MSSNY eNews: October 6, 2021
Calling Exceptional Women Physicians!
MSSNY’s Medical, Educational and Scientific Foundation (MESF) is holding leadership seminars for women on three Saturday mornings in October that cover various topics, including women physicians and their legislative impact featuring NYS Senate Majority Leader Andrea Stewart Cousins and Assemblywoman Patricia Fahy; how CEOs and medical administrators deal with women physicians; and wellness and women physicians.
Jon Chilingerian, PhD is the facilitator for the virtual series, which will be split into three segments on October 16, 23 & 30 beginning at 8 a.m. Case studies and other resource materials will be sent to registrants. The program is open to all women physicians, including residents, and medical students. Following is more specific information on each of the three segments:
Saturday, October 16 (8 am-11:30 am): “Albany, Women Physicians and Their Legislative Impact.” This session will include presentations by Patricia Clancy, MSSNY’s Senior Vice President/ Managing Director of Public Health and Education; Bonnie Litvack MD, MSSNY Past President, Chair of MESF; and NYS Senate Majority Leader Andrea Stewart Cousins and Assemblywoman Patricia Fahy.
Saturday, October 23 (8 am-11:30 a.m): “How Do CEOs and Medical Administrators Deal with Women Physicians?” This segment focuses on a presentation by Jon Chilingerian PhD on effective clinical leadership for women physicians. Dr. Jody Gittel’s presentation will cover what women physicians need to know to effectively operate in a male-dominated health care world. M. Monica Sweeney, MD, MPH, FACP and Palma Shaw, MD, FACS, RPVI will share their experiences in a male-dominated health care world.
Saturday, October 30 at (8 am-11:30 am): “Wellness and Women Physicians.” This segment focuses on the challenges women physicians face as they advance in their medical education or medical practice—while faced with family and other life stressors. Stress and burnout, which impacts women with greater frequency and severity, will be discussed in this segment. It will include a presentation by Jo Shapiro MD of Brigham and Women’s Hospital who will focus on peer-to-peer relations. Carol Bernstein MD from Einstein School of Medicine will talk about gender differences in burnout. In addition, Frank Dowling, MD will review his experience with MSSNY’s peer-to-peer (P2P) program and the importance of women reaching out to a peer to discuss those life stressors.
Female physicians, residents or medical students are encouraged to register for this event by sending an email to Pat Clancy at firstname.lastname@example.org or by calling her at 518-465-8085. Please provide your name and contact information to her by October 8, 2021.
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 9.0 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physician Advocacy Urged to Pushback Against HHS’ Insurer-Biased Interpretation of No Surprises Act
Physicians are urged to contact Senators Schumer and Gillibrand as well as their respective Representative in Congress to ask that they request that the US Department of Health and Human Services (HHS) revise its recently announced regulations to implement provisions of the “No Surprises Act”, establishing a federal independent dispute resolution (IDR) process for out of network surprise bills. A letter or tweet can be sent using this link: Urge Congress to Urge HHS to Revise Independent Dispute Resolution Regulations
Physician and hospital groups across the country have uniformly criticized the HHS regulations as a gross deviation from the law passed by Congress last December. The Congressional intent articulated in the No Surprises Act was to create an IDR process to protect patients that was appropriately balanced and did not favor either the insurer or the physician in claims disputes. Specifically, the final language adopted by Congress required the arbiter to consider numerous factors, including patient acuity or complexity of services, demonstrations of previous good faith efforts to negotiate in-network rates and previously contracted rates, in addition to the insurers’ median in-network rate, without specifying that one factor take precedence over another.
However, instead of following the statutory language, HHS and other federal agencies designed an IDR process that heavily favors health insurance companies in payment disputes. The language in the rule directs the IDR arbiter to give priority to the insurer-calculated median in-network amount, called the qualifying payment amount (QPA), over the other considerations noted above. It also imposes a number of requirements on the arbiter if they decide to make a decision that deviates from the insurer-determined QPA. This effectively ties the hands of the arbiter.
In a statement released to the press last week, MSSNY President Dr. Joseph Sellers said that “In implementing the Independent Dispute Resolution (IDR) process for resolving patient surprise medical bills – a process that New York physicians has strongly supported for many years – HHS has clearly sought to put its thumb on the scale in favor of multi-billion-dollar insurance companies.”
AMA President Dr. Gerald Harmon noted “The interim final regulation issued late yesterday to implement the No Surprises Act ignores congressional intent and flies in the face of the Biden Administration’s stated concerns about consolidation in the health care marketplace. It disregards the insurance industry’s role in creating the problem of surprise billing at the expense of independent physician practices whose ability to negotiate provider network contracts continues to erode.”
With the law scheduled to take effect January 1, 2022, MSSNY intends to work with the AMA and other allied groups to advocate for needed changes to the regulation to ensure that the IDR process is implemented in a way that better achieves balance in the IDR process, to protect care availability in hospital emergency departments. Again, a letter can be sent from here: Urge Congress to Urge HHS to Revise Independent Dispute Resolution Regulations
NYS Department of Financial Services Issues Report and Recommendations to Reduce Health Care Costs & Simplify New York’s Complex Healthcare System:
MSSNY Part of Broad-Based Group of Stakeholders Appointed to Take Deep Dive into the Issues
After a year-long project working with a broad-based group of stakeholders known as the Health Care Administrative Simplification Workgroup which included MSSNY, the New York Medical Group Management Association (NYMGMA), the New York Health Plan Association, the Greater New York Hospital Association, the Healthcare Association of New York State (HANYS), Medicaid Matters, and a host of others, the New York State Department of Financial Services (DFS) delivered a report to the New York State Legislature with 25 recommendations to reduce health care costs and complexities for the benefit of patients, providers, and health insurers. The Workgroup was created by statute in 2020 to study, evaluate and make recommendations about how to address these important issues.
Administrative costs are estimated to be as much as 30% of total health care costs. The Workgroup recommended solutions to address administrative inefficiencies and reduce costs for the benefit of all health care stakeholders, including most importantly patients. The recommendations contained a number of targeted steps recommended by MSSNY. While they do not alleviate the need for comprehensive legislation to address unnecessary and excessive administrative burdens imposed by health insurers, if implemented as intended it could help to somewhat reduce these hassles.
Among the recommendations included in the report:
- Simplify Prior Authorization Health plans should clearly identify services that require prior authorization and annually review these services to identify where prior authorization and repeat prior authorizations can be removed. Reducing these requirements helps patients gain quicker access to necessary care.
- Simplify Credentialing To expedite credentialing decisions, Health plans should use uniform credentialing applications including standardizing additional information requested and implement online portals or telephone hotlines for providers to obtain meaningful information on the status of their applications.
- Encourage Electronic Claims Submission Providers should submit claims electronically, where possible, instead of by paper or facsimile, and health plans should accept claims that are submitted electronically, as well as accept medical record documentation through their portals.
- Make Clinical Review Criteria More Transparent Health plans should post their clinical review criteria on their websites and make them available within five days of a request. This easy access to clinical review criteria allows patients to be better informed about when care is covered for specific health conditions. Health plans should 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.
- Standardize Financial Assistance & Other Forms Hospitals should be required to use a uniform, standard financial assistance form, with standard eligibility criteria, for patients to apply for financial assistance with hospital bills. The form should be easily accessible and publicly available on each hospital’s website, DOH’s website, and translated into languages other than English. These efforts will make it easier to apply for financial assistance with hospital bills. Health plans should also use a standard form for policyholders to designate an authorized representative and the form should be accepted by all health plans, making it easier for patients to obtain assistance in dealing with their health plan.
- Encourage Access to Electronic Medical Records Health plans and providers should continue to discuss a path forward for providing access to electronic medical records and options to streamline the exchange of medical records.
MSSNY will continue to work with DFS and DOH, as well as the other stakeholders to this workgroup, to ensure that these recommended steps are being implemented by health insurers and update membership on new developments and changes.
New Application Cycle for $25.5 Billion in COVID-19 Provider Funding
The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), has announced a new application cycle for $25.5 billion in COVID-19 provider funding (Phase 4). The application for the funds is open now, and will close on October 26, 2021 at 11:59 p.m. ET. Applicants will be able to apply for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments during the application process. In order to streamline the application process and minimize administrative burdens, providers will apply for both programs in a single application.
PRF Phase 4 is open to a broad range of providers with changes in operating revenues and expenses. ARP Rural is specifically available to providers who serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). See a detailed list of eligible provider types here.
HHS recently hosted a briefing session to provide information about these upcoming funding opportunities – view the video here. HRSA will also host webinar sessions featuring guidance on how to navigate the application portal.
- Wednesday, October 13, 3:00 – 4:00 p.m. ET – register to attend
- Thursday, October 21, 3:00 – 4:00 p.m. ET – register to attend
Real time technical assistance is available by calling the Provider Support Line at (866) 569-3522, for TTY dial 711. Hours of operation are 8 a.m. to 10 p.m. CT, Monday through Friday.
NYACP Encourages Medical Students to Participate in Annual Meeting on October 8 and Offers Free ACP Membership to Medical Students
The NYACP Annual Scientific Meeting on Friday, October 8 from 8 am – 4 pm will be online once again as COVID-19 and its variants continue to be a threat to members and colleagues. This year’s agenda will highlight challenges members faced over the past year, along with exciting cutting edge breakout sessions. Click here for more information about the October 8 NYACP Annual Scientific Meeting
- All medical students are welcome to apply for free ACP Membership–join here!
- Medical Students are welcome to attend the NYACP Annual Scientific Meeting and can register for free here.
Medicine and Inclusivity: Instilling Pride in LGBTQ+ Patients and Colleagues Webinar Sponsored by Nassau County Medical Society
Title: Medicine and Inclusivity: Instilling Pride in LGBTQ+ Patients and Colleagues
Speaker: David Rosenthal, DO, PhD, Medical Director, Northwell Health, Physician Partners, LGBTQ Transgender Program
This is an educational opportunity to learn about the ongoing issues that the LGBTQ+ community faces and strive toward positive change to create safe, supporting spaces for LGBTQ+ patients, med school students, and doctors. In the spirit of community outreach, the goal is to teach those in attendance more about the importance of kindness, acceptance, and respect as they navigate their medical careers and leave well-informed on the support and resources that they can share with those they know who might be struggling.
Date: October 26, 2021
Time: 6-7 PM
Registration link: https://us02web.zoom.us/webinar/register/WN_y7daTJyIQ4WieGNDZ-ZgQw
MSSNY Member Dr. Barry B. Perlman Takes Readers on a 50-Year Personal and Historical Tour of Psychiatry in New Memoir
In Rearview: A Psychiatrist Reflects on Practice and Advocacy in a Time of Healthcare System Change, Dr. Barry B. Perlman offers an overview of his career in medicine. From his first inklings of interest in mental health issues tied to his grandmother’s bouts of severe depression and his mother’s volunteer work with persons discharged from psychiatric hospitals, through closing his practice and retirement, Perlman recounts the entire arc of his psychiatric and medical career in a series of thoughtful, conversational, personal reminiscences. He also covers topics central to the practice of psychiatry, such as suicide, violence, poverty, and electroconvulsive therapy.
Dr. Perlman served as president of the New York State Psychiatric Association, was appointed Chair of the NYS Mental Health Services Council by Governor George Pataki, and served as a member of the State Hospital Review and Planning Council. Based on his participation, he describes the process and tensions involved in shaping public policy.
Readers will be taken on a tour of the multidimensional life of an activist psychiatrist whose professional life encompassed provision of direct clinical care, running a psychiatric department under challenging circumstances, and trying to improve the lives of New Yorkers living with serious mental illness.
NYSDOH Approves Cultural Competence Training Offered by HHS
The New York State Department of Health (DOH) has approved cultural competence training offered by the United States Department of Health and Human Services (HHS), Office of Minority Health education program, Think Cultural Health. With the implementation of this training, MMCP participating providers will be positioned to provide more effective and culturally competent care delivery to enrollees and decrease health disparities. The memo can be found here.
Statewide Health Care Facility Transformation Program III Funds Available
On September 30, 2021, the New York State Department of Health announced the availability of funds under the Statewide Health Care Facility Transformation Program III, established pursuant to Section 2825-f of the Public Health Law.
A total of up to $208,294,869 is available through this Request for Applications (RFA #18406) to health care providers to facilitate health care transformation activities (including merger, consolidation, acquisition or other activities) intended to (a) create financially sustainable systems of care; (b) preserve or expand essential health care services; (c) modernize obsolete facility physical plants and infrastructure; (d) foster participation in alternative payment arrangements; (e) for residential health care facilities, increase the quality of resident care or experience; or (f) improve health information technology infrastructure, including telehealth, to strengthen the health care continuum.
Eligible Applicants include general hospitals, designated Regional Perinatal Centers, residential care facilities, adult care facilities, assisted living programs and children’s residential treatment facilities, as well as community-based health care providers. A minimum of $529,611 of the total amount must be awarded to community-based health care providers, which are defined as diagnostic and treatment centers, mental health and alcohol and substance abuse treatment clinics, Article 16 clinics, home care providers, hospices, and primary care providers. In addition, a minimum of $23,138,160 must be awarded to residential health care facilities, and up to $5,000,000 of the total awarded funds may be made available to Regional Perinatal Centers to establish telehealth applications.
The Statewide Health Care Facility Transformation Program III RFA can be accessed through the New York State Department of Health website at http://www.health.ny.gov/funding/, or through the Grants Gateway website at http://grantsreform.ny.gov. Applications must be submitted in Grants Gateway by 4:00 PM EST on Wednesday, January 12, 2022.
Questions regarding the Statewide Health Care Facility Transformation Program III (RFA #18406) can be e-mailed by Thursday, October 28, 2021 to Statewide3@health.ny.gov.
An informational Applicant Webinar will be held on Thursday, October 14, 2021 at 3:00 PM. To register for the meeting, go here..
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Health Research, Inc. (HRI) has a job opening within the AIDS Institute’s Office of the Medical Director for a Public Health Physician II. Please distribute this announcement widely through your networks. Interested individuals can apply for this position through the HRI website.