Tag: Interested in Telemedicine?

PRESIDENT’S MESSAGE Dr. Malcolm Reid

Aug. 5, 2016 Volume 16, Number 28

Dear Colleagues:

According to Medicare.gov, telemedicine (which may also be referred to as “telehealth,” or “virtual healthcare”) “seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.”

With evidence-based telemedicine, clinicians can evaluate, diagnose and treat patients remotely using store-and-forward technology or real-time video conferencing.  Remote practitioners can capture and transmit medical data to share with peers and specialists around the corner or around the world.

About five years ago, I attended a Council meeting where a physician executive from UnitedHealthcare gave us a presentation informing us that telemedicine was in our near future and it was a good idea whose time had come. When the presentation ended, the room was silent until a Council member spoke up and said that this was an outrage and goes against one of the ancient tenets of medicine—that we had to lay our hands on our patients to examine them. An extended lively discussion ensued and finally, one Councilor had the courage to ask what the logistics of payment for a telehealth exam would be.

Today, we are well aware that telemedicine is provided throughout New York and is spreading rapidly. From our current and ongoing research, we know that there are different payment arrangements to practitioners who provide this new and vital service— “vital” as in a mother of four children and one of them has a high fever. She should not be expected to pack up the family car for a trip to the emergency room when her fears can be allayed by speaking to (hopefully) a NY physician. In addition, does a patient really need to make a trip to the office when they all they need is a routine prescription refill?

Many plans pay equally to the level of service based on the documentation contained in the medical record.

On July 18, we sent out a survey regarding telemedicine. Since this is a MSSNY hot topic, we are surprised at the low response rate. As we continue to develop our plans for your benefit, you could help us out by completing our 10-question survey. Even better, you can send it on to your colleagues so that we have a clearer picture of our members’ interest.

Please take it NOW!

10-question  telemedicine survey

Malcolm Reid, MD, MPP
MSSNY President

Please send your comments to comments@mssny.org

Westchester, LI Medical Groups Team Up for Contract with Empire BCBS
Commack, LI-based Independent Physicians Association of Nassau/Suffolk Counties (IPANS) and Hudson Doctors Independent Physicians Association in Valhalla, N.Y., plan to develop a shared-savings contract with Empire BlueCross BlueShield. John Franco, MD, President and Medical Director of the Nassau Suffolk of Independent Physicians Association of Nassau/Suffolk Counties (IPANS) and a member of MSSNY’s Task Force on Survival of Independent Practice, said, “We here at IPANS are very pleased to affiliate with Hudson IPA. Independent physicians will have greater strength in numbers and receive the necessary support to remain independent and successful.”

The two groups represent about 1,600 physicians generating about $2 billion in annual revenue, said Anthony Demetracopoulos, executive director and general counsel of the Hudson Doctors IPA, based in Valhalla, N.Y. The Hudson Doctors IPA was created in 1996 as an association for medical faculty from New York Medical College in Valhalla, but now it includes mostly non-faculty physicians. In a potential accountable care arrangement with Empire, the entity would be responsible for cost and quality for about 50,000 patients. In all, the doctors involved in the two groups see about 500,000 patients annually. (Crains, Aug 3)

With more doctors, the organizations can more easily afford investments in software that helps physicians track their patients through the health care system and avoid unnecessary duplication of care.

The agreement will give IPANS greater scale, making the combined entity more attractive to managed-care plans, which are increasingly shrinking their networks to include only high-performing providers. Hudson Doctors IPA could also help IPANS improve certain processes, such as credentialing doctors to verify their certifications, malpractice insurance and hospital privileges.

Tom Lee, MD, a board member of Hudson Doctors IPA, and Co-Chair of MSSNY’s Task Force on Survival of Independent Practice and commented, “”Hudson Doctors IPA looks forward to collaborating with IPANS to provide quality integrated services for our physician members’ patients, and keep independent practice a viable option for physicians in the future.”

Fee Waivers for Non-Compensated NYS License Renewal
A point of information for those physicians who have retired and are no longer compensated for medical care provided – a waiver of the fee for the registration of your license as a physician in the State of New York is allowed under the provisions of Section 6524(10) of the New York State Education Law.  This law allows a waiver of the registration fee requirement for physicians who certify to the State Education Department that, for the period of their registration, they will only practice medicine without compensation or the expectation or promise of compensation. The waiver of the registration fee is limited to the duration of the registration period indicated the affidavit.  http://www.mcms.org/sites/default/files/resources/NC-Affidavit11-02.pdf or see attached.

Patient Advocacy Groups Rally to Urge Governor Cuomo to Sign Step Therapy Override Bill Into Law
Dozens of patient advocates rallied at the State Capitol this week to urge Governor Cuomo to sign into law legislation (A.2834-D/S.3419-C) supported by MSSNY and unanimously passed by the State Legislature that would establish specific criteria for physicians to request an override of a health insurer “step therapy” medication protocol when it is in the best interest of their patients’ health.

The rally received significant media attention, including from WNYT,  TWC’s Capital Tonight and Politico-NY.

Las week, MSSNY representatives joined several other patient advocacy groups in a meeting with Governor Cuomo’s top health policy staff last week to urge that he sign this bill into law.   In addition to lobbying staff, MSSNY was also represented by Interspecialty Committee and Committee to End Healthcare Disparities member Dr. Inderpal Chhabra, who spoke regarding the hassles he regularly experiences with some insurers when trying to assure his patients have coverage for the medications they need.  Also joining the meeting were representatives of the NYS Society of Dermatology and Dermatologic Surgery (MSSNY member Dr. Mary Ruth Buchness), the NYS Academy of Family Physicians, the National Psoriasis Foundation, the Global Healthy Living Foundation, National Lupus Foundation, Mental Health Association of New York State, National Alliance on Mental Illness-NY, and the American Cancer Society.

To assist in our collective efforts to convince Governor Cuomo to sign this important bill into law, we ask you send a letter to him in support of this legislation.  A customizable template is available from MSSNY’s Grassroots Action Site here.

We know the insurers are strongly fighting this bill, so the Governor’s office needs to hear your support.

AG Warns Stop False Advertising re Ineffective Products as “Zika-Preventive”
Attorney General Eric T. Schneiderman announced that his office issued cease and desist letters to seven companies that market products with claims that the products prevent or protect against Zika virus even though the products are known to be ineffective for that purpose. The letters demand that the companies selling these products stop advertising them as “Zika-protective” or “Zika-preventive.” The Attorney General also issued a consumer alert warning New Yorkers about the deceptive ads and directing them to evidence-based Zika prevention measures that have been recommended by public health authorities.

“The only products that provide effective protection from mosquito bites contain DEET, picaridin, oil of lemon eucalyptus, and an insect repellent called IR3535 – all other products are a waste of money and may put you at risk of being bitten,” said NYC Health Commissioner Dr. Mary T. Bassett. “We continue to remind women who are pregnant or trying to become pregnant to not travel to a Zika-affected area – that includes most of Latin America and the Caribbean, and a neighborhood in Miami, Florida. Because of the risk of sexual transmission, partners of pregnant women should consider staying away from these areas, too.”
http://www.mssny.org/MSSNY/Public_Health/2016/SCHNEIDERMAN_ISSUES_CEASE_AND_DESIST_LETTERS.aspx

NY DFS Issues Letter Expressing Strong Concerns with Anthem-Cigna Merger Proposal
Noting its “serious concerns that Anthem’s proposed acquisition of Cigna will adversely impact the competitiveness of the health insurance market and harm consumers in New York”, this week the New York Department of Financial Services publicly released a letter from DFS Superintendent Maria Vullo indicating that she intends to call a public hearing to more fully evaluate the proposal.

The DFS announcement comes on the heels of litigation filed by the US Department of Justice two weeks ago (See the press release here  to block the proposed Anthem takeover of Cigna, as well as the proposed Aetna takeover of Humana.  In announcing the suit, DOJ noted that the proposed mergers of four of the five largest health insurance companies in the country “are unprecedented in their scale and in their scope”.

The DOJ intervention had been strongly supported by the American Medical Association, numerous state medical societies across the country including MSSNY, and several powerful consumer/patient advocacy groups.

However, as reported last week, Anthem (the parent of Empire) indicated its intent to fight the DOJ action, including purchasing full-page ads in several national papers including the Washington Post, the USA Today and the New York Times to present a letter to the public from its chair, Joseph Swedish, that it was “surprised and disappointed” by the DOJ’s actions.

The letter from Superintendent Vullo noted the huge market impact if Anthem and Cigna were permitted to merge.  It would increase Anthem’s market share across commercial products to 31.2% statewide, of which Anthem would command 9.8% of New York’s fully insured market and 47.6% of the self-insured market.  The biggest impact would be felt in the New York City metro area, where Anthem would control nearly 70% percent of the commercial self-insured market in the Bronx and Staten Island, 63% in Queens and Brooklyn, and 55% in Putnam County.

“Increased concentration means that insurers are more able to offer non-negotiable rates to providers in a take it or leave it deal. Therefore, the merger likely would limit New Yorkers’ access to healthcare because providers would be forced either to not participate with the dominant insurer or to cut hours or services in order to accommodate a deal they have to accept. This result would be highly problematic for New York consumers.”

We will keep you posted as to when the hearing is scheduled.

CDC Director: Zika Travel Advisory Could Last as Long As a Year
The Center for Disease Control and Prevention’s travel advisory for the south Florida neighborhood experiencing a Zika outbreak could last for as long as a year, according to CDC director Dr. Tom Frieden. “When dengue hit Florida a few years ago, it took over a year to control that outbreak. We certainly hope that doesn’t happen. We saw what happened in the Florida Keys and that did go on for a long time despite extensive efforts,” he said. 

James Hitt, MD to Step Into Dr. Eugene Gosy’s Pain Specialty Practice in Amherst
The Buffalo News reports: “The temporary arrangement to care for Dr. Eugene Gosy’s 9,500 patients ends this week, but another doctor is stepping in to ensure the big pain management practice remains open.” http://bit.ly/2aIpNu7 Dr. Gosy, a neurologist and pain specialist, was indicted in April on federal charges. His large patient load was due to the fact that many physicians referred their patients to Dr. Gosy. Area physicians were very concerned about Dr. Gosy’s practice closing, since he was the only pain specialist in the Amherst area.

Three area physicians volunteered to keep Dr. Gosy’s practice going temporarily. As of August 1, James Hitt, MD, a pain management specialist who had been working with cancer patients at Roswell Park Cancer Institute and veterans at the Buffalo VA Medical Center.

Want to Learn More about Comprehensive Primary Care?
On August 1, CMS opened the application for practices to apply for Comprehensive Primary Care Plus (CPC+), the largest-ever initiative to improve primary care in America. CPC+ rewards value and quality through an innovative payment structure to support comprehensive primary care.

In CPC+, CMS has provisionally selected 57 payer partners, including commercial insurers, state Medicaid agencies, Medicaid managed care organizations, and Medicare Advantage plans in 14 regions across the nation.

Want to learn more about CPC+?

–          Get your questions answered in the Practice FAQs.

–          Register for one of the 20 upcoming CPC+ Practice Open Door
Forums in August and September.

–          Watch the CPC+ Video Series to get an overview of CPC+
payment innovations and care delivery transformation.

–          Submit a CPC+ application via the online portal today through
11:59pm ET on Thursday, September 15.

–          Download the CPC+ toolkit: CPC+ In Brief, CPC+ Care
Delivery Transformation Brief, and CPC+ Payment Innovations
Brief and Case Studies.

At CMS, we believe CPC+ is the future of primary care in America. We are pleased to partner with aligned public and private payers across the country to support up to 5,000 practices delivering the care that best meets the needs of their patients and improves health outcomes.

Timely Reporting of Provider Enrollment Information Changes
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1617.pdf

Reviewing your Medicare provider enrollment in the Provider Enrollment Chain Organization System (PECOS) system, takes about 10 minutes.  https://pecos.cms.hhs.gov  Your password for this system is the one you would have obtained when you created your National Provider Identifier (NPI) number.  If you don’t know your password, please call the National Plan & Provider Enumeration System.  The NPI Enumerator may be contacted at the following:  NPI customer service: 800.465.3203 |800.692.2326 (TTY); or, you can email them at:  customerservice@npienumerator.com

Suicide Among Veterans: 20 Per Day
The suicide rate among U.S. veterans increased by nearly one-third between 2001 and 2014, according to a Veterans Affairs (VA) report released this week. According to the report, an average of 20 veterans died from suicide daily in 2014, totaling about 7,300 suicide deaths that year. VA estimated that the veteran suicide rate increased by 32 percent from 2001 to 2014. In comparison, the suicide rate among the total U.S. population increased by 23 percent during that time.

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