Tag: MSSNY eNews

MSSNY eNews: October 23, 2020 – Non-Medical Vaccine Exemptions Endanger Public Health—Law Must Stand

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Colleagues:

Although it seems like decades ago, it was just 2019 when NY State was at the epicenter of another infectious disease crisis, an outbreak of measles in Rockland County.  Due to religious and philosophical exemptions, vaccination rates in the county had fallen significantly with data showing six schools with vaccine religious exemption rates above 20% and another 17 schools with rates of more than 8%.

Our MSSNY, along with a large coalition, recognized the perils associated with the falling vaccination rates and worked successfully with the NYS legislature and the Governor to enact legislation eliminating non-medical exemption for vaccinations.  This public health law was signed in June 2019 and will help protect NYS residents against common childhood diseases.

However, a lawsuit (F.F. v. State of New York) was filed by a group of families that previously had religious exemptions from vaccines.   They argued that the new law violates the families’ state and federal constitutional rights to religious freedom. They also asserted that the repeal violates the U.S. Constitution’s Equal Protection Clause and forces them to comply or otherwise violate New York’s compulsory education laws. A trial court heard and dismissed this case, but an appeal has been filed.

Your MSSNY, the New York State American Academy of Pediatrics and the AMA Litigation Center have filed an amicus brief supporting the State of New York in the appeal, saying “eliminating religious objections was clearly in the best interest of public health.”

The brief explains that measles is a highly contagious disease, requiring nearly 95% of the population be vaccinated in order to achieve herd immunity. It goes on to discuss that 3% of the people who receive the vaccination will not be immune and others have medical conditions that prevent them from being safely vaccinated. It explains that, to achieve the goal of herd immunity nearly everyone who does not have a medical contraindication must be vaccinated.

The brief states “New York’s experience has shown that religious exemptions cause vaccination rates to fall below that level, resulting in dangerous and potentially deadly outbreaks. The decision to eliminate these exemptions will protect the health and the lives of New Yorkers.”

Whether we are discussing measles vaccines, flu vaccines or Covid vaccines, scientific knowledge will continue to guide our MSSNY policies and our advocacy as we strive to protect the health and well-being of the residents of NY State.

Bonnie Litvack MD
MSSNY President

MSSNY and Other Physician Organizations Call for NYS DOH and the Governor to Provide Flexibility in Reporting COVID-19 Results
October 22, 2020, Westbury, NY—Today, the Medical Society of the State of New York (MSSNY), the NY Chapter of the American College of Physicians, the New York State Academy of Family Physicians and the NYS American Academy of Pediatrics, Chapters 1, 2 & 3 called upon the NYS Department of Health and the Governor’s office to provide flexibility for reporting results of COVID-19 and Influenza tests performed in physician offices.  A survey conducted by these medical societies found that many physicians will be unable to provide these critically needed tests without more time to report results for fear of the potentially significant penalties for failure to comply.

On September 21, NYS Department of Health Commissioner Howard Zucker sent a notice to all healthcare providers requiring the reporting of all positive and negative COVID-19 and flu tests to the NYS Department of Health within 3 hours.   Additionally, the order requires that the ordering physicians report contact information, employment and/or school information for each patient.  Penalties for non-compliance are up to $2000/day.   The medical organizations are advocating for the removal of the three-hour reporting requirement for the negative tests.

“Physicians across the state share the goal of having information as soon as reasonably possible to begin contact tracing and other containment efforts. Three hours, however, is simply not enough time for busy and overburdened practices to report results, especially negative results,” says Bonnie Litvack, MD, President of MSSNY.

“A survey, conducted by MSSNY in conjunction with several specialty societies, found that over 60% of physicians believe the three-hour reporting period is a daunting, if not impossible, task for many practices,” continues Dr. Litvack.  “Over 78% of the respondents indicated that they are unable to comply with the three-hour requirement.  MSSNY is gravely concerned that these requirements may discourage practices from ordering tests and offering testing at a time when COVID-19 rates are rising in our state and more testing, not less is needed.”

“The reporting requirement is likely to compel many practices to forego providing COVID and flu tests which will inconvenience patients by requiring them to have these tests performed elsewhere,” says NYSAFP president Jason Matuszak, MD. “Also, requiring patients to go to multiple locations for tests increases their risk of exposure. Rapid tests could be done at the primary care practice, as opposed to waiting days to get results back from a commercial lab which would allow patients to know their results sooner.”

“Pediatricians across New York are deeply concerned that the recent three-hour reporting requirement for both COVID-19 and Flu test is unrealistic for community-based practices, says Warren Seigel, MD, FAAP, Chair of NYSAAP, District II.  “The recently imposed requirement will discourage offices from offering Flu and/or COVID-19 tests on site.  Sending patients to alternative venues for testing is inefficient, may contribute to the spread of disease and is a breach of medical home principles.

We urge the Department of Health to work with the house of medicine to design a more reasonable turnaround time so all practices can better serve their patients and still meet the state’s requirements for timely data on infections.”

Urge DOH to Provide More Flexibility on Reporting Results
Join with @MSSNY and urge @GovernorAndrewCuomo and @NYSDOH to
increase the 3-hour reporting window for all COVID and Flu test results so providers can comply!

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NYS COVID Data: https://forward.ny.gov/percentage-positive-results-region-dashboard

Physicians Less Likely to Vote Than Others, 3-State Study Finds
Physicians in California, New York, and Texas are less likely than the general public to vote in elections, according to findings in JAMA Internal Medicine.

Researchers examined data from a national provider registry and voter files from the three states. The proportion of physicians who voted in elections from 2006 through 2018 was significantly lower than the proportion of the general population who voted (average across elections, 37% vs. 51%). This was largely due to lower voter registration among physicians (50% vs. 66%).

Among physicians who were registered to vote, however, voter turnout was higher in all elections relative to the general population (for example, in 2018, 75% vs. 62%).

Findings were consistent regardless of political party.

The researchers conclude, “Future efforts to improve physician voter participation should explore the influence of both increasing voter registration and election turnout.”

JAMA Internal Medicine research letter; Background: Prior Physician’s First Watch coverage of voter turnout among physicians (2016)

Many U.S. Coronavirus Deaths Were Avoidable
If the U.S. death rate had matched that of other wealthy countries, between about 55,000 and 215,000 Americans would still be alive, according to a scathing new analysis by Columbia University’s National Center for Disaster Preparedness.

Why it matters: These countries have taken a significantly different approach to the virus than the U.S., providing yet another example that things did not have to be this way.

  • “Had the U.S. government implemented an ‘averaged’ approach that mirrored these countries … a minimum of 130,000 COVID-19 deaths might have been avoidable given alternate policies, implementation, and leadership,” the authors write.
  • “This discrepancy, which continues to grow daily, provides objective crude measure for assessing the government response to this unprecedented health emergency.”

Between the lines: The analysis points to several factors that set the U.S. response apart from other countries’, including insufficient testing and contact tracing, a delayed initial response, the lack of a national mask mandate or guidance, politicization and the “failure of top officials to model best practices.”

  • “Particularly, it is the inability or unwillingness of U.S. officials to adapt or improve the federal response over the course of the pandemic that has strongly contributed to the nation’s uniquely high COVID-19 fatality rate,” the authors conclude.

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NYS NEW Paid Sick Leave Law
Need to know more about New York’s new paid sick leave law effective September 30?  Here is more info from NYS Department of Labor: https://www.ny.gov/new-york-paid-sick-leave/new-york-paid-sick-leave#eligibility

AMA Calls for Information Blocking Enforcement Discretion
The Trump Administration’s Final Rule on information blocking requires all physicians to come into compliance with the Rule’s requirements by Nov. 2. While the rule makes several important changes to electronic health record (EHR) vendor technology, including improving usability and interoperability, the rule also creates a new and complex set of administrative and regulatory requirements that physicians must follow in order to be compliant with the information blocking provisions.

Specifically, physicians are required to establish a new compliance framework to handle all medical record requests coming into their office. Information blocking rules require physicians to respond to and release patients’ medical records for nearly every request they receive unless an appropriate exception can be claimed.

Physicians must also examine, create, modify, and update all policies and procedures their organization uses to manage medical record requests. Documenting how a physician applies exceptions—and their organizational policies—to each information request will be important in maintaining compliance with the information blocking rules.

The AMA, along with several professional associations and provider organizations, sent a letter to the Office of the National Coordinator for Health Information Technology (ONC) asking for enforcement discretion for at least one year to allow physicians time to come into compliance with the new rules without fear of being penalized. The COVID-19 pandemic is straining physician resources and office staff and will make coming into compliance with the Nov. 2 deadline impractical. The AMA is also developing a resource to help physicians better understand the rule’s requirements.

Additional fact sheets and webinars on the rule can be found on ONC’s website.

CDC Report: Hispanics’ Death Rates Rose 16.3% in May to 26.4% in August
Hispanic Americans are dying from COVID-19 at higher rates than earlier in the pandemic, a CDC report finds. Researchers analyzed data from 114,411 COVID-19 deaths reported to the National Vital Statistics System and found the percentage of Hispanic decedents rose from 16.3 percent in May to 26.4 percent in August.

 

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Paid Family Leave Webinars for Employers and HR Professionals: Updates for 2021
The New York State Workers’ Compensation Board is pleased to invite you to a special Paid Family Leave webinar specifically for employers and HR professionals.

Each one-hour, online session will provide an overview of the state’s landmark Paid Family Leave benefit, including important information regarding COVID-19, updates for 2021, and resources to help you share information with your employees.

Paid Family Leave is employee-paid insurance that provides employees with job-protected, paid time off from work to bond with a new child, care for a family member with a serious health condition, or assist when a spouse, domestic partner, child or parent is deployed abroad on active military service.  As of March 2020, Paid Family Leave may also be available in the event an employee, or their minor dependent child, is subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19.

Register

Please join us for a live presentation on one of the following dates. Each session is free, and we will leave time at the end for your questions. Registration is required.

Wednesday, November 4, 2020: 10:00 a.m. – 11:00 a.m.
Wednesday, November 18, 2020: 10:00 a.m. – 11:00 a.m.

Additional Paid Family Leave resources are available

New York State offers complete details on Paid Family Leave at PaidFamilyLeave.ny.gov, including updates for 2021 and COVID-19. The employer page also contains helpful resources, including employer forms, fact sheets and past webinars. Help is also available via a toll-free Paid Family Leave Helpline at (844) 337-6303, Monday through Friday, 8:30 a.m. – 4:30 p.m.

Veterans Matters: TBI in Returning Veterans Webinar 
The Medical Society of the State of New York and Nassau County Medical Society are hosting a CME live webinar entitled Veterans Matters: TBI in Returning Veterans on Tuesday, November 3, 2020 at 7:30 am.

Click HERE to view the flyer and register for the program!
When:             November 3, 2020 at 7:30 am
Faculty:           David Podwall, MD

Educational Objectives:

  • Identify signs and symptoms indicative of the spectrum from concussion/mild TBI to severe TBI
  • Examine evidence-based treatment modalities and when to refer to a specialist
  • Identify red flags that indicate alternate or more severe pathology
  • Outline an appropriate management plan for a patient presenting with concussion/TBI including a return to “normal life” protocol

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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Join Round Table Regarding NYS’s Response to Increase in HIV and Gonorrhea
Dear Colleague,

We invite you to share your ideas and suggestions to inform New York State’s response to the increases in HIV and gonorrhea. This interactive virtual feedback session will provide Monroe County community providers the opportunity to provide input. Insight gained from these sessions will inform New York State Department of Health response to the HIV and gonorrhea increases in Monroe County.

When: Friday, October 30, 2020 | 11am – 12:30pm
Where: Zoom

Please register here. 

Erica Lovrin
Health Program Aide
Office of the Medical Director, AIDS Institute
New York State Department of Health
Room 259, Corning Tower ESP
Albany, NY 12237
518-473-8815 | Erica.lovrin@health.ny.gov

CDC Expands Definition Of ‘Close Contacts,’ After Study Suggests COVID-19 Can Be Passed in Brief Interactions
The CDC, on October 21, expanded how it defines a “close contact” of someone with Covid-19 as it released new evidence showing the coronavirus can be passed during relatively brief interactions.

Previously, the CDC described a close contact as someone who spent 15 minutes or more within six feet of someone who was infectious. Now, the agency says it is someone who spent a cumulative 15 minutes or more within six feet of someone who was infectious over 24 hours, even if the time is not consecutive, according to an agency spokesperson.

Close contacts are those who are tracked down during contact tracing and are recommended to quarantine.

The announcement from the CDC comes as scientists described in a new study how a correctional officer in Vermont appears to have contracted the coronavirus during “multiple brief encounters” with six incarcerated people who had COVID-19. The infected people were awaiting the results of their Covid-19 tests while the interactions happened.

In the study, the authors — including officials from the CDC and Vermont’s health and corrections departments — noted that the data for defining a close contact have been limited. “A primary purpose of contact tracing is to identify persons with higher risk exposures and therefore higher probabilities of developing infection, which can guide decisions on quarantining and work restrictions,” they wrote, adding that “public health officials should consider transmission-risk implications of cumulative exposure time within such settings.”

Experts have long noted that the 15-minute, within-six-feet rule was not some sort of threshold that needed to be hit for transmission to occur. So much about whether spread happens depends on how infectious a person is, how well-ventilated the room that people are in is, how the virus might move through the air in a particular setting, whether people are wearing masks, and more. The 15-minute window had just been used as a benchmark to prioritize who should be followed up with for contact tracing and quarantine.

One reason why the length of interactions might matter, experts think, is because people need to be exposed to a certain level of virus if they are going to get infected. Researchers still aren’t sure what that “infectious dose” is — and if a higher dose corresponds to how sick people are likely to get — but the thought is that the longer someone is around someone else who is infectious, the higher level of virus they will be subjected to, and the more likely they are to get COVID-19.

After the officer was diagnosed with Covid-19 in August, health officials and staff at the correctional facility reviewed surveillance footage of his interactions with the six incarcerated people. Though he never spent 15 straight minutes within six feet of any one of them, he was within six feet of them at least 22 times for one eight-hour shift, cumulating in at least 17 minutes of exposure. During their interactions, the incarcerated people were wearing masks most, but not all, of the time, while the officer always had a microfiber cloth mask, gown, and eye protection on.

Garfunkel Wild Names Andrew Blustein Chairman
MSSNY’s Counsel, Garfunkel Wild, P.C., a premier law firm with a specialty in health law, is pleased to announce Andrew Blustein has been named the firm’s new Chairman, effective October 1, 2020. Andrew succeeds Robert Wild, founding member of Garfunkel Wild. While Robert will assume the title of Chairman Emeritus, he is not retiring and will continue his practice and charitable work.

Andrew was appointed Vice Chairman four years ago as part of the firm’s leadership succession plan allowing him to work with outgoing Chairman Robert Wild while transitioning into the new role.

Andrew arrived at Garfunkel Wild 28 years ago and has held multiple leadership positions. He has been a member of the Firm’s Executive Committee for nearly a decade and co-founded and co-chairs the Firm’s Health Care Information and Technology Practice Group and E-Health and Telemedicine Practice Group.

Andrew steps into his new role after another successful year. In the last 12 months alone, the firm doubled the size of its Connecticut office, introducing a new integrated Biotechnology, Life Science and Medical Device Practice group and added 12 attorneys. The firm continues to focus on strategic planning, including attorney development and future growth into new markets and practice areas.

Garfunkel Wild, P.C. is a full-service law firm providing assistance to a broad range of clients, including hospitals, health care systems and other health care facilities, organizations, practitioners, and technology companies. Garfunkel Wild, P.C. is ranked in Chambers USA, The Best Lawyers in America© and Super Lawyers. For more, visit www.garfunkelwild.com.

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Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.Rhinebeck Estate for Sale A world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.
The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.

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.

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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

OBGYN Physician for Our Upper East Side Practice
Gynecology office setting only – No Obstetrics. Please contact the office at 212-772-3722 Email: olarugabriela@aol.com. Office Location: VCARE OBGYN 328 East 75th St. Suite 4 New York NY 10021 REQUIREMENTS: Doctor of Medicine degree. New York Medical License. DEA Board Certified OBGYN

 

 

 

 

 

 

 

 

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MSSNY eNews: July 17, 2020 – Legislators Are Back! MSSNY Issues at Stake!


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Dear Colleagues:

Legislators Are Back! MSSNY Issues at Stake!
The pandemic caused all of us to have our years unfold in ways far different than we thought it was going to be.

The New York State Legislature is no exception.

With several state legislators contracting the virus in mid-March and most of the state smartly following instructions to stay “socially distant” the State Legislature essentially suspended proceedings in early April after enactment of the State Budget (with limited returns for focused agendas in late May and mid-June).

Now with our low infection rates having made New York a model for the country, the Legislature is returning to Session next week, mostly virtually, to take up a “robust agenda” (as one legislator described it) of items that had been put on hold due to the pandemic response.  While many of the items under consideration are local issues important for the constituents of a particular Assembly or Senate district, there are also numerous health care items that could be brought up for discussion and have a significant impact on physicians and their patients.

One of these items is legislation (A.10427/S.8497) strongly opposed by MSSNY that would repeal the liability protections for physicians and other health care providers enacted in the State Budget for patient care provided as part of the Covid-19 response effort. These protections were not only for direct care provided to Covid-19 patients but also for the extremely difficult triaging decisions made when hospitals particularly downstate were being overwhelmed with patients.  These protections are also absolutely essential for physicians who were required by state government to postpone so-called elective procedures to prioritize health care resources for Covid-19 patients.

MSSNY worked together with the specialty societies to send a letter to the Legislature expressing its strong objections to this proposal.  I also had a letter to the editor of the Albany Times-Union published this week objecting to this short-sighted legislation.

While the bill’s proponents have focused on nursing home issues as the basis for repealing these liability protections, the impact of the legislation goes far beyond nursing homes.  In both our letter to the Legislature and to the Albany T-U, we noted our strong concerns that this legislation will not only prevent hospitals and other health care facilities from re-developing capacity in case of a second “surge” but also would unfairly retroactively remove the liability protection that healthcare professionals and facilities believed they had in responding to the crisis of patient load exceeding capacity.

As you know, we found ourselves making extraordinary medical decisions in confronting a new deadly disease with an unprecedented volume of patients. At the same time were asked to provide health care services that were not within our usual scope of services, and often without adequate protective equipment, threatening our health and our families’ health.

Certainly, it is important to assess our pandemic response for the purposes of improving how we can respond if there is a “second surge” in New York, or for future pandemics.  But undoing protections to our healthcare heroes who bravely treated patients on the frontlines would be extremely unfair and counterproductive for future response efforts.

Please remain alert for further updates.  We are continuing to work closely with our allies across healthcare sectors to advocate for the protection of this important law.

Bonnie Litvack, MD
MSSNY President

MSSNY Continues to Oppose Numerous Legislative Mandate Bills
With the Legislature set to return to Session next week, MSSNY continues to oppose countless well-intended but problematic bills under active consideration that would add significant new mandates on medical care delivery.

Taken together, these proposals would add significant new record keeping responsibilities that would also impose civil sanctions and/or disciplinary action for failing even in one instance to properly follow the mandate.  These proposals include:

Urge Your Legislator to Oppose Massive Liability Expansion Bill
With the State Legislature to return to Session next week to take up many items that had been set aside due to the pandemic, all physicians are urged to contact their legislators to have them oppose legislation (A.5612/S.4006) that has advanced that would greatly expand the possible damages awardable in a wrongful death action, and have the effect of greatly expanding our already outrageously high liability insurance premiums.  

You can send a letter here.

One recent actuarial estimate indicated that passage of this legislation could require a liability premium increase of nearly 50%.  

These kinds of increases are untenable particularly at a time when physician practices have been struggling to stay afloat due to the enormous drop in patient visits arising from the pandemic.

Please urge your legislators to oppose this legislation today!

MSSNY Working with NYSOS Urges Legislature to Keep Patient Safety Standards for Ophthalmological Care
Proposed legislation (A.1193-C/S.4035-A) to permit optometrists to prescribe certain oral medications has been amended, over the objection of ophthalmologists, to weaken optometrist training requirements designed to ensure patient safety. The bill was advanced by the Assembly Higher Education and Codes Committees this week.

To send a letter in opposition, click here: https://p2a.co/HsyXbSp

The bill had been negotiated between the NYS ophthalmological society and NYS Optometry Association but has been amended as follows:

  • Significantly reducing the training required of optometrists to prescribe these oral medications;
  • Removing the requirement that optometrists taking the required certification course and final examination retake the course if they have failed the final examination three times; and
  • Eliminating a proposed requirement that optometrists to furnish evidence that they have completed required continuing education courses when they submit an application for license renewal;

To read MSSNY’s memo in opposition to this legislation, click here.

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Members of New York’s Congressional Delegation Team Up in Bipartisan Push for Additional Funding for Community Physicians in CARES Act
Representatives Anthony Brindisi (D-Utica) and Elise Stefanik (R-Plattsburgh) teamed up this week to send a letter to the Secretary of Health & Human Services (HHS), Alex Azar, urging support for additional funding in the federal CARES Act, to help community physicians across New York State as they work to recover from the economic impact of the COVID19 crisis.

Specifically, the letter notes that, “Like many businesses, community physicians in New York have experienced a devastating impact on their practices because of the COVID-19 crisis, with patients having to appropriately limit their trips out of the house, including to their doctor’s office, along with the suspension of all elective procedures for months during lockdowns. The impact has devastated practices and jeopardized jobs for millions across the state.”

The letter also quotes a MSSNY survey this spring that found that 79% of physicians had seen a reduction of more than 50% in the volume of patients visiting their practices. Nearly 3/4 of physicians had a greater than 50% drop in practice revenue; and 40% had to lay off, or furlough, at least 25% of their staff. A recent Fair Health report indicating that patient visits to physician practices were down by nearly 80% in the Northeast.[1]

MSSNY’s Division of Governmental Affairs will continue to engage on this important issue and provide updates to members. CARY, AUSTER

[1] FAIR Health, Healthcare Professionals and the Impact of COVID-19, A FAIR Health Brief, June 10, 2020,https://s3.amazonaws.com/media2.fairhealth.org/brief/asset/Healthcare%20Professionals%20and%20the%20Imp act%20of%20COVID-19%20-%20A%20Comparative%20Study%20of%20Revenue%20and%20Utilization%20- %20A%20FAIR%20Health%20Brief.pdf

Quality Health Plans of NY (QHPNY) No Longer Contracted with Medicare
Please be aware, QHPNY no longer has a contract with Medicare effective February 29, 2020.  QHPNY is responsible for all payment of claims for its (prior) members. CMS understands that QHPNY is in the process of being liquidated by the New York State Department of Insurance.  Once that happens, that State will pay the remaining claims.  CMS heard from physicians regarding outstanding claims. CMS has advised them to file a complaint for unpaid claims with the New York State Department of Financial Services.  Complaints can be made by submitting to www.dfs.ny.gov/consumer/filecomplaint.htm  After which, calls can be made to 212 480 6400. (Regina McNally, VP Socio-Med Div.)

New York’s Health Premiums Remain Among the Highest in the U.S.
The average cost of New Yorkers’ health benefits increased by less than the national average in 2019 but remained among the highest in the U.S., according to recently published federal data.

The average cost for family coverage rose 4 percent to $22,874, which was 12 percent above the national average and second only to Alaska, according to an annual survey of private-sector employers by the U.S. Agency for Healthcare Research and Quality (see first chart). The average cost of single coverage rose 2 percent to $7,890, which was 13 percent above the national average and third behind Alaska and Delaware.

Those increases were a bit lower than the nationwide jumps of 5 percent for family coverage and 4 percent for single coverage.

Still, all those figures were two or three times the general inflation rate – continuing a long-term pattern for New York and the U.S.

New York’s insurance has traditionally been more expensive than national norms, but the gap has been getting wider in recent decades (see second chart).

The state’s high cost of living is likely a factor, especially in the New York City area. State policy also drives up premiums by heavily taxing health insurance and continually adding to a long list of coverage mandates. (empire Center, July 17)

Missed Childhood Vaccines Could Be Bigger Threat than COVID-19, WHO says
The COVID-19 pandemic has spurred a major decline in childhood immunization rates worldwide, the consequences of which could be more severe than the pandemic, the World Health Organization warned.

“The avoidable suffering and death caused by children missing out on routine immunizations could be far greater than COVID-19 itself,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said in a statement cited by The Hill.

The WHO, CDC and other health partners polled 82 countries June 5-20. Sixty-nine percent of countries reporting on their vaccine programs said efforts were disrupted or suspended due to the pandemic. The most common reasons for disrupted vaccine programs were shortages of personal protective equipment, travel restrictions and a lack of available health workers.

Preliminary data for January through April also shows a “substantial drop” in the number of children receiving three doses of the vaccine against diphtheria, tetanus and pertussis, the WHO said. This could be the first time the world sees a drop in immunization coverage for these diseases in 28 years.

The WHO and UNICEF said they are providing resources and services to help countries make up lost ground on childhood vaccinations.

To learn more, click here.

HHS Telemedicine Hack on Telemedicine (One Hour per Week) Begins on July 22
This course is a free10-week learning community to accelerate telemedicine implementation for ambulatory providers. It is a learning collaborative from the US Department of Health and Human Services and others addressing telemedicine. Questions should be directed to: c19ECHO@salud.unm.edu

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Managing Your Social Media Presence Webinar on August 12
On August 12, at 12 noon, MLMIC and HANYS will present a one-hour webinar designed to help healthcare providers optimize their social media strategy and minimize risks associated with its use. Read more at MLMIC.com

Please Take the AMA Survey on Telehealth Impact (on) Physicians
The American Medical Association has been working on a Telehealth Impact Physician survey in collaboration with MITRE, Mayo and others as part of an effort of the COVID-19 Healthcare Coalition.

You are invited to complete the Telehealth Impact Study Provider Questionnaire by clicking on the link below.  The study has been approved by the Mayo Clinic IRB and is part of our efforts in the COVID-19 Healthcare Coalition to address the pandemic. Since COVID-19 started, we have experienced a significant shift towards telehealth.  The goal of this project is to learn more about your experience with telehealth to identify the challenges and barriers, as well as the benefits. 

Building on existing research, your response will help inform additional resources needed across the industry and health care community, provide insights to federal and state policymakers, and identify gaps in current research. Respondent and organization information will remain confidential and will only be reported in aggregate. The findings will be shared and made available to all on the COVID-19 Healthcare Coalition website, as well as shared by the various organizations participating in the Coalition Telehealth Workgroup*. 

The COVID-19 Healthcare Coalition is focused on understanding your experience of telehealth as an individual physician, nurse practitioner, or physician assistant. Please click here to start the survey https://src.co1.qualtrics.com/jfe/form/SV_6KAkyEVfhtGj3vL. The survey is expected to take up to 15-20 minutes and we ask that you complete the survey by August 13th, 2020.  Please remember to press submit when you get to the end of the survey. 

We want to hear from as many clinicians as possible to inform our work. If you have colleagues who use telehealth, please consider forwarding this invitation to them. 

Thank you in advance for your consideration and valuable insights. 

Best Regards,
Steve R. Ommen, MD
Medical Director, Center for Connected Care, Mayo Clinic
Francis X. Campion, MD, FACP
Principal Lead, Digital Health
MITRE Corporation 

*COVID-19 Healthcare Coalition Telehealth Workgroup: American Medical Association (AMA), American Telemedicine Association (ATA), Digital Medical Society (DiMe), MassChallenge Health Tech, Mayo Clinic and MITRE Corporation. The AMA, while a part of the Coalition Telehealth Workgroup, is not a formal member of the COVID-19 Healthcare Coalition.

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MSSNY’s Weekly Podcast

What is the Cost of COVID-19 Hospitalization?
The median in-network commercial charge for COVID-19 hospitalizations ranged from $34,662 for the 23 to 30 age group to $4

5,683 for the 51 to 60 age group, new data show.

The 51 to 60 age group was the most expensive to treat as well as the most common to be hospitalized for COVID-19, accounting for nearly 30% of related hospitalizations, according to an analysis of commercial claims from January through May by not-for-profit research firm Fair Health. Although, the age distribution may be in flux, researchers said, pointing to recent reports indicating that the average age of new COVID-19 cases dropped by about 15 years.

In the South, Midwest and West, individuals aged 19 to 40 accounted for larger shares of COVID-19 claims than in the Northeast and the nation as a whole.

The study mirrored Medicare claims data showing that chronic kidney disease and kidney failure were the most common comorbidities of hospitalized COVID-19 patients.

Many Medicare beneficiaries, which Fair Health’s analysis excludes, end up under the Medicare severity-diagnosis related group of respiratory system diagnosis with ventilator support, which yields more than $42,000, said Glenn Melnick, a healthcare economist at the University of Southern California who has been studying COVID-19-related utilization and reimbursement trends. That may explain why the commercial claims for those 61 and older are relatively lower, he said, noting that it could also be related to claims lag since a lot of older patients are staying in the hospital longer. Still, the charges and payments for the upper age groups seem low, especially since commercial insurers typically pay more than Medicare, Melnick said.

The total charges to treat COVID-19 within hospital settings are projected to range from at least $362 billion to as high as $1.45 trillion, Fair Health estimates.

The Fair Health analysis revealed that males were associated with a larger share (54%) of COVID-19 commercial claims, according to Fair Health data. The office setting was the most common venue for initial diagnoses, except for patients aged 61 and older, who were most commonly diagnosed initially in an inpatient setting.

Notably, the Northeast had the highest percentage of COVID-19 patients first diagnosed via telehealth, which was typically the least-common medium.

Physicians and data experts at Santa Clara (Calif.) Valley Medical Center developed a COVID-19 risk score that aims to maximize resources and direct treatment. If they are male, over the age of 60, have a body-mass index of at least 30 and have comorbidities like diabetes or heart conditions, they are more likely to get sick, Santa Clara Valley Medical Center experts’ analysis of nearly 7,000 emergency department visits revealed. Patients who have fewer than three of those characteristics are extremely unlikely to require hospitalization. And 1 in 8 patients who meet at least three of the criteria will likely get very sick.

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November 17, 2017 – Talking “The Talk” at Thanksgiving

 

Charles Rothberg, MD - MSSNY President
PRESIDENT’S MESSAGE
Charles Rothberg, MD
November 17, 2017
Volume 17
Number 43

Dear Colleagues:

Longtime MSSNY member, Dr. Pat Bomba, has been working enthusiastically on end-of-life issues for well over two decades. The champion of “the tough conversation” has earned  her national recognition for her work; other states have followed New York’s lead. Dr. Bomba created and promoted the end-of-life-care document called MOLST (Medical Orders for Life Sustaining Treatment) for people who are in good health and those who are seriously ill.  MOLST helps fill in the gaps of a living will, and makes sure everyone in the health care system is guided by the patient’s own preferences for care.

According to a recent editorial Dr. Bomba wrote, her family has a Thanksgiving tradition dating back to 1992 that has nothing to do with food or football. Her message is something you may want to think about for yourself, your family, your patients and your practice.

As a health plan medical director with an expertise in geriatrics, palliative care and end-of-life issues, Dr. Bomba knows opening this topic leads to difficult but meaningful conversation. She recommends that everyone 18 years and older complete a Health Care Proxy and then, should share copies with their physician, lawyer and most importantly, their families.

At the Bomba’s annual family turkey dinner, they have an advance care planning discussion whereby they “focus on what makes life worth living at this point in our lives. I encourage every family to embrace our Thanksgiving tradition. Our Thanksgiving and thoughtful MOLST discussions helped our family honor our mom’s wishes at the end of her life.”

As she writes, “Advance care planning is a gift to yourself and your family. Choose the person you trust to make medical decisions if you lose the ability to make medical decisions and share your values, beliefs and what matters most with your family and loved ones.

While at first you might think it’s morbid to discuss such issues at a festive gathering, we’ve found sharing our wishes for end-of-life care actually brings us closer. We gain peace of mind knowing our own wishes will be understood and honored in the event we can’t speak for ourselves.”

As she succinctly puts it, “No pumpkin pie, until you tell me how you want to live until you die.” After dinner, “the adults in our family stay at the table and talk about what matters most in our lives. We review our advance directives to make sure they reflect our current feelings.”

The New York eMOLST Registry is an electronic database centrally housing MOLST forms and CDFs to allow 24/7 access in an emergency. eMOLST allows for electronic completion of the current New York State Department of Health-5003 MOLST form.  By moving the MOLST form to a readily accessible electronic format and creating the New York eMOLST Registry, physicians and EMS professionals, can have access to MOLST forms at all sites of care including hospitals, nursing homes and in the community.

Discussing and documenting each family member’s wishes when they are well will save family turmoil in the future.

For physicians, you can download the doctor-specific information here.

This is not just for your patients. This information is for you and your family.

I wish you and your families a Happy Thanksgiving.

Sincerely,

Charles Rothberg, MD
MSSNY President

Please send your comments to comments@mssny.org


enews large

MSSNY Phone Number for Garfunkel Wild
Our new law firm, Garfunkel Wild, has established a phone number for exclusive use by MSSNY members: 516-393-2230.  We also have a group of attorneys dedicated to receiving the phone calls to ensure that any MSSNY member who calls will receive prompt service.

They want to hear from you!

DFS Imposes $2 Million Fine on Cigna for Selling Unapproved Health Insurance Policies
This week, New York Department of Financial Services Superintendent Maria Vullo announced the imposition of a $2 million fine on Cigna for violations of New York State Insurance Law involving the illegal sale of stop-loss insurance and unapproved health insurance policies that would otherwise have been part of New York’s small-group market.

According to a consent order entered into with Cigna, DFS found that Cigna improperly sold stop-loss and fully insured health insurance policies outside of New York to New York-based small groups with employees in New York State.  The press release noted that Cigna sold 81 group health insurance policies in violation of New York Insurance Law, including 38 stop-loss insurance policies to New York small groups seeking to self-insure and 43 fully insured health insurance policies to small groups as if they were selling to non-New York small groups.

To read the full press release, click here.

Governor Again Vetoes Legislation to Permit Prescription Refills Longer than Original Prescription
Recently, Governor Cuomo vetoed legislation (A.6731-B/S.5171-B) that would have authorized pharmacists to refill non-controlled substance prescriptions in a quantity greater than that set forth in the prescriber’s original prescription. In effect, it would have enabled pharmacists to provide 90-day refills of particular prescription medication even if the original prescription called for a shorter refill duration, such as 30 days.

While there were some changes to a similar bill that was vetoed last year, Governor Cuomo noted in the veto message his concerns that “the bill retains the provisions that would risk contributing to the distribution of larger quantities of prescription medications than may be necessary for a specific patient”.  Moreover, he noted his concern that “it would still allow the pharmacist to infringe on the physician-patient relationship” because the notification to the prescriber would not occur until after the prescription is filled.


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AHA and ACC Redefine High Blood Pressure Reading
Acting for the first time in 14 years, the American Heart Association, the American College of Cardiology and nine other groups redefined high blood pressure as a reading of 130 over 80, down from 140 over 90.” This “change means that 46 percent of US adults, many of them under the age of 45, now will be considered hypertensive.” The Post points out that “under the previous guideline, 32 percent of US adults had” hypertension.

On its front page, the New York Times (11/14) reports that “under the guidelines…the number of men under age 45 with a diagnosis of high blood pressure will triple, and the prevalence among women under age 45 will double. The guidelines presented at a heart association meeting and published in the Journal of the American College of Cardiology, also spell out exactly how health care providers and people at home should check blood pressure.” For instance, physicians “and nurses are urged to let patients rest five minutes first and then to average at least two readings over two visits.” Meanwhile, “patients are urged to take regular readings at home, with a device checked out by their health care providers.”

Click here to read the AMA statement on the updated guideline for measuring blood pressure.

Tip of the Week: Is it Appropriate to Report Kinesio Taping with Strapping Codes?
By Jacqueline Thelian, CPC, CPC-I, CHCA, Medco Consultants, Inc.

As per Current Procedural Guidelines (CPT), the CPT Assistant and the Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination (LCD) L33631 it is inappropriate to report Kinesio taping with any of the CPT codes for strapping (29200, 29240, 29260, 29280, 29520, 97799, 97039, 29799).

Strapping may be used to treat strains, sprains, dislocations, and some fractures. The strapping codes are intended to be used when the desired effect is to provide total immobilization or restriction of movement.”

Kinesio taping is not utilized for immobilization; rather its function is to provide support and stability to joints and muscles without affecting circulation and range of motion.

The CPT Assistant goes on to state the Kinesio taping is considered to be an inclusive part of neuromuscular re-education or therapeutic exercise and would not be separately reported.

The Centers for Medicare and Medicaid Services (CMS) Local Coverage Determination (LCD) L33631 Outpatient Physical and Occupational Therapy Services under the General Guidelines for Strapping also considers the Kinesio taping to be considered inclusive to CPT codes 97110 and 97112.

Source:

  • National Government Services Inc. Local Coverage Determination (LCD) L33631
  • CPT Assistant March 2012, Surgery Musculoskeletal System

If you have a coding or compliance question you would like to have answered please send your question to MSSNY at eskelly@mssny.org, and complete the subject line with Tip of the Week.

Your membership yields results and will continue to do so. When your 2018 invoice arrives, please renew. KEEP MSSNY STRONG!

What Can I Do?

Help Us Advocate Legislation to Prevent Mid-Year Prescription Formulary Changes
Concerned about changes to health insurer prescription drug formularies that may adversely impact your patients? MSSNY has been working collaboratively with several patient advocacy groups to support legislation (A.2317, People-Stokes/S.5022-A, Serino) that would prohibit health insurers from moving a drug to a higher-cost tier or removing a prescription drug from a formulary during a policy year.  To help facilitate advocacy in support of this legislation, the group New York Health Works has developed a survey to enable physicians and patients to better document the full extent of this problem.  Please take just a few minutes to respond to the survey by clicking here.

Share Your Personal Stories about Challenges You Face as a Physician
MSSNY wants legislators to hear directly from New York Physicians about the challenges they face as medical practitioners.  Personal stories are vital for enhancing our messages on issues of concern to the medical professionals, particularly to legislators who represent the area where those professionals practice.

We plan to gather personalized stories from physicians and medical students to print as flyers and articles that can be distributed to legislators and journalists. Opting in to share your stories is entirely voluntary. We value and respect your privacy, which is why your permission is needed for us to share these stories. Please click here to fill out the brief Physician Questionnaire.

MSSNY to Implement National Diabetes Prevention Program; Physicians Encouraged to Take Diabetes Awareness Survey
The Medical Society of the State of New York has partnered with the American Medical Association to bring its Prevent Diabetes STAT initiative to New York.  MSSNY has developed a short survey to sample physician’s knowledge of the National Diabetes Prevention Program (DPP) and the Prevent Diabetes STATTM program.  This survey can be taken by clicking here.

The AMA previously rolled out the program through partnerships with state medical societies in California, Michigan and South Carolina. New York is one of eight states where the AMA is extending the program. The DPP model encourages physicians to screen patients for prediabetes, a condition in which blood glucose levels are higher than normal but below the threshold for a diabetes diagnosis. Patients identified as pre-diabetic are referred to diabetes prevention programs that meet certain criteria established by the Centers for Disease Control and Prevention.

This initiative will help bridge the gap between the clinical care setting and communities to reduce the incidence of type 2 diabetes by educating and connecting more patients to evidence-based lifestyle change programs that are available in their communities, including programs offered where they work, through community and faith-based organizations, and online.

“MSSNY’s partnership with the AMA is a key step towards making an immediate impact on the health of New Yorkers,” said Dr. Geoffrey Moore, Chair of MSSNY’s Preventative Medicine and Family Health Committee and a lifestyle medicine physician based in Ithaca, NY. “The Centers for Disease Control and the American Medical Association have developed a great educational toolkit and, through our partnership, we seek to extend the benefits of these tools to all physicians and patients throughout New York State.”

In the coming year, MSSNY will be developing education sessions and articles outlining important information about diabetes in the MSSNY Daily and E-News.  Educational webinars and podcasts tailored to both physicians and patients on prediabetes and diabetes are also being developed. MSSNY’s website includes a Diabetes webpage and physicians are encouraged to visit for more information about Type 2 Diabetes and to learn more about MSSNY’s partnership with the AMA.

Please Urge Governor Cuomo to Veto Disastrous Liability Expansion Bill and Work for Comprehensive Reform Instead
With just a few weeks left in 2017, please help us to urge Governor Cuomo to veto legislation (S.6800/A.8516) that would significantly expand the time to bring a medical malpractice lawsuit, in circumstances based upon an “alleged negligent failure to diagnose a malignant tumor or cancer.”  If signed into law it would likely prompt a double digit increase in physician and hospital malpractice premiums.  You can send a letter to the Governor here and call 518-474-8390.

The bill will likely be delivered to Governor within the next few weeks, upon which he will have 10 days to decide to sign it or veto it.  While many physicians have contacted the Governor to urge a veto of this legislation, we need an overwhelming demonstration from physicians regarding how this bill will harm access to care in their communities if this bill is not paired with needed tort reforms to bring down the exorbitant costs of medical liability insurance in New York.

Physicians have been active in warning the public about the patient care access problems this bill will exacerbate if it is signed into law.  Recently Albany radiologist and MSSNY member and Albany radiologist Dr. Robert Rapaport had a commentary published in the Albany Times-Union urging that the Governor veto this bill and instead work for comprehensive reform.  Moreover, a letter to the Editor from MSSNY’s Dr. Rothberg urging a veto was also recently published in the Albany Times-Union (letter).   Similar letters from regional and statewide physician leaders have also appeared in:

MEDICAL STUDENTS

Share Your Personal Stories about Challenges You Face as a Medical Student
MSSNY wants legislators to hear directly from medical students about the challenges they face as future physicians.  Personal stories are vital for enhancing our messages on issues of concern to the medical professionals, particularly to legislators who represent the area where those professionals practice.

We plan to gather personalized stories from physicians and medical students to print as flyers and articles that can be distributed to legislators and journalists. Opting in to share your stories is entirely voluntary. We value and respect your privacy, which is why your permission is needed for us to share these stories. Please click here to fill out the brief Medical Student Questionnaire.

WEBINARS/SEMINARS

CME Webinar on December 6: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician:
Upcoming in MSSNY’s Medical Matters continuing medical education (CME) webinar series is: An Unusual and Highly Resistant Fungus in NYS: An Update on Candida auris for the Practicing Physician.  This webinar will take place on Wednesday, December 6, 2017 at 7:30 a.m.  Emily Lutterloh, MD, MPH, Director, Bureau of Healthcare Associated Infections, from the New York State Department of Health will conduct this presentation.  Register for this webinar here.

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

Educational objectives are:

  • Provide an update on the emerging multi-drug resistant yeast, Candida auris ( auris), globally and in New York State
  • Describe the risk factors for auris infection and the recommended diagnostic approach
  • Review the recommendations for auris, including infection prevention and control measures

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. 

Educate Your Patients About the Flu
It’s flu season!  New York State Department of Health has had reports of seasonal influenza in nearly every county. Encourage your patients to listen to MSSNY’s brief and informative podcast on influenza vaccine here.

MSSNY also has a podcast on the pneumococcal vaccine for patient’s 60 and older here. Or click here listen to all 13 of MSSNY’s podcasts on topics such as the Zika virus, emergency preparedness and a variety of adult vaccines.

Buprenorphine Training to be held in Sullivan County December 2nd
The NYSDOH AIDS Institute and the Sullivan County Public Health Department are hosting a Buprenorphine Eligibility Waiver Training for Clinical Providers on Saturday, December 2,

from 8:00AM to 1:00PM at Catskill Regional Medical Center, 68 Harris-Bushville Rd, Board Room, Harris, NY 12742.

This training is for physicians, nurse practitioners, physician assistants, pharmacists, and medical residents. Sullivan County has some of the highest rates of opioid overdose in New York State. In just the first seven months of 2017, Sullivan County has experienced a reported 20 overdose deaths.  From 2013-2016, there were approximately 75 reported opioid overdose deaths.

DOH is seeking to increase the volume of providers in and around the county that are able to offer medication assisted treatment (MAT) to people using opioids whom could benefit from buprenorphine (or “suboxone”).  Attached is a flyer with further information, including location, online registration, and more details. Further information will be sent out to confirmed attendees. Light refreshments will be provided. Registration closes on November 29th at 5pm.Trainers: Sharon Stancliff, MD, Harm Reduction Coalition, New York, NY; Bruce Trigg, MD, Harm Reduction Coalition, New York, NY

Please Note: CME Credits will be made available. This is the first half of the minimum required 8 hours of training, and the second half must be completed online after attendance to the live training. Currently NPs & PAs are required to take an additional 16 hours of online training which is available on the PCSS-MAT website (Part 2). For more information about buprenorphine related trainings, mentoring, coaching, technical assistance and more, please contact us at buprenorphine@health.ny.gov or 1-800-692-8528.

Want to Learn More about New York’s New Step Therapy Override Law?
Please click here to view a webinar discussing New York’s new law that gives physicians a stronger ability to override a health insurer’s step therapy protocol when seeking to assure their patients can receive coverage for necessary prescription medications. Among the faculty for the program are MSSNY President-elect Dr. Thomas Madejski and MSSNY Senior Vice President Moe Auster. The webinar, sponsored by the National Psoriasis Foundation, will provide physicians with 0.5 hours of CME credit.

The new law will be applicable to all NY-regulated health plans as of January 1, 2018.  However, since the law applies to health insurance plans “delivered, issued for delivery issued or renewed” after January 1, 2017, many group health insurance plans across the State are already required to follow the new law.

MSSNY has created a template for physicians and their support staff to use in requesting a step therapy protocol override, available here.

Enforcement is the key to assuring that the law is working as intended.  Therefore, please let us know if you see instances where health insurers are not following the law.  Moreover, you can file a complaint with the State here.

MEDICARE/MEDICAID INFORMATION

You Must Enroll In Medicaid FFS to Treat MMC Patients
In September, MSSNY alerted the membership of a new federal regulation resulting from the 21st Century Cures Act.  The regulation requires that any physician treating Medicaid recipients in a Medicaid Managed Care (MMC) plan must now enroll in Medicaid Fee-for-Service (FFS) in order to continue treating MMC patients.  By now, you should have received letters from your MMC plan explaining this requirement.

Some of our members raised concerns about the requirement.  To research the matter, Regina McNally, VP of SME, called the Director of Medicaid provider enrollment at the NYS DOH.  Based on that contact, we have been advised of the following:

Regarding Medicaid Managed Care physicians who want to continue treating Medicaid Managed care recipients, the DOH has no intention of terminating any physician who has his/her application on file before the deadline.  So, if the provider enrollment application is submitted before January 1, 2018, the DOH will work with the physician(s) to ensure that the information is properly on file.  Since the application is submitted to CSC, the Medicaid Intermediary, first for scanning into their system and then forwarded to the NYS DOH for review to ensure accuracy, it would be advisable to have the application filed by December 1, 2017.  This should give sufficient time to ensure that the application is on file.

Note:  Physicians do not have to treat Medicaid fee-for-service recipients even though they have enrolled in the program.  However, physicians do need to enroll in order to continue treating Medicaid Managed care recipients.

New Deadline: Participate in Field Testing of Episode-Based Cost Measures by November 20
The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for feedback on its cost measures field test to November 20, 2017.

As a reminder, CMS is conducting a field test for eight episode-based cost measures before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program. During the field test, clinicians may access confidential feedback reports with information about their performance on these new measures. All stakeholders are also invited to comment on the measures and supplemental documents.

The eight episode-based cost measures are:

    1. Elective Outpatient Percutaneous Coronary Intervention (PCI)

  1. Knee Arthroplasty
  2. Revascularization for Lower Extremity Chronic Critical Limb Ischemia
  3. Routine Cataract Removal with Intraocular Lens (IOL) Implantation
  4. Screening/Surveillance Colonoscopy
  5. Intracranial Hemorrhage or Cerebral Infarction
  6. Simple Pneumonia with Hospitalization
  7. ST-Elevation Myocardial Infarction (STEMI) with (PCI) 

Participate in Field Testing through November 20, 2017
The field test is a voluntary opportunity for stakeholders to comment on the measure specifications and the report template for the eight measures in their current stage of development. This feedback will be considered in refining the measures and for future measure development activities.

If you or your clinician group perform(s) or manage(s) the care for one or more of the procedures or medical conditions represented in the measures above, you might have a confidential Field Test Report on the CMS Enterprise Portal. For group practices, reports are available for the TIN of the group practice. Please refer to the “2017-10-cost-measure-field-test-access-guide.pdf” in the zip file linked below for instructions on setting up or activating your EIDM account. The supplemental documentation listed below is included in a zip file on the MACRA page under the “What’s new” section and “Episode-based cost measures” subsection. To download the zip file directly, please click here.

  • Field Test Mock Report
  • Draft Cost Measure Methodology
  • Draft Measure Codes List

Please provide comments through this online survey by 11:59 PM ET on November 20, 2017.

For More Information. You may refer to the fact sheet or FAQs
document for additional information. If you have any questions, please contact QPPCostMeasureTesting@ketchum.com.

New Medicare Card: Provider Ombudsman Announced
The Provider Ombudsman for the New Medicare Card serves as a CMS resource for the provider community. The Ombudsman will ensure that CMS hears and understands any implementation problems experienced by clinicians, hospitals, suppliers, and other providers. Dr. Eugene Freund will be serving in this position. He will also communicate about the New Medicare Card to providers and collaborate with CMS components to develop solutions to any implementation problems that arise. To reach the Ombudsman, contact: NMCProviderQuestions@cms.hhs.gov.

The Medicare Beneficiary Ombudsman and CMS staff will address inquiries from Medicare beneficiaries and their representatives through existing inquiry processes. Visit Medicare.gov for information on how the Medicare Beneficiary Ombudsman can help you.

Summary and Statement: 2018 QPP Final Rule
Last week, CMS issued the long-awaited Medicare Quality Payment Program final regulation for 2018.  PAI’s comments discussed the need for continued physician flexibility and greater simplicity to allow physicians to transition to the program successfully.

The final regulation’s impact on physician practices is a mixed bag, as discussed in PAI’s statement, released earlier this week. PAI applauds CMS for finalizing its policy to increase the low-volume threshold and include an interim final rule to support the needs of those impacted by recent natural disasters.

However, PAI is disappointed that the final regulation includes certain policies that could unintentionally put some patients, physicians, and practices at a disadvantage. One policy of concern will increase the weight of the cost category from 0% in 2017 to 10% in 2018, utilizing the Medicare Spending per Beneficiary (MSPB) and total per capita cost measures, while new episode-based cost category measures that more accurately assess health care service utilization and appropriately attribute costs are still under development and not part of the scoring.

A summary of the final rule provisions is available here; a CMS Fact Sheet is available here. Blood Eosinophil And Neutrophil Concentrations May Predict Lung Function Declines In WTC-Exposed Firefighters, Research Suggests.

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Upper East Side Plastic Surgery Office Available for Rent or Share
Beautifully equipped Plastic Surgery office available for part-time share along with Quad A-certified OR available for rent. Located in a lovely carriage house on the Upper East Side in close proximity to Lenox Hill Hospital and MEETH and conveniently located near all NYC mass transit. 1 exam room/OR and Recovery room along with large administrative space. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/ DERM/ ENT/or other Medical MDs. Please contact Kim at Kim@madisonps.com (212) 628-7600.>/div>

Saratoga Springs, NY – Professional Office Space for Lease
Medically oriented building currently occupied by five parties.  The Suite, Suite 700, has 2904 sq. ft., second floor (elevator), excellent off-road parking with drive-thru patient portico in a well maintained and attractive building close to the local hospital.
The lease area has a large waiting room, administrative rooms, lunch room, four examining rooms, one procedure room and one for storage.  Separate staff entrance.  Attractively priced without triple net obligations.  $4,500/month + heat + utilities.  Call Lauren regarding Suite 700 at (518) 587-2020.

Riverdale Medical Office for Sale – Prime Location
Co-op with private entrance features 2 exam rooms, lab, office & bathroom. Must see! Call 718-230-7069

For Rent or Share – Woodbury, Long Island
Beautiful recently renovated Plastic Surgery office available for part-time share and AAAA-certified (by end of summer). OR available for rent. Centrally located
on Long Island.Close to expressways. 3 exam rooms, 1 procedure room /OR.
Waiting room, break room and personal office. Free WIFI. Available for full or half-days. Suits Plastic/Cosmetic Surgeons/Derm/ENT/
ObGyn/Podiatry or other Medical MDs.
Contact Patricia at info@cosmetichg.com
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PHYSICIAN OPPORTUNITIES

Medical Director: Binghamton University College Physician (SL-6)
Department: Student Health ServicesLocations:   Binghamton, NYPosted: Oct 24, ’17Type:  Full-timeRef. No.: 49225The Decker Student Health Services Center at Binghamton University (The State University of New York at Binghamton) invites New York State Medical or Osteopathic Board Certified Physicians (Internal Medicine, Family Practice) to apply for a full-time, twelve-month position. This position plans, directs, supervises, and participates in the outpatient medical care of undergraduates and graduate students of a diverse student base.  The person will have excellent, primary care diagnostic skills as well as experience and proficiency in common outpatient surgical procedures, EKG and pulmonary function study interpretation, office laboratory and clinical microscopy.  This position functions as an on-site medical consultant and collaborative physician to the professional staff that includes 10 nurses, 5 nurse practitioners and 7 physicians.The individual will have five years of clinical experience after residency training and experience with staff oversight and leadership.The Medical Director provides the university campus with infectious disease direction (e.g. meningitis, measles and tuberculosis) and emergency management; participates on the Crisis Response Team; provides direction and consultation to the Dean of Students, University Counseling Center and Residential Life.  This person will be responsible for accreditation activities including; completion of internal and external benchmark studies peer chart review; completion of assessment plans, survey and risk management reports; meeting with site visitors; and following through on recommendations.Requirements: Required qualifications: NYS Board Certified Medical or Osteopathic Physicians (Internal Medicine, Family Practice) from an accredited institution; 5 years of clinical experience after residency; NYS medical license and DEA certificate that are free from special conditions or limitations. Salary: commensurate with qualifications and experience. Preferred qualifications are, but not limited to: college health familiarity; experience with diverse populations; electronic health record navigation; quality assurance, and continuous quality improvement; public health and policy experience. Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/Cover letters may be addressed “To the Search Committee.” Postings active on the website accept applications until closure. For information on the Dual Career Program, please visit:
https://www.binghamton.edu/human-resources/dual-career-program/
Application Instructions:Deadline for Internal Applicants:  11/07/2017 Deadline for External Applicants:  Open until filled Review of applications will begin immediately and continue until the vacancy is filled.Persons interested in this position should apply online.Please submit: 1. Resume 2.Cover letter, and 3.Contact information for three professional references You may add additional files/documents after uploading your resume. After you fill out your contact information, you will be directed to the upload page. Please login to check/edit your profile or to upload additional documents: http://binghamton.interviewexchange.com/login.jsp Payroll information can be found on our website http://www.binghamton.edu/human-resources/payroll/
Additional Information:Offers of employment may be contingent upon successful completion of a pre-employment background check and verification of degree(s) and credentials.Binghamton University is a tobacco-free campus.Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation.  If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.govEqual Opportunity/Affirmative Action Employer
The State University of New York is an Equal Opportunity/Affirmative Action Employer.  It is the policy of Binghamton University to provide for and promote equal opportunity employment, compensation, and other terms and conditions of employment without discrimination on the basis of age, race, color, religion, disability, national origin, gender, sexual orientation, veteran or military service member status, marital status, domestic violence victim status, genetic predisposition or carrier status, or arrest and/or criminal conviction record unless based upon a bona fide occupational qualification or other exception.As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here. The State University of New York is an Equal Opportunity/Affirmative Action Employer.  As required by title IX and its implementing regulations Binghamton University does not discriminate on the basis of sex in the educational programs and activities which it operates.  This requirement extends to employment and admission.  Inquiries about sex discrimination may be directed to the University Title IX Coordinator or directly to the Office of Civil Rights (OCR).  Contact information for the Title IX Coordinator and OCR, as well as the University’s complete Non-Discrimination Notice may be found here.

Medical Director – AIDS Institute
Minimum Qualifications:
Current license and registration to practice medicine in New York State and board certification AND either a Master’s Degree in Public Health or two years of experience in an HIV program or public health program.Preferred Qualifications:
Master’s Degree in Public Health.  Five years of experience including clinical service in an HIV program or clinical fellowship program (infectious diseases/HIV medicine).  Experience in quality management/quality improvement.  Knowledge of the HIV health care delivery system in New York State. Experience in/knowledge of the New York State Ending the Epidemic initiative.  Experience in STD prevention and care, drug user health, and/or LGBT health.  Experience in health policy development, analysis and evaluation.  Experience with evolving health information technologies.  Experience in health program management and administration.
Responsibilities: The Medical Director, AIDS Institute, plays a significant role in shaping HIV, hepatitis C, and STD care and services, drug user health, and LGBT health care throughout New York State.Please click the link below for more information pertaining to this position and to apply: “https://careers-healthresearch.icims.com/jobs/3742/medical-director—aids-institute/job” Affirmative Action/Equal Opportunity Employer/Qualified Individuals with Disabilities/Qualified Protected Veterans

Multiple Physician Positions with DOHMH Office of School Health
Office of School Health is the largest program of the New York City Department of Health and Mental Hygiene (DOHMH). This bureau is responsible for managing the health issues and promoting the well-being of the over 1.3 million children and adolescents enrolled in New York City’s 1700 school buildings.

Positions with the Office of School Health (OSH) combine clinical skills and public health training.

Adolescent School Health Physician
This position offers to the interested physician the opportunity to help address the clinical and public health needs of adolescents in NYC high schools. The physician will work with the innovative Connecting Adolescents to Comprehensive Health Care (CATCH) Program, which provides select reproductive health services to adolescents in select NYC high schools. In addition, the physician will provide medical care and public health services through additional programs offered to adolescents by the Office of School Health.

Under the supervision of the High School Supervising Physician, the Adolescent School Health Physician’s responsibilities will include but are not limited to:

  • Provide CATCH reproductive health services in select high schools.
  • Perform mandated physical examinations (New Admission Exams, Sports Physicals, and Working Paper Physicals).
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support the development and implementation of initiatives that promote positive health behaviors and reduce high risk behaviors in the adolescent population.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve medical issues that affect school performance.
  • Support all medical initiatives established by the Office of School Health, e.g. programs and protocols in asthma, reproductive health, obesity and diabetes.
  • Maintain good public relations and communicate effectively within the school community and community-based organizations.
  • Keep abreast of health management policy statements and emerging clinical research related to school health.
  • Participate in OSH research activities.
  • Work within the mandates, policies and protocols of the Office of School Health.
  • Attend all mandated DOHMH and OSH trainings.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277208. 

School Health Field Physician
Under the direction of the Supervising Physician, the School Health Physician’s will:

  • Improve the health of school children through case management of chronic disease, preventive health screening and counseling, health education, and referrals.
  • Perform mandated physical examination (new entrant, sport physical, working paper physicals.
  • Develop relationships with community health providers in order to optimize medical management of students with health issues.
  • Attend to the health needs of your assigned school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain adequate student health records.
  • Serve as a consultant to the school nurse and administration on school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of all students.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Develop and maintain professional relationships within the school community.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes initiatives.
  • Provide trainings/presentations to school staff, community organizations, or parents.
  • Stay abreast of health management policy statements and emerging research within the health community related to school health.
  • Participate in School Health research and quality improvement activities.
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions.
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel:osh@health.nyc.gov OR Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 279844. 

Supervising School Health Physician 
Job Description
Under the supervision of the Deputy Medical Director, the Supervising Medical Doctor’s responsibilities will include but not be limited to:

  • Supervise School Health Physicians.
  • Work within the mandates, policies and protocols of the Office of School Health (OSH).
  • Attend to the health needs of a designated school community.
  • Utilize the Automated Student Health Record (ASHR) to maintain accurate student health records.
  • Serve as a consultant to the school nurse and school administrative staff regarding school related health concerns.
  • Support the development of school educational and prevention programs promoting the health and wellness of students.
  • Participate in policy development and revisions as indicated.
  • Provide clinical assistance in the event of an environmental or communicable disease occurrence.
  • Function as a liaison for students with community health providers to resolve health issues that affect school functioning.
  • Develop and maintain professional relationships within the school community and the community at large.
  • Support all medical initiatives put forth by the Office of School Health, e.g. Asthma, Reproductive health, Obesity and Diabetes Initiatives.
  • Keep abreast of health management policy statements and emerging research within the health community affecting school health.
  • Assist with or provide trainings/presentations to school health physicians, nurses, school staff, community organizations or parents
  • Participate in School Health research and quality improvement activities
  • Participate in all mandated DOHMH and Office of School Health trainings and professional development sessions
  • Attend all program meetings and Continuing Medical Education classes provided by the Office of School Health.

To Apply: Please email your resume and cover letter to Dr. Caroline Volel: osh@health.nyc.gov  OR  Apply online at https://a127-jobs.nyc.gov/.  In the Job ID search bar, enter: job ID number # 277026

MEDICAL EQUIPMENT

Retiring from pediatrics. I have medical equipment to donate: examining table, pediatric examining table with a scale, medical scale, examining instruments and miscellaneous office items. Forest Hills. Call 718 275-5858 or email mkolak59@gmail.com

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