December 9, 2016 – Last Chance to Write the Gov on Step Therapy!

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
December 9, 2016
Volume 16
Number 43

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Dear Colleagues:

There are only a few days left for physicians to send a letter to Governor Cuomo requesting that he sign into law a bill (A.2834-D/S.3419-C) that would establish specific criteria for physicians to request an override of an insurer’s step therapy medication protocol when it is in the best interest of their patients’ health. The bill has already passed in the State Legislature. We know the insurers are strongly fighting this bill, so the Governor’s office needs to hear your support.

The bill is one of few remaining bills that has not yet been delivered to the Governor, but should be sent within a few days.

MSSNY strongly supported this bill, and worked with a wide array of patient advocacy organizations and specialty societies to achieve passage of this legislation.

A few weeks back, MSSNY President-elect Dr. Charles Rothberg appeared in a FIOS Long Island news story discussing the importance of this legislation. In October, my letter to the editor in support of the legislation appeared in the Albany Times-Union. I was responding to an inflammatory op-ed attacking this common sense legislation written by a representative of health insurance industry.

The bill would require a health insurer to grant a physician’s override request of an insurer step therapy protocol if the drug required by the insurer is contraindicated, likely to be ineffective, or if the patient is stable on the medication requested by the physician.  If the physician’s request for an override of the step therapy protocol is denied, it would enable a physician to formally appeal the decision both within the plan’s existing appeal mechanism as well as taking an external appeal.

This has been a heck of a fight. Let’s not give up now.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York
Save the Date:
MSSNY Physician Advocacy Day in Albany March 8!

Please send your comments to comments@mssny.org


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NYS DOH Announces Expansion of Medical Marijuana to Include Chronic Pain
The New York State Department of Health announced this week that it will proposed regulations to include “chronic pain” as a qualifying condition for patients who have been certified to use medical marijuana. DOH also announced that regulations will also allow wholesaling of medical marijuana products, removing the cap on the number of products available to patients, making it easier for hospitals to allow certified patients to self-administer medical marijuana.

In a press release issued by the Department of Health, Commissioner Howard  Zucker, MD, said, “These are major steps forward for New York’s Medical Marijuana Program and the thousands of patients who are benefiting from it every day. These enhancements will continue to strengthen the program and improve patient access by making medical marijuana available to patients suffering from chronic pain and making more products available at dispensing facilities across the state.”

The department has filed a proposed regulatory amendments to add chronic pain as a qualifying condition and defines chronic pain as “any severe debilitating pain that the practitioner determines degrades health and functional capability; where the patient has contraindications, has experienced intolerable side effects, or has experienced failure of one or more previously tried therapeutic options; and where there is documented medical evidence of such pain having lasted three months or more beyond onset, or the practitioner reasonably anticipates such pain to last three months or more beyond onset.” The amendment will be published in the New York State Register on December 21, 2016. It will then be subject to a 45-day comment period before it can be adopted.

Last week, the Department authorized nurse practitioners to certify patients for medical marijuana. The department also filed a proposed rulemaking that was published to enable physician assistants to register with the Department to certify patients for medical marijuana, as long as their supervising physicians are also registered to certify patients.  This amendment will not take effect until it is filed for adoption after the public comment period.

In a letter to the DOH Commissioner, MSSNY President Malcolm Reid, MD, expressed concerns over the chronic pain expansion at a time when there is likely an enhanced risk of federal prosecution with the upcoming change in the federal administration.   A copy of the letter can be found HERE.

Medicaid to Cover Gender-Transition Care for Minor Children in NY as of Dec. 7
The Wall Street Journal (12/6) reports the New York Health Department announced December 6 that New York State Medicaid will start covering gender-transition care for youths under a new regulation that went into effect December 7 .The department noted that all medically necessary hormone treatments and surgeries for transgender youths will now be covered by Medicaid.

CDC Wants to Interview Primary Care Physicians Re Fall Prevention
The Centers for Disease Control and Prevention (CDC) will be  conducting a series of individual interviews with primary care physicians (and other health care professionals) to better understand fall prevention among older adults. CDC’s STEADI Initiative. Flyer available here.

Interviews are:

  • Only 30 minutes
  • Conducted over the phone
  • Flexible scheduled

Participants receive a $25 Amazon gift card

Physicians who are NOT eligible include:

  • Providers who work exclusively in a hospital setting with inpatients
  • Geriatricians who have completed a geriatrics fellowship
  • Residents

Attn: YPs, Residents, Fellows and Medical Students: Meeting in Westbury Feb. 11
Save the Date for the Annual Joint Meeting of the Young Physicians, Resident and Fellow, and Medical Student Sections: Saturday, February 11, 2017 at the Marriott Courtyard, 1800 Privado Road, Westbury NY 11590.

Presentations will include “Telemedicine/Telehealth: Tools for clinical practice and patient engagement.” Gain a better understanding of and appreciation for the use of telemedicine as part of a patient management strategy that will improve and increase access to treatment, lower costs, and more effectively engage patients.

We will also present important financial planning strategies and tips specifically for younger physicians, including Student Loan Management, Main Financial Issues to Address in Residency and as you Transition to Practice, Asset Protection Strategies and Risk Management, and more.

Policy will be created, elections will be held.

YPS and RFS register at sbennett@mssny.org; MSS register at mreyes@mssny.org.

Free Publicity For MSSNY Members
ClearDoc Video is FREE to MSSNY Members who reserve their spot by Monday, Dec. 12th

ClearDoc shoots the videos in under an hour right from your office. Click Here to see some MSSNY Member Videos. ClearDoc is a video educational platform for patients and a great way to generate new patients. ClearDoc is going live in January and already has:

  • 100’s of NY doctors recording answers
  • 1000+ Videos
  • 21 Specialties
  • Dozens of MSSNY Members
  • Multiple State Level Association Endorsements

We are only providing the free videos and placement offer on ClearDoc until Monday, Dec. 12th. Please reserve your spot today.

If you have interest or just want to check out some current MSSNY members doing video, go to  MSSNY.GetClearDoc.com

Urban Institute: Over 1M New Yorkers Could Be Uninsured if ACA Is Repealed
More than 1.1 million New Yorkers could become uninsured by 2019 under a partial repeal of the ACA, according to a report issued this week by the Urban Institute which examines the implications of a partial repeal of the Affordable Care Act (ACA). The report also concluded:

  • New York would lose more than $10 billion by 2028 in premium tax credits and cost-sharing reductions, which help make health insurance more affordable for individuals and families; and
  • New York would lose approximately $47 billion by 2028 in funding for Medicaid and the Children’s Health Insurance Program (CHIP). 

IMG Symposium on December 14 at Jacobi Hospital, Bronx
The IMG symposium:
When:   December 14, Wednesday
Where:  Jacobi Medical Center, 1400 Pelham Parkway South, Bronx NY 10461
Building #4, 2nd Floor Conference Room
Time:    5.30 pm

A light dinner will be provided.  IMG Symposium Presented By Essen Health Care, Medical Society of the State New York (MSSNY), and Bronx County Medical Society. 

John P. Belmont Named Vice President of Legislative and Regulatory Affairs
John P. Belmont has been named Vice President of Legislative and Regulatory Affairs for MSSNY. He replaces Moe Auster, who was recently promoted to the position of Senior Vice President for Legislative and Regulatory Affairs for MSSNY.

“John brings to MSSNY a tremendous amount of knowledge of the New York State legislative process,” said MSSNY President Dr. Malcolm Reid.  “We believe he will be a great advocate for needed improvements to New York’s healthcare system to address the many challenges faced by New York’s dedicated physicians who are working to assure their patients can receive the quality and timely care they need.”

Before joining MSSNY, Mr. Belmont was a Legislative Representative for the Civil Service Employees Association’s influential Legislative and Political Operations arm since December 2006.  The Civil Service Employees Association is one of the largest unions in the United States representing 300,000 active and retired, public and private employees

As a Legislative Representative, Mr. Belmont developed and analyzed proposed legislation and lobbied members of the Assembly, Senate and the Governor’s office on issues of interest to CSEA.  He also participated in planning and conducting member education and training for CSEA membership.

Prior to CSEA, Mr. Belmont worked for the New York State Assembly as a researcher for the Communication and Informational Services Department, where he researched legislation and legislative programs for assigned regions and provided support for member outreach programs including all media outreach and demographic research.

A political science graduate of the College of Saint Rose, Mr. Belmont holds a Trade Union Program Certificate in trade union management and executive leadership from Harvard University. He lives in Colonie, New York.

MSSNY Veterans’ Matters Upcoming Programs on Substance Use Disorders; Physicians Strongly Urged To Attend
The Medical Society of the State of New York has expanded its Veterans’ Matters mental health training initiative by including additional programming on substance use among returning veterans alongside programs on PTSD and TBI as well as Suicide. Veterans’ Matters is conducted through webinars and live grand rounds presentations all over the state.

Presenting faculty for Veterans’ Matters will be Frank Dowling, MD who will present a substance use disorders webinar on Thursday, December 15th at 8 a.m.  On January 13th, a live grand rounds presentation of the same program will be conducted at 8 a.m.  by Dr. Dowling at Brookhaven Memorial Hospital, 101 Hospital Rd, Patchogue, NY.  Each program is accredited for one credit hour of continuing medical education.  Registration is required.

To register for a webinar, click on a date below

Substance Use Disorders – Thursday, 12/15/16 at 8 am
Substance Use Disorders: Live at Brookhaven Memorial Hospital – 1/13/16 at 8 am

Information and the educational objectives for each webinar can be found here:

Substance Use Disorders –12/15/16
Substance Use Disorders: Live at Brookhaven Memorial Hospital – 1/13/16 

If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg Elperin at gelperin@mssny.org or call (518)465-8085.

Alert from HHS: Phishing Email Disguised as Official OCR Audit Communication
It has come to our attention that a phishing email is being circulated on mock HHS Departmental letterhead under the signature of OCR’s Director, Jocelyn Samuels. This email appears to be an official government communication, and targets employees of HIPAA covered entities and their business associates.  The email prompts recipients to click a link regarding possible inclusion in the HIPAA Privacy, Security, and Breach Rules Audit Program.  The link directs individuals to a non-governmental website marketing a firm’s cybersecurity services. In no way is this firm associated with the U.S. Department of Health and Human Services or the Office for Civil Rights.  We take the unauthorized use of this material by this firm very seriously.

OCR would like to further share that this phishing email originates from the email address OSOCRAudit@hhs-gov.us and directs individuals to a URL at http://www.hhs-gov.us.

This is a subtle difference from the official email address for our HIPAA audit program, OSOCRAudit@hhs.gov but such subtlety is typical in phishing scams.

Covered entities and business associates should alert their employees of this issue and take note that official communications regarding the HIPAA audit program are sent to selected auditees from the email address OSOCRAudit@hhs.gov. In the event that you or your organization has a question as to whether it has received an official communication from our agency regarding a HIPAA audit, please contact us via email at OSOCRAudit@hhs.gov.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Seminars: Triage in a Disaster and Impact of Shooter/Bombing on Healthcare
MSSNY will continue its Medical Matters webinars on January 18, 2017 at 7:30 a.m. with Triage in a Disaster Event.   Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here. 

Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well.

February’s webinar will be: The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team. This program will be held on Wednesday, February 15, 2017 at 7:30 a.m. Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

The educational Objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event.  2) Identify means by which members of the healthcare team can address stress before,  during and after an active shooter/bombing event.  3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. MSSNY 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.

Know Your Provider Enrollment Revalidation Due Date to Protect Your Bottom Line!
Revalidate before your due date to avoid a hold on your Medicare payments and a possible deactivation or lapse in your Medicare billing privileges.

There are several ways to find your revalidation due date.

Generally, the due date will remain with the provider/supplier throughout subsequent revalidation cycles. So you will not have to wonder about the due date the next time you need to revalidate.

NOTE:  Unsolicited applications received 6 months prior to the revalidation due date will be returned to the provider.

Need assistance? Providers/Suppliers can register for our provider enrollment revalidation webinars by either using the following links, Part A / Part B or by visiting the NGSMedicare.com website. The webinars below can be found under the Education Tab by selecting Webinars, Teleconference and Events.

  • Provider Enrollment Revalidation
  • Getting Connected to PECOS
  • Submitting Revalidation via PECOS Application
  • Submitting Revalidation via Paper Application for a Part A providers
  • Submitting Revalidation via Paper Application for a Part B providers

Let’s Chat about Provider Enrollment Revalidation

RSVP now at internship@essenmd.com or by calling (929) 239-4160.

Send this invite to colleagues and friends. FLYER 

AMPAC Announces Dates for 2017 Candidate Workshop
Ever wonder how Doctors get elected to Congress or your state legislature?  Considering a run for office for yourself?  Join us February 17-19 at the AMPAC Candidate Workshop in Washington, DC and we’ll teach you how to run a winning political campaign, just like we taught many of your 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.

For more information visit us at AMPAC online. To apply simply fill out the online registration form or email us at: politicaleducation@ama-assn.org.

Your run for office starts today! 

US Health Spending Averaged Nearly $10,000 Per Person In 2015
The New York Times (12/2) reports the Department of Health and Human Services announced on Nov. 30 that healthcare spending in the US “increased last year at the fastest rate since the 2008 recession, reaching $3.2 trillion, or an average of nearly $10,000 a person.” The HHS report, which was published online in the journal Health Affairs, attributed “the increase in federal spending…mainly [to] the expansion of Medicaid eligibility and enrollment.” The Wall Street Journal (12/2) reports spending also grew faster than expected, with national health expenditures increasing 5.8 percent compared with the Centers for Medicare and Medicaid Services’ projected growth of 5.5 percent.


CLASSIFIEDS


Bronx Office Space for Rent
Morris Park-Van Nest, Bronx. Brand New Construction at Highly Desirable Intersection. 2,350 sq. ft. + Ground Level + 1,300 sq. ft. Lower Level; Open Floor Plan. Please Call Anthony Mameli 347-387-9768 or Email to: anthony@md-cre.com. Charles Rutenberg Realty – Exclusive.

State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space (preview images of space can be seen on www.instagram.com/dermroom). $8,000-$11,500/month. For details contact (212)–583–2966 or email Hefderm@outlook.com, no brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up


Physician Opportunities


Executive Director – Bronx County Medical Society
Bronx County Medical Society, a leader in promoting excellence in Clinical Care, Education & Public Policy, is seeking an executive director. Candidates should have either a bachelor degree and/or three years of work experience with non-profit medical groups. The Executive Director should be knowledgeable on healthcare policy and nonprofit compliance. Candidate must demonstrate strength in event planning and fundraising, member recruitment and retention, community outreach, and possess strong communication skills. We offer a competitive salary and benefits package. Please send resume and cover letter to Diane Miller, Executive Director at bxcms@msn.com


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

 

 

 

December 2, 2016 – What You Need to Know Re: PTSD

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
December 2, 2016
Volume 16, Number 42

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Dear Colleagues:

I can state with confidence that all physicians agree that our veterans deserve the best and  timely medical care available to them.

The Veteran’s Choice Program now allows veterans to receive medical care in the community if the VA cannot schedule an appointment within 30 days of the veteran’s preferred date, or the date determined medically necessary by their physician, or if the veteran resides more than 40 miles from their closest VA medical facility. It was authorized under the Veterans Access, Choice, and Accountability Act of 2014 and provides $10B for non-VA medical care to eligible Veterans.

MSSNY has expanded its Veterans’ Matters mental health training initiative by including additional programming on substance use disorders and suicide in returning veterans.  Veterans’ Matters is conducted through webinars and live grand rounds presentations all over the state.

Frank Dowling, MD, a board-certified psychiatrist, will be presenting a PTSD and TBI webinar on Wednesday, December 7th at 7:30 am. An active member of MSSNY, Dr. Dowling currently serves as Commissioner for Science and Public Health. Previously, he served as co-chair of the Addiction and Psychiatric Medicine Committee, chair of the Task Force on Alcohol and Health and vice chair of the Committee on Bioterror and Emergency Preparedness. In addition, he serves on the Advisory Committee and as faculty for the Veteran’s Mental Health Training Initiative, a collaborative effort by MSSNY, NYSPA and NASW-NY to train NY practitioners to assist warriors and veterans with post-traumatic stress and TBI.  

On December 15th, a Substance Use Disorders webinar will also be conducted at 8 am by Dr. Dowling.  Each program is accredited for one-credit hour of continuing medical education.  Registration is required. 

To register for a webinar, click on a date below

PTSD and TBI – Wednesday, 12/7/16 at 7:30 am
Substance Use Disorders – Thursday, 12/15/16 at 8 am

Information and the educational objectives for each webinar can be found here

PTSD and TBI – 12/7/16
Substance Use Disorders –12/15/16

If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg Elperin at gelperin@mssny.org or call (518)465-8085.

If you wish to become a physician who treats veterans, for more details about the Veterans Choice Program, visit http://www.va.gov/opa/choiceact/for_providers.asp

You must accept Medicare rates and have a full, current and unrestricted license in New York.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


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Gov. Signs MSSNY-Supported Legislation to Permit Pharmacy to Pharmacy Transfer of eRx
Governor Cuomo has signed into law legislation advocated for by MSSNY that would permit an e-prescription to be forwarded from one pharmacy to another pharmacy.  The law takes effect March 1, 2017. The purpose of the legislation is to address situations where a patient must request a physician to issue a new e-prescription if the pharmacy to whom an e-prescription was originally submitted does not have the medication in stock. Instead, the pharmacy can forward the e-prescription to another pharmacy requested by the patient. It is another “administrative simplification” measure signed into law this fall that was strongly advocated for by MSSNY and other specialty societies. Other measures signed into law include:

  • Eliminating the requirement for physicians to report to DOH when a written prescription must be issued in lieu of an e-prescription;
  • Requiring the DOH and DFS to create uniform standards for how health insurers impose prescription prior authorization protocols
  • Reducing from 90 to 60 days the time within which a health plan must review a physician’s application to be included in the plan’s network

We thank the hundreds of physicians who contacted their legislators and the Governor to urge that this measure be signed into law. 

Gov. Vetoes Legislation to Enable Pharmacists to Change Length of Prescription Fills
Governor Cuomo has vetoed legislation that would have permitted pharmacists to increase the supply of a non-controlled drug prescription up to a 90-day supply, provided it did not exceed the total amount prescribed by the physician. Basically, it would have permitted a pharmacy to issue a 90-day supply of a medication with 3 refills, instead of following the physician’s prescription for a 30-day supply of a medication with 11 refills. In vetoing the bill the Governor noted that it a) would promote the unnecessary filling of larger quantities of prescription medication, “which could increase the amount of unused drugs in circulation and heighten concerns about safe disposal” and b) “unnecessarily infringes on the doctor-patient prescribing relationship…by allowing pharmacists to unilaterally determine that an additional supply of a drug refill is warranted without first obtaining the practitioner’s approval”.

Nurse Practitioners Can Now Certify Patients for Medical Marijuana
Nurse practitioners will now have the ability to certify patients for the use of medical marijuana under recent regulatory rules changes. Statutorily, the Commissioner of Health, Howard Zucker, MD, had the authority to seek an expansion under the law to allow nurse practitioners to certify patients for use of medical marijuana. In order for nurse practitioners to register with DOH to issue certifications for patients, the practitioner must take the required four-hour course.

Recent press reports have also indicated that the New York State Department of Health will seek to allow physicians assistants to certify patients for the use of medical marijuana if their supervising physicians have been authorized to certify patients. Additionally, the department officials have announced that it is considering allowing the use of medical marijuana for the treatment of chronic pain and also indicated that regulations will be developed to allow for this. MSSNY leadership and its committees are currently reviewing these proposals. Approximately 750 physicians have taken the required course on medical marijuana and have registered with the Department of Health to be able to certify that patients are eligible to receive medical marijuana. 

Medical Matters CME Webinar Series Continues in 2017; Registration Now Open
The Medical Society of the State of New York will continue its Medical Matters webinars on
January 18, 2017 at 7:30 a.m.
with Triage in a Disaster Event.  Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here. 

Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well.  

February’s Webinar

The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team.  This program will be held on
Wednesday, February 15, 2017 at 7:30 am.
Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. 

The educational objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event.  2) Identify means by which members of the healthcare team can address stress before, during and after an active shooter/bombing event.  3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

MSSNY designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Deadline for Informal Review of Potential Penalties Extended
Physicians who want to contest potential payment penalties associated with the Physician Quality Reporting System (PQRS) and/or the Value Modifier (VM) now have until December 7 to file a request for an informal review of their data.  Previously, the deadline to request a review was November 30 but the Centers for Medicare and Medicaid Services announced yesterday that the deadline will be extended by one week.

The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act.  Failure to successfully complete required PQRS reporting will result in a 2% penalty.  Value Modifier penalties can range from 1% to 4% depending on the size of the practice and its performance on cost and quality measures.  PQRS penalties were communicated to physicians by mail as well as in the PQRS feedback reports posted on the CMS web site.  Value Modifier penalties and bonuses can be found in Quality and Resource Use Reports (QRURs) posted on the web site only.

Those who have questions, even if they are uncertain about penalty status, are urged to submit a request for informal review.  Although in most cases a successful PQRS review will trigger an automatic review of related VM penalties, program officials say the safest course is to file requests for review of both PQRS and VM data.

  • To File A Request for PQRS Informal Review:

Go to the Quality Reporting Communication Support Page (CSP), select “related links” in communication support page in the upper left-hand corner, then select “informal review request” followed by “”PQRSs informal review” and fill out requested information when new page opens.

If you have not already done so, 2015 PQRS feedback reports can be accessed on the CMS Enterprise Portal using an Enterprise Identity Management (EIDM) account. See PQRS Analysis and Payment webpage for more information.

For additional questions regarding the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time. To avoid security violations, do not include personal identifying information, such as Social Security Number or TIN, in e-mail inquiries to the QualityNet Help Desk.

  • To File A Request for VM Informal Review:

For information on how to file, see the 2017 Value Modifier Informal Review Request Quick Reference Guide.

For More Information, see: How webpage and/or  2015 QRUR and 2017 Value Modifier webpage.

Help Desk Information: For EIDM, contact the QualityNet Help Desk at qnetsupport@hcqis.org or 866-288-8912 (TTY 877-715- 6222);  For QRURs or the Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3)


Residents and Fellows
: Register for Poster Symposium; Jan. 31 Deadline
MSSNY is very pleased to announce the 12th Resident/Fellow/Medical Student Poster Symposium:

When:   Friday, April 21, 2017
Where: Westchester Marriott
Tarrytown, New York
Time:   2 pm – 4:30 pm

Click here for detailed guidelines.

Deadline for abstract submission is 4 pm, Tuesday, January 31, 2017. Check out last year’s Abstract Book here.

We welcome your participation. Participants must be MSSNY members, and membership is free for first-time resident members. Join online. 

Student News: USMLE Step 2: Determine the Cause of Morbidity and Death
If you’re preparing for the United States Medical Licensing Examination® (USMLE®) Step 2 exam, you might want to know which questions are most often missed by those taking the practice test. Check out this example from Kaplan Medical, and view an expert video explanation of the answer. This USMLE® Step 2 practice test question deals with a 68-year-old man whose complaints include headache, dizziness and fatigue. Read more at AMA Wire.


For Your Patients
: FREE Rx Cards for Discounted Drugs
MSSNY has teamed up with the New York Rx Card program to provide FREE discount prescription drug cards to your employees and patients.  The New York Rx Card can be used for savings of up to 75 percent on prescription drugs at over 68,000 pharmacies nationwide.  The New York Rx Card discounts brand names and generics as well as non-covered medications for those patients who may have prescription coverage.  The program has no membership restrictions, no income requirements, no age limitations and there are no applications to complete.

Please encourage your patients to print a free New York Rx Card at  www.newyorkrx.com.

Patients also can secure the discount by simply walking into any CVS pharmacy in the state and asking for the New York Rx Card discount even if they do not have a card.

The drug cards also can be mailed to your clinic at NO COST by contacting the drug card’s program director, Chez Ciccone, via email at cc@nyrxcard.com or by phone at 800.931.2297.

We believe this is an easy and innovative way to help your patients get the prescription drugs they need to be treated effectively.

WSJ: Hospital Construction in New York City Booming Since 2013
The Wall Street Journal reports: “Hospitals in the city spent more than $6 billion on construction from 2013 through 2015 and are expected to spend $8.2 billion from 2016 through 2018, according to a survey and analysis from the New York Building Congress, an industry group.” (WSJ 12/1/)


CLASSIFIEDS


Bronx Office Space for Rent
Morris Park-Van Nest, Bronx. Brand New Construction at Highly Desirable Intersection. 2,350 sq. ft. + Ground Level + 1,300 sq. ft. Lower Level; Open Floor Plan. Please Call Anthony Mameli 347-387-9768 or Email to: anthony@md-cre.com. Charles Rutenberg Realty – Exclusive.

State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space (preview images of space can be seen on www.instagram.com/dermroom). $8,000-$11,500/month. For details contact (212)–583–2966 or email Hefderm@outlook.com, no brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Want to Sell Your Medical Practice? Do You Have Medical Office Space to Sell or Share?
Clineeds is a new online platform designed to help medical providers sell their practice or buy, sell and share medical office space. Listing is FREE! No contracts. No commitments. No fees. Sign up today at http://www.clineeds.com/sign-up


Physician Opportunities


Executive Director – Bronx County Medical Society
Bronx County Medical Society, a leader in promoting excellence in Clinical Care, Education & Public Policy, is seeking an executive director. Candidates should have either a bachelor degree and/or three years of work experience with non-profit medical groups. The Executive Director should be knowledgeable on healthcare policy and nonprofit compliance. Candidate must demonstrate strength in event planning and fundraising, member recruitment and retention, community outreach, and possess strong communication skills. We offer a competitive salary and benefits package. Please send resume and cover letter to Diane Miller, Executive Director at bxcms@msn.com


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

 

 

 

November 18, 2016 – Alphabet Soup Mania!

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
November 18, 2016
Volume 16, Number 41

mssny_enews_dividend

Dear Colleagues:

MACRA, MIPS, APNs, EHR, PQRS, MU, SGR, IPA, HMO, PPO, PPN, CMS, CSC, NGS, PAC, CAC, etc.

Yes, the alphabet soup continues. If you have been around long enough, you know what most of these acronyms mean. Historically, we had traditional indemnity health insurance plans. We had usual customary and reasonable charges. We had prevailing community fees.  Ah, the good old days.

Next came what was supposed to be the best thing since sliced bread— managed care.  Pre-certifications and prior authorizations reigned. Then, the pendulum swung the other way and gave us capitation with a mix of fee-for-service. This worked well for a little while—until the plans figured out that under capitation, some providers made more money than under fee-for-service.  Uh-oh, switch back to fee-for-service stat.

Now, the pendulum swings again.  The government comes up with MACRA.  They describe it as a new payment methodology. Really?  Again, if you have been around long enough, it is just the pendulum swinging back yet again.

The government is just trying to see what they are paying for – call it MIPs, APNs, call it value-based medical care.  Call it what you will –quite simply, it is just the government demanding to know what it is paying. To do so, it forces physicians to jump through hoops and put square pegs into round holes to justify being paid for the care provided to patients.

If you need help with the payment games, reach out to your medical society. For dues paying members, we are here to help.

If you really want or need a description of the acronyms, call Regina McNally, VP, Socio-Medical Economics, 516 488 6100, ext. 332.

Now, for the good news! This week MLMIC declared a new 20% general dividend for policyholders. The dividend — which will apply to policyholders who are insured on May 1, 2017, and maintain continuous coverage through July 1, 2017 — will be based upon the annual rate of premium in effect on May 1, 2017. MLMIC has always had strong standing and stability in the challenging New York insurance market, and this dividend in addition to their arrangement with Berkshire Hathaway will bring policyholders continued peace of mind.

(See story below)

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


enews large

MLMIC Board Declares 20% Dividend for Policyholders
MLMIC’s board has declared a new 20% general dividend for policyholders. The dividend — which will apply to policyholders who are insured on May 1, 2017, and maintain continuous coverage through July 1, 2017 — will be based upon the annual rate of premium in effect on May 1, 2017.  It will provide meaningful financial relief to policyholders.

The board’s decision to declare this dividend is based on MLMIC’s statutory admitted assets of approximately $5.8 billion, a surplus of $1.9 billion and statutory net income of approximately $100 million. These figures, available in the company’s September 30, 2016, statutory financial statement, show the company’s overall financial condition remains sound.

The new dividend is separate and apart from MLMIC’s agreement to become part of the Berkshire Hathaway family of companies. That process takes a while and is on track to be completed by next year’s end. In the meantime, MLMIC’s strong financial performance enables it to offer a 20% dividend.

An overview of the September 30, 2016, statutory financial statement is available here, and the full financial statement has been filed with New York State Department of Financial Services.

Governor Signs MSSNY-Backed Administrative Simplification Bills into Law
Governor Cuomo this week signed into law two bills supported by MSSNY designed to reduce some of the administrative burdens on physicians in their dealings with health insurers.

  • The first bill (A.501-E, Cusick/S.2545-D, Lanza) would reduce from 90 to 60 days the time within which a health insurer must complete its review of the application of a physician to participate in the network of a health insurer, as well as reducing from 90 to 60 days the time within which a physician in some situations can become “provisionally credentialed” if the plan does not complete its review.   The bill also eliminates some ambiguous statutory language that currently gives discretion to a health insurer to delay a decision on a physician’s application after these deadlines have passed.   The new law applies to credentialing applications received by health insurers on or after April 1, 2017.
  • The second bill (A.6983-A, McDonald/S.4721-A, Hannon) would direct the Commissioner of Health and Department of Financial Services to create standards to provide greater uniformity among health insurers of the processes to be followed when physicians request insurers to cover their patients’ needed prescription medications.  MSSNY worked closely with the New York Chapter of the American College of Physicians in advocating for this legislation.   The law takes effect immediately.

Urge Gov. to Sign Law to Permit E-Prescription Transfers between Pharmacies
All physicians are urged to contact the Governor to urge that he sign into law legislation (A.10448. Schimmel/S.7537, Martins) supported by MSSNY that would permit a pharmacy to transfer an e-prescription to another pharmacy. 
Physicians can send a letter to the Governor from here.  

This law would address concerns faced by both patients and physicians when a pharmacy may be out of stock of a particular medication, and may be unable to fill the prescription.  Current laws pertaining to e-prescribing do not allow for the transfer of an e-prescription from one pharmacy to another. In such instance the only recourse available to the patient is to return to the physician’s office – if it is open—to have him/her send the e-prescription to another pharmacy. This creates unnecessary duplication for the physician, and unnecessary delays for the patient waiting to receive their needed medications. This legislation would help to address these concerns.

Counting Absentee Ballots for 2 Senate Races; 24 Newly Elected to NY Legislature
With the absentee ballots of 2 Long Island State Senate races still being counted, it has not yet been officially determined which party will have majority control of the New York State Senate. Of the 63 seats in the State Senate, 30 Republicans have been elected, and 31 Democrats. However, one of the Democrats, Simcha Felder, has previously “conferenced” with the Republicans. The 2 State Senate seats not yet officially decided are currently held by Republicans Carl Marcellino and Michael Venditto.  Also unclear at this time is the role of the 7-member Independent Democratic Caucus led by Senator Jeff Klein.

The November 8 elections also saw 24 candidates newly elected to the New York State Legislature, including 18 new Assemblymembers and 6 new Senators. 
Below is a list of these newly elected members, and the members of the Legislature they will be replacing:

Chamber District FIRST Last Party Replaced
Assembly 30 (NYC) Brian Barnwell Dem Margaret Markey
Assembly 94 (Hudson Valley) Kevin Byrne GOP Steve Katz
Assembly 44 (NYC) Robert Carroll Dem James Brennan
Assembly 72 (NYC) Carmen De La Rosa Dem Guillermo Linares
Assembly 70 (NYC) Inez Dickens Dem Keith Wright
Assembly 16
(Long Island)
Anthony D’Urso Dem Michelle Schimel
Assembly 133 (Western NY) Joe Errigo (former Assemblyman) GOP Bill Nojay
Assembly 115 (North Country) D. Billy Jones Dem Janet Duprey
Assembly 20
(Long Island)
Melissa Miller GOP Todd Kaminsky
Assembly 101 (Central NY) Brian Miller GOP Claudia Tenney
Assembly 145 (Western NY) Angelo Morinello GOP John Ceretto
Assembly 65 (NYC) Yuh-Line Niou Dem Alice Cancel
Assembly 144 (Western NY) Michael Norris GOP Jane Corwin
Assembly 23 (NYC) Stacey Pheffer Amato Dem Phil Goldfeder
Assembly 33 (NYC) Clyde Vanel Dem Barbara Clark
Assembly 143 (Western NY) Monica Wallace Dem Angela Wozniak
Assembly 112 (Capital District) Mary Beth Walsh GOP James Tedisco
Assembly 56 (NYC) Tremaine Wright Dem Annette Robinson
Senate 31 (NYC) Marisol Alcantara Dem Adriano Espaillat
Senate 36 (NYC) Jamaal Bailey Dem Ruth Hassell-Thompson
Senate 54 (Central NY) Pamela Helming GOP Michael Nozzolio
Senate 60 (Western NY) Chris Jacobs GOP Marc Panepinto
Senate 7
(Long Island)
Elaine Phillips GOP Jack Martins
Senate 49 (Capital District) James N. Tedisco (former Assemblyman) GOP Hugh Farley

Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


MSSNY Veterans’ Matters Now Includes CME Programs on Substance Use and Suicide; Physicians Strongly Urged to Attend
The Medical Society of the State of New York is expanding its Veterans’ Matters mental health training initiative by including additional programming on substance use disorders and suicide in returning veterans.  Veterans’ Matters is conducted through webinars and live grand rounds presentations all over the state.

Presenting faculty for Veterans’ Matters includes Frank Dowling, MD and John McIntyre, MD. The Medical Society will present a PTSD and TBI webinar on Wednesday, December 7th at 7:30 a.m.  On December 15th, a Substance Use Disorders webinar will be conducted at 8 a.m.   Registration is required.

 

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

MSSNY designates each live activity for a maximum of 1 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

To register for a webinar, click on a date below:

Information and the educational objectives for each webinar can be found here:

PTSD and TBI – 12/7/16
Substance Use Disorders –12/15/16

If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg  Elperin at gelperin@mssny.org or call (518)465-8085. 

MACRA Educational Program This Monday Evening from 7-8:30PM
Do you have questions about how to comply with the new Medicare MIPS requirements taking effect in 2017?  This
Monday, November 21, from 7-8:30 PM
is the first of several programs being offered by the AMA to help physicians better understand  the requirements of the new Quality Payment Programs (QPP) that were created by the Medicare Access and CHIP Reauthorization Act (MACRA). To register for Monday night’s program, click here:  https://cc.readytalk.com/r/y70aavsqh5g0&eom

Other similar programs upcoming include:

  • Thursday,  Dec. 1 – 6:30 pm – 9 pm ET
    Register here:
  • Tuesday,  Dec. 6, 8:00 pm – 9:30 pm ET
    Register here.
  • Saturday,  Dec. 10, 12 PM -1:30 ET
    Register here.

DOH Recommends Four Brooklyn Hospital Merge
A new report commissioned by the state Department of Health recommends that four financially struggling Brooklyn hospitals merge into one regional health system, with one of the hospitals drastically reducing inpatient services.

The four hospitals—Brookdale University Hospital and Medical Center, Kingsbrook Jewish Medical Center, Interfaith Medical Center and Wyckoff Heights Medical Center—will require $310 million in operating subsidies from the state in fiscal 2017, which ends March 31, 2017. The report was authored by Northwell Ventures, the consulting arm of Northwell Health. The combined losses of the four hospitals are expected to grow to $405 million by fiscal 2021. Over the five-year period the hospitals will have lost $1.8 billion. Gov. Andrew Cuomo and the state Department of Health must now determine whether they support Northwell’s proposals. To move forward, the plan must also be approved by the boards of the four Brooklyn hospitals. 

AMA Statement Re Principles of Health Care Reform That Congress Must Address
With the entire Affordable Care Act likely to be revisited in the New Year by the Congress and President-elect Trump, the AMA released the following statement after receiving extensive testimony from physicians representing a wide array of perspectives at its House of Delegates meeting this past weekend.

“The AMA House of Delegates, reflecting more than 170 state and specialty medical societies from across the country, today reaffirmed its commitment to health care reform that improves access to care for all patients. 

“Using a comprehensive policy framework that has been refined over the past two decades, the AMA will actively engage the incoming Trump Administration and Congress in discussions on the future direction of health care. The AMA remains committed to improving health insurance coverage so that patients receive timely, high quality care, preventive services, medications and other necessary treatments.  

“A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured. We will also advance recommendations to support the delivery of high quality patient care.  Policymakers have a notable opportunity to also reduce excessive regulatory burdens that diminish physicians’ time devoted to patient care and increase costs. 

“Health care reform is a journey involving many complex issues and challenges, and the AMA is committed to working with federal and state policymakers to advance reforms to improve the health of the nation.”

Among the key principles highlighted by the AMA in its policy framework that they urge policymakers to consider:

  • Individually owned and selected health insurance using refundable and advanceable tax credit
  • Support a requirement that individuals and families who can afford health insurance be required to obtain it;
  • Required coverage of pre-existing conditions;
  • Expanded availability of Health Savings Accounts (HSAs);
  • Continued availability of those under 29 to stay on parents’ coverage;
  • Adequate Provider Networks in Medicare, Medicaid and Commercial Insurance;
  • Health Plan Transparency/Accurate Network Listings;
  • Medical Liability Reform;
  • Fair Medicaid Payment/Parity with Medicare payments; and
  • Affordable Prescription Medications


CMS Launches New Online Tool to Make Payment Program Easier for Clinicians
Today, CMS released a tool to share automatically electronic data for the Medicare Quality Payment Program. This new release is the first in a series that will be part of CMS’s ongoing efforts to spur the creation of innovative, customizable tools to reduce burden for clinicians, while also supporting high-quality care for patients.

In October, CMS released the Quality Payment Program website, an interactive site to help clinicians understand the program and successfully participate. Today’s release, commonly referred to as an Application Program Interface (API), builds on that site by making it easier for other organizations to retrieve and maintain the Quality Payment Program’s measures and enable them to build applications for clinicians and their practices. The API, available at www.qpp.cms.gov/education, will allow developers to write software using the information described on the Explore Measures section ofwww.QPP.cms.gov

.Based on interviews with clinicians, CMS created the Explores Measures tool, which enables clinicians and practice managers to select measures that likely fit their practice, assemble them into a group, and print or save them for reference. Already, tens of thousands of people are using this tool.

Several groups have applauded the release of this information, including: the American Academy of Ophthalmology, the Network for Regional Healthcare Improvement (NHRI), American College of Radiology (ACR), American College of Physicians (ACP), National Rural Accountable Care Consortium, Great Lakes PTN, Pacific Business Group on Health, Compass PTN, TMF QIN-QIO, and the Mountain Pacific Quality Health Foundation.

As the program and its supporting website mature, CMS will continue to release data and APIs to spur innovation and keep participants up-to-date.

To see the API Swagger documentation, please visit: https://qpp.cms.gov/api/

CMS Finalized Claims-Based Data Collection Process that Is “Less Burdensome”
CMS finalized a claims-based data collection process on the frequency of and inputs involved in global surgical services that is much less burdensome for physicians than CMS’ earlier proposal. Key changes include:

  • CMS’ decision to use 99024 for reporting post-operative services rather than the proposed set of time-based G-codes
  • Reporting is no longer required for pre-operative visits
  • Reporting is only triggered for services that meet certain minimum thresholds annually—CPT codes billed by more than 100 practitioners over 10,000 times or have allowed charges in excess of $10 million

The final rule increases payments for Chronic Care Management services by accepting CPT and RUC recommendations urging CMS to ease the administrative burden and expand the opportunities for physicians. CPT codes 99358 and 99359 for non-face-to-face prolonged E/M services will also be billable under Medicare beginning in 2017.

Medicare Announces New RAC Contracts
Last week, Medicare announced the new Recovery Auditor contracts, which sets limits for the post-claims review process and dictates when Recovery Audit Contractors (RAC) will be eligible to receive their contingency fees.

Among the changes specified in the new contracts, RACs will no longer automatically receive contingency fees for each identified overpayment. This new policy requires the RACs to pass the second level of a five-level appeals process before receiving their contingency fee. The new RAC contracts also establish new audit timelines—the RAC lookback period for inpatient claims is reduced from three years to six months—and the two midnights rule will continue to be exempted from RAC audits.

These changes are in addition to Medicare’s recent pilot program that directs RACs to consider as a low-priority reviewing claims from providers participating in Advanced Alternative Payment Models under the new Quality Payment Program.

Medical Matters CME Webinar Series Continues in 2017; Registration Now Open
The Medical Society of the State of New York will continue its Medical Matters webinars on
January 18, 2017 at 7:30 am with Triage in a Disaster Event
.  Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee, will serve as faculty for this program. Registration is now open for this webinar here.

Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well.

February’s webinar will be:
The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team
. This program will be held on Wednesday, February 15, 2017 at 7:30 a.m. and faculty will be Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

The educational Objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event; 2) Identify means by which members of the healthcare team can manage the stress during and after an active shooter/bombing event; 3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

A copy of the flyer can be accessed 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 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. 

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

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.

MSSNY Participates in Antimicrobial Resistance Prevention Task Force
The New York State Department of Health (NYSDOH) convened the first-ever multidisciplinary New York State Antimicrobial Resistance Prevention and Control Task Force (NYS-ARTF) Summit this week. The summit addressed the need for prevention strategies throughout the health system and built on the work outlined at the July roundtable discussion on “Antimicrobial Resistance in Healthcare Facilities,” which was hosted by NYSDOH, Greater New York Hospital Association, and the Healthcare Association of New York State.

The engagement of stakeholders in the summit and roundtable is a key element in New York State’s comprehensive strategy to address the persistent and growing threat of multi-drug resistant bacteria. Cases of drug resistant Candida auris, a serious and sometimes fatal fungal infection andmcr-1, a novel drug resistant gene present in some bacteria, have been reported in New York. The Centers for Disease Control and Prevention (CDC) estimate that each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections.

“Through this Summit, the Task Force is working with New York State’s healthcare leaders to shape a state-wide response to the growing public health threat of multi-drug resistant bacteria,” said Commissioner of Health Dr. Howard Zucker. “If antimicrobial resistance is not addressed, we face a future where these medicines may no longer work, and infections will become difficult or impossible to treat. The most vulnerable among us will be the most at-risk.”

The summit involved experts from various disciplines including healthcare, agriculture, and veterinary care, as well as academia, community groups, and federal, state, and local government.

Stakeholders participating in the summit were previously asked to outline New York State’s top priorities in the efforts to combat antibiotic resistance. Among the priorities listed were:

  • To expand antimicrobial stewardship programs and improve infection prevention and control practices in all hospitals and nursing homes
  • To limit antibiotic use in food producing animals
  • To educate and support healthcare providers to optimize antibiotic prescribing
  • To educate consumers about appropriate antibiotic prescribing and use
  • To develop rapid diagnostic tests to distinguish bacteria from viruses and identify antibiotic resistance
  • To improve communication when patients are transferred between healthcare facilities

During the Summit, participants collaborated on designing practical solutions to achieve these priorities. The input from participants will be compiled to develop and implement a statewide strategic approach to combatting antimicrobial resistance as well as a report of recommendations that will be submitted to Governor Andrew M. Cuomo, by December 31, 2016.

“Get Smart” Campaign on Antibiotic Resistance November 14-20th
The New York State Department of Health will hold its “Get Smart (Know When Antibiotics Work) Week” on Nov 14-20th and the campaign is intended to create awareness within the physician and patient community about the growing resistance to antibiotics.  Get Smart  About Antibiotics Week (Get Smart Week) is a national, annual observance intended to engage relevant stakeholders – including professional societies, advocacy groups, for-profit companies, state and local health departments, the general public, the media and others – around antibiotic stewardship in the outpatient, inpatient, and animal health settings.

New York’s “Get Smart Campaign” promotion of the “Get Smart Guarantee” , an easy way for healthcare providers to display their commitment to appropriate antibiotic prescribing and use. The provider may use the free poster within the office and place their own photo on the poster and sign it.

There are also patient palm cards, which are a nice educational “takeaway” for a patient if they can’t have antibiotics (if their illness is viral, for instance).

The NY Get Smart Campaign would be very happy to send materials to individual providers. Contact Mary Beth Wenger at marybeth.wenger@health.ny.gov   or at (518)-474-1036.


CLASSIFIEDS


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

Bronx Office Space for Lease
Morris Park-Van Nest, Bronx. Brand New Construction at  Highly Desirable Intersection. 2,350 sq.  ft. + Ground Level + 1,300 sq. ft. Lower Level; Open Floor Plan.  Please Call Anthony Mameli 347-387-9768 or Email to: anthony@md-cre.com. Charles Rutenberg Realty – Exclusive.

State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space. $8,000-$11,500/month. Contact: (212)–583–2966, email: hefderm@outlook.com for details. No Brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Physician Opportunities


Executive Director – Bronx County Medical Society
Bronx County Medical Society, a leader in promoting excellence in Clinical Care, Education & Public Policy, is seeking an executive director. Candidates should have either a bachelor degree and/or three years of work experience with non-profit medical groups. The Executive Director should be knowledgeable on healthcare policy and nonprofit compliance. Candidate must demonstrate strength in event planning and fundraising, member recruitment and retention, community outreach, and possess strong communication skills. We offer a competitive salary and benefits package. Please send resume and cover letter to Diane Miller, Executive Director at bxcms@msn.com


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

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

 

 

 

 

 

 

 

 

 

 

 

 

 

November 11, 2016 – We Love Our Vets

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
November 11, 2016
Volume 16, Number 40

MLMIC Insurance

Dear Colleagues:

As we observe Veterans Day this year and thank veterans for their service, it makes me proud to be in a position where we, as physicians, can give something back.

Last year, MSSNY launched its Veterans’ Matters program, a primary-care training initiative focused on making sure that our returning veterans receive the best evidence-based treatment.  Since its implementation, Veterans’ Matters has educated hundreds of primary-care providers all over the state on how to identify, refer, and treat post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), two of the most important mental health concerns that affect our veterans today. The program is built on the simple premise that veterans matter, and getting them the care they deserve starts with giving doctors the best resources to understand veterans and the unique challenges of military culture.

That’s why I’m happy to announce that MSSNY is expanding Veterans’ Matters to include new programs on substance use disorders and suicide prevention. These programs will feature monthly webinars and live grand rounds presentations across the state.

To register for a webinar, click on one of the following dates. More dates will be announced soon.

Veterans’ Matters: PTSD and TBI – 12/7/16, 7:30 am
Veterans’ Matters: Substance Use Disorders – 12/15/16, 8 am

To access a flyer, click on a program date below:
12/7/16, 12/15/16

If you are interested in scheduling a Veterans’ Matters grand rounds session in your community, please contact Greg Elperin (gelperin@mssny.org or 518-465-8085).

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


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Statement by MSSNY President Malcolm Reid, MD, MPP Regarding Crains Article Examining the Reduction in Independent Practice
“Today’s Crains New York article highlighting the endangered species that is independent physician practice is the inevitable end product of federal and state policies that have resulted in extraordinary overhead cost burdens and paperwork responsibilities, and less time to deliver patient care. Physicians should have a fair choice of practice setting to deliver care to their patients, whether that is in a large health system, large medical group or within a smaller medical practice. Unfortunately, too many physicians find they have no choice but to become employed in large health systems due to the untenable squeeze between these huge and growing overhead costs, and unjustified cuts in payments from insurers if they are even allowed to stay in their networks.

This changing dynamic has profound implications for our patients.  Many physicians enjoy independent practice because of the personal attention that can be directed to their patients without external interference.  Indeed, that is the heart of the patient-physician relationship. Certainly, existing patient-physician relationships can be maintained (and even in some cases improved) as physicians change care delivery settings, but many of these treatment relationships can be disrupted due to new external demands placed on physicians from their new employers.  We urge our state and federal policymakers to be cognizant of these trends in health care delivery as they consider future measures that would only further increase these overhead costs and administrative burdens.”

MSSNY Participates in Antimicrobial Resistance Prevention Task Force
The NYSDOH convened the first-ever multidisciplinary New York State Antimicrobial Resistance Prevention and Control Task Force (NYS-ARTF) Summit this week. The summit addressed the need for prevention strategies throughout the health system and built on the work outlined at the July roundtable discussion on “Antimicrobial Resistance in Healthcare Facilities,” which was hosted by NYSDOH, Greater New York Hospital Association, and the Healthcare Association of New York State.

The engagement of stakeholders in the summit and roundtable is a key element in New York State’s comprehensive strategy to address the persistent and growing threat of multi-drug resistant bacteria. Cases of drug resistant Candida auris, a serious and sometimes fatal fungal infection and mcr-1, a novel drug resistant gene present in some bacteria, have been reported in New York. The Centers for Disease Control and Prevention (CDC) estimate that each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections.

“Through this Summit, the Task Force is working with New York State’s healthcare leaders to shape a state-wide response to the growing public health threat of multi-drug resistant bacteria,” said Commissioner of Health Dr. Howard Zucker. “If antimicrobial resistance is not addressed, we face a future where these medicines may no longer work, and infections will become difficult or impossible to treat. The most vulnerable among us will be the most at-risk.”

The summit involved experts from various disciplines including healthcare, agriculture, and veterinary care, as well as academia, community groups, and federal, state, and local government.

Stakeholders participating in the summit were previously asked to outline New York State’s top priorities in the efforts to combat antibiotic resistance. Among the priorities listed were:

  • To expand antimicrobial stewardship programs and improve infection prevention and control practices in all hospitals and nursing homes
  • To limit antibiotic use in food producing animals
  • To educate and support healthcare providers to optimize antibiotic prescribing
  • To educate consumers about appropriate antibiotic prescribing and use
  • To develop rapid diagnostic tests to distinguish bacteria from viruses and identify antibiotic resistance
  • To improve communication when patients are transferred between healthcare facilities

During the Summit, participants collaborated on designing practical solutions to achieve these priorities. The input from participants will be compiled to develop and implement a statewide strategic approach to combatting antimicrobial resistance as well as a report of recommendations that will be submitted to Governor Andrew M. Cuomo, by December 31, 2016.

AMA: Educational Opportunities to Fully Understand QPP Created by MACRA
The AMA is offering several educational opportunities to help physicians understand the requirements of the new Quality Payment Program (QPP) that was created by the Medicare Access and CHIP Reauthorization Act (MACRA).   The sessions have been scheduled to give physicians an understanding of what the final rule means for their practice and what they need to do as part of the QPP. All of the sessions are open to physicians and medical society staff. We hope you will take advantage and register for these opportunities to learn what you need to know and pass along the registration information to your physician members.

  • Monday,  Nov. 21, 7 pm – 8:30 pm EST  Physician/Staff  webinar     Registration
  • Thursday,  Dec. 1 – 6:30 pm – 9 pm EST
    Atlanta regional seminar (streaming and webinar)
    Cobb Galleria Center
    Atlanta Georgia
    Registration
  • Tuesday,  Dec. 6, 8:00 pm – 9:30 pm EST Physician/staff  webinar
    Registration
  • Saturday,  Dec. 10, 9 am -11:30 PST
    San Francisco regional seminar (streaming and webinar)
    Marriot Marquis
    San Francisco, CA
    Registration

Take MSSNY Survey Now: Current Responses Highlight Problems of Pared Down/Inadequate Insurer Networks
MSSNY’s recent survey of physicians has highlighted the concerns of many physicians regarding whether health insurance networks are adequate to truly meet patient care needs.  Nearly 80% of physician respondents to the survey indicated that they had experienced a situation where one of their patients could not quickly receive the care they need due to the inadequacy of a health insurer’s network.

Moreover, limited networks continue to be a problem, with over 25% of responding physicians indicating that they were, within the last 2 years, dropped from a health insurer’s network, and over 40% indicating that an insurer with whom they participate had not included them in a new coverage product.   Addressing inadequate insurer networks, including assuring the availability of out of network coverage in New York’s Exchange, will be an important part of MSSNY’s 2017 Legislative Program.

The survey has also sought physician perspective on their participation in value-based payment programs.  There is still time to add your voice to this survey if you have not already.  Please click here.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


“When Is the Flu Not the Flu?” CME Webinar on Nov. 16; Registration Now Open
MSSNY will begin its 2017 Medical Matters continuing medical education (CME) webinar series with “When Is the Flu Not the Flu?” on Wednesday, November 16, 2016 at 7:30 a.m.   William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are: 1). Recognize the distinction between influenza virus infections and other similarly presenting illnesses.  2). Describe strategies for prevention, diagnosis and management of patients presenting with flu-like symptoms. 

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. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Additional programs are will be conducted in January-May 2017, and topics include: Triage in a Disaster Event; The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team; and Mosquito Borne Diseases.  Program dates for Medical Matters will be announced shortly. 

Electronic Prescribing Waivers Expire on March 26, 2017
As of March 27, 2016, practitioners must electronically prescribe both controlled and non-controlled substances. Current Department of Health (DOH)-approved waivers from the requirement to electronically prescribe will expire on March 26, 2017.

Practitioners requiring a waiver after March 26, 2017, must submit a new request which includes an updated statement of facts describing the continuing circumstances supporting the waiver. Beginning December 27, 2016, a renewal request can be submitted for review to the DOH Bureau of Narcotic Enforcement (BNE). Please note, practitioners who no longer need a waiver are required by law to notify BNE, within five business days of gaining the capability to issue an electronic prescription.

Practitioners issuing less than 25 prescriptions per year for both controlled and non-controlled substances combined should submit a certification (DOH-5221) in lieu of a waiver request. Unlike a waiver request, a certification does not require DOH approval. It is a simpler process which only requires a practitioner’s attestation and upon submission, allows low-volume prescribers (25 prescriptions or less per year) to continue to issue paper prescriptions. To request a new waiver or to submit a certification online, log into the Health Commerce System here and access the “Electronic Prescribing Waivers” (EPW) application. If you need to request a paper form, please call 1-866- 811-7957. Additional information regarding electronic prescribing can be found on our website here.

Practitioners issuing less than 25 prescriptions per year for both controlled and non-controlled substances combined should submit a certification (DOH-5221) in lieu of a waiver request.  Unlike a waiver request, a certification does not require DOH approval. It is a simpler process which only requires a practitioner’s attestation and upon submission, allows low-volume prescribers (25 prescriptions or less per year) to continue to issue paper prescriptions.   To request a new waiver or to submit a certification online, log into the Health Commerce System here and access the “Electronic Prescribing Waivers” (EPW) application. If you need to request a paper form, please call 1-866-811-7957. Additional information regarding electronic prescribing can be found on our website at www.health.ny.gov/professionals/narcotic.

A copy of the letter can be found HERE.

Register Now for NY eHealth Collaborative on December 6-7
The New York eHealth Collaborative’s Digital Health Conference (DHC) on December 6-7 at New World Stages in Manhattan brings together 500 senior-level healthcare industry leaders to learn about new innovations and to foster dynamic conversation addressing how healthcare is being redefined through technology. This year, the conference is a Who’s Who of New York’s healthcare and health tech community gather for two days of networking, lively intellectual exchange, and exploration to see what’s new, what’s cutting edge, and what will shape the future of healthcare. Join your peers and register today!

MSSNY Members will receive a 10% registration discount. Use code MSSNY when registering at www.DigitalHealthConference.com.

“Get Smart” Campaign On Antibiotic Resistance To Be Held November 14-20th
The New York State Department of Health will hold its “Get Smart (Know When Antibiotics Work) Week” on Nov 14-20th and the campaign is intended to create awareness within the physician and patient community about the growing resistance to antibiotics.  Get Smart  About Antibiotics Week (Get Smart Week) is a national, annual observance intended to engage relevant stakeholders – including professional societies, advocacy groups, for-profit companies, state and local health departments, the general public, the media and others – around antibiotic stewardship in the outpatient, inpatient, and animal health settings.

New York’s “Get Smart Campaign” promotion of the “Get Smart Guarantee,” an easy way for healthcare providers to display their commitment to appropriate antibiotic prescribing and use. The provider may use the free poster within the office and place their own photo on the poster and sign it.

There are also patient palm cards, which are a nice educational “takeaway” for a patient if they can’t have antibiotics (if their illness is viral, for instance).

The NY Get Smart Campaign will send materials to individual providers. Contact Mary Beth Wenger at marybeth.wenger@health.ny.gov   or at (518)-474-1036. 

Multidrug-Resistant Yeast Identified in U.S.
Cases of multidrug-resistant Candida auris infection have been identified for the first time in the U.S., the CDC reports in MMWR. This follows a CDC alert this summer requesting that clinicians report any cases to their health departments. The invasive yeast has been reported on four other continents.

Based in part on a retrospective review of microbiology records, seven cases in four states from 2013 to 2016 were found. All of the affected patients had preexisting medical conditions, such as blood malignancies or brain tumor. Four patients died soon after C. auris was identified. Many of the isolates were resistant to multiple antifungals.

The agency cautions that the infections may have been transmitted in healthcare settings and that the pathogen may initially be misidentified as other Candida species.

The CDC advises healthcare workers to use standard and contact precautions in patients colonized or infected with C. auris.

MMWR article here.

Monroe County Welcomes Their New Executive
The Monroe County Medical Society Search Committee has hired a new Executive to replace Nancy Adams, who is retiring shortly. Christopher Bell has an MBA from the Simon School of Business and an MS in Marriage and Family Therapy form the University of Rochester School of Medicine and Dentistry. He comes to MCMS with knowledge of the key challenges facing physicians and is looking forward to supporting our membership and their staffs.

Chris previously worked with the Finger Lakes Performing Provider System and UR Medicine, supporting state and federal programs that are transforming health care, including the Delivery Service Reform Incentive Payment Program, Patient Centered Medical Home, Meaningful Use, and Physician Quality Reporting System. Additionally, Chris has supported the implementation of Electronic Medical Record systems in New York, New Orleans, and Illinois which has helped him understand the challenges physicians face in using these systems.

Chris lives in Fairport with his wife and daughter.


CLASSIFIEDS


Bronx Office Space for Lease
Morris Park-Van Nest, Bronx. Brand New Construction at  Highly Desirable Intersection. 2,350 sq.  ft. + Ground Level + 1,300 sq. ft. Lower Level; Open Floor Plan.  Please Call Anthony Mameli 347-387-9768 or Email to: anthony@md-cre.com. Charles Rutenberg Realty – Exclusive.


State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space. $8,000-$11,500/month. Contact: (212)–583–2966, email: hefderm@outlook.com for details. No Brokers.



Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

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

Physician Opportunities


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

October 28, 2016 – Snapshot Survey-Do You Know What Value Based Pay Is?

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
October 28, 2016
Volume 16, Number 38

mlmichereforyou_enews_102016

Dear Colleagues:

Federal and state policymakers are increasingly leaning on public and commercial payers to increase the use of so-called value-based payments in Medicare, Medicaid and commercial health coverage.

MSSNY has created a survey to assess to what extent physicians are already participating in such value-based payment structures.  We also would like to obtain your perspective regarding the sufficiency of health insurer networks to be sure your patients can receive the care they need. The purpose of this survey is to assess to what extent physicians are already participating in such value-based payment structures.

I am hoping it will give us a “snapshot” and some “conversational data” regarding each of these topics that we can use in our advocacy.

Please take a few minutes to help us to help you.

Click here the survey.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


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Physicians Urged to Familiarize Themselves with Medicare Quality Payment Program Rules Effective for 2017
As previously reported, CMS has issued its final rule implementing the Medicare Quality Payment Program that starts in 2017.   The American Medical Association (AMA) has prepared two summaries that you can review from MSSNY’s website to familiarize yourself with the important provisions of this rule.  You can access these documents by clicking HERE and HERE.

Among the positive changes contained in the final rule that provide some flexibility to physicians in complying with new Medicare Merit Based Incentive Payment System (MIPS) include:

  • increasing from $10,000 to $30,000 the annual Medicare revenue threshold requiring participation in the MIPS program;
  • enabling physicians who report on one quality measure or one quality improvement activity for 2017 to avoid a 2019 Medicare payment penalty;
  • enabling physicians who report 90 continuous days (instead of the entire year) of quality data to be eligible for a 2019 Medicare payment bonus;
  • reducing from 90% to 50%  the percentage of patients of which a physician has to report quality measures;
  • Reducing from 11 to 5 the number of measures to be reported in the Advancing Care Information category (which replaces Meaningful Use) and permitting 90-day rather than full year reporting;
  • Enabling physicians practices recognized as a “Patient Centered Medical Home” to receive full credit in the “Clinical Practice Improvement” Category (15% of your MIPS score); and
  • Eliminating the “Cost” component in the 2017 MIPS evaluations.


Weekly Charting Tip: Prescribing Medical Marijuana
In New York, if you are registered, you may provide a prescription for your patient to receive an acceptable form of medical marijuana if they have one of the following diagnoses: Cancer, HIV Infection or AIDS, ALS, Epilepsy, Inflammatory Bowel Disease, Neuropathy, or Huntington’s Disease. Here is the catch: You patient MUST have associated or complicating conditions that ONLY include: cachexia (wasting syndrome), severe or chronic pain, severe nausea, seizures, or severe of persistent muscle spasms.

CAUTION: It is NOT sufficient to have a diagnosis JUST of severe or chronic pain! It must be associated with one of the listed diagnoses. Additionally, the diagnosis MUST be severe, debilitating or life threatening that is also accompanied by one of the acceptable diagnoses. For example, somebody diagnosed with Basal Cell Carcinoma probably would not qualify. A neuropathy MUST have notations in your chart that specifies how and where the neuropathy is causing severe pain or is debilitating. The nature of the pain? What the patient can do, or no longer do must be charted as well. It is not enough just to list a diagnosis and some symptoms. Go into detail. This is another example of how to avoid a problem; have a complete and accurate chart!  If you have any questions, please contact Kern Augustine, P.C. at 1-800-445-0954 or via email at info@DrLaw.com. 

“When Is the Flu Not the Flu?” Nov. 16 CME Webinar Registration Open
MSSNY will begin its 2017 Medical Matters continuing medical education (CME) webinar series with “When Is the Flu Not the Flu?” on Wednesday, November 16, 2016 at 7:30 a.m.   William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are: 1). Recognize the distinction between influenza virus infections and other similarly presenting illnesses.  2). Describe strategies for prevention, diagnosis and management of patients presenting with flu-like symptoms. 

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. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Additional programs are will be conducted in January-May 2017, and topics include: Triage in a Disaster Event; The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team; and Mosquito Borne Diseases.  Program dates for Medical Matters will be announced shortly.

Webinar: Learn More about the New Medicare Quality Payment Program
CMS invites you to join webinar on November 15 on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule with comment period. The webinars will provide an overview of the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) incentive payment provisions under MACRA, collectively referred to as the Quality Payment Program.

Quality Payment Program Final Rule MLN Connects® Call — November 15

  • Date: Tuesday, November 15, 2016
  • Time: 1:30 to 3:00 PM ET
  • Register MLN Connects Event Registration.
  • Target Audience: Medicare Part B Fee-For-Service clinicians, office managers and administrators; state and national associations that represent healthcare providers; and other stakeholders.

During these calls, participants will learn about the provisions in the recently released final rule; participants should review the rule prior to the call. A question and answer session will follow the presentation.

Space for these webinars is limited. Register now to secure your spot. After you register, you will receive an email message with a dial-in number and webinar link. Please note, you will not be able to share your participant information because it will be unique to you.

For More Information

To learn more about the final rule and the Quality Payment Program, view the following resources:


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


AMA Webinar on How Final Rule Affects Your Practice
On November 21 and December 6, the AMA will host educational webinar sessions to help physicians prepare and understand what the final rule means for their practice.

Register for November 21
Register for December 6

Review of all the provisions of the final rule is ongoing.  Medical societies across the country including the AMA and MSSNY had advocated for additional flexibility, particularly for smaller practices that may not have the infrastructure necessary to be successful in these value-based payment programs.

LI Pharmacist Gets Up To 24 Years for Selling Black-Market HIV Meds
Attorney General Eric T. Schneiderman announced that pharmacist Ira Gross, 63, of Babylon, was sentenced to 8 to 24 years in state prison for his role in selling over $274M dollars of diverted, medically worthless HIV medication. Gross was also ordered to pay back the amount he pocketed as a result of the scheme, which totaled $25.2M.

The evidence at trial revealed that from 2008 to 2012, Gross and others sold the diverted medications, mostly expensive HIV antiretroviral medications purchased off the street, to MOMS Pharmacy in Melville. MOMS Pharmacy then dispensed the diverted medications to thousands of its unsuspecting patients, many of whom were Medicaid recipients, throughout New York and other states.  Ultimately, the New York Medicaid program paid $124M for those tainted medications distributed to New York Medicaid patients.

Gross organized the scheme and coordinated the sale of the diverted street medication to MOMS Pharmacy. Evidence at trial showed that Gross paid Glenn Schabel, the supervising pharmacist and compliance officer for MOMS Pharmacy, over $5 million to buy medication that he knew or should have known were diverted. Schabel, 55, of Melville, was also arrested and pleaded guilty in September 2016 to Criminal Diversion of Prescription Medications and Prescriptions in the First Degree and Commercial Bribe Receiving in the First Degree.  Schabel was sentenced to two to six years in state prison and has paid $5.45M in restitution.

Free DOH Posters Educate Patients re Appropriate Antibiotic Prescribing
The NYS Department of Health and the NY “Get Smart Campaign” are pleased to share brand new “Get Smart Guaranteeposters to demonstrate healthcare professionals’ commitment to appropriate antibiotic prescribing. 

The posters can be personalized with a provider’s photo and signed. When displayed, they not only enhance provider “buy-in” to appropriate antibiotic prescribing but are also a way to educate patients about appropriate antibiotic prescribing and use.  CDC-sponsored “Get Smart Week” is November 14-20 (but the DOH would appreciate displaying these posters year-round!) The posters may be downloaded via this link.

Simpler yet, the NY Get Smart Campaign can mail you limited copies of 11”  X 17” Get Smart Guarantee posters. The poster is available at no cost to you and may be ordered by contacting the NYSDOH Get Smart Program Coordinator, Mary Beth Wenger, at marybeth.wenger@health.ny.gov Additionally, there are patient Palm Cards carrying the same message, which can be handed out to patients, explaining why antibiotics aren’t always the answer.

Healthcare providers may be pressured by patients to prescribe antibiotics even when they have a viral infection. Displaying this poster in waiting or examination rooms sends a message to patients that antibiotics aren’t always appropriate. We hope the posters will help facilitate conversations with patients on the appropriate use of antibiotics.

New Diabetes Guidelines Recommend that Patients Move Every 30 Minutes
The American Diabetes Association now recommends that patients with diabetes take a break from prolonged sitting every 30 minutes, citing blood glucose benefits. This could mean 3 or more minutes of standing, walking, or doing light-intensity activities like office chair swivels. Previously, the group recommended movement breaks every 90 minutes.

The group’s first comprehensive physical activity guidelines, published in Diabetes Care, also make the following recommendations:

  • Physical activity should be prescribed to all patients with diabetes.
  • Patients should aim to get at least 150 minutes of physical activity every week. Both resistance and aerobic training are encouraged. Patients should go no more than 2 consecutive days without activity.
  • Older adults with diabetes should aim for 2–3 days a week of flexibility or balance training, such as tai chi or yoga.

The document also provides guidance for youth, pregnant patients, physical activity considerations with various diabetes complications, and suggested carbohydrate intake before exercise.

American Diabetes Association news release

CMS: New Ops for Clinicians to Join Advanced Alternative Pay Models
CMS announced new opportunities for clinicians to join Advanced Alternative Payment Models (APMs) developed by the CMS Innovation Center to improve care and potentially earn an incentive payment under the Quality Payment Program created through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program rewards clinicians with sufficient participation in Advanced APMs that align incentives for high-quality, patient-centered care. By giving more clinicians the opportunity to participate in these models, today’s announcement will extend the benefits of high-quality, coordinated care to more Medicare beneficiaries.

CMS is announcing that it expects to re-open applications for new practices and payers in the Comprehensive Primary Care Plus (CPC+) model and new participants in the Next Generation Accountable Care Organization (ACO) model for the 2018 performance year. In addition, CMS is announcing that the Innovation Center’s Oncology Care Model with two-sided risk will now be available in 2017, which will qualify the model as an Advanced APM beginning in the 2017 performance year.

In 2017, under the Quality Payment Program, clinicians may earn a 5 percent incentive payment through sufficient participation in the following Advanced APMs:

  • Comprehensive ESRD Care Model (Large Dialysis Organization (LDO) arrangement)
  • Comprehensive ESRD Care Model (non-LDO arrangement)
  • CPC+
  • Medicare Shared Savings Program ACOs – Track 2
  • Medicare Shared Savings Program ACOs – Track 3
  • Next Generation ACO Model
  • Oncology Care Model (two-sided risk arrangement)

In 2018, we anticipate that clinicians may also earn the incentive payment through sufficient participation in the following models:

  • ACO Track 1+
  • New voluntary bundled payment model
  • Comprehensive Care for Joint Replacement Payment Model (Certified Electronic Health Record Technology (CEHRT) track)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT track)

These lists will continue to change and grow as more models are proposed and developed in partnership with the clinician community and the Physician-Focused Payment Model Technical Advisory Committee.

For more information, please click here.

Insurers Must Be Up to Date on Physician Participation Info for MA Plans
Starting next year, the federal government will require health insurers to give patients enrolled in  Medicare Advantage plans or in policies sold in the federally run health exchange up-to-date details about which doctors are in their plans and taking new patients.

Under a rule published last month by CMS, Medicare Advantage plans must contact doctors and other providers every three months and update their online directories in “real time.” Online directories for policies sold through healthcare.gov, the health law exchange run by the federal government in 37 states, must be updated monthly, CMS announced in a separate rule.

Inaccuracies in the Medicare Advantage directories may trigger penalties of up to $25,000 a day per beneficiary or bans on new enrollment and marketing. CMS will also use the directories to help determine whether insurers have enough doctors to meet beneficiaries’ needs.

The administration last year announced rules designed to make sure those networks have adequate numbers of providers. The newest rules will help guarantee that consumers get good information on those networks.

Nearly 9 million people have enrolled in plans on the federal marketplace for 2015, according to officials.

Incorrect information was found for almost half of the 5,832 doctors listed in directories for 54 Medicare Advantage plans checked last fall, they said. Only online directories were examined.

CDPHP and Capital Care Create Acuitas Health for Value-Based Pay Success
For nearly a decade, CDPHP and CapitalCare have partnered to achieve a shared mission of improving the quality and affordability of health care for residents in and around the Capital Region. The organizations – which are philosophically aligned around the goals of value-based care – have taken that partnership to the next level, creating an organization which will allow physicians to remain independent, while offering patients access to better health, better care, and lower costs.

Acuitas Health provides practices with a turn-key solution needed to succeed in a value-based payment environment. This includes a comprehensive readiness assessment, realignment of staff and workflows, and oftentimes, a total transformation in the way the practice delivers care.

Acuitas Health will embed care managers within physician practices and use sophisticated population health management tools to identify patients with gaps in care or are at high-risk, or rising risk, clinically. Care managers will work with the practice to engage with patients, ensuring that individuals receive the right care, at the right time.  For more information on Acuitas Health, please visit www.acuitashealth.com.

Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 24 counties throughout New York.

CapitalCare Medical Group is a physician-owned medical practice with over 650 employees including more than 230 healthcare professionals.  The group offers primary care services in Family Practice, Pediatrics and Internal Medicine throughout the Capital Region. CapitalCare also provides services in Endocrinology, Pulmonary and Sleep Medicine, Developmental-Behavioral Pediatrics, Nephrology, adult and pediatric Neurology, medical nutrition therapy, comprehensive diabetes education and operates a state-of-the-art clinical laboratory.

Children with Persistent Post-Concussion Symptoms May Have Lower Quality of Life Than Youngsters Who Have Recovered
Research Indicates that children “with persistent symptoms months after a concussion have lower quality of life than kids who have recovered, but even kids who recovered quickly may still struggle,” researchers found after assessing “quality of life factors for about 2,000 kids aged five to 18 years who had presented to an emergency department within two days of suffering an acute concussion.” The findings were published online in JAMA Pediatrics.

RFP for Office of Temporary and Disability Assistance

REQUEST FOR PROPOSALS


The New York State Office of Temporary and Disability Assistance (OTDA), Division of Disability Determinations is issuing a Request for Proposal (RFP) to solicit proposals from qualified vendors for the establishment of one contract medical provider to establish a site in the upstate area of the Capital District, NY (including the cities of Albany, Schenectady, and Troy and the immediate geographic area) to perform medical examinations and ancillary testing of claimants applying for Social Security disability benefits. If your organization is capable of performing a high volume of medical examinations and diagnostic tests, the Capital District Consultative Examination RFP can be found on the OTDA website at https://otda.ny.gov/contracts/procurement-bid.asp.  If your organization wishes to receive a hard copy of the RFP, please send your request immediately by Certified Mail to:


Mr. Lawrence Rockefeller
NYS Office of Temporary and Disability Assistance
Division of Disability Determinations
One Commerce Plaza, 10th Floor
99 Washington Avenue
Albany, New York 12210


The RFP release date is September 14, 2016 with proposals due no later than November 2, 2016 at 3:00 p.m. EST.  If you have any questions, you may contact Melinda Kuiken at (518) 626-3042.


CLASSIFIEDS


State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space. $8,000-$11,500/month. Contact: (212)–583–2966, email: hefderm@outlook.com for details. No Brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

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

Physician Opportunities

County Executive
The Suffolk County Medical Society, a 501C-6 corporation, recognized as the premier professional medical association for the physicians of Suffolk County, is seeking to fill the position of Executive Director.  Successful candidates will possess a Bachelor Degree, (Masters Degree preferred in a healthcare-related field and/or Business/Finance).  Should have minimum of five years experience in healthcare or association management .  Must possess the following abilities: have a thorough working knowledge of the health care industry;  serve as a strong physician and patient advocate; be able to successfully balance multiple demands; possess strong leadership skills with excellent oral and written communications.For more information and a complete job description, visit www.scms-sam.org.  Please forward a resume with a cover letter outlining how you meet the parameters of the position, including salary requirements, to stuscms@optonline.net.  Position scheduled to begin February, 2017.



A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

Council – November 3, 2016

AGENDA
Council Meeting
November 3, 2016, 9:00 am
Courtyard Marriott, Westbury Long Island
1800 Privado Road
Westbury, NY  11590

A.Call to Order and Roll Call

B. Approval of the Council Minutes of September 15, 2016

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

    1. President’s Report

a.  Letter to Katherine Ceraolo, NYSDOH re All Payor       Database Proposed Regulations
b.  Minutes of the Executive Committee
Teleconference
, October 6, 2016
c. Subpoena, United States of America, et al., v.
Anthem, Inc., et. al.
d. Memorandum, Presidential Appointments to the
2017 Nominating Committee

      1.  Board of Trustees Report  – Dr. Leah McCormack will present the report (handout)
      2.  Secretary’s Report – Dr. Arthur Fougner will present the report for Nominations for Life  Membership & Dues Remissions
      3. MLMIC Report – Mr. Donald Fager will present a verbal report
      4.  AMA Delegation Update – Dr. John Kennedy will present a verbal report
      5.  MSSNYPAC Report – DrJoseph Sellers will present the report
      6. MESF Update – Dr. Joseph Maldonado/Tom Donoghue will present the report (handout)
      7.  CME Update Dr. Mark Adams will present the report
      8.  MACRA PresentationCynthia Brown, Vice President,
        Government Affairs, AMA MACRA PowerPoint Presentation
        (VIA WEBEX)   (Also PowerPoint will be a handout at Council)
      1. Commissioners (All Action Items)
        Commissioner of Governmental Relations,
        Gregory Pinto, MD, Commissioner
        Legislative and Physician Advocacy Committee,
        Paul A. Pipia, MD, Chair

        a. MSSNY’s 2017 Legislative Program
        b. Resolution 53-2016, Expansion of Independent Dispute Resolution Process
        c. Resolution 62-2016, Medical Malpractice Reform to Medical Injury Compensation (No-Fault)
        d. Resolution 100-2016, Unionization of Employed Physicians
        e. Resolution 101-2016, Employed Physicians
        f. Resolution 107-2016, Protection of Clinical Decision Making & Ownership of Medical Practices
        Materials to the Public
        g. Resolution 108-2016, Board Certification in Advertisements or Marketing
    1. Councilors (All Action Items from County Societies and District Branches)
      No reports submitted

D. Reports of Officers (Informational)
1. Office of the President – Meetings attended:

MSSNYPAC meeting, at the Water Club
NYS Medical/Specialty Exec. Conference
Fundraiser for Heastie @ Karhoo
Westchester County Legislative Breakfast
Connecticut State Medical Society Dinner Meeting
CME Committee Meeting
MLMIC Executive Committee
Third & Fourth District Retreat
Queens County Gala
Westchester Doctors Distinction Award Dinner
      1. Office of the President Elect – Charles Rothberg, MD
      2. Office of the Vice President – Thomas J. Madejski, MD
      3. Office of the Treasurer – Joseph R. Sellers, MD,
        Financial Statement for the period January 1, 2016  –
        September 30, 2016
      4. Office of the Speaker  –  Kira A. Geraci-Ciradullo, MD, MPH

E. Reports of Councilors (Informational)
1. Kings/Richmond Report  Parag H. Mehta, MD
2. Manhattan/Bronx Report – Joshua M. Cohen, MD, MPH
3. Nassau County Report – Paul A. Pipia, MD
4. Queens County Report – Saulius J. Skeivys, MD
 5. Suffolk County Report – Maria A. Basile, MD, MBA 
6. Third District Branch Report – Brian P. Murray, MD
7. Fourth District Branch Report – John J. Kennedy, MD
8. Fifth District Branch Report –Howard H. Huang, MD
9. Sixth District Branch Report – Robert A. Hesson, MD
10. Seventh District Branch Report – Mark J. Adams, MD
11. Eighth District Branch Report
Edward Kelly Bartels, MD
12. Ninth District Branch Report – Thomas T. Lee, MD
13. Medical Student Section Report
         Christina Kratschmer 
14. Organized Medical Staff Section Report –
          Richard A. Ritter, MD (no written report submitted)
             15. Resident & Fellow Section Report
Robert A. Viviano, DO
16. Young Physician Section Report – L. Carlos Zapata, MD
                     (no written report submitted) 

F. Commissioners (Committee Informational Reports/Minutes)
1. Commissioner of Communications
                  Joshua M. Cohen, MD, MPH
a. Report of the Division of Communications

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

3. Commissioner of Governmental Relations,
     Gregory Pinto,  MD, Commissioner

G. Report of the Executive Vice President, Philip Schuh, CPA, MS
               Membership Dues Revenue Schedule

HReport of the General Counsel, Donald Moy, Esq.
               Legal Services & Efforts of Kern Augustine, P.C. provided on                  behalf of MSSNY       

I. Report of the Alliance, Bonnie Liebers, Co-President
               Alliance Report

J. Other Information/Announcements

1. AMA-MACRA Final Rule Background Documents
2. 2017 Jamboree Medical Staff Volunteers (from Dr. Sellers)
3. PAI Board Minutes (25 MB)
4. Oscar/Magna Care Network
5. Letter on TRICARE-Telemedicine
6. MSSNY’s participation in the New York State Fair via Support of the Onondaga County Medical Society
7. Summary of VBP Meeting, October 18, 2016
8. Physicians Foundation Board Meeting Minutes October, 2016

K.  Adjournment

NOTE:           Following adjournment, a meeting of the MSSNY Long Range Planning Task Force will be held at MSSNY Headquarters.

October 21, 2016 – MACRA Rules Final!

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
October 21, 2016
Volume 16, Number 37

mlmichereforyou_enews_102016

Dear Colleagues:

This week, CMS issued a final rule outlining the requirements of the new Quality Payment Program for physicians that was created by the Medicare Access and CHIP Reauthorization Act (MACRA).

As has been widely reported, there were positive changes contained in the final rule that provide some flexibility to physicians in complying with new Medicare Merit Based Incentive Payment System (MIPS).  These include:

  • enabling physicians who report at least some 2017 data before March 31, 2018 to avoid a 2019 Medicare payment penalty;
  • increasing from $10,000 to $30,000 the annual Medicare revenue threshold requiring participation in the MIPS program;
  • reducing from 90% to 50%  the percentage of Medicare patients of which a physician has to report quality measures;
  • Reducing from 11 to 5 the number of measures to be reported in the Advancing Care Information category (which replaces Meaningful Use) and
  • Eliminating the Value based component in the 2017 MIPS evaluations.

Summaries, fact sheets and other CMS resources are available on the agency’s web site.  In the coming days, the AMA will make additional resources available on its own MACRA web page.  To access the Quality Payment Program Overview Fact Sheet, click here.

While the AMA is in the process of fully analyzing the regulations, a first review reveals that CMS responded to many of the concerns expressed by physicians about the proposed rule issued last spring.  On November 21 and December 6, the AMA will host educational webinar sessions to help physicians prepare and understand what the final rule means for their practice.

Register for November 21
Register for December 6

Review of all the provisions of the final rule is ongoing.  Medical societies across the country including the AMA and MSSNY had advocated for additional flexibility, particularly for smaller practices that may not have the infrastructure necessary to be successful in these value-based payment programs.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


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Webinar: An Overview of MACRA (Quality Payment Program)
CMS invites physicians to join a webinar on October 26 at 2:00 PM ET, on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule with comment period. The webinar will provide an overview of the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) incentive payment provisions under MACRA, collectively referred to as the Quality Payment Program.

Webinar Details

Quality Payment Program Overview

  • Date: Wednesday, October 26, 2016
  • Time: 2:00 to 3:00 PM ET
  • Register Here.

Space for this webinar is limited. Register now to secure your spot. After you register, you will receive an email message with a dial-in number and webinar link. Please note, you will not be able to share your participant information because it will be unique to you. 

Please Review Comprehensive Medicare Quality Payment Program Summaries
The American Medical Association (AMA) has prepared two summaries that you can review from MSSNY’s website to familiarize yourself with the important provisions of this rule.  You can access these documents by clicking HERE and HERE.

More MACRA  Help from the AMA
|Two documents prepared by the AMA’s Washington Office, outlining major provisions of Medicare’s new Quality Payment Program (QPP) for physicians that was created by the Medicare Access and CHIP Reauthorization Act (MACRA).  The longer summary document provides some detail of the various components of the final rule that was issued last week, and notes where key improvements were made to the policies set forth in the original proposed rule.  The second is a chart with more abbreviated descriptions of changes to the original proposed rule that were secured. These documents will be posted on the AMA’s MACRA web page, www.ama-assn.org/go/medicarepayment.  Additional material is in the process of being developed.

  • The AMA Payment Model Evaluator is an innovative tool offering initial assessments to physicians so they can determine how their practices will be impacted by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Developed with the expertise of physicians and input from partners, the tool will give physicians and their staff a brief assessment, as well as relevant educational and actionable resources. Once physicians and medical practice administrators fill out the online questionnaire, they will receive guidance for participating in the MACRA payment model that is best for them. The AMA will continually update the Payment Model Evaluator to respond to regulatory changes and to keep practices up to date throughout the new payment and care delivery reform process. The tool is free to all physicians and their practice administrators.
  • The AMA STEPS Forward™ collection of practice improvement strategies has new MACRA-specific tools. Accurate and successful reporting on quality metrics is crucial to the new Medicare payment system, both in the current Physician Quality Reporting System program and under MACRA’s new Quality Payment Programs. Each STEPS Forward module focuses on a specific challenge and offers real-world solutions, steps for implementation,, case studies, continuing medical education, and downloadable tools and resources. Physicians and their practice staff can use these to help improve practice efficiency and ultimately enhance patient care, physician satisfaction and practice sustainability. The full collection, which now includes 42 modules, has a variety of tools that will help physicians and their practices, including:

The AMA launched a ReachMD podcast series titled Inside Medicare’s New Payment System. Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS), Dr. Gurman, AMA staff experts, and others are featured on the series, which will include five episodes to help physicians be informed on upcoming Medicare changes.

Learn more on AMA Wire® about these tools or check out other key changes to the Medicare payment system.

Attached are two documents prepared by the AMA’s Washington Office, outlining major provisions of Medicare’s new Quality Payment Program (QPP) for physicians that was created by the Medicare Access and CHIP Reauthorization Act (MACRA).  The longer summary document provides some detail of the various components of the final rule that was issued last week, and notes where key improvements were made to the policies set forth in the original proposed rule.  The second is a chart with more abbreviated descriptions of changes to the original proposed rule that were secured.

These documents are posted on the AMA’s MACRA web page, www.ama-assn.org/go/medicarepayment.

DOH Commissioner’s Grand Rounds on Dietary Supplements on Nov. 29
New York State Department of Health Commissioner Howard Zucker, MD, will host a medical grand rounds on Tuesday, November 29, 2016, 7:30 – 9:00 am at The Wadsworth Center – David Axelrod Institute, 120 New Scotland Avenue, Albany, NY 12208.   The topic will be:  “Dietary Supplements: Buyer Beware, Provider Be Wary”.

Faculty for the event will be Pieter A. Cohen, MD, Assistant Professor of Medicine, Harvard Medical School Internist, Cambridge Health Alliance; Nina Ahmad, MD, Medical Director, Division of Epidemiology, New York State Department of Health and Nathan Graber, MD, MPH, Director, Center for Environmental Health, New York State Department of Health. Registration for this session is required and a copy of the flyer can be found here.

Nov. 17 Webinar Best Practices for Palliative Care in Primary Care
This program will address best practices for integrating palliative care services into the primary care and/or PCMH settings. This webinar will cover the evidence and business case for this approach, strategies for patient acceptance, and examples of successful implementation.

Webinar Details

Date: November 17

Time: 1 p.m.
Featured Speaker: Joan Dacher, Ph.D., R.N., N.P., Professor of Nursing, The Sage Colleges; and Co-Chair, New York State Palliative Care Education and Training Council

Registration: Register online. 

DFS: Guidance to Insurers New Substance Abuse Coverage Requirement
The New York Department of Financial Services has issued a 9-page guidance to health insurance companies reminding them of new requirements enacted earlier this year to expand coverage for substance use disorder treatments.   This includes expanded prescription drug coverage, and expanded inpatient and outpatient coverage, coverage for naloxone, and expedited pre-authorization requirements.  To read the guidance, click here.

When Is the Flu Not the Flu?” CME Webinar Nov. 16; Registration Now Open
MSSNY will begin its 2017 Medical Matters continuing medical education (CME) webinar series with “When Is the Flu Not the Flu?” on Wednesday, November 16, 2016 at 7:30 a.m.   William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org. 

Educational objectives are: 1). Recognize the distinction between influenza virus infections and other similarly presenting illnesses.  2). Describe strategies for prevention, diagnosis and management of patients presenting with flu-like symptoms. 

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. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Additional programs are will be conducted in January-May 2017, and topics include: Triage in a Disaster Event; The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team; and Mosquito Borne Diseases.  Program dates for Medical Matters will be announced shortly.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Billing for Influenza Correctly
NGS published CMS article titled, “Billing for Influenza: New CPT Code 90674” on 9/30/2016. The article advises that MACs may direct use of an NOC code to allow billing for the vaccine for dates of service on or after 8/1/2016 and before 1/1/2017; however, NGS is not allowing an NOC code and your claims will deny as an invalid code. CPT Code 90674 will be added with the January 2017 release. Please hold your claims until the January release is implemented; Additionally, Part A MACs will be holding claims from 1/1/2017 to 2/20/2017. At this time, any claims received on and after 1/1/2017 will be released for payment beginning 2/20/2017.The Seasonal Influenza Vaccines Pricing on the CMS website shows the CPT 90674 payment allowance is $22.93 effective for dates 8/1/2016-7/31/2017.

Fentanyl the Cause of 16% of All NYC Overdose Deaths
In 2015, 146 overdose deaths in New York City involved fentanyl, 16 percent of all overdose deaths, according to the city health department. Never before had fentanyl accounted for more than 3 percent of overdose deaths in the city. On Monday, the city’s health department reported that since July 1, 47 percent of confirmed drug overdose deaths involved fentanyl. That’s up from 39 percent through the first six months of the year, according to provisional data. That data also shows there have been 725 confirmed overdose deaths to date in New York City and that 581 of these deaths occurred during the first six months of 2016.

Adults Stressed out Due to Presidential Election
According to an online survey conducted by the American Psychological Association (APA). Some 52% of U.S. adults find the 2016 presidential election to be a “very or somewhat significant source of stress,” Over 3500 adults aged 18 and older completed the survey in August 2016. Among the other findings:

  • Rates of stress were similar among Democrats and Republicans, and among women and men.
  • Those over age 70 were most likely to feel election stress (59%), while those aged 38 to 51 were least likely (45%).
  • Some 60% of Americans with disabilities found the election stressful, versus 48% of those without disabilities.
  • Stress was more common among adults who used social media (54%) than among those who did not (45%).

The APA offers these tips for coping:

  • “Limit your media consumption. Read just enough to stay informed.”
  • Don’t talk politics if you think the discussion could “escalate to conflict.”
  • “Whatever happens on Nov. 8, life will go on. … Avoid catastrophizing.”


REQUEST FOR PROPOSALS

The New York State Office of Temporary and Disability Assistance (OTDA), Division of Disability Determinations is issuing a Request for Proposal (RFP) to solicit proposals from qualified vendors for the establishment of one contract medical provider to establish a site in the upstate area of the Capital District, NY (including the cities of Albany, Schenectady, and Troy and the immediate geographic area) to perform medical examinations and ancillary testing of claimants applying for Social Security disability benefits. If your organization is capable of performing a high volume of medical examinations and diagnostic tests, the Capital District Consultative Examination RFP can be found on the OTDA website at https://otda.ny.gov/contracts/procurement-bid.asp.  If your organization wishes to receive a hard copy of the RFP, please send your request immediately by Certified Mail to:

Mr. Lawrence Rockefeller
NYS Office of Temporary and Disability Assistance
Division of Disability Determinations
One Commerce Plaza, 10th Floor
99 Washington Avenue
Albany, New York 12210

The RFP release date is September 14, 2016 with proposals due no later than November 2, 2016 at 3:00 p.m. EST.  If you have any questions, you may contact Melinda Kuiken at (518) 626-3042.


CLASSIFIEDS


State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space. $8,000-$11,500/month. Contact: (212)–583–2966, email: hefderm@outlook.com for details. No Brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

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

Physician Opportunities

County Executive
The Suffolk County Medical Society, a 501C-6 corporation, recognized as the premier professional medical association for the physicians of Suffolk County, is seeking to fill the position of Executive Director.  Successful candidates will possess a Bachelor Degree, (Masters Degree preferred in a healthcare-related field and/or Business/Finance).  Should have minimum of five years experience in healthcare or association management .  Must possess the following abilities: have a thorough working knowledge of the health care industry;  serve as a strong physician and patient advocate; be able to successfully balance multiple demands; possess strong leadership skills with excellent oral and written communications.For more information and a complete job description, visit www.scms-sam.org.  Please forward a resume with a cover letter outlining how you meet the parameters of the position, including salary requirements, to stuscms@optonline.net.  Position scheduled to begin February, 2017.



A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.


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

 

 

 

 

 

 

 

 

 

 

 

 

 

October 14, 2016 – Get Your CME Here!

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
October 14, 2016
Volume 16, Number 36

MLMIC

Dear Colleagues:

On Friday, September 30, I had the pleasure of meeting with MSSNY’s Committee on Continuing Medical Education, chaired by E. Kenneth Freiberg, DO.  The CME Committee oversees MSSNY’s dual role as both a Recognized Accreditor of 33 CME providers in New York State and an Accredited Provider of CME activities.

In order to support these two roles, there are two CME subcommittees:  the Subcommittee on Surveys (chaired by Pauline Hecht, MD) and the Subcommittee on Educational Programs (chaired by Sheldon Putterman, MD).  MSSNY couldn’t ask for a more dedicated, passionate, and hard-working group.  The Subcommittee on Surveys and the full CME Committee meet quarterly (in March, June, September, and December), while the Subcommittee on Educational Programs meets monthly to approve both directly and jointly provided activities and analyze the results of activities that have occurred.

MSSNY is in the process of revising its CME website http://cme.mssny.org  to incorporate all of MSSNY CME programming.  It is anticipated that the revisions will be completed early in 2017.   In the meantime, the cme.mssny.org site offers over 50 CME programs, which include the Opioid Webinar series, public health topics such as Zika, Ebola, influenza, and pertussis, and others.  Additionally, there are courses related to bioterrorism, emergency preparedness, and mental health.

If you are new to the site, you will have to register as a new user with a log on and password.   Please go here to see the array of programs MSSNY has to offer.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


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Physicians Required to Comply with “Non-Discrimination” Reporting
Under new HHS rules implementing the ACA “Nondiscrimination” provision, covered entities (which include most healthcare providers) must post and publish new mandatory nondiscrimination statements and taglines by October 16, 2016.

According to the AMA, the rule does not apply to physicians who participate only in Medicare Part B, though it does apply to physicians who participate in Federal or State Exchange plans, Medicaid or receive meaningful use incentive payments. Physicians should note that in addition to administrative enforcement mechanisms, such as loss of federal financial assistance, individuals are permitted to bring individual or class action violation claims directly against them in federal court.

Covered physicians must comply with the following requirements:

  • Post a notice of nondiscrimination and taglines in multiple languages
  • Develop and implement a language access plan
  • Designate a compliance coordinator and adopt grievance procedures (applicable to group practices with 15 or more employees)

To help reduce burden and costs, the HHS Office of Civil Rights (OCR) has translated into 64 languages a sample notice and taglines for use by covered entities. In addition, OCR has published a summary of the rulefactsheets on key provisions and a list of frequently asked questions.

To read a comprehensive summary prepared by Donald Moy, Esq. from the firm of MSSNY’s General Counsel, Kern Augustine P.C., click here. 

CMS Finalizes the New Medicare Quality Payment Program
Today, the Department of Health and Human Services (HHS) finalized its policy implementing the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM) incentive payment provisions in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), collectively referred to as the Quality Payment Program.

While the program begins January 1, 2017, CMS has laid out different time frames for when physicians can begin to participate to avoid penalties in Medicare payment in 2019. CMS also raised to $30,000 the Medicare revenue threshold that enables a physician to be exempted from the MIPS program.

The final rule with comment period offers a fresh start for Medicare by centering payments around the care that is best for the patients, providing more options to clinicians for innovative care and payment approaches, and reducing administrative burden to give clinicians more time to spend with their patients, instead of on paperwork.

Accompanying today’s announcement is a new Quality Payment Program website, which will explain the new program and help clinicians easily identify the measures most meaningful to their practice or specialty.

To see the press release and obtain more information about today’s announcement, including a fact sheet, please click here.

To learn more about the rule, click here.

AMA and MSSNY evaluation of the final rule is ongoing and further updates will be provided.

ICD-10 Updates for 10-01-16
In reference to the ICD-10 diagnosis code updates that were scheduled to be effective on October 1, 2016, Excellus has advised us that the ICD-10 codes are in their claim processing system.  However, Excellus is currently updating their clearinghouse to accept these codes electronically. Excellus expects that the clearinghouse will be updated by 10/19/16.  These delays will cause rejections/denials if you are submitting with the updated ICD-10 diagnosis codes. Since the claims will be rejected from the Clearinghouse, the claims would not have entered the Excellus system so you will have to resubmit the claims for payment.
Other payers might be experiencing some delays with their ICD-10 updates, as well.

OSCAR Health Insurance Narrowing Physician and Hospital Network
Oscar Health Insurance has begun to notify its participating provider network physicians that their contract participation will be amended effective January 1, 2017.  Please see the attached communications. As you should know, Oscar Health Insurance began their services utilizing the Magna Care network of physicians.  Now, Oscar plans to reduce its network and contract directly with their own network of physicians.

Two letters are attached.  One letter was sent out to providers who will continue to be in network, by direct contract, with Oscar in 2017, and the other letter was sent out to providers who will not be participating in the Oscar 2017 network. Both letters have information on Oscar’s continuity of care policy.  Both letters advise the physicians that their Magna Care contract remains intact and unaffected by this change.

http://www.mssnyenews.org/wp-content/uploads/2016/10/MagnaCare-Letter-1.pdf

http://www.mssnyenews.org/wp-content/uploads/2016/10/MagnaCare-Letter-2.pdf

Based on additional contact with Oscar Health Insurance, MSSNY has been advised that Oscar is conducting a comprehensive outreach to all Oscar members/patients impacted by the network change. Oscar has processes in place to support their members in continuity of care as well as finding in network providers.

Informed sources report that Oscar will reduce its provider network in New York, by half.  This may impact 20,000 doctors.  Its hospital network will decrease from 77 facilities to just 31.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Beware of “Seamless Conversion” for Your Medicare Patients
A policy known as seamless conversion allows insurance companies to move members of their commercial or Medicaid managed-care plans over to Medicare Advantage plans if they first ask permission from the CMS. The Medicare Advantage plans mean more revenue for insurers, but it often means patients’ doctors will be considered out of network. The CMS believes the transition to Medicare Advantage should be implemented to ensure continuity of care and recently issued a memo to insurers reminding them about seamless conversion as a way to transition enrollees.

The concern among many physicians is that the CMS’ seamless conversion is not as advantageous to patients as it is to its insurers and financial interests. Physicians nationwide have been critical of the secrecy of the plan as well and some groups are pushing for the CMS to publicly release information on which Medicare Advantage plans have been approved.

The goal of assuring a continuity of care seems contradicted when a patient’s non-Medicare insurance has been covering their care at a practice but the practice is not in the Medicare Advantage plan’s network. It has been rumored that Aetna, Humana and UnitedHealthcare have asked for permission to participate in seamless conversion. Patient advocacy groups are also pushing against this policy and requesting that the CMS require insurers to get confirmation from a beneficiary that they understand their network may have changed and allow for a special enrollment period in case their doctors are not in network.

In response to the criticism, the CMS countered that beneficiaries should be more vigilant in opening and reviewing all mail from their current insurer. The CMS further shifted the onus on enrollees to make sure to ask about provider and pharmacy networks and noted that patients can opt out of Medicare Advantage plans. The CMS has also said that it will make public which insurers use seamless conversion later this year.

Click here to download a MSSNY flyer for your patients to inform them that they may be switched into a Medicare Advantage Plan without their knowledge.

“When Is the Flu Not the Flu?” CME Webinar on Nov. 16; Registration Now Open
MSSNY will begin its 2017 Medical Matters continuing medical education (CME) webinar series with “When Is the Flu Not the Flu?” on Wednesday, November 16, 2016 at 7:30 a.m.   William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are: 1). Recognize the distinction between influenza virus infections and other similarly presenting illnesses.  2). Describe strategies for prevention, diagnosis and management of patients presenting with flu-like symptoms. 

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. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Additional programs are will be conducted in January-May 2017, and topics include: Triage in a Disaster Event; The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team; and Mosquito Borne Diseases.  Program dates for Medical Matters will be announced shortly.

Democrat (Psychiatrists 76%) or Republican (Surgeons 67%)?Physicians in certain specialties are much more likely to be registered as Democrats or Republicans, according to analysis by the New York Times’ “The Upshot.” For instance, the analysis found that 67 percent of surgeons in the study sample identified as Republican, while 76 percent of psychiatrists were registered as Democrats. (New York Times’ “The Upshot,” (10/6).

PQRS Negative Payment Adjustment Notification
PQRS participants are now being notified by letter regarding the 2017 negative payment adjustments. If you did not participate in PQRS in 2015, or did not satisfactorily participate in 2015, all of your 2017 Medicare Part B reimbursement will be subject to a -2.0% adjustment.

If you think that this negative payment adjustment has been applied incorrectly, you can request an informal review — but you must request a review on or before November 30, 2016 at 11:59 pm. CMS will investigate the merits of your request and issue a decision within 90 days of receipt.

Start with these steps:

Review your Feedback Report and 2015 AQRUR

Request an informal review (note: there are no hardship exemptions for the PQRS negative payment adjustment)

Register for the live CSMS AQRUR webinars

Download the CSMS on-demand PQRS webinars

Questions? Please contact theQualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or qnetsupport@hcqis.org. They are available from 7 am – 7 pm Central Time, Monday through Friday. 

RFP for Office of Temporary and Disability Assistance

The New York State Office of Temporary and Disability Assistance (OTDA), Division of Disability Determinations is issuing a Request for Proposal (RFP) to solicit proposals from qualified vendors for the establishment of one contract medical provider to establish a site in the upstate area of the Capital District, NY (including the cities of Albany, Schenectady, and Troy and the immediate geographic area) to perform medical examinations and ancillary testing of claimants applying for Social Security disability benefits. If your organization is capable of performing a high volume of medical examinations and diagnostic tests, the Capital District Consultative Examination RFP can be found on the OTDA website here.  If your organization wishes to receive a hard copy of the RFP,  please send your request immediately by Certified Mail to:

Mr. Lawrence Rockefeller
NYS Office of Temporary and Disability Assistance
Division of Disability Determinations
One Commerce Plaza, 10th Floor
99 Washington Avenue
Albany, New York 12210

The RFP release date is September 14, 2016 with proposals due no later than November 2, 2016 at 3:00 p.m. EST.  If you have any questions, you may contact Melinda Kuiken at (518) 626-3042. 

Nursing Home Residents: Ventilators Not Increasing Life Expectancy
The “number of nursing home residents with advanced dementia” connected to ventilators has increased significantly in recent years although it “doesn’t appear to help them live longer,” according to a new study published in JAMA Internal Medicine, researchers found that in 2000 only 39 of every 1,000 nursing home residents with dementia who were hospitalized were connected to ventilators, but in 2013 that had increased to 78 of every 1,000.

CMS Website to Review Resources on 2016 Program Requirements
The Centers for Medicare & Medicaid Services (CMS) has created the following materials to help providers attest successfully to the Medicare and Medicaid EHR Incentive Programs in 2016.

CMS is encouraging EPs, eligible hospitals, and CAHs to use the relevant resources to prepare for attestation.

For More Information
Visit the EHR Events page and listen to previous webinars for EPs and eligible hospitals/CAHs to learn more about the EHR Incentive Programs in 2016.

Price of Insulin Increases, Along With Rebates to PBMs
The Wall Street Journal (10/7) reported that while the list price of top-selling insulins have doubled since 2011, most of the revenue has gone to pharmacy-benefit managers (PBM), rather than drugmakers. Experts say that PBMs have demanded higher rebates to include the drugs on their preferred lists.


CLASSIFIEDS



Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.

Well-Established Nassau County Internal Medicine Practice Available for Acquisition
After serving the community for 34 years, this well-established internal medicine practice is available for acquisition. The practice is multi-specialty with significant volume of primary care patients. This office is located in Plainview on a major street with excellent visibility and accessibility, with ample parking. For more information please call (516)822-4706 or E-mail to surendralal1@yahoo.com


Considering Outsourcing Your Billing?
Elite Medical Revenue Solutions, LLC specializes in Practice Management.  We can quickly solve your insurance billing problems by filing and following up on your claims and billing. We provide some of the most innovative and powerful solutions in the market today: online, and in real-time. Our CMS provides you with control and gives you and your staff complete access from any computer with Internet access. Services include: Practice Management, Claims Filing & Follow-up, Electronic Health Records (EHR), Online Patient Payment Portal & Collections, Certified Coding Services & Audit Prevention, Paperless Document Filing, HIPPA Compliance Documentation. Call us today at 888 334-6585 or visit us at www.elitemedsolutions.net
emrs

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

Physician Opportunities

County Executive
The Suffolk County Medical Society, a 501C-6 corporation, recognized as the premier professional medical association for the physicians of Suffolk County, is seeking to fill the position of Executive Director.  Successful candidates will possess a Bachelor Degree, (Masters Degree preferred in a healthcare-related field and/or Business/Finance).  Should have minimum of five years experience in healthcare or association management .  Must possess the following abilities: have a thorough working knowledge of the health care industry;  serve as a strong physician and patient advocate; be able to successfully balance multiple demands; possess strong leadership skills with excellent oral and written communications.For more information and a complete job description, visit www.scms-sam.org.  Please forward a resume with a cover letter outlining how you meet the parameters of the position, including salary requirements, to stuscms@optonline.net.  Position scheduled to begin February, 2017.



A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777

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

 

 

 

 

 

 

 

 

 

 

 

 

 

October 7, 2016 – Should Medicare Negotiate Drug Prices?

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
October 7, 2016
Volume 16, Number 35

MLMIC

Dear Colleagues:

Our successes at MSSNY are achieved as a result of the combined efforts of many energetic physicians across the State along with the efforts of our talented staff.

Today is the last day of one of our leading staff members, Senior Vice President and Chief Legislative Counsel Elizabeth Dears Kent.  After dedicating 22 years of her professional life to advocating on our behalf, Liz is moving on to an amazing opportunity to be the Governmental Affairs Director for EHR vendor Dr. First.

Her legislative accomplishments for us are enormous, from efforts to enact the Managed Care Bill of Rights in the 1990s, to our most recent successes in providing needed flexibility for physicians in complying with the e-prescribing mandate.  She has been extensively involved in efforts to prevent the enactment of literally hundreds of adverse bills, including bills that would have increased your liability premiums, inappropriately expanded the scope of practice of numerous non-physicians, and have required overbroad and costly state regulation of private physician offices.  She has also helped steer MSSNY through some of the most difficult issues facing our profession, including the transition to value-based payments across public and private payors, and the increased demand for public information regarding the quality of care of physicians and other health care providers.

All physicians across the State of New York owe Liz a big thank you for all of her efforts.

As part of her diligence, Liz trained her successor well, long time MSSNY lobbyist, Morris (Moe) Auster, who ably will take the reins of our Government Affairs division.  We wish Moe the best of luck.  With all the challenges we face, we know he’s got his work cut out for him.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


enews large

If You Have Not Revalidated with Medicaid, You Will Not Be Paid after October 27
Effective for eMedNY claims processing starting October 27, 2016, all claims from non-revalidating billing providers will be pended until the provider’s revalidation package is received. To avoid interruption of claims payment, providers must revalidate immediately.

The federal regulation 42 CFR 455.414 requires providers to revalidate their enrollment with the New York State Medicaid Program. Providers have already received individual written reminders to revalidate, although thousands of providers have not done so. The deadline for submission of revalidation packages was September 25, 2016.

To revalidate:

  1. Visit the Provider Enrollment page at www.emedny.org/revalidation,

locate your enrollment form and additional required documentation, and determine whether an enrollment fee is required. There is a slide presentation, step-by-step processes, and an FAQ section. These resources provide important information on the revalidation process.

  1. Complete and mail the appropriate form(s) with all required documentation to the address provided. Keep a copy of the forms and documentation.

Next steps:

  1. Allow 2 to 3 weeks for the receipt and processing of the revalidation packet by eMedNY.  Once your completed revalidation is received and processed, all claims that have been held due to missing or late revalidation will be released for processing during that cycle.
  2. If more than 3 weeks have passed since sending the revalidation to eMedNY, please contact providerenrollment@health.ny.govwith the subject “FINAL REVALIDATION NOTICE” and provide all pertinent information regarding your submission, such as the date you sent it, and the address you sent it to so that we can research it.
  3. The remittance message for these pended claims is: Health Claim Status Code: 46 INTERNAL REVIEW/AUDIT

If you have additional questions about revalidation, please contact us at providerenrollment@health.ny.gov with the subject “FINAL REVALIDATION NOTICE”, or call the eMedNY Call Center at 800-343-9000 Option 2.

Physicians Required to Comply with “Non-Discrimination” Reporting Provisions by Mid-October
Under new HHS rules implementing the ACA “Nondiscrimination” provision, covered entities (which include most physicians) must post and publish new mandatory nondiscrimination statements and taglines in the 15 most popular languages for the State by October 16, 2016. This is CMS’ list of the top 15 languages spoken in New York: Spanish; Chinese; Russian; French Creole; Korean; Italian; Yiddish; Bengali; Polish; Arabic; French; Urdu;  Tagalog; Greek and Albanian.

To read a comprehensive summary prepared by Donald Moy, Esq. from the firm of MSSNY’s General Counsel, Kern Augustine PC, to assist physicians with compliance, click here.

At this time, MSSNY is exploring some vendors that should be able to help our members deal with real-time translation services to comply with both the LEP (language) and the ADA (hearing impaired/blind) requirements.  Until we have completed our research, you should contact your local hospital since they subscribe to the translation services and the hospital may be able to make a referral for use in your office, at the present time.  As soon as our research is completed, we will get back to you.

KFF Poll: 88% Said Medicare Should Be Able to Negotiate Drug Prices
An overwhelming majority of Americans favor government action to restrain prescription drug prices, according to a poll released by the Kaiser Family Foundation on September 29.

Eighty-two percent of those polled said they want Medicare to negotiate prices with the companies, which Congress does not allow. Seventy-eight percent favored limiting the amount companies can charge for high-cost drugs, such as those that fight cancer or hepatitis, according to the poll from the Kaiser Family Foundation. And more than two-thirds want to let Americans buy drugs imported from Canada. Support is strong no matter the political party. The poll found that while a majority of Americans still believed prescription drugs developed over the past two decades have improved lives, respect is dwindling. In 2008, 73 percent of Americans said the medicines had this positive effect, but that number dropped to 62 percent in August 2015.

The poll found that three-quarters of Americans considered drug costs unreasonable. Despite the perceived burden, the poll also discovered that 73 percent of people taking prescription medicines said it had been easy to afford their drugs. People in fair or poor health and those taking four or more drugs were more likely to say they were having trouble affording prescriptions than more healthy people.

Other ideas were less popular, including two restricting consumers. A minority of those polled favored eliminating prescription drug advertisements, which has been suggested to quell the aggressive marketing companies do directly to consumers. Only 4 in 10 Americans favored requiring people to pay more if they don’t choose the least expensive version of a drug to treat their illness.

The survey was conducted between Sept. 14 and 20 among 1,204 people, using both land lines and cell phones. The margin of error was +/- 3 percent.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


Reports Show 2017 Medicare Payment Adjustments
As reported in the September 29 AMA Advocacy Update, Medicare has made available two new reports with information on 2015 cost and quality data that indicate which physicians or practices will see related Medicare payment adjustments in 2017.

The 2015 Physician Quality Reporting System (PQRS) Feedback Reports and 2015 Annual Quality and Resource Use Reports (QRUR) were released on September 26, and CMS is mailing letters to physicians beginning September 26 if they will have a penalty.

The payment adjustments detailed in these reports are NOT the result of MACRA legislation passed by Congress in 2015.  They are associated with current federal statutory pay for performance programs that are being replaced in 2019 with the new MIPS system created under MACRA.

2015 PQRS penalty letters notify physicians and groups who are scheduled to receive a 2% penalty in 2017 based on 2015 PQRS reporting. The PQRS feedback report allows physicians to look up whether they will receive the 2% 2017 PQRS penalty, and contains detailed information on program year 2015 PQRS reporting results.

The 2015 Annual QRURs provide information on how practices performed on quality and cost measures used in the Value Modifier (VM) and whether their VM payment adjustment will be positive, negative or neutral and the specific amount. VM penalties can range from -1% to -4% depending on practice size and performance. Bonus payments depend on how much money is collected from penalties and to date the 2017 bonus size has not been publically announced by CMS.

Practices that believe there are errors in the report or calculation of the payment adjustment should file for an informal review by the end of November.

How to access the reports:

  • An Enterprise Identity Management (EIDM) account with the appropriate role is required for participants to obtain 2015 PQRS feedback reports and 2015 Annual QRURs.
  • If you already have an EIDM account, visit the CMS websiteto sign up for the appropriate EIDM role or contact QualityNet Help Desk to determine if someone in the practice already has that role.
  • To sign up for an EIDM account, visit the CMS Enterprise Portaland click “New User Registration” under “Login to CMS Secure Portal.”
  • For more information on viewing the reports, view the PQRS Analysis and Payment webpageand How to Obtain a QRUR webpage.

Information on the informal review process:

  • To request an informal review of a 2017 PQRS negative payment adjustment, view the “2015 Physician Quality Reporting System (PQRS): 2017 Negative Payment Adjustment – Informal Review Made Simple” guide on the PQRS Analysis and Payment webpage.
  • To request an informal review of the 2015 QRURs or the 2017 Value Modifier calculation, see the 2015 QRUR and 2017 Value Modifier webpage.

WCB Proposes a Drug Formulary for Injured Workers
The New York State Workers Compensation Board is inviting public comment on a Discussion Document available from its website that proposes the creation of a Workers Compensation pharmacy benefit plan.

In releasing the Discussion Document the Board noted: “The rapid pace of change in the pharmaceutical industry over the last few years has rendered the Board’s pharmacy benefit structure inadequate to address the overwhelming number of new medications that have been introduced to the medical community. The Board’s current pharmacy benefit describes reimbursement levels for brand, generic and compounded products, but otherwise provides little structure or guidance to prescribers. There is no drug formulary in place; no requirement for pre-approval/prior authorization; no process to ensure the appropriateness of prescribed medications.”

The deadline for receiving comments is November 14.  MSSNY will work with affected specialty societies and groups representing injured workers to review the document and will provide comments as necessary.

MSSNY-Home Care Workgroup Seeks to Reduce Administrative Burdens
As directed at this year’s House of Delegates, MSSNY has established a work group with the Home Care Association of New York State (HCA) to collaborate on efforts to address overbearing administrative burdens that stand in the way of patients receiving, and physicians ordering, needed home care services.  The first meeting of the group took place in September and another is scheduled for the end of October.

One of the most important issues under discussion is how best to reduce the burden of the so-called “Face to Face” requirement included in the ACA.  This provision requires a certifying physician to document that he or she, or a non-physician practitioner (NP or PA) working with the physician, has seen the patient, as a precondition of eligibility for Medicare and Medicaid coverage for home health services.  Many home care agencies and physicians have noted that the CMS regulations implementing this provision have created unnecessary and overly burdensome documentation requirements that are delaying or denying coverage for needed home care services.  One home care provider shared an example of a CMS review agent denying the patient’s coverage for services based on his assessment of the physician’s documentation, despite concurring that the patient met the requisite eligibility criteria and indeed needed the services.

On the federal level, New York Representatives Tom Reed (R-Southern Tier) and Paul Tonko (D-Capital District) initiated a sign on letter to CMS with over 70 other members of Congress to urge simplification of the Face to Face requirement.  Specifically, the letter noted that “the current regulations contain complicated, confusing, and overlapping documentation requirements that exceed the intent of the law passed by Congress. These requirements have imposed a significant burden on home health providers and physicians in our districts”.

On the state level, as the state has now moved (as of July 1) to implement Face-to-Face for Medicaid,  HCA and MSSNY, the Healthcare Association of New York State (HANYS) and the Iroquois Healthcare Alliance have met with the New York DOH to urge mitigation of such an added layer of burden for Medicaid.  These groups have also suggested areas where the Face to Face requirement could be eliminated entirely for Medicaid, such as within the context care delivered under managed care, or other “managed care-like” models, such as within a regional Performing Provider System (PPS) established under DSRIP, or an ACO, health home or other integrated model.

The work group has also discussed the importance of assuring physicians are properly educated regarding these federal requirements, including the importance of completing certification in a timely and comprehensive manner.

MSSNY Representatives for this work group include Dr. Evelyn Dooley-Seidman, Chair of MSSNY’s Long-Term Care Committee; MSSNY Board of Trustees Member Dr. Andrew Kleinman; Dr. Ruth Kleinman; Dr. Eugene Kalmut; and Dr. Jay Slotkin.

To view a brief CMS power point presentation regarding these Face to Face rules, go here.  To read a detailed FAQ document prepared by CMS, go here.

For more information about the activities of the Task Force, please contact mauster@mssny.org.

Most Children Who Contract Zika after Birth Only Fall Mildly Ill, Study Suggests
The New York Times (9/30) reported that a study published in The Lancet Infectious Diseases suggests that “serious complications are rare among children infected with the Zika virus after birth.” Researchers used data reported to the Centers for Disease Control and Prevention since 2015, including “about 160 teenagers and toddlers” aged 1 month to 17 years. In general, “these children got only mildly ill: 129 had a rash, C.D.C. researchers found, while half were feverish and a quarter had red eyes or joint pain.”

AMA: “CMS Listened about MACRA Reporting”
Recently, the AMA saw evidence that CMS has been listening to physician concerns, when CMS Acting Administrator Andrew Slavitt announced that physicians can choose among four options to avoid payment penalties in 2019. Medicine welcomed CMS’ decision to allow physicians to pick their own pace for the initial MACRA reporting period in 2017 as a positive step toward giving all physicians a fair opportunity to succeed.

Although details on MACRA implementation will not be available until the final rule is released later this fall, we have developed a number of resources to help physician practices begin to prepare for the transition to the new payment system:

  • MACRA website – Includes a checklist with steps practices can take now to prepare, an action kit and slideshow with information about what is in the proposed rule, an outline of advocacy efforts, a “Guide to physician-focused payment models,” and additional resources
  • AMA STEPS Forward® module, “Preparing your practice for value-based care – CME-accredited activity provides steps to take, answers to common questions and case vignettes
  • New podcast series “Inside Medicare’s new payment system” (available here) – Produced by ReachMD, these downloadable audio stories feature interviews with industry experts and physician leaders (including CMS’ Andy Slavitt, AMA President Andrew Gurman, MD, and the AMA’s Richard Deem and Michael Tutty)
  • AMA Wire® stories – Ongoing articles on the latest MACRA developments, how physicians are participating in new models of care, and more

The AMA will soon release a new web-based tool to help physicians understand which MACRA pathway is best for them and assess its impact on their practice. The AMA is planning regional seminars on MACRA, as well as webinars for physicians and “train the trainer” webinars.


RFP for Office of Temporary and Disability Assistance


REQUEST FOR PROPOSALS

The New York State Office of Temporary and Disability Assistance (OTDA), Division of Disability Determinations is issuing a Request for Proposal (RFP) to solicit proposals from qualified vendors for the establishment of one contract medical provider to establish a site in the upstate area of the Capital District, NY (including the cities of Albany, Schenectady, and Troy and the immediate geographic area) to perform medical examinations and ancillary testing of claimants applying for Social Security disability benefits. If your organization is capable of performing a high volume of medical examinations and diagnostic tests, the Capital District Consultative Examination RFP can be found on the OTDA website at https://otda.ny.gov/contracts/procurement-bid.asp.  If your organization wishes to receive a hard copy of the RFP, please send your request immediately by Certified Mail to:

Mr. Lawrence Rockefeller
NYS Office of Temporary and Disability Assistance
Division of Disability Determinations
One Commerce Plaza, 10th Floor
99 Washington Avenue
Albany, New York 12210

The RFP release date is September 14, 2016 with proposals due no later than November 2, 2016 at 3:00 p.m. EST.  If you have any questions, you may contact Melinda Kuiken at (518) 626-3042.


New Law Reduces Physician Reporting Burdens for Paper Prescriptions
As reported last week, Governor Cuomo has signed into law legislation (S.6779, Hannon)/A.9335,Gottfried) strongly supported and advocated for by MSSNY which eliminates the requirement for a physician to report a litany of information to the New York DOH when he/she must issue a paper prescription in lieu of an e-prescription.  Instead, the new law requires that the physician make a notation in the patient’s medical record that a paper/oral/fax prescription was issued in those circumstances, articulated in the statute, that are excepted from the general e-prescribing requirement.  These circumstances include:

  • Temporary technological or electrical failure;
  • When the prescription will be dispensed by a pharmacy located outside the state;
  • When the physician reasonably determines that an e-prescription would be impractical for the patient to obtain the medication in a timely manner, and such delay would adversely impact the patient’s medical condition.

MSSNY thanks the many physicians across New York who responded to our call to contact their legislators and the Governor to express their support for this legislation.  MSSNY worked closely with the Healthcare Association of New York State (HANYS) and numerous specialty societies to advocate for this important change to the law.

Upon learning that the bill was signed into law, MSSNY President, Malcolm Reid, MD issued the following statement. “We are pleased that Governor Cuomo has signed into law legislation to reduce the reporting burdens in those situations when a physician must issue a paper prescription.  We thank Senator Hannon and Assemblyman Gottfried for championing this legislation.  We look forward to working with the Governor and the Legislature to address other obstacles related to e-prescribing that interfere with patients timely receiving needed medications”.


Millennials Don’t Plan on Getting Flu Shot
 A survey conducted in September by Harris Poll on behalf of CityMD, an urgent-care-center network, found that 52 percent of millennials don’t plan on getting the flu shot during this year’s influenza season. Of those, 49 percent said they don’t trust that the vaccine will prevent them from getting the flu. An additional 29 percent worried that getting the shot will actually make them catch the virus. Citing recent studies, the CDC says the vaccine “reduces the risk of flu illness by about 50 percent to 60 percent.” Last season, 43.6 percent of Americans got the vaccine, according to CDC data.


CLASSIFIEDS



Elegant Plastic Surgery Office (Upper East Side Manhattan)
Very large and classy office to share. Located in the ground floor of a 25′ x 100′ carriage house opposite the 66th Street Armory with large consult room, 2+ treatment/exam rooms, large waiting room, business office, storage. See video of office — you won’t believe it: www.youtube.com/watch?v=Uli8Cck_eRA   $5000/month incl utilities. no brokers. Call Doctor Fischman at (212) 472–3300.Jeffrey R. Fischman, M.D.  110 E 66th Street.


Well-Established Nassau County Internal Medicine Practice Available for Acquisition
After serving the community for 34 years, this well-established internal medicine practice is available for acquisition. The practice is multi-specialty with significant volume of primary care patients. This office is located in Plainview on a major street with excellent visibility and accessibility, with ample parking. For more information please call (516)822-4706 or E-mail to surendralal1@yahoo.com


Considering Outsourcing Your Billing?
Elite Medical Revenue Solutions, LLC specializes in Practice Management.  We can quickly solve your insurance billing problems by filing and following up on your claims and billing. We provide some of the most innovative and powerful solutions in the market today: online, and in real-time. Our CMS provides you with control and gives you and your staff complete access from any computer with Internet access. Services include: Practice Management, Claims Filing & Follow-up, Electronic Health Records (EHR), Online Patient Payment Portal & Collections, Certified Coding Services & Audit Prevention, Paperless Document Filing, HIPPA Compliance Documentation. Call us today at 888 334-6585 or visit us at www.elitemedsolutions.net
emrs

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

Physician Opportunities

County Executive
The Suffolk County Medical Society, a 501C-6 corporation, recognized as the premier professional medical association for the physicians of Suffolk County, is seeking to fill the position of Executive Director.  Successful candidates will possess a Bachelor Degree, (Masters Degree preferred in a healthcare-related field and/or Business/Finance).  Should have minimum of five years experience in healthcare or association management .  Must possess the following abilities: have a thorough working knowledge of the health care industry;  serve as a strong physician and patient advocate; be able to successfully balance multiple demands; possess strong leadership skills with excellent oral and written communications.For more information and a complete job description, visit www.scms-sam.org.  Please forward a resume with a cover letter outlining how you meet the parameters of the position, including salary requirements, to stuscms@optonline.net.  Position scheduled to begin February, 2017.



A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777

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

 

 

 

 

 

 

 

 

 

 

 

 

 

September 23, 2016 – Tell Gov Now: Remove E-Prescribing Hassles

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

September 23, 2016
Volume 16, Number 33

MLMIC

Dear Colleagues:

E-prescribing has become a fact of life. Over the last few years, most of us have accepted and adapted to issuing prescriptions electronically, except for those who have a waiver. However, we all know that there are times when circumstances beyond our control require exceptions to e-prescribing—and it’s time to reduce the hassles associated with those situations.

Legislation advanced by MSSNY to rectify E-Prescribing issues encountered by physicians passed both Houses in June—and has now been delivered to the Governor for his signature.

We need your help in urging the Governor to sign into law this recently passed legislation (A.9335, Gottfried/S.6779, Hannon).

The first bill, (S. 6779, Hannon/A.9335-B,Gottfried) would ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing. Presently, the Bureau of Narcotic Enforcement (BNE) requires physicians to electronically submit to the department an onerous amount of information about the issuance of each and every paper prescription. The bill on the Governor’s desk affords a much better alternative by allowing physicians and other prescribers to make a notation in the patient’s chart indicating that they have invoked one of the three statutory exceptions. The letter urging the Governor to sign the bill can be accessed by clicking here.

The second bill (A.10448, Schimel/S. 7537, Martins) would authorize a pharmacy that does not have a particular medication in stock to transfer the prescription to another pharmacy. Currently, e-prescriptions cannot be transferred by one pharmacy to another, thereby requiring the patient to return to or call the prescriber’s office to ask that he/she transmit the e-prescription to another pharmacy. This creates unnecessary burdens on the patient and delays timely access to their medication. The letter urging the Governor to sign the bill can be accessed by clicking here.

The Governor needs to hear from all of us—the New York physicians who take care of our patients every day. Our focus should remain on the patients who depend on us—not on onerous hassles that take us away from patient care. Please take a minute and contact Governor Cuomo now.

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


enews large

Physicians Must Post Nondiscrimination Statements by Oct. 19
Under new HHS rules implementing the ACA “Nondiscrimination” provision, covered entities (which includes most healthcare providers) must post and publish new mandatory nondiscrimination statements and taglines by October 16, 2016.

According to the AMA, the rule does NOT apply to physicians who participate only in Medicare Part B, though it does apply to physicians who participate in Federal or State Exchange plans, Medicaid or receive meaningful use incentive payments. Physicians should note that in addition to administrative enforcement mechanisms, such as loss of federal financial assistance, individuals are permitted to bring individual or class action violation claims directly against them in federal court. This new rule is the first federal civil rights law to broadly prohibit discrimination on the basis of sex in federally funded health programs. It also includes important protections for individuals with disabilities and enhances language assistance for people with limited English proficiency.

Covered physicians must comply with the following requirements:

  • Post a notice of nondiscrimination and taglines in the top 15 languages spoken by individuals with limited English proficiency
  • Develop and implement a language access plan
  • Designate a compliance coordinator and adopt grievance procedures (applicable to group practices with 15 or more employees)
  • Submit an assurance of compliance form to OCR

To assist with implementation, OCR has translated into 64 languages a sample notice and taglines for use by covered entities. In addition, OCR has published a summary of the rulefactsheets on key provisions and a list of frequently asked questions. 


New Report: New York Leads Nation in Medical Home Adoption
A new report from United Hospital Fund (UHF) titled The Growth of Medical Homes in New York State, 2014 to 2016 examines the continued growth of the medical home model in New York, breaking it out by region, degree of certification, and type of facility. New York State continues to lead the nation in adoption of the medical home model; a notable finding of the report is that much of the overall recent growth of medical homes is occurring in hospital clinics as they expand their primary care programs, the explicit goal of several state initiatives.

The report also explains the number of concurrent and competing medical home models, several of which are being supported by New York State initiatives. The proliferation of models has created some confusion among providers, and raises some logistical questions for the State as it continues to promote primary care: how to align the competing programs, how to encourage multipayer support, how to ensure that medical homes can still start up under value-based payment systems, and how to make sure small practices aren’t left behind in these efforts. 


MSSNY Makes Endorsements for the 2016 November Elections
At the September 15, 2016 meeting of the MSSNY Council, the following legislators/candidates were endorsed for election by the Medical Society of the State of New York.   Each has demonstrated themselves to be champions of issues to preserve the ability of patients to continue to receive needed and timely physician care. 

To see which candidates were endorsed by MSSNY, click here.


Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


AMA Releases Updated Competition in Health Insurance Report
The AMA released its 2016 Update to its Competition in Health Care Report this week that once again indicated the need for more competition in health insurance markets, and efforts to block the proposed mergers among four of the nation’s biggest health insurance companies.   To read the press release, click here.

MSSNY President Dr. Malcolm Reid recently presented testimony at a New York Department of Financial Services hearing expressing significant concerns about the impact to patient care if the Anthem-Cigna merger to be approved.  The Anthem-Cigna and Aetna-Humana proposed mergers have been challenged by the US Department of Justice.  New York Attorney General Eric Schneiderman joined the action by the DOJ in seeking to block the proposed Anthem-Cigna merger.

The AMA press release noted that, on an individual basis, the Anthem-Cigna proposed merger would diminish competition in 121 metropolitan areas located throughout the 14 states where Anthem is licensed to provide commercial coverage, including: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. The AMA press release also noted that the Aetna-Humana proposed merger would diminish competition in 57 metropolitan areas located throughout 15 states, including: Arizona, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Ohio, Tennessee, Texas, Utah, Wisconsin and West Virginia.

On an individual basis, the Anthem-Cigna merger would diminish competition in 121 metropolitan areas located throughout the 14 states where Anthem is licensed to provide commercial coverage, including: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. Nine of these 14 states are working to block the Anthem-Cigna merger. States that have yet to take an antitrust position on the merger include: Indiana, Kentucky, Nevada, Ohio and Wisconsin.


Liquidator’s Adjudication of Policy Claims Against Health Republic Insurance
On September 15, 2016, the Supreme Court for the State of New York signed an order setting October 11, 2016 at 10:00 a.m. as the date and time for any interested parties or their attorneys to appear and show cause why an order approving certain procedures (the “Claims Adjudication Procedure”) for adjudicating claims for payment under Health Republic’s insurance policies should not be entered.

If you are a health care provider and have a Policy Claim against Health Republic, you should have submitted your Policy Claim in accordance with the deadlines and procedures set forth in the contract governing your provision of services to former members of Health Republic (your “Health Republic Contract”). If you already properly submitted a Policy Claim in accordance with the requirements of your Health Republic Contract, you do not need to re-submit it.

It is anticipated that EOBs will begin to be mailed to Providers and Members in the first quarter of 2017. If a Provider accepts the EOB, they are not required to take any further action. If a Provider disagrees with the EOB, they will have the opportunity to appeal any and all determinations set forth in the EOB through Health Republic’s website at www.healthrepublicny.org or by paper copy to the address indicated in the Claims Adjudication Procedure. The written appeal and supporting documentation must be submitted within 60 days of the date of mailing of the EOB. The Liquidator and her agents, utilizing the appropriate resources to investigate the appeal, will review each appeal and, within 60 days, either grant the appeal and issue a revised EOB or deny the appeal and provide the reasons for the denial.

If a Provider objects to the determination of the appeal, the Provider will have 30 days from the date the notice of denial is sent to file an objection to the denial of the appeal. PROVIDERS WHO WOULD LIKE TO RECEIVE A HARD COPY OF THE CLAIMS ADJUDICATION PROCEDURE SHOULD CONTACT THE GARDEN CITY GROUP VIA THE HEALTH REPUBLIC HOTLINE at (866) 680-0893. Requests for further information or questions may be directed to (866) 680-0893 or www.healthrepublicny.org.


 “When Is the Flu Not the Flu?” CME Webinar on Nov. 16; Registration Now Open
MSSNY will begin its 2017 Medical Matters continuing medical education (CME) webinar series with “When Is the Flu Not the Flu?” on Wednesday, November 16, 2016 at 7:30 a.m.   William Valenti, MD, chair of MSSNY Infectious Disease Committee and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

A copy of the flyer can be accessed here. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

Educational objectives are: 1). Recognize the distinction between influenza virus infections and other similarly presenting illnesses.  2). Describe strategies for prevention, diagnosis and management of patients presenting with flu-like symptoms. 

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. 

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. Additional programs are will be conducted in January-May 2017, and topics include: Triage in a Disaster Event; The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team; and Mosquito Borne Diseases.  Program dates for Medical Matters will be announced shortly. 


YP/Resident Leadership Seminar Slated for Syracuse Oct 21-22
Following an exciting Leadership Seminar for downstate physicians in April, MSSNY’s Medical Educational and Scientific Foundation (MESF) has now slated a Leadership program for upstate physicians in Syracuse from late afternoon Friday, Oct 21 through Saturday, Oct 22.

The program is scheduled for the Doubletree Inn at Syracuse Thruway exit 36. A renowned faculty from Brandeis and Harvard University will lead the program, which is focused on management techniques needed by physicians in an integrated health care environment.

Attendees at the April downstate Leadership Seminar gave the program rave reviews. The program is limited to 40 physician attendees aged 40 and under with all costs covered under a grant from The Physicians Foundation.  For further information, contact MESF Executive Director at Tom Donoghue tdonoghue@mssny.org. 


Pediatrics Group: “Time to Say ‘No’” to Codeine for Children
The American Academy of Pediatrics is urging clinicians and parents to stop giving codeine to children, citing risks for respiratory depression and death.

Highlights of the clinical report, published in Pediatrics, include:

  • Genetic variation in codeine metabolism can lead to excessive morphine levels in some children, and is a particular concern in those with sleep-disordered breathing. From 1965 to 2015, the FDA Adverse Event Reporting System recorded 64 children with severe respiratory depression and 24 deaths associated with use of codeine.
  • Despite warnings from the FDA and international groups, codeine continues to be used widely for pediatric pain and cough. In 2011, it was prescribed to more than 800,000 U.S. children younger than 11 years. Codeine is available in over-the counter cough medicines in 28 states.
  • Among the limited alternatives for pediatric analgesia, other opioids are not recommended due to similar safety concerns. Nonopioid options, chiefly nonsteroidal anti-inflammatory agents and acetaminophen, may be effective for mild-to-moderate pain.

Pediatrics online-first page

Full NEJM Journal Watch Pediatrics and Adolescent Medicine coverage of AAP clinical report


CLASSIFIEDS


Well-Established Nassau County Internal Medicine Practice Available for Acquisition
After serving the community for 34 years, this well-established internal medicine practice is available for acquisition. The practice is multi-specialty with significant volume of primary care patients. This office is located in Plainview on a major street with excellent visibility and accessibility, with ample parking. For more information please call (516)822-4706 or E-mail to surendralal1@yahoo.com


Considering Outsourcing Your Billing?
Elite Medical Revenue Solutions, LLC specializes in Practice Management.  We can quickly solve your insurance billing problems by filing and following up on your claims and billing. We provide some of the most innovative and powerful solutions in the market today: online, and in real-time. Our CMS provides you with control and gives you and your staff complete access from any computer with Internet access. Services include: Practice Management, Claims Filing & Follow-up, Electronic Health Records (EHR), Online Patient Payment Portal & Collections, Certified Coding Services & Audit Prevention, Paperless Document Filing, HIPPA Compliance Documentation. Call us today at 888 334-6585 or visit us at www.elitemedsolutions.net
emrs

Office Space – 1185 Park Ave. (94th St.) Full-time
Ideal for busy medical subspecialty.  Exclusive use of consult, exam room. Stress test, echo available.  Beautiful décor.  Public transportation nearby.  Available immediately. Please call 212-996-2900 or e-mail: robertreichsteinmd@gmail.com

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

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

Physician Opportunities

A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.



A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).

If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.



Crown Medical PC Needs a New Internist and Pediatrician to Join Our Team! Salary $200,000 + plus benefits.
As a part of our continued growth, we are searching for a new Internist and Pediatrician to join our team. Salary is $200,000 + plus benefits.
Primary Responsibilities:
Examines, diagnoses and treats patients for acute injuries, infections, and illnesses
Counsels and educates patients and families about acute and chronic conditions or concerns
Documents items such as: chief complaint, past medical, family, and social history, review of systems, examinations, medications, allergies, assessment and plan
Formulates diagnostic and treatment plans
Prescribes and administers medications, therapies, and procedures
Orders lab and imaging tests to determine and manage an immediate treatment plan and provides advice on follow up
Responsible for the coordination of care with specialists and appropriate ancillary services
Completes all documentation and paperwork in a timely manner
Maintains quality of care standards as defined by the practice
Required Qualifications:
Active and unrestricted New York medical license
Board certified in Internal Medicine or Pediatrics
Current and unrestricted DEA certificate
Effective communication skills
Outstanding organization skills and ability to multi-task
Takes Initiative, creative, has problem solving ability, is adaptable, and flexible
Ability to work without direct supervision and practice autonomously
Ability to work in fast-paced environment
Crown Medical, PC / ER Medical, PC
Contact: Michael Furman
Practice Administrator
718-208-1215
e: michael@crownmd.com


Nurse Practitioner/ Family Practice Physician
Full time/part time Urgent Care; Primary care/urgent care experience necessary. Rome NY. 315-335-7777

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

 

 

 

 

 

 

 

 

 

 

 

 

 

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