andrew Kleinman, who spearheaded the solutions to these
major issues for over a decade.

MSSNY Vice President Joseph Sellers awarded a commemorative
plaque to retiring State Senator James Seward. Dr. Sellers recalled
that he was impressed by Sen. Seward when he visited
one of Dr. Seller’s patients who was hospitalized.

Students representing their medical schools made the trip to
Albany to discuss their issues with their local representatives.

eNews

NY Coronavirus Statistics:

  • NEW YORK #Covid19 numbers
    4,000 people under cautionary quarantine
  • 44 people under mandatory quarantine
  • number of people who’ve tested positive is now 33, with all 11 new cases linked to the New Rochelle lawyer who works in Manhattan.
  • Total infected people hospitalized: 5


Information Sources:

NYS DOH
CDC
Johns Hopkins Global Interactive Map


CMS Issues Guidance on Coronavirus Coverage
WASHINGTON — CMS released information detailing how government health programs and certain plans will cover coronavirus-related services.

The agency also developed an additional code that labs can use to bill for coronavirus diagnostic tests not made by CDC, which CMS says will help boost testing and tracking of new cases. Medicare will cover diagnostic tests on or after Feb. 4 for the coronavirus test, and the health program for the elderly also covers medically necessary hospitalizations, virtual “check-ins” and more.

Children can receive all medically necessary testing and diagnostic services and recommended vaccines are covered without cost-sharing, CMS said.

In the new guidance, CMS reiterates that Obamacare plans will generally have to cover lab tests — with the caveat that states don’t all require the same standard of benefits and some people may see cost-sharing if the insurers haven’t waived co-pays for the tests.

Some insurers have already said they would waive cost-sharing or the tests. However, CMS notes that large employer plans don’t have to follow Obamacare’s rules — so patients with those plans may not be covered or may be on the hook for a co-pay.

The agency hasn’t decided whether a vaccine would be free under Obamacare’s rules for covering preventive treatment but said officials would offer new guidance when a vaccine hits the market.

Hospital costs associated with coronavirus treatment will also vary by state and by plan, CMS said, even though emergency care and hospitalization fall under the ACA’s essential health benefits.

On telehealth, Medicare pays for “virtual check-ins” for patients consulting practitioners they already know, given certain restrictions on time and content, CMS said. It also pays for communication through patient portals.

Medicare patients treated at rural health facilities may be covered for full virtual visits. Medicaid and CHIP telehealth coverage is determined by states.


How to talk to K-12 Children about Coronavirus
School psychologists are worried about coronavirus anxiety among kids in K-12 schools.

The National Association of School Psychologists is offering guidance to school mental health professionals, administrators, school crisis response teams and parents on how to help staff and students cope with the virus, called COVID-19.

Brock, a past president of NASP who wrote some of the guidance, said educators and psychologists can expect questions, and how they respond should depend on the developmental level of the students. In an interview with POLITICO, he offered some advice on how to talk with students about coronavirus.

This transcript has been edited for length and clarity.

What type of impact are you seeing on kids?

What is being reported to us is consistent with kids asking questions and being somewhat anxious, nervous, worried about the extent to which this could affect them. It’s too soon to be really specific regarding the extent to which this is impacting students. Young children are going to be more likely impacted and affected by adult reactions. Older students, conversely, are going to be in a position to more accurately gauge independently the threat presented by COVID-19.

How should school administrators, teachers and psychologists talk to students about this virus? Should they talk about it at all?

It’s going to vary depending upon developmental level. I would suggest that especially for the younger kids, we want their questions to be our guide. So beyond making sure my younger kids are engaging in behaviors that are going to keep them healthy and safe, I’m not going to give them a lot of unasked-for information about things like mortality statistics. … The other thing that I’ll be careful about with younger kids is screening media. There is an appropriate degree of attention to this being given by the media, but younger children may not be able to accurately interpret that. 

What about for middle and high school students?

For older kids, actually, I like to make available well-crafted media reports to help them understand the objective threat that’s being presented to them. 

What if students start asking more detailed questions?

The answer that I’m going to give for ‘What is COVID-19?’ is going to be different for a second-grader than it is going to be for a high school science class. In high school science class, we’re probably going to talk about viruses. Maybe a good teacher might even use this as a teachable moment, work it into the curriculum. For the younger child, it’s more like, ‘Yeah, there’s this flu that’s going around, and it’s a new flu, so we’re kind of worried about it. Do you have any questions about the new flu? 

Are there any concerns about this virus creating stigmas in a school setting?

We have seen that kind of thing in the past where people try to find someone or something to blame. Sometimes that is associated with behaviors that could be labeled bullying. And we do our best to try to mitigate that because it’s just not helpful. For the kid that’s bullied, now they’re stressed about being sick and they’re being bullied on top of it. For the bully, it’s just not an adaptive behavior. 

Brock provided some questions he expects from young children and how he would respond:

Question: Will I get sick?

Answer: We don’t know. I can’t promise you that you will not get sick, but there are some very important things you can do to help keep yourself and others healthy [and then list guidance offered by the CDC.

Question: What will happen if I get sick?

Answer: When people get this virus, they will have a temperature, a cough, and it might be difficult for them to catch their breath. Very few children are getting sick, but when they do, parents, doctors and other adults are able to help them feel better [CDC].

Statement: I am scared of coronavirus!

Response: During cold and flu season people do get sick, and sometimes so sick they need to see a doctor. It is a very good idea to do what we can to stay healthy. In our community … [and then offer any specific guidance from local health officials regarding whether or not a given community is at risk]. Here are things you can to do to keep from getting sick [and then list guidance offered by the CDC].

Question: Why is everyone talking so much about coronavirus?

Answer: Because it is new and for some people who are very old and not in good health it might cause them to see a doctor and go to the hospital.

Question: Will I die?

Answer: So far very few children are getting sick, and no young children have died. [If you are talking to a child 9 years of age or younger you could say: “So far no child your age has died.” (References have been made to World Meter and JAMA)


Low Back, Neck Pain Costs Are the Most Expensive Health Conditions

The total U.S. health bill for 2016 — excluding over-the-counter drugs, home health care, and spending on research and infrastructure — came to some $3.1 trillion, researchers estimate in JAMA. That represents over a doubling in spending since 1996.Payment came from private health insurers (48%), government health insurance (43%), and out-of-pocket payments (9%). Low back and neck pain constituted the top two spending spots. These two, combined with other musculoskeletal disorders, consumed over a quarter of a trillion dollars in 2016.

A commentator notes encouraging declines in spending for ischemic heart disease, heart failure, colorectal cancer, and lower-respiratory-tract infections, which “likely reflect population-wide improvements in primary and secondary prevention.”

What weren’t encouraging were findings for rheumatoid arthritis and multiple sclerosis, where expensive specialty drugs are commonly used. For such drugs, he advocates negotiations with drug makers based on “rigorous cost-effectiveness analysis.”

Regular Use of Fish Oil Linked to Lower Risk for Premature Death
Research links “regular use of fish oil supplements to a lower risk of premature death and cardiovascular disease (CVD).” Investigators “kept track of participants over a nine-year period on average, and found that fish oil supplements were associated with a 13% lower risk of death, a 16% lower risk of dying from cardiovascular disease, and a 7% lower risk of cardiovascular disease events such as stroke or heart attack.” The findings were published in the BMJ.


Smartphone Users More Likely to Use Pain-Relieving Medication for Headaches
Researchers investigating the association between smartphone use and new headaches “found that smartphone users were more likely to use more pain medication but find less relief compared to those who didn’t use smartphones,” according to a new study published in Neurology Clinical Practice. Specifically, “96% of smartphone users were more likely to take pain-relieving drugs compared to 81% of non-smartphone users.” Moreover, “smartphone users also reported less relief from headaches after taking medication, with 84% finding moderate or complete relief from headache pain compared to 94% of non-users.”

 


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if youThank you.
(WILKS)


Dr. Michael Goldstein Running for Congress in Connecticut
New York County Medical Society Trustee and Past President Michael T. Goldstein, MD, JD, is running for office.   He is running in the Connecticut  Fourth Congressional District  —  information about his platform, which  has a strong health care component, naturally  —   is available at Goldstein for Congress.


Dr. Fougner and Dr. Choi

MSSNY President Dr. Art Fougner and Young Physicians
Chair Dr. Daniel Choi at the NY Academy of Medicine
last Saturday, March 1.

Medical Students

YPS Meeting in Manhattan. From left. Dr. Purvi Parikh
who was a panelist for Milennials in Private Practice;
Is It Even Possible?”: Dr. Erik Eiting; Dr. Carlos Zapata;
and Moderator Dr. Daniel Choi.

 


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ANNOUNCEMENT OF ANTICIPATED JOB OPPORTUNITY
Open to the Public

TITLE Community Health Program Manager 3 – 32201
SALARY/GRADE $109,956 – $138,763 / M-4
NEGOTIATING UNIT Management Confidential (06)
LOCATION
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Corning Tower, Empire State Plaza
Albany, NY 12237
MINIMUM QUALIFICATIONS
TRANSFER: Current NYS employee with one year or more of contingent-permanent or permanent competitive service in a title at or above Grade 29/M-3 and eligible for transfer under Section 52.6 of the Civil Service Law.
PROVISIONAL*: a bachelor’s degree AND seven years professional public health experience in a governmental public health agency or public health program* that receives funding from a public health governmental agency. Of the seven years required experience, three years must include supervision of professional staff and the following management responsibilities: program planning and implementation, AND program evaluation and monitoring, AND development and implementation of policies and procedures.
The required professional experience must include either:

1. Designing or implementing a public health outreach, promotion, or disease prevention program; OR
2. Conducting disease surveillance or a disease control program.

For the purposes of this recruitment, a public health program focuses primarily on the prevention of disease through outreach and public health education or health promotion, including population-based plans of care, not just plans of care for individual patients, or the study of the prevalence or causes of disease through population-based studies.
Examples of non-qualifying experience include, but are not limited to: providing clinical care in therapeutic health care facilities including public hospitals, physician’s offices, supervised community-based settings or home care settings; discharge planning or utilization review; developing treatment plans for patients in community settings; regulatory oversight of health care providers to determine compliance with laws, rules or regulations; reviewing appropriateness of services for insurance companies, Medicare, Medicaid, governmental agencies or other third-party payors; or other experience limited to administrative support of public health programs such as operations management, personnel, staff development, fiscal administration, contract/grant management, budgeting or health care finance is not considered qualifying, nor is the provision of medical services to a fixed population.

Read More Here


 

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

 

MSSNYeNews: A Colleague in Need Is a Colleague Indeed – February 28, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 28, 2020

Vol. 23  Number 9


MSSNYPAC Seal

 


Colleagues:

You can’t live a perfect day without doing something for someone who can never repay you.”
–John Wooden

I had just finished dinner when I got the call. A physician, whom many of you reading this may know, was calling, mainly out of desperation, seeking a sympathetic ear. Embroiled in a horrific family court battle over an adopted special needs child and the family may be at the end of the line. Quite frankly, this was a cry for help. I listened, made a few suggestions and agreed to cross our fingers, make a plan and hope for the best. This struggle has not been without cost, not only emotional but financial as well.

The word colleague is derived from two Latin words – college (one chosen along with another) and legare (to send or choose as a deputy.) But these are often merely words describing associates. For physicians, a colleague is more than that – we are all members of a fellowship. We took an oath. Part of that oath conveys a duty to each other. If one of us is in trouble, we all are in trouble. We should be the embodiment of Dumas’ “All for one and one for all.” If you are so inclined, there’s a Go Fund Me page.

Oh yes, one more thing – See You In Albany!

We will all go down together.

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President



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Capital Update

This Week’s Legislative Podcast


Please Plan to Be in Albany for MSSNY‘s Annual “Physician Advocacy Day” Wednesday March 4th
Are you planning to join us this Wednesday in Albany? With the Governor’s Budget Proposal teeing up items for serious concern such as Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, but also supported reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.       (ALI)


Governor Cuomo Announces Emergency Appropriation to Combat Coronavirus
Gov. Andrew Cuomo announced this week $40 million emergency appropriation to assist state and local governments to hire staff and procure equipment necessary to combat the coronavirus.   Additionally, the governor will seek legislation that would grant authority to NYS Health Commissioner Howard Zucker, MD, to ensure that health department and hospitals to take certain actions in response to the outbreak.

DOH will also convene local health departments and hospitals to ensure that appropriate protocols are in place for responding to the virus.  Gov. Cuomo has also called upon the federal government to authorize the Wadsworth Lab and NYC Public Health Lab to test for the virus, which would allow expanded capacity within the northeast.  Gov. Cuomo indicated that the state has worked to develop and validate a test that complies with protocol.

New York State has had 26 patients that have tested negative for the virus as of Feb. 26th.   Coronavirus is now a reportable disease and physicians are required to report suspect cases to their local department of health.  NYS also has a coronavirus hotline at 1-888-364-3065.  Physicians can find further information by going to the New York State Department of Health website for healthcare providers here.

NYC physicians should click here.

DOH has also issued a Feb. 11th letter to physicians about patients who presented with respiratory symptoms.

Evaluating and Reporting Persons Under Investigation (PUI) – Click here.

(CLANCY)


 

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Please Urge Your Legislators to Reject Unfair Disregarding of Physician Due Process
With Part L of Governor’s proposed Health/Mental Hygiene Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to continue to contact their legislators to urge that the Legislature reject this unfair proposal, and plan to be in Albany this Wednesday, March 4 for Physician Advocacy Day.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.

That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.   

MSSNY has joined with 18 state specialty societies and the NYS Society of Physician Assistants in a communication to the Legislature setting forth our concerns in greater detail.  Moreover, thousands of physicians from across the State have contacted their local legislators to express their severe concerns with this grossly unfair proposal.  Have you?

Please urge your legislators to reject this proposal from the Budget.   (AUSTER)


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MSSNY and Public Health Organizations Advocate for Ban on Flavored Vaping and Tobacco Products
This week, MSSNY joined with over 50 other public health organizations in urging the New York State Legislature enact legislation that would ban flavored vaping and tobacco products. S.428B/A.47A sponsored by Senator Brad Hoylman and Assemblywoman Linda Rosenthal, would ban flavored vaping products, including menthol.  The bill is currently on the floor in the state senate and in the Assembly Codes Committee.

A. 8808/S. 6808, sponsored by Assemblywoman Rodneyse Bichottee and Senator Hoylman, would ban flavored tobacco products such as cigarillos and chewing tobacco.  Gov. Andrew Cuomo has also proposed in his New York State budget that the Legislature implement a ban on flavored vaping products.  MSSNY is working with groups such as NYS Association of County Health Officials, the American Heart Association, the American Cancer Society, the NYS PTA, Campaign for Tobacco Free Kids, the NYS Chapter of the AAP and Roswell Park to enact these provisions.
(DIVISION OF GOVERNMENTAL AFFAIRS)


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MSSNY to State Legislature – Elimination of Excess Liability Program Will Diminsh Patient Access to Specialized Care
Physicians are urged to contact their legislators to request that the Excess Medical Malpractice Insurance Program be extended.  This program, which provides nearly 17,000 physicians across the State with an additional $1 million/$3 million of liability coverage above the primary $1.3M/$3.9M layer, is being proposed to be eliminated after June 30.  This is despite the fact that this coverage is needed more than ever due to New York’s excessive and growing liability costs that far exceed all other states.  A letter to your legislators can be sent here.

Unfortunately, the Excess program has become a “political pawn” in discussions regarding ways to address the State’s huge budget deficit.    The liability exposure level of physicians makes it clear that this Excess protection is more essential than ever.   Without this protection, many physicians will face difficulties continuing to practice. Indeed, those who would be dropped would be personally exposed to financial ruin in the event that a judgment or award exceeded the limits of the primary layer.  If anything, the program actually needs to be expanded, not diminished.

Let your legislator know that, in the absence of comprehensive medical liability reform, physicians need this secondary layer of liability insurance to protect against New York’s excessive verdicts and settlements. (AUSTER)


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Physicians Urged to Contact Their Legislators to Oppose Massive Liability Premium Increasing Legislation
All physicians are urged to contact their Senators and Assemblymembers to urge that they oppose harmful legislation (S.4006/A.5612) that would enormously expand the damages awardable in a wrongful death legal action.  One recent actuarial study concluded that, if this legislation were to be enacted, it would require medical liability premiums increase to increase 47%!!  A letter to your local legislators can be sent from here.

This week the legislation was reported from the Senate Judiciary Committee to the Senate Finance Committee by an 8-1 vote.  However, the vote did receive some pushback as Senator Diane Savino (D-Staten Island) voted against the legislation and Senators Neil Breslin (D-Albany County), AndrewGournades (D-Brooklyn), Ken LaValle (R-Suffolk County), Tom O’Mara (R-Southern Tier) and Kevin Thomas (D-Nassau County) voted “without recommendation”.

Legislators need to understand the downstream impact of these measures.  At a time when New York physicians and hospitals already incur the highest liability costs in the country by far, legislation that requires any increase in premiums, let alone at the level this legislation would require, cannot be incurred without creating a serious adverse impact in patient access to needed care across New York State.  (AUSTER)


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MSSNY, County Medical Societies Testify to Provide Medicaid Cost-Savings Recommendations
As the newly configured Medicaid Redesign Team (MRT2) continues its work to arrive at recommendations to achieve $2.5 billion in savings for inclusion in the April 1 State Budget deadline, physician leaders and physician advocates promoted its’ recommendations at Rochester and Albany MRT2 public forums.

Their recommendations included: expansion of Medicaid coverage for in-home physician care visits and telemedicine to help reduce rising transportation costs, expansion of the Patient-Centered Medical Home program (which according to DOH has demonstrated itself to reduce patient medical costs), and long overdue liability medical liability reform (since the State must subsidize the excessive liability costs in New York that are much less in other states).

Here is the link to the Albany forum with testimony at the 1:12 mark by MSSNY Vice-President and Cobleskill pediatrician Dr. Joe Sellers.

Here is a the link to the Rochester forum at 2:00 mark by Monroe County Medical Society Executive Director Chris Bell.

MSSNY President and Queens OB-GYN Dr. Art Fougner is slated to speak at the Monday forum in New York City.   (AUSTER)


Physician Mandate Bills Begin to Pile Up in Albany
As if physicians needed one more reason to be in Albany on March 4, the State Legislature has been advancing numerous bills through its Committee process that, while well-intended, would place substantial new mandates on physician care delivery at a time when physicians are already drowning in administrative tasks that take time away from patient care delivery.  They also unfairly place the physician at risk of financial penalty by DOH or even license sanction by the OPMC if the physician fails to document even one time that they performed the mandated task. These proposals include:

  • Mandated conspicuous posting in a physician’s office of a patient’s ability to file a complaint with the Office of Professional Conduct (A.7991-A/S.6678-A). Assembly Floor/Senate Floor
  • Mandated notification to epileptic patients of the risk of sudden death due to epilepsy (S.5397-A/A.7807-A). On Assembly Floor/On Senate Floor
  • Mandated co-prescribing of naloxone for patients: a) taking 50 mmg per day b) with a history of substance use disorder or c) concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics (S.5150-B/A.5603-B). Passed Senate.  In Assembly Ways & Means
  • Mandated reporting of rescue inhaler prescriptions to the statewide immunization system (S.7337). On Senate floor
  • Mandated dissemination of a pamphlet prior to performance of a pelvic exam (S.7544/A.9600). On Senate floor/In Assembly Health
  • Mandated procedure for a maternal health care provider to provide written notification to patients regarding the risks of a C-section (A.318-A/S.2888-A). Passed Assembly/In Senate Women’s Issue Committee
  • Mandated proof of completion of CME on cultural competency, including paying for an additional fee to SED on top of the biennial $600 registration fee (S.2406-A). Passed Senate/In Assembly Higher Education Committee
  • Mandated seeking of a detailed patient/family member consent for a nursing home resident prior to the receipt of a psychotropic medication, or detailed documentation of the need to provide such medication without consent (A.1033/S.5441). Passed Assembly/In Senate Health Committee
  • Mandated completion of additional questions for the NYS Physician Profile including office hours, whether accepting new patients and an unknown number of practice demographic questions. Contained in Part K of the Governor’s proposed Health/Mental Hygiene Budget bill. (DIVISION OF GOVERNMENTAL AFFAIRS)


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“Coronaviruses 2020” CME Webinar on March 18th Registration Now Open
The first suspected case of locally acquired COVID-19 in the United State was announced on February 27, 2020.  Learn more about this and other coronaviruses by signing up for Medical Matters: Coronaviruses 2020 on March 18th at 7:30am.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar.   

Educational objectives are:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role in the public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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


Registration Now Open for CME Series on Pain Management, Palliative Care & Addiction; NYS Requires Every Prescriber to Take 3 Hour Course by July 1, 2020
The Medical Society of the State of New York announces an updated series of three one-hour CME webinars on pain management, palliative care and addiction.  New York State statute requires all prescribers, holding a DEA license, to complete three hours of coursework every three years.  Coursework must include the following:

  • New York State and federal requirements for prescribing controlled substances
  • Pain management
  • Appropriate prescribing
  • Managing acute pain
  • Palliative medicine
  • Prevention, screening and signs of addiction
  • Responses to abuse and addiction
  • End of life care

These webinars are being offered FREE OF CHARGE to MSSNY members. A discount code was emailed to members on February 24, 2020.  Please contact Melissa Hoffman at mhoffman@mssny.org if you did not receive this discount code.

The Medical Society of the State of New York has worked with the New York State Office for Alcoholism and Substance Abuse Services (OASAS) in the development of this program.  Following the webinars, the course will be offered on-line on the MSSNY CME site.   The program will be offered to MSSNY members free of charge and there is a non-member fee of $150 for the on-line series.

The three webinars cover all issues required in the New York State statute and participation is only by computer, or with the Webex app.

Webinars will be held on: Tuesday March 10, 2020—7:30-8:30am

Understanding the Current Legal Landscape in New York State for Prescribing Controlled Substances

Faculty: Patricia Bruckenthal, PhD, APRN-BS, FAAN & Robert Kent, Esq., NYS OASAS General Counsel

Educational Objectives:

  • Understand New York State and Federal Requirements for Prescribing Controlled Substances
  • Discuss Guidelines for Chronic Pain

Register for this webinar.

Tuesday March 17, 2020—7:30-8:30am

When to Consider Opioid Therapy for Chronic Non-Cancer Pain & in Palliative Care

Faculty: Charles Argoff, MD

Educational Objectives:

  • Discuss evidence based best practice recommendations for opioid therapy for chronic pain, patient risk assessments and documentation
  • Describe palliative medical care and end-of-life care

Register for this webinar.

Tuesday March 24, 2020—7:30-8:30am

Patients with Opioid Use Disorders: Identification, Treatment, and Management of Co-occurring Pain

Faculty: Jeffrey Selzer, MD, Marc Manseau, MD, MPH, NYS OASAS Medical Director

Educational Objectives:

  • Describe the Potential for Addiction, Patient Screening, Diagnosis and Subsequent Treatment or Referral
  • Recommend Tools to Assist in the Identification of High-Risk Patients for Whom Opioids are Indicated and Prescribed
  • Describe Strategies for Treating Pain in Patients with Substance Use Disorders

Register for this webinar.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org or 518-465-8085


Veterans Matters: The Special Mental Health Needs of Women Veterans Live Seminar in Saratoga
The Medical Society of the State of New York is hosting a CME live seminar entitled Veterans Matters: The Special Mental Health Needs of Women Veterans on Wednesday, March 18, 2020 at 6:45 pm at Nove Restaurant, 707 Saratoga Road, Wilton, NY 12831.

Malene Ingram, MD & Colonel, U.S. Army Reserves, will serve as faculty for this program. The educational objectives are:

  • Review how the increased role of women in the military has impacted their mental health
  • Describe mental health concerns unique to women veterans and how to identify them
  • Identify barriers that women veterans face in getting the specific care they need

Reservations can be made by contacting Gregory Pinto, MD at gregory685@aol.com or (518) 587-0772. Dinner charge for non-MSSNY member is $35.00 and no charge for MSSNY members and their spouses.

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.                      (HOFFMAN)


 

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Register now for CME Course at MSSNY House of Delegates April 23 & 24
MSSNY will be offering multiple CME courses on Thursday April 23rd and Friday April 24th at the 2020 House of Delegates in Tarrytown.

Click here to register for as many or few of these offerings as you can. 

Thursday April 23, 2020

1:00-2:00pm       Medical Matters: Triage in a Disaster Event

2:00-3:00pm       Veterans Matters: TBI in Returning Veterans

3:00-4:00pm       Steps to Physician Wellness and Resiliency

4:00-5:00pm       The Health of Sexual and Gender Minorities

Friday April 24, 2020

1:00-4:00pm       Pain Management, Palliative Care & Addiction

For more information please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085.


Veterans Mental Health Training Initiative – Save the Date!
The Medical Society of the State of New York, along with the New York Psychiatric Association and the National Association of Social Workers-NYS will hold a two-day Veterans Healthcare Training Initiative with interactive seminars and panel discussions on the health and mental health care needs of veterans. Continuing Medical Education (CME) credits will be offered for various programs.

The event will be held on Friday, May 1st and Saturday, May 2nd at the HNA Palisades Premier Conference Center, 334 Route 9W, Palisades, NY 10964.

Registration details coming soon!              (HOFFMAN)

eNews

Novel Coronavirus Information

NYS DOH

CDCEvaluating and Reporting Persons Under Investigation (PUI)

CDC – Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020

INFO BY NY COUNTY

JOHNS HOPKINS CENTER FOR SCIENCE AND ENGINEERING INTERACTIVE INTERNATIONAL MAP IN REAL TIME


New US Coronavirus Cases: Human Testing for Drug Begins
Fifty-seven COVID-19 cases have been reported in the U.S. as of 9 a.m., Feb. 26. This is an increase from 53 cases reported by the CDC Feb. 24. The source of exposure for the new cases is currently unknown.    

U.S. Residents Should Expect Community Spread of Novel Coronavirus

A top CDC official warned Feb. 25,  “It’s not so much a question of if this will happen anymore, but when and how many people in this country will have severe illness,” said Nancy Messonnier, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases. https://www.cdc.gov/media/releases/2020/a0225-cdc-telebriefing-covid-19.html

The CDC on Tuesday warned that it expects the novel coronavirus that has sparked outbreaks around the world to begin spreading at a community level in the United States, as a top official said that disruptions to daily life could be “severe.”

“As we’ve seen from recent countries with community spread, when it has hit those countries, it has moved quite rapidly. We want to make sure the American public is prepared…As more and more countries experience community spread, successful containment at our borders becomes harder and harder,” she said.

There have been 14 cases of the virus diagnosed in the U.S., all in people who traveled recently to China or their close contacts. Another 39 U.S. residents have been infected in other parts of the world before being repatriated and quarantined. But CDC officials say the country could soon see more cases as the virus starts to spread through communities in areas outside China, including Iran, South Korea, and Italy. (Feb. 25)


Majority of Current/Former Smokers Don’t Get Recommended Cancer Screenings
The majority of those who ought to be getting annual lung cancer screenings aren’t getting them, according to a new CDC analysis. Among those ages 55-80, the U.S. Preventive Services Task Force recommends annual screenings for current smokers or those who quit in the past 15 years and who have a history of smoking at least 30 packs of cigarettes a year.

But according to data on screening collected by 10 states in 2017, around 12% of adults met the USPTF criteria, but only a small fraction of those individuals actually got a CT scan in the previous year to screen for cancer. Of the 10 states that reported the data, Florida had the highest rate of lung cancer screenings, with 16% reporting having had CT scans. The data is only from a minority of states but indicate a need for better public health initiatives to educate people about screening, according to the report.


AMA Statement on Ninth Circuit Title X Decision
 “The American Medical Association (AMA) is disappointed by – and strongly disagrees with – the reasoning behind a federal appeals court’s decision to allow the Trump administration to enforce a gag rule on physicians.

“The judges failed to properly take into consideration the AMA’s legal arguments or the decision’s impact on either health care or the patient-physician relationship. This government overreach and interference demands that physicians violate their ethical obligations – prohibiting open, frank conversations with patients about all their health care options – if they want to continue treating patients under the Title X program. It is unconscionable that the government is telling physicians that they can treat this underserved population only if they promise not to discuss or make referrals for all treatment options.

“As this case moves to the next stage, we’ll continue to fight for open conversations between patients and physicians – the cornerstone of quality health care.”

Statement Attributable to:
Patrice A. Harris M.D., M.A.
President, American Medical Association


Lung Cancer More Prevalent Among Young Women Than Young Men in US
Cancer Therapy Advisor (2/19) reports researchers found that “the incidence of lung cancer appears to be higher among young women compared with young men in the United States as well as 5 other countries.” The findings were published in the International Journal of Cancer.


Physicians Seeing Increasing Number of Young Adults with Symptoms of Alcohol Consumption-Related Acute Liver Disease
Last month, “the National Institute on Alcohol Abuse and Alcoholism published a study” indicating that “from 1999 to 2017 the number of alcohol-related deaths per year doubled, rising from 35,914 to 72,558,” with “just under a third of those” resulting “from liver disease.”

This “trend is particularly pronounced in middle-aged women, where studies suggest that high-risk drinking is the highest it has ever been.” Physicians are seeing an increasing number of “people in their 20s and 30s with symptoms of acute liver disease related to alcohol consumption.”


FDA Approves New Cholesterol-Lowering Drug
The FDA has approved bempedoic acid (marketed as Nexletol) to help lower LDL cholesterol in adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease for whom statins are deemed insufficient. The oral ATP citrate lyase inhibitor, the first approved in its class, acts by decreasing cholesterol biosynthesis and upregulating LDL receptors, the manufacturer says.

It’s indicated as an adjunct to diet and maximally tolerated statin therapy. In phase 3 studies comprising over 3000 patients, once daily bempedoic acid was superior to placebo (a mean 18% placebo-corrected LDL reduction) in patients also taking moderate- or high-intensity statins. The manufacturer notes that uric acid levels should be monitored in those taking bempedoic acid, as it may increase risk for gout. Additionally, the drug has been associated with tendon rupture and should not be used in patients with prior tendon disorders.

Bempedoic acid’s effects on cardiovascular morbidity or mortality are unknown, the manufacturer says.
Background: NEJM Journal Watch Cardiology coverage of phase 3 s


Medicaid

Across the Board (ATB) Medicaid Payment Reductions
Effective for dates of service on or after January 1, 2020, through March 31, 2020, and each State Fiscal Year thereafter, all non-exempt Department of Health state funds Medicaid payments will be uniformly reduced by 1%. For services subject to the 1% reduction, all fee-for service payments will receive a decrease to Medicaid checks and/or Electronic Funds Transfers for dates of services on or after January 1, 2020. Conversely, managed care payments to health plans will be reduced through a 1% reduction to premium rates effective January 1, 2020. Remittances will reflect the 1% reduction (appearing as an “FC2” recoupment) starting in cycle 2219, which has a check release date of 3/18/2020.
Please Click Here to read the full physician notice; or call 1-800-343-9000
emednyalert@csra.com


MSSNY Past President Dan O’Keeffe Dies at 98
MSSNY President Dr. Dan O’Keeffe died Sunday, Feb. 23, 2020. He was 98½ years old and leaves his legacy. Raised in his beloved North Creek, he was a star basketball player at Johnsburg Central School, ski champion, and avid hunter. He attended Holy Cross College and did his medical education and training at the Albany Medical Center. After serving in the Air Force, he settled in Glens Falls and touched many lives as a physician practicing obstetrics and gynecology.

In 1951, he started the practice that became Women’s Care in Glens Falls. Over 40 years, he delivered more than 10,000 babies. He served as president of the Warren County Medical Society, St. Luke Physician’s Guild, Warren County Chapter of the American Cancer Society, Medical Staff of the Glens Falls Hospital, and the New York State Medical Society.

He was the chief gynecologist at the 1980 Winter Olympics in Lake Placid. At age 65, he decided to take up tennis and went on to become the Senior Olympic US National Champion in his 80s. Dr. Dan also wrote and published four books: One Heartbeat From Heaven (The Story of the O’Keeffe Hunting Camp 1915-1965); Halfway To Heaven (Livin’ in the “Crick”); Ride Up – Slide Down (A History of Skiing at Gore Mountain); You Really Made Housecalls? (The Practice and Politics of Medicine). He was very proud that all three of his children followed his footsteps, each becoming an OB/Gyn physician, Jim O’Keeffe, MD, Dan O’Keeffe III, MD, and Kate O’Keeffe, MD. He is survived by nine grandchildren, and five great-grandchildren.

To express online condolences visit www.sbfuneralhome.com.


 


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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Council – March 5, 2020

AGENDA
MSSNY Council Meeting
Thursday, March 5, 2020
Albany Renaissance Hotel
144 State Street
Albany, NY  12207

A. Call to Order and Roll Call

B. APPROVAL of the January 30, 2020 Minutes

C. New Business (Informational/Action Items)

1.  President’s Report (No Written Report Submitted)

2.  Board of Trustees Report – Dr. Sam Unterricht will present the report (handout)

3.  Secretary’s Report – Dr. Frank Dowling will present the report

4.  MLMIC Update –  Dr. Lombardo will present the report  (verbal)

5.  AMA Delegation Report – Dr. John Kennedy will present the report (verbal)

6.  MSSNYPAC Report– Dr. Thomas Lee will present the report (handout)

7.  County Federation Report – Dr. Aaron Kumar will present the report

8. Commissioners (Action Items – For Council Approval)
 a. Commissioner of Science & Public Health, Joshua M. Cohen, MD
•  Resolution 2019-73 – Hospice Recertification for Non-Cancer
Diagnosis (i.e.dementia)
•  Resolution 2019-274 – End of Life Care Payment
•  Resolution 2019-111 – MSSNY Support for Impairment Research
•  MSSNY Policy 125.996

D. Reports of Officers (Verbal)

  1. Office of the President – Arthur C. Fougner, MD
  2. Office of the President Elect – Bonnie L. Litvack, MD
  3. Office of the Vice President – Joseph R. Sellers, MD
  4. Office of the Immediate Past President – Thomas J. Madejski, MD
  5. Office of the Treasurer – Mark J. Adams, MD Financial Statement for the period 01/01/19 to 12/31/19
  6. Office of the Speaker – William R. Latreille, Jr., MD

E. Reports of Councilors  (Informational Items)

  1. Kings & Richmond Report – Adolph B. Meyer, MD
  2. Manhattan & Bronx Report – Joshua M. Cohen, MD
  3. Nassau County Report – Paul A. Pipia, MD
  4. Queens County Report – Saulius J. Skeivys, MD
  5. Suffolk County Report – Linda S. Efferen, MD
  6. Third District Branch Report – Brian P. Murray, MD (No Report Submitted)
  7. Fourth District Branch Report – Gregory L. Pinto, MD (No Report Submitted)
  8. Fifth District Branch Report –Howard H. Huang, MD
  9. Sixth District Branch Report – Robert A. Hesson, MD (No Report Submitted)
  10. Seventh District Branch Report – Janine L. Fogarty, MD
    (No Report Submitted)
  11. Eighth District Branch Report – Mark R. Jajkowski MD
  12. Ninth District Branch Report – Thomas T. Lee, MD
  13. Medical Student Section Report – Peter Joo (No Report Submitted)
  14. Organized Medical Staff Section Report – Stephen F. Coccaro, MD
  15. Resident & Fellow Section Report – Catherine Steger, DO
    (No Report Submitted)
  16. Young Physician Section Report – L. Carlos Zapata, MD
    (No Report Submitted)

F. Commissioners (Informational Items)

1.  Commissioner of Continuing Medical Education, Mark J. Adams, MD
   (No written report submitted)

2.  Commissioner of Communications, Maria A. Basile, MD, MBA
  a. Report from the Division of Communications

3.  Commissioner of Governmental Relations, Gregory Pinto, MD
  a. Physicians & Physician Assistants Discipline Sign-on Letter
  b. Letter addressed to Honorable Heastie & Stewart-Cousins regarding
patient care in New York State
  c. 2020-2021 Budget Priorities
  d. Testimony

  e. Long Term Care Minutes
  f.  Quality Improvement and Patient Safety Minutes

4. Commissioner of Membership, Parag H. Mehta, MD  
 Membership Committee Report (verbal)

5. Commissioner of Science & Public Health, Joshua M. Cohen, MD
 a. Addiction & Psychiatric Medicine Minutes
 b. Committee to Eliminate Health Disparities Minutes
 c. Heart, Lung & Cancer Minutes
 d. Infectious Diseases Minutes
 e. Physician Wellness & Resilience Minutes

6. Commissioner of Socio Medical Economics, Howard H. Huang, MD
    (No written report submitted)

G. Report of the Executive Vice President, Philip Schuh, CPA, MS

  1. Membership Dues Revenue Schedule
  2. Group Institutional Dues Comparison Report

H.  Report of the General Counsel, Garfunkel Wild, P.C. Sandra Jensen, Esq.

Approval – Queens County Medical Society Bylaws (Action Item)

I.  Report of the Alliance, Barbara Ellman
Alliance Report

J. Other Information/Announcements
1. Medicaid Fiscal Accountability Regulation Letters
2. Prior Authorization Letters

K. Adjournment

 

 

 

 

MSSNY Statement on Excess Medical Liability Insurance Program


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
February 21, 2020

MSSNY STATEMENT ON EXCESS MEDICAL LIABILITY INSURANCE PROGRAM 

Statement attributable to:
Art Fougner, MD
President, Medical Society of the State of New York

“Getting rid of New York’s Excess Medical Liability Insurance program without taking steps to bring down our exorbitant costs will very likely result in not being able to find a physician who will want to practice in New York in future years.

It is well documented how aberrant New York’s liability costs are compared to the rest of the country. The Excess program helps provide a modicum of protection for NY’s Doctors.

Unless the State Legislature decides to enact liability reform, extending this Excess program is essential for preserving patient access to specialized care.”

# # #

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.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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MSSNYeNews: Stupid Insurance Tricks, Continued – February 21, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 21, 2020

Vol. 23  Number 8


MSSNYPAC Seal

 


Colleagues:

Apparently, Meyer Lansky chose the wrong racket. Case in point – Advanced Gynecology and Laparoscopy of North Jersey, et al v CIGNA Health and Life Insurance.

In summary, the lawsuit alleges that CIGNA accepts the out-of-network provider’s claims at the full billed amount and requests the same amount from the self-insured health plan. However, instead of paying the medical provider or member, CIGNA hires a Repricing Company to try and negotiate a reduction. If the provider refuses to negotiate, CIGNA pays the claim at an exorbitantly low level but appears to keep the difference between what was removed from the self-insured health plan and what was paid to the medical providers. In an attempt to conceal this from the patient and self-insured health plan, CIGNA issued Electronic Remittance Advice or paper Explanation of Benefits forms (collectively, the “EOB”) misrepresent the balance as “Discount” to the members, certifying the member is not responsible for the balance, while simultaneously representing the balance to the Plaintiffs as member liability or “Amount Not Covered”.

Curiously, CIGNA has been actively suing out-of-network physicians for not collecting patient liabilities in full. Moreover, the complaint includes allegations of RICO violations as well. You can read the whole thing at the above link.

Yes, as through this world I’ve wandered
I’ve seen lots of funny men;
Some will rob you with a six gun.
And some with a fountain pen.
–Woody Guthrie, Pretty Boy Floyd

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President


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eNews

Urge Your Legislators to Reject Undermining Physician Due Process
With Part L of Governor’s proposed Health/Mental Hygiene Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to continue to contact their legislators to urge that the Legislature reject this unfair proposal, and plan to be in Albany on March 4 for Physician Advocacy Day.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.  That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.   

MSSNY has joined with 16 state specialty societies in a communication to the Legislature setting forth our concerns in greater detail. Moreover, MSSNY President Dr. Art Fougner recently appeared on the WCNY “Capitol Pressroom” radio program to discuss MSSNY’s concerns with this proposal.

Please urge your legislators to reject this proposal from the Budget.


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One-Sided Surprise Bill Proposals Advance in Congress – Contact Your Representatives Today
All physicians are urged to continue to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative to express strong concerns with the various proposals before Congress that would substantially limit insurer responsibility for coverage of out of network emergency and surprise medical bills.  A letter can be sent here.

While MSSNY supports the goals of legislation to prevent surprise medical bills, most proposals advanced so far are steered heavily to the benefit of insurance companies, and do not have the balance of New York’s law.  Last week the House Ways & Means Committee and Education & Labor Committee advanced separate proposals.  While the Ed & Labor proposal was very similar to Energy & Commerce proposal advanced last year strongly opposed by MSSNY and many other physician organizations, the W&M proposal did make a few marginal improvements including rejecting a benchmark payment and permitting the consideration of many factors.

However, the IDR mechanism identified in the legislation would also prohibit the consideration of physician charge data and require the consideration of median in-network data, which in all certainty will skew the results towards the insurance companies.  In fact, when the proposal was scored by the Congressional Budget Office (CBO), it was noted that “in facilities where surprise bills are likely, average payment rates for both in- and out-of-network care would move toward the median in-network rate.  Moreover, the proposal only provides for a minimal review of insurer networks, which is the major contributing factor to the problem of surprise bills.

Therefore, this proposal remains highly problematic, and MSSNY President Dr. Art Fougner offered this statement supporting efforts to “ensure a fair federal legislative solution to protect patients from surprise out of network bills”, but that “far more balance is needed in what has been put forward so far”, and that the proposal released Friday by the US House Ways & Means “provides a few marginal steps forward but would still hand an enormous gift to already market dominant health insurance companies by tilting the factors in its dispute resolution mechanism towards the insurance industry.”


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“Coronaviruses 2020” CME Webinar on March 18th Registration Now Open
There have been 29 confirmed cases of COVID-19 in the United State as of February 20, 2020.  Learn more about this and other coronaviruses by signing up for Medical Matters: Coronaviruses 2020 on March 18th at 7:30am.  William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.  Please click here to view the flyer for this program.

Educational objectives are:

  • Become familiar with the epidemiology and clinical features of coronaviruses
  • Understand the physician’s role int eh public health response to an infectious disease outbreak
  • Identify the circumstances that have contributed to the rapid spread of COVID-19

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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


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Registration Now Open for Steps to Physician Wellness and Resiliency
MSSNY’s Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here.  Please click here to view the flyer for this program.

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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

Physician Wellness Flyer


Several NY Counties Pushing Back Against Gov.’s Medicaid Cost-Shifting Plan
The Buffalo (NY) News (2/14) reported, “Officials from Erie County, New York City and elsewhere are pushing back on an additional Medicaid cost-shifting plan that they say could be even worse than what Gov. Andrew M. Cuomo recently proposed in his new budget.” This “latest fight is over millions of dollars counties receive each year from the federal government for additional Medicaid services and costs under the Affordable Care Act.”


 

Dr. Pinto

Saratoga County President Greg Pinto, MD with Assemblywoman Carrie Woerner, Assembly District 113 (Saratoga) at 2-19-2020 Legislative Update meeting of the Saratoga County Medical Society.


NYS DOH Flu Tracker
https://nyshc.health.ny.gov/web/nyapd/new-york-state-flu-tracker


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Unregulated/Deeply Discounted Insulin Sales Common on Craigslist
Reuters (2/17) reports, “Unregulated and deeply discounted sales of insulin are common on Craigslist,” research indicated. Over the course of “a two-week period, researchers turned up 327 ads from private parties selling insulin at a fraction of the retail price,” investigators found. The study’s co-author said, “The take home message from this study is that patients (with diabetes) should not have to go to Craigslist to find affordable insulin.” She added, “There has to be a better way than patients going out on their own and seeking out potentially harmful products.” The findings were published online in a research letter in JAMA Internal Medicine (subscription required).


Grandparents May Be Bad Influence on Children’s Weight
Grandparents can be a bad influence on kids’ weight,” investigators concluded after analyzing data from “23 studies conducted in the United States and eight other countries.” That analysis revealed that children “who were cared for by grandparents had nearly 30% higher odds for being overweight or obese.” The findings of the systematic review and meta-analysis were published online in the journal Childhood Obesity.


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MSSNY Young Physicians, Resident Fellow, Med Student Social
Friday, 2/28/2020, 6pm-9pm
Sessions 73 – 73rd St. and 1st Ave. New York, NY
RSVP for social here


Just One Dose of HPV Vaccine May Help Prevent Cervical Disease

A single dose of human papillomavirus (HPV) vaccine is associated with a significant reduction in cervical disease, according to a retrospective study in Cancer. The CDC generally recommends two doses for those vaccinated between ages 9 and 14, and three doses for those vaccinated later.

Using a U.S. insurance claims database, researchers matched nearly 67,000 females aged 9 to 26 who received at least one dose of the quadrivalent HPV vaccine with 67,000 unvaccinated controls.

The estimated rate of preinvasive cervical disease at 5 years was 2.65% in the unvaccinated group, versus 1.62%, 1.99%, and 1.86% among those who received one, two, and three vaccine doses, respectively, between ages 15 and 19. After multivariable adjustment, one vaccine dose was associated with a 36% risk reduction; two doses, a 28% reduction; and three doses, a 34% reduction.

Editorialists say the findings “add to the growing evidence suggesting that there may truly be no major difference in protection against cervical preinvasive lesions … conferred by 1, 2, or 3 doses of HPV vaccination.”

Cancer article
Background: Prior Physician’s First Watch coverage of single-dose HPV vaccination


Considering a Run for Office for Yourself?
AMPAC Candidate Workshop February 28 – March 1, 2020

Ever wonder how Doctors get elected to Congress or your state legislature? The AMPAC Candidate Workshop will teach you how to run a winning political campaign, just like we taught many of your AMA colleagues over the years.

The Candidate Workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office.

Additional details below

This one-and-a-half-day workshop is designed to provide you with the skills and strategic approach you will need to make a run for public office. Some of the topics include: how and when to make the decision to run; the importance of a disciplined campaign plan and message; the secrets of effective fundraising; what kinds of media advertising are right for your campaign; how to handle the inevitable crises that emerge for every campaign; the role of your spouse and your family; and how to become a better public speaker.

Registration is now open. There are still a few spots remaining but don’t delay. The registration fee is $250 for AMA members ($1,000 non-members), spouses and state medical society staff. The fee is waived for students/residents, however, there are limited slots and the AMPAC Board will review and select from the pool of qualified applicants. For more information visit AMPAC online. To apply, simply fill out the online registration form or email your questions to: politicaleducation@ama-assn.org.


Med Schools Recruit LGBTQ Students to Improve Care for LGBTQ Patients
The AP (2/19) reports on efforts to increase the number of LGBTQ physicians, which LGBTQ advocates say should improve the quality of care received by LGBTQ patients. The article says that “when being heterosexual is presumed even in doctors’ offices, those who identify otherwise can feel marginalized and less likely to seek medical care, contributing to health problems” such as mental health issues, alcohol and drug use, and forgone preventive care, according to LGBTQ advocates.

The article adds that some medical schools are pushing to recruit more LGBTQ students citing “research showing that patients often get better care when treated by doctors more like them.” Exact numbers of LGBTQ medical students and doctors are unknown. In 2018, the AMA added sexual orientation and gender identity as an option for members to include in demographic profiles the group compiles.

Of the 15,000 doctors and students who have volunteered that information so far, about 4% identify as LGBTQ. That is similar to Gallup estimates for the general U.S. population, although LGBTQ advocates believe the numbers are higher and rising as more people are willing to “out” themselves. This past fall, Harvard’s entering class of medical students was 15% LGBTQ, a milestone that is no accident.


Bill Correctly for Medicare Telehealth Services
In a recent report, the Office of Inspector General (OIG) determined that the CMS improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services video to help you bill correctly.

Additional resources:

·       Telehealth Services (PDF) Medicare Learning Network Booklet

·       Medicare Claims Processing Manual, Chapter 12 (PDF), Section 190

·       Medicare Telehealth Payment Eligibility Analyzer

·       List of Covered Telehealth Services webpage

·       CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements OIG Report


 


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

MSSNY Grassroots Banner

When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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RENTAL/LEASING SPACE


Office Rental 30 Central Park South
Three exam rooms, consultation, reception and secretarial rooms. Ground floor next to Plaza Hotel.
Elegantly decorated and fully equipped with operating suite on site. Part or full time. $1280/month for each exam plus consultation room.213.371.0468 www.drcenedese.com


Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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We improve the employee and patient experience to help you achieve your goals and grow your practice. How? With strategic processes that support you, your staff, and your patients! We integrate your values into all areas of your practice including hiring, training, communication and operational strategies. Whether you’re independent or part of a group, we have an approach that will work for you. If you’re ready to strengthen your practice, we can help. 

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Furnished Luxury Park Avenue East 70’s Medical Office Rental Available.
Voted most beautiful block on UES. Private Entrance. Central A/C.
Dedicated consultation room, exam room, procedure room, reception and nurse areas in a multispecialty office setting. Suitable for all subspecialties. Walk to Lenox Hill Hospital and NY Cornell. Proximate to Mt Sinai Hospital. Subway 2 blocks away. Full Time/Part Time. No fee.
START SEEING PATIENTS IMMEDIATELY!!!
Please call or text 929 316-1032

JOB OPPORTUNITIES

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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNYeNews: Presidents Day – February 14, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 14, 2020

Vol. 23  Number 7


MSSNYPAC Seal


National Advocacy Conference in Washington DC
National Advocacy Conference in Washington DC Feb. 10-12
MSSNY members in Washington, DC advocating for legislation that puts patients before profits (left to right) Jerome Cohen, MD; MSSNY President-Elect Bonnie Litvack, MD; Purvi Parikh, MD; Jeff Morgan, Legislative Director to NY Rep. Paul Tonko; MSSNY Immediate Past President Tom Madejski, MD; MSSNY President Art Fougner, MD; Daniel Choi, MD; MSSNY Executive VP Phil Schuh; Pratisthe Kiorala, MD


Colleagues:

This Monday, we celebrate Presidents Day. The holiday could not come at a better time. While we agonize over Congress’ inching closer toward awarding insurers the upper hand on surprise bills and, at the same time, worry about Albany’s empowering OPMC, it would be wise to reflect on the lives and examples of America’s Romulus and Remus – George Washington and Abraham Lincoln.

George Washington truly led by example. He took command of a group of rag-tag patriots and led them with spirit, guile and whatever he found at his disposal to victory over the world’s mightiest power. At the height of his military career, he resigned his commission. When offered the scepter of King, he became instead President. After two terms, he retired to private life and left the office to others. George Washington observed that “happiness and moral duty are inseparably connected.” As historian Forest McDonald observed, Washington was “the instrument by which an inconsequential people took the first steps toward becoming a great nation.”

Abraham Lincoln was not a military man yet became the Commander in Chief during the second most important conflict in our history. Lincoln did not attend Harvard or Yale, yet he became arguably the most famous lawyer in our history. Federal judge Herbert George would ask a rhetorical question:

“Would you rather have the edge in the facts of a case, the law of a case or Abraham Lincoln as your lawyer?” Lincoln advised us that a “house divided against itself cannot stand.” We would be wise to heed his counsel.

So, this weekend, take a few moments away from prior authorizations and mouse clicks to reflect on how we got here and, more importantly, where we are going. Remember that another, more recent president pointed the way to that “Shining City on a Hill.”

Remember our patients. Do not despair. We will get there.

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President


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Capital Update

MSSNY Legislative Podcasts


Please Plan To Be in Albany for MSSNY‘s Annual “Physician Advocacy Day” March 4th
With State Budget discussions beginning to heat up the need for physician advocacy and grassroots involvement is greater than ever. With the Governor’s Budget Proposal teeing up items for potential concern such as Medicaid cuts, cuts to the Excess Medical Liability Insurance Program, and changes to the physician disciplinary process, but also supported reforms such as regulating PBMs and a flavored tobacco ban, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Please join hundreds of your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program. Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org.                                                                   (ALI)


MSSNY Leaders & Staff Hold Key Meetings in DC to Discuss “Surprise Billing” & Other Pressing Issues
On February 10 – 12, MSSNY member leaders, and staff, attended the American Medical Association’s (AMA) National advocacy conference, in Washington, DC., and held meetings with New York’s Congressional delegation. Attendees included the following:

  1. Art Fougner (Current MSSNY President)
  2. Bonnie Litvack-Penn (Incoming MSSNY President)
  3. Jerome Cohen
  4. Dan Choi
  5. Jacqueline Bello
  6. Thomas Madejski (MSSNY Immediate Past-President)
  7. Willie Underwood
  8. Yetunde Olowe
  9. Purvi Parikh

The group discussed several of MSSNY’s most pressing legislative priorities, with a heavy focus on the issue of Surprise Billing, which has multiple bills moving through Congress to try and resolve this issue in a way that serves the needs of both physicians and patients. Among the lawmakers’ offices that MSSNY met with were Senator Chuck Schumer, Senator Kirsten Gillibrand, Representative Paul Tonko (D- Schenectady), Representative Brian Higgins (D- Buffalo), Representative Eliott Engel (D-Westchester/Bronx), Dr. Tom Reed (R-Southern Tier), and Representative Joe Morelle (D-Rochester).

In addition to the “Surprise Billing” issue, MSSNY members discussed the need for federal legislation to reign in the number of services that are subject to prior authorization and a study of the potential public health impact of marijuana for recreational purposes.   (CARY)


 

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One-Sided Surprise Bill Proposals Advance in Congress – Contact Your Representatives Today
All physicians are urged to continue to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative to express strong concerns with the various proposals before Congress that would substantially limit insurer responsibility for coverage of out of network emergency and surprise medical bills.  A letter can be sent here: Please click here.

While MSSNY supports the goals of legislation to prevent surprise medical bills, most proposals advanced so far are steered heavily to the benefit of insurance companies, and do not have the balance of New York’s law.  This week the House Ways & Means Committee and Education & Labor Committee advanced separate proposals.  While the Ed & Labor proposal was very similar to Energy & Commerce proposal advanced last year strongly opposed by MSSNY and many other physician organizations, the W&M proposal did make a few marginal improvements including rejecting a benchmark payment and permitting the consideration of many factors.

However, the IDR mechanism identified in the legislation would also prohibit the consideration of physician charge data and require the consideration of median in-network data, which in all certainty will skew the results towards the insurance companies.  In fact, when the proposal was scored by the Congressional Budget Office (CBO), it was noted that “in facilities where surprise bills are likely, average payment rates for both in- and out-of-network care would move toward the median in-network rate.  Moreover, the proposal only provides for a minimal review of insurer networks, which is the major contributing factor to the problem of surprise bills.

Therefore, this proposal remains highly problematic, and MSSNY President Dr. Art Fougner offered the following comments in response:

“New York’s dedicated physicians remain anxious to work with all parties to ensure a fair federal legislative solution to protect patients from surprise out of network bills.  However, far more balance is needed in what has been put forward so far.  The proposal released Friday by the US House Ways & Means provides a few marginal steps forward but would still hand an enormous gift to already market dominant health insurance companies by tilting the factors in its dispute resolution mechanism towards the insurance industry.  Even worse, it fails to provide meaningful steps to make sure health insurance physician networks are adequate, to help protect patients from finding themselves in the position in a hospital where they are treated by an out of network physician.

These new proposals remain far different than the comprehensive and balanced measure that was enacted in New York, which not only put in place a balanced dispute resolution system to protect patients, but also put in place new measures to better ensure that health plan networks and out of network coverage was comprehensive.  We urge Congress to revise their proposals to more closely resemble New York’s acclaimed approach, which has had zero adverse premium impact and has saved consumers hundreds of millions of dollars.” (AUSTER, CARY)


Initial Meeting of the MRT 2
This week brought the initial meeting of the second iteration of the Governor’s Medicaid Redesign Team (MRT), charged with recommending $2.5 billion in Medicaid savings as part of an effort to enact a State Budget by April 1.  The meeting generally covered a review of the successes of the previous MRT, a statement of the general charge and activities for the MRT 2, and identifying the highest cost drivers in the Medicaid program that will be under the microscope for revisions.

There will be 3 meetings of the MRT 2, including this week’s, March 2 in NYC and a third meeting to be announced for mid-March.  There will also be a Long Term Care advisory group established.  They will be soliciting public input online as well as through 3 upcoming public forums/evening webinars. The next one will be place on Tuesday February 18th from noon – 3pm, at the Monroe County Community College, High Falls Auditorium, 321 State St., Rochester, NY

In looking at the services for 6.2 million Medicaid enrollees, among the highest cost drivers identified included:

  • LTC and Consumer Directed Personal Care Program (800% growth from 2016 to 2021)
  • Prescription Drugs (36% growth from 2011 to 2019, exceeding 25% medical CPI)
  • Transportation (up 131% from 2011 to 2019)
  • Case management including Health homes
  • Program Integrity (reducing fraud and abuse, and ensuring cost-efficient delivery of care for Medicaid recipients)
  • Distressed Hospitals (160% increase)

It was also noted that, among the 770,000 “dual eligibles” in New York, only 3% are enrolled in managed care programs.

The only area where physician care under Medicaid appeared to be directly implicated was the stated 344% increase in the Patient Centered Medical Home program from 2011 to 2019, which pays physicians a PMPM bonus to help manage the care of certain Medicaid patients.  However, DOH also noted that patients enrolled in PCMH also had significantly lower health costs overall than non-PCMH enrollees.  MSSNY has repeatedly argued to legislators that Medicaid payments to physicians are already among the lowest in the country, represent a good investment in care delivery, and therefore should be spared from future cuts.  MSSNY also continues to raise strong concerns about the lack of a community based physician on the MRT 2.

It was also noted that the public could submit recommendation to the MRT 2 for Medicaid cost-saving suggestions from here: Please click here  (AUSTER, ALI)                                                       


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Please Urge Your Legislators to Reject Unfair Disregarding of Physician Due Process
With Part L of Governor’s proposed Health/Mental Hygiene Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to continue to contact their legislators contact here to urge that the Legislature reject this unfair proposal, and plan to be in Albany on March 4 for Physician Advocacy Day.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.  That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.  

MSSNY has joined with 16 state specialty societies in a communication to the Legislature setting forth our concerns in greater detail.  Moreover, MSSNY President Dr. Art Fougner recently appeared on the WCNY “Capitol Pressroom” radio program to discuss MSSNY’s concerns with this proposal.

Please urge your legislators to reject this proposal from the Budget. (AUSTER)


Physician Mandate Bills Begin to Pile Up in Albany
As if physicians needed one more reason to be in Albany on March 4, the State Legislature has been advancing numerous bills through its Committee process that, while well-intended, would place substantial new mandates on physician care delivery at a time when physicians are already drowning in administrative tasks that take time away from patient care delivery.  They also unfairly place the physician at risk of financial penalty or even license sanction by DOH/OPMC if the physician fails to document that they performed the mandated task.  These proposals include:

  • Mandated conspicuous posting in a physician’s office of a patient’s ability to file a complaint with the Office of Professional Conduct (A.7991-A/S.6678-A). Assembly Floor/Senate Health Committee
  • Mandated notification to epileptic patients of the risk of sudden death due to epilepsy (S.5397-A/A.7807-A). On Assembly Floor/On Senate Floor
  • Mandated co-prescribing of naloxone for patients: a) taking 50 mmg per day b) with a history of substance use disorder or c) concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics (S.5150-B/A.5603-B). Passed Senate.  In Assembly Ways & Means
  • Mandated reporting of rescue inhaler prescriptions to the statewide immunization system (S.7337). On Senate floor
  • Mandated dissemination of a pamphlet prior to performance of a pelvic exam (S.7544/A.9600). On Senate floor/In Assembly Health
  • Mandated proof of completion of CME on cultural competency, including paying for an additional fee to SED on top of the bi-ennial $600 registration fee (S.2406-A). Passed Senate/In Assembly Higher Education Committee
  • Mandated seeking of a detailed patient/family member consent for a nursing home resident prior to the receipt of a psychotropic medication, or detailed documentation of the need to provide such medication without consent (A.1033/S.5441). On Assembly Floor/Senate Health Committee.
    (AUSTER, CLANCY

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Rear Seat Belt Measure Passes NYS Assembly; On Senate Calendar for Vote
A measure that would require safety belts for persons 16 years and younger in are back seat passengers in a motor vehicle has passed the New York State Assembly and is pending on the Senate Calendar for a vote.   This measure, Assembly Bill 6163/ S. 4336, is sponsored by Assemblymember Walter Mosely and Senator David Carlucci and the Medical Society of the State of New York supports this measure.

The MSSNY House of Delegates unanimously adopted policy urging that seat belts be required in both front and rear seats.  One of the safest choices drivers and passengers can make is to buckle up and 89.6% of drivers and passengers buckled up in 2018, saving 14,955 lives.   According to the 2015 data from the National Highway Traffic Safety Committee, 4.3% of 22,441 fatalities — or 966 deaths — involved unrestrained people in rear seats.  Research also found that unbuckled rear-seat travelers are eight times as likely as buckled rear-seat passengers to be injured or killed in a crash.

Thirty-eight states have laws that allow police officers to ticket a driver if the driver or the front-seat passenger is not wearing a seat belt, while only 18 states have the same laws for rear-seat riders. Those laws, along with police checks, public education campaigns, and seat-belt reminder systems, have helped increase use of seat belts in all seats.

Rear seating passengers who are older are less likely than front-seat passengers to wear a seat belt, making them more likely to injure themselves and drivers or other passengers in a crash.  Adult rear-row occupants were less likely to use seat belts, with just 70 percent of those ages 20 to 54, and 86 percent of those 55 and older using restraints, according to the Insurance Institute for Highway Safety. According to the Institute for Highway Safety (IHS), adult rear seat passengers are at greater risk for chest injuries and traumatic brain injuries than front seat passengers.                                          (CLANCY)


Register Now for CME Courses at MSSNY House of Delegates April 23 & 24
MSSNY will be offering multiple CME courses on Thursday April 23rd and Friday April 24th at the 2020 House of Delegates in Tarrytown.  Click Please click here to register for as many or few of these offerings as you can.

Thursday April 23, 2020

1:00-2:00pm       Medical Matters: Triage in a Disaster Event

2:00-3:00pm       Veterans Matters: TBI in Returning Veterans

3:00-4:00pm       Steps to Physician Wellness and Resiliency

4:00-5:00pm       The Health of Sexual and Gender Minorities

Friday April 24, 2020

1:00-4:00pm       Pain Management, Palliative Care & Addiction

For more information please contact Melissa Hoffman at mhoffman@mssny.org or call (518) 465-8085. (CLANCY, HOFFMAN)


Registration Now Open for “Steps to Physician Wellness and Resiliency”
MSSNY Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here.

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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


Registration Now Open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

With the outbreak of the Wuhan Coronavirus (COVID-19) it is doubly important for physicians to learn about the incident command system and crisis communications from the NYS Department of Health’s perspective.  This program provides physicians with vital information that would be needed to combat a public health emergency.  Be sure to note the format of this webinar includes extended time and takes place in the evening.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here:  Please click here.

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (CLANCY, HOFFMAN)


Veterans Matters: PTSD in Returning Veterans Live Seminar at Our Lady of Lourdes Memorial Hospital
The Medical Society of the State of New York is hosting a CME live seminar entitled Veterans Matters: PTSD in Returning Veterans on Thursday, February 27, 2020 at 12:00 pm at Our Lady of Lourdes Memorial Hospital, 169 Riverside Drive, Binghamton, NY 13905.

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PTSD
  • Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
  • Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

Reservations can be made by contacting Jean Jenkins at jjenkins@ascension.org or (607) 798-5290.

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.
(CLANCY, HOFFMAN)          


 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org


eNews

Physicians Are Fighting BCBS Plan Requiring Use of Mail-Order Pharmacies
A group of eight medical societies are pushing back against a proposal from BlueCross BlueShield of Tennessee that the groups fear will hurt patient access to critical drugs. (American Academy of Ophthalmology; American Academy of Dermatology; American College of Rheumatology; American Gastroenterological Association; American Urological Association; Coalition of State Rheumatology Organizations; Alabama Society for Rheumatic Diseases; Tennessee Rheumatology Society)

The proposed policy change would require physicians to use mail-order pharmacies to order drugs that have to be administered in-office, instead of allowing physician offices to bulk-order the drugs and keep them in-house. It would apply to drugs such as those given to rheumatoid arthritis patients that have to be administered by physicians in their offices.

BCBS said the policy changes are designed to save money for Tennessee-based employers and the people covered by their healthcare plans. The medical groups argue that the policy, which would mean physicians can only order the drugs on an as-needed basis for each patient, would delay patient care, reduce access to much-needed drugs, inflate out-of-pocket costs and increase drug waste.

Under the proposal, physicians would have to obtain the drugs from BCBS’ preferred pharmacies and then wait for that pharmacy to ship them, which the groups argue is just a way for BCBS to get rebates from its pharmacy benefit managers.

The groups are also concerned that they won’t be able to ensure the drugs are safe and haven’t been exposed to high temperatures. Additionally, extra doses would be required to be thrown away, increasing drug waste. The new policy could also mean patients have to go to a more expensive hospital outpatient setting if their physician can’t afford to obtain the drugs from the preferred pharmacies, which could be a significant barrier to access for some patients.

“We’re not asking members to see a different doctor or receive care at a different facility,” BCBS said on its website. The company added that the changes apply to only 5,500 of its 3.5 million members.  In a letter to BCBS, Ellen Gravallesse, MD, said: “We have had an alarming number of practices reporting they have been denied the ability to use therapies currently available in their offices to administer patient care quickly.” (Becker’s Healthcare Feb. 13)


If You’re a Physician under 40, Don’t Miss Feb. 28 Meeting in Manhattan!
For all medical students, residents, fellows, and new attendings starting practice in the last 8 years in the NY Metro Area and Long Island, don’t miss the upcoming Medical Society of the State of New York Joint Section Annual Meeting on February 28th from 8:30am-12:30pm at the New York Academy of Medicine, 1216 5th Avenue. New York, NY. More information and registration available at: www.mssnyconference.org Earn CME and learn from experts on how to succeed when starting practice and how to best advocate for your patients outside of the hospital and clinic. Limited space available. 3.0 AMA PRA Category I CME Credits available.

Program:

1.     Keynote speaker: The Evolving Healthcare Landscape: Challenges and Opportunities for Young Physicians by Jesse Ehrenfeld, Current AMA Board of Trustees Chair.

2.      “How to Avoid Malpractice Lawsuits in the First 5 Years of Practice” by William Hassett, Esq. from Fager, Amsler, Keller & Schoppmann, LLP.

3.      Millennials in Private Practice: Is It Even Possible? A Panel Discussion by Millennial Independent Physicians with Sonia Bahlani; Dhaval Bhanusali, MD, FAAD; Purvi Parikh, MD; Saya Nagori, MD. Moderated by: Daniel E. Choi, MD #doctor #medicalstudent #SoMeDocs



CDC Confirms 15th Case of Coronavirus Disease (COVID-19)
Yesterday, CDC confirmed another infection with Coronavirus Disease (COVID-19) in the United States. The patient is among a group of people under a federal quarantine order at JBSA-Lackland in Texas because of their recent return to the U.S. on a State Department-chartered flight that arrived on February 7, 2020.

All people who lived or traveled in Hubei Province, China, are considered at high risk of having been exposed to this virus and are subject to a temporary 14-day quarantine upon entry into the United States. This is the first person under quarantine at JBSA-Lackland who had symptoms and tested positive for COVID-19. The individual is currently isolated and receiving medical care at a designated hospital nearby.

This brings the total number of COVID-19 cases in the United States to 15. There will likely be additional cases in the coming days and weeks, including among other people recently returned from Wuhan. While 195 people were discharged from quarantine on Tuesday, more than 600 people who returned on chartered flights from Wuhan remain under federal quarantine and are being closely monitored to contain the spread of the virus.

For the latest information on the outbreak, visit CDC’s Novel Coronavirus 2019 website(Thursday, February 13, 2020 CDC release)


Yale New Haven Hospital Sued Over Exam Policy for Employees 70+ Years
The U.S. Equal Employment Opportunity Commission is suing Yale New Haven Hospital, alleging its policy mandating eye and neuropsychological exams for employees age 70 or older who seek medical privileges violates two federal antidiscrimination laws.

Yale New Haven implemented its late career practitioner policy about four years ago. The policy requires employees 70 and older who apply for or seek to renew staff privileges to take both medical exams. Employees under the age of 70 are not required to take the exam.

In the lawsuit, filed Feb. 11, EEOC claims that the individuals required to be tested are singled out solely because of their age, instead of a suspicion that their cognitive abilities may have declined.

As a result, Yale New Haven’s policy violates the Age Discrimination in Employment Act, the lawsuit says. “While Yale New Haven Hospital may claim its policy is well-intentioned, it violates antidiscrimination laws,” said Jeffrey Burstein, a regional attorney for the EEOC’s New York District office. “There are many other nondiscriminatory methods already in place to ensure the competence of all of its physicians and other healthcare providers, regardless of age.”

In addition, the EEOC charges that the policy also violates the Americans with Disabilities Act because it subjects employees to medical examinations that are not job-related. (Becker’s Hospital Review Feb 12)



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Lawsuit: Juul Bought Ad Space on Kids’ Websites Including Cartoon Network
E-cigarette maker Juul Labs Inc bought online advertisements on teen-focused websites for Nickelodeon, Cartoon Network and Seventeen magazine after it launched its product in 2015, according to a lawsuit filed on Wednesday by the Massachusetts attorney general’s office.

The allegations in the lawsuit, stemming from a more than year-long investigation, contradict repeated claims by Juul executives that the company never intentionally targeted teenagers, even as its products became enormously popular among high-school and middle-school students in recent years. (Reuters Business News 2/12)


Two States Have Each Reported 200+ Vaping-Related Illnesses
As of Feb. 4, a total of 2,758 hospitalized EVALI cases have been reported to CDC, an increase of 47 since the last CDC update Jan. 21.

Four updates:

  1. Sixty-four EVALI deaths have been confirmed in 28 states and the District of Columbia, up from 60 reported Jan. 21.
  2. The most EVALI cases have been in Texas and Illinois, with each state reporting between 200 and 249 illnesses as of Feb. 4.
  3. Vitamin E acetate, an additive in some THC-containing e-cigarette or vaping products, has been strongly linked to the outbreak.
  4. The recent decline in EVALI cases is due in part to a reporting lag. More deaths are currently under investigation, according to the CDC. Beckers Hospital Review, Feb 12

The outbreak of lung injury associated with vaping has slowed but it has not stopped. CDC data released Tuesday show 2,758 hospitalized individuals (three new) and 64 deaths.


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Would You Like to Be a Judge?
If you’re coming to the House of Delegates meeting – or just live in the neighborhood – please consider participating as a poster judge at this year’s Symposium. The event will take place in Tarrytown on Friday, April 24, 2020. Judging occurs between 1:30 and 3:30 pm. Each judge evaluates approximately 8 – 10 posters and is generally done in an hour. Contact sbennett@mssny.org


Register Now!  Young Physicians/Resident Fellow/Medical Students Meeting

When: Saturday, February 29, 2020
Time: 8:30 am – 12:30 pm
Where: New York Academy of Medicine, 1216 Fifth Avenue, Manhattan.
Why: Guest speakers, panel program “Is Private Practice Even Possible?”, important updates on how to avoid malpractice lawsuits in early practice. Webinar available.

Click here for required preregistration and details.


 


SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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Three exam rooms, consultation, reception and secretarial rooms. Ground floor next to Plaza Hotel.
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Midtown Medical Office for Rent
Beautiful office for rent in midtown Manhattan located opposite Grand Central Station on 42nd Street and Madison avenue. ideal for medical and surgical specialists as there are five spacious exam rooms with an accredited quad a certified operating room with anesthesia services. You can perform procedures and see patients. Rent for three days a week is $3,200 and 4 days a week is $4,100 Interested physicians please email cpmgman@gmail.com or call 914-582-0749.


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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNY Raises Strong Concerns with New Surprise Billing Proposals Coming Out of Washington


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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
February 10, 2020

MSSNY Raises Strong Concerns with New Surprise Billing Proposals Coming Out of Washington

Statement attributable to:
Art Fougner, MD
President, Medical Society of the State of New York 

“New York’s dedicated physicians remain anxious to work with all parties to ensure a fair federal legislative solution to protect patients from surprise out of network bills.  However, far more balance is needed in what has been put forward so far.  The proposal released Friday by the US House Ways & Means provides a few marginal steps forward, but would still hand an enormous gift to already market dominant health insurance companies by tilting the factors in its dispute resolution mechanism towards the insurance industry.  Even worse, it fails to provide meaningful steps to make sure health insurance physician networks are adequate, to help protect patients from finding themselves in the position in a hospital where they are treated by an out of network physician. 

These new proposals remain far different than the comprehensive and balanced measure that was enacted in New York, which not only put in place a balanced dispute resolution system to protect patients, but also put in place new measures to better ensure that health plan networks and out of network coverage was comprehensive.  We urge Congress to revise their proposals to more closely resemble New York’s acclaimed approach, which has had zero adverse premium impact and has saved consumers hundreds of millions of dollars.”

# # #

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.

MSSNY Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

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MSSNYeNews: Open Letter on OPMC – February 7, 2020

Arthur Fougner MSSNY Presiident

PRESIDENT’S MESSAGE
Arthur Fougner, MD
MSSNY President

MSSNY eNews
February 7, 2020

Vol. 23  Number 6


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Colleagues:

On January 13, The Medical Society of the State of New York met with Health Commissioner Dr. Howard Zucker as well as Keith Servis and Paula Breen of the Office of Professional Medical Conduct. It was by all accounts a cordial meeting. We were there to share our thoughts on Physician Wellness, what the stressors were for NY’s doctors and to explore potential solutions. Dr. Zucker offered that government mandates might be one of the stressors. We voiced some fears raised by the “State of the State” about OPMC but were reassured by Ms. Breen that our concerns were largely unfounded. We left optimistic and agreed to continue our dialog.

Despite this collaborative dialogue, we then saw what was being proposed within the legislative proposal for the Health and Mental Hygiene section of the Budget to unfairly malign physicians. The first element is to lower the threshold for the Commissioner of Health to summarily suspend a physician’s license. As the result of a physician’s inappropriate use of disposable syringes, the Medical Society had worked with the Department of Health to add the ability of the Commissioner to suspend the license of any physician felt to be an imminent threat to public health. We feel that the summary suspension of license without due process is such a significant matter that the threshold should be as high as possible as the ramifications of acutely severing longstanding patient-doctor relationships are enormous. Any lowering of this bar should be undertaken only after serious study of all its effects and therefore not as part of the budget process.

The second has to do with removing the OPMC Board’s oversight of the Executive Secretary and substitute oversight only by the Health Commissioner. On its face, this appears again to remove a level of due process from the system as the Board would discuss and deliberate more thoroughly than one individual could. We wonder if the governor views due process as a bug not a feature of the system.

Finally, the third and perhaps most inimical is the proposal to publicize complaints, valid or not, before any real evaluation is undertaken. OPMC complaints would then become the equivalent of a bad Yelp review on steroids. As an example, consider the case of a drug-seeking patient whose physician would not accede to her wishes. In retaliation, she files complaint with OPMC that the physician sexually assaulted her. Or how about an insurance company trying to teach a physician a lesson for making too many complaints to a government body? Ultimately, the physician was found not guilty of any misconduct. Had an allegation of sexual assault become public, his career would have been over. Former Labor Secretary Raymond L Donovan once famously asked, “Which office do I go to get my reputation back?” That office did not exist then and it doesn’t exist now.

New York State has been labeled the worst state for doctors by Wallethub. NY’s high cost of living along with its decidedly unfriendly malpractice climate have driven over half of the young physicians who train in New York out of the state. If government officials wish to know what NY stressors lead to physician burnout, they need only look to the current budget proposal. We would only hope that everyone awakens to the realization that as far as NY physician stress and burnout are concerned, Albany has not been the solution to the problem. Thus far, Albany IS the problem.

But we are not without recourse.  Your MSSNY has been hard at work, in the halls of the Capitol, and in the media, pushing back against this and other adverse Budget proposals.  We need to keep it up. 

I do have two asks. The first is for all reading this who haven’t already done so to text MSSNY to 52886 to get our grassroots alerts which will generate a letter sent to our elected officials on this and other issues of concern. The second is to arrange to join us on March 4 on Lobby Day to let Albany know exactly how we feel.

Comments? comments@mssny.org@mssnytweet; @sonodoc99

Arthur Fougner, MD
MSSNY President


 

Capital Update


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Plan to Be in Albany on March 4th for MSSNY’s “Physician Advocacy Day”
With so many issues of concern in the Governor’s Budget, the need for physician advocacy and grassroots involvement is greater than ever. Items of concern Medicaid cuts, legalized marijuana and changes to the physician disciplinary process, while supporting reforms such as include regulating PBMs and a flavored tobacco ban. Therefore, it is imperative that physicians be in contact with their local legislators to ensure the physician community’s message is well-represented.

One opportunity is to participate in MSSNY’s “Physician Advocacy Day” that will be held on Wednesday, March 4th in the Lewis Swyer Theatre in the Egg located at the Empire State Plaza, Albany NY. Click here to register!

Join your colleagues from all around New York State and come to MSSNY’s Physician Advocacy Day to speak with your legislators and key policymakers to ensure they’re making the right choices for New York’s physicians and their patients.

A brief luncheon to which members of each House are invited to speak with their constituents will follow the morning program.  Please work with your County Medical Societies to schedule appointments for physicians to meet with their elected representatives.

If you have any questions/comments, please contact Raza Ali at rali@mssny.org. (ALI)


MSSNY Continues to Push Back Against Troubling Proposal to Bypass Disciplinary Due Process
With Part L of Governor’s proposed Health Budget bill containing extremely troubling measures to bypass important due process protections for physicians during disciplinary proceedings, all physicians are urged to contact their legislators contact here to urge that the Legislature reject this unfair proposal.

The proposal would, among many other provisions, make it far easier for the Commissioner of Health to disclose to the public that a physician is under disciplinary investigation or summarily suspend a physician with only a minimal finding of risk to the public, as opposed to the much stronger “imminent danger” standard now required for bypassing existing due process protections.

That is particularly troubling given that only a small percentage of complaints to OPMC result in a disciplinary sanction.  MSSNY has indicated that we agree with the importance of acting quickly when it is imperative, but these proposals would completely undermine important and longstanding due process protections. Given that most complaints are dismissed without any sanction or action, this series of proposed changes to bypass these rights would create a substantial possibility of unfairly destroying an innocent physician’s career.    

MSSNY has joined with 16 state specialty societies in a communication to the Legislature setting forth our concerns in greater detail. Moreover, this week, MSSNY President Dr. Art Fougner appeared on the WCNY “Capitol Pressroom” radio program to discuss MSSNY’s concerns with this proposal.

Please urge your legislators to reject this proposal from the Budget.   (AUSTER)


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MSSNY: Community Physician Perspective Needs to Be Considered on Medicaid Redesign Recommendations
MSSNY has raised strong concerns that the newly appointed Medicaid Redesign Team charged with identifying $2.5 billion in State Budget savings has not included any community-based treating physicians. For the full list of appointees, click here.

The MRT2, chaired by Northwell CEO Michael Dowling and former SEIU Chair Dennis Rivera, includes state agency commissioners who are MDs, including Health Commissioner Dr. Howard Zucker and Mental Health Commissioner Dr. Ann Sullivan.  However, MSSNY is very concerned that the recommendations may lack the perspective of a physician in practice regularly treating patients, particularly those covered by Medicaid. The Committee is expected to consider further cuts to Medicaid payments, as well as possible revisions to the Excess Medical Malpractice Insurance Program.

After the MRT2 composition was announced, MSSNY President Dr. Art Fougner offered a public statement noting that: “It is perplexing that despite the hundreds of thousands of patients insured by Medicaid who are treated by a physician, and the tens of thousands of physicians who deliver care to these patients every year, not a single community-based physician has been appointed to the MRT 2.

We are further perplexed that some parts of the health care system actually have multiple representatives on this group. A $2.5 billion Medicaid savings target is almost certainly going to examine programs that impact patient access to community-based physician care, so it is very important that these physicians’ perspectives are represented on this Group.

To ignore or marginalize physicians’ perspective on our health care system is wholly unfair, not only to New York’s dedicated physicians but to all New Yorkers—the patients we serve.  We will of course continue to work with the Legislature and Administration on identifying responsible ways to address our State Budget deficit.”

Media articles reporting on the appointment of the MRT2 have noted similar concerns about lack of representation raised by Senate Health Committee Chair Gustavo Rivera, Assembly Health Committee Chair Richard Gottfried, and representatives of various provider associations such as clinics and home care associations.     (AUSTER)


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Physicians Urged to Support Efforts to Enact Ban on Flavored Vaping Products; MSSNY Meets with Governor to Discuss Vaping Epidemic
Physicians are urged to send a letter to the governor and to their member of the New York State Legislature urging enactment of provisions in the New York State budget that would prohibit the sale or distribution of flavored e-cigarettes or vaping products.  MSSNY strongly supports the proposed budget provision and urges physicians to take action here.

This week, MSSNY joined other patient advocacy organizations in a meeting with Governor Andrew Cuomo, NYS Department of Health Commissioner Howard Zucker, MD, and gubernatorial staff to discuss the continued vaping epidemic in New York State and ways to combat it including discussion of passage of the governor’s language within the context of the budget.  MSSNY joined with other health groups such as the New York State Association of County Health Officials, (NYSACHO), the NYS PTA, the NYS American Academy of Pediatrics, Chapters 1, 2 & 3, the American Heart Association, the American Cancer Society and the Coalition for Tobacco Free Kids.  (CLANCY)


NY AG Appeals Judges Order to Strike Down Emergency e-Cigarette Flavor Ban
On Friday New York State Attorney General Letitia James appealed a Supreme Court Justices order that struck down New York’s emergency ban on flavored e-cigarettes. Acting Supreme Court Justice Catherine Cholakis ruled that Governor Andrew Cuomo and health officials had exceeded their authority in approving the temporary ban last fall and that it should be left to the legislature to develop the law and policy around the issue. James’s office has asked the court of appeals to clarify how the ‘separation of powers doctrine’ applies to the issue over the emergency vaping flavor ban.

MSSNY supports the packages of bills brought forth in the legislature by Senator Brad Hoylman and Assemblywoman Bichotte to combat the vaping epidemic, as well as a package of proposals being advanced by the Governor.         (ALI) 


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Surprise Bill Resolution Heats Up in Congress – Contact Your Representatives Today
With new legislation to address the issue of surprise medical bills likely to receive a “mark-up” by the US House Education & Labor Committee next week, all physicians are urged to contact New York’s Senators Schumer and Gillibrand, as well as their respective Representative, to request that they enact a fair surprise bill law similar to New York’s highly acclaimed law.

A letter can be sent from here.  With Congress under pressure to find new revenue sources to help fund the federal Budget once the existing Budget resolution expires on May 22, the Congressional Budget Office has erroneously identified grossly unfair surprise billing legislation sponsored by Rep. Pallone and Sen. Alexander (H.R. 3630/S.1895) as one revenue source.  Unfortunately, this proposal would give insurers the power to pay for surprise out of network bills based upon insurers’ self-determined in-network rates, with little power to meaningfully to seek a more fair payment.

This would give enormous new powers to already market dominant insurers to drop physicians from their networks, or to significantly drop in-network payments.  Moreover, this is significant contrast to New York’s law, which sought to strike a fair balance to ensure that on-specialty care in hospital emergency departments was not jeopardized.

New York physician leaders will be having meetings with key members of New York’s Congressional delegation on Capitol Hill the week of February 10th.  Their message will be that physicians very much agree with the goal of the legislation to protect patients from facing these bills but disagree strongly with the solutions being offered.

Please contact your representatives today.    (AUSTER, CARY)


Senate Sets Recommendations to Combat Heroin and Opioid Abuse; DOH Releases Opioid Annual Report
The week the New York State Senate released its opioid abuse report setting forth recommendations for legislation to further respond to the opioid and heroin abuse epidemic.  The recommendations include some measures that MSSNY opposes such as S.5150-B, mandatory co-prescribing of naloxone for certain pain patients.  It does include measures that MSSNY worked to improve (S.7102-A, expanding the topics to be covered in the mandatory 3-hour pain course) and measures that MSSNY supports such as S.7115 which would permit “partial fills” of controlled substances.

All of these measures have passed in the NYS Senate.  On the other hand, the report did not include legislation imposing significant requirements on physicians such as mandatory notification to patients of the many risks associated with prescribing opioids (S.4277), and mandatory consideration of alternatives to opioid medications (S.5867).  These measures remain in the Senate Health Committee.  The report does discuss the importance of prescribers “Discussing risks and alternatives with patients” as a priority issue. A copy of the report can be found here.

This week the NYS DOH also released its New York State Opioid Annual Report 2019.  This report reflects the work of many programs within the New York State Department of Health, in partnership with other agencies which have worked collaboratively to address the opioid epidemic. The report provides an overview of opioid-related mortality, morbidity, naloxone distribution and administration, controlled substance prescriptions, and opioid use disorder treatment, including medication assisted treatment across New York State. It also summarizes new and expanded initiatives, and collaborative cross-disciplinary efforts implemented by the NYSDOH and partners. A copy of the report can be found here.           (CLANCY) 


MSSNY Joins Public Health Partners to Urge Restoration of Governor’s Cuts to Crucial State Programs Focused on Healthcare Workforce
On Tuesday, February 4th, MSSNY staff joined partners with the Workforce Advisory Group (WAG), for a full day of meetings in Albany with key policymakers, urging restoration of proposed cuts by Governor Cuomo to programs that support the healthcare related workforce. These programs include the Empire Clinical Research Investigator Program (ECRIP), Area Health Education Center (AHEC), the Center of Health Workforce Studies, Rural Health Access Development, and the Diversity in Medicine Scholarship Program. WAG is comprised of stakeholders in the health care field across New York, has advocated for and works closely with the Department of Health (DOH) on a variety of programmatic and funding issues related to Doctors Across New York (DANY), of which MSSNY is also a member.

The DANY program was established in 2008 to assist with the recruitment and retention of physicians in areas of need across New York State that lack the capacity to meet community needs by providing funding in exchange for loan repayment and practice support. DANY is a valued player in the recruitment and retention of physicians in underserved areas across the state, but the number of placements has not kept pace with the growing physician shortage.

MSSNY will continue to work with WAG as budget negotiations heat up and will share new information as it becomes available.   (CARY)


MSSNY Presents Testimony Raises Concerns with a Number of State Budget Proposals
On Wednesday January 29th, MSSNY Senior Vice President Moe Auster presented testimony to a joint Senate-Assembly Committee hearing Budget hearing .examining the proposed State Budget for Fiscal Year 2020-2021.  Among the issues he raised on MSSNY’s behalf:

  • Strong objections to proposals that would permit the bypassing of long-standing physician due process when a complaint is filed is OPMC;
  • Strong objections to the recent 1% cut to physician Medicaid payments, as well as concerns regarding even deeper cuts that could be imposed to meet a $2.5 Billion Medicaid savings target based upon recommendations of the revised Medicaid Redesign Team;
  • Support for funding to extend the Excess Medical Malpractice Insurance program, but strong objections to the failure to include historical language extending the program
  • Strong objections to a proposal to permit the sale of recreational or “adult use” marijuana
  • Strong objections to the significant expansion of the existing physician-pharmacist collaborative drug program to include nurse practitioners and physician assistants.
  • Support for proposals to regulate PBMs
  • Support for proposals to limit the sale of flavored tobacco products and to help prevent the health risks associated with vaping
  • Support for health insurance reforms, including creation of an administrative simplification task force and health claims denial transparency report.

To view a video of the testimony, click here. You can either advance to the 8:04 mark, or scroll to the direct link to Mr. Auster’s testimony.        (AUSTER)


Registration now open for “Steps to Physician Wellness and Resiliency”
MSSNY Committee on Physician Wellness and Resiliency will hold its first webinar, entitled Steps to Physician Wellness and Resiliency on February 25th from 7:30-8:30am. Jeffrey Selzer, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress related problems and know when to seek professional assistance

Register by clicking here.

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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


Registration now open for Medical Matters: Virtual Drill: Incident Command System & Crisis Communications
MSSNY’s next Medical Matters will feature a Virtual Drill on the Incident Command System and Crisis Communications on February 19th from 6:00-8:00pm. Faculty for this program are: Arthur Cooper, MD; Pat Anders, MS, MEP; William Valenti, MD and Lorraine Giordano, MD.

Educational Objectives are:

  • Obtain information about local, state and national chain of command in a public health emergency and learn how to access resources
  • Understand the importance of planning for medical surge and triage of patients, as well as staff and family considerations, in the office-based practice setting during a health emergency
  • Develop an understanding that all public health emergencies can potentially have mental health implications for survivors and others connected with the event
  • Acquire skills for the management of patients in a public health emergency

Please note that there are recommended pre-course materials to be viewed prior to this virtual drill. You will be sent a link with your registration confirmation. We encourage all participants to examine these prior to the Virtual Drill.  Register by clicking here.

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

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 2.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (HOFFMAN)


Veterans Matters: PTSD in Returning Veterans Live Seminar at The Brooklyn Hospital
The Medical Society of the State of New York, along with the Medical Society of County of Kings & Medical Society of Bay Ridge are hosting a CME live seminar entitled Veterans Matters: PTSD in Returning Veterans on Wednesday, February 12, 2020 at 7:00 pm at The Brooklyn Hospital Center, Conference Room 2a/2b, 121 DeKalb Avenue, Brooklyn, NY 11201.

Adolph Meyer, MD will serve as faculty for this program and the educational objectives are:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PTSD
  • Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
  • Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

Reservations can be made by contacting Dr. Lisa Eng at DrEng@NewLifeWellnessny.com or call (917) 952-8814. All participants must RSVP to receive parking accommodations.

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.     (SHERPA)     

 pschuh@mssny.org mauster@mssny.org  pclancy@mssny.org  zcary@mssny.org
rali@mssny.org
eNews

FDA Grants Emergency Use Approval for Coronavirus Testing Kits
The FDA “on Tuesday granted emergency use approval for state public health laboratories to start testing for the new flu-like coronavirus…using kits developed by the Centers for Disease Control and Prevention (CDC).” Under the approval, “state public health labs can order test kits and also start the work of validating the tests within their own labs to make sure their scientists are using it correctly, Scott Becker, the executive director of the Association of Public Health Laboratories (APHL), said. “CDC reports highest pediatric flu death toll in 17 years.” (Reuters )If flu activity continues to rise in the same trajectory, the U.S. could see one of the worst flu seasons in decades, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN in a separate report.


71% of Physicians Say Electronic Records Contribute to Burnout
More than half of physicians reported symptoms of burnout in a 2014 study, and while that rate dropped to 43 percent in a 2017 follow-up, it is still much higher than the rate for all US workers, which stayed essentially flat in those years. What has gone wrong with our once beloved profession?

A report in The American Journal of Medicine last year looked at this question. It defined burnout as 1) lacking a sense of accomplishment, 2) cynicism, and 3) lack of enthusiasm for our work. It found that the one thing in medicine that seemed to correlate with the rise of burnout was the electronic medical record, introduced in 2008. A Stanford study showed that 71 percent of doctors say that electronic health records contribute to burnout.


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Rep. Clarke Brings Primary Physician Dr. Donald Moore to State of the Union Address
U.S. Rep. Yvette D. Clarke (D- Brownsville, Crown Heights, East Flatbush, Flatbush, Kensington, Park Slope, Prospect Heights, Midwood, Sheepshead Bay, Marine Park, Gerritsen Beach, Prospect Lefferts Gardens) attended this week’s State of the Union and brought MSSNY member  (Kings County) Donald E. Moore MD a primary care physician from Brooklyn and champion for Medicare for All, as her guest.

Democrats brought more than 80 patients, doctors and health care advocates from across the country to this year’s State of the Union. “I was honored to bring Brooklyn physician Dr. Donald Moore who is well known in our community and is one of the greatest advocates for Medicare for All. The time is now to prioritize health care as a right, not a privilege, and Dr. Moore walks this walk every day in his medical practice,” she added.


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Fewer People Are Regularly Visiting Their Primary Care Physicians
Visits to primary care physicians are on the decline, according to new research. Previous research has suggested that patients who regularly see PCPs tend to be healthier, but insurance claims data from one insurer from 2008-2016 reveal that regular visits to PCPs have declined by nearly 25%. The share of adults who didn’t have any visits with their PCP in a given year rose from around 38% to 46%, while visits to other settings — such as urgent care centers — also increased.

Young adults, those with chronic conditions, and those living in low-income areas were least likely to have visited their PCP. The authors of the study suggest that these declines in PCP visits may be because people perceive regular checkups as unnecessary, and because of rising costs — the average cost per visit increased by around $10 over the study period.


First Peanut Allergy Treatment Approved
The FDA has approved Palforzia to reduce the risk for allergic reactions in children with confirmed peanut allergies. Patients aged 4 to 17 years can start the oral treatment, and its continued use is approved for those ages 4 and up. After the initial dose, 11 increasing doses are given over several months. The first time a higher dose is given, it is administered in a supervised healthcare setting where allergic reactions can be managed. After tolerating all the up-dosing levels, the patient enters a maintenance phase, where the 300-mg dose is given at home daily.

A study of roughly 500 people with peanut allergy found that after 6 months of treatment, 67% of Palforzia recipients could tolerate a single 600-mg dose of peanut protein with only mild allergic symptoms, compared with 4% of those receiving placebo. Common side effects include abdominal pain, vomiting, mouth tingling, itching, hives, wheezing, and anaphylaxis. The treatment is contraindicated in patients with uncontrolled asthma.

The FDA requires that prescribers be educated on the risk for anaphylaxis. Patients should still take steps to avoid ingesting peanuts and have injectable epinephrine on hand. FDA news release; Palforzia prescribing information (PDF).


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NY Doctor Sentenced for Accepting Bribes/Kickbacks in Exchange for Prescribing Fentanyl
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced today that Alexandru Burducea, a doctor who practiced in Manhattan, was sentenced in Manhattan federal court to 57 months in prison for conspiring to violate the Anti-Kickback Statute, in connection with a scheme to prescribe Subsys, a potent fentanyl-based spray, in exchange for bribes and kickbacks from Subsys’s manufacturer, Insys Therapeutics.  Burducea pled guilty on February 14, 2019 and was sentenced by United States District Judge Kimba M. Wood.

U.S. Attorney Geoffrey S. Berman said: “Before September 2014, Alexandru Burducea, a doctor who practiced in Manhattan, had never prescribed Subsys, a potent fentanyl-based spray.  By the second quarter of 2015, however – in exchange for bribes and kickbacks from Subsys’s manufacturer, Insys Therapeutics – Burducea became approximately the 14th-highest prescriber of Subsys in the country. Burducea sacrificed the safety of his patients to satisfy his own greed and will now spend time in federal prison for his reckless prescribing of this highly addictive and deadly drug.” 

The Insys Speakers Bureau

Subsys, which is manufactured by Insys, is a powerful painkiller approximately 50 to 100 times more potent than morphine. The FDA approved Subsys only for the management of breakthrough pain in cancer patients.  Prescriptions of Subsys typically cost thousands of dollars each month, and Medicare and Medicaid, as well as commercial insurers, reimbursed prescriptions written by Burducea.

In or about August 2012, Insys launched a “Speakers Bureau,” a roster of doctors who would conduct programs (“Speaker Programs”) purportedly aimed at educating other practitioners about Subsys.  In reality, Insys used its Speakers Bureau to induce the doctors who served as speakers to prescribe large volumes of Subsys by paying them Speaker Program fees.  Speakers were supposed to conduct an educational slide presentation for other health care practitioners at each Speaker Program.  In reality, many of the Speaker Programs were predominantly social affairs where no educational presentation about Subsys occurred.  Attendance sign-in sheets for the Speaker Programs were frequently forged by adding the names and signatures of health care practitioners who had not actually been present.

Burducea’s Participation in the Scheme

Dr. Burducea, certified in pain management and anesthesiology, was an Assistant Professor of anesthesiology at a large Manhattan hospital.  He also practiced at an anesthesiology and pain management office associated with the hospital.  From in or about September 2014 until in or about June 2015, BURDUCEA received approximately $68,400 in Speaker Program fees from Insys in exchange for prescribing large volumes of Subsys.

In addition, Insys hired BURDUCEA’s then-girlfriend, now wife, to work as BURDUCEA’s sales representative, and the company paid her large commissions based on the volume of Subsys prescribed by her assigned doctors, which included Dr. Burducea. Dr. Burducea, who had never prescribed Subsys before in or about September 2014, became approximately the 14th-highest prescriber of Subsys nationally in the second quarter of 2015, accounting for total net sales of the drug of approximately $621,345 in that quarter. (Press release from Department of Justice U.S. Attorney’s Office Southern District of New York)


WORKERS COMP

New Drug Formulary FAQs
To support the successful implementation of the New York Workers’ Compensation Formulary (NY WC Formulary), the Board continues to educate medical providers and payers about the Formulary and prior authorization process. This includes providing timely responses to frequently asked questions and requests for clarification. This week, the Board published a new round of frequently asked questions (FAQs). Please visit the Board’s Drug Formulary Overview webpage for the latest FAQs as well as:

  • An overview of the NY WC Formulary and the prior authorization process
  • The latest version of the NY WC Formulary
  • A Quick Guide to the NY WC Formulary
  • NY WC Formulary Dashboard Guides for Providers and Payers/TPAs

More Information

For more information, visit the Drug Formulary Overview Page

General NY WC Formulary questions: WCBFormularyQuestions@wcb.ny.gov

Technical support questions: WCBCustomerSupport@wcb.ny.gov

Subscribe for email notifications


MEDICARE

Medicare Provider Enrollment
A new Medicare Provider Enrollment Educational Tool is available. Learn about:

  • Eligibility and process
  • Application fee for institutional providers
  • Revalidation
  • Provider Enrollment, Chain and Ownership System (PECOS)

SIGN UP TO RECEIVE ALERTS FROM MSSNY’S GRASSROOTS ACTION CENTER

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When you subscribe to the Medical Society of the State of New York Grassroots Action Center, the Division of Governmental Affairs will alert you when legislation and issues of importance to physicians and patients, either in the NYS legislature or in Congress, are at critical stages.

Accordingly, contact from constituents would be vital to influencing the path and future of that legislation or issue.

Alerts will be accompanied by recommended actions you or your designee can take to have maximum impact such as calling, tweeting and emailing a customizable letter to your legislators.

If you are concerned with health care policy formation in New York State, please subscribe today by texting MSSNY to 52886 and you will be prompted to enter your email address.  When you sign up, it is best to use your NY-based voting address or practice address (if you do not reside in NY) for your alerts.

Contact the Division of Governmental Affairs at 518-465-8085 or albany@mssny.org if you have questions or comments.  Thank you.
(WILKS)


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Great Career Opportunities for Clinical Physicians
Physicians, are you looking for a change?  Tired of working long shifts with an overwhelming patient load?  Come work at a well-equipped and staffed correctional facility where you can MAKE a difference, working with a smaller number of patients for reasonable hours.

Starting salary is $143,381 – $171,631 *Additional $20,000 geographical differential for Clinton & Franklin CF, and $10,000 for Five Points, Greene and Groveland CFs. We offer full-time, part-time & hourly/per-diem positions.

We have openings in the following counties offering a choice of urban, suburban or rural living:

Clinton*                 Clinton Correctional Facility (sporting and recreational outlets)
Chemung               Elmira and Southport Corrl Facilities (Gateway to the Finger Lakes)
Columbia*             Hudson Correctional Facility (antiquing, arts & collectables)
Dutchess                Green Haven Correctional Facility (Hudson River Valley Beauty)
Franklin*                Franklin & Upstate Corrl Facilities (North Country, 1 hour to Montreal)
Greene*                 Greene Correctional Facility (rural charm yet only 2 hours to NY City)
Livingston*            Groveland Correctional Facility (State Parks, hiking, fishing)
Oneida                   Mohawk Correctional Facility (Cooperstown, breweries)
Orleans                  Albion Correctional Facility (Greater Niagara Region & Canal Town Culture)
Sullivan                  Woodbourne Correctional Facility (mountains, outlets, entertainment)
Seneca*                 Five Points Correctional Facility (heart of wine country)
St. Lawrence          Riverview Correctional Facility (hiking, boating and museums)
Ulster                     Shawangunk and Wallkill Corrl Facility (Catskill Mountains, Casinos)
Washington           Great Meadow Corrl Facility (Between Vermont & Green Mountains)
Westchester           Bedford Hills Correctional Facility (Less than 1 Hour to NYC)
Wyoming               Wyoming Correctional Facility (waterfalls, family farms, natural beauty)

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Inquire with the Facility Personnel Office regarding benefits and anticipated opportunities: http://www.doccs.ny.gov/faclist.html. Contact: www.doccs.ny.gov or DOCCS Personnel Office at (518) 457-8132 for more information and to apply.



 

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

 

MSSNY Calls for Physician Representation on the MRT 2

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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
February 5, 2020

MSSNY CALLS FOR PHYSICIAN REPRESENTATION ON THE MRT 2

Statement attributable to:
Art Fougner, MD

President, Medical Society of the State of New York

“It is perplexing that despite the hundreds of thousands of patients insured by Medicaid who are treated by a physician, and the tens of thousands of physicians who deliver care to these patients every year, not a single community-based physician has been appointed to the MRT 2.

We are further perplexed that some parts of the health care system actually have multiple representatives on this group. A $2.5 billion Medicaid savings target is almost certainly going to examine programs that impact patient access to community-based physician care, so it is very important that these physicians’ perspectives are represented on this Group.

To ignore or marginalize physicians’ perspective on our health care system is wholly unfair, not only to New York’s dedicated physicians but to all New Yorkers—the patients we serve.  We will of course continue to work with the Legislature and Administration on identifying responsible ways to address our State Budget deficit.”

# # #

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
516.488.6100 x 302
rraia@mssny.org

 

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