MSSNY eNews: April 1, 2022

Message from MSSNY President Dr Joseph Sellers:
In-Person House of Delegates Meeting in May!

Colleagues:
After two long years of more Zoom meetings than we care to count, we are all looking forward to once again connecting with colleagues in-person at MSSNY’s House of Delegates meeting on May 21.

We’re doing things a bit differently this year—although the HOD itself will be held in-person, we will hold the Reference Committee meetings virtually well in advance of the House. The first meeting is this Sunday, April 3 and the meetings continue through next week. Following is the schedule of meetings:

Sunday, April 3@ 9 AM/Governmental Affairs B
Monday, April 4@ 6 PM/Governmental Affairs A
Tuesday, April 5@ 6:30 PM/Bylaws
Wednesday, April 6@ 6:30 PM/Reports of Officers
Thursday, April 7 @6 PM/Socio-Medical Economics
Saturday, April 9@ 9 AM/Public Health and Education

Since any MSSNY member can participate in Reference Committee meetings, this presents a unique opportunity for members to join the meetings without traveling. Please remember to register for each hearing to ensure receipt of the Zoom link and to allow the Chairs to identify the participant, resolution authors, and conflicts of interest. A 90-second limitation on testimony will be in effect.  Separate registration is required for each reference committee hearing and is unique to the individual registered.

We have a fantastic House of Delegates planned—including a grand celebration befitting a two-year absence of meeting in person—and we’d like to remind you to place Journal ads or ask your colleagues, friends, and institutions to place an ad celebrating MSSNY members for their dedicated service throughout the COVID-19 pandemic. Visit the HOD Sponsor page for more information.

The Journal will be distributed to all MSSNY delegates and other leaders.  Ads are at the following rates:

• Half Page =$500
• Color Full Page =$1,000
• Silver Full Page =$1,500
• Gold Full Page =$2,000

We are looking forward to a productive House of Delegates meeting—and to reconnecting with friends and colleagues.

Joseph Sellers, MD, FAAP
MSSNY President

President-Elect Dr. Parag Mehta
(Be advised, video is very quiet. Increased volume may be required.)

Physician Payments Plummet after State Health Plan Upends Surprise-Billing Process: Crain’s New York Reports
MSSNY, together with the NYS Society of Anesthesiologists and the NYS Society of Plastic Surgeons, has written to the Governor to express its deep concerns with the position taken by the NY Department of Civil Service (DCS) that NYSHIP/Empire Plan is no longer subject to NY insurance law regulations when the Empire Plan reimburses out-of-network physicians for medically necessary services covered by the Empire Plan, including the State IDR process for resolving disputes.   The letter noted that, if not addressed promptly, surgical and medical specialty practices will suffer long-term irreparable harm that will cause many of them to go out of business or drastically reduce their services.  The letter also notes that this decision could harm patients, who will see the availability of high-quality medical services significantly reduced.

Today’s Crain’s New York features comments from MSSNY Executive Vice-President Troy Oechsner noting the physician community’s alarm with this arbitrary and unfair action taken by DCS and United Healthcare. The article also features MSSNY member and Long Island anesthesiologist Dr. Steve Schulman, who noted that his “medical group is now at risk of losing millions of dollars in reimbursements for services it has provided to Empire Plan enrollees” and that this could have “a ripple effect on patients’ access to surgical services and specialty medical care”.  He further noted, “If payments are delayed and significantly lower than expected, practices may close.”

The article also mentions that several physician groups, together with NYSHIP/Empire Plan enrollees, filed a lawsuit this week against DCS and United Healthcare arguing that the Empire Plan is subject to state law, including the surprise bill law.  MSSNY is not a party to the lawsuit.

Legislature & Governor Still Negotiating State Budget
Despite today’s due date, legislative leaders and the Governor are continuing to negotiate key details of the many aspects of the New York State Budget.  With the State coming close to a deadline that could impact payment to state employees, legislators are scheduled to return to Albany on Monday to begin pass the various Budget bills, once they are finally agreed upon. Here is a summary of the top issues “in play” affecting physicians and their patients:

Telehealth Payment Parity. Both the Executive Budget proposal and the Senate’s Budget proposal included language supported by MSSNY to require health insurers to pay telehealth services at levels equal to in-person services.  The Assembly did not include this provision in their one-House Budget, but negotiations are ongoing.  MSSNY’s support, together with ACOG-District 2, the New York State Psychiatric Association and other specialty societies, was highlighted in a story by the Albany-area ABC-TV affiliate .

Because this issue is still being negotiated, physicians are urged to send a letter in support here: Support Payment Parity for Telehealth Services (p2a.co)

Public Health Investments. Both one-House Budget proposals agreed with the Executive Budget proposal to significantly increase funding for the Doctors Across New York student loan repayment program, and to implement a 1% across the board Medicaid payment increase.

Both Houses also agreed with various initiatives to increase and maintain access to comprehensive health insurance, including increasing the upper income threshold eligibility for the State’s Essential Plan health insurance program, and eliminating premium requirements for eligibility for the CHIP program for families making less than 223% FPL.

Excess Medical Malpractice Insurance Program. The final Budget is likely to include another one-year extension of the current Excess Insurance Program.

Scope of Practice Proposals. Both one-House Budget proposals did not include language opposed by MSSNY that would create further silos in healthcare by permitting pharmacists to perform numerous lab tests without physician coordination and eliminating current statutory requirements for nurse practitioners (NPs) to maintain collaborative relationships with physicians.

The Assembly Budget proposal would permanently extend the existing law that requires NPs with more than 3,600 hours experience to comply with simplified collaboration standards that do not require a written practice agreement but ensure there are defined collaborative relationships with a physician practicing in the same specialty. The Senate indicated that “each scope of practice deserves a robust conversation outside the context of the Executive Budget.”

MSSNY’s concerns with these proposals were detailed in a Crains Health Pulse article (Scope Creep concerns (crainsnewyork.com).  Physicians can send a letter in support of protecting physician-led team care here: Protect Physician-Led Team-Based Care (p2a.co)

Licensing/Oversight Proposals. Both Houses did not include a proposal to transfer oversight of the several health professions from the Department of Education to the Department of Health. However, the issue remains under discussion.

Interstate Medical Licensure Compact. The Assembly did not include a proposal to permit New York to join the Interstate Medical Licensure Compact. The Senate included the proposal in its one-house Budget.

Surprise Bill Law Changes. Both one-House Budget proposals did not include language contained within the Governor’s Budget to make changes to New York’s surprise bill law to ensure it meets the requirements of the federal No Surprises Act (NSA) recently passed by Congress.  Most of these changes have been implemented through Circular letters issued last December by the NY Department of Financial Services. While MSSNY did not object to formalizing these necessary changes to statute that had been advanced in the Executive Budget, it did oppose one aspect of that proposal – not required by the NSA – that would require the Independent Dispute Resolution entity to consider the insurer’s self-determined median in-network payment amounts.

Once the Budget bills are enacted, MSSNY will provide physicians with a summary of the top issues that impact physicians and their patients.

MSSNY Seeks NYS Funding for the Veterans Mental Health Training Initiative
MSSNY staff and leadership continue to advocate for funding the Veterans Mental Health Training Initiative (VMHTI) within the NYS budget. Since 2008, this program had been funded through a legislative add-on to provide skills, development, and education for primary care physicians and other mental health providers to treat veterans within their practice. This initiative is a partnership between the Medical Society of the State of New York, The New York State Psychiatric Association, and the National Association of Social Workers-New York State.

These associations work to deliver free training to service providers across New York. They also work with counties implementing the NYS Joseph P. Dwyer Veterans Peer Support programs, which provide holistic care for returning veterans. Through this initiative, MSSNY has been able to provide seminars, webinars, and other online programming to MSSNY’s county medical societies and hospitals. MSSNY is asking physicians send a letter on the VMHTI through its Grassroots Action Center (GAC) to ensure that this funding is included in the state budget.

CMS Releases Guidance on Virtual Credit Cards and EFT/ERA Payments
The Centers for Medicare & Medicaid Services (CMS) has released new guidance on Virtual Credit Cards (VCC) and electronic funds transfer (EFT)/electronic remittance advice (ERA) payment transactions, as well as business associate compliance  with the Health Insurance Portability and Accountability Act’s (HIPAA) Administrative Simplification requirements.  Last fall, MSSNY joined with the AMA and medical societies across the country   advocating to CMS in a sign-on letter  raising concerns with health insurers forcing physicians to pay percentage-based EFT fees for electronic payments.

As reported by the AMA, CMS’ new guidance notes that:

• VCCs may be used for payment but health plans may not force physicians to accept them.
• As business associates to health plans, payment vendors must comply with the HIPAA-mandated transactions.
• EFT value-add services may “adversely affect” the HIPAA-mandated standard transaction and thus health plans may not force providers to accept them from a vendor as a condition of receiving electronic payments.

The AMA further recommends that physicians review the new guidance and talk to their health plans about any services they are currently receiving that they do not want. Physicians should distinguish between fees their own business associates may provide and fees the health plan requires. Additionally, physicians filing Administrative Simplification Enforcement and Testing Tool (ASETT) complaints should be sure to name the health plan in their complaint, as the health plan is ultimately responsible for compliance with HIPAA.

MSSNY will continue to work with the AMA in monitoring additional developments on this issue as well as working with physicians to have insurers violating these policies be investigated by regulatory enforcement agencies.

CMS Re-Implements 1% Medicare Sequestration Cut
At the end of 2021, MSSNY worked with the AMA and medical societies across the country in  support of legislation passed by Congress to prevent a cumulative 10% cut to Medicare payments that included extending a temporary halt of the 2% Medicare sequester cut.  The federal legislation provided an extension of full sequestration relief until March 31, 2022.  As reported by the AMA, starting today April 1, physicians, hospitals, and other health care providers will receive only partial relief from Medicare sequestration as a 1% Medicare sequester goes into effect for the next three months. Then, on July 1, there will be a return of the full 2% Medicare sequester.

The AMA and other stakeholders recently sent a letter to Congress asking that sequestration relief be extended through the end of the public health emergency. However, the AMA reports that there was little support in Congress to prevent further sequestration cuts, and that the phased-in return of sequestration is a signal of congressional intent that relief in the form of moratoriums will no longer be forthcoming.

The AMA will continue to work with Congress to create a fair Medicare physician payment system.

Medical Matters CME Webinar: Stresses & Distresses in the Time of COVID-19
The COVID-19 pandemic has caused innumerable mental health struggles that will likely be present for years to come.  Register now for Stresses & Distresses in the Time of COVID-19  on Wednesday April 20, 2022, at 7:30 a.m. to learn more about the stress the COVID pandemic has caused.  Craig Katz, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee, will serve as faculty for this program. Register now.

Educational objectives are:

• Illustrate the many sources of stress that society has endured in recent years
• Identify the many different ways the resulting distress can be experienced
• Discuss what clinical approaches are available to help

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. 

MSSNY Webinar: Improving Well-Being and Reducing Burnout Among Healthcare Workers
The COVID-19 pandemic has exacerbated burnout among healthcare workers. Join MSSNY for this webinar to learn more about how systems and health care workers can impact wellness culture to decrease rates of burnout. Serving as faculty for this webinar will be Michael Privitera, MD and Arthur Hengerer, MD. Register now!

Educational objectives are:

• Define and give examples of extraneous cognitive load
• Explain why reducing extraneous cognitive load burden may be more impactful in improving patient safety than education alone
• Give two examples of application of cognitive ergonomics that can reduce the risk of clinician burnout and latent medical error

Additional information or assistance with registration may be obtained by contacting Cayla Lauder at clauder@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.

Peer to Peer (P2P) Program
After all that we have been through as a nation and a society, physicians deserve a week of recognition more than ever. Physicians, nurses, and other healthcare providers have worked tirelessly through a two-year global pandemic. So, if there was ever a time to say thank you and honor physicians, it is now.

National Physicians Week is recognized annually from March 25 to 31. As physicians took an oath to ethically help others to heal, MSSNY offers the suggestion that a mere thank you, or acknowledgment of what your physician means to you, can truly help “heal thy physician.” As of September 2021, there were just over one million professionally active physicians in the United States, all of whom worked tirelessly to fight COVID-19.  Some believe that gratitude is the simplest, most powerful way to acknowledge another person’s value and humanity. Gratitude can instill hope and a sense of pride in what someone does and or means to you.

MSSNY and the peer supporters recognize the hard work and dedication the physicians put into their job, and we are here to offer a friendly ear.

If someone you know is struggling with life stressors, reach out to the P2P program to connect them to a peer supporter!

Email: P2P@mssny.org and request that you be connected with a peer supporter

Phone: 1-844-P2P-PEER (1-844-727-7337) and request that you be connected with a peer supporter

Classified Ads Available for:

Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate

For help, information or to place your ad, call Roseann Raia at 516-488-6100
ext. 302
For the MSSNY 2022 Ad RateSheet, please click here.

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Rendr- Transforming Healthcare – Primary Care Opportunity: Internal or Family Medicine Physician, Bilingual English and Chinese (Mandarin or Cantonese)
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