NEWS OF NEW YORK - Medical Society of the State of New York

MEDICAL SOCIETY OF THE STATE OF NEW YORK
NEWS OF NEW YORK
P r o v i d i n g I n f o r m a t i o n t o A s s i s t P h y s i c i a n s i n t h e S t a t e o f N e w Yo r k
Volume 71 • Number 11
www.mssny.org
December 2015
Doctor Shortage Imperils Primary Care Expansion
Results of HANYS’ 2014 Physician Advocacy Survey
New York continues to experience a shortage of
physicians, especially primary care physicians (PCPs)
in upstate New York. While many healthcare providers cite physician shortages and difficulty with
recruitment and retention for many specialty physicians, PCPs continue to represent the largest overall
percentage of need, particularly in upstate New York.
The following charts are based on the findings from
HANYS’ 2014 Annual Physician Advocacy Survey and
represent responses from 94 hospitals/health systems across New York State, excluding New York City,
for a response rate of 65%. This report covers the
period from September 2013 through August 2014.
NEED FOR PRIMARY CARE
PHYSICIANS STATEWIDE
Respondents reported a total need of 942 physi(Continued on page 5)
INSIDE NEWS
Register for
E-prescribing
webinar����������������� page 2
Editorial: Learn from
HR meltdown ��������� page 4
Contact numbers
for most insurers……page 6
Queens County
Masked Ball
photos������������������� page 8
Westchester
Doctors of
Distinction�������������page 11
CLICK ICONS TO FOLLOW
MSSNY ON FACEBOOK
OR TWITTER.
DOH Bureau of Narcotic Enforcement Information on
Medical Marijuana Program
The New York State Department of
Health’s Bureau of Narcotic Enforcement
announces the availability of the required
four-hour medical use of marijuana course.
Practitioners who wish to register with the
Department and certify their patients for
the Medical Marijuana Program must complete this course. The Compassionate Care
Act, signed into law on July 5, 2014, authorized the Department of Health to implement
a Medical Marijuana Program in New York
State. Practitioners who wish to register with
the Department and certify their patients for
the Medical Marijuana Program must:
•b
e qualified, by training or experience,
to treat patients with one or more of the
serious conditions eligible for medical
marijuana;
• be licensed, in good standing as a physician and practicing medicine, as defined
in article one hundred thirty one of the
Education Law, in New York State;
• possess a Health Commerce System
(HCS) Medical Professions Account user
ID and password;
• possess an active Drug Enforcement
Administration
(DEA)
registration
(Continued on page 2)
Health Republic Enrollees to Transition to
Excellus, MVP or Fidelis Coverage
Health Republic enrollees who do not select a new plan by November 30 will be autoenrolled in Excellus, MVP or Fidelis for the remainder of 2015, according to an announcement
today by the NYS Department of Financial Services and NY State of Health (Click here).
In addition, Fidelis, Excellus, and MVP have agreed to credit any deductible and out-ofpocket amounts that consumers have already paid through their Health Republic coverage
during 2015 – helping ensure that individuals who make the transition will not be required to
restart these payments in 2015.
According to the press release, during the third week of November, individuals enrolled
in Health Republic through NYSOH and who have not yet selected a new health plan for
December 1, 2015, will receive an auto-enrollment notice from NYSOH telling them — based
(Continued on page 6)
Register Now For E-Prescribing CME Webinar
MSSNY is hosting a free continuing medical education webinar on E-prescribing on December 9 at 7:30 a.m. for MSSNY
members.
Registration is now open to MSSNY physicians by clicking
here. Select training center and then upcoming tabs. A copy
of the flyer can be found here. The program, entitled, “New
York State Requirement for E-prescribing of All Substances,”
includes the following educational objectives:
• Describe the e-prescribing mandate, to whom it applies,
when it becomes effective, and how physicians can comply
with its requirements.
• Describe the practitioner electronic prescribing of controlled
substances registration process, to whom it pertains, and
the information required to be provided by physicians in
order to register eRX software with the Bureau of Narcotics
Enforcement.
• Describe the exceptions to the e-prescribing mandate
and any additional requirements associated with those
exceptions.
• Describe the application process and criteria for a waiver
from the e-prescribing mandate.
• Describe what rules pertain to physicians who only prescribe non-controlled substances
Further information can be obtained by contacting Terri
Holmes at [email protected].
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.
E-prescribing of all substances will be required in New York State by
March 27, 2016. The ISTOP legislation enacted in 2012 required e-prescribing of ALL substances. Regulations pertaining to the E-prescribing
requirements were adopted on March 27, 2013. The Medical Society of the
State of New York was successful in obtaining a delay in the e-prescribing
requirements for all substances to March 27, 2016.
Information on Medical
Marijuana Program
(Continued from page 1)
number; and
•c
omplete
the
four
hour
Department-approved
medical
use of marijuana course.
Departmental officials anticipate that
the four hour department approved
online course is available to practitioners through the TheAnswerPage, an
established online medical education
provider.
The course will include the following topics, which are required in the
regulations: the pharmacology of marijuana; contraindications; side effects;
adverse reactions; overdose prevention; drug interactions; dosing; routes
of administration; risks and benefits;
warnings and precautions; and abuse
and dependence. The cost to take the
course is $249, and practitioners will
earn 4.5 hours of CME credit upon
successful completion of the course.
Additional information regarding the
practitioner registration process is
available on the Department’s Medical
Marijuana Program webpage, which
can easily be accessed via this link.
Please monitor the webpage frequently for updates and contact the
department with any questions: New
York State Department of Health,
Bureau of Narcotic Enforcement,
Medical Marijuana Program, Riverview
Center, 50 Broadway, Albany, NY
12204; Call 866-811-7957 or email
[email protected]
for
more
information.
Page 2 • MSSNY’s News of New York • December 2015
December 2015 • MSSNY’s News of New York • Page 3
PRESIDENT’S COLUMN
Lessons from Health Republic in Contracting and Justice
for Minority Voices
CONTRACTING LESSONS
failing to fulfill your duties and
Over the past few months,
responsibilities to patients
we have learned of the failure
when a contract is breached
of Health Republic as an insurer
by the insurer. Physicians must
in New York’s Health Exchange.
be mindful that a breach of
The insurer offered healthcare
contract by the insurer may
benefits to insureds for a prenot relieve a physician of his/
mium that was lower than other
her responsibilities. Physicians
products on the Exchange.
must be careful not to respond
Reports claim the insurer
to an insurer’s financial breach
Joseph R.
underpriced their products conby taking steps that might be
Maldonado, Jr.,
tributing to a $77 million loss
legal and ethical /professional
MD, MSc, MBA,
in 2014 and a $100 million loss
breaches on their part. Do
DipEBHC
this year.
not jeopardize your patient’s
The recent MSSNY Survey on
health by postponing appointlosses for New York’s physicians particiments for needed services because you
pating in the Health Republic products
are awaiting a patient to gain new health
show losses in the millions of dollars for
insurance coverage. Do not run the risk
New York’s physicians. Clearly, this will
of being accused of abandonment of care
weigh heavily on the minds of physicians
because you dropped a patient from your
as they go forward with participation in
panel without appropriate notice.
other health reform initiatives in New
Physicians should consider an insurer’s
York that carry significant financial risk
history in the marketplace as they confor doctors. How can you minimize risk?
sider whether or not to participate in the
Physicians must recognize that risk
products offered. Physicians should be
comes in many forms. On first blush,
cautious about the number of patients
there is financial risk of participating
on their provider panel associated with
with a risky product. There are other
any one dominant insurer. A problem
legal and ethical risks associated with
(Continued on page 15)
MSSNY-PAC
The Importance of MSSNYPAC
Are you a member of
MSSNYPAC? If so, thank
you! If not, we need
you to join us. Without
a strong MSSNYPAC,
there could be dire consequences.
MSSNY’s Legislative Program for 2016,
developed by MSSNY’s Committee on
Legislative and Physician Advocacy, cochaired by Paul Pipia, MD and Brian Murray,
MD was approved at the November 5th
Council meeting. The Program was developed with significant input from County
and Specialty Medical Societies. Our major
points of focus will include medical liability reform, insurance reform, revision to
the e-prescribing rules, and opposition to
additional mandates such as a mandate to
take a CME course on pain management
and end of life care.
One of our most immediate threats is
legislation which would greatly lengthen
the statute of limitations for medical liability
cases which would trigger huge increases
in medical liability premiums. During a
press conference held earlier this year,
Senate Majority Leader
Flanagan, in response to a
question from a Daily News
reporter, said that issues
like malpractice reform
“have never been done in isolation.” He
stated that immediately following the conclusion of Session, a series of roundtables
with parties on both sides of this issue will
be convened so that the issues can be
addressed “sooner rather than later.”
MSSNY leadership and Governmental
Affairs staff have since met with Senate
staff to reiterate our strong opposition
to changing the statute of limitations,
the need to narrow its application, and
requested support for sensible tort reforms
to reduce physician premium rates.
Separately, MSSNY and several allies
have been meeting to advance a united
strategy. Our legislative goals include
certificate of merit reforms, immunity for
peer review conducted on both the hospital and practice level and disclosure of
the medical expert. And, of course, we will
(Continued on page 14)
Page 4 • MSSNY’s News of New York • December 2015
MEDICAL SOCIETY OF THE STATE OF NEW YORK
NEWS OF NEW YORK
MEDICAL SOCIETY
OF THE STATE OF NEW YORK
Joseph R. Maldonado, Jr., MD, President
William Latreille, MD, Chairman of the Board
Philip A. Schuh, CPA, Executive Vice President
COMMUNICATIONS AND PUBLICATIONS
Joshua M. Cohen, MD, MPH, Commissioner
NEWS OF NEW YORK
Published by Medical Society
of the State of New York
Vice President, Communications and Editor
Christina Cronin Southard, Editor
[email protected]
News of New York Staff
Manager, Communications Division
Julie Vecchione DeSimone
[email protected]
Roseann Raia, Communications Coordinator
[email protected]
Steven Sachs, Web Administrator
[email protected]
Susan Herbst, Page Designer
NEWS OF NEW YORK
ADVERTISING REPRESENTATIVES
For general advertising information contact
Christina Cronin Southard
Phone 516-488-6100 ext 355
[email protected]
The News of New York is published monthly as
the official publication of the Medical Society of
the State of New York. Information on the publication is available from the Communications Division, Medical Society of the State of New York,
865 Merrick Avenue, P.O. Box 9007, Westbury, NY
11590.
The acceptance of a product, service or company as an advertiser or as a membership benefit
of the Medical Society of the State of New York
does not imply endorsement and/or approval of
this product, service or company by the Medical
Society of the State of New York. The Member Benefits Committee urges all our physician members
to exercise good judgment when purchasing any
product or service.
Although MSSNY makes efforts to avoid clerical
or printing mistakes, errors may occur. In no event
shall any liability of MSSNY for clerical or printing
mistakes exceed the charges paid by the advertiser for the advertisement, or for that portion of the
advertisement in error if the primary or essential
message of the advertisement has not been totally
altered or substantially rendered meaningless as a
result of the error. Liability of MSSNY to the advertiser for the failure to publish or omission of
all or any portion of any advertisement shall in no
event exceed the charges paid by the advertiser
for the advertisement, or for that portion of the
advertisement omitted if the primary or essential
message of the advertisement has not been totally
altered or substantially rendered meaningless as
a result of the omission. MSSNY shall not be liable for any special, indirect or inconsequential
damages, including lost profits, whether or not
foreseeable, that may occur because of an error
in any advertisement, or any omission of a part or
the whole of any advertisement.
Results of HANYS’ 2014 Physician Advocacy Survey
(Continued from page 1)
cians, of which 192 were PCPs (20%). HANYS also
inquired about the number of primary care clinics
that each hospital/health system operates. The 94
respondents identified a total of 542 primary care
sites. In addition, 69% indicated that they had
increased their primary care capacity over the past
three years. In many communities in upstate New
York, these hospitals and health systems are the
sole providers of primary care in their communities. Further, the total number of primary care sites
operated by hospitals/health systems that did not
respond to the survey is likely much greater, and
would greatly increase the actual need.
CHANGE IN OVERALL PHYSICIAN SUPPLY
AND MIGRATION STATEWIDE
Hospital employment of physicians has been
increasing. Respondents reported that among their
total physicians, 26% are directly employed, and
among new hires, that number rose to 33%. In
2014, respondents reported hiring a total of 888
new physicians; however, a total of 2,104 physicians either resigned or retired, a net loss of 1,216.
PRIMARY CARE STRATEGIES STATEWIDE
The chart at right indicates responses to survey questions on strategies providers are using
to expand access to primary care. Clearly, hospitals/health systems are doing everything possible
to enhance their primary care services, yet the
shortage of providers makes this more challenging. Respondents were asked several questions
about their primary care capacity. Seventy-seven
percent of respondents indicated that their current primary care capacity was insufficient to meet
current needs, and 74% indicated that their current capacity is insufficient to meet future needs.
HANYS also asked about ability to recruit non-physician clinicians such as nurse practitioners (NPs)
and physician assistants (PAs). Seventytwo percent
indicated that they are planning to recruit a significant number of NPs, PAs, and physicians to meet
future needs.The percent of primary care services
provided in the community by physicians and primary care practitioners employed by the hospital/
health system ranged from a low of 0% (four facilities) to a high of 90% (five facilities), with a median
of 40%. In many rural communities,the hospital/
health system is the sole provider of primary care
services. With the increasing emphasis on primary
care and care coordination, identifying an adequate
supply of PCPs will continue to be a challenge, especially in rural and under-served parts of the state.
NEED FOR PHYSICIANS UPSTATE
The upstate providers identified a total need for
615 new physicians, which represents 65% of the
total need reported. The breakout by specialty is as
follows:
(Continued on page 6)
December 2015 • MSSNY’s News of New York • Page 5
Results of HANYS’ 2014 Physician
Advocacy Survey
(Continued from page 5)
PCPs represent 25% of the total physician need in upstate New
York’s regions, with an overall need of 154 PCPs at 64 hospitals/
health systems. Further, 78% of upstate facilities indicated that
PCPs were very difficult to recruit.
Upstate providers use many of the same strategies to respond
to healthcare reform as the rest of the state, with some important
differences. Upstate hospitals are somewhat less likely to expand
office hours on nights and weekends. They are also less likely to
add more sites. Possible explanations could include a lack of an
adequate number of physicians to be available to patients when
they call, and a lack of access to capital to expand their sites.
DOWNSTATE VS. UPSTATE PRIMARY CARE STRATEGIES
Upstate providers use many of the same strategies to respond
to healthcare reform as the rest of the state, with some important
differences. Upstate hospitals are somewhat less likely to expand
office hours on nights and weekends. They are also less likely to
add more sites. Possible explanations could include a lack of an
adequate number of physicians to be available to patients when
they call, and a lack of access to capital to expand their sites.
Health Republic Enrollees to
Transition to Excellus, MVP
or Fidelis Coverage
(Continued from page 1)
on their county of residence – whether they
will be auto-enrolled in either Fidelis Care,
Excellus, or MVP. Individuals who reside in
the Rochester area (including Livingston,
Monroe, Ontario, Seneca, Wayne and Yates
counties) will receive an offer to enroll from
Excellus. Individuals who reside in Ulster
County will receive an offer to enroll in
MVP. Individuals who reside in all other
counties of the state will receive an offer to
enroll from Fidelis Care. In order for coverage to become effective, individuals will
need to make their premium payment for
the month of December 2015. Consumers
will be auto enrolled into the same metal
tier or option that is most similar to the
coverage the individual selected through
Health Republic.
As noted in the DFS press release, under
New York law, Health Republic members who are: a) in an ongoing course
of treatment with a physicians for a lifethreatening or a degenerative and disabling
condition or disease, or b) in the second or
third trimester of a pregnancy when their
new coverage becomes effective, may be
able to continue to receive care from their
physician for up to 60 days (or through
pregnancy) under their new health insurance policy, even if the physician does not
participate with the new health insurer
(subject to agreement by that physician).
From Regina McNally, VP Socio Med;
Here Are Contact Numbers for Insurers
Recently, I
have been hearing from our members that many
have been having difficulty reaching
various health plans and/or health
insurance related entities. So, I contacted many of these organizations
to create a one-stop shop for contact
information.
Please share this with your colleagues and office staff.
If you or your staff has better contacts to get your issues resolved,
please be sure to continue to utilize
those contacts. This contact list is
meant to be helpful for those persons
who do not have that first point of
contact or need another point of contact with an organization.
Of course, when situations arise
whereby an impasse has been
reached and I might be of some
assistance, please contact me at
[email protected] or 516-4886100 x332.
Click here to view the contact list.
Health Republic Survey
MSSNY recently polled our members
about the financial meltdown of Health
Republic. Combining the survey results
with financial data received from
numerous physician practices across
the state, it’s estimated that physicians across New York State are owed
at least tens of millions of dollars from
Health Republic.
Of the almost 800 physician respondents, 43% have outstanding claims to
Health Republic, of which:
7% are owed $100,000 or more
18% are owed $25,000 or more
45% are owed $5,000 or more
At the same time, MSSNY has heard
from multiple physician practices that
Page 6 • MSSNY’s News of New York • December 2015
are owed between $1 and $5 million.
Additionally, more than 80% of
respondents say that Health Republic
officials haven’t provided them with
clear information regarding the implications of the company’s shut down.
MSSNY has been in ongoing contact
with DFS and New York State of Health
officials to obtain necessary information for physicians to better assist their
patients, as well as to assure physicians are fully paid for the care they
have provided to patients insured by
Health Republic.
If you have not responded to the survey, please respond NOW!
Take survey here.
MSSNY Joins Physician Leaders in our Nation’s Capital to Advocate
for Administrative Simplification
In late October, Saratoga Springs ENT
and MSSNY Board of Trustees member
Dr. Robert Hughes joined MSSNY staff
and physician leaders from other states
in Washington DC to advocate for legislation to reduce some of the overwhelming
bureaucratic hassles physicians are facing
in various aspects of the Medicare program.
Joint advocacy meetings with representatives of the California, Florida and Texas
medical associations were held with
numerous Senators and Representatives
who serve on key health care policy committees in support of legislation to:
• Reduce the hassles associated with
complying with onerous federal regu-
NY Judge Rules Against
Lawsuit that Makes
Assisted Suicide a Crime
On October 19, a state civil judge
ruled against a lawsuit that makes
assisted suicide a felony. Judge Joan
Kenney ruled that while she was
sympathetic to the patients’ plight,
the US Supreme Court has already
found that New York state laws
prohibiting assisted suicide do not
violate civil rights.
Attorney General Eric Schneiderman
argued against assisted suicide
because of New York’s “longstanding
commitment to the preservation of
life,” he said. In her decision, released
on October 19, Judge Kenney quoted
a 1997 ruling by former US Supreme
Court Chief Justice William Rehnquist
that states laws barring lethal
medication do not “infringe on fundamental rights.”
The patient plaintiffs, a 55-yearold former FedEx worker with AIDS,
an 81-year-old retired attorney with
bladder cancer and a 60-year-old
philanthropist with Lou Gehrig’s disease — are appealing the decision.
Currently, assisted suicide is
legal in Montana, Washington, New
Mexico, Oregon and Vermont.
Join MSSNYPAC
today at
www.mssny.org
lations governing the use of electronic
medical records (HR 3309, Ellmers);
• Restore some fairness in the conducting of audits by Medicare Recovery
Audit Contractors (HR 2568, Holding);
• Repeal the excise tax on comprehensive health insurance plans (“Cadillac
Tax”) that was contained within the
ACA scheduled to go into effect in
2018 (several bills including: S.2075,
Brown; S.2045, Heller; and HR 2050,
Courtney).
There was wide support for many of the
provisions contained within each of these
proposals, and substantial efforts are being
made to incorporate elements of these
proposals into various end of year “must
do” bills under development by Congress. Meetings were held with the offices of
Senator Charles Schumer, Rep. Tom Reed
(Ways & Means Committee) and Rep.
Chris Collins (Energy & Commerce Health
Subcommittee) from New York; Senator
John Cornyn, Rep. Dr. Michael Burgess
and Rep. Kevin Brady (Chair, W&M Health
Subcommittee) from Texas; Senator Bill
Cassidy (Senate HELP Committee) from
Louisiana; Rep. Dianne Black (W&M
Health Subcommittee) and Rep. Marsha
Blackburn (E&C Health Subcommittee)
from Tennessee; and Rep. Dr. Tom Price
(W&M Health Subcommittee) of Georgia.
PRESIDENT’S COLUMN
(Continued from page 4)
or bad relationship with an insurer that
accounts for a large portion of your
practice may financially destroy your
practice or minimize your abilities to
drop an insurer or negotiate with them.
In contracting, physicians should understand their options to their patients if
the insurer becomes insolvent. This
means understanding the steps permitted by contract relative to seeing
patients, rescheduling patients, collecting payments upfront and discharging
patients from the practice. Don’t make
an insurer’s failure into your failure to
treat a patient. Do the right thing.
JUSTICE FOR MINORITY VOICES
This past month, the American Medical
Association held its Interim meeting in
Atlanta. The House of Delegates had to
contend with a controversial resolution
asking for action by the AMA concerning Planned Parenthood. As expected,
the resolution was contentious. The
deliberations in the House represented
what I believe was the saddest moment
in my 35 year engagement in organized
medicine. Through the strategic use of
a parliamentary tactic, one group was
able to move to silence a minority voice
in the House of Medicine. The parliamentary tactic to table the controversial
resolution came prior to its debate in the
pertinent reference committee. Because
a motion to table does not allow debate,
the use of this legitimate parliamentary
tool was effectively aimed to squelch
hearing the minority voice. A more
equitable use of this parliamentary tactic
would have been to implement it at the
House floor debate AFTER the reference
committee had allowed the minority to
express its views and help shape debate.
In my view, this was an egregious repudiation of the Democratic process, which
affords all voices the opportunity to be
heard.
Despite appeals to the Speakers and
to those who wanted to use the parliamentary tactic to squelch debate
against using this parliamentary nuclear
option, the majority of Delegates voted
to table the resolution. Ultimately, the
minority was able to present its views
in reference committee in the deliberations of another similar resolution. It
is my goal and intent to work with the
MSSNY Speaker and Vice-Speaker to
insure that going forward, our MSSNY
and AMA does not permit the use of
parliamentary tactics which silence the
minority regardless of how controversial
the subject.
If we cannot listen to each other and
respect each other’s contribution to the
shaping of our positions, then there is no
purpose in being a member of organized
medicine.
MSSNY MEMBERS IN THE NEWS WANTED!
Have you – or a colleague – recently won an award or been recognized by your
hospital, community or other organization? We want to hear about your accomplishments for possible inclusion in our Members In The News feature in News
of New York. Please contact Julie Vecchione DeSimone:
[email protected] or 516.488.6100 x340.
December 2015 • MSSNY’s News of New York • Page 7
209th Annual Past Presidents’ Masked Ball
On Saturday, October 24, the Medical Society of the County of Queens held its
209th Annual Masked Ball and Physician Expo in the Rose Room at Terrace on the Park.
(front, left to right): Louis J. Auguste, MD, Past President & Secretary, Board of Trustees Medical Society of County of
Queens (MSCQ); Paul S. Aaronson, MD, MSCQ Past President; Joseph R. Maldonado, MD, MSSNY President; Deborah S.
Blenner, MD, Immediate Past President, MSCQ; Ralph E. Scholsman, MD, MSCQ Past President, MSQC Trustee Emeritus
and MSSNY Past President; Leah S. McCormack, MD, MSCQ Past President, MSCQ Trustee Emeritus and MSSNY Past
President; (back, left to right): Robert L. Kraft, MD, MSCQ Past President, 2015 Gala Chair; Saulius J. Skeivys, MD,
MSCQ Past President and MSSNY Councilor; Inderpal Chhabra, MSQC Past President; Arthur C Fougner, MD, MSCQ Past
President, MSQC Trustee and MSSNY Secretary; James E. Satterfield, MD, MSCQ Past President & Trustee.
MSSNY President Joseph R. Maldonado, MD, presents the
MSCQ President’s medal to Deborah S. Blenner, MD, Immediate
Past President, MSCQ.
(above) Arthur C Fougner, MD, MSCQ
Past President, MSCQ Trustee and MSSNY
Secretary, presents the NYC Recognition
Certificate to Chantal L. Weinhold, Senior
VP & Regional Executive Director of NS-LIJ’s
Central Region. Ms. Chantal is the 2015
MSQC Community Service Award Recipient.
(right) MSCQ Past Presidents
Dr. Leah McCormack (left) and
Dr. Arthur Fougner (right)
(far right) Immediate Past President
Dr. Blenner enjoys the Masked Ball with
her son.
Page 8 • MSSNY’s News of New York • December 2015
MSSNY’s Amazing Doctors
Three surgeons, Drs. Kenneth
D. Anthone, Amar Atwal and
Ephraim Atwal offered free
cataract surgeries on October
16 at their clinic, Atwal Eye
Care in Cheektowaga (Erie) for
non-insured and low income
area residents, as well as
military veterans and recent
immigrants. Dr. Anthone has
Dr. Amar Atwal,
donated 150 cataract surgerDr. Ephraim Atwal and
ies locally with the Eyes On
Dr. Ken Anthone America Foundation. Dr. Amar
Atwal is the Founder and Medical Director of Atwal Eye Care
/ Buffalo Care Associates and Buffalo Ambulatory Surgery
Center. Dr. Ephraim Atwal specializes in Laser Vision
Correction including LASIK and PRK. This was the group’s
seventh year providing free surgery to people in need.
FIVE MSSNY MEMBERS HONORED AT WESTCHESTER
DOCTORS OF DISTINCTION
The Third Annual Westchester Doctors of Distinction
Award held on October 29 at the Bristal in Armonk honored
the following MSSNY members:
• Craig Zalvan, MD (Humanitarian Award)
• Scott D. Hayworth, MD (Lifetime Achievement Award)
• Andrew Kleinman, MD (Leadership in Medical Advocacy
Award)
• Robert Gary Josephberg, MD (Excellence in Medical
Research)
• Mark Russakoff, MD (Leadership in Medical Advocacy)
Avoid Medicare Penalties
Reporting PQRS has never been more
important. The penalty for not reporting is,
at a minimum, – 2.0% but it could be more.
Understanding the rules can be confusing
but is necessary. MSSNY has arranged special rates for members from Covisint – a
service to help practices with PQRS reporting. With Covisint PQRS you can confidently
avoid the 2017 payment adjustment of
-2.0%.
Covisint features include:
• Paper and electronic data collection
methods
• Web-based application access and data
entry
• Easy and Quick …The measures group
option only requires 20 patients
• HIPAA-compliant database
• Automated data submission
MSSNY Members save $100. Call
(516) 488-6100, Extension 403 or
email: [email protected] for your
MSSNY Member discount code. Use it
at the time of submission and receive
a discounted submission rate of $199.
Have questions about PQRS? Plan to attend
one of our live Q&A sessions to get all of
your questions answered and more. Visit
Covisint at: www.pqrs.covisint.com or
contact them at 866.823.3958 for more Southern Medical Association Presents
MEDICAL
DILEMMAS
IN PATIENT CARE:
2015 UPDATE
Focus on Cardiovascular,
Infectious, Liver and
Pulmonary Diseases
Crowne Plaza Times Square
Manhattan Hotel • New York, NY
December 18-20, 2015
Also Available
via Live Webcast
Register Today! Visit http://sma.org/medical-dilemmas
Final 2016 Medicare Physician Fee
Schedule Rule Issued
On October 30, CMS released the final Medicare Physician Fee Schedule
rule for 2016, along with a fact sheet describing many of its most notable
provisions.
The AMA notes that as a result of the interplay between numerous statutory provisions, the Medicare fee schedule conversion factor will be reduced
by 0.29% in 2016, from $35.93 to $35.83.
Here’s why: The Medicare Access and Chip Reauthorization Act (MACRA),
which repealed the SGR, increased the conversion factor by 0.5% on July 1
and called for additional annual updates of 0.5% from 2016 through 2019.
However, the Protecting Access to Medicare Act of 2014 enacted in April 2014,
established an annual target for reductions in Medicare payment schedule
expenditures that result from adjustments to misvalued codes. The Achieving
a Better Life Experience Act of 2014, enacted in December 2014, accelerated
the application of the expenditure reduction target, setting targets of 1% for
2016 and 0.5% for 2017 and 2018. Unfortunately, the Medicare payment
rule only identified “misvalued code” changes that achieved 0.23% in net
reductions, which required CMS to impose a 0.77% reduction to all Medicare
professional services, more than offsetting the increases contained in MACRA.
Among its numerous provisions, the Medicare fee schedule rule for 2016
includes provisions to establish payments for advanced care planning. It also
sets forth terms for the bonus and penalties physicians will face in the ValueBased Modifier Program in 2018 based upon 2016 performance. Groups of
physicians with 10 or more face a bonus or penalty of +/- 4%; while solo
practitioners and or physicians in groups of 9 or less face a bonus or penalty
of +/- 2%. The program will sunset after 2019 as part of the transition to the
Merit Based Incentive Payment System (MIPS).
December 2015 • MSSNY’s News of New York • Page 9
USPSTF Recommends Blood Glucose
Screening For All Overweight Adults
Between Ages of 40 And 70
In the recommendations appearing Oct. 27 in the Annals
of Internal Medicine, the US Preventive Services Task Force
(USPSTF) advises blood glucose testing for all adults who are
overweight and who are between the ages of 40 and 70, even
if they display no symptoms of diabetes.
The specifics of the screening recommendations, classified
as Grade B, note additional risk factors for patients with a high
percentage of abdominal fat, high cholesterol, high blood pressure, physical inactivity and smoking. For those patients whose
glucose levels are normal, re-screening every three years was
recommended.
Buyer Beware: Too Good to Be True?
There are now over 40 insurers competing for medical
liability insurance in NYS. Sometimes premium quotes can
seem too good to be true. This might be because insurers
are providing less coverage, shifting coverage from occurrence to claims made, or offering an attractive discount
that may not persist.
If a quote seems too good to be true, give MLMIC a call
at (716) 648-5923. We’ve seen a lot in our 40 years in NYS
and can often spot differences that may make a difference.
Barbara Ellman, MSSNY’s Associate
Director for Policy, Recognized for
Service to MSSNY
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Page 10 • MSSNY’s News of New York • December 2015
MSSNY President Dr. Joseph Maldonado presents a certificate
of appreciation at the November Council meeting to Barbara
Ellman, MSSNY’s Associate Director for Policy, in recognition
of her many years of dedicated service to MSSNY. Ms. Ellman,
who will retire at the end of the year, first became involved
with the society in 1986 alongside her late husband Al Ellman,
MD, a longtime MSSNY member who served as Commissioner
of Governmental Affairs. She was hired by MSSNY in 1997
and, over the last 18 years, has been committed to many
issues, including scope of practice, medical students and
health care disparities. In retirement, Ms. Ellman will serve
the MSSNY Alliance as co-president elect in 2016, and copresident in 2017.
Five MSSNY Members Honored at Westchester Doctors of Distinction
The Third Annual Westchester Doctors of Distinction Award held on October 29 at the Bristal in Armonk
honored the following MSSNY members:
(Top row, left) Dr. L. Mark Russakoff presented with
the Leadership in Medical Advocacy Award by Dr. Elaine
Healy.
(Top row, right) Dr. Scott Hayworth presented with
the Lifetime Achievement Award by John Pilkington,
Esq.
(Bottom row, left) Dr. Andrew Kleinman presented
with the Leadership in Medical Advocacy Award by Dr.
Elaine Healy, VP of United Healthcare Medical Affairs
and Medical Director of United Hebrew of New Rochelle.
(Bottom row, center) Dr. Robert Gary Josephberg
presented with the Excellence in Medical Research
Award by Daniel Angiolillo, retired associate justice
of the Appellate
Division of the New
York state Supreme
Court.
(Bottom row,
right) Dr. Craig
Zalvan presented with the
Humanitarian
Award by MSSNY
Speaker of the
House Dr. Keira
Geraci-Ciardullo.
December 2015 • MSSNY’s News of New York • Page 11
CMS Supports Advance Care Planning
The Centers for Medicare and Medicaid Services (CMS)
released the 2016 Medicare Physician Fee Schedule on October
30, 2015. For the first time, two new CPT codes are included
to reimburse for advance care planning.
The decision by CMS to approve payment for end-of-life
counseling affirms advance care planning is a critical component of clinical practice. Additionally, the value of thoughtful
advance care planning discussions between patients and
clinicians is recognized. This is a vital step in ensuring person-centered care. Medical decisions should be based on the
individual’s values, beliefs and goals for care that in turn drive
the choice of interventions.
Shared medical decision-making must be well informed and
cannot be presumed. With the increasing diversity of our population, as well as clinicians and caregivers, there is only one
way to know “what matters most” to the person. You must
ask the person. This decision supports the National POLST
Paradigm Program and New York’s MOLST and eMOLST.
CMS will begin reimbursing for these conversations starting
January 1, 2016. The two advance care planning codes are:
• 99497 for an initial 30 minute voluntary advance care
planning consultation (Final RVU 1.5)
• 99498 as an add-on code for additional 30 minute time
blocks needed (Final RVU 1.4)
New York has been a leader in advance care planning and
supports the Institute of Medicine’s Report, Dying in America
recommendation that encourages “financial incentives for
improved shared decision making and advance care planning
that reduces the utilization of unnecessary medical services
and those not consistent with a patient’s goals for care.” The
actions taken by CMS align with this recommendation and
should be followed by other insurers.
The CMS decision is applauded by CompassionAndSupport.
org, the MOLST Statewide Implementation Team and the
National Healthcare Decisions Day (NHDD) NYS Coalition.
Support for the decision was provided during the comment
period. Read the letter of support.
For additional information, view the Advance Care Planning
code section of the final rule.
More Leeway in Two-Midnight Rule
CMS issued changes to the two-midnight rule that give
physicians broader leeway to determine if someone should
be treated on an inpatient basis. But the controversial policy is largely intact.
Whether a hospital will be reimbursed for an inpatient
stay that lasts fewer than two nights will depend on such
factors as the severity of a patient’s symptoms and the
likelihood of an adverse event. Inpatient stays that do not
keep a patient in the hospital overnight will be prioritized
for review. CMS officials said they will continue to monitor
hospital admission practices and look for any evidence of
gaming. But instead of sending recovery audit contractors who are paid to dispute claims to conduct the initial
review, quality improvement organizations will be the first
to investigate.
GNYHA was among the plaintiffs in a class-action suit
filed earlier this year that challenged reimbursement cuts
made in association with the two-midnight rule. The group
voiced support for the changes in a memo released on
October 30.
Page 12 • MSSNY’s News of New York • December 2015
Rep. Collins Introduced HR Ensuring
Children’s Access to Specialty Care Act
When it comes to getting the health care our local families deserve, we have a big problem here in Western New
York and across this country. Due to large medical school
debts and intense training requirements, the number of doctors choosing to become pediatric subspecialists is rapidly
declining.
Without doctors that possess the specific training these
subspecialists have, rural areas like those in Western New
York are being left behind, unable to provide the specific
medical care to children need.
To combat this problem, I introduced H.R. 1859, the
Ensuring Children’s Access to Specialty Care Act. This bill,
which is endorsed by more than 40 organizations active in
the healthcare community, will encourage more doctors to
become pediatric subspecialists.
The legislation will add pediatric subspecialists to the loan
repayment program provided by the National Health Service
Corps (NHSC) for doctors who practice in underserved areas.
This program enables participants to receive up to $50,000
in loan repayments for each year they work in high-need
and underserved areas, for a maximum of two years.
By expanding access to this NHSC program, young pediatric subspecialists will be able to take advantage of existing
and currently unused residency slots. This simple change
would dramatically increase the number of pediatric subspecialists our country, and our area, desperately needs.
This legislation, along with increased advocacy promoting
the importance of pediatric subspecialists, will go a long way
towards ensuring that our families residing in rural areas can
access the medical care they deserve.
Congressman Chris Collins (NY-27)
202-225-5265 (office) • 202-329-3695 (cell)
[email protected]
chriscollins.house.gov
MSSNY CME Online Programs Offer 50
Courses Free of Charge
The Medical Society’s continuing medical education online
programs now offer 50 courses for physicians and other
health care providers. Recent courses under Medical Matters
include topics such as Isolation and Quarantine, Epidemiology
101 and Ebola. Advocacy Matters courses include Two Factor
Authentication which is related to the E-prescribing requirement which will go into effect on March 27, 2016.
Physicians can access these educational programs by clicking here. New registrants to the site will have to register and
create a username and password, which should be retained
and be used for continued access to the site. Once registered
and logged into the site, physicians will be taken to an instruction page. Click on “My Training Page” which is located at the
top of the page to view and take the various courses. Once physicians have registered, they will have daily access
to the coursework just by logging in. The “My Training Page”
is personalized for each physician and allows the learner to
keep track of the when they have completed the course work,
evaluation and quiz. Certificates are readily available and can
be download by the physician upon completion. Each course
is mostly accredited for 1.0 AMA/PRA Category 1 credits™.
Further information on all these programs may be obtained by
contacting Pat Clancy at [email protected]. ALLIANCE
Alliance Seeking New Members For Orange County
AMSSNY is in the process of reorganizing the Orange County Medical Society
Alliance. We have a small group of young,
determined physician spouses who are
taking steps to reorganize an Alliance
in Orange County. If you are interested
in meeting other “Family of Medicine”
members please contact our Executive
Director Kathleen Rohrer at 1-800-5234405 ext. 396 or by email at krohrer@
mssny.org.
INVESTING IN OUR FUTURE HEALTH
CARE PROVIDERS
Alliance members continue to raise
funds for students pursuing health care
careers via luncheons, dinners, holiday cards, and ads. The Broome County
Alliance raised $6,000 in awards and
scholarships; Jefferson County awarded
$14,000 in scholarships; Onondaga
County awarded eight $1,000 scholarships; Richmond County has $6,000 to
award and Schenectady County awarded
two $3,000 scholarships. That is a total
of $40,000 this year, which represents
a tremendous investment in our future
health care providers. Please consider
being a part of our efforts at one of the
following events:
• Broome County dinner on December
3rd at PS Restaurant
• Onondaga County dinner on December
2nd at the Genesee Grande
• Schenectady County Alliance Luncheon
and Fashion Show on December 3rd at
the Glen Sanders Mansion in Scotia If you are interested in attending please
bring a friend and contact our Executive,
Kathy Rohrer for details.
20TH ANNIVERSARY OF SAVE
Across the state, Alliance members
participated in some remarkable projects
to commemorate the 20th Anniversary
of the 1995 AMA/AMAA initiative, SAVE
(Stop America’s Violence Everywhere).
For 20 years, State Alliance members
have worked to raise awareness and
combat the destructive power of violence
in our communities by using materials
developed by the AMA Alliance for this
purpose.
Schenectady County members created
a Facebook page and posted photos of
supporters wearing the color blue as a
symbol that violence is never the answer.
Other county activities for SAVE Day and
National Domestic Violence Awareness
Month events were also posted. By noon
on October 13 (SAVE DAY is October
14th) the Facebook page had 88 likes,
113 people engaged and a post reach
of 726 people. Schenectady County
members arranged for billboards displaying our message and logo to be shown
on the major roadways into and out of
Albany on October 13 and 14, with the
help of Lange media. Onondaga County
Alliance hosted a “Shelter Shower” for
the residents of Vera House in Syracuse.
The shelter director gave an informative
accounting of their services and all the
people they help – women, children, men
and the elderly – who are experiencing
physical, mental, emotional or financial abuse. Schenectady County Alliance
also raised funds for SAFE, Inc. a not for
profit, tax exempt corporation with two
programs: Project Safe and Safe House.
Broome County Alliance annually raise
funds for the RISE Shelter. JOIN US FOR LEGISLATION DAY IN
ALBANY
Looking ahead, please save the date of
March 8, 2016 for our annual participation in “Legislation Day” in Albany. This
is a great chance to visit your legislators and support the bills that will benefit
patient care and help physicians in their
very challenging profession.
Another date to save is April 14-15,
2016, AMSSNY’s Annual meeting in conjunction with MSSNY’s House of Delegates
meeting in Tarrytown, NY. All physician
spouses are invited and encouraged to
attend this meeting as we plan for the
future of your Alliance.
:
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For information or to order FREE
cards to distribute to your patients,
contact: [email protected]
December 2015 • MSSNY’s News of New York • Page 13
MSSNY 11th Annual Poster Symposium
April 15, 2016
for Residents, Fellows and Medical Students
ENTER YOUR POSTER IN
• Clinical medicine (includes
clinical research, health
policy, quality improvement,
medical education)
• Clinical vignettes
• Medical student research
Submit entries in abstract form
to [email protected]
by Jan 25, 2016, 4 pm
SUBMISSION ELIGIBILITY
All entrants must be
• Active in a residency/fellowship training program, or
medical students
• Current MSSNY members.
Join at www.mssny.org
• Able to attend 2016 MSSNY House of Delegates meeting to present and discuss entry
• Entrants are responsible for travel and related costs
For detailed guidelines
[email protected] or 516-488-6100 ext 383
Page 14 • MSSNY’s News of New York • December 2015
Deadline for abstract submission
4 pm, January 25, 2016
Presentations will take place at
MSSNY House of Delegates
Friday, April 15, 2016, 2 – 4:30 pm
Westchester Marriott
Tarrytown, New York
Medical Society of the State of New York
OBITUARIES
CALAMEL, Peter M.; Lockport
NY. Died October 12, 2015,
age 87. Erie County Medical
Society.
CARDILLO,
Thomas
E.;
Fairport NY. Died September
16, 2015, age 90. Monroe
County Medical Society.
COLEMAN, Louise J.; New
York NY. Died June 05, 2015,
age 93. New York County
Medical Society.
DREYFUS, Joseph C. III; New
York NY.
Died September
26, 2015, age 79. New York
County Medical Society.
FELTON, Maxwell; New York
NY. Died August 05, 2015,
age 82.
Medical Society
County of Kings.
GERSHBERG, Herbert; New
York NY. Died January 11,
2015, age 97.
New York
County Medical Society.
GREENBERG, I. Melbourne;
Roslyn NY. Died October 06,
2015, age 94. Nassau County
Medical Society.
GRIER, W. Robson N.;
Bronxville NY. Died February
22, 2015, age 91. New York
County Medical Society.
HOEPLINGER,
Mark
A.
C.; West Seneca NY. Died
October 08, 2015, age 62.
Erie County Medical Society.
INCAVO, Joseph Francis;
Fairport NY. Died October 21,
2015, age 84. Monroe County
Medical Society.
MAYERSON, Donald Joel;
New York NY. Died February
09, 2015, age 76. New York
County Medical Society.
MORRELL, James Francis;
Ambler PA. Died September
24, 2015, age 92. Nassau
County Medical Society.
NARINS, Richard B.; East
Aurora NY. Died October 08,
2015, age 78. Erie County
Medical Society.
ROTH, Herbert B.; Melville
NY. Died October 19, 2015,
age 84.
Nassau County
Medical Society.
RUSKIN, Edwin Robert; White
Plains NY. Died February 09,
2015, age 92. Medical Society
County of Westchester.
SHILS, Maurice Edward;
Winston-Salem NC.
Died
June 29, 2015, age 100. New
York County Medical Society.
SMALL, Robert D.; White
Plains NY. Died July 15, 2015,
age 63.
Medical Society
County of Westchester.
THOMSON,
Kenneth
S.;
Macedon NY. Died September
25, 2015, age 92. Monroe
County Medical Society.
Colorado Ballot Measure Would
Replace ACA With Single-Payer Plan.
The Washington Times (10/26, A1, Richardson)
reports that advocates for a single-payer healthcare
system in Colorado “have submitted 156,107 signatures, far more than the 98,492 required to qualify for
the November 2016 ballot, to the Colorado secretary
of state’s office for verification.” The ColoradoCare program, which would cost $25 billion and be funded “with
a 10 percent payroll tax increase,” would “provide all
residents with Medicare-style health care coverage and
allow the state to dump Obamacare.”
BUSINESS SHOWCASE
December 2015 • MSSNY’s News of New York • Page 15
MSSNY-PAC
(Continued from page 4)
continue to press the importance of a cap on pain and suffering
which studies have shown reduce physician liability costs. Hospitals
have advanced the expansion of the Medical Indemnity Fund to all
neurological cases, the reduction of the pre-judgment interest percentage and the elimination of joint and several liability.
MSSNY’s communications strategy will focus a great deal on the
resolution of the statute of limitations issue. Included within these
communications will be messages which express the importance of
a robust MSSNYPAC.
Regardless of specialty, every physician this year has received
tangible relief from mandates MSSNY has defeated or forestalled
and laws it has prevented from being enacted. Take a look at the
items listed below and ask yourself what additional costs your
practice would have incurred if any of these victories had not been
achieved this year.
This is the value of MSSNY and MSSNYPAC. MSSNYPAC assures
that the voices of physicians –whether in private practice or in
practice in institutional settings—can be heard when so many other
special interest groups with diametrically opposite views aggressively push for policies that would impede your ability to continue
to deliver the care your patients expect.
BLOCKED GOVERNMENTAL MANDATES
• Secured delay in implementation of eRX mandate; physicians
given one more year (March 27, 2016) to purchase/install system.
• Defeated CME Mandate for course on I-STOP, DEA Regulations,
pain management, addiction prevention & end of life care.
• Prevented conferral of authority to Public Health and Health
Planning Council (a hospital dominated regulatory body) to designate what type of procedures and what forms of anesthesia
can be performed/used in physician owned office-based surgical
practices.
PREVENTED ADDITIONAL GOVERNMENTAL REGULATION
OF PHYSICIAN PRACTICES
• Defeated Urgent Care proposal to require accreditation and
adherence to draconian & burdensome state regulation.
• Significantly modified OBS proposal to remove registration and
additional reporting requirements.
PREVENTED INCREASE IN MEDICAL LIABILITY PREMIUM
COSTS
• Excess continued at $127.4M without programmatic changes
which would narrow physician eligibility for additional $1m
coverage.
• Defeated Regressive Medical Liability Bills including Date of
Discovery bill which would have resulted in a 15% premium
increase.
PREVENTED ENCROACHMENT INTO MEDICAL PRACTICE BY
NON-PHYSICIAN OR CORPORATE INTERESTS
• Defeated proposal to allow corporately owned retail clinics to go
in business to compete with physicians.
• Defeated Non-Physician Scope of Practice Bills:
• Optometrist prescribe oral medications
• Dentists perform cosmetic procedures in the oral and maxillofacial area
• Podiatrists diagnose and treat cutaneous conditions
• Nurse Anesthetists administer anesthesia without physician
supervision
• Corporate law changes to allow physicians and non-physicians to co-own medical practices
As we have said before, advocacy is a mixture of knowledgeable
and effective lobbyists and physician leadership, physician grassroots action and coordinated political action. We need the latter to
retain our seat at the table to make the efforts of the former most
effective.
Thank you to the many of you who have joined MSSNYPAC and
MSSNYPAC’s Chairman’s Club. You have shown true dedication to
your profession and patients. But we need so many more to also
contribute. If you haven’t yet joined, please do so immediately
by going to MSSNYPAC under the Governmental Affairs Tab on
MSSNY’s new website (click here). Together all of medicine can
achieve tangible objectives which protect physician practices and
the patient’s they serve.
CLASSIFIED ADVERTISING
Classified ads can be accessed at www.mssny.org. Click classifieds.
JANUARY 2016 ISSUE CLOSES DECEMBER 15 • $200 PER AD; $250 WITH PHOTO
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Newly renovated medical office. Windows in every room looks out to a park
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3 bathrooms and a shower. Central air and wireless. All specialties welcome.
Public transportation nearby. Please call 212-772-6011
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Modern 3000 sq. ft. Medical Office to Rent Near the United Nations.
Handicapped accessible; private reception area; secretarial area available;
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Leasing or Selling Space? Selling your practice or equipment? All Ads $200; $250 with Photo • Call 516-488-6100, ext 355
Page 16 • MSSNY’s News of New York • December 2015