MSSNY eNews: April 8, 2022

Message from MSSNY President Dr Joseph Sellers:
Physicians Are Worthy of the Same Compassion We Give Our Patients

Colleagues:
Last week, I was moved by an essay in the New York Times by Dr. Seema Jilani entitled Why So Many Doctors Treat Their Mental Health in Secret, and submitted a Letter to the Editor. Although the Times did not print the letter, I want to share it with all of you here:

Thank you for addressing the critical issue of physician mental health with this eloquent, poignant, and brave essay. Dr. Jilani’s words evoke strong emotion in those of us who are proud to serve as physicians.  We endure years of education and training because we have a calling to heal. But the COVID-19 pandemic has taken a toll on what has always been a stressful profession—and so many struggle in silence.

The Committee for Physician Health, a division of The Medical Society of the State of New York (MSSNY), provides non-disciplinary, confidential assistance to physicians, residents, and medical students with stress, difficult adjustment, substance abuse and other psychiatric disorders.

And in July 2020, just as the pandemic was heating up, MSSNY launched a program to provide physicians, residents, and medical students the opportunity to speak with a peer about life stressors.  The Peer-to-Peer program offers a confidential discussion with a physician peer supporter—an individual trained to share experiences, listen without judgment, and validate feelings.

As Dr. Jilani so aptly states, “physicians are worthy of the same compassion we give our patients.”

Joseph Sellers, MD, FAAP, FACP
MSSNY President

Legislature Closes in on Passing Budget
After being a week overdue, the State Legislature was giving final passage to a $220 billion Budget package today.  At press time, while some bills remain to be printed and staff is continuing to pore through the thousands of pages of publicly available Budget bills, 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 (see related article).
• 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.
• 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 will continue its review of the many Budget provisions and will provide a further comprehensive update next week.

Telehealth Payment Parity Included in FY2022-23 Budget
After many months of strongly advocating for payment parity for Telehealth services, included in the final Budget is a provision that will require health insurers to pay physicians on par with what they’re paid for an in-person visit when providing the same care using Telehealth services. The policy covers all modalities of Telehealth. With the provisions scheduled to sunset in 2 years, the Budget bill also calls for a study by DFS and DOH to study the impact of payment parity using utilization data from health insurers.

While we will need to again advocate for this important physician and patient protection in 2 years, it is a very significant first step.  MSSNY thanks Governor Kathy Hochul, Senators Gustavo Rivera and Peter Harckham, and Assemblymembers Richard Gottfried and Carrie Woerner for their leadership on this issue. MSSNY also worked closely with the American College of Obstetricians and Gynecologists (ACOG), the New York State Psychiatric Association (NYSPA), the New York Chapter American College of Physicians (NYACP), New York State Academy of Family Physicians (NYSAFP), and a range of other specialty societies representing physicians across New York State, as well as the Healthcare Association of New York State (HANYS).

Physicians May Request Extra Time to Report Provider Relief Funds, HRSA Says
Due largely to AMA and specialty society advocacy, the Health Resources and Services Administration (HRSA) has decided to reopen the reporting time for recipients of Period 1 Provider Relief Funds. In the AMA’s March 31, letter to HRSA, the AMA and 31 national medical specialty societies noted small and rural practices appeared to be particularly impacted by the potential recoupment, and that physician practices were unaware of the deadline.

Those 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. 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. The AMA will continue to advocate for greater flexibility and more information to ensure physician practices have an adequate opportunity to come into compliance.

MSSNY Supports Legislation to Ban Use of Step Therapy Protocols for Mental Health
Legislation (A.3276, Aileen M. Gunther- D, Monticello) passed the Assembly this week that will prohibit the use of step therapy protocols for coverage for the diagnosis and treatment of mental health conditions including prescription drug coverage. Identical legislation (S.5909, Todd Kaminsky- D, Rockville Centre) is before the Senate Insurance Committee.

Step Therapy, also known as “Fail First” policies, force patients to try treatment deemed less costly by the insurer in place of the therapy originally prescribed by their physician, and to “fail first” before the insurer will cover the original treatment. Too often, this requires patients to take medications that they have previously tried without success, wait months for approval to switch to another option after failing with a given drug, and frequently to suffer adverse effects from taking an inferior medication. In 2016, MSSNY successfully advocated with a number of patient advocacy groups in strong support of a far-reaching law that established defined criteria to facilitate the ability of a physician to override a health insurer’s step therapy protocol.

Studies on the impact of step therapy policies have found they can actually increase total health care costs in the long run through increased emergency room visits and hospitalization as a result of taking the wrong medication. These policies are particularly dangerous for patients with mental health conditions, where they’re associated with a higher risk of patients abandoning their treatment, often with dire consequences like homelessness and incarceration.

MSSNY will continue to advocate for this bill in the Senate.

Physician Judges Needed: MSSNY’s Resident/Fellow and Medical Students Poster Symposium

The Resident and Fellow Section is seeking volunteers to serve as in-person judges for its Poster Symposium.  Judging will take place at MSSNY’s House of Delegates in Tarrytown on Friday, May 20 from 1:00 PM – 4:00 PM in the Tarrytown Ballroom.  If you are interested in serving as an in-person judge please contact Kathy Rohrer at krohrer@mssny.org

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.

Improving Well-Being and Reducing Burnout Among Health Care Workers: April 26 @ 7:30am

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

Educational objectives:

• 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

Women in Medicine 2022: Up the Down Staircase: May 21, 8:40-9:40am

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

Educational objectives:

• 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.

Stresses & Distresses in the Time of COVID-19: Medical Matters CME Webinar

The COVID-19 pandemic has caused innumerable mental health sequelae that will likely be present for years to come.  To learn more, register for Stresses & Distresses in the Time of COVID-19 on Wednesday April 20, 2022, at 7:30 a.m. 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:

• Illustrate the many sources of stress that society is enduring in recent years
• Identify the many ways different ways the resulting distress can be experienced
• Discuss what clinical approaches are available for helping

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.

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.

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.