MSSNYeNews: January 8, 2021 – 2021: Ready for a New Chapter


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Colleagues:

Happy New Year to all.  I think we are all relieved that 2020 and all its bad karma is behind us.  The New Year is starting with some positive updates about expansion of vaccine eligibility and a new money-saving MSSNY benefit.

COVID-19 Vaccine Updates

The New Year started off with the right sentiment in this regard when on 1/4/2021 all community physicians and their patient facing office staff were added to the 1a list of those authorized to receive the COVID-19 vaccine. View information on how to get the COVID-19 vaccine.

We share the goal of the Governor and the DOH of getting as many vaccines into arms as quickly as possible. We need to reach herd immunity to get back to some semblance of normal—and that requires 70-90% of the population to be vaccinated. Time wasted = lives lost.  Hospitalization rates are increasing, the UK strain that spreads more quickly is in NY, staff shortages are appearing, and we want to avoid another shutdown of elective surgery and a shutdown of our economy. Time is of the essence!

We are aware that implementation of the vaccine roll-out has been bumpy, and we have been in constant communication and partnership with DOH to right the ship.   MSSNY has made DOH aware of the IT website issues, communication problems concerning pop-up sites and issues identifying locations with availability—and DOH has responded.  Please make sure you are checking your MSSNY communications frequently as MSSNY is sharing all communications concerning vaccine and availability with our county societies, sending direct email communication to our physicians, and is posting the information on our website and on social media in an effort to get the information to physicians in real time.

Currently we are still in the 1a phase of vaccination and after 3 weeks of vaccinations, 1 million New Yorkers in the 1a category have yet to be offered their first dose.  The speed of vaccination must increase.  The next category 1b (Those >75yo and essential workers) includes 3 million New Yorkers.  To speed up vaccination we need to add significant additional capacity – our Community Physician Practice Distributors who are ready, willing, and able experienced vaccinators!

Volunteers Needed 

We will also need all hands-on deck and to that end MSSNY is encouraging all physicians, residents, students, and retired physicians to volunteer to provide COVID-19 immunizations through ServNY.  ServNY is a volunteer management system, administered by the department’s Office of Health Emergency Preparedness (OHEP) that was established after 9/11.  It is a web-based registry of individuals willing to assist on behalf of New York State during an emergency. When volunteers are needed, they are automatically notified via phone or e-mail with the information necessary for a volunteer to determine if they are ready and available for the assignment.  Physicians would most likely be contacted by their local Department of Health, the regional hospital hub, or by the county’s Medical Reserve Corp.  Sign–up through ServNY provides liability protections for physicians and other health care providers during their service to the NYS.  The sign-up is through the NYS health Commerce site.

NYS Department of Health has two numbers for assistance:

  • 1-866-529-1890, option 1 to assist with the Heath Commerce System
  • ServNY at 1-518-408-5163

Savings for Your Practice And/Or Yourself: Group Purchasing

MSSNY is now offering a GPO benefit for MSSNY members through Premier Inc., one of the largest group purchasing companies. There are no fees and no minimums, just savings for you and your practice, which in most cases will more than cover the cost of MSSNY membership. Premier offers a portfolio featuring over 900 suppliers and 2,000 products and services, including numerous PPE products! See our website www.mssny.org, contact MSSNY-Premier@premierinc.com or call (888) 258-3273.

I am hopeful that the challenges of 2020 will give way to a stronger, more cohesive profession and a new chapter of engagement in organized medicine leading to a healthier New York and a stronger profession.

Bonnie Litvack, MD
MSSNY President


Capital Update

MSSNY Weekly Podcast


Notes from Governor Cuomo’s Briefing:
COVID:
– Day 314
– Statewide positivity rate without micro-clusters: 7.49%
– Statewide rate with micro-clusters: 7.7%
– Micro-cluster rate: 8.3%
– 243,0000 tests conducted
– 161 deaths
– 8,561 hospitalizations, up 13
– 1,475 ICU patients, up 51
– 912 intubations, up 53

Hospitalizations by Region:
– Finger Lakes: 905 (0.08%)
– Western NY: 530 (0.04%)
– Southern Tier: 212 (0.03%)
– Mid Hudson: 980 (0.04%)
– NYC: 3,066 (0.04%)
– Long Island: 1,552 (0.05%)
– Central NY: 374 (0.05%)
– Mohawk Valley: 321 (0.07%)
– Capital Region: 515 (0.05%)
– North Country: 106 (0.03%)

Positivity by Region:
– Finger Lakes: 10.22%
– Western NY: 8.61%
– Southern Tier: 5.30%
– Mid Hudson: 8.12%
– NYC: 6.42%
– Long Island: 9.68%
– Central NY: 8.57%
– Mohawk Valley: 10.80%
– Capital Region: 10.16%
– North Country: 8.45%
– Manhattan: 4.45%
– Staten Island: 7.84%
– Brooklyn: 6.70%
– Queens: 7.49%
– Bronx: 8.21%

Vaccine:
– Gov. cautioned “frightening infection rate” of new strain, combined with
low supply of the vaccine can still cause stress on the hospital system
– State is concerned about low vaccination rate for healthcare workers,
particularly in New York City, which is currently at 13%
Private providers, ambulatory centers, pharmacies, county health departments
will begin being utilized next week

– On Monday, reservations for vaccinations will be accepted, the state will have a
website to sign up
– Healthcare workers must continue to be prioritized, but the next tier (1b)
will be eligible as well
– NYSDOH will hold a webinar on Monday for new providers, county DOHs
– State will allocate to distribution network proportionately by population
of each group and region
– State will be mandating social equity distribution by local health departments
Gov. signing an EO making additional staff eligible to administer vaccinations
DOH is setting up 20 “mass distribution sites” in the coming weeks: Javits Center
will be open next Wednesday

– Gov. noted at the current rate, the first two tiers (1a) and (1b) will not be
completed until mid-April

Federal:
– Gov. further condemned the events at the U.S. Capitol, and
President Trump’s actions; Gov. questioned the lack of security at the Capitol

State of the State:
– Will be on Monday, will be focused on specific initiatives, post-COVID issues
– Gov. proposing legislation to process absentee ballots as soon as they’re received
and begin being counted on election day
– Also to extend early voting hours, and extend timeframe to request absentee ballot
to 45 days before an election
– Gov. will propose legislation to create an Office to End Domestic and Gender-Based
Violence, and to authorize courts to force abusers to pay damages, including housing
and moving costs
– Legislation will also create new misdemeanor for those convicted of domestic violence
attempting to purchase guns, closing a loophole in existing law
– Also proposing legislation for a statewide eviction moratorium on commercial evictions
to be extended until May 1
– Also, penalties for late residential rent payments will be prohibited through May 1
– Gov. also announced the creation of a new public space at Pier 76 on the west side of
Manhattan, where a tow pound currently exists
– By law, NYPD had to vacate this space by January 1, it will be transferred to
Hudson River Park Trust, which will be accepting proposals for design this month

On when vaccinations will start for second (1b) tier:
– Appointments can be scheduled on Monday, some pharmacies will begin
administering Monday, others will take longer
– Gov. said website will be available Monday, listing available sites and accepting
reservations
– Gov. added the Biden administration is currently working on increasing the
supply available to states

On any updates on reallocation of vaccine from low-performing hospitals:
– Gov. responded that performance from hospitals has increased over the
last week, but low-performing hospitals will not receive additional allocations
– Gov. said this issue is expected to be solved by the new distribution
network being introduced next week

On current vaccination number:
– 479,000 vaccines done so far in the state
– Nursing home residents, staff will be completed by the end of next week

On how the state will ensure healthcare workers will continue to be prioritized:
– Providers must continue to give priority to healthcare workers when
scheduling appointments
– New providers in the distribution network are required to vaccinate their
own workers prior to administering the vaccine


Vaccine Availability by Counties That Have Submitted Schedules

View a list of Counties that have submitted vaccine schedules.

  • Saratoga County
  • Westchester County
  • Nassau County
  • Suffolk County
  • Essex, Warren, Wash, Clinton, Franklin Counties

Governor’s State of the State Message This Monday
With the State Legislature initiating the 2021 Legislative Session earlier week, this upcoming Monday the Governor will unveil his State of State message, followed by his release of the proposed State Budget for the 2021-22 Fiscal Year the following week (likely 1/19).

With the State looking to close a historic $65 billion multi-year deficit, there is likely to be many concerning provisions impacting the state’s health care system, even as physicians and other care providers struggle to manage historic drops in patient visits and revenue.  Please remain alert for comprehensive summaries and follow up action steps as these documents are released next week and the following week.                                     (AUSTER)


Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here: Webinar Registration – Zoom

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders in the morning (this year via Zoom), and then have virtual visits with their respective legislators in the afternoon.

With the Governor and the State Legislature needing to create tens of billions of savings to the State Budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous proposals to inappropriately expand the scope of practice for various non-physicians as well as numerous proposals to mandate how physicians provide care to their patients.

Please plan to join hundreds of colleagues from around the State on March 2! (ALI)


MSSNY Prioritizes Key Telehealth Policies Department of Financial Services (DFS) Extends COVID19 Telehealth Policy
One of the key items MSSNY will be working on for the 2021 legislative session, is to advocate for policies to help maintain expanded health insurance coverage for telemedicine services and to advocate for parity in payment for health care services delivered via video, as well as required insurer coverage for delivering care for audio-only visits with patients. A central part of this work will include advocating for passage of legislation to require health insurers to provide “payment parity” between telemedicine visits and in-office visits. MSSNY is teaming up in this effort with a range of provider organizations including many specialty societies, the Healthcare Association of New York State (HANYS), communication centers, among others. To read the letter: click here.

Prior to the onset of the COVID19 crisis, some physicians across the state had integrated Telemedicine into their practices, but the pandemic forced physicians, and other health care providers, to quickly increase their capacity to provide care remotely. A May 2020 MSSNY survey showed that 83% of the physician respondents indicated they had incorporated telemedicine into their practice, with nearly half the respondents noting that they were treating at least 25% of their patients remotely. Moreover, a spring 2020 Fair Health study showed that, for the northeastern part of the country, use of Telehealth went from 0.08% of claim submissions in May 2019, to 12.5% in the span of a month. (report.

Additionally, the New York Department of Financial Services (DFS) extended for additional 60 days (until March 5) its emergency rules supported by MSSNY requiring New York State health insurance plans to cover Telehealth services without patient cost-sharing.

In early 2020, the DFS issued a circular letter detailing its requirements for insurers to a) waive cost-sharing requirements for services delivered via telemedicine b) permit coverage for health care services delivered via audio-only mechanisms and c) enabling delivery of telemedicine services through basic smartphone and video technologies. To read the letter: (circular letter)

Even though states have started administering Covid vaccines, public health experts anticipate that COVID-19 will remain a public health threat for the foreseeable future, making it reasonably likely that this expanded Telehealth coverage policy will need to be extended well beyond March. (CARY, AUSTER)


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Governor Announces Proposal to Legalize Adult Use Recreational Marijuana
Governor Andrew Cuomo this week announced a proposal to create an Office of Cannabis Management to regulate both the medical and adult-use of marijuana.   The governor’s proposal will be part of his State of State and his 2021-22 New York State budget.  The governor estimated that this proposal would generate more than $300 million in tax revenue—however, that revenue is not anticipated to be generated for several years.

The Medical Society of the State of New York is opposed to the legalization of recreational marijuana and continues to oppose this measure along with the New York State Association of County Health Officials (NYSACHO), the Mental Health Association of New York State, the NYS PTA, and Smart Approaches to Marijuana (SAM).  MSSNY believes that with the COVID-19 pandemic, this measure, if enacted would create an even greater stress on New York State’s public health system.  The National Institute of Drug Abuse (NIDA) reports that COVID-19 is a respiratory illness that attacks the lungs, and is a serious threat to anyone who smokes or vapes tobacco or marijuana products.

MSSNY has also been working with various states in expressing opposition to the legalization of recreational marijuana. MSSNY also joined with the state medical societies of Delaware, New Jersey, New York, Ohio, and Pennsylvania to express mutually shared concerns about state governments’ efforts to legalize marijuana for recreational use. Legalization continues to present serious public health concerns.  A copy of the press release can be found here.                                 (CLANCY, AUSTER)


 

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MSSNY Partners With “Let’s Get Immunized NY”
The Medical Society of the State of New York has partnered with “Let’s Get Immunized NY”  a campaign that strives to provide all New Yorkers reliable and trustworthy information on immunization and encourage New Yorkers to get recommended vaccines.  The campaign will also support policies that protect and improve access to immunization, increase awareness of the public health benefits of vaccination, and address health disparities with vaccine access, especially in medically underserved areas and communities with low immunization rates.

MSSNY is also on the steering committee for Let’s Get Immunized NY.   Some of the organizations that are part of this campaign are:  The NYS Chapter of the Academy of Family Physicians; the NYS American Academy of Pediatrics, NYS Chapters 1, 2, & 3; the NYS Association of County Health Officials (NYSACHO); the March of Dimes; the NYS Public Health Association; The Business Council and the NYS Farm Bureau.  Further information may be obtained at the website: http://www.letsgetimmunizedny.org (CLANCY)           


Assemblyman Gottfried Reintroduces Physician-Friendly Legislation
Assemblyman Richard N, Gottfried (D-Manhattan), Chair of the New York State Assembly Committee on Health, has reintroduced three pieces of legislation that MSSNY has supported for several past legislative cycles. They are:

1. A.832, which would prohibit or restrict a number of practices between HMOs and health care providers that negatively impact physicians’ ability to provide the highest quality of care. 2. A.951, which would permit some collective negotiations between physicians and health insurance plans under close supervision by the state. 3. A.879, which ensures that health plans can only deny payment for covered benefits after review by a physician, or other health care professional, licensed in New York State and when the provider is board certified in the same, or similar, specialty as the treatment under review.

MSSNY thanks Chairman Gottfried for his continued leadership on these important bills and will update its membership as they advance this session.   (CARY)


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Registration Now Open: Veterans Matters: PTSD in Returning Veterans Webinar
Tuesday, January 26th @ 7:30 am 

The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer HERE

When:                 January 26, 2020 at 7:30 am
Faculty:               Frank Dowling, MD

Educational Objectives:

Identify diagnostic criteria for PTSD
Discuss medical and psychiatric comorbidities of military related PSTD
Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
Discuss strategies to help veterans overcome stigma to seek and accept treatment for military related trauma

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085.

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.


COVID-19 & Mental Health: Registration Now Open for Two CME Webinars
January 20, 2021 @ 7:30am Medical Matters: COVID-19 & Mental Health of Patients Click here to register

February 5, 2021 @ 7:30am Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers Click here to register

The COVID-19 pandemic has contributed to countless health problems over the past year.  Not the least of which are mental health related.  Learn more about how the COVID-19 pandemic has affected the mental health of patients on January 20th at 7:30am and how it has affected physicians and other healthcare workers on February 5th at 7:30am.

Dr. Craig Katz will serve as faculty for both webinars. Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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 each 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. 


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Vaccine Availability by Counties That Have Submitted Schedules
View a list of Counties that have submitted vaccine schedules.

  • Saratoga County
  • Westchester County
  • Nassau County
  • Suffolk County
  • Essex, Warren, Wash, Clinton, Franklin Counties

MSSNY Information for Physicians: How to Get the COVID-19 Vaccine
Community-based physicians and their  staff are now eligible to receive the COVID-19 vaccine.  Below is information on how physicians and staff, including NY City based physicians, can make an appointment to receive the vaccine.

To better ensure expeditious distribution of the COVID-19 vaccine, this week the Governor announced additional possible enforcement actions against hospitals that do not distribute their supply within the week they receive it.

COVID-19 Vaccine Process for NY State Physicians and Staff
The web page will ask for information for your name, where you live, and what you do for a living.  If you are in a priority group currently getting the vaccine, the site will show you the location of health care providers who can give you the vaccine near you.  Just choose the one you prefer, and schedule the appointment.

COVID-19 Vaccine Process for NYC Physicians and Staff
The New York City Department of Health and Mental Hygiene updated their COVID-19 vaccination page with information for non-hospital providers, including vaccination locations and related scheduling.

The NYC Department of Health and Mental Hygiene indicated that vaccine locations and supply are limited, and they are working very hard to ensure that providers and their staff across New York City are vaccinated as quickly as possible. The City plans to ramp up capacity at these sites and add sites over the coming weeks. MSSNY encourages physicians to check the NYC vaccination page regularly, as this is where the most up-to-date information will be posted.

Community-based physicians and staff eligibility information can be found here.

Physicians, Residents, Students and Retired Physicians Who Would Like to Volunteer to Provide COVID-19 Immunizations
The Medical Society of the State of New York encourages the physician community to volunteer to provide COVID-19 Immunizations to residents of New York State. The first step in this process is by signing up for ServNY. .


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Congressional Package Includes Expansion of Paycheck Protection Program (PPP)
As was recently reported, the Congressional year end package included an additional $284 billion for the Paycheck Protection Program (PPP).  Importantly, it would enable a second PPP forgivable loan for the hardest-hit small businesses (including physician practices) with 300 or fewer employees which can demonstrate a loss of 25% of gross receipts in any quarter during 2020 when compared to the same quarter in 2019.

Moreover, it would also provide that loans will not be included in taxable income, and clarifies that deductions are allowed for expenses paid with proceeds of a forgiven PPP loan, effective as of the date of enactment of the CARES Act and applicable to subsequent PPP loans.  MSSNY had heard from several physicians concerned that receipt of a PPP loan/grant was going to cause them to not be able to deduct business expenses due to a recent IRS interpretation.

Please read here for a comprehensive AMA summary of this and many other provisions in the Congressional Covid relief package.


Congress Passes Measure to Address Surprise Medical Bills
As was widely reported, among the provisions contained in the year-end Congressional Covid relief package was a comprehensive measure to establish a federal standard for addressing surprise out-of-network medical bills.

The new federal surprise bill provisions will apply to patients insured by ERISA plans, and New York’s approach would continue to be followed for out of network claims from patients insured in state-regulated plans.  There are similarities in this federal standard to New York’s well-regarded approach, but also significant differences for which MSSNY expressed serious concerns.

Here is a comprehensive summary of these provisions from the AMA: https://www.mssnyenews.org/wp-content/uploads/2020/12/Summary-of-Surprise-Billing-Language-12-21-20.pdf

The measure, to take effect January 1, 2022, would ensure that patients are “held harmless” from surprise out-of-network medical bills. Like New York’s law, patients would only be required to pay the in-network cost-sharing, (i.e., copayment, coinsurance, and deductibles) amount for out-of-network emergency care, for certain ancillary services provided by out-of-network providers at in-network facilities, and for out-of-network care provided at in-network facilities without the patient’s informed consent.

However, unlike New York’s law, the federal provision calls for a 30-day open negotiation period for out of network physicians and payers to settle out-of-network claims, and if the 30 day negotiation period is unsuccessful, requires either the physician or the health plan to initiate an independent dispute resolution (IDR) process within 4 days of the end of the 30-day period.

The federal IDR process is similar to New York’s mechanism in that the IDR entity would select which side – the physician’s or the insurer’s suggested payment – will prevail.  Physicians may batch similar services in one proceeding when claims are from the same payer, but the bill permits only 30 days of batching.  The IDR entity would consider numerous sources of information brought by either party, such as the provider’s training and experience, patient acuity, and the complexity of furnishing the item or service.   However, in a significant departure from New York, neither provider charges nor usual and customary charges may be considered by the IDR entity, and the IDR entity is required to consider the market-based median in-network rate.  This a major deficiency that MSSNY has highlighted in its advocacy efforts over the last year on this issue, and was noted by MSSNY President Dr. Bonnie Litvack in MSSNY’s press release.

The Congressional provisions also address “voluntary” out of network services by providing that non-participating providers at participating facilities may not bill a patient more than the cost-sharing requirements or balance bill the patient unless the notice and consent requirements are met. These consent requirements include providing the patient with written notice and consent 72 hours in advance of appointment; providing a good faith estimate of the costs of the services; and providing the patient with a list of in-network providers at the facility and information regarding medical care management, such as prior authorization.

At participating facilities, the notice and consent exception does not apply to out-of-network providers of radiology, pathology, emergency, anesthesiology, diagnostic, and neonatal services; assistant surgeons, hospitalists, intensivists, and providers offering services when no other in-network provider is available.

Further analysis of this far-reaching legislation is ongoing, so please remain alert for further updates.


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Congressional Package Helps to Prevent or Reduce Medicare Cuts
As a result of an advocacy effort across medicine including from the AMA and MSSNY, the year-end Congressional package included a number of steps that helped to prevent and/or reduce what would have been enormous cuts to Medicare payments to many physician specialties.  Specifically, the bill:

  • Provides for a one-time, one-year increase in the Medicare physician fee schedule of 3.75%, to support physicians and other professionals in adjusting to changes in the Medicare physician fee schedule during 2021, and to provide relief during the COVID-19 public health emergency.
  • Delays for 3 years the Secretary’s implementation of Code G2211 which reportedly will increase the MPFS by approximately 3%.
  • Delays the -2% sequestration cuts for 3 months.

As noted in this chart developed by the AMA analyzing the specialty by specialty impact of these Congressional actions, an example of the impact:

  • Under the original CMS Medicare 2021 payment rule, ophthalmologists were expected to see a 6% cut, but now will face likely no cut.
  • Under the original CMS Medicare 2021 payment rule, general surgeons were expected to see a 6% cut, but now will face likely no cut.
  • Under the original CMS Medicare 2021 payment rule, neurosurgeons were expected to see a 6% cut, but now likely will face no cut.
  • Under the original CMS Medicare 2021 payment rule, interventional radiologists were expected to see an 8% cut, but now it will be a likely 2% cut.
  • Under the original CMS Medicare 2021 payment rule, internal medicine was expected to see a 4% increase, but now likely a 6% increase.
  • Under the original CMS Medicare 2021 payment rule, anesthesiology was expected to see an 8% cut, but now likely a 2% cut.
  • Under the original CMS Medicare 2021 payment rule, PM&R was expected to see a 3% cut, but now likely will have a 3% increase.

Importantly, as well, the long overdue E&M increases set forth in the CMS 2021 Medicare payment rule will go forward.

We thank all the physicians who took the time to respond to our call for grassroots action on this and the litany of other “year-end” issues before Congress.  We anticipate that CMS will soon issue an update announcing these changes arising from Congressional action.


2021 E & M Coding Changes Webinar on Friday, Jan. 22 from 12-2 PM
On January 22 from 12 noon to 2PM,  MSSNY will be hosting a webinar for our Members regarding the 2021 E & M coding changes.  NGS Medicare staff will be making the presentation. NGS will be sending a registration URL to MSSNY shortly that we will then send on to the membership.


Five States with Highest Confirmed Cases
The 5 states with the highest total confirmed cases are:

  1. California: 2.536,832
  2. Texas: 1,885, 609
    3. Florida:1,409, 906
    4. New York: 1,064, 297
    5. Illinois: 999, 288

Deaths: New York has the most deaths due to COVID-19 with 38,912 reported fatalities, followed by Texas with 29,123 deaths, and California with 28,081.

Tests administered: California leads in number of persons tested with 34,548,621 people tested, followed by New York with 26,333,682 people tested, and Florida with 16,310,438 people tested.


How NY Hospitals Are Using Their Allocated Their Allocated Vaccine
Gov. Andrew Cuomo in his Jan.6 briefing provided an updated list of the top and bottom 10 hospitals that have used their allocated vaccines. The previous list was of health systems. In the city, NYU Langone’s Tisch Hospital in Kips Bay (100%), Richmond University Medical Center on Staten Island (100%), SUNY Downstate in East Flatbush (100%), New York-Presbyterian on the Upper East Side (99%) and Northwell Health’s Lenox Hill Hospital (87%) were top performers. Montefiore Mount Vernon (11%) and Montefiore New Rochelle (23%) in Westchester County, Brookdale Hospital Medical Center in Brownsville (24%), NYC Health + Hospitals—Queens in Jamaica (29%) and NYC Health + wHospitals—Coney Island (34%) were the lowest performing.


FDA Warns Against Changes to Authorized Dosing Schedules of COVID-19 Vaccines
FDA officials recommend all health care professionals should continue to administer 2 full doses of the 2 COVID-19 vaccines currently available.

In a new statement, the US Food and Drug Administration (FDA) recommended all health care professionals should continue to administer 2 full doses of the 2 vaccines currently available against the coronavirus disease 2019 (COVID-19).

The statement comes after discussions, including reports in the media, about altering the dosing schedule in order to immunize more individuals against COVID-19. Proposed alternatives include reducing the number of doses, extending the length of time between doses, changing the dose, or mixing and matching vaccines, according to the FDA.

The FDA has granted emergency use authorization for vaccines produced by Pfizer-BioNTech and Moderna. “At this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence. Without appropriate data supporting such changes in vaccine administration, we run a significant risk of placing public health at risk, undermining the historic vaccination efforts to protect the population from COVID-19,” said FDA Commissioner Stephen M. Hahn, MD, and Peter Marks, MD, PhD, director, Center for Biologics Evaluation and Research, FDA, in the statement.

Hahn and Marks noted that administering rating a single-dose regimen and/or administering less than the dose studied in clinical trials is concerning, “as there is some indication that the depth of the immune response is associated with the duration of protection provided.”

Although data from the phase 3 trials of both the Pfizer-BioNTech and Moderna COVID-19 vaccine suggested some protection following the first dose, the FDA cautioned that the participants who did not receive 2 vaccine doses at either a 3- or 4-week intervals were only followed for a short period of time.

“We cannot conclude anything definitive about the depth or duration of protection after a single dose of vaccine from the single dose percentages reported by the companies,” said Hahn and Marks.

The current available data continues to support the use of the 2 vaccines. For the Pfizer-BioNTech COVID-19 vaccine, the interval is 21 days between the first and second dose and 28 days between doses for the Moderna vaccine.

“We know that some of these discussions about changing the dosing schedule or dose are based on a belief that changing the dose or dosing schedule can help get more vaccine to the public faster,” concluded Hahn and Marks. “However, making such changes that are not supported by adequate scientific evidence may ultimately be counterproductive to public whealth.” (Patient Care. Jan 7).


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COVID-19 ‘Long Haulers’ Identify 205 Virus Symptoms
Researchers have identified more than 200 long-term symptoms that can affect COVID-19 “long haulers,” or people who experience prolonged effects from the virus, according to a survey published Dec. 24 in the medical preprint server medRxiv.

Researchers polled 3,762 adults from 56 countries with confirmed or suspected COVID-19 cases. Respondents developed symptoms before June 2020 and experienced them for a minimum of 28 days.

Four survey findings:

  1. In total, respondents identified 205 symptoms in 10 organs linked to the virus, including 66 symptoms traced over seven months.
  2. The most commonly reported symptoms after six months were fatigue (77.7 percent), post-exertional malaise (72.2 percent) and cognitive dysfunction (55.4 percent).
  3. Respondents who were sick six months after symptom onset experienced an average of 13.8 symptoms.
  4. Most respondents had not returned to full-time work due to their health issues.

The survey has not been peer-reviewed. (Jan. 4 Becker’s Hospital)


States Ranked by Percentage of COVID-19 Vaccines Administered: Jan. 7
The CDC’s data tracker compiles data from healthcare facilities and public health authorities. It updates daily to report the total number of COVID-19 vaccines that have been distributed to each state and thew total number each state has administered.


Shortened Quarantine May Pose Transmission Risk, CDC Finds
About 19 percent of people who were exposed to COVID-19 and remained negative or asymptomatic through the first week developed an infection by the end of the 14-day quarantine period, according to the CDC’s Jan. 1 Morbidity and Mortality Weekly Report. 

Using interim data from an ongoing study, CDC researchers identified 185 household contacts who were exposed to COVID-19. A total of 109 household contacts had detectable SARS-CoV-2 at any point during the 14-day quarantine period after exposure. Among the close contacts infected, 76 percent (83) of test results were positive within seven days after the index patient’s illness onset, while 86 percent (94) of infections were detected within 10 days.

About 81 percent of household contacts who remained negative or asymptomatic through the first week after exposure did not develop COVID-19 through day 14. This increased to 93 percent for those who remained asymptomatic or negative through day 10.

In an effort to get more people to comply, the CDC trimmed its quarantine recommendations in December to 10 days without symptoms or seven days without symptoms and a negative test result.

In this latest report, researchers concluded the original 14-day quarantine period is the most effective way to minimize the spread of COVID-19.

“Although persons might be more adherent to a shorter quarantine period, such a policy is not without risk for further spread,” the report said. “Persons released from quarantine before 14 days should continue to avoid close contact and wear masks when around others until 14 days after their last exposure.”


 

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Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

 

 

 

 

 

 

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MSSNY eNews: January 6, 2021 – MSSNY Info. for Physicians: How to Get the COVID-19 Vaccine

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MSSNY Information for Physicians: How to Get the COVID-19 Vaccine
Community-based physicians and their staff are now eligible to receive the COVID-19 vaccine.  Below is information on how physicians and staff, including NY City based physicians, can make an appointment to receive the vaccine.

To better ensure expeditious distribution of the COVID-19 vaccine, today the Governor announced additional possible enforcement actions against hospitals that do not distribute their supply within the week they receive it.  

COVID-19 Vaccine Process for NY State Physicians and Staff

The web page will ask for information for your name, where you live, and what you do for a living.  If you are in a priority group currently getting the vaccine, the site will show you the location of health care providers who can give you the vaccine near you.  Just choose the one you prefer, and schedule the appointment.  

COVID-19 Vaccine Process for NYC Physicians and Staff

The New York City Department of Health and Mental Hygiene updated their COVID-19 vaccination page with information for non-hospital providers, including vaccination locations and related scheduling.

The NYC Department of Health and Mental Hygiene indicated that vaccine locations and supply are limited, and they are working very hard to ensure that providers and their staff across New York City are vaccinated as quickly as possible. The City plans to ramp up capacity at these sites and add sites over the coming weeks. MSSNY encourages physicians to check the NYC vaccination page regularly, as this is where the most up-to-date information will be posted.

Community-based physicians and staff eligibility information can be found here

Physicians, Residents, Students and Retired Physicians Who Would Like to Volunteer to Provide COVID-19 Immunizations

The Medical Society of the State of New York encourages the physician community to volunteer to provide COVID-19 Immunizations to residents of New York State. The first step in this process is by signing up for ServNY.

Established after 9/11, ServNY is a volunteer management system, administered by the department’s Office of Health Emergency Preparedness (OHEP), that is a Web-based registry of individuals who make themselves available to assist on behalf of New York State during an emergency.  Registering is important, as credentials are verified upon registration and periodically thereafter.

When volunteers are needed, ServNY will automatically notify potential volunteers via phone or e-mail with the information necessary for a volunteer to determine if they are ready and available for the assignment.  Physicians would most likely be contacted by their local Department of Health, the regional hospital hub or by the county’s Medical Reserve Corp.  Activation through this system ensure that there are liability protections for physicians and other health care providers.

NYS Department of Health has two numbers for assistance:

  • 1-866-529-1890, option 1 to assist with the Health Commerce System
  • ServNY at 1-518-408-5163


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Gov. Cuomo’s Briefing Highlights
COVID:

– Day 312
– Statewide positivity rate without micro-clusters: 8.13%
– Statewide rate with micro-clusters: 8.41%
– Micro-cluster rate: 9%
– 197,816 tests conducted
– 161 deaths
– 8,665 hospitalizations, up 75
– 1,408 ICU patients, up 16
– 877 intubations, up 26

Hospitalizations by Region:

– Finger Lakes: 934, (0.08%)
– Western NY: 540 (0.04%)
– Southern Tier: 220 (0.03%)
– Mid Hudson: 984 (0.04%)
– Central NY: 403 (0.05%)
– Mohawk Valley: 306 (0.06%)
– NYC: 3,107 (0.04%)
– Long Island: 1,614 (0.06%)
– Capital Region: 472 (0.04%)
– North Country: 85 (0.02%)

Positivity Rate by Region:

– Finger Lakes: 10.29%
– Western NY: 8.76%
– Southern Tier: 5.56%
– Mid Hudson: 8.18%
– Central NY: 9.13%
– Mohawk Valley: 10.67%
– NYC: 6.39%
– Long Island: 9.52%
– Capital Region: 10.07%
– North Country: 9.19%
– Manhattan 3.98%
– Staten Island:7.82%
– Brooklyn: 6.38%
– Queens: 7.47%
– Bronx: 7.48%

Vaccine:

– Gov. said first priority is to protect hospital capacity and staff, particularly with new strain being found in NY
– Gov. said the hospital staff vaccination rate has been improving dramatically this week, has tripled since Monday

– If a hospital hits an unacceptable refusal rate among staff, the vaccine will be reallocated to another facility that needs it
– Gov. said 85% of hospital staff surveyed will accept the vaccine
– Next tier after healthcare workers is over 6 million people, Gov. said it may take weeks or months to vaccinate
– Other vaccines will be approved, the supply available is expected to increase
– Large scale distribution to the general public is expected in March or April

Federal:

– Gov. criticized federal government’s lack of response to UK COVID strain
– Gov. sent letter today to DHS Secretary Wolf, CDC Director Redfield, requesting US Customs and Border Protection test all incoming international travelers
– UK strain case in Saratoga, New York may be a result of travel to UK 

Q&A:

On how the state will ensure all residents comply with vaccine:
– Gov. agreed this is still complicated, will be difficult to get to 70-90% vaccination rate
– Gov. said an aggressive education campaign will be released once the vaccine is available to the general public

On why Gov. is requesting travel restrictions when the new strain is already in NY, what NY is doing to contain it, and updates on Saratoga case:

– Gov. said he contacted airlines from UK to prevent the strain coming into NY when it was first discovered
– The state has been testing for the new strain, and contact tracing the confirmed case
– The person who has the confirmed case was in contact with someone who had traveled to the UK
– Gov. said numerous mutations can be expected, saying this underscores the need for travel restrictions and testing travelers

On why Gov. has not opened up vaccine to next tier if allocations are not being utilized by hospitals:

– Gov. said there is not enough supply for that, so far, there are only 900,000 doses for 2.1 million healthcare workers, who are top priority
– There are still healthcare workers that have not received it, until this is the case, there is no additional supply available



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Gov. Asks Feds: Screen International Travelers for COVID Variants at NY Airports
The governor has sent a letter to Department of Homeland Security Acting Secretary Chad Wolf, Health and Human Services Secretary Alex Azar and CDC Director Robert Redfield asking that U.S. Customs and Border Protection require everyone coming into New York airports from outside the country to show they have been tested before admission, or to allow the Port Authority of New York and New Jersey to screen for proof of such testing.

“The virus is mutating every day. … There’s been dozens of mutations,” Cuomo said at a morning briefing on Wednesday. “Who knows if the next mutation is going to be effective with the vaccine? ….”

The request came just days after state health officials confirmed New York’s first case of a COVID-19 variant, which was first identified in the U.K. (Politico, Jan 6)


Gov. Wants to Increase 300,000 Weekly Dose of Vaccine by Boosting Distribution
New York is talking to the federal government about an increase in its weekly 300,000-dose vaccine supply as it prepares to boost distribution, Governor Andrew Cuomo said. The state has enrolled 3,762 distribution sites, of which 636 are activated and giving Covid-19 vaccines to health-care workers. So far, only about 900,000 vaccines have been distributed for a cohort of 2.1 million health-care workers, Cuomo said Tuesday at a virus briefing.

“You’d need another four weeks of allocations before you can get out of health-care workers, roughly, roughly, before you finish 1A and then move to 1B,” Cuomo said, describing the state’s tiered distribution system. The 1B category includes essential workers and members of the general public over the age of 75, he said.

Cuomo said the vaccine will be administered at convention centers, colleges, churches, and community centers, as well as pop-up sites. Teachers unions, police and fire departments and mass-transit systems will be asked to distribute their own vaccines to alleviate the burden on systems dealing with the general public, the governor said. “To the extent we can have the essential workers use their own employees or their own health-system provider to do their own vaccines, that removes a burden from the retail system, if you will, it removes them from the hospital system,” the governor said.


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Follow Inoculation Progress: Bloomberg Vaccine TrackerBloomberg Vaccine Tracker


15% of Workers at Long Term Healthcare Facilities Decline Vaccine
As the vaccination of nursing home residents and staff against Covid-19 enters its third week, long-term-care association leaders reported that efforts had been met with more resistance from workers than residents. Dr. Howard Zucker, state commissioner of health, said in Gov. Andrew Cuomo’s Monday briefing that about 10% of nursing home residents and 15% of staff have declined the vaccine.

Anecdotally, some facilities have seen rates as high as 80% of staff initially unwilling to be vaccinated, said Michael Balboni, executive director of the Greater New York Health Care Facilities Association, a nonprofit serving the needs of long-term-care facilities. In comparison, the process for residents has been more or less smooth sailing, association leaders said.

Cuomo said in his briefing that as of Monday, 288 of 611 enrolled facilities in the federal vaccination program for nursing homes—or 47%—had completed the first dose for residents. The state would expedite the program to achieve 85% of residents vaccinated with the first dose by the end of this week, with the remaining 15% to be covered in the following two weeks, Cuomo said.

The state’s assistance would help many associations achieve their ideal time frame of broad coverage with the first dose by Jan. 11, Hanse said. Many anticipated bottlenecks for the rollout were unfounded, long-term-care leaders said. Because Walgreens and CVS were the designated administrators for the nursing home vaccine program, many homes initially worried they would have trouble contacting big national chains to schedule appointments, Balboni said.

When pharmacy staff were on-site, getting nursing home workers to take the vaccines was a different story, Heyman said. “We can’t just assume that if we offer the vaccine, the staff will just take it,” Balboni said. It is not clear why workers have been more unwilling to take the inoculation than residents. Maybe residents—who are older—acknowledge that they are at higher risk of dying should they contract Covid-19 and are more willing to take it to protect themselves, Heyman suggested.

For vaccination efforts to work, both nursing home residents and staff have to be vaccinated, Heyman said. “Otherwise, there will be gaps in the protection we’re trying to build,” he said. (Crain’s Health Pulse, Jan. 6)


Registration Now Open Veterans Matters: PTSD in Returning Veterans Webinar
Tuesday, January 26th @ 7:30 am
The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer

When:          January 26, 2020 at 7:30 am
Faculty:        Frank Dowling, MD

Educational Objectives:

  • Identify diagnostic criteria for PTSD
  • Discuss medical and psychiatric comorbidities of military related PSTD
  • Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
  • Discuss strategies to help veterans overcome stigma to seek and accept treatment for military-related trauma

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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.

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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 Christina Southard 516-488-6100 x355 • fax 516-488-2188


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Community-Based Physicians and Staff Expected to Receive COVID-19 Vaccine Beginning Jan 4

Dear Colleague:

Community-based physicians and staff that have direct in-person patient care contact are expected to begin receiving the COVID-19 vaccine on January 4th.  Details on how and where immunizations will be obtained are still being worked out by the New York State Department of Health.  Please be assured that MSSNY will provide information as soon as we have it.  Several documents have been posted to the NYSDOH vaccination site.

“NYS Vaccination Program Guidance for Facilities Receiving COVID-19 Vaccine Phase 1A Only” is available here.

Effective next week, January 4th, this list will be expanded to include:

·   All Outpatient/Ambulatory front line, high risk health care providers who provide direct in-person patient care or other staff of any age in a position where they have direct contact with patients, such as receptionists. This will include but is not limited to hospital and community based ambulatory care, primary care, outpatient behavioral health services, phlebotomists, physical and occupational therapists, and specialty clinics including dialysis centers.

·   All front line, high risk public health workers who have direct contact with patients.

·   Health care workers at testing sites.

Effective this week, the following populations are prioritized for vaccination:

·   High-risk hospital and FQHC staff, including OMH psychiatric centers

·   Emergency Medical Services (EMS) personnel

·   Medical Examiners and Coroners

·   Funeral workers who have direct contact with infectious material and bodily fluids

·   Agency staff and residents in congregate living situations run by the OPWDD, OMH and OASAS.

·   Urgent Care providers

·   Staff administering the COVID-19 vaccine

Also see: 

1. Additional guidance for weeks 1-4 including tables of prioritization schedule and vaccination sites is available here. Local health departments are now listed in this table page 6-listed under vaccine recipients.

2. Storage and handling guidance

3. Demographic self-report form for those receiving vaccine

COVID-19 Relief Package 

As you may have heard, the President on Sunday night signed into law the COVID-19 relief package he had previously threatened to veto.  The measure contains a number of far-reaching proposals that impact physicians, including helping to prevent or reduce significant Medicare cuts that physicians were going to receive starting in a few days; another $284 billion for the Paycheck Protection Program for small businesses including physician practices who may have already received a PPP loan/grant; ensuring that receipt of a PPP loan/grant will not prevent a business from deducting expenses it might otherwise have deducted; and funding for an additional 1,000 medical residency positions.  It also includes the federal provisions for addressing surprise out of network bills, which had been improved but contained significant problematic provisions as well.

See our December 23 MSSNY e-news for more information on these issues.

Sincerely, 

Bonnie M. Litvack, MD
President, Medical Society of the State of New York 

80 Percent of NY Physicians Plan to Get Immunized When Vaccine Is Widely Available 

For Immediate Release

 

80 Percent of NY Physicians Plan to Get Immunized When Vaccine
Is Widely Available 


November 30, 2020, Westbury, NY
—According to a survey conducted by the Medical Society of State of New York, nearly 80% of New York State’s community and hospital-based physicians plan to become immunized with the COVID-19 vaccine when it becomes widely available.

Only 7.5% of physician respondents to the survey indicated that they would not receive the vaccine.

The survey also reported that three-quarters of physicians’ patients are asking about the safety and efficacy of the vaccine. However, nearly 70% of physicians estimated that at least half of their patients will receive the COVID-19 vaccine once it is widely available.

When asked, nearly 70% of the physicians reported that they believe that communicating to their patients that they themselves have been immunized with the COVID-19 vaccine would be the most effective way of combatting vaccine hesitancy. Over two-thirds of responding physicians believe that having a state-wide educational campaign on the importance of being immunized against COVID-19 would be instrumental in also combatting vaccine hesitancy. Physicians also believe that another essential component is having statewide educational brochures and flyers (46.50%) that can be distributed to patients along with a prepared script on the importance of getting the vaccine with an explanation of safety (41.76%).

“This survey clearly shows that community and hospital physicians are prepared to receive the COVID-19 vaccine when it becomes widely available and that by immunizing themselves, they can send a strong message to their patients that being immunized is the best protection possible,” says MSSNY President Bonnie Litvack, MD.

Sixty-six percent of physicians stated that vaccine hesitancy is the biggest obstacle in getting New Yorkers vaccinated; 61% believe that NOT having an adequate supply of the COVID-19 vaccine could be another obstacle. Nearly 50% of responding physicians indicated that having a sufficient supply of the COVID-19 vaccine was of concern while ensuring that there is equitable access to the vaccine; 39% cited concerns about the safety and efficacy of the vaccine.

Along with traditional immunizers, such as the community and hospital-based physicians, the survey asked physicians about regional and local points of distribution (PODs) to administer the vaccine. Almost 65% of physicians indicated that they thought their patients would have safety concerns regarding COVID-19 spread due to the number of people that would be at a POD location and 61% thought that their patients may not be able to travel to the locations of the POD. Over 48% thought that screening for medical contraindications and who would be administering the vaccine would be of concerns to patients; 43% are concerned about language barriers.

“New York physicians stand ready and able to begin the process of immunizing New Yorkers and the Medical Society of the State of New York believes that the trust patients have in their physicians will go far in combatting vaccine hesitancy,” says MSSNY President Bonnie Litvack, MD. “Community-based physicians’ practices are located in New York’s rural, suburban, and urban areas and more often than not, those physicians speak the language of their patients, and most importantly, have the trust of their patients. As physicians, we must all work together to immunize all New Yorkers with the COVID-19 vaccine.

“We must change the course of this pandemic, and the best way to do it is through a vaccine,” says Dr. Litvack.

# # #

Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.


Media Contact:
Roseann Raia
Communications / Marketing
Medical Society of the State of New York
865 Merrick Ave.
Westbury, New York
516-488-6100 ext 302
rraia@mssny.org

 

MSSNY eNews: November 20, 2020 – I Am Thankful


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Colleagues:

I Am Thankful
While this is a Thanksgiving season like no other, as the holiday approaches I find myself even more thankful than in years past.

I am thankful that our scientists worked around the clock to develop effective vaccines to combat this pandemic and that delivery of the first shipment is imminent. Our NYS Vaccine Task Force is hard at work to ensure a seamless vaccine roll out in New York. Thank you to all who have signed up to distribute the vaccine and those that intend to sign up.

Here is information that you will need concerning the process:

Information for Private Practicing Physicians Regarding COVID-19 Vaccine 

The following information was obtained from the NYS Department of Health November 19, 2020 webinar regarding steps for physicians to serve as a distributor of COVID 19 vaccine to patients.

Step One — Register for the Immunization Information System

  • Physicians who do not have an account are urged to register in the NYS Immunization Information System (NYSIIS). Physicians residing in New York City will need to register with the Citywide Immunization Registry (CIR)
  • This is because all COVID-19 Vaccination Program providers (each location submitting a profile) will need a NYSIIS or a CIR account
  • Your practice may currently have a NYSIIS or CIR account, but it is important to review the information so that appropriate staff has access

For health care providers located outside of New York City, take the following steps for new users in NYSIIS-See the Checklist to Go Live with NYSIIS here.

  1. NYSIIS is located on the Health Commerce System. If responsible staff do not yet have an HCS account, they must apply for one.
  2. Take the NYSIIS Administrative User Training located here.

New York City physicians should register their practice online in CIR here.

Step 2: Enroll in the COVID-19 Vaccination Program

  • In addition to registering with NYSIIS or CIR, physicians will then need to enroll in the COVID-19 Vaccine Program.
  • NYSDOH and NYC DOHMH are implementing a phased approach to provider enrollment and will notify private practices physician as each new group is opened for enrollment. MSSNY understands that this will occur for private practicing physicians beginning in December.
  • Providers in NYS, outside of NYC, will enroll in the NYS COVID-19 Vaccination Program through the Health Commerce System.
  • Providers in NYC will enroll in the NYC COVID-19 Vaccination Program through the CIR.
  • Networks with facilities or providers in both NYS and NYS should enroll their facilities or provides outside of NYC in the NYS Covid-19 Vaccination Program through the Health Commerce System and enroll facilities or providers in NYC in the NYC Covid-19 Vaccination Program through the CIR.

Step 3 Ordering, Receiving and Administering Vaccine

  • When COVID-19 vaccine is available, providers in NYS, outside of NYC, will order Covid-19 Vaccine through NYSII and providers in NYC will order Covid-19 vaccine through the CIR. Orders will be approved by NYS DOH and shipped directly from the vaccine manufacturer or CDC distributor.
  • When vaccine is available, functions staff perform in NYSIIS or CIR will include monitoring vaccine inventory, entering doses administered and/or performing data exchange (uploading and downloading data) between the provider’s electronic health system and NYSII/CIR; entering vaccine returns and wastage, and generating reports for internal review (e.g. doses administered).

I am thankful to our Physician Wellness and Resilience Committee for actualizing our Peer to Peer program just when it was needed most.  I am thankful to all that volunteered as peer supporters and am comforted to know that you are there should any of us need you. Please spread the word about our Confidential helpline phone number (1-844-P2P-PEER) and email address (p2p@mssny.org).

I am thankful that our MSSNY has professional and dedicated staff that go above and beyond to promote our agenda and help sustain our practices.  This past weekend our MSSNY EVP Mr. Phillip Schuh received the well-deserved honor of the AMA Medical Executive Lifetime Achievement Award for guiding New York physicians through a rapidly changing medical practice environment during his more than 30 years with MSSNY.

This year, I am thankful for things big and small but most importantly for the health of my family and friends and the fortitude of our profession.

Wishing you and your family a safe and very happy Thanksgiving,

Bonnie Litvack, MD
MSSNY President


MSSNY in the news this week:

Also ran in:


MSSNY Weekly Podcast


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Gov. Cuomo’s Press Conference Last Night

  • The positivity rate in the micro-cluster focus areas dropped slightly to 4.11 percent. Excluding these areas, it was 2.38 percent. Of the 195,239 tests reported yesterday, 5,310, or 2.72 percent, were positive. Total hospitalizations rose to 2,276. Sadly, we lost 31 New Yorkers to the virus.
  • New York updated the COVID-19 micro-cluster focus zones. Rockland County’s Yellow Zone will be expanded, and parts of Orange and Westchester counties will become Yellow Zones due to increased cases, positivity, and hospital admissions from these areas. All the maps of the current micro-cluster focus zones are available here.
  • I met with President-elect Joe Biden and Vice President-elect Kamala Harris and fellow governors to discuss the ongoing COVID response. We look forward to a strong federal-state partnership and to working hand-in-hand in the months ahead. Topics of discussion included how to achieve a fast and equitable vaccine distribution, how to help our communities recover economically and more.
  • Round two of the successful Nourish NY program is underway. So far, 1.7 million pounds of raw milk has been turned into dairy products and distributed by food banks, in addition to 210,000 pounds of produce. Over 940,000 households have received products sourced from New York farms through this initiative, which is helping keep businesses and families afloat.
  • A smaller Thanksgiving celebration doesn’t mean you have to skip out on the great food. To help New Yorkers plan for smaller holiday gatherings, I Love NY created a list of scaled-down recipes that are great for smaller Thanksgiving celebrations.

NYSDOH Gives Update on Medicaid Redesign Team’s (MRT II) Pharmacy Benefit Carve Out Initiative
The New York State Department of Health (DOH) hosted a webinar earlier this week to provide an update on the State Budget initiative to transition the Medicaid Pharmacy benefit from Managed Care back into the fee-for-service (FFS) program. Among the goals in transitioning the pharmacy program from Managed Care back to FFS, is to provide full transparency into prescription drug costs, centralizing and leveraging negotiation power, and, importantly, providing a single drug formulary with standardized utilization management protocols rather than dozens of separate formularies.

Key highlights for providers from the November 16th webinar included an update on the transition and communications timeline. Specifically, that Managed Care Plans (MCPs) will no longer be responsible for physician/practitioner administered drugs that are not included on the Medicaid Pharmacy List of Reimbursable Drugs and that those drugs will not be subject to the carve-out.

However, the new policy also directs the MCPs to continue to offer the benefit when provided by a non-pharmacy provider. (e.g. outpatient hospital, clinic, physician’s office)[1] To learn more details, please click here.

The update also included critical information for physicians about enrollees and billing under the new system such as providers must be enrolled in the FFS program as billing providers in order to continue to serve Medicaid Managed Care members. For additional information regarding this aspect of the transition, please go here.

MSSNY’s Department of Governmental Affairs will provide an update following DOH’s next webinar, which is scheduled for mid-December.


NY Physicians Still in Need of Affordable PPE to Meet Patients’ Needs
Many physician offices across the state of New York are straining to meet their patient care needs due to a lack of available and affordable PPE. This challenging dynamic was highlighted in a USA Today-New York article earlier this week.

A recent physician survey conducted by MSSNY noted that nearly 2/3 of the physician respondents indicated that they are at least “sometimes” finding it difficult to obtain needed PPE. Over 40% of the physician respondents have indicated that it takes them at least 4 weeks to get their PPE from when they order it; while 53% of the physician respondents said the cost of PPE has gone up by at least 25% compared to pre-pandemic levels, and nearly 1/3 have said the cost has gone up by more than 50%.

Of greatest concern, 1/3 of the physician respondents indicated that the lack of available/affordable PPE has adversely impacted their ability to care for their patients. The survey results indicate that further government intervention is urgently needed to help make PPE more widely available to our community physician practices.

We look forward to working with Senator Schumer and our New York Congressional Delegation on measures such as that announced today to help expand this availability so that patient care is not disrupted or delayed due to these shortages.

(See AMA Project N95 article below to order PPE if you are an AMA member.)


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MSSNY President Speaks About Physicians’ Efforts to Combat Misinformation During The COVID-19 Pandemic
MSSNY President Dr. Bonnie Litvack spoke to Spectrum News Buffalo ‘s Captial Report about physicians’ efforts to combat misinformation during the COVID-19 pandemic. In New York, Dr. Litvack said that while physicians are facing an increase in coronavirus cases, they also have to confront misinformation about how dangerous the virus is, how the virus spreads, and the importance of different public health measures aimed at stopping the spread of the virus.


AMA Collaborates with Project N95 Again to Make PPE Available to AMA Members
The American Medical Association (AMA) is collaborating with Project N95 (a not-for-profit, National COVID-19 Clearinghouse) again to make quality-certified personal protective equipment (PPE) available exclusively for AMA members to purchase with no minimum.  

To place an order: 

Go here to begin the process. Please note that Project N95 has updated its website, so the order process has changed.

  • Order deadline:

The deadline to place an order is Monday, Nov. 23, at 3 p.m. Central time.

  • Available equipment(we are offering two new products (duck bill respirator, face shield))
  • Makrite 9500 N95 Surgical Respirator; size S
  • Makrite 9500 N95 Surgical Respirator;size M/L
  • Makrite 910-N95FMX Surgical Respirator (Duck Bill)
  • AAMI Level 1 Isolation Gown
  • Face Shield 2/ Elastic and Foam Headband
  • Bundle (1 box M/L Surg Respirator, 1 box S Surg Respirator, 3 bags Isolation Gowns)

All orders will be aggregated and shipped no later than December 26, via UPS ground.  Gowns and face shields may start shipping as early as December 8. Respirators ship on December 21 and the bundle ships December 26.


MSSNY in Crain’s: Physicians Urge against Looming Medicare Cuts
The Medical Society of the State of New York last week issued a statement in support of New York congressional members—both Democrats and Republicans—who signed a letter urging legislation to prevent double-digit Medicare cuts in 2021.

Dr. Bonnie Litvack, president of the medical society, said in a statement that the proposed decreases could “significantly, adversely impact access to care to many seniors.” The group, she added, earlier this month also joined with eight other northeastern state medical associations in sending a letter urging Congress to pass legislation to prevent the cuts.

Litvack said they “could not come at a worse time as we again confront a surge in Covid-19 cases and practices have not fully recovered from record drops in patient visits.”

The cuts are tied to a proposed change by the Centers for Medicare and Medicaid Services to the Medicare Physician Fee Schedule. The medical societies noted in their letter to congressional leaders that the rule would increase payments for evaluation and management codes, which are needed. At the same time, however, CMS is bound by statute to remain budget neutral, needing to offset any increases by making corresponding decreases.

To meet the requirement, CMS has proposed a nearly 11% decrease to the conversion factor that determines all Medicare payment rates, the medical societies noted.

“These cuts will be harmful to primary care physicians and other medical specialty types,” the group wrote. “For example, while the positive evaluation and management changes were meant to give primary care providers a significant increase, having a conversion factor decrease of 11% means that those benefits are diminished—especially in the face of increased cost and decreased reimbursements during the pandemic.”

The proposed rule would bring extreme cuts to many specialties—8% for critical care, 9% for cardiac surgery, 11% for radiology and 8% for anesthesiology, they noted.

“Many of these physicians are the same ones that are on the front lines of Covid-19 and cannot withstand further cuts of this magnitude,” the medical societies reiterated in their letter. “We urge you to work together to pass legislation to waive the statutory budget neutrality requirements to avoid these cuts.”


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AMA Announces New CPT Codes For COVID-19 Immunizations
The AMA on November 10 announced a handful of new CPT codes for reporting COVID-19 vaccine products and immunization administration.

The code release includes two vaccine product codes and four vaccine administration codes. These new CPT codes will allow healthcare providers to report and track the administration of these COVID-19 vaccines once they receive approval or an emergency use authorization from the Food and Drug Administration. The codes will go into effect at that time.

The vaccine codes are linked to products manufactured by Pfizer Inc. and Moderna Inc. They are:

  • 91300, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted, for intramuscular use. Vaccine manufacturer: Pfizer Inc.
  • 91301, SARS-CoV-2 (COVID-19) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage, for intramuscular use. Vaccine manufacturer: Moderna Inc.

Each vaccine product code is linked with a pair of vaccine administration codes, which correspond to first and second doses.

For the 91300 product code, providers would report:

  • 0001A, immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 30 mcg/0.3 mL dosage, diluent reconstituted; first dose
  • 0002A, …; second dose

For the 91301 product code, providers would report:

  • 0011A, immunization administration by intramuscular injection of SARS-CoV-2 (COVID-19) vaccine, mRNA-LNP, spike protein, preservative free, 100 mcg/0.5 mL dosage; first dose
  • 0012A, second dose

The AMA says that it is critical that the codes “are available prior to the public availability of the vaccines to facilitate updating of healthcare electronic systems across the U.S.” November 16, 2020 Medicare Web


Monica Sweeny MDDr. Monica Sweeney Receives AMA Spirit of Medicine Award
The American Medical Association (AMA) Foundation Board of Directors have named Dr. Monica Sweeney as a recipient of the 2020 Excellence in Medicine Awards.

In her notification to Dr. Sweeney of her Dr. Debasish Mridha Spirit of Medicine Award, Dr. Jacqueline A. Bello, the AMAF President, stated:

“This annual awards program honor physicians who represent the highest values of altruism, compassion and dedication to patient care. The caliber of our nominees was awe-inspiring, and your selection from such an impressive group speaks volumes in recognizing your dedication to the profession of medicine. As an Excellence in Medicine Awards recipient, you will be honored during an awards ceremony hosted by the AMA Foundation in 2021 (date TBD). In addition, this award comes with an AMA Foundation grant of $2,500 to the organization of Dr. Sweeney’s choosing.”

Dr. Sweeney has been an active member of MSSNY since 1989. She currently serves on MSSNY’s Committee to Eliminate Health Disparities, Infectious Diseases Committee, Task Force on End of Life Care, and Women Physicians Committee. She previously served as a delegate to MSSNY’s House of Delegates and on the Preventative Medicine and Family Health Committee and the Rural Subcommittee.


Phil Schuh MSSNY CEO

MSSNY EVP Is Recipient of AMA Medical Executive Lifetime Achievement Award
Phil Schuh, CPA, has been MSSNY’s Executive Vice President and CFO since 2010 and head of MSSNY’s Finance Division for the previous 20 years. He has been an innovator, mediator, and financial wizard during challenging times. Phil is also a Founding Board Member of the prestigious Physicians Foundation, where he meets with other key state medical society leaders to collaborate on solutions endemic to all. Phil is also the CEO of MSSNY’s Empire State Medical, Scientific & Educational Foundation, Inc.

As Phil stated in his AMA speech, “I want to thank the New York Delegation, MSSNY’s leadership and staff for allowing me to be part of their lives. My job has provided me the opportunity to work with many AMA delegates. I am always amazed at the intensity and focus that you bring to the table.”

Mr. Schuh will be retiring from MSSNY at the end of 2020.


Don’t Wait, Apply Now! 2020 MIPS Extreme and Uncontrollable Circumstances Exception and Interoperability Hardship Exception Applications are Due Dec. 31

Extreme and Uncontrollable Circumstances Application & COVID-19

The COVID-19 pandemic has impacted all clinicians across the United States and territories. However, CMS recognizes that not all practices have been impacted by COVID-19 to the same extent. For the 2020 performance year, CMS will be using our Extreme and Uncontrollable Circumstances policy to allow MIPS eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 public health emergency.

If you have any concerns about the effect of the COVID-19 pandemic on your performance data, including cost measures, for the 2020 performance period, submit an application now and be sure to cite COVID-19 as the reason for your application.

If you have an approved application, you can still receive scores for the Quality, Improvement Activities, and Promoting Interoperability performance categories if you submit data. If the cost performance category is included in your approved application, you will not be scored on cost measures even if other data are submitted.

Learn more in the 2020 Exceptions Applications Fact Sheet.

Note: CMS has proposed to allow APM Entities to apply to reweight MIPS performance categories as a result of extreme and uncontrollable circumstances, such as the public health emergency resulting from the COVID-19 pandemic. Learn more in the 2021 Quality Payment Program Proposed Rule Overview Fact Sheet.

MIPS Promoting Interoperability Hardship Exceptions

MIPS eligible clinicians, groups, and virtual groups may qualify for a re-weighting of the Promoting Interoperability performance category to 0% if they:

  • Are a small practice;
  • Have decertified EHR technology;
  • Have insufficient Internet connectivity;
  • Face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress, or vendor issues; or
  • Lack control over the availability of CEHRT.

Note: If you are already exempt from reporting Promoting Interoperability data, you don’t need to apply.

How do I Apply?

New for 2020: You must have a HCQIS Access Roles and Profile (HARP) account to complete and submit an exception application on behalf of yourself, or another MIPS eligible clinician, group, virtual group or APM Entity. For more information on HARP accounts, please refer to the Register for a HARP Account document in the QPP Access User Guide.

Once you register for a HARP account, sign in to qpp.cms.gov, select ‘Exceptions Applications’ on the left-hand navigation, select ‘Add New Exception,’ and select ‘Extreme and Uncontrollable Circumstances Exception’ or ‘Promoting Interoperability Hardship Exception.’

How do I Know if I Am Approved? If you apply for either of the exceptions, you will be notified by email if your request was approved or denied. If approved, this will also be added to your eligibility profile on the QPP Participation Status Tool, but may not appear in the tool until the submission window is open in 2021.

For More Information

Questions? Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, please consider calling during non-peak hours—before 10:00 a.m. and after 2:00 p.m. ET.


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Calling All MSSNY Social Media Ambassadors!
MSSNY has created a gallery of social media assets for both our Peer to Peer (P2P) program, which offers physicians, residents, and medical students an opportunity to talk with a peer about life stressors, and our “Masking Up” campaign to stop the spread of COVID-19.

Please download and share to your social media accounts to help get the word out:

Tag us @mssnytweet and @mssnygram and use one or more of the following hashtags in your posts: #MSSNY, #MSSNYStrong, #P2P #MaskUpNY #MaskUpAmerica.

Click HERE to view the flyer and register for the program!

When:                 November 23, 2020 at 7:30 am
Faculty:               Jack McIntyre, MD

Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans
  • Explore evidence-based diagnostic, intervention and treatment options
  • Identify barriers to identification and treatment in military culture and methods to overcome them

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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.

If you missed the TBI in Returning Veterans webinar on November 3rd, you can now view it online at https://cme.mssny.org/.  

MSSNY’s Peer to Peer (P2P) Program

Last weekend we heard of the suicide death of a physician at North Shore University Hospital. MSSNY has been working hospital officials to make sure that all personnel have resources available to reach out and get help or speak with a peer if needed.  Since this tragedy may have impacted many of our colleagues, MSSNY wants to let you know that you are not alone.

The Medical Society of the State of New York offers to physicians, residents, and medical students an opportunity to talk with a peer about some of life stressors. With the advent of the COVID-19 pandemic, some of the emotional issues related to this event, may also be troubling for our colleagues.   MSSNY now has over 40 peer supporters trained to support their colleagues

If you or someone you know is struggling with everyday life stressors, reach out to the P2P program to be connected with a peer supporter to help!

Email: P2P@mssny.org or phone: 1-844-P2P-PEER (1-844-727-7337) and request that you be connected with a peer supporter.


Veterans Matters: Suicide in Veterans Webinar
The Medical Society of the State of New York is hosting a CME live webinar entitled Veterans Matters: Suicide in Veterans on Monday, November 23, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!

When:           November 23, 2020 at 7:30 am
Faculty:        Jack McIntyre, MD

Educational Objectives:

  • Address the causes and warning signs of suicide and suicidal behavior among veterans
  • Explore evidence-based diagnostic, intervention, and treatment options
  • Identify barriers to identification and treatment in military culture and methods to overcome them

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085

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 </a.of their participation in the activity.


Registration Now Open 
Veterans Healthcare Training Conference
Veterans Mental Health Training Initiative: ½ Day Virtual Conference
Saturday, December 5th @ 8:30 am – 11:30 am
.

The Medical Society of the State of New York, New York State Psychiatric Association and the New York State Chapter of National Association of Social Workers is hosting a joint ½ day virtual conference on Saturday, December 5, 2020 at 8:30 am to 11:30 am. .

Register HERE for the program! Click HERE to view the flyer.
View the Agenda HERE.

Educational Objectives:

  • Identify signs and symptoms of mental health responses, including depression, anxiety, PTSD, and suicidal ideation in veteran patients
  • Review relevant statistics related to the veteran population, including their access to and use of healthcare
  • Recognize the importance of primary care specialists and community mental health providers in screening individuals for military service
  • Discuss the impact the COVID-19 pandemic has had on mental health of veteran patients 

Panel 1: 9:15 – 10:10 am.

The Challenges: The Health & Mental Health Issues Facing Veterans & Their Families Amid Pandemic, & Efforts to Address, Including VMHTI .

Keynote Speaker: Joe Geraci, Lt. Colonel, U.S. Army; LMHC
Panelists: Frank Dowling, MD (MSSNY)
Gretchen Foley, MD
Sharon Bailey, Major, USAF (Ret.), LCSW-R.
Invited legislators: Senator Carlucci, Assemblywoman Gunther.

This panel will focus on challenges faced by veterans, related to the COVID-19 pandemic, including factors that exacerbate mental health and substance use disorder, suicidal ideation, and self-medication trends..

The focus of this panel will be to discuss short term impacts that have emerged as a result of COVID-19, as well as longer-term effects of global fear, stress, and isolation, including the re-triggering of Post-Traumatic Stress symptoms..

Speakers will review current statistics related to the pandemic and cultural factors that may cause or heighten anxiety and/or depression symptoms, as well as efforts that have been put in place to address and manage these challenges. Keynote Speaker, Moderator, and Panelists will include Veterans, Physicians, and Mental Health Experts in the Field of Veteran Services.

Panel 2: 10:30 – 11:20 am.

What Has Helped: The Successes, Including Veterans Sharing What Has Made a Difference in Transition, & Clinicians Sharing Best Practices for Identification,
Treatment & Referral .

Panelists: Malene Ingram, MD & Colonel, U.S. Army (MSSNY)

Marianne Goodman, MD
Mike Shurmatz, U.S. Army (Ret.), LMSW
Ben Pomerance, Esq., Deputy Director for Program Development for NYS Division
of Veterans’ Affairs.

Invited Legislators: Senator Brooks, Assemblywoman Barrett

This panel will be a continuation from Panel 1 (The Challenges) and will subsequently focus on what has been most helpful for veterans who have been struggling during the COVID-19 pandemic, and what that brings up for them.

Speakers will discuss what is most effective in terms of improving overall mental health, decreasing anxiety, minimizing substance misuse, and reducing the risk and prevalence of suicide in the veteran community.  Speakers will share what practices have been most effective, as well as what areas to focus on for screening, treatment, and best-fit referrals.

This panel will discuss what has proven to be successful, in order to pave the way for, and build upon, positive outcomes for veterans seeking care. Keynote Speaker, Moderator, and Panelists will include Veterans, Physicians, and Mental Health Experts in the Field of Veteran Services..

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085..

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 3.0 AMA PRA Category 1 credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.


Registration Now Open for Steps to Physician Wellness and Resiliency
Registration is now open for Steps to Physician Wellness and Resiliency on December 10th from 7:30-8:30 am.

Frank Dowling, MD will serve as faculty for this webinar.

Educational Objectives are:

  • Review the warning signs that stress, depression, anxiety, or substance use may impact work or personal life
  • Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools
  • Recognize self-monitoring strategies for stress-related problems and know when to seek professional assistance

Register by clicking here.  Please click here to view the flyer for this program.

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

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.


 

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Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Rhinebeck Estate for SaleElegant, custom-built home with unparalleled craftsmanship and attention to detail. Set on 10.6 acres in Rhinebeck, bordering Drayton Grant Park at Burger Hill, this home offers character, ambiance and livability. The foyer entry features a tastefully designed staircase, millwork, high ceilings & cherry wood floors. Custom windows provide plenty of natural light. The kitchen with marble counter-topped island evokes farmhouse luxury, with cozy fireside seating area for winter, and glass doors from the hexagonal eat-in kitchen leading to the expansive stone terrace for warmer months. The master suite boasts a high vaulted ceiling, double walk-in closets & bath with clawfoot tub. Two bedrooms with generous closets plus two full baths are also on the second floor plus a sitting room/office or fourth bedroom. Generous closets throughout including a hidden 3 floor elevator. Immaculate lower level with media room, exercise room, bar, wine cellar & full bath. Beautifully landscaped gardens surround the home, a well-established vegetable garden is adjacent to 2-story barn, which is equipped with water & electricity and hilltop views abound. Close to Village & Amtrak. EXCLUSIVE View full listing http://garydimauro.com/listing/traditional-rhinebeck-luxury/ Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Rachel Hyman-Rouse at Gary DiMauro Real Estate 845-876-5100 x 10 / 917-686-4906

UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at drfox.903parkave@gmail.com.

UES Park Avenue Medical Office Space         


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Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com


 

 

 

 

 

 

 

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