MSSNY Pulse: July 29, 2022
Message from MSSNY President Parag Mehta, MD:
Physician Leadership During Crisis: We Need You
As New York physicians, we are facing an unprecedented crisis with the possibility of an increase in malpractice premiums by 40%. The wrongful death lawsuit expansion bill that was passed by the legislature and will be considered by Governor Hochul will affect all businesses, municipalities, hospitals, and physicians—and it will cripple the entire healthcare system of New York. It will disproportionately impact safety net hospitals and underserved communities, creating a further chasm in disparity. Businesses will leave NY or go out of business, and those who remain will face no choice but to pass on the increased cost of care to consumers. As we all know, healthcare does not have the option to pass on increased costs.
To address any crisis, we must stay united and engaged, build a network of teams, remain optimistic, demonstrate deliberate calm, and communicate effectively. We don’t have a predefined response, so we create behaviors and mindsets that will prevent us from overreacting.
MSSNY is hard at work convincing the Governor that she must veto this bill. Our efforts thus far include the following:
- MSSNY met with the Governor’s office to urge a veto.
- MSSNY sent a joint letter with 16 specialty societies to Governor Hochul (see first story below, which contains the letter).
- MSSNY joined forces with HANYS and GNYHA to evaluate the actual impact of this legislation, and we have also received a report from actuary Milliman which outlined the shocking increase in insurance premiums by 40%.
- MSSNY is actively engaged with MLMIC to engage physicians across the State to contact the Governor through MSSNY’s Grassroots Action Center.
- MSSNY used media and social media effectively, including an op-ed in the Albany Times Union and advocacy alerts through Twitter, Facebook and Instagram.
- MSSNY is asking all leaders like you to educate everyone around you and contact the governor, urging her to veto the bill.
I encourage you to take this opportunity to engage in advocacy for better healthcare for NY and a better environment in which to practice medicine. NY is the best place to train physicians but the worst place to practice medicine. Let’s change that together. Please urge Governor Hochul to veto S.74-A/A.6770 here.
And, finally, remember to smile. As mother Teresa so famously said, “Every time you smile at someone, it is an action of love, a gift to that person, a beautiful thing.” Smiling reduces stress, makes you more relaxed and helps your immune system function better. Smiling more contributes to living a longer, healthier life.
I’d like to hear from you—our MSSNY members. Please email me your comments and suggestions at MSSNYpresident@mssny.org.
Parag Mehta, MD
MSSNY Joins Forces with 16 Specialty Societies to Urge Governor to Veto Wrongful Death Lawsuit Expansion Bill
MSSNY, along with 16 Specialty Societies, sent a letter urging the Governor to veto the wrongful death lawsuit expansion bill:
“Our respective associations, which together represent tens of thousands of physicians across the state of New York providing care to hundreds of thousands of New Yorkers each year, urge you to recommend a veto of the above-referenced legislation that would exponentially expand damages and lawsuits for ‘wrongful death’ by including compensation for grief or anguish. The explosive increase in liability costs that expansions like this bill would necessitate would cause significant damage to our healthcare safety net, driving physicians out of state, and exacerbate the already challenging patient access to care issues we face.
One recent actuarial study has estimated that this legislation could increase New York’s already outrageously high medical liability premiums by nearly 40%…read more
Lawsuits, Reimbursement, and Liability Insurance. Facing the Realities of a Post-Roe Era
On June 24, 2022, the US Supreme Court overturned Roe v. Wade, beginning the process for thirteen states to ban abortions. A recent article in JAMA focuses on the ability of physicians to practice medicine within these states and the possible legal ramifications and increased cost of practicing medicine.
Insurance providers assess malpractice insurance pricing based on a physician’s legal involvement as a signal of high-risk behavior. Experts are concerned that any abortion-related prosecution could increase physicians’ premiums to the extent that they might stop performing the procedures. Increases in liability may sway some physicians to practice medicine to protect themselves from liability. Still, under the Emergency Medical Treatment & Labor Act, any physician that can be proved to alter care for a pregnant patient is liable to financial sanctions from the Centers for Medicare & Medicaid Services. The uncertainties surrounding these issues will lead to increased stress and physician burnout.
The Supreme Court’s New Direction and the Public’s Health
In a recent JAMA Forum, Joshua N. Auerbach, JD and Joshua M. Sharfstein, MD contend that the Supreme Court’s new direction poses a profound threat to the public’s health. Recently the US Supreme Court eliminated the right to terminate a pregnancy, expanded the right to carry a gun, restricted the ability of the US Environmental Protection Agency to reduce power plant emissions, and stopped the Occupational Safety and Health Administration from protecting workers from COVID-19.
Together, these decisions abandon a long-standing and productive exchange between the Supreme Court and the scientific community that substantially advanced the development of the law over the last century. As a result, these cases are likely to have severe and lasting consequences, from exposing US residents to higher maternal mortality rates and gun violence, to more extreme weather and other climate-related risks. The authors believe the risks of ignoring the results of experiments are just as dangerous as casting aside scientific understanding, severely threatening public health.
The Supreme Court’s New Direction and the Public’s Health (JAMA, 7/21, Auerbach, Sharfstein).
Performance Metrics of Substance Use Disorder Care Among Medicaid Enrollees in New York, New York
Lack of substance use disorder treatment contributes to adverse personal and social outcomes, with an estimated hundred thousand drug overdose deaths in the United States from April 2020 to 2021. Yet, of the nearly 20 million US adults meeting substance use disorder diagnostic criteria, only 1 in 10 receives specialty treatment.
This study used administrative Medicaid data from January 2009 to December 2017 from New York City, where two-thirds of the Medicaid population of New York State resides, to identify how Medicaid-managed care plans compare to substance use disorder and its treatment coverage across access and quality indicators. This data highlighted the importance of monitoring access, quality, and outcomes of SUD treatment among Medicaid-covered populations. The study results potentially provide an initial step toward making valid comparisons of substance use disorder treatment across Medicaid-managed care plans in the largest market in the country.
Performance Metrics of Substance Use Disorder Care Among Medicaid Enrollees in New York, New York (JAMA, 7/1, Alegria, Falgas-Bague, Fukuda).
Climbing Melatonin Use for Insomnia Raises Safety Concerns
Insomnia rates have risen dramatically over the past two decades, with roughly one-third of US adults experiencing insomnia. Similarly, a recent CDC report found that one-third of US children and adolescents aren’t getting sufficient sleep.
Sales data indicates the trend is accelerating, with melatonin sales increasing to $821 million in 2020 from $339 million in 2017. The data also showed that more adults are using doses greater than 5 mg, which boosts serum melatonin levels far beyond typical nighttime peak concentrations before declining after 4 to 8 hours.
Sleep experts are concerned about the potential harm melatonin use without physician oversight may cause, particularly at higher doses and over the long term. US poison centers have reported a startling increase in calls about children who have ingested melatonin in the past decade.
Climbing Melatonin Use for Insomnia Raises Safety Concerns (JAMA, 7/27, Kuehn)
Fast and Accurate Internal Credentialing
Every practice strives to improve its internal credentialing process to avoid losing the ability to bill insurance. WCH has been doing credentialing for over 20 years for a variety of specialties and knows the challenges of handling credentialing internally.
Most of the credentialing work today is managed internally. This work includes adding new providers in the group, updating demographics, and managing existing credentialing with all the approved insurances. This process requires attention to dates, correct and timely submission of information, and the ability to track the entire process. Keep in mind that most of the credentialing work is handled within the practice either by the front desk, the practice manager, or even family members that are working with the doctor. Over time staff changes, credentialing responsibility shifts, and data gets lost. Leaving new people without past credentialing processes and with new growing headaches to respond to the payers.
In facing these complications, WCH has developed a simple, automated credentialed tool – CredyApp—which helps to better manage and control the practice’s credentialing process. Whether the credentialing is being done in a multispecialty clinic, laboratory, solo provider, or urgent care, CredyApp will transform your practice to help prevent the loss of credentialing data, documents, re-credentialing dates, and missed reappointments.
CredyApp Features Include:
- Library of insurance contacts
- Access to staff and doctors in the group to view credentialing
- Tracking credentialing progress from submission to approval
- Due date reminders for tasks and follow-ups
- Multifunctional dashboard for every user
- Managing expirable documents
- Automated Reports about practice/provider credentialing
- Ability to handle credentialing processes by remote workers
- Integration with NPI/CMS Data Sets
Practice Credentialing Dashboard:
Incorrect credentialing can cost your practice a great amount of lost revenue and staff time. Take advantage of the 72-day free trial. Sign up at https://credyapp.com/ or schedule a talk with Olga Khabinskay, MBA Director of Operations, HBMA Payer Relations Committee Member at https://calendly.com/olgakwch/wchservices
MSSNY Applauds House Ways and Means Committee for Taking Action on Legislation to Streamline Prior Authorization for Medicare Advantage (MA) Plans
MSSNY applauds the work of the U.S. House of Representatives’ Committee on Ways and Means, for voting to advance for full House consideration the “Improving Seniors’ Timely Access to Care Act” (H.R. 8487), this week. New York Representatives Brian Higgins and Tom Suozzi are members of the committee and the bill was introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Ami Bera, MD, (D-CA), and Larry Bucshon, MD, (R-IN).
The legislation would protect patients from unnecessary delays in care by streamlining and standardizing prior authorization in the Medicare Advantage (MA) program. Specifically, the bill would improve prior authorization by:
- Establishing an electronic prior authorization (ePA) program and reduce how long a health plan can consider a prior authorization request.
- Standardizing and streamlining the prior authorization process for routinely approved services, including establishing a list of services eligible for real-time prior authorization decisions.
- Ensuring prior authorization requests are reviewed by qualified medical personnel.
- Increasing transparency around MA prior authorization requirements and their use.
Many studies have detailed the growing hassles faced by physicians in their efforts to provide care to their patients, a major contributing factor to the rising concern of burnout among health care professionals. One such hassle relates to PA requirements, which is a health plan cost utilization-management process that requires physicians to get approval before a prescribed treatment, test, or medical service can be provided to a patient. While this management tool can certainly be appropriate in some cases, it is often imposed for health care services that are usually approved, and often requires extraordinary amounts of time to navigate in order to ensure patients can receive the care they need. A recently released AMA survey reported that 91% of respondents said PAs resulted in notable delays in care; 87% reported that PAs interferes with continuity of care, while 83% reported that the number of PAs required has increased over the past five years.
The legislation has over 300 House cosponsors and is strongly supported by over 500 endorsing organizations representing patients, providers, and the medical technology and biopharmaceutical industry including the AMA and MSSNY.
MSSNY will continue to track this issue and provide updates as the bill moves forward.
Please Contact Your Members of Congress to Prevent Steep Cuts for 2023
Due to varying provisions expiring at the end of 2022, physicians face an over 8% cut in their Medicare payments for 2023 unless the United States Congress again acts to prevent these cuts. Therefore, physicians are urged to send a letter to their respective member of Congress. Physicians can use the AMA Grassroots Network to make this contact. Be Heard | Physicians Grassroots Network
Late last year, physician advocates from across the country united to successfully persuade Congress to delay a “perfect storm” of Medicare payment cuts totaling 10% that, if permitted to be implemented, would have severely impeded patient access to care.
It’s clear that Congress must work with the physician community to develop long-term solutions to the systemic problems with the Medicare physician payment system and preserve patient access by passing legislation. In the meantime, policymakers need to address the immediate problem.
Before the end of the year, we are asking Congress to:
- Extend the Congressionally enacted 3% temporary increase in the Medicare physician fee schedule
- Provide relief for an additional 1.5% budget neutrality cut that is planned for 2023
- End the statutory annual freeze and provide an inflation-based update for the coming year
- Waive the 4% PAYGO sequester necessitated by passage of legislation unrelated to Medicare
With members of Congress scheduled to return home for the August district work period, now is a great time to make these contacts. Again, you can send a letter from here: Be Heard | Physicians Grassroots Network
MSSNY Update on Harmful Liability Expansion
Why it is important to urge Governor Hochul to Sign Managed Care Reform Bills and Veto Harmful Liability Expansion? Listen Here.
Identifying and Submitting Formal Complaints to the Regulator
Have you exhausted your avenues with claim appeals, and now want to submit a formal complaint to the regulator? This tool will help you identify which regulator is the appropriate one to submit to. If you are a member of MSSNY please contact Heather if you need assistance with this.
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 email@example.com
Save the Date August 9th, 2022 CMS and NGS Open Agenda Meeting
Join Heather Lopez, MSSNY’s Director of Physician Payment & Practice, for the Center for Medicare & Medicaid Services and National Government Services’ open agenda meeting. Members are encouraged to participate and open a direct communication line with policymakers that otherwise can be difficult to reach.
“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 7:30 am. William Valenti, MD, chair of the 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 firstname.lastname@example.org 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.
Physician Payment and Practice
Since 2021, the Medical Society of the State of New York has secured millions in unpaid claims for our physicians from medical insurance providers. These victories have led to much financial relief for sole practitioners, and it is a vital service that we provide at MSSNY. We would like to formally introduce you to our Director of Physician Payment & Practice, Heather Lopez, who is essential in delivering these victories for our physicians. Heather comes to MSSNY after a long career in the St. Mary’s healthcare system, where she honed her practice management, billing, and reimbursement skills. Her expertise is available to you during her monthly member call, where you can voice your concerns and receive a consultation. Please reach out to Heather for her assistance in practice management, CPT/ICD10 coding, contract negotiation, billing, insurance barriers, and reimbursement methodology.
Physicians’ search services • allied medical placements • locum tenens • practice valuation • practice brokerage • practice consulting • real estate
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 email@example.com 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: RecruitmentStAlbans@nysvets.org
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 firstname.lastname@example.org.
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: melissaA@nestseekers.com 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
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 email@example.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 medicine under the guidance of dedicated medical leadership. www.rendrcare.com.