Community-Based Physicians and Staff Expected to Receive COVID-19 Vaccine Beginning Jan 4

Dear Colleague:

Community-based physicians and staff that have direct in-person patient care contact are expected to begin receiving the COVID-19 vaccine on January 4th.  Details on how and where immunizations will be obtained are still being worked out by the New York State Department of Health.  Please be assured that MSSNY will provide information as soon as we have it.  Several documents have been posted to the NYSDOH vaccination site.

“NYS Vaccination Program Guidance for Facilities Receiving COVID-19 Vaccine Phase 1A Only” is available here.

Effective next week, January 4th, this list will be expanded to include:

·   All Outpatient/Ambulatory front line, high risk health care providers who provide direct in-person patient care or other staff of any age in a position where they have direct contact with patients, such as receptionists. This will include but is not limited to hospital and community based ambulatory care, primary care, outpatient behavioral health services, phlebotomists, physical and occupational therapists, and specialty clinics including dialysis centers.

·   All front line, high risk public health workers who have direct contact with patients.

·   Health care workers at testing sites.

Effective this week, the following populations are prioritized for vaccination:

·   High-risk hospital and FQHC staff, including OMH psychiatric centers

·   Emergency Medical Services (EMS) personnel

·   Medical Examiners and Coroners

·   Funeral workers who have direct contact with infectious material and bodily fluids

·   Agency staff and residents in congregate living situations run by the OPWDD, OMH and OASAS.

·   Urgent Care providers

·   Staff administering the COVID-19 vaccine

Also see: 

1. Additional guidance for weeks 1-4 including tables of prioritization schedule and vaccination sites is available here. Local health departments are now listed in this table page 6-listed under vaccine recipients.

2. Storage and handling guidance

3. Demographic self-report form for those receiving vaccine

COVID-19 Relief Package 

As you may have heard, the President on Sunday night signed into law the COVID-19 relief package he had previously threatened to veto.  The measure contains a number of far-reaching proposals that impact physicians, including helping to prevent or reduce significant Medicare cuts that physicians were going to receive starting in a few days; another $284 billion for the Paycheck Protection Program for small businesses including physician practices who may have already received a PPP loan/grant; ensuring that receipt of a PPP loan/grant will not prevent a business from deducting expenses it might otherwise have deducted; and funding for an additional 1,000 medical residency positions.  It also includes the federal provisions for addressing surprise out of network bills, which had been improved but contained significant problematic provisions as well.

See our December 23 MSSNY e-news for more information on these issues.

Sincerely, 

Bonnie M. Litvack, MD
President, Medical Society of the State of New York 

New York City / New York State COVID-19 Vaccination Program Enrollment

COVID-19 Vaccine Update

There is a New York State Department of Health website that discusses the COVID-19 Vaccine COVID-19 Vaccine | COVID-19 Vaccine (ny.gov) and information can also be obtained on the CDC website: Healthcare Professionals: Preparing for COVID-19 Vaccination (cdc.gov)

This week, the Governor issued a new Executive Order No. 202.82 that permits licensed physicians and certified nurse practitioner to issue non-patient specific orders for the administration of the COVID-19 vaccine to nurses, physician assistants, special assistants, pharmacists and other persons authorized by the commissioner.  The executive order also waives the consent provision for those persons 19 years or older from having their vaccine data entered into the New York State Immunizations Information System (NYSIIS).  This provision was the consent procedure for all immunizations.

Additionally, the Executive Order specifies that the administration of a COVID-19 or Influenza vaccination is required to be reported to the NYSIIS or CIR systems within 24 hours regardless of the patient’s age.  Recognizing that many physicians who regularly provide influenza immunizations to their adult patients are not currently connected to the NYSIIS system, MSSNY has raised concerns to the NYSDOH and has urged that this requirement be reconsidered.

For those private practices who are becoming a COVID-19 vaccine provider, there is information that must be communicated to the patient or their caregiver prior to them receiving the COVID-19 vaccine and includes an explanation of the Emergency Use Authorization (EUA).  This form is titled the “Fact Sheet for Recipients and Caregivers” and can be download at www.cvdvaccine.com .  The New York State Department of Health has indicated that there is no specific written consent form required, however, an informed consent process is required for the patient to understand the Emergency Use Authorization (EUA) and the risks and benefits of vaccination.  This may be performed verbally or by using a consent form and the NYS DOH will provide a sample consent form for use in health settings should health care providers choose to use a consent form. That form is not yet available.


New York City COVID-19 Vaccination Program Enrollment

The New York City Department of Health and Mental Hygiene is now enrolling private practices, independent pharmacies and other facilities that will immunize adults in the NYC COVID-19 Vaccination Program.

Click on the links below to review the letter and instructions on how to sign the COVID-19 Vaccination Program Provider Agreement in the online Citywide Immunization Registry (CIR):

For questions, please call the Provider Access Line at 1-866-692-3641 or email nycimmunize@health.nyc.gov. Periodic updates will be sent to keep you informed and the COVID-19 vaccine webpage will be updated.


New York State COVID-19 Vaccination Program Enrollment

The New York State Department of Health (NYSDOH) is now enrolling healthcare provider practices (outside of New York City’s five boroughs) in the NYSDOH COVID-19 Vaccination Program.

Practices (outside NYC) interested in administering COVID-19 vaccine when the vaccine becomes available to their group must enroll in the NYSDOH program to be ready to order and receive publicly supplied COVID-19 vaccine and ancillary supplies.

Please review the following attached documentation and complete the online COVID-19 vaccine enrollment application located in the Health Commerce System by Friday, December 18, 2020.

Send questions regarding the NYSDOH enrollment process to: COVID19Vaccine@health.ny.gov

Vaccine Update from MSSNY President Bonnie Litvack, MD

Dear Colleague:

This pandemic has stretched the capabilities of every single American, indeed every citizen of the world. The financial and economic fall-out, the mental, emotional, and physical toll every one of us has felt for the last eight months has been immense. Recovery may take many years. Everyone is weary and everyone is exhausted.

But there is one thing I know: physicians are resilient and have proven time and again that they will take care of patients day in and day out without fail, because that is who we are and that is what our profession is all about.

Over the last week there have been many phone calls and emails from physicians with concerns that they will not be immunized for COVID-19.

The reality is that all physicians and other healthcare workers are considered in the 1a vaccination group and will be offered vaccination before the next phase of vaccination begins. However, at the moment vaccine is still in short supply and only about 50,000 or so have been vaccinated to date in NY.

In the next week or so the state is expecting 5-600,000 doses and those will all go to the 1a category. There are 2 million people in the 1a group. The hope is over the next month or so that NYS will get enough vaccine to vaccinate the 1a group, which includes physicians and office staff that have patient contact.

Regional hubs have been assigned throughout the state and those hubs are currently developing the plans with the local health departments on how the vaccine will be distributed in their areas. Each region is supposed to be using an algorithm to decide who gets the vaccine first within the 1a group; that algorithm factors in work exposure as well as personal risk factors. The hubs will reach out to the non-hospital affiliated doctors when vaccine is available for them and their staffs. They are counting on our help to distribute the vaccine. We are hoping to have the contact information for each regional hub shortly and will provide you with that information.

The regional hubs are: Greater New York Hospital Association for New York City; Northwell Health System for Long Island; Westchester Medical Center for Mid-Hudson; Albany Medical Center for Capital Region; Champlain Valley Physicians Hospital for the North Country; Mohawk Medical Center for the Mohawk Valley; United Health Systems for the Southern Tier; SUNY Upstate Medical Center for Central New York; University of Rochester Medical Center for Finger Lakes; Catholic Health System for Western New York.

This country is soon to embark on a mass immunization and all physicians will again be called upon to help in the effort. We urge you to be an advocate for COVID-19 immunization by becoming immunized, and encouraging your staff and colleagues to do the same. Recommend immunization to your patients and consider being a COVID-19 immunizer.

Information on this process can be found here.

The good news today is the national purchase of vaccines from Pfizer and BioNTech for delivery in the second quarter of 2021. With this new purchase, our patients will be able to receive the vaccine earlier. While I wish there was an adequate supply of vaccine available immediately for all physicians and other healthcare workers, unfortunately, that is not the case. However, please know that there is a NYS plan and community physicians with and without hospital affiliation are included and will be vaccinated in the priority group.

Thank you for all that you have done and will do. I sincerely wish you a wonderful holiday season and look forward to a better New York.

Warmest regards,

Bonnie Litvack, MD
President, Medical Society of the State of New York

MSSNY eNews: December 23, 2020 – Here’s to 2021!


.MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

Here’s to 2021!

Never before have I so looked forward to New Year’s Eve.  Closing the chapter on 2020 will be a huge relief.   The drop of the ball in Times Square will signify the end of a year of darkness and the beginning of a New Year where we will cherish the family gathering, the coffee with colleagues and the dinners with friends that we once took for granted.

But before we get there, these last few weeks of 2020 have been quite busy so here is the update:

COVID-19 Vaccine Information:
Some of you have been lucky enough to be in the first group vaccinated within NYS (approximately 40,000 people as of yesterday.) However, most of you are still awaiting vaccination.  Those of you providing in person care to patients are in the first vaccination group (1a) and will get vaccinated as soon as the supply is available.

NYS is expecting approximately 500,000 – 600,000 doses of vaccine in the next couple of weeks. Sit tight, you have not been overlooked but remember there are about 2 million people in the 1a category.

Many of you have contacted the society with questions about where, when, and how you and your office staff get vaccinated. For doctors that are on a medical staff, employed or not, you will receive your vaccination from the hospital.  Priority is to be given based on exposure risk and personal health risk factors, NOT based on employment status. 

MSSNY has communicated with top officials at the DOH and the Governor’s office in charge of vaccine distribution concerning the questions that we do not yet have answers for:  Where do doctors not affiliated with a medical staff get vaccinated? How, when, and where do the office staff of community doctors get vaccinated?  If a community-based physician practice has applied to be a vaccine distributor, will they be getting vaccine now for themselves and their other 1a staff? 

We hope to have answers to these questions shortly and when we do, we will post them to our website, email them and post them on social media so stay tuned and know that we care and are listening.

The Year End Federal Spending Package
As noted in several articles below, late Monday, Congress passed a comprehensive spending package that would fund the federal government through 2021. The end-of-year package contains some positive measures for physicians, including a new round of funding for the Paycheck Protection Program and provisions to ensure the continued ability to deduct certain essential business expenses for those who receive these loans, and important provisions to help reduce the very steep impending 2021 Medicare cuts.

However, the congressional bill also included a surprise medical billing dispute resolution component. MSSNY has long supported efforts to add federal protections to help prevent patients from receiving unexpected bills. However, despite the valiant efforts by the collective house of medicine (with a substantial New York component) the final federal version is greatly tilted in favor of health insurance companies and is inconsistent with New York’s far more balanced approach to addressing surprise medical bills for patients insured under state-regulated plans.

MSSNY has communicated to our NYS Congressional delegation our concerns that health insurers will take advantage to dramatically cut payments for their network participating physicians at a time when community physician practices are already at the edge of extinction due to a variety of factors and in a year when physicians have put their health and their families’ health at risk to ensure their patients receive the care they need.

Further complicating the picture is the President now threatening to veto the entire package because he believes the $600 direct payments to most Americans called for in the COVID-19 relief package is insufficient.  As if 2020 was not already enough of a roller coaster. Stay tuned for further details.

A very Merry Christmas to all that celebrate.  May your stocking be filled with vaccine dates for you and your staff.   Here’s to a joyful, healthy, and happy 2021!

Bonnie Litvack, MD
MSSNY President


Year End COVID-19 Package: Congressional Hits and Misses
“The end-of-year package agreed to by Congress contains some positive measures, including a new round of funding for the Paycheck Protection Program that assisted many community-based physician practices on the verge of closure earlier this year due to historic drops in patient visits.

Also important are provisions to ensure the continued ability to deduct certain essential business expenses for those who receive these loans, and provisions to help reduce though not eliminate the very steep Medicare cuts countless physicians will face for delivering health care services to their patients in 2021.

“Regarding the surprise medical billing dispute resolution component of this package, we have long supported efforts to add additional federal protections to help prevent patients from receiving these unexpected bills.  However, while the final version contains slight improvements from earlier versions, it does not address our fundamental concern we have repeatedly raised that the dispute resolution mechanism to resolve insurer-physician differences is greatly tilted in favor of health insurance companies.  Health insurers will be permitted to present data as to the appropriate cost of the health care services while physicians for all practical purposes will not be permitted to offer their own data.

“This is grossly unfair, and inconsistent with New York’s far more balanced approach to addressing surprise medical bills for patients insured under state-regulated plans. With this new, even greater leverage, we are very concerned that health insurers will take advantage to dramatically cut payments for their network participating physicians at a time when community physician practices are already at the edge of extinction due to a variety of factors.  More forced employment arrangements are inevitable, furthering reducing competition in health care delivery and driving up costs.

“We thank the efforts of the many members of the New York Congressional Delegation who have worked diligently to improve many of these provisions from earlier versions. However, the bottom line remains that this year-end Congressional package does as much harm as good to our front-line physicians who have put their health and their families’ health at risk this year to ensure their patients receive the care they need.”


Congressional Package Helps to Prevent or Reduce Medicare Cuts
As a result of an advocacy effort across medicine including from the AMA and MSSNY, the year-end Congressional package – if signed into law – would take a number of steps to help prevent and/or reduce what would have been enormous cuts to Medicare payments to many physician specialties.  Specifically, it would:

  • Provide for a one-time, one-year increase in the Medicare physician fee schedule of 3.75%, to support physicians and other professionals in adjusting to changes in the Medicare physician fee schedule during 2021, and to provide relief during the COVID-19 public health emergency.
  • Delay for 3 years the Secretary’s implementation of Code G2211 which reportedly will increase the MPFS by approximately 3%.
  • Delay the -2% sequestration cuts for 3 months

As noted in this chart developed by the AMA analyzing the specialty by specialty impact of these Congressional actions, an example of the impact:

  • Under the original CMS Medicare 2021 payment rule, ophthalmologists were expected to see a 6% cut, but now will face likely no cut.
  • Under the original CMS Medicare 2021 payment rule, general surgeons were expected to see a 6% cut, but now will face likely no cut.
  • Under the original CMS Medicare 2021 payment rule, neurosurgeons were expected to see a 6% cut, but now likely will face no cut.
  • Under the original CMS Medicare 2021 payment rule, interventional radiologists were expected to see an 8% cut, but now it will be a likely 2% cut
  • Under the original CMS Medicare 2021 payment rule, internal medicine was expected to see a 4% increase, but now likely a 6% increase.
  • Under the original CMS Medicare 2021 payment rule, anesthesiology was expected to see an 8% cut, but now likely a 2% cut.
  • Under the original CMS Medicare 2021 payment rule, PM&R was expected to see a 3% cut, but now likely will have a 3% increase.

Importantly, as well, the long overdue E&M changes set forth in the CMS 2021 Medicare payment rule will go forward.


Congressional Package Includes Expansion of Paycheck Protection Program (PPP)
The Congressional year end package included an additional $284 billion for the Paycheck Protection Program (PPP).  Importantly, if signed into law, it would enable a second PPP forgivable loan for the hardest-hit small businesses (including physician practices) and non-profits with 300 or fewer employees which can demonstrate a loss of 25% of gross receipts in any quarter during 2020 when compared to the same quarter in 2019.

Importantly, it would also provide that loans will not be included in taxable income, and clarifies that deductions are allowed for expenses paid with proceeds of a forgiven PPP loan, effective as of the date of enactment of the CARES Act and applicable to subsequent PPP loans.  MSSNY had heard from several physicians concerned that receipt of a PPP loan/grant was going to cause them to not be able to deduct business expenses due to a recent IRS interpretation.

It would also provide for an additional $20 billion for EIDL Advance Grants. Small businesses and nonprofits in low-income communities are eligible to receive $10,000 grants, previous recipients are also eligible to receive the full $10,000 if their award was less in the first round of grants.

Please read here for a comprehensive AMA summary of this and many other provisions in the Congressional COVID relief package.


MLMIC Banner


Congress Passes Measure to Address Surprise Medical Bills – Improvements Over Earlier Version but Still Titled in Favor of Insurance Companies
As has been widely reported, among the provisions contained in the year-end Congressional COVID relief package is a comprehensive measure to establish a federal standard for addressing surprise out-of-network medical bills.

If signed into law, based upon initial review and conversations with Congressional staff and the AMA, the new federal surprise bill provisions will apply to patients insured by ERISA plans, and New York’s approach would continue to be followed for out of network claims from patients insured in state-regulated plans.  There are similarities in this federal standard to New York’s well-regarded approach, but also significant differences for which MSSNY expressed serious concerns.

Here is a comprehensive summary of these provisions from the AMA:

The measure would ensure that patients are “held harmless” from surprise out-of-network medical bills. Like New York’s law, patients would only be required to pay the in-network cost-sharing, (i.e., copayment, coinsurance, and deductibles) amount for out-of-network emergency care, for certain ancillary services provided by out-of-network providers at in-network facilities, and for out-of-network care provided at in-network facilities without the patient’s informed consent.

However, unlike New York’s law, the federal provision calls for a 30-day open negotiation period for out of network physicians and payers to settle out-of-network claims, and if the 30 day negotiation period is unsuccessful, requires either the physician or the health plan to initiate an independent dispute resolution (IDR) process within 4 days of the end of the 30-day period.

The federal IDR process is similar to New York’s mechanism in that the IDR entity would select which side – the physician’s or the insurer’s suggested payment – will prevail.  Physicians may batch similar services in one proceeding when claims are from the same payer, but the bill permits only 30 days of batching.  The IDR entity would consider numerous sources of information brought by either party, such as the provider’s training and experience, patient acuity, and the complexity of furnishing the item or service.

However, in a significant departure from New York, neither provider charges nor usual and customary charges may be considered by the IDR entity, and the IDR entity is required to consider the market-based median in-network rate.  This a major deficiency that MSSNY has highlighted in its advocacy efforts over the last year on this issue, and was noted by MSSNY President Dr. Bonnie Litvack in MSSNY’s press release:

“it does not address our fundamental concern we have repeatedly raised that the dispute resolution mechanism to resolve insurer-physician differences is greatly tilted in favor of health insurance companies.  Health insurers will be permitted to present data as to the appropriate cost of the health care services while physicians for all practical purposes will not be permitted to offer their own data.”

There were improvements in this version over a version announced a week ago including a prohibition of the consideration of Medicare or Medicaid data by the IDR, as well as elimination of provisions that would have set up cumbersome processes to require patients to receive a detailed description of services rendered within 15 days of the date of service and required a patient to be billed within 90 days of the date of service even if the claims had not been fully adjudicated by the health insurer.

The Congressional provisions also address “voluntary” out of network services by providing that non-participating providers at participating facilities may not bill a patient more than the cost-sharing requirements or balance bill the patient unless the notice and consent requirements are met. These consent requirements include providing the patient with written notice and consent 72 hours in advance of appointment; providing a good faith estimate of the costs of the services; and providing the patient with a list of in-network providers at the facility and information regarding medical care management, such as prior authorization.  At participating facilities, the notice and consent exception does not apply to out-of-network providers of radiology, pathology, emergency, anesthesiology, diagnostic and neonatal services; assistant surgeons, hospitalists, intensivists, and providers offering services when no other in-network provider is available.

Further analysis of this far-reaching legislation is ongoing, so please remain alert for further updates.


Tribute to MSSNY’s Long Time Tech Genius, Brian Petrucco
Our MSSNY family was very saddened by the unexpected passing of our long-time technical support staffer Brian Petrucco on December 13.  Brian was an unsung hero to our collective MSSNY efforts – anyone who has run or worked in an office can appreciate the absolutely indispensable role that a technical support person plays in our day to day lives.

Brian not only provided this support for the MSSNY Albany office, but he regularly traveled to the various MSSNY offices across the State to ensure our systems were working properly so we could better carry out our mission to provide needed services to our member physicians.

Brian genuinely loved what he did and was always happy to provide needed answers to various technical questions that the staff posed to him, and like an accomplished chef (Brian was also a very good cook!), he enjoyed providing the fine details of how he fixed a particular technical glitch.

Like many MSSNY staffers, his contributions grew significantly over the years, and he was often in the office over many hours over a weekend to ensure that our interconnected computer systems were functioning properly.  As the pandemic forced much of MSSNY’s staff to work remotely, he ably helped to ensure that our transition from in-person to virtual was seamless, and unnoticeable to our physician members.

Brian and his wife Tanya had a great love of exotic travel, including getting married on a glacier in Alaska.

Brian leaves a legacy of a tremendous amount of “behind the scenes” work to assist the physicians of New York and is someone that will be extremely hard to replace.

Rest in peace, Brian.


CPH Banner


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration – Zoom

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders in the morning (this year via Zoom), and then have virtual visits with their respective legislators in the afternoon.

With the Governor and the State Legislature needing to create tens of billions of savings to the State Budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous proposals to inappropriately expand the scope of practice for various non-physicians as well as numerous proposals to mandate how physicians provide care to their patients.

Please plan to join hundreds of colleagues from around the State on March 2!


Pfizer to Deliver 70 Million Doses by June 30
The Trump administration has reached a deal with Pfizer to buy an additional 100 million doses of the company’s COVID-19 vaccine, effectively doubling the federal government’s supply from Pfizer.

The pharmaceutical giant is to deliver 70 million doses by June 30, 2021 and complete the rest of the order by the end of the following month, according to a statement released today by the Department of Health and Human Services. Pfizer said the U.S. government has agreed to pay $1.95 billion for the additional doses of its vaccine, which was developed jointly with BioNTech. (NPR, Dec 23)


MSSNY President Interviewed Re COVID-19 Impact on Healthcare Workers
USA Today (12/22) Network New York interviewed MSSNY President Dr. Bonnie Litvack, a Westchester County radiologist, about the COVID-19 pandemic and the impact on healthcare workers. Dr. Litvack said, “A lot of physicians and other health care workers have sort of borne the brunt of the pandemic. … It’s something that has affected physicians like it has most New Yorkers, in many ways, in terms of physical pain and mentally and the stress of increased patient caseloads and in terms of financial stress to keep their doors open.”


Summary: Physicians Foundation 2020 Survey of America’s Physicians
I want to start by thanking you for your support and participation in The Physicians Foundation Three-Part 2020 Survey of America’s Physicians. Throughout 2020, we have had multiple touch points with physicians regarding their perspective on the current state of the medical profession; how practice patterns, career plans and attitudes are evolving; their attitudes on navigating the current political landscape; and how COVID-19 is impacting their practices, patients, and their own wellbeing.

As the health care landscape evolves amid COVID-19, America’s physicians are faced with countless obstacles when it comes to delivering high-quality, cost-efficient care. As the foundation of our health care system, physicians’ voices must be heard.

For ease, I have attached in this email and linked here, an executive summary of all three surveys. We hope that you will share these to ensure physician insights are being included in all conversations about health care reform in America.

Robert Seligson
Chief Executive Officer
The Physicians Foundation

Note: MSSNY is a charter member of The Physician Foundation.


Dr. Fauci: Fast-Spreading COVID-19 Variant in U.K. Is Probably Already in U.S.
Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN fast-spreading COVID-19 variant in U.K. is probably already in the U.S.

(12/22). Dr. Fauci said imposing a U.K. travel ban would be a “rather dramatic step” for the U.S., though more than 40 other countries have already closed their doors to Britain, reports The New York TimesPfizer and Moderna are both testing their vaccines against the new variant, according to CNN. Pfizer and Moderna are testing their COVID-19 vaccines against a mutated strain of the coronavirus that first appeared in England, CNN reported.

Moderna said: “We expect that the Moderna vaccine-induced immunity would be protective against the variants recently described in the U.K.; we will be performing additional tests in the coming weeks.”

Pfizer said it is generating data on how well blood samples from immunized people are able to neutralize the new strain, CNN reported.

The strain hasn’t been identified in the U.S., but the CDC said Dec. 22 that “given the small fraction of U.S. infections that have been sequenced, the variant could already be in the United States without having been detected.”


COVID-19 Patients with Neurological Problems Have A Higher Mortality Risk Individuals hospitalized with Covid-19 and neurological problems, including stroke and confusion, have a higher risk of dying than other COVID patients, according to a new study by researchers at Montefiore Health System and Albert Einstein College of Medicine. Montefiore and Einstein said in announcing the study that its findings have the potential to identify and focus treatment efforts on the individuals most at risk. The study was published Friday afternoon in Neurology, the medical journal of the American Academy of Neurology.

The study examined data from 4,711 COVID-19 patients who were admitted to Montefiore during the six-week period between March 1 and April 16. Of those patients, 581—or 12%—had neurological problems serious enough to warrant brain imaging.

Among patients who underwent brain imaging, 55 were diagnosed with stroke and 258 exhibited confusion or altered thinking ability, Montefiore and Einstein said. Individuals with stroke were twice as likely to die—the group had 49% mortality compared with a matched control group, which had 24% mortality. More than half of the stroke patients in the study did not have hypertension or other underlying risk factors for stroke.

People with confusion had a 40% mortality rate compared with 33% for their matched control, which was also statistically significant, the researchers found. “This study is the first to show that the presence of neurological symptoms, particularly stroke and confused or altered thinking, may indicate a more serious course of illness, even when pulmonary problems aren’t severe,” said Dr. David Altschul, chief of the division of neurovascular surgery at Einstein and Montefiore, and associate professor in the Department of Neurological Surgery and of radiology at Einstein, in a statement.

“Hospitals can use this knowledge to prioritize treatment and, hopefully, save more lives during this pandemic,” Altschul, who is also surgical director of the Montefiore Comprehensive Center for Stroke Care and the study’s co-author, added. Montefiore and Einstein said there were no funding sources for the study. (Crain’s Pulse, Dec. 20)


Sellers Insurance Banner


CDC: Next Priorities for Vaccine: Ages 75+, Front-Line Essential Workers
People age 75 and older and front-line essential workers should be the next priority groups to receive COVID-19 vaccines, the CDC’s Advisory Committee on Immunization Practices put forth Dec. 20.

The committee vote establishes their recommendation for vaccine distribution in the remainder of phase 1 — phases 1b and 1c.

  • Healthcare personnel and long-term care facility residents made up phase 1a.
  • Phase 1b applies to adults age 75 and older and front-line workers essential to societal functions, such as teachers, firefighters, prison officers and police.
  • Phase 1c expands access to adults 65 and older, people with underlying medical conditions that put them at higher risk of severe illness from COVID-19, and other essential workers including those in food service, construction, waste, and trucking.

The next step is for CDC Director Robert Redfield, MD, to accept the committee’s recommendations. They would then be published in the CDC’s “Morbidity and Mortality Weekly” later this week and shared as official CDC guidance.


Stanford University Protest

Stanford Medicine residents protested after they were not included in the vaccine distribution plan. (Photo: Becker’s Hospital Review, Dec. 22)

Stanford Medicine Residents Protest Being Left Out of The Vaccine Allocation
“We take complete responsibility for the errors in the execution of our vaccine distribution plan,” said Lisa Kim, a Stanford Medicine spokesperson. “Our intent was to develop an ethical and equitable process for distribution of the vaccine.

We apologize to our entire community, including our residents, fellows, and other frontline care providers, who have performed heroically during our pandemic response. We are immediately revising our plan to better sequence the distribution of the vaccine.”

An algorithm chose who would be the first 5,000 in line. The residents said they were told they were at a disadvantage because they did not have an assigned “location” to plug into the calculation and because they are young, according to an email sent by a chief resident to his peers. Stanford Medicine has about 1,300 across all disciplines.

Only seven made the priority vaccination list, despite the fact that this week, residents were asked to volunteer for ICU coverage in anticipation of a surge in COVID-19 cases. The algorithm has been corrected. The university quickly revised its vaccine distribution plan to prioritize health workers including residents and fellows. Stanford also created a new committee that would consider the interests of all stakeholders.


New Member Benefit: MSSNY’s Partner with Premier Group (Essensa) Purchasing
We are excited to announce registration information for our new group purchasing partnership between MSSNY and Premier.

We expect this new partnership to result in lower operating costs and improved access to supplies and products for MSSNY members who sign on to purchase through Premier negotiated agreements.

Sign up today and begin taking advantage of the value and savings Premier brings to the table for MSSNY members:  

  • A leading healthcare improvement company dedicated to better care and outcomes at lower costs
  • Nearly 30 years of experience in the alternate site group purchasing organization space
  • A portfolio featuring more than 900 suppliers and 2,000 products and services ranging from pharmaceuticals to medical/surgical supplies to business solutions and more (including numerous PPE solutions!)
  • A distributor neutral approach, meaning MSSNY members can continue using existing distributors while accessing Premier-negotiated pricing
  • A commitment to hands-on service to ensure MSSNY members are receiving the best value for all their purchasing needs

Click the links below to access specifics on the program:

  • Continuum of Care Overview: High level overview of the Premier program and the value it provides
  • GPO FAQ: Questions and answers to further introduce Premier and explain the program
  • Physician Practices information sheet: Provides value proposition of the Premier program, followed by specific suppliers and contracts members will be able to access, broken down by category
  • What to Expect: Step by step onboarding guide for members

Questions? Email MSSNY-Premier@premierinc.com or call (888) 258-3273.

Register now!


JAMA Original Investigation Dec 22, 2020: Variation in US Hospital Mortality Rates for Patients Admitted With COVID-19 During the First 6 Months of the Pandemic


Garfunkel Wild Ad


Registration Now Open Veterans Matters: PTSD in Returning Veterans Webinar
Tuesday, January 26th @ 7:30 am

The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer

When:          January 26, 2020 at 7:30 am
Faculty:        Frank Dowling, MD

Educational Objectives:

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

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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

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


Communications Department Christmas Card


 

Classifieds

Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

 

 

 

 

 

 

.

 

 

.

 

Year End COVID Package – Congressional Hits and Misses

For Immediate Release
December 22, 2020 

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

Year End COVID-19 Package: Congressional Hits and Misses

“The end-of-year package agreed to by Congress contains some positive measures, including a new round of funding for the Paycheck Protection Program that assisted many community-based physician practices on the verge of closure earlier this year due to historic drops in patient visits.   Also important are provisions to ensure the continued ability to deduct certain essential business expenses for those who receive these loans, and provisions to help reduce though not eliminate the very steep Medicare cuts countless physicians will face for delivering health care services to their patients in 2021.

“Regarding the surprise medical billing dispute resolution component of this package, we have long supported efforts to add additional federal protections to help prevent patients from receiving these unexpected bills.  However, while the final version contains slight improvements from earlier versions, it does not address our fundamental concern we have repeatedly raised that the dispute resolution mechanism to resolve insurer-physician differences is greatly tilted in favor of health insurance companies.  Health insurers will be permitted to present data as to the appropriate cost of the health care services while physicians for all practical purposes will not be permitted to offer their own data.

“This is grossly unfair, and inconsistent with New York’s far more balanced approach to addressing surprise medical bills for patients insured under state-regulated plans. With this new, even greater leverage, we are very concerned that health insurers will take advantage to dramatically cut payments for their network participating physicians at a time when community physician practices are already at the edge of extinction due to a variety of factors.  More forced employment arrangements are inevitable, furthering reducing competition in health care delivery and driving up costs.

“We thank the efforts of the many members of the New York Congressional Delegation who have worked diligently to improve many of these provisions from earlier versions. However, the bottom line remains that this year-end Congressional package does as much harm as good to our front-line physicians who have put their health and their families’ health at risk this year to ensure their patients receive the care they need.”

# # #

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


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

 

MSSNY eNews: December 18, 2020 – MSSNY Partners with Premier Group Purchasing


.MSSNY’s Partnership with Premier Group Purchasing

MSSNY’s Partnership with Premier Group Purchasing

Colleagues:

We are excited to announce registration information for our new group purchasing partnership between MSSNY and Premier.

We expect this new partnership to result in lower operating costs and improved access to supplies and products for MSSNY members who sign on to purchase through Premier negotiated agreements.

Sign up today and begin taking advantage of the value and savings Premier brings to the table for MSSNY members:  

  • A leading healthcare improvement company dedicated to better care and outcomes at lower costs
  • Nearly 30 years of experience in the alternate site group purchasing organization space
  • A portfolio featuring more than 900 suppliers and 2,000 products and services ranging from pharmaceuticals to medical/surgical supplies to business solutions and more (including numerous PPE solutions!)
  • A distributor neutral approach, meaning MSSNY members can continue using existing distributors while accessing Premier-negotiated pricing
  • A commitment to hands-on service to ensure MSSNY members are receiving the best value for all their purchasing needs

Click the links below to access specifics on the program:

  • Continuum of Care Overview: High level overview of the Premier program and the value it provides
  • GPO FAQ: Questions and answers to further introduce Premier and explain the program
  • Physician Practices information sheet: Provides value proposition of the Premier program, followed by specific suppliers and contracts members will be able to access, broken down by category
  • What to Expect: Step by step onboarding guide for members

Questions? Email MSSNY-Premier@premierinc.com or call (888) 258-3273.

Register now!

Bonnie Litvack, MD
MSSNY President


Congress Scurries to Finish Year End Package – Your Action Still Needed!
As the US Congress scrambles to finish a year-end continuing Budget resolution and COVID relief package, all physicians are urged to continue to contact their respective US Representative and Senators Schumer and Gillibrand to request that they:

1) Work to substantially revise an insurance industry-favoring proposal to address out of network surprise medical bills that, unlike New York’s heralded approach to surprise medical bills, prohibits the arbitrator from even considering physician or FAIR Health charge data. This proposal adversely impacts all physicians, not just out of network physicians, as health insurers will be even more empowered to ratchet down physician payment;

2) Prevent potentially steep Medicare cuts for many specialties while enabling long     overdue E&M payment increases to go forward; and

3)   Support programs to help address the huge drop in patient revenue facing physician practices this year

MSSNY President Dr. Bonnie Litvack had issued a statement earlier this week urging Congress to “go back to the drawing board” on its grossly unfair surprise bill proposal MSSNY Statement on US Congressional Committees’ Surprise Billing Agreement   – Congress is likely to work well into the weekend, and perhaps even into early next week, to finalize this package, so please continue to contact your Representatives!


MSSNY Weekly Podcast
Vaccines, COVID relief and Surprise Bills


Gov. Cuomo: Hospitals to Lead Regional Vaccine Distribution
Nearly a dozen hospitals and health systems across New York have been chosen to lead the regional distribution and administration of Covid-19 vaccines to essential workers and prioritized members of the public, Gov. Andrew Cuomo said Wednesday.

Key context: Local hospitals, which will serve as regional vaccination hubs, must work with community officials in developing plans for administering Covid-19 immunizations. Those plans, Cuomo said, must be submitted to and approved by the Department of Health by early January so they are in place by the time New York has enough doses to enter Phase II of its vaccination effort — likely in late January.

Cuomo said the model will allow local health officials, county governments and community-based organizations to coordinate on a distribution plan that ensures outreach to hard-to-reach communities and meets the needs of the region. It will also ensure politics are not part of the process, he said.

“It’s a medical procedure, it will be handled by medical professionals. There will be no political favoritism,” he said during a late-morning news conference.

Cuomo noted that the state will have a “Vaccine Command Control Center” and will provide support to implement the plans.

Details: Regional vaccination hub coordinators include: The Greater New York Hospital Association for New York City; Northwell Health Systems for Long Island; Albany Medical Center for the Capital Region; Catholic Health System for Western New York; SUNY Upstate Medical Center for Central New York; and Westchester Medical Center for the Mid-Hudson region.

Champlain Valley Physicians Hospital, meanwhile, will oversee efforts in the North County; Mohawk Valley Medical Center will coordinate vaccinations in the Mohawk Valley; United Health Services will serve as the regional hub for the Southern Tier; and University of Rochester Medical Center will lead vaccine efforts in the Finger Lakes.

Vaccine costs: The governor said that he has directed the Department of Financial Services to ensure that no New Yorker has to pay for a Covid-19 vaccine and that insurers cover the costs.

“In New York state, no person will have to pay a penny for a vaccination,” he said. “We want people to get vaccinated. It shouldn’t be about wealth. No one will pay a penny.”

New York had administered around 4,000 total Covid-19 vaccine doses as of noon on Wednesday.


Notes from Governor Cuomo’s Briefing

COVID:
– Day 293
– Statewide rate without micro-clusters: 4.60%
– Statewide rate with micro-clusters: 5%
– Micro-cluster rate: 6%
– 249,000 tests
– 120 deaths
– 6,081 hospitalizations, down 66
– 1,068 ICU patients, down 27
– 592 intubations, down 19

Hospitalizations by Region:
– Finger Lakes: 746 (0.06%)
– Western NY: 474 (0.03%)
– Southern Tier: 164 (0.04%)
– Central NY: 385 (0.05%)
– Mid Hudson: 739 (0.03%)
– NYC: 1,984 (0.02%)
– Long Island: 1,007 (0.04%)
– Capital Region: 331 (0.03%)
– Mohawk Valley: 188 (0.04%)
– North Country: 63 (0.02%)

Hospitals:
– Gov. said he believes hospitals will have enough capacity to manage
increases
– Downstate, an additional 31,000 beds have been added
– Northwell, GNYHA will back up smaller systems and NYC H&H
– State spoke with Erie, Monroe hospitals and HANYS, they have added additional
capacity, are prepared
– Gov. reiterated DOH requires state must be notified if hospitals are within 3 weeks
of hitting 85% capacity, added that no hospital has so far

Vaccine:
Vaccination period is expected to take between 6-9 months
– Gov. again said he would take the vaccine publicly
– FDA has authorized Moderna vaccine, state advisory panel also approved it
– 346,000 doses from Moderna expected next week
– Gov. said original shipment from Pfizer contained more doses than intended
– FDA, DOH have authorized additional doses
– 19,000 vaccinations administered so far in NY
– Vaccine information available at: www.ny.gov/vaccine


COVID-19 Vaccine Update
There is a New York State Department of Health website that discusses the COVID-19 Vaccine COVID-19 Vaccine | COVID-19 Vaccine (ny.gov) and information can also be obtained on the CDC website: Healthcare Professionals: Preparing for COVID-19 Vaccination (cdc.gov)

This week, the Governor issued a new Executive Order No. 202.82 that permits licensed physicians and certified nurse practitioner to issue non-patient specific orders for the administration of the COVID-19 vaccine to nurses, physician assistants, special assistants, pharmacists and other persons authorized by the commissioner.  The executive order also waives the consent provision for those persons 19 years or older from having their vaccine data entered into the New York State Immunizations Information System (NYSIIS).  This provision was the consent procedure for all immunizations.

Additionally, the Executive Order specifies that the administration of a COVID-19 or Influenza vaccination is required to be reported to the NYSIIS or CIR systems within 24 hours regardless of the patient’s age.  Recognizing that many physicians who regularly provide influenza immunizations to their adult patients are not currently connected to the NYSIIS system, MSSNY has raised concerns to the NYSDOH and has urged that this requirement be reconsidered.

For those private practices who are becoming a COVID-19 Vaccine provider, there is information that must be communicated to the patient or their caregiver prior to them receiving the COVID-19 vaccine and includes an explanation of the Emergency Use Authorization (EUA).

This form is titled the “Fact Sheet for Recipients and Caregivers” and can be download at www.cvdvaccine.com . The New York State Department of Health has indicated that there is no specific written consent form required, however, an informed consent process is required for the patient to understand the Emergency Use Authorization (EUA) and the risks and benefits of vaccination.  This may be performed verbally or by using a consent form and the NYS DOH will provide a sample consent form for use in health settings should a health care provider choose to use a consent form.  That form is not yet available.

Non Patient-Specific Standing Order for the Administration of the PfizerBioNTech COVID-19 Vaccination for the Initial Phase of the COVID-19 Vaccination Program


MLMIC Banner


Employers Can Require COVID-19 Vaccine, EEOC Says
Employers can legally require staff to receive a COVID-19 vaccine before returning to their place of work, according to updated guidelines from the U.S. Equal Employment Opportunity Commission.

Under the Americans with Disabilities Act, employers are permitted to impose “a requirement that an individual shall not pose a direct threat to the health or safety of individuals in the workplace,” the EEOC said in a Dec. 16 guideline.

However, employers must provide a “reasonable accommodation” for employees who have a disability or sincere religious beliefs that forbid vaccinations. Accommodations may include temporarily changing an employee’s job duties, modifying work schedules, or installing plexiglass barriers to separate employees, according to the commission.

If a reasonable accommodation cannot be made, and the unvaccinated employee poses a “direct threat” to other employees’ health and safety, employers may prevent the individual from entering the workplace. However, this is not grounds to automatically terminate the employee, the EEOC said.
To learn more, click here.


FDA Authorizes First Fully At-Home COVID-19 Test
The FDA granted emergency approval Dec. 15 for the first fully at-home COVID-19 diagnostic test, which doesn’t need a prescription and doesn’t need to be sent to a lab. The Ellume COVID-19 Home Test is a rapid antigen test that detects proteins from the virus from a nasal swab and can be used on anyone over 2 years old.

“Today’s authorization is a major milestone in diagnostic testing for COVID-19. By authorizing a test for over-the-counter use, the FDA allows it to be sold in places like drug stores, where a patient can buy it, swab their nose, run the test, and find out their results in as little as 20 minutes,” said FDA Commissioner Stephen Hahn, MD. The agency warned that a small percentage of results may be false.

The test correctly identified 96 percent of positive samples and 100 percent of negative samples in people with symptoms. In those without symptoms, the test correctly identified 91 percent of positive samples and 96 percent of negative samples. The FDA said that people without symptoms should treat a positive result from the Ellume test as presumptively positive until confirmed by a lab test. Those with symptoms who get a negative result should follow up with their healthcare provider to decide whether they should get another test, the FDA said.

The Ellume test connects to a smartphone app to give results, which come in about 20 minutes. The app reports the results to public health authorities to help monitor disease prevalence. Ellume said it expects to make more than 3 million tests in January. The company didn’t mention how much the tests will cost.

The FDA previously has given emergency approval for an at-home COVID-19 test from LabCorp that doesn’t require a prescription, but must be sent to a lab for results. The agency authorized the first at-home COVID-19 test in November, but that requires a prescription and must be sent to a lab. (Becker’s Hospital Review, Dec.18)


New York City COVID-19 Vaccination Program Enrollment
The New York City Department of Health and Mental Hygiene is now enrolling private practices, independent pharmacies and other facilities that will immunize adults in the NYC COVID-19 Vaccination Program.

Click on the links below to review the letter and instructions on how to sign the COVID-19 Vaccination Program Provider Agreement in the online Citywide Immunization Registry (CIR):

Attend a webinar on completing the Provider Agreement in the CIR:
Enrollment in the NYC COVID-19 Vaccination Program
Tuesday, December 15, 2020, 1:00 to 2:00 p.m.
Register Here

For questions, please call the Provider Access Line at 1-866-692-3641 or email nycimmunize@health.nyc.gov. Periodic updates will be sent to keep you informed and the COVID-19 vaccine webpage will be updated.


Sellers Insurance Banner


More Students Are Entering Medical School
AAMC data show that the number of first-year medical students grew in 2020. Women continue to outnumber men among future physicians, and underrepresented groups are making modest gains.

The number of people entering medical school in the United States reached a two-decade high in 2020 with a total of 22,239 matriculants, according to new data from the AAMC (Association of American Medical Colleges). That number represents a 1.7% increase over the 2019 entering class.

Meanwhile, applicants for the class of 2021 are skyrocketing, with the number already up 18% compared to last year.

“This increased interest in medicine comes at a crucial moment,” said David J. Skorton, MD, AAMC president and CEO. “The pandemic is spotlighting the extraordinary services that physicians provide on the front lines. It’s heartening to see that more students want to pursue a career in medicine to serve their communities and make a difference.”

The data show that medical schools are also making gradual progress in diversifying their ranks while experiencing little growth — or even declines — in applicants from most underrepresented groups. One population showing a notable increase is Black or African American men: Their numbers in medical schools rose 6.2% overall, with a 12.2% increase in new students.

Some key data help paint the picture of medical students from underrepresented backgrounds:

  • Although the percentage of Hispanic, Latino, or Spanish-origin applicants dropped slightly, matriculants increased 8.6% to 2,678.
  • The number of Black or African American applicants remained roughly the same, but matriculants increased by 10.5% to 2,117.
  • American Indian or Alaska Native matriculants rose 7.8% to 248, while applicants in that group fell 4.3%.

The number of entering students identifying as Black or from other underrepresented groups rose overall. But those increases were concentrated only at a tiny number of schools, highlighting the important role of historically Black colleges and universities and Hispanic-serving institutions, experts say. “This underscores the critical role of minority-serving institutions, but it also shows that other schools must recommit to diversifying their classes to increase those historically underrepresented in medical school,” argued Geoffrey Young, PhD, AAMC senior director of student affairs and programs. (AAMC, Dec. 16)


Moderate Sleep Loss Boosts Risk of Medical Errors 53%, Study Finds
Even moderate levels of sleep deprivation among physicians can cause a significant increase in the risk of medical errors, a study published Dec. 7 in JAMA Network Open found.

Researchers surveyed physicians at 11 academic medical centers nationwide on various wellness topics, including sleep, between November 2016 and October 2018. More than 11,300 physicians provided survey responses on sleep habits, and 7,762 responded to questions about self-reported medical errors.

Residents had higher rates of sleep-related impairment than attending physicians, and residents in surgical specialties reported the most sleep deprivation among the 12 medical specialties included in the analysis. Among attending physicians, emergency medicine specialists reported the most sleep-related impairment, while surgical specialists reported the least.

After adjusting for such factors as training status and practice specialty, researchers found physicians who reported moderate levels of sleep deprivation had a 53 percent greater chance of self-reporting a clinically significant medical error. This figure jumped to 97 percent for physicians with the highest rates of sleep deprivation.

“Sleep-related impairment was associated with increased burnout, decreased professional fulfillment and increased self-reported clinically significant medical error,” study authors concluded. “Interventions to mitigate sleep-related impairment in physicians are warranted.”

To view the full study, click here.


CDC Issues Advisory as Drug Overdose Deaths Spike
The CDC issued a Health Alert Network advisory to medical and public health professionals and others Thursday, saying drug overdose deaths have soared to the highest number ever recorded in a 12-month period. Approximately 81,230 drug overdose deaths occurred in the U.S. in the 12 months ending May 2020, with the largest spike after the COVID-19 public health emergency started, from March 2020 to May 2020.

Drug overdose deaths were rising before March, but the findings suggest they accelerated during COVID-19, the agency said.

“The disruption to daily life due to the COVID-19 pandemic has hit those with substance use disorder hard,” said CDC Director Robert Redfield, MD, in a statement. “As we continue the fight to end this pandemic, it’s important to not lose sight of different groups being affected in other ways. We need to take care of people suffering from unintended consequences.”

The number of deaths increased 18.2% from the 12-month period ending in June 2019 to the 12-month period ending in May 2020 and appeared to be driven largely by deaths involving synthetic opioids like illicitly manufactured fentanyl, according to the CDC.

Of 38 jurisdictions with available synthetic opioid data in the CDC’s analysis, 37 reported increases in synthetic opioid overdose deaths. Eighteen reported increases greater than 50%. Ten western states reported more than a 98% increase in synthetic opioid-involved deaths. Cocaine-related overdose deaths also increased by 26.5% in the 12-month period; these were likely connected to using cocaine together with illicitly manufactured fentanyl or heroin, the CDC noted.

Overdose deaths involving stimulants like methamphetamine increased by 34.8% and exceeded the number of cocaine-involved deaths. These deaths have been increasing with and without synthetic opioid co-use and at a rate faster than overdose deaths involving cocaine, the agency said, noting the rise was consistent with the growth of methamphetamine in the illicit drug supply and increases in methamphetamine-related treatment admissions.

The advisory recommended that naloxone use and overdose education be expanded, that awareness and availability of treatment for substance use disorder be improved, and that drug overdose outbreaks and spikes be monitored more rapidly. (Medpage, Dec.17)


Altfest Banner


Registration Now Open Veterans Matters: PTSD in Returning Veterans Webinar

Tuesday, January 26th @ 7:30 am

The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer

When:          January 26, 2020 at 7:30 am
Faculty:        Frank Dowling, MD

Educational Objectives:

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

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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

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


Now More Than Ever, Patients Need Relief from the High Cost of Prescriptions
While COVID-19 has dominated the headlines for months, many New York residents are also dealing with health issues unrelated to the virus that may require medications. In addition, many have lost their jobs and health insurance. The New York Rx Card may be able to help ease the burden of costly prescription medications for your patients. This savings program is designed to help those who may be uninsured, underinsured or who have health insurance coverage with no prescription benefits – but anyone can use it.

Patients (and physicians) can save up to 80% on prescription drugs by using this free card. All they need to do is present the card at a pharmacy when paying for a prescription. In instances in which patients are unable to go to the pharmacy in person, they should call the pharmacy to provide the information and the discount can be applied.

If you are interested in ordering cards for your practice, clinic, hospital or for yourself, please contact Program Director Chez Ciccone or call 800-931-2297. The card can also be printed at home or in your office.

New Rx Banner



Classifieds

Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

 

 

 

 

 

 

.

 

 

.

MSSNY eNews: December 16, 2020 – Surprise Billing is Flat Out Give Away to Insurance Companies

.

From MSSNY Govt. Affairs: Please Contact Your Legislator!
Congress is at a critical tipping point on a number of issues as they try to finalize a year end spending package in the next 24 hours or so.  Among the proposals in the mix is a terrible federal “surprise bill” fix which would prohibit consideration of physician charge data in its IDR process to resolve insurer-out of network physician disputes, which would tilt the process enormously in favor of insurers and have a significant negative downstream effect on all participating physicians as well.  It appears to not pre-empt New York’s well-regarded law but it would definitely apply to all ERISA claims and create a precedent for New York to change its more balanced law.

We have also developed a customizable grassroots template that focuses on this and other end of the year issues (more stimulus $ for NY, preventing steep Medicare cuts) that your physicians can use:  Urge Congress to Prevent Medicare Cuts, Expand Lifeline Programs and Oppose One-Sided Surprise Bill Proposals (p2a.co)

Join with @MSSNY Join with @MSSNYtweet to urge Congress to prevent Medicare Cuts, expand financial lifeline programs, and oppose one-sided surprise medical bill solutions.


MSSNY Press Release Dec. 14 re Surprise Billing:
Surprise Billing is Flat Out Give Away to Insurance Companies

“Let’s be clear.

The new House-Senate committees’ surprise billing legislative agreement is a flat out give away to already enormously profitable insurance companies at the expense of community physicians on the front lines during the pandemic.  If this proposal were to be enacted, it will reduce patient choice in New York by compelling even more private practice physicians into forced employment arrangements.

We are disappointed that Congress did not look to New York’s well-regarded surprise medical bill law as a model of balance. Instead, they chose a methodology for resolving surprise bills that is designed to tip the scales grossly in favor of insurance companies and empower them to further squeeze patient care physicians at a time when many physicians are also about to absorb huge Medicare cuts.

Indeed, the CBO estimates that most of the so-called savings from this surprise bill proposal would come from cuts insurance companies would impose of network participating physicians, not out of network physicians.  The end result will inevitably be greatly reduced access to care for our patients.

So, as the year-end nears, instead of a thank you to the hundreds of thousands of physicians across the country who have put their own lives and the lives of their families at risk, Congress is giving these physicians a giant lump of coal.  We continue to urge that Congress take action to protect patients from surprise medical bills, but this proposal is way off the mark.

We urge Congress to go back to the drawing board and develop a more balanced proposal. Our health care safety net depends upon it.”


Crain’s: Legislation will Help Insurance Companies at the Expense of Doctors
The House-Senate committees’ legislative agreement on surprise billing will help insurance companies at the expense of community physicians, the Medical Society of the State of New York says. The agreement calls for insurers to make a payment to a provider that is determined either through negotiation between the parties or an independent dispute resolution process. It specifies that there is no minimum payment threshold to enter dispute resolution, and that claims may be batched together to ease administrative burden.

“If this proposal were to be enacted, it will reduce patient choice in New York by compelling even more private practice physicians into forced employment arrangements,” Dr. Bonnie Litvack, president of the medical society, said in a statement released Monday. “We are disappointed that Congress did not look to New York’s well-regarded surprise medical bill law as a model of balance. “Instead,” Litvack continued, Congress “chose a methodology for resolving surprise bills that is designed to tip the scales grossly in favor of insurance companies and empower them to further squeeze patient care physicians at a time when many physicians are also about to absorb huge Medicare cuts.”

Congressional leaders said Friday in announcing the bipartisan agreement that the proposed legislation would protect patients from surprise medical bills and establish a fair framework to resolve payment disputes between providers and insurance companies.

Litvack said the medical society is urging Congress to continue to take action to protect patients, but to “develop a more balanced proposal.” (Crain’s’ Pulse, Dec. 15)”



MLMIC Banner


NYSDOH COVID-19 Update Tomorrow 2 PM
Please join the NYS Department of Health Thursday, December 17th at 1:00 PM – 2:00 PM for a COVID-19 update for healthcare providers.

To accommodate the large number of participants, find our webinar streaming via YouTube Live (and available for viewing immediately thereafter) on the NYSDOH COVID website for providers: https://coronavirus.health.ny.gov/weekly-healthcare-provider-update

Audio number and code: 844-512-2950 Access code 6641017#


Gov. Cuomo’s Briefing Highlights, Tuesday, Dec. 15 

  1. Total COVID hospitalizations rose to 5,982. Of the 194,188 tests reported yesterday, 10,353, or 5.33 percent, were positive. There were 1,065 patients in ICU yesterday, up 25 from the previous day. Of them, 580 are intubated. Sadly, we lost 128 New Yorkers to the virus.
  1. New York hospitals continue to receive and administer doses of the COVID vaccine. Among them was Upstate University Hospital in Syracuse, NY, which administered doses that arrived today to the first members of its staff. The doses were administered to Upstate employees Kenzo Mukendi, Caprice Hibbler and Suzanne Buck, by Chief Nursing Officer Nancy Page.
  2. The Finger Lakes region, with 725 hospitalizations, has the highest rate of COVID hospitalization by population. Hospitalizations in the Finger Lakes represent 0.06 percent of the region’s population. Western New York has 520 hospitalizations (0.04 percent of its population); Central New York has 350 hospitalizations (0.05 percent); Mohawk Valley has 192 hospitalizations (0.04 percent); Long Island has 972 hospitalizations (0.03 percent); the Mid-Hudson has 735 hospitalizations (0.03 percent); the Capital Region has 288 hospitalizations (0.03 percent); Southern Tier has 166 hospitalizations (0.03 percent); and New York City has 1,968 hospitalizations (0.02 percent). The North Country, with 56 hospitalizations (0.01 percent), has the lowest rate of hospitalizations due to COVID.


Sellers Insurance Banner


New York State COVID-19 Vaccination Program Enrollment
The New York State Department of Health (NYSDOH) is now enrolling healthcare provider practices (outside of New York City’s five boroughs) in the NYSDOH COVID-19 Vaccination Program. Practices (outside NYC) interested in administering COVID-19 vaccine when the vaccine becomes available to their group must enroll in the NYSDOH program to be ready to order and receive publicly supplied COVID-19 vaccine and ancillary supplies.

Please review the following attached documentation and complete the online COVID-19 vaccine enrollment application located in the Health Commerce System by Friday, December 18, 2020.

Send questions regarding the NYSDOH enrollment process to: COVID19Vaccine@health.ny.gov


FDA Verifies Safety, Efficacy Data for Moderna COVID-19 Vaccine Candidate
Ahead of a Dec. 17 meeting of its Vaccines and Related Biological Products Advisory Committee, the Food and Drug Administration released a briefing document confirming Moderna’s data on the safety and efficacy of the mRNA-1273 COVID-19 vaccine candidate. FDA said mRNA-1273 is 94.1% effective in preventing severe COVID-19, with “no specific safety concerns identified that would preclude issuance of an (emergency use authorization).” Like the Pfizer vaccine approved last week, the Moderna candidate requires two doses, albeit 28 days apart, compared with Pfizer’s 21. Once approved for emergency use, Moderna is expected to supply 200 million vaccine doses to the U.S. through the end of 2021. (Dec.15, American Hospital Association)


Updates: COVID-19 Deaths Surpass 300K

  • The nation’s COVID-19 death toll surpassed 300,000 Dec. 14, the same day the first Americans received Pfizer’s vaccine. The U.S. is reporting an average of 2,427 deaths daily, up 300 deaths per day from this spring’s peak, according to data from The COVID Tracking Project.
  • COVID-19 hospitalizations also hit a record 110,549 on Dec. 14, according to COVID Tracking Project data.
  • The average American could receive a COVID-19 vaccine by early April, Anthony Fauci, MD, said in a Dec. 14 interview with MSNBC. The nation’s top infectious disease expert said most Americans could be vaccinated by late spring or early summer. By fall, “the level of infection will be so low in society we can start essentially approaching some form of normality,” Dr. Fauci said.
  • A bipartisan group of lawmakers released a two-part relief plan Dec. 14. The first package contains $748 billion in aid for small businesses, jobless benefits, and healthcare providers. The second $160 billion proposal includes more controversial measures such as state and local aid, as well as liability protections related to COVID-19.
  • The FDA said the Moderna vaccine is highly effective against severe COVID-19, and it is expected to approve the vaccine for use Dec. 18, officials close to the matter told The New York Times. The agency confirmed Moderna’s assessment that its vaccine is 94.1 percent effective, and said potential side effects — including fever, headache, and fatigue — are not dangerous. Moderna’s vaccine would be the second coronavirus vaccine approved for emergency use in the U.S., after Pfizer and BioNTech’s vaccine. (Becker’s Hospital Review, Dec. 16)

COVID-19 Vaccine Codes: Updated Effective Date for Pfizer-BioNTech
On December 11, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID‑19 Vaccine for the prevention of COVID-19 for individuals 16 years of age and older. Review Pfizer’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use.

During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review our updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when you submit claims to Medicare; don’t include the vaccine product codes when vaccines are free.



Garfunkel Wild Ad


55% Of Pediatric Residents Experience Burnout
New survey data reveal that more than half of pediatric residents experience burnout. Researchers surveyed residents training at more than 120 programs in the U.S. between 2016 and 2018, and found that almost 55% of them each year experienced burnout.

There were no clear demographic trends, but the scientists found correlations between burnout and other factors, such as poor mental health, greater stress, and more sleepiness. At the same time, those experiencing burnout were less likely to show mindfulness, self-compassion, and high levels of empathy and resilience. Those who reported better quality of life in 2017 — including more mindfulness — were associated with a lower risk of burnout the following year, according to the data. These links between quality of life and burnout offer opportunities for future interventions, the authors write.

MSSNY has established a confidential helpline phone number (1-844-P2P-PEER) and an email address (p2p@mssny.org) so that physicians may be connected with a peer 24 hours a day/7 days a week. In addition to offering a trained, empathetic ear, peer supporters may provide information on specific resources that can offer further support, provide positive coping skills, or connect physicians to professionals for more focused assistance.


Now More Than Ever, Patients Need Relief from the High Cost of Prescriptions
While COVID-19 has dominated the headlines for months, many New York residents are also dealing with health issues unrelated to the virus that may require medications. In addition, many have lost their jobs and health insurance. The New York Rx Card may be able to help ease the burden of costly prescription medications for your patients. This savings program is designed to help those who may be uninsured, underinsured or who have health insurance coverage with no prescription benefits – but anyone can use it.

Patients (and physicians) can save up to 80% on prescription drugs by using this free card. All they need to do is present the card at a pharmacy when paying for a prescription. In instances in which patients are unable to go to the pharmacy in person, they should call the pharmacy to provide the information and the discount can be applied.

If you are interested in ordering cards for your practice, clinic, hospital or for yourself, please contact Program Director Chez Ciccone or call 800-931-2297.

New Rx Banner

Classifieds

Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.


Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

 

 

 

MSSNY Statement on US Congressional Committees’ Surprise Billing Agreement  

For Immediate Release
December 14, 2020

 

MSSNY Statement on US Congressional Committees’ Surprise Billing Agreement
“Agreement is Giveaway to Enormously Profitable Insurance Companies and is at the Expense of Community Physicians on the Front Lines Delivering Patient Care During Pandemic” 

Statement Attributable to:
Bonnie Litvack, MD
President, Medical Society of the State of New York

“Let’s be clear. The new House-Senate committees’ surprise billing legislative agreement is a flat-out giveaway to already enormously profitable insurance companies at the expense of community physicians on the front lines during the pandemic.

“If this proposal were to be enacted, it will reduce patient choice in New York by compelling even more private practice physicians into forced employment arrangements. We are disappointed that Congress did not look to New York’s well-regarded surprise medical bill law as a model of balance. Instead, they chose a methodology for resolving surprise bills that is designed to tip the scales grossly in favor of insurance companies and empower them to further squeeze patient care physicians at a time when many physicians are also about to absorb huge Medicare cuts.

“Indeed, the CBO estimates that most of the so-called savings from this surprise bill proposal would come from cuts insurance companies would impose of network participating physicians, not out-of-network physicians. The end result will inevitably be greatly reduced access to care for our patients.

“So, as the year-end nears, instead of a thank you to the hundreds of thousands of physicians across the country who have put their own lives and the lives of their families at risk, Congress is giving these physicians a giant lump of coal. We continue to urge that Congress take action to protect patients from surprise medical bills, but this proposal is way off the mark.

“MSSNY urges Congress to go back to the drawing board and develop a more balanced proposal. Our health care safety net depends upon it.”

# # #

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


Media Contact:
Roseann Raia

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

 

MSSNY eNews: December 11, 2020 – More Good News on the Vaccine Front


.

Colleagues:

More good news on the vaccine front this week and not a moment too soon as reports indicate hospitals are reaching capacity throughout the nation.

Yesterday, FDA advisors voted 17-4 that the benefits of the Pfizer-BioNTech COVID-19 vaccine outweigh its risks for use in individuals 16 years of age and older.

The vote paves the way for the FDA to grant emergency use authorization (EUA) within the next few days. The FDA review released earlier this week indicated the efficacy of the two dose Pfizer vaccine is approximately 95%. The advisory panel will meet again shortly on 12/17 to offer recommendations on Moderna Inc.’s COVID-19 vaccine.

Back on the home front, New York State has started mobilizing the first phase of the vaccine role out. New York has been appropriated approximately 170,000 doses of the Pfizer vaccine. Those first doses will be distributed around the state to hospital frontline workers and nursing home residents and staff with distribution prioritized to areas based on virus surge.

Until the vaccine is widely available and most of the population is vaccinated, hospital capacity will remain a top concern. In fact, this week, data was released from the Department of Health and Human Services showing that 1/3 of Americans are living in areas where hospitals are running critically short of intensive care unit beds. In response, our Governor has directed hospitals to expand bed capacity by greater than 50% and has called on retired physicians and nurses to rejoin the workforce. However, in one corner of our state, the Kingsbrook Jewish Medical Center Hospital is actually slated for closure on January 1, 2021.

This plan predated the pandemic and the current surge. Several regional physician advocacy groups including the Medical Society of the County of Kings and the Manhattan Central Medical Society are urging that it remain open given this surge in COVID-19 cases and hospitalizations. This approximately 200 bed hospital predominately serves communities of color and may be critical to meeting the healthcare needs of the Brooklyn area during the next phase of this pandemic. Our medical society agrees with the Governor that hospital bed capacity is of paramount importance and therefore is joining with these other societies to urge reconsideration of the timing of this closure.

With the virus surging and our censuses rising, it is of the utmost importance that we as physicians take care of ourselves so that we can remain healthy, physically and mentally, to guide our patients and our state out of the pandemic. Remember that MSSNY is there for you and accessing our confidential peer to peer program is only an email (p2p@mssny.org) or phone call (1-844-P2P-PEER) away.

Bonnie Litvack, MD
MSSNY President


MSSNY Weekly Podcast:
Vaccine Approval, Stimulus Package & Upcoming Educational Programs


Notes from Governor Cuomo’s Friday Briefing:
COVID:
– Day 286
– Three focal points: hospital capacity, containment, vaccinations
– NYS Clinical Advisory Task Force approved FDA decision on vaccine unanimously
– Statewide positivity rate without micro-clusters: 4.55%
– Statewide rate with micro-clusters: 4.9%
– Micro-cluster positivity rate: 6.8%
– 212,000 tests conducted yesterday
– 21 million tests conducted to date
– 87 deaths
– 5,321 hospitalizations
– 1,007 ICU
– 546 intubations

Hospitalizations by Region:
– Finger Lakes: 611, 0.05%
– Western NY: 548, 0.04%
– Gov. noted increase in Western NY is beginning to flatten
– Southern Tier: 161, 0.03%
– Mid-Hudson: 696, 0.03%
– NYC: 1,668, 0.02%
– Long Island: 846, 0.03%
– Capital Region: 244, 0.02%
– Central New York: 314, 0.04%
– Mohawk Valley: 186, 0.04%
– North Country: 47, 0.01%

Winter Plan:
– Schools “almost without exception” are safer than broader communities
– Gov. said schools should be open unless there is spread within the school
– Gov. called hospitalization increase “dramatic”
– However, ICU rate is down 30%, 50% fewer intubations than in Spring
– Also, length of stay in hospital went from 11 days in Spring to 5 currently
– Death rate also decreased from 23% previously to 8% now
– Gov. discussed contact tracing data on where spread is occurring: primarily household gatherings, healthcare delivery, higher education students
– Gov. said indoor dining spread is better, but “still an issue”
– Gyms are now one of the lowest venues for spread, personal care services are much lower now as well
– Rate of transmission is 1.3% currently, which Gov. called “problematic”

New Restrictions Being Implemented:
– Based on CDC guidance, rate of transmission, and density indoor dining in NYC will close beginning Monday, December 14
– Outdoor dining, takeout to continue
– Gov. stressed federal government needs to provide relief for restaurants, bars
– Gov. announced NY will extend commercial eviction moratorium, but did not specify for how long
– Gov. added that gyms and salons can operate in orange zones with reduced capacity at 25%, and bi-weekly testing
– Outside NYC, in orange zones indoor dining will continue to be monitored

Potential New Restrictions:
– Red zone puts region on NY Pause, metric is 21 days from 90% hospital capacity,
– Gov. said this is necessary if hospitals are in risk of being overwhelmed
– Orange zone occurs if 4% positive rate over 10 days, or up to 80% hospital capacity, or high rate of hospital admission as determined by DOH
– Yellow zone occurs if 3% positivity rate over 10 days, or if region is in top 10% of hospital admissions
– Gov. said based on these metrics, new zoning will be announced on Monday
– In Staten Island: 26 deaths, which is 25% of NYC deaths, although Staten Island is 5% of the population
– Staten Island also high in hospital admission rate of increase

Hospitals:
– Hospitals are already at 25% increase in staff and beds
– Hospitals must remain under 85% capacity, can do so by adding additional 25% bed capacity or by reducing elective surgeries
– Over 85% capacity equals critical hospital capacity

Vaccine:
– 170,000 doses of Pfizer vaccine expected “imminently”
– 346,000 doses of Moderna vaccine expected week of Dec. 21
– Gov. stressed the need for inclusivity for the vaccine, cited his letter sent to HHS Secretary Azar

Members of Congress:
– Reps. Jeffries, Meng, Haaland, Castro, and Bass attended virtually
– Representatives discussed the need for state and local aid, equitable distribution of the vaccine to all communities, and vaccine prioritization


New York City COVID-19 Vaccination Program Enrollment
The New York City Department of Health and Mental Hygiene is now enrolling private practices, independent pharmacies and other facilities that will immunize adults in the NYC COVID-19 Vaccination Program.

Click on the links below to review the letter and instructions on how to sign the COVID-19 Vaccination Program Provider Agreement in the online Citywide Immunization Registry (CIR):

Attend a webinar on completing the Provider Agreement in the CIR:
Enrollment in the NYC COVID-19 Vaccination Program
Tuesday, December 15, 2020, 1:00 to 2:00 p.m.
Register Here

For questions, please call the Provider Access Line at 1-866-692-3641 or email nycimmunize@health.nyc.gov. Periodic updates will be sent to keep you informed and the COVID-19 vaccine webpage will be updated.


New York State COVID-19 Vaccination Program Enrollment
The New York State Department of Health (NYSDOH) is now enrolling healthcare provider practices (outside of New York City’s five boroughs) in the NYSDOH COVID-19 Vaccination Program.

Practices (outside NYC) interested in administering COVID-19 vaccine when the vaccine becomes available to their group must enroll in the NYSDOH program to be ready to order and receive publicly supplied COVID-19 vaccine and ancillary supplies.

Please review the following attached documentation and complete the online COVID-19 vaccine enrollment application located in the Health Commerce System by Friday, December 18, 2020.

Send questions regarding the NYSDOH enrollment process to: COVID19Vaccine@health.ny.gov


MLMIC Banner


2021 Medicare Payment Rule Finalizes Steep 10% Conversion Factor Cut – Contact Your Member of Congress to Prevent CMS from Implementing
The American Medical Association has developed a comprehensive summary of the 2021 Medicare physician payment rule.  As has been widely reported, while the payment rule incorporates some long overdue increases in E&M codes, statutory budget neutrality rules are forcing a 10.2% cut in the conversion factor.

Therefore, MSSNY has been working together with numerous state medical associations and the AMA in support of Congressional legislation to prevent the conversion factor cut (while urging the E&M changes to go forward).  You can join us in these efforts by sending a letter from here: Urge Congress to Prevent Medicare Cuts, Expand Lifeline Programs and Oppose One-Sided Surprise Bill Proposals (p2a.co)

From the AMA Summary – CY 2021 Physician Fee Schedule Ratesetting and Conversion Factor

  • The final CY 2021 Medicare Physician Fee Schedule (PFS) conversion factor is $32.4085, which represents a 10.2% reduction from the CY 2020 conversion factor of $36.09.
  • Similarly, the final CY 2021 anesthesia conversion factor is $20.0547, down 9.61% from the CY 2020 anesthesia conversion factor of $22.20.
  • The most widespread specialty impacts of the relative value unit (RVU) changes are generally related to the changes to RVUs for specific services resulting from the E/M office visit increases and other changes made by CMS. The AMA/Specialty Society RVS Update Committee’s (RUC) recommendations account for a 5.5% reduction to the conversion factor. The remaining spending increases and resulting conversion factor reduction is attributed to various CMS proposals to increase valuation for specific services, including the E/M visits and the new G2211 visit complexity add-on code.
    • E/M visits billed using CPT codes comprise approximately 45% of allowed charges for PFS services. Office and outpatient E/M visits comprise approximately 25% of allowed charges for PFS services.
    • There is considerable variability within the specialties of the Federation in terms of E/M level of visits and volume. Physicians such as family practitioners who do not provide procedural interventions or diagnostic tests have most of their allowed charges from E/M visits. Therefore, these practitioners and other primary care providers should expect to see increases for their E/M visits.
  • CMS finalized Current Procedural Terminology® (CPT) descriptors, guidelines, and payment rates effective on January 1, 2021, which are a significant modification to the coding, documentation, and payment of E/M services for office and outpatient visits. In the final rule, CMS retained five levels of coding for established patients, reduced to four levels for new patients, and revised code definitions. CMS revalued services analogous to office outpatient E/M visits.

Should Physicians Who Had COVID-19 Still Get the Vaccine?
“Healthcare workers are recommended to be first in line for COVID-19 vaccines once they’re authorized, but many have already been infected — leading to a debate about whether they should give up their place in line,” reports Medpage Today (D’Ambrosio, 12/3). “Experts disagree when it comes to interpreting the evidence regarding lasting immunity and the need for vaccination among healthcare workers (or anyone, for that matter) who’ve already been infected.

Cases of reinfection have been documented; they appear to be rare, but the true rate remains unknown. For starters, second infections won’t be recognized as such if the first was never detected. Likewise, an asymptomatic reinfection may go unnoticed, yet the individual may still transmit it to others. It would not be good if that person happens to be a healthcare worker.” Medpage Today reports on the debate here.


Poll: Only About Half of Americans Want to Get Vaccinated Against COVID-19
The AP (12/9, Neergaard, Fingerhut) reports, “As states frantically prepare to begin months of vaccinations that could end the pandemic, a new poll finds only about half of Americans are ready to roll up their sleeves when their turn comes.”

The Associated Press-NORC Center for Public Affairs Research survey “shows about a quarter of U.S. adults aren’t sure if they want to get vaccinated against the coronavirus,” while “roughly another quarter say they won’t.” Those “on the fence have safety concerns and want to watch how the initial rollout fares.”


MSSNY in the News this Week

WGRZ – 2 Buffalo (NBC Affiliate) – 12/08/20
2 On Your Side Answers Questions About The Coronavirus Vaccine
(MSSNY President Dr. Bonnie Litvack interviewed)

Crain’s Health Pulse – 12/09/20
MEDICARE CUTS
(MSSNY Statement / President Dr. Bonnie Litvack quoted)


Join Garfunkel Health Advisors for Webinar on Changes to E/M Coding and Documentation Requirements in 2021
Join Garfunkel Health Advisors, Inc. to prepare you for the biggest change in decades to the documentation and coding guidelines for Evaluation and Management (E/M) services, which go into effect on January 1, 2021.

Who this will affect: The Centers for Medicare and Medicaid Services (CMS) new E/M coding changes will affect every provider that bills for office and outpatient visits, including physicians, NPPs, practice plans, hospitals, HIT companies, health plans and health systems.

Why you need to attend: It is critical that the provider community understand the full impact of these changes, how they will affect your reimbursement and how to train your providers and staff to ensure compliance. This webinar will provide practical guidance on the most important aspects of the new rules and discuss best practices to reduce your audit and compliance risks.

Register for the webinar here.


Sellers Insurance Banner


MSSNY Offers Access to PPE Supply Chain in Collaboration with American Society of Plastic Surgeons
MSSNY is pleased to again offer members access to purchase PPE supplies through the American Society of Plastic Surgeons (ASPS) PPE supply chain program. Items available range from N95 masks and face shields to hand sanitizer and alcohol wipes. New items are consistently being added and restocked. Please note that shipment times may vary from several days to several weeks. Some orders may be fulfilled by outside vendors with longer shipping times. To see the available supplies and create an account to purchase items, visit this website.


COVID-19 from a Physician-Patient Perspective
Register now to learn more about what it is like to experience COVID-19 as both physician and patient.  Register now for: “COVID-19 from a Physician-Patient Perspectiveon Wednesday, December 16, 2020 at 7:30 a.m.  Lorraine Giordano, vice chair of MSSNY Committee on Emergency Preparedness and Disaster/Terrorism Response and Parag Mehta, MD, MSSNY Vice President will serve as faculty for this program. Registration is now open for this webinar here

Educational objectives are:

  • Describe COVID-19 from the perspective of both patient and physician
  • Examine insights gained from experiencing SARS CoV-2 firsthand
  • Identify chronic and acute symptoms that are prominent as a result of experiencing COVID-19 as a patient

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

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

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


Altfest Banner


The Beginning of the End: COVID-19 Vaccine Considerations for Long Term Care Providers
Join Garfunkel Wild for an update from a former CDC pandemic expert on the ethical, legal, and logistical challenges of the COVID-19 vaccine roll-out.

When: Thursday, December 17, 2-3:00 pm

Register for the Webinar

Senior living providers are eagerly awaiting a COVID-19 vaccine — but protection against COVID-19 includes multiple strategies and the logistics around inoculating residents and employees are complex. Join Dr. Lisa Koonin, founder of Health Preparedness Partners, LLC, who spent more than 30 years at the CDC. Dr. Koonin led the development of national pandemic influenza preparedness and response plans and policies, served in leadership positions for multiple national and international emergency responses (including the 2016 Zika response, 2014-2015 Ebola response, 2013 H7N9 avian influenza outbreak in China, 2009 – 2010 H1N1 influenza pandemic), and has consulted with businesses, state and local governments, healthcare facilities, and ministries of health around the world, to improve emergency preparedness.

Why you need to attend: We will provide a current pandemic update, and discuss the ethical, legal and logistical challenges of the vaccine roll-out. Our panel will also discuss patient consent and liability, employee strategies, and infection control. Please sign up to hear the insight and new information needed to help protect your staff and residents.  If you have questions that you would like our panel to address, kindly submit them to Mandy Kaplan at mkaplan@garfunkelwild.com before December 15, 2020.


“PTSD in Returning Veterans” Webinar
The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click here to register for the program. View the program flyer here.

When: January 26, 2020 at 7:30 am
Faculty: Frank Dowling, MD

Educational Objectives:

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

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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

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

Classifieds

Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com

 

 

 

 

 

 

 

.

 

 

.

Enroll in the NYC COVID-19 Vaccination Program

Enroll in the NYC COVID-19 Vaccination Program

The New York City Department of Health and Mental Hygiene is now enrolling private practices, independent pharmacies and other facilities that will immunize adults in the NYC COVID-19 Vaccination Program.

Click on the links below to review the letter and instructions on how to sign the COVID-19 Vaccination Program Provider Agreement in the online Citywide Immunization Registry (CIR):

General Provider Letter on COVID-19 Vaccines

COVID-19 Vaccination Program Provider Agreement and Profile Form

COVID-19 Provider Vaccination Agreement-Access Instructions

Attend a webinar on completing the Provider Agreement in the CIR:
Enrollment in the NYC COVID-19 Vaccination Program
Tuesday, December 15, 2020, 1:00 to 2:00 p.m.

Register Here

For questions, please call the Provider Access Line at 1-866-692-3641 or email nycimmunize@health.nyc.gov. Periodic updates will be sent to keep you informed and the COVID-19 vaccine webpage will be updated.

1 2