MSSNY eNews: September 24, 2021 – MSSNY Passes Resolution on Mandatory Vaccines and Masking
MSSNY Passes Resolution on Mandatory Vaccines and Masking
I am often amazed and energized by the wisdom, the thoughtfulness, and the focused attention to both the science and the art of medicine on the part of my MSSNY colleagues whenever we meet. All those qualities were on full display both last weekend at our virtual House of Delegates meeting and again at yesterday’s Council meeting.
Yesterday’s Council meeting, for example, included a robust discussion about COVID vaccinations. As the COVID pandemic continues to pose a major threat to the health of the public, MSSNY Council passed a resolution that calls for MSSNY to advocate for mandatory COVID-19 vaccination among all healthcare workers and support staff who regularly interface with the public. In addition, MSSNY will advocate for mandatory COVID-19 vaccination among all school-aged children, once the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) confirm the safety and efficacy of the COVID-19 vaccines in the pediatric population.
And, finally, MSSNY will advocate for mandatory facial masking among all healthcare workers and support staff who regularly interface with the public, as well as all students, teachers, and administrative and support personnel in all primary, secondary, and postsecondary educational facilities in New York State for the duration of the COVID-19 pandemic and based upon the recommendations of the CDC and/or the New York State Department of Health.
And, as always, we must continue to get the message out that when there are questions or feelings of uncertainty, patients should turn to us—their trusted physicians—to guide them.
Joseph Sellers, MD, FAAP, FACP
Highlights of the 2021 House of Delegates
The House of Delegates meeting held last Saturday was very successful. Despite the necessity to be held virtually, the discussion and debate was vigorous and productive.
The results of the election of New York Delegates to the AMA, which were announced late on Saturday, are posted to the MSSNY HOD pages. Congratulations to all those elected for the term January 2022 through December 2023!
Actions of the House, which detail the actions for each resolution considered by the House, have been posted to the MSSNY website.
Following are some highlights:
Support Physicians Providing Gender Affirming Care for Youth
MSSNY supports physicians in New York who provide gender-affirming care to people including transgender and non-binary youth and opposes the criminalization of providing gender-affirming care for youth.
We’re Mad as Hell and We Aren’t Going to Take it Anymore
MSSNY will aggressively work with county and special medical societies across the State to collect examples of health insurers inappropriately denying payment for care, inappropriately delaying patient access to needed treatment and abusive audit practices for redress by the New York State Department of Financial Services and New York State Department of Health. MSSNY will educate physicians regarding strategies to assist in collecting examples for review by state oversight agencies, such as use of relevant ICD-10 codes that identify in the electronic medical record when patients have difficulty accessing care due to inappropriate denials.
Enforcement of Administrative Simplification Requirements – CMS
MSSNY takes the position that the AMA must advocate (1) that there is parity in the enforcement of the HIPAA Privacy Rule and HIPAA Administrative Simplification requirements; (2) that the CMS imposes penalties on health plan violations of HIPAA with the same rigor it imposes penalties on healthcare providers for violations of MIPS and other requirements and that the AMA must advocate that the CMS investigates all valid allegations of HIPAA Administrative simplification requirements thoroughly and offer transparently in its processes and decisions as required by the Administrative Procedure Act (APA). MSSNY also takes the position that the AMA must advocate that the CMS resolves all complaints related to the non-compliant payment methods including opt-out virtual credit cards and illegal EFT fees and MSSNY strongly disapproves of the failure by the CMS Office of Burden Reduction to effectively enforce the HIPAA administrative simplification requirements as required by the law and its failure to impose financial penalties for non-compliance by health plans.
15 Month Prescribing
MSSNY will advocate for changes to New York State insurance and Medicaid laws that would allow physicians, at their discretion and based on patient compliance, to prescribe non-controlled substances for 15 months.
Require Methadone Dispenser to Report to I STOP – PMP
MSSNY will seek legislative or other regulatory interventions to require the reporting of methadone into the state’s Prescription Monitoring Program (PMP) and will support requiring the interconnectivity between the state PMP and methadone clinics.
September 11th as a MSSNY Day of Observance
In order to acknowledge our special relationship to what happened on September 11, 2001 to New Yorkers, to our nation, to New York physicians and to our first responders, and to honor and remember those who died and those whose health and well-being have been affected by this terrible incident, MSSNY will recognize and support September 11th as an annual MSSNY day of observance. MSSNY will urge the AMA to recognize September 11th as an annual day of observance.
Site of Service Availability
MSSNY will continue to advocate to reduce health insurer pre-authorization burdens, including eliminating pre-authorization requirements and restrictions based on site of service.
Medicare Advantage Plan Mandates
MSSNY will urge the AMA to advocate for federal legislation to ensure that no person should be mandated to change from traditional Medicare to Medicare Advantage (MA) plans.
Insurance Coverage for Scalp Cooling (Cold Cap) Therapy
MSSNY will seek by legislation and/or regulation, universal insurance coverage for Scalp Cooling (Cold Cap) Therapy and will work with consumer groups to challenge insurers on Scalp Cooling (Cold Cap) Therapy medical necessity denials and encourage appeals to independent third-party reviewers and send a similar resolution to the AMA.
CPT Denials/Service/Preauthorization Denials and Prior Authorization – CPT Codes for Fair Compensation
MSSNY will advocate that the AMA will include fair compensation based on CPT codes for appeal of wrongfully denied services in any Model Legislation and as a basis for all advocacy, including those for Prior Authorization reforms and that CPT codes must fully reflect the aggregated time and effort expended by physician practices. MSSNY will urge the AMA to establish a CPT code by the AMA CPT® Editorial Panel to account for administrative work involved in prior authorizations that reflects the actual time expended by physician practices to advocate on behalf of patients and to comply with insurer requirements and urge the AMA to establish a CPT Code by the AMA CPT® Editorial Panel to account for administrative work that reflects the actual time expended by physician practices and their billing vendors involved in successfully appealing wrongful pre-and post-service denials.
Payment for Physicians’ Work: Appealing Insurance Company Denials for Payment
MSSNY will, by legislation or regulation, seek payment for physicians’ time and effort involved in preparing appeals for reversal of denials of payment for medical care, procedures, and medications by insurers and other third-party payers on behalf of their patients.
MSSNY Statement Regarding Resignation of Department of Health Commissioner Howard Zucker, MD
Following is MSSNY President Dr. Joseph Sellers’ statement regarding Dr. Zucker’s resignation:
“MSSNY is grateful to Dr. Zucker for his many years of service as he worked to protect the residents of New York State, especially as he helped to lead the State’s response to the COVID-19 pandemic—one of the most challenging public health threats of our lifetimes. We look forward to continuing to work collaboratively with the Department of Health staff to promote vaccination in response to the ongoing pandemic, and in addressing additional public health threats.”
Crain’s New York Business (9/24) reports that in a statement, Medical Society of the State of New York President Dr. Joseph Sellers said, “We look forward to continuing to work collaboratively with the Department of Health staff to promote vaccination in response to the ongoing pandemic and in addressing additional public health threats.”
CDC Director Overrules Advisory Panel to Broaden Recommended Use of Pfizer-BioNTech COVID-19 Vaccine Booster Shots for Frontline Workers
The New York Times (9/23, Mandavilli, Mueller) reports that on Friday, CDC Director Dr. Rochelle Walensky “overruled a recommendation by an agency advisory panel that had refused to endorse booster shots of the Pfizer-BioNTech Covid vaccine for frontline workers.” The CDC’s Advisory Committee on Immunization Practices had “recommended the boosters for a wide range of Americans, including tens of millions of older adults and younger people at high risk for the disease. But they excluded health care workers, teachers and others whose jobs put them at risk.”
Dr. Sellers Answers Viewers Questions About COVID-19 Vaccine
On Cheddar News, MSSNY president Joseph Sellers, MD answered viewer questions surrounding Pfizer and BioNTech’s announcement that the data from the trial of their vaccine in children ages five to 11 showed the vaccine is safe and generates a “robust” response, along with other general questions.
NYS Department of Financial Services (DFS) Proposes Permanent Regulations for Audio-Only Telehealth Coverage
The New York State Department of Financial Services (DFS) released proposed regulations on Wednesday, September 22nd to make permanent existing temporary regulations that require health insurers to cover audio-only Telehealth services for care to patients. DFS had previously promulgated a 90-day emergency regulation to require coverage for audio-only Telehealth services, but that temporary regulation expires in October.
The proposed regulation would also permit an insurer to “engage in reasonable fraud, waste and abuse detection efforts, including to prevent payments for services that do not warrant separate reimbursement”.
Please note that last year a statute was enacted that requires Medicaid to cover audio-only Telehealth. The New York State Department of Health (DOH) issued a guidance document, this summer, for how Medicaid will continue to cover Telehealth services, including audio-only services.
There is a 60-day comment period that, ends on November 21st, and MSSNY is reviewing the proposal and will issue comments, if needed. To view the proposed permanent regulations, please go to: Proposed 62nd Amendment to Insurance Regulation 62 (11 NYCRR 52)
MSSNY’s Medical, Educational and Scientific Foundation (MESF) Seeks Nomination for Women’s Leadership Conference
MSSNY’s Medical, Education and Science Foundation (MESF), is seeking women physicians to attend the MESF Leadership Seminars for Women. Self-nominations are welcomed. This program will be a virtual format and will be split into three segments with Jon Chilingerian, PhD acting as facilitator for the series. The three segments are slated for October 16, 23 & 30 beginning at 8 a.m. Additional information will be provided to those that are nominated with a link to materials.
This program is open to all women physicians, including residents and medical students. The program is as follows:
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 The Honorable Deborah Glick of the NYS Assembly.
Saturday, October 23 (8 am-11:30 am): “How Do CEO’s and Medical Administrators Deal with Women Physicians?” This segment will focus on a presentation by Jon Chilingerian PhD on effective clinical leadership for women physicians while Dr. Gittel’s presentation will key to what women physicians need to know to effectively operate in a male dominated health care world. In addition, this segment will include a presentation by Linda Clark MD, Chair of MSSNY’s Health Equity Committee who will focus on diversity in the medical field and issues facing physicians of color.
Saturday, October 30 at (8 am-11:30 am): “Wellness and Women Physicians.” This segment will focus on the challenges women physicians face 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. This segment 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.
Please consider nominating a female physician, resident, or medical student who you believe would benefit from attending this exciting, educational MESF leadership seminar. Self-nominations are acceptable. Nominations can be sent to: Pat Clancy at email@example.com or by calling her at 518-465-8085. Please provide your nomination and contact information for them to me by October 4, 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. Physician should only claim credit commensurate with the extent of their participation in the activity.
Happy Women in Medicine Month to MSSNY’s Women Physicians!
Calling all Medical School Students! Join MSSNY’s Medical Student Section Meeting on October 2
Save the Date! The MSSNY Medical Student Section meeting has been scheduled for Saturday October 2nd at 9 am. The meeting will once again be held virtually via Zoom. Please invite your fellow students and encourage them to attend to learn more about MSSNY and the Medical Student Section. The event will include guest speakers MSSNY President Joseph Sellers, M.D. and MSSNY Secretary and member of the AMA Advisory Committee on LGBTQ Issues Frank Dowling, M.D.
Elections will be held for student delegates to the MSSNY House of Delegates. Click here for more information about this role.
Guidance on How to Request a Supply of COVID-19 Monoclonal Antibody (mAb) Therapeutics
The NYS DOH released updated details on how New York State (NYS) providers can submit requests for a supply of monoclonal antibody (mAb) therapeutics. At this time, only providers who have an active account from AmerisourceBergen can submit a request. Click here to read the detailed announcement.
The NYS DOH has launched an online form to intake requests for supplies of monoclonal (Ab) therapeutics from New York State providers. The mAb products affected are bamlanivimab/etesevimab, etesevimab (to pair with bamlanivimab already on hand), and casirivimab/imdevimab (REGEN-COV). Information on how to request mAb products, including how to complete the online form, can be found in the attached guidance. For questions, please email: COVID19therapeutics@health.ny.gov.
Top Ten Reasons to Get Vaccinated Against COVID-19
The NYS Department of Health has produced a flyer in both English and Spanish that highlights ten reasons to get vaccinated against COVID-19. Click here to download the flyer to post in your office.
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