MSSNY Pulse: July 22, 2022

Message from MSSNY President Parag Mehta, MD:
Physicians: Urge Gov to Veto Wrongful Death Liability Expansion

This week, my opinion piece on legislation to greatly increase amounts that can be awarded in wrongful death lawsuits was printed in the Albany (NY) Times Union (7/19).  As I wrote in my op-ed, not very long ago New York’s physicians were cheered as heroes for our efforts to combat the COVID-19 pandemic. But the cheers are long forgotten.

Now the physicians of New York face a potential new disaster, due to a well-intentioned – but egregiously harmful – bill recently passed by the New York state Legislature. MSSNY is working with many other organizations, including hospitals, MLMIC, business groups and local government groups to request a veto.

The Wrongful Death bill’s most significant change allows a decedent’s survivors to recover expanded non-economic damages, including money for their own pain and suffering, anguish, and loss of companionship, in addition to pain suffered by the deceased.  The bill further:

  • Extends the statute of limitations from 2 to 3.5 years
  • Expands who can recover to “close family members” , so practically anyone can claim closeness to deceased
  • Takes effect immediately, applying retroactively to all existing suits as well as future suits.

Even if Governor Hochul vetoes or amends the legislation, we need to educate our legislature and consumers that NY remains the best place to study medicine but the worst place to practice medicine—which means the talent that NY creates does not stay in NY.

MSSNY is calling a meeting on July 28th of healthcare leaders to address this issue and plans to stay engaged with our legislature for a dialogue.

I urgently call on each of you—my fellow New York state physicians—to Contact Governor Hochul to urge her to veto this bill.

Climate Change is a Public Health Crisis
As the historic heat wave sweeps across the United States and much of Europe, we are reminded of the impact climate change and extreme heat have on public health. Climate change is a public health crisis. I encourage you to read through MSSNY’s policy on climate change, and the white paper developed by MSSNY’s Preventive Medicine and Family Health Issues Committee.

We all can bounce back. We can achieve our goals and dreams by refusing to give up despite rejection and criticism. When we get a rejection, we take it personally and become sad and hopeless.  It is a matter of building up courage, strength, wisdom, and perseverance by accepting yourself the way you are, having self-respect, building self-confidence, and learning to accept failure.

And, finally, I’d like to hear from you—our MSSNY members. Please email me your comments and suggestions at

Parag Mehta, MD
MSSNY President

NYS Department of Financial Services Issues Circular Letter on Utilization Review Best Practices
The New York DFS issued a Circular letter this week to remind health insurers and their delegates conducting utilization review about applicable New York laws as well as best practices identified in a recent Administrative Simplification Workgroup report to ensure patients receive needed care while reducing unnecessary obstacles to receiving this care.  MSSNY participated in this workgroup together with representatives of the state’s leading health care advocacy organizations representing consumers, health plans and hospitals.

Regarding pre-authorization, the Circular letter urges health insurers to, at least annually, review health care services that are generally approved through preauthorization to identify where preauthorization requirements may be removed.  The letter also notes that, as a best practice, health insurers should review circumstances where repeat preauthorization requirements for the same patient or same treatment can be eliminated.  It also urges health insurers to adopt evidence-based and peer-reviewed clinical guidelines with the most current data informing best practices for patient care and make the guidelines available to providers.

Regarding medical record reviews, the Circular letter also reminds health insurers of existing statutory provisions that “provide that when making prospective, concurrent, and retrospective determinations, utilization review agents may collect only such information as is necessary to make such determination” It also strongly encourages the transmission of documents electronically, including following the HIPAA standards for electronic transmission of documents for preauthorization requests, where available.  In addition, the electronic submission of claim attachments, where feasible, such as the use of a web portal, is strongly recommended, and health insurers should offer assistance to providers to facilitate the use of issuer web portals.

The Circular letter also sets forth best practices in a number of other areas, including health insurers’ clinical review criteria, grievance procedures, and peer to peer reviews.

New HHS Toolkit for Pediatricians and Family Physicians to Increase COVID Vaccine Confidence
The U.S. Department of Health and Human Services’ (HHS) public education campaign, We Can Do This, recently launched the Pediatricians and Family Physicians Toolkit to help physicians increase confidence in and uptake of COVID-19 vaccines among their patients and in the communities they serve.

Managing Conflicts with Families of Critically Ill Patients During Conversations About End-of-life Decisions in Neonatal, Pediatric, and Adult Intensive Care
Intensive care is a stressful environment in which team-family conflicts commonly occur. If managed poorly, conflicts can have adverse effects on all parties involved. Previous studies mainly investigated these conflicts and their management retrospectively.

This study aimed to prospectively explore team-family disputes, including its main topics, complicating factors, doctors’ conflict management strategies, and the effect of these strategies. The conclusion underlined the importance of doctors tailoring their communication strategies to the concrete conflict topic(s) and to the context- and family-related factors which complicate a specific conflict.

How doctors manage conflicts with families of critically ill patients during conversations about end-of-life decisions in neonatal, pediatric, and adult intensive care. (Intensive Care Med, 6/30, Spijkers).

Intensive Care Med

Iatrogenic Opioid Withdrawal Syndromes in Adults in Intensive Care Units: A Narrative Review
Opioids are used for pain management both during hospitalization and outpatient treatment. Their use in hospitalized patients includes patients on mechanical ventilation and postoperative patients. One large study based on 1.14 million hospital admissions reported that nearly 51% of hospital admissions include orders for opioids. These drugs suppress the production of endogenous neurotransmitters by decreasing cAMP levels, thereby reducing pain signals.

For patients that have been taking opioids for an extended period, drug tolerance and physical dependence can develop and leave the patient at risk of developing opioid withdrawal syndrome. While considerable effort has been devoted to outpatient opiate prescription and subsequent addiction and withdrawal symptoms in adults, opiate use during acute care hospitalizations has been neglected.

This review in the Journal of Thoracic Disease focuses on the frequency and characteristics of the iatrogenic opiate withdrawal syndrome in critically ill hospitalized adults, demonstrating that this syndrome occurs at relatively high frequency in ICU patients requiring mechanical ventilation;

Iatrogenic opioid withdrawal syndromes in adults in intensive care units: a narrative review. (JTD, 6/22, Patrice S.).

Opioid Withdrawal Syndromes in Adults

MSSNY Joins with Patient Advocacy Groups to Urge Governor to Sign Measures to Reduce Administrative Hassle
Recently MSSNY joined with 30 other patient advocacy organizations in a group statement NY Legislature Passes Important Patient Protections in 2022 Session ( urging Governor Hochul to sign into a law a number of important reform measures to reduce the unnecessary administrative hassles that patients and their physicians experience in their interactions with health insurance companies.  The groups included the Mental Health Association of New York, Aimed Alliance and Bleeding Disorders Advocacy Network.

Physicians are urged to send letters to the Governor in support of the measures, which include:

  • 879 (Gottfried)/S.8113 (Cleare), would prohibit a health insurer from denying a claim or pre-approval request for patient care unless the reviewing physician is board-certified or board eligible in the same or similar specialty as the physician who typically recommends the treatment or manages the condition that is under review. It would also require that the health plan’s reviewing physician have a New York license to practice medicine.  Physicians can send a letter in support here: Require Health Insurers to Use Appropriately Trained Reviewers (
  • 1741-A (Gottfried)/S.5299-A (Rivera), would prohibit health insurers from preventing patients from using copay cards or coupons to help meet their often- enormous deductibles. Enactment of this legislation would help patients, particularly those on chronic medication therapies, to realize the full benefit of these discount cards and help them meet their deductible requirements earlier in a calendar year.  Physicians can send a letter in support here: End Copay Accumulators (
  • 3276 (Gunther)/S.5909 (Kaminsky), would prevent health insurers from imposing step therapy or fail first protocols on coverage for prescription medications to address patient mental health conditions.  In 2016, MSSNY worked with several patient advocacy groups to enact a law that established strict criteria to better enable a physician, on behalf of their patient, to override a health insurer step therapy/fail first protocol.  This legislation would go further than the 2016 law, ensuring that these health insurer step therapy protocols would not apply to mental health medications in the first place.  Physicians can send a letter in support here: Urge Governor to Sign A.3276/S.5909 (

“The Medical Society of the State of New York (MSSNY) applauds the New York State Assembly and Senate for passing multiple pieces of legislation this session that seek to ensure patients have timely access to the treatment and medications they need to treat their conditions.” said Dr. Parag Mehta, President of MSSNY. “Our patients who rely upon these needed medications and treatments should not have to face the unnecessary administrative roadblocks often imposed by health insurers these bills seek to remedy. We urge Governor Hochul to sign all three bills and put these important safeguards in place as soon as possible.”

MSSNY Members Contribute to New Health Informatics Book Series
Congratulations to MSSNY President Dr. Parag Mehta and fellow MSSNY member Dr. Patricia Bomba for their contributions to Dr. Salvatore Volpe’s newest publication, Health Informatics: Multidisciplinary Approaches for Current and Future Professionals (HIMSS Book Series).

Dr. Sal Volpe
Dr. Sal Volpe
Dr. Patricia Bomba
Dr. Patricia Bomba

“Health Informatics Multidisciplinary Approaches for Current, and Future Professionals is essential reading for policymakers, doctors, administrators, and frontline healthcare workers. The book illustrates that deep integration by and between all aspects of care delivery, including IT, employee training and education, finance, and clinical practice, will produce improved health outcomes and reduced costs.”
–John August, Program Director, Partners Program, ILR Scheinman Institute, ILR School, Cornell University.

Report Identifies Largest US Physician Groups Amid Shift From Independent Practices
MedPage Today (7/14, Fiore) reports the US’ largest physician group has nearly 12,000 doctors, according to a Definitive Healthcare report that highlights how physicians have increasingly become employees rather than owners of independent practices. The report also found that the top 10 physician groups have more than 60,000 doctors in total. Medical Society of the State of New York Immediate Past President Joseph Sellers, MD, previously told MedPage Today that the trend “has been going on for probably 40 years.” Sellers said, There has been a change from physicians working in solo practice into group practices, into larger groups, and into groups affiliated [with] or groups owned by a health system, similar to the consolidation of our hospitals from individual hospitals into systems.

Val Renewal Banner

Empire BlueCross BlueShield Backs Out of New York City’s Plan to Move Retirees from Medicare Supplemental Insurance to Medicare Advantage Plus
As reported in Crains this week, Empire BlueCross BlueShield announced that it was backing out of the City of New York’s plan to move 250,000 retired municipal workers from Medicare supplemental insurance plans to Medicare Advantage. The new benefits would have been administered by the Retiree Health Alliance plan, a public-private collaboration between BCBS and nonprofit EmblemHealth. NYC officials said the change would have saved the city as much as $600 million per year as the cost of retirees’ benefits would have shifted to the federal government.

Originally, retirees who didn’t want to join Medicare Advantage were told they could keep their supplemental plans, but would have to pay an additional cost to keep traditional Medicare. However, there was strong objection from many retirees and various health care providers, which led to litigation challenging the move.

In a memo shared by the NYC Organization of Public Service Retirees, a group of about 2,000 retirees that formed in opposition to the city’s proposed plan, BCBS said it was backing out because the city did not provide them with exact plan benefit details by the date requested.

From the start, the city’s plan to make the switch was met with legal challenges from other insurance providers and retirees. Among retirees’ concerns about the change was that many doctors would refuse to participate because of laborious prior authorization requirements.

MSSNY will continue to track this story and share updates as they become available including whether a revised version of this plan will be developed.

CMS Plans to Delay Implementation of Narrowed Definition of “Substantive”
The Centers for Medicare & Medicaid Services (CMS) plans to delay the implementation of the narrowed definition of “substantive” as it relates to split or shared encounters from January 2023 to January 2024.

The proposed delay was included in the July 7 release of the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule. This comes on the heels of a letter from nearly 20 physicians’ organizations penned in March urging CMS to reverse course on their final rule, requiring the billing provider to spend more than 50% of the time on the facility-based split/shared patient encounter.

The letter cited concerns regarding the perceived negative implications for rule-driven deviation from a collaborative care delivery model, patient experience, and a knowledge gap regarding physician and organizational impact of rule implementation.

Organizations must balance their approach with other regulatory and industry shifts as they grapple with CMS’s newest development. To date, 27 states have adopted full practice authority for nurse practitioners (NPs).

Additionally, a growing body of evidence supports that advanced practice providers (APPs) functioning in the hospital setting improve outcomes, patient experience, and readmission.

Rx Banner

National Government Services Medicare Mobile is Expanding:
Introducing Medicare News
Receive Exclusive Medicare News Directly to Your Phone. Text NEWS to 37702 to receive exclusive notifications on breaking news, important updates, upcoming educational events, and more. The NGS aims to inform and educate the Medicare community in a more personal and readily available channel. Breaking and bi-weekly news items may include essential updates, virtual event announcements, YouTube video links, telephone/lVR/NGSConnex/website outages, or system maintenance news.

“Monkeypox: An Evolving Story” Webinar on August 16
Monkeypox has been spreading globally in non-endemic countries.  Learn more about the monkeypox outbreak by registering for Monkeypox: An Evolving Story on August 16th at 7:30am.  William Valenti, MD chair of MSSNY Infectious Diseases Committee and Erick Eiting, MD, MPH co-chair of MSSNY Health Equity Committee will serve as faculty for this webinar. Register now

Educational Objectives are:

  • Identify monkeypox epidemiology and its presentation
  • Outline testing, treatment and vaccine options for monkeypox
  • Discuss New York State and New York City guidelines

Contact Melissa Hoffman at for additional information or assistance with registration.

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.

Are You Prepared for Your Next Contract Negotiation?
A physician-founded and physician-driven company, Resolve is bringing change to employment contracts by providing data and transparency into the physician market. Using the most accurate data on compensation and other contract terms sourced from actual contracts, Resolve delivers the insights and expertise to help physicians negotiate for what they truly deserve and take control of their careers. Please visit Resolve to receive exclusive MSSNY Pricing.

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.

Rheumatology Practice Sublet – Great Neck, NY
Sublet opportunity available at an established medical office in Great Neck, NY. Prime location near LIJ, Northshore University and St. Francis Hospitals. Fully equipped office with onsite parking and proximity to mass transit. Contact 516-972-2986/ for more info.

Medical Office with Ample Patient Parking + 1 Family For Sale in the Most Desired Area of Hollis Hills. Priced to Sell!
One of a kind medical office investment opportunity and growth in the most desirable areas of Hollis Hills! This property is an S1 zoning that allows a medical practice, located within proximity of LIJ and Manhasset hospital, Lake Success Pro Health Medical offices with ample patient parking and much more, this unique property features a residential space split level style with 5 bedrooms, 3.5 baths living room, dining room with a wood burning fireplace, kitchen, oversized sunroom/den, 1 car garage and laundry room.

The Lower level has a separate entrance, 4 exam rooms, a doctor’s private office, filling rooms and endless closet storage.
Conveniently located near schools, worship houses, transportation, GCP, LIE, Cross Island & Clearview Expressway, restaurants, shopping centers and much more! To inquire, please call Claudia (917-554-4158) or Bella at (718-344-2153).

Recruiting for Full or Part time (20 hours per week Chief of Medical Services).  Salary is negotiable.
Oversees and directs the planning, implementation, and supervision of health and medical services for residents at the NYS Veterans Home at St Albans. Develops, implements, and evaluates medical treatment standards and procedures; and provides technical and operational guidance and direction to medical and health care staff. Serves as a medical consultant and liaison; and develops recommendations for medical assessments, treatments, and care. Implements and monitors contract agreements and the provision of contracted medical and health related services. Participates in program audits and reviews. Supervises the credentialing and privileging process to ensure that medical staff possess appropriate credentials and maintain appropriate levels of continuing education; and participates in the development of recruitment programs and hiring and selection processes. Provides clinical and administrative supervision and guidance to physicians and other health care professionals.  Possession of a license and current registration to practice medicine in New York State and six years of post-licensure medical practice experience, two years of which must have been in an administrative or supervisory capacity. Must be fully COVID 19 vaccinated.

Send CV to:

Office Space To Share / Financial District NYC.
111 John St., Ste 1460, NYC 10038 (between Cliff & Pearl St.)
A block away from the South Street Seaport. Easy access to office Central hub for all subway lines (A, C, 2, 3, 4, 5, J, Z, E), a quick walk from NJ path train.

Beautifully renovated, 1,300 sq ft. modern space. Available Monday, Wednesday, Friday and weekends.

Private rooms with pocket doors. Access to building 24/7, security/door man in the lobby, very safe. Daily rate $450. Contact (917) 514-1299 text/call.

Medical Office for Share in Medical Park with Free Big Parking Lot in Westchester County
Medical office for sublet in Medical Park with free big parking lot, located at West Harrison, border of White Plains in Westchester County. Office includes a big waiting room with a kitchen, doctors office, exam room, and reception area. All rooms are available for whole days of Monday, Tuesday, Wednesday, Saturday, Thursday (Thursday full day on every 1st and 3rd week and Thursday morning on every 2nd and 4th week each month, or we can discuss more options). Monthly rent $600 for once a week usage, $1100 for twice a week usage, $1500 for three-day a week usage. Newly renovated and fully furnished. Text May if you are interested 646-338-4803

Board Certified Internal or Family Medicine Physician
Join our caring team and our mission to provide the highest standard of healthcare to each of our patients. Medical office in Eastern Nassau County looking a for a hard-working, responsible Physician to join our team.

Responsibilities include care for, diagnosing and managing patients.

Please send Curriculum Vitae to

MANHATTAN MEDICAL SUITE FOR SALE –Prestigious Coop on 45 East 62nd St. between Madison & Park!!
This approximately 1100 square foot medical suite has a grand reception area that is large enough for 2 or 3 people to work from. There is an additional nook area currently used for paper chart files that could also be utilized to update charts online or for bookkeeping. The waiting room has approximately 10 ft ceilings and a marble fireplace. The mahogany veneered office also has high ceilings. The reception area and hallway have a drop ceiling that was installed to accommodate duct work for air conditioning. There are 1.5 bathrooms. Medical equipment is also available for sale. The property needs a cosmetic renovation update.

To schedule a showing: or Call: Melissa Alonso with Nestseekers International: 646.403.7311

IDEAL LOCATION: 45 East 62nd – Prime Lennox Hill
PRICE: $1,100,000 with 50% Financing Permitted
Monthly Maintenance: $4775

Medical Office for Rent (Poughkeepsie) and Share (Tuckahoe)
Poughkeepsie Office Suite 1100+ sq ft, w/ five office consult-exam rooms, waiting and receptionist area, restroom & private restroom, 1 block away from MidHudson Regional Hospital. Tuckahoe office 2 1500+ sqft suites for share, 3 exam rooms with procedure room, storage room. 1 block away from train station.

Please call or text 646-302-3085 or email

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: 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 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 medicine under the guidance of dedicated medical leadership.

Board Certified Cardiologist Position
Exceptional private practice cardiology employment opportunity. Manhattan Cardiology is a state-of-the-art cardiology practice located in the heart of Midtown Manhattan. The position is 100% outpatient cardiology with minimal call and excellent compensation structure and benefits. The practice is looking to add an enthusiastic and hardworking cardiologist to join our team.

Board certification is preferred in general cardiology, echocardiography, and ideally RPVI.

Job Type: Full Time with a very competitive salary and excellent benefits awaits the qualified candidate.

Please send resumes to

Board Certified Internal or Family Medicine Physician
Be a part of our care team and join our mission to provide the highest standard of healthcare to each one of our patients. Medical Offices of Manhattan is looking for a full time enthusiastic, hard-working and responsible Board-Certified Internal or Family Medicine Physician.

Responsibilities include caring for, diagnosing and managing patients. Board certification is a must. The position is 100% outpatient with minimal call and an excellent salary with benefits.

Please send resumes to

Physician Assistant/Nurse Practitioner
A growing multispecialty practice in Manhattan, Medical Offices of Manhattan and Manhattan Cardiology is seeking for an enthusiastic, hardworking Board Certified Physician Assistant or Nurse Practitioner.

Responsibilities include caring for, diagnosing, and managing patients in both the primary care and cardiology setting. The Physician Assistant or Nurse Practitioner will collaborate with the team in diagnosing and creating plans for each patient.

The position is 100% outpatient with minimal call and excellent salary with benefits.

Please send resumes to

GI Physician Assistant/Nurse Practitioner
Medical Offices of Manhattan, a multi-specialty medical office is seeking for immediate hiring for an experienced and hardworking GI Physician Assistant.

Responsibilities includes managing Adult Gastroenterology patients with varying disease processes, including but not limited to GERD, IBD, bowel pattern changes, abdominal pain, and diseases related to the liver, pancreas, GI tract, and gallbladder; develops, implements, and manages therapeutic treatment regimens in collaboration with the Gastroenterologists and must possess excellent communication skills, with a focus on a team approach to patient-centered care

The position is 100% outpatient with minimal call and excellent salary with benefits.

Please send resumes to

Psychiatric Nurse Practitioner
Medical Offices of Manhattan, a multi-specialty medical office is seeking our newest team member, a Psychiatric Mental Health Nurse Practitioner to join our fast-growing team of mental health professionals.

Responsibilities includes managing both complex psychiatric and common medical problems, assess and diagnose illness states and initiate psychotropic medication (as needed) and other therapeutic interventions and collaborate with the team in diagnosing and creating plans for each patient.

The position is 100% outpatient with minimal call and excellent salary with benefits.

Please send resumes to

In Network Registered Dietician
A growing multispecialty practice in Manhattan, Medical Offices of Manhattan is seeking an In Network Registered Dietician to join our care team for immediate need.

Responsibilities includes but not limited to conducting nutritional assessment, developing and implementing patient specific care plans and recommending nutrition care plans to patients as well as recommending therapeutic diet modifications and /or supplemental feedings to patients. Must have a degree in Nutrition or Dietetics, should be RD license, Registration by the Commission on Registration (CDR) as a Registered Dietitian (RD) in New York State plus specialized certifications as needed.

The position is 100% outpatient with excellent salary with benefits.

Please send resumes to

Board Certified Gastroenterologist Position:
Exceptional private practice gastroenterologist employment opportunity. Medical Offices of Manhattan, a multi-specialty medical office is seeking for immediate hiring for a board certified, experienced and hardworking Gastroenterologist.

Responsibilities includes managing Adult Gastroenterology patients with varying disease processes, including but not limited to GERD, IBD, bowel pattern changes, abdominal pain, and diseases related to the liver, pancreas, GI tract, and gallbladder; develops, implements, and manages therapeutic treatment regimens and must possess excellent communication skills, with a focus on a team approach to patient-centered care

The position is 100% outpatient with minimal call and excellent salary with benefits.

Please send resumes to