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:


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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
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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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November 18, 2016 – Alphabet Soup Mania!

Dr. Reid
PRESIDENT’S MESSAGE
Dr. Malcolm Reid
November 18, 2016
Volume 16, Number 41

mssny_enews_dividend

Dear Colleagues:

MACRA, MIPS, APNs, EHR, PQRS, MU, SGR, IPA, HMO, PPO, PPN, CMS, CSC, NGS, PAC, CAC, etc.

Yes, the alphabet soup continues. If you have been around long enough, you know what most of these acronyms mean. Historically, we had traditional indemnity health insurance plans. We had usual customary and reasonable charges. We had prevailing community fees.  Ah, the good old days.

Next came what was supposed to be the best thing since sliced bread— managed care.  Pre-certifications and prior authorizations reigned. Then, the pendulum swung the other way and gave us capitation with a mix of fee-for-service. This worked well for a little while—until the plans figured out that under capitation, some providers made more money than under fee-for-service.  Uh-oh, switch back to fee-for-service stat.

Now, the pendulum swings again.  The government comes up with MACRA.  They describe it as a new payment methodology. Really?  Again, if you have been around long enough, it is just the pendulum swinging back yet again.

The government is just trying to see what they are paying for – call it MIPs, APNs, call it value-based medical care.  Call it what you will –quite simply, it is just the government demanding to know what it is paying. To do so, it forces physicians to jump through hoops and put square pegs into round holes to justify being paid for the care provided to patients.

If you need help with the payment games, reach out to your medical society. For dues paying members, we are here to help.

If you really want or need a description of the acronyms, call Regina McNally, VP, Socio-Medical Economics, 516 488 6100, ext. 332.

Now, for the good news! This week MLMIC declared a new 20% general dividend for policyholders. The dividend — which will apply to policyholders who are insured on May 1, 2017, and maintain continuous coverage through July 1, 2017 — will be based upon the annual rate of premium in effect on May 1, 2017. MLMIC has always had strong standing and stability in the challenging New York insurance market, and this dividend in addition to their arrangement with Berkshire Hathaway will bring policyholders continued peace of mind.

(See story below)

Malcolm Reid, MD, MPP
President, Medical Society of the State of New York

Please send your comments to comments@mssny.org


enews large

MLMIC Board Declares 20% Dividend for Policyholders
MLMIC’s board has declared a new 20% general dividend for policyholders. The dividend — which will apply to policyholders who are insured on May 1, 2017, and maintain continuous coverage through July 1, 2017 — will be based upon the annual rate of premium in effect on May 1, 2017.  It will provide meaningful financial relief to policyholders.

The board’s decision to declare this dividend is based on MLMIC’s statutory admitted assets of approximately $5.8 billion, a surplus of $1.9 billion and statutory net income of approximately $100 million. These figures, available in the company’s September 30, 2016, statutory financial statement, show the company’s overall financial condition remains sound.

The new dividend is separate and apart from MLMIC’s agreement to become part of the Berkshire Hathaway family of companies. That process takes a while and is on track to be completed by next year’s end. In the meantime, MLMIC’s strong financial performance enables it to offer a 20% dividend.

An overview of the September 30, 2016, statutory financial statement is available here, and the full financial statement has been filed with New York State Department of Financial Services.

Governor Signs MSSNY-Backed Administrative Simplification Bills into Law
Governor Cuomo this week signed into law two bills supported by MSSNY designed to reduce some of the administrative burdens on physicians in their dealings with health insurers.

  • The first bill (A.501-E, Cusick/S.2545-D, Lanza) would reduce from 90 to 60 days the time within which a health insurer must complete its review of the application of a physician to participate in the network of a health insurer, as well as reducing from 90 to 60 days the time within which a physician in some situations can become “provisionally credentialed” if the plan does not complete its review.   The bill also eliminates some ambiguous statutory language that currently gives discretion to a health insurer to delay a decision on a physician’s application after these deadlines have passed.   The new law applies to credentialing applications received by health insurers on or after April 1, 2017.
  • The second bill (A.6983-A, McDonald/S.4721-A, Hannon) would direct the Commissioner of Health and Department of Financial Services to create standards to provide greater uniformity among health insurers of the processes to be followed when physicians request insurers to cover their patients’ needed prescription medications.  MSSNY worked closely with the New York Chapter of the American College of Physicians in advocating for this legislation.   The law takes effect immediately.

Urge Gov. to Sign Law to Permit E-Prescription Transfers between Pharmacies
All physicians are urged to contact the Governor to urge that he sign into law legislation (A.10448. Schimmel/S.7537, Martins) supported by MSSNY that would permit a pharmacy to transfer an e-prescription to another pharmacy. 
Physicians can send a letter to the Governor from here.  

This law would address concerns faced by both patients and physicians when a pharmacy may be out of stock of a particular medication, and may be unable to fill the prescription.  Current laws pertaining to e-prescribing do not allow for the transfer of an e-prescription from one pharmacy to another. In such instance the only recourse available to the patient is to return to the physician’s office – if it is open—to have him/her send the e-prescription to another pharmacy. This creates unnecessary duplication for the physician, and unnecessary delays for the patient waiting to receive their needed medications. This legislation would help to address these concerns.

Counting Absentee Ballots for 2 Senate Races; 24 Newly Elected to NY Legislature
With the absentee ballots of 2 Long Island State Senate races still being counted, it has not yet been officially determined which party will have majority control of the New York State Senate. Of the 63 seats in the State Senate, 30 Republicans have been elected, and 31 Democrats. However, one of the Democrats, Simcha Felder, has previously “conferenced” with the Republicans. The 2 State Senate seats not yet officially decided are currently held by Republicans Carl Marcellino and Michael Venditto.  Also unclear at this time is the role of the 7-member Independent Democratic Caucus led by Senator Jeff Klein.

The November 8 elections also saw 24 candidates newly elected to the New York State Legislature, including 18 new Assemblymembers and 6 new Senators. 
Below is a list of these newly elected members, and the members of the Legislature they will be replacing:

Chamber District FIRST Last Party Replaced
Assembly 30 (NYC) Brian Barnwell Dem Margaret Markey
Assembly 94 (Hudson Valley) Kevin Byrne GOP Steve Katz
Assembly 44 (NYC) Robert Carroll Dem James Brennan
Assembly 72 (NYC) Carmen De La Rosa Dem Guillermo Linares
Assembly 70 (NYC) Inez Dickens Dem Keith Wright
Assembly 16
(Long Island)
Anthony D’Urso Dem Michelle Schimel
Assembly 133 (Western NY) Joe Errigo (former Assemblyman) GOP Bill Nojay
Assembly 115 (North Country) D. Billy Jones Dem Janet Duprey
Assembly 20
(Long Island)
Melissa Miller GOP Todd Kaminsky
Assembly 101 (Central NY) Brian Miller GOP Claudia Tenney
Assembly 145 (Western NY) Angelo Morinello GOP John Ceretto
Assembly 65 (NYC) Yuh-Line Niou Dem Alice Cancel
Assembly 144 (Western NY) Michael Norris GOP Jane Corwin
Assembly 23 (NYC) Stacey Pheffer Amato Dem Phil Goldfeder
Assembly 33 (NYC) Clyde Vanel Dem Barbara Clark
Assembly 143 (Western NY) Monica Wallace Dem Angela Wozniak
Assembly 112 (Capital District) Mary Beth Walsh GOP James Tedisco
Assembly 56 (NYC) Tremaine Wright Dem Annette Robinson
Senate 31 (NYC) Marisol Alcantara Dem Adriano Espaillat
Senate 36 (NYC) Jamaal Bailey Dem Ruth Hassell-Thompson
Senate 54 (Central NY) Pamela Helming GOP Michael Nozzolio
Senate 60 (Western NY) Chris Jacobs GOP Marc Panepinto
Senate 7
(Long Island)
Elaine Phillips GOP Jack Martins
Senate 49 (Capital District) James N. Tedisco (former Assemblyman) GOP Hugh Farley

Your membership yields results and will continue to do so. When your 2017 invoice arrives, please renew. KEEP MSSNY STRONG!


MSSNY Veterans’ Matters Now Includes CME Programs on Substance Use and Suicide; Physicians Strongly Urged to Attend
The Medical Society of the State of New York is expanding its Veterans’ Matters mental health training initiative by including additional programming on substance use disorders and suicide in returning veterans.  Veterans’ Matters is conducted through webinars and live grand rounds presentations all over the state.

Presenting faculty for Veterans’ Matters includes Frank Dowling, MD and John McIntyre, MD. The Medical Society will present a PTSD and TBI webinar on Wednesday, December 7th at 7:30 a.m.  On December 15th, a Substance Use Disorders webinar will be conducted at 8 a.m.   Registration is required.

 

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.

MSSNY designates each live activity for a maximum of 1 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

To register for a webinar, click on a date below:

Information and the educational objectives for each webinar can be found here:

PTSD and TBI – 12/7/16
Substance Use Disorders –12/15/16

If your hospital is interested in having one of these programs presented, or if you need assistance with registering, please contact Greg  Elperin at gelperin@mssny.org or call (518)465-8085. 

MACRA Educational Program This Monday Evening from 7-8:30PM
Do you have questions about how to comply with the new Medicare MIPS requirements taking effect in 2017?  This
Monday, November 21, from 7-8:30 PM
is the first of several programs being offered by the AMA to help physicians better understand  the requirements of the new Quality Payment Programs (QPP) that were created by the Medicare Access and CHIP Reauthorization Act (MACRA). To register for Monday night’s program, click here:  https://cc.readytalk.com/r/y70aavsqh5g0&eom

Other similar programs upcoming include:

  • Thursday,  Dec. 1 – 6:30 pm – 9 pm ET
    Register here:
  • Tuesday,  Dec. 6, 8:00 pm – 9:30 pm ET
    Register here.
  • Saturday,  Dec. 10, 12 PM -1:30 ET
    Register here.

DOH Recommends Four Brooklyn Hospital Merge
A new report commissioned by the state Department of Health recommends that four financially struggling Brooklyn hospitals merge into one regional health system, with one of the hospitals drastically reducing inpatient services.

The four hospitals—Brookdale University Hospital and Medical Center, Kingsbrook Jewish Medical Center, Interfaith Medical Center and Wyckoff Heights Medical Center—will require $310 million in operating subsidies from the state in fiscal 2017, which ends March 31, 2017. The report was authored by Northwell Ventures, the consulting arm of Northwell Health. The combined losses of the four hospitals are expected to grow to $405 million by fiscal 2021. Over the five-year period the hospitals will have lost $1.8 billion. Gov. Andrew Cuomo and the state Department of Health must now determine whether they support Northwell’s proposals. To move forward, the plan must also be approved by the boards of the four Brooklyn hospitals. 

AMA Statement Re Principles of Health Care Reform That Congress Must Address
With the entire Affordable Care Act likely to be revisited in the New Year by the Congress and President-elect Trump, the AMA released the following statement after receiving extensive testimony from physicians representing a wide array of perspectives at its House of Delegates meeting this past weekend.

“The AMA House of Delegates, reflecting more than 170 state and specialty medical societies from across the country, today reaffirmed its commitment to health care reform that improves access to care for all patients. 

“Using a comprehensive policy framework that has been refined over the past two decades, the AMA will actively engage the incoming Trump Administration and Congress in discussions on the future direction of health care. The AMA remains committed to improving health insurance coverage so that patients receive timely, high quality care, preventive services, medications and other necessary treatments.  

“A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured. We will also advance recommendations to support the delivery of high quality patient care.  Policymakers have a notable opportunity to also reduce excessive regulatory burdens that diminish physicians’ time devoted to patient care and increase costs. 

“Health care reform is a journey involving many complex issues and challenges, and the AMA is committed to working with federal and state policymakers to advance reforms to improve the health of the nation.”

Among the key principles highlighted by the AMA in its policy framework that they urge policymakers to consider:

  • Individually owned and selected health insurance using refundable and advanceable tax credit
  • Support a requirement that individuals and families who can afford health insurance be required to obtain it;
  • Required coverage of pre-existing conditions;
  • Expanded availability of Health Savings Accounts (HSAs);
  • Continued availability of those under 29 to stay on parents’ coverage;
  • Adequate Provider Networks in Medicare, Medicaid and Commercial Insurance;
  • Health Plan Transparency/Accurate Network Listings;
  • Medical Liability Reform;
  • Fair Medicaid Payment/Parity with Medicare payments; and
  • Affordable Prescription Medications


CMS Launches New Online Tool to Make Payment Program Easier for Clinicians
Today, CMS released a tool to share automatically electronic data for the Medicare Quality Payment Program. This new release is the first in a series that will be part of CMS’s ongoing efforts to spur the creation of innovative, customizable tools to reduce burden for clinicians, while also supporting high-quality care for patients.

In October, CMS released the Quality Payment Program website, an interactive site to help clinicians understand the program and successfully participate. Today’s release, commonly referred to as an Application Program Interface (API), builds on that site by making it easier for other organizations to retrieve and maintain the Quality Payment Program’s measures and enable them to build applications for clinicians and their practices. The API, available at www.qpp.cms.gov/education, will allow developers to write software using the information described on the Explore Measures section ofwww.QPP.cms.gov

.Based on interviews with clinicians, CMS created the Explores Measures tool, which enables clinicians and practice managers to select measures that likely fit their practice, assemble them into a group, and print or save them for reference. Already, tens of thousands of people are using this tool.

Several groups have applauded the release of this information, including: the American Academy of Ophthalmology, the Network for Regional Healthcare Improvement (NHRI), American College of Radiology (ACR), American College of Physicians (ACP), National Rural Accountable Care Consortium, Great Lakes PTN, Pacific Business Group on Health, Compass PTN, TMF QIN-QIO, and the Mountain Pacific Quality Health Foundation.

As the program and its supporting website mature, CMS will continue to release data and APIs to spur innovation and keep participants up-to-date.

To see the API Swagger documentation, please visit: https://qpp.cms.gov/api/

CMS Finalized Claims-Based Data Collection Process that Is “Less Burdensome”
CMS finalized a claims-based data collection process on the frequency of and inputs involved in global surgical services that is much less burdensome for physicians than CMS’ earlier proposal. Key changes include:

  • CMS’ decision to use 99024 for reporting post-operative services rather than the proposed set of time-based G-codes
  • Reporting is no longer required for pre-operative visits
  • Reporting is only triggered for services that meet certain minimum thresholds annually—CPT codes billed by more than 100 practitioners over 10,000 times or have allowed charges in excess of $10 million

The final rule increases payments for Chronic Care Management services by accepting CPT and RUC recommendations urging CMS to ease the administrative burden and expand the opportunities for physicians. CPT codes 99358 and 99359 for non-face-to-face prolonged E/M services will also be billable under Medicare beginning in 2017.

Medicare Announces New RAC Contracts
Last week, Medicare announced the new Recovery Auditor contracts, which sets limits for the post-claims review process and dictates when Recovery Audit Contractors (RAC) will be eligible to receive their contingency fees.

Among the changes specified in the new contracts, RACs will no longer automatically receive contingency fees for each identified overpayment. This new policy requires the RACs to pass the second level of a five-level appeals process before receiving their contingency fee. The new RAC contracts also establish new audit timelines—the RAC lookback period for inpatient claims is reduced from three years to six months—and the two midnights rule will continue to be exempted from RAC audits.

These changes are in addition to Medicare’s recent pilot program that directs RACs to consider as a low-priority reviewing claims from providers participating in Advanced Alternative Payment Models under the new Quality Payment Program.

Medical Matters CME Webinar Series Continues in 2017; Registration Now Open
The Medical Society of the State of New York will continue its Medical Matters webinars on
January 18, 2017 at 7:30 am with Triage in a Disaster Event
.  Arthur Cooper, MD, vice-chair of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee and Zachary Hickman, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee, will serve as faculty for this program. Registration is now open for this webinar here.

Educational objectives are: 1) Describe the importance of immediate bleeding suppression during a disaster event; 2) Describe the SALT methodology for triage and where to access SALT training; 3) Recognize the importance of not just general triage training, but triage training for bio-events as well.

February’s webinar will be:
The Mental Health Impact of Active Shooter/Bombing on the Healthcare Team
. This program will be held on Wednesday, February 15, 2017 at 7:30 a.m. and faculty will be Craig Katz, MD, member of MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee will serve as faculty for this program. Registration is now open for this webinar here.

The educational Objectives are: 1) Describe the psychological problems and stress symptoms that can result from caring for victims of an active shooter/bombing event; 2) Identify means by which members of the healthcare team can manage the stress during and after an active shooter/bombing event; 3) Review resources and methodologies available to address the mental health impact of an active shooter/bombing on the healthcare team.

A copy of the flyer can be accessed here. 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 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. 

The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Medical Matters is a series of CME webinars sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response.

MSSNY Participates in Antimicrobial Resistance Prevention Task Force
The New York State Department of Health (NYSDOH) convened the first-ever multidisciplinary New York State Antimicrobial Resistance Prevention and Control Task Force (NYS-ARTF) Summit this week. The summit addressed the need for prevention strategies throughout the health system and built on the work outlined at the July roundtable discussion on “Antimicrobial Resistance in Healthcare Facilities,” which was hosted by NYSDOH, Greater New York Hospital Association, and the Healthcare Association of New York State.

The engagement of stakeholders in the summit and roundtable is a key element in New York State’s comprehensive strategy to address the persistent and growing threat of multi-drug resistant bacteria. Cases of drug resistant Candida auris, a serious and sometimes fatal fungal infection andmcr-1, a novel drug resistant gene present in some bacteria, have been reported in New York. The Centers for Disease Control and Prevention (CDC) estimate that each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result of these infections.

“Through this Summit, the Task Force is working with New York State’s healthcare leaders to shape a state-wide response to the growing public health threat of multi-drug resistant bacteria,” said Commissioner of Health Dr. Howard Zucker. “If antimicrobial resistance is not addressed, we face a future where these medicines may no longer work, and infections will become difficult or impossible to treat. The most vulnerable among us will be the most at-risk.”

The summit involved experts from various disciplines including healthcare, agriculture, and veterinary care, as well as academia, community groups, and federal, state, and local government.

Stakeholders participating in the summit were previously asked to outline New York State’s top priorities in the efforts to combat antibiotic resistance. Among the priorities listed were:

  • To expand antimicrobial stewardship programs and improve infection prevention and control practices in all hospitals and nursing homes
  • To limit antibiotic use in food producing animals
  • To educate and support healthcare providers to optimize antibiotic prescribing
  • To educate consumers about appropriate antibiotic prescribing and use
  • To develop rapid diagnostic tests to distinguish bacteria from viruses and identify antibiotic resistance
  • To improve communication when patients are transferred between healthcare facilities

During the Summit, participants collaborated on designing practical solutions to achieve these priorities. The input from participants will be compiled to develop and implement a statewide strategic approach to combatting antimicrobial resistance as well as a report of recommendations that will be submitted to Governor Andrew M. Cuomo, by December 31, 2016.

“Get Smart” Campaign on Antibiotic Resistance November 14-20th
The New York State Department of Health will hold its “Get Smart (Know When Antibiotics Work) Week” on Nov 14-20th and the campaign is intended to create awareness within the physician and patient community about the growing resistance to antibiotics.  Get Smart  About Antibiotics Week (Get Smart Week) is a national, annual observance intended to engage relevant stakeholders – including professional societies, advocacy groups, for-profit companies, state and local health departments, the general public, the media and others – around antibiotic stewardship in the outpatient, inpatient, and animal health settings.

New York’s “Get Smart Campaign” promotion of the “Get Smart Guarantee” , an easy way for healthcare providers to display their commitment to appropriate antibiotic prescribing and use. The provider may use the free poster within the office and place their own photo on the poster and sign it.

There are also patient palm cards, which are a nice educational “takeaway” for a patient if they can’t have antibiotics (if their illness is viral, for instance).

The NY Get Smart Campaign would be very happy to send materials to individual providers. Contact Mary Beth Wenger at marybeth.wenger@health.ny.gov   or at (518)-474-1036.


CLASSIFIEDS


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State of the Art Midtown Medical Office for Rent
Elegant, modern, beautifully designed medical office available, furnished or non-furnished. Full or part time share with thriving Dermatology practice which occupies its own floor. Class A Architects and Designers Building in the best possible Midtown East location near Bloomingdales. Your own private corner, consultation room, two or three large equipped treatment rooms with beautiful cabinetry, sinks, and exam tables. All rooms wired and windowed. Shared oversized waiting room, kitchenette. Your own reception, administrative, front desk and storage space. $8,000-$11,500/month. Contact: (212)–583–2966, email: hefderm@outlook.com for details. No Brokers.


Elegant Plastic Surgery Office (Upper East Side Manhattan)
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Physician Opportunities


Executive Director – Bronx County Medical Society
Bronx County Medical Society, a leader in promoting excellence in Clinical Care, Education & Public Policy, is seeking an executive director. Candidates should have either a bachelor degree and/or three years of work experience with non-profit medical groups. The Executive Director should be knowledgeable on healthcare policy and nonprofit compliance. Candidate must demonstrate strength in event planning and fundraising, member recruitment and retention, community outreach, and possess strong communication skills. We offer a competitive salary and benefits package. Please send resume and cover letter to Diane Miller, Executive Director at bxcms@msn.com


A Private Multidisciplinary Medical Group is seeking an Internal Medicine/Family Medicine Physician in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire an Internal Medicine/Family Medicine Physician. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

A Private Multidisciplinary Medical Group is seeking a Podiatrist in Manhattan
A well-established Manhattan based private multidisciplinary medical group is seeking to hire a Podiatrist. This is a great opportunity to start your own practice in a modern office in midtown Manhattan. Attractive base salary plus comprehensive benefits package offered (Malpractice, 3 weeks paid vacation, 1 week CME, CME allowance, paid health insurance, etc).If you are a solo practitioner in private practice looking to join a private group practice, we will work with you to make the transition seamless. Please email your CV to tsrgexpress@gmail.com. No recruiters please.

CALL FOR RATES & INFO. CHRISTINA SOUTHARD: 516-488-6100 ext. 355