MSSNY eNews: May 18, 2022

MSSNY Continuing Push for Passage of Copay Accumulator Legislation by End of Legislative Session
Physicians are urged to contact (take action) their legislators to urge the passage of legislation (A.1741/S.5299) that would prohibit health insurers from preventing patients from using copay cards or coupons to help these patients meet their often enormous deductibles.

Importantly, the bill passed the New York State Assembly this afternoon, and is on floor of the Senate where hopefully it will be taken up next week. MSSNY has been working with several patient and physician advocacy groups to support this important legislation.  Read our joint press release here.

Last week, MSSNY President Dr. Joseph Sellers, MD, joined the bill sponsors and various patient advocacy groups urging action on this legislation before session ends on June 2nd.

Urge Your Legislators to Reject Untenable Measures to Drive Up Physician Liability Premiums by Over 40%
Physicians are urged to contact their legislators to request that they reject legislation (S.74-A/A.6770) that is strongly opposed by MSSNY, hospital associations, and numerous other groups. This legislation would create untenable increases in New York’s already excessive medical liability costs by greatly expanding the types of damages awardable in all wrongful death actions, including lawsuits against physicians. Please visit our Grassroots Action Center (GAC) to take action and let your legislators know to oppose this legislation. A letter and/or tweet can be sent from here: Don’t Chase Physicians out of NY! (

The bill has advanced to the Assembly floor and to the Senate Finance Committee.

One recent actuarial estimate indicated that passage of this legislation could require a liability premium increase of over 40%, which translates to tens of thousands of dollars in new costs for physicians, many of whom already pay tens or hundreds of thousands of dollars per year in their insurance costs. This could make it impossible for many physicians to stay in practice in New York.  Under ordinary circumstances, these kinds of increases would be unsustainable and could have huge negative consequences on patient access to care at community hospitals and physician offices.  However, with so many physician practices only beginning to recover from the huge drop in patient visits and revenue during the pandemic, legislation to impose such premium increases would be unconscionable. It could prompt significant disruptions in patient access to care.

While some advocates have claimed that New York’s existing wrongful death law is an outlier compared to other states, what they do not mention is that most of these other states also have comprehensive provisions to contain excessive medical liability insurance costs, including limits on damages.  New York has no such law, which is why our medical liability insurance and payout costs far exceed every other state in the country, making New York regularly ranked as one of the worst states in the country to be a physician. Best & Worst States for Doctors ( & Worst States for Doctors (

Please let your legislators know that comprehensive legislation is needed to bring down New York’s excessively high medical liability premiums, which far exceed every other state in the country, instead of stand-alone bills that would drive up these costs.


Are You Having Issues with Empire/Anthem Claims?
Have you found yourself having issues specific to claims? Please see below information from Empire/Anthem to ensure you have the most up-to-date information regarding how to escalate your concerns in the proper order.

Did you know?

Provider Relations is not the first point of contact for billing/claims issues and cannot accept inquiries that have not first gone through the following escalation process: Claims and billing inquiries must be processed in the Provider Services Call Center per the numbers indicated above. (Note that you should allow 30-45 days for resolution/response.)

If the Call Center Representative does not sufficiently address your issue, please request to speak to a supervisor or manager. If the manager cannot assist you immediately, you will receive a call-back within two business days, excluding holidays and weekends. If the manager’s response does not resolve the issue, you may escalate your concerns and fill out a web form to the Provider Experience Team link below. You must include the inquiry number/reference number, Provider Services response, name of the manager/supervisor you spoke with, member name, ID and prefix, DOS, claim number, and details on the issue to Provider Experience.

For more complex matters, contracted medical providers should email the Provider Experience Team and complete the Provider Maintenance form. A representative will be assigned to you and will make contact within 48 hours.

Log in or register for Availity here. Availity can be used to verify member benefits and eligibility, accept claims, view claims status, and submit and view prior authorization requests. You can also live chat with a representative in Availity. Login to the Availity Portal and select Anthem from the payer spaces drop-down menu. Then select Chat with Payer and complete the pre-chat form to start your chat.

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 |

Numerous Physician Mandate Bills Under Consideration in the Final Weeks of Session
As we head into the final 2 weeks of the legislative session, physicians are urged to contact their legislators (Oppose Mandates ( to request that they reject the array of bills under active consideration in the Senate and Assembly that would impose requirements on physicians delivering care to their patients.

MSSNY has been working together with numerous affected specialty societies (Letter) to highlight their collective concerns that, while each of these proposals may have good intentions, in totality they are creating significant new documentation requirements that place the physician’s licensure in jeopardy if there is an instance where they fail to document that they completed a task.

Despite expressed concerns from MSSNY and various specialty societies, one of these objectionable bills (S.2521-C/A.3470-C) passed both Houses this week to require enhanced disclosure by hospitals and other health care providers to patients of facility fees not covered by insurance, including requiring employed health care providers to disclose in advance if their employer health system is charging a facility fee. While MSSNY and several specialty societies have strongly objected to the aspect of the legislation to require an employee to disclose fees charged by their employer, the C-print of this legislation was a significant improvement over an earlier, untenable, version which would have required physicians and hospitals to jointly bill.

Some of the remaining mandate bills under consideration include:

  • S.213/A.1615 – Requires physicians to obtain the school attended by their pediatric patients.
  • S.2103-B/A.5841-B – Requires physicians to obtain a detailed patient/family member consent for a nursing home resident prior to the receipt of a psychotropic medication, or detailed documentation of the need to provide such medication without consent.
  • S.2736/A.217 – Requires physicians and other maternal care providers to provide information to pregnant patients regarding the risks of a caesarean section to patients scheduled to have a C-section.
  • S.4640/A.273 – Requires physicians and other care providers to document that they considered and discussed numerous alternatives to opioid treatment prior to writing an opioid prescription for a patient.
  • S.6287-B/A.7560-A – Requires OB-GYNs to provide information to their pregnant patients regarding the risks of cytomegalovirus (CMV).
  • S.7865/A.5976-A – Requires physicians and other maternal care providers providing pre- and post-natal care or pediatric care to invite the mother to fill out a questionnaire to detect maternal depression.
  • S.8455/A.9380 – Requires physicians and other maternal care providers to provide information to patients about the potential consequences of an episiotomy.

Please remain alert for further updates on these issues.

CMS-1500 Form: Important Reminders for Physicians
Are you ready for the July 1, 2022CMS-1500 form implementation? The Workers’ Compensation Board (Board) is transitioning to the CMS-1500 form, which will streamline the medical billing process and reduce the paperwork requirements in the workers’ compensation system. The more straightforward billing process will require health care providers to use the CMS-1500 form for all workers’ compensation medical billing, including the medical narrative attachment of the injured worker’s temporary impairment percentage, work status, and the casual relationship of the injury. The report is at risk of being legally defective if you do not prominently include the medical narrative. You will not receive payment, and you will be leaving the injured worker unable to receive benefits and treatment. To ensure forms are submitted promptly, it is encouraged to use an XML submission partner.

Bills for ancillary services such as radiology, anesthesiology, or surgery have unique attachment requirements.

You must first sign up for the medical portal to register for XML Submissions. You must then apply for electronic submission of medical bills to payers and the Board. Now discuss the submission details with an approved XML submission partner. Begin reaping the benefits of quicker payments, confirmation of invoices within seven days, and submission assistance.

On July 1, 2022, the following forms will be discontinued:

  • Doctor’s Initial Report (Form C-4, Form EC-4)
  • Continuation to Carrier/Employer Billing Section (Form C-4.1)
  • Doctor’s Progress Report (Form C-4.2, Form EC-4.2)
  • Ancillary Medical Report (Form C-4AMR, Form EC-4AMR)
  • Doctor’s Narrative Report (Form EC-4NARR)
  • Occupational/Physical Therapist’s Report (Form OT/PT-4, Form EOT/PT-4)
  • Psychologists Report (Form PS-4)
  • Ophthalmologist’s Report (Form C-5)

Pursuant to 12 NYCRR 325-1.25(b)(1), effective July 1, 2022, bills submitted on any of the above forms shall not be eligible for an award issued through the medical dispute process under the provisions of the Workers’ Compensation Law.

For more information, please visit the Board’s website or email For clinical feedback and questions, email

New York State Department of Health Updated COVID-19 Advisory
New York State Department of Health (NYSDOH) updated its advisory on the infection prevention and control recommendations that all healthcare settings in New York should follow during the COVID-19 pandemic. Except for when alternate NYSDOH guidance is available, NYSDOH recommends that all healthcare settings adhere to the infection prevention and control guidance issued by the Centers for Disease Control and Prevention (CDC) in Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic.

Healthcare facility personnel are advised to regularly and frequently review the NYSDOH website, the New York State Health Commerce System, the CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic and, for nursing homes, the Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes for updates to NYS and CDC guidance.

General questions or comments about this advisory can be sent to:,, or

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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: 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 medicineunder 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

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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