MSSNY eNews: April 13, 2022

MSSNY Recoups $8,400 for Member in Insurance Take-Back
A MSSNY member recently received a take-back letter from a third-party reviewer regarding four insurance claims totaling $8,400 and contacted MSSNY’s Physician Payment and Practice Director Heather Lopez for assistance. Upon her review, Heather determined that the documentation that the physician provided to the third-party reviewer indeed included the medical record that the reviewer said was not included on the claim.

The third-party reviewer continued to say that they would be taking back the $8,400.

Heather called the third-party reviewer to discuss further and advised that what they were asking for was provided to them and that they had neglected to review. She further advised there was absolutely no reason why this should be taken back, and all appropriate information was accurately displayed in the medical record per scope of practice.

In a subsequent email to Heather, the insurer informed her that the review on the claims had been cancelled and there will be no take back of the $8,400 claims.

If you have questions about this or any other insurance concern, contact MSSNY’s Director of Physician Payment and Practice, Heather Lopez, at 518.465.8085 X332 |hlopez@mssny.org

Did You Volunteer for MSSNY this Past Year? We Want to Feature You During National Volunteer Week!
Did you volunteer for MSSNY this past year? If the answer is yes, please send us a quote on the importance of volunteering your time to MSSNY no later than this Saturday, April 16^th. Send your quote to MemberResources@mssny.org and you might see yourself featured in our communications vehicles!

Budget Passed by Legislature Contains Several Meaningful New Initiatives
This past weekend, the New York State Legislature and Governor Hochul completed enactment of a $220 Billion State Budget for Fiscal Year 2022-23. Of importance to physicians, it includes:

• Telehealth Payment Parity. A law strongly advocated for by MSSNY (together with several specialty societies) requiring health insurers to pay equal for telehealth services that they would pay for comparable in-person services. The law will have to be extended in 2 years.
• Increasing Physician Loan Repayment. A 75% increase in funding (to nearly $16 million) for the Doctors Across New York student loan repayment program, where physicians can receive up to $120,000 in student loan relief for providing care (for at least 3 years) in an underserved area.
• Medicaid Payment Increases. A restoration of the 2020 1.5% cut to Medicaid payments and a further across the Board 1% payment increase.  Moreover, effective April 1, E&M and Medicine codes in Medicaid fee for service are being increased to 70% of Medicare (currently at only 45% or 58% of Medicare).
• Med Mal Excess Restored.  A straight one-year extension of the Excess Medical Malpractice Insurance program. MSSNY worked with specialty societies to fight back against an Executive Budget proposal that would have required physicians to pay upfront for this very expensive coverage and then be reimbursed.
• Insurance Reforms. Targeted health insurance reforms including requiring all New York state regulated health insurers to complete credentialing review within 60 days of the physician’s network participation application, as well as another measure to ensure all health insurers follow rules that limit excessive medical record requests.
• Insurance Coverage Expansion. Increasing New Yorkers’ eligibility for the Essential Plan with those with incomes up to 250% FPL; elimination of premiums for CHIP coverage for families up to 223% FPL; and one-year post-partum Medicaid coverage.

Importantly, as well, the final Health Budget bill also deleted Executive Budget proposals for which MSSNY had raised concerns, including:

• No Rx Prior Authorization. Imposing new prior authorization requirements for prescriptions written for patients covered by Medicaid and Medicaid Managed Care
• No Interstate Compact. Permitting New York to join the Interstate Medical Licensure compact

However, despite strong MSSNY opposition and other groups, the following proposals were included in the agreed upon Health Budget.

• Nurse Practitioners. Extending in statute for 2 years the current Executive Order provision that exempts Nurse Practitioners with more than 3,600 hours experience from having to maintain proof of collaborative relationships with physicians practicing in the same specialty.
• Additional Criteria for IDR. As part of a comprehensive proposal to update New York’s surprise bill law to incorporate mandatory elements of the federal No Surprises Act, while the provisions importantly eliminated the requirement for a patient to execute an Assignment of Benefits, it also included median in-network payment data as one of the express criteria to be considered by the Independent Dispute resolution entity in addition to the usual and customary charge of the physician and the particular expertise of that physician.

Also of note, the Budget allocates a pool of funds within the Department of Health to provide bonuses for health care employees who make less than $125,000 per year. Employers required to participate in the program include health care entities subject to a Certificate of Need process, or which have at least 20% of their patients covered under Medicaid. The bonuses range from $500 for a part-time worker to $3,000 for a full-time worker, over a 6-month period.

MSSNY staff is continuing its review of the many Budget provisions and will provide further updates.

Reminder: Provider Relief Fund Requests for Late Reporting Due by April 22/HRSA Identifies Extenuating Circumstances
The Health Resources and Services Administration (HRSA) has decided to reopen the reporting time for recipients of Period 1 Provider Relief Funds. Physicians who received more than $10,000 in provider relief funds and failed to submit their Period 1 report should act immediately. Between Monday, April 11 and Friday, April 22, 2022, at 11:59 pm ET, providers who have not submitted their Period 1 report may submit a late Reporting Period 1 report request. Physician practices should receive information about how to submit a request directly from HRSA via email. If a provider did not submit a Period 1 report and does not hear from HRSA, the provider may initiate communication by calling (866) 569-3522.

During this reopening period, a provider must choose an extenuating circumstance(s) that prevented compliance with the original reporting deadline. HRSA has just released the following as allowable extenuating circumstances:

• Severe illness or death – a severe medical condition or death of a provider or key staff member responsible for reporting hindered the organization’s ability to complete the report during the Reporting Period.
• Impacted by natural disaster – a natural disaster occurred during or in close proximity of the end of the Reporting Period damaging the organization’s records or information technology.
• Lack of receipt of reporting communications – an incorrect email or mailing address on file with HRSA prevented the organization from receiving instructions prior to the Reporting Period deadline.
• Failure to click “submit” – the organization registered and prepared a report in the PRF Reporting Portal, but failed to take the final step to click “submit” prior to deadline.
• Internal miscommunication or error – Internal miscommunication or error regarding the individual who was authorized and expected to submit the report on behalf of the organization and/or the registered point of contact in the PRF Reporting Portal.
•  Incomplete Targeted Distribution payments – the organization’s parent entity completed all General Distribution payments, but a Targeted Distribution(s) was not reported on by the subsidiary.

While attesting to an extenuating circumstance is required, no supporting document or proof is required. If HRSA approves the extenuated circumstances form, the provider will receive a notification to proceed with completing the Reporting Period 1 report shortly thereafter. Providers will have 10 days from the notification receipt date to submit the late Period 1 report in the PRF Reporting Portal. More information is available here. The AMA will continue to advocate for greater flexibility and more information to ensure physician practices have an adequate opportunity to come into compliance.

Two HHS Events to Honor Black Maternal Health Week
In observation and honor of Black Maternal Health Week, the U.S. Department of Health and Human Services (HHS) invites you to two conversations on April 14^th. HHS is taking unprecedented action to close disparities and strengthen Black maternal health by expanding coverage, implementing new policies, and providing funding to ensure safer pregnancies and postpartum services for new parents and their babies. They will continue to advance the Biden-Harris Administration’s commitment to ensuring equitable access to health care before, during, and after pregnancy for all mothers in our country.

HHS Secretary Xavier Becerra and State Leaders Discuss Black Maternal Health Week

Thursday, April 14^th at 3:00 PM ET

Register here

This conversation will focus on what States and the Federal government are doing to address inequities in Black maternal health. The discussion will focus on current challenges and opportunities for improvement in maternal health outcomes for Black women at both the State and Federal levels.

The Conversation will include remarks from key leaders including:

• Moderator: Jess Marcella, Deputy Assistant Secretary, Office of Population Affairs in the Office of the Assistant Secretary for Health at HHS
• Xavier Becerra, Secretary of HHS
• Tammy Snyder Murphy, First Lady, New Jersey
• Trudi Inslee, First Spouse, Washington

Honoring Black Maternal Health Week: A Discussion of Challenges and Opportunities to Improve Black Maternal Health

Thursday, April 14^th at 1:00 PM ET
(no registration is required)

Our goal is to bring awareness to the maternal health crisis through an authentic conversation amongst each well-known participants and HHS moderators about their maternal health experiences. The discussion will highlight that all Black women are more adversely affected by maternal health morbidities and the need for action.

The Conversation will include remarks from key leaders including:

• Moderator: Loyce Pace, Assistant Secretary for Global Affairs at HHS
• Chiquita Brooks-LaSure, Administrator of the Centers for Medicare and Medicaid Services (CMS)
• Dr. Dara Kass, Regional Director for HHS Region 2
• Hannah Bronfman, Activist, Author & Wellness Entrepreneur
• Latham Thomas, MamaGlow Founder and CEO
• Jazmyn Simon, Actress and Author
• Codie Elaine Oliver, Producer and Director

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.

Join MSSNY In Kicking Off Wellness
MSSNY will be hosting a series of physician wellness webinars covering various topics within the realm of wellness over the next few months.

Registration for Improving Well-Being and Reducing Burnout Among Health Care Workers Now Open – April 26, 2022 @ 7:30am

Michael Privitera, MD and Arthur Hengerer, MD will serve as faculty. Register now!

Educational objectives are:

• Define and give examples of extraneous cognitive load
• Explain rationale of 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

Registration for Women in Medicine 2022: Up the Down Staircase Now Open – May 21, 2022 @ 8:40-9:40am

Carol Bernstein, MD will serve as faculty. Register now!

Educational objectives are:

• Identify significant stressors contributing to burnout as they specifically impact women physicians in the era of Covid.
• Increase knowledge of potential strategies that can be used to support women physicians, especially when working in dynamically changing and stressful clinical environments.
• Identify potential systemic solutions as well as practical techniques that promote growth and resilience in women physicians.

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
Stress and burnout among physicians have been well documented for years. The COVID-19 pandemic is exacerbating the public health problem of physician burnout in New York state. Throughout the pandemic, physicians and other health professionals have faced concerns about safety, overworking and feelings of loss. Without an intervention, it is possible that a high number of physicians over the next few years may develop chronic stress reactions, anger, clinical depression, substance abuse, post-traumatic stress disorder and suicidality.

Watch here to see Frank Dowling, MD and Charles Rothberg, MD give an interview on MSSNY’s P2P program.

If someone you know is struggling with life stressors, reach out to the P2P program to connect them to a peer supporter: P2P@mssny.org  or 1-844-P2P-PEER (1-844-727-7337).

If you wish to become a trained peer supporter, reach out to Cayla Lauder, MPH, Program Coordinator, at clauder@mssny.org.

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.

Medical Office Suite for Rent  (Downtown, New York City) – Ready to Move In!
On Canal Street, NYC : near Mulberry and Mott Street. Busy area near Subways. In a professional 7day/week concierge building . Office Suite 1002+ sq ft, beautiful & bright w/ five office consult-exam rooms, Spacious waiting and receptionist area, utility room & private restroom.  MUST SEE!  Please Call for showing at: 917-378-2699 or email: cnyc2828@gmail.com. Ask for Sammie.

Rendr- Transforming Healthcare – Leadership Opportunity: Associate Chief Medical Office, SVP of Population Health, Bilingual English and Chinese (Mandarin or Cantonese) preferred Job Position: Associate Chief Medical Office, SVP of Population Health in this role, you will lead and provide a wide range of support through population health, quality measures, practice transformation, Rendr360 department, House Calls, and other projects.  Please send resumes careers@rendrcare.com. We are offering leadership opportunities to Physicians who are interested in providing high-quality clinical care to our patients in the diverse communities that we serve. As a rapidly growing network, we provide a supportive environment for our physicians to practice medicineunder the guidance of dedicated medical leadership. www.rendrcare.com.

Rendr- Transforming Healthcare – Primary Care Opportunity: Internal or Family Medicine Physician, Bilingual English and Chinese (Mandarin or Cantonese)
Job Position: Internal Family Medicine Physician please send resumes to: careers@rendrcare.com. We are offering employment opportunities to Internal or Family Medicine Physicians who are interested in providing high-quality clinical care to our patients in the diverse communities that we serve. As a rapidly growing network, we provide a supportive environment for our physicians to practice medicine

under the guidance of dedicated medical leadership. www.rendrcare.com.