NEWS CAPSULES

 

June 11, 2021

June 4, 2021

May 28, 202

May 21, 2021 

May 14, 2021

May 7, 2021

April 30, 2021

April 23, 2021

April 16, 2021 

April 9, 2021

April 2, 2021

March 26, 2021

March 5, 2021

February 26, 2021

February 19, 2021

January 22, 2021

January 15, 2021

January 8, 2021

December 26, 2020

December 18, 2020

December 11, 2020

December 4, 2020

November 27, 2020

November 23, 2020

November 16, 2020

November 6, 2020

June 11, 2021

CME Grand Rounds and Annual Meeting, June 23, 2021, 6:00 p.m.: The Society’s next Virtual Grand Rounds Presentation will be Wednesday, June 23, 2021, 6:00 p.m. to 7:00 p.m., immediately followed by the Society’s 2021 Annual Meeting at 7:00 p.m. Join us for the free CME hour and then the Annual Meeting, as we thank Doctor Arthur Cooper for his successful presidency and welcome Doctor Keith LaScalea to a new term. Register HERE. for Specialty Updates for Non–Specialists: “Clearing the Fog: Acute and Chronic Neurological Effects of COVID–19.” The Westchester Academy of Medicine and the New York County Medical Society gratefully acknowledge the Clifford L. Spingarn, MD Educational Memorial Fund for the support of this CME activity.

Speaker: Mark Milstein, MD, Director of the Adult Neurology Residency Training Program at Montefiore, and Associate Professor of Neurology and Medicine at Albert Einstein College of Medicine.

Learning Objectives: Participants will be able to:
Distinguish between acute and chronic neurological symptoms of COVID–19;
understand the hypothesized pathophysiology of neurological symptoms of COVID–19; and
summarize current research and proposed therapies for chronic neurological symptoms of COVID–19.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and the New York County Medical Society. The Westchester Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians. The Westchester Academy of Medicine designates this live webinar activity for a maximum of 1.0 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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Thanks to Our Members as Legislative Session Ends: Next steps include asking the Governor to sign legislation passed by the Assembly and Senate to:

— provide greater accountability and transparency of the practices of Pharmacy Benefit Managers (PBMs);

— significantly limit the ability of health insurers to move medications to higher cost–sharing tiers for their prescription drug formularies during a policy year; and

— require health insurers to conspicuously state whether a claim or a bill has been partially approved or entirely denied.

We also fought successfully against legislation that would have:

— required hospital–based physicians to jointly submit consolidated bills with their hospitals. Our concern was this legislation would put non–employed physicians at the mercy of the hospitals where they practice since the legislation does not specify how payments to hospitals from this “single bill” would then be distributed to these physicians;

— required notice to patients prior to hospitals, health systems and health care providers charging patients for so–called “facility fees” (distinct from professional fees), including whether the patient's health coverage will cover the facility fee. The bill would have required the physician, rather than the faciliy, to notify the patient;

— greatly expanded the types of damages awardable in “Wrongful Death” actions. One recent actuarial estimate indicated that passage of legislation such as this could have required a liability premium increase of nearly 50%, which could have meant tens of thousands of dollars in new costs for many physicians who are already paying tens to hundreds of thousands of dollars per year in their insurance costs;

— eliminated any statutory requirements for nurse practitioners to maintain collaborative arrangements with a physician practicing in the same specialty;

— permitted physician assistants to perform fluoroscopy;

— expanded ability of podiatrists to perform wound care unrelated to foot care;

— permitted pharmacists to perform various lab tests without referral from a physician; and

— created independent practice for nurse anesthetists.

Thanks to the members of MSSNY and New York County, we worked together on behalf of physicians and patients in New York State.
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From the President:

Dear Colleagues:

Numerous media outlets have recently reported that violent, prejudicial thoughts were expressed by an individual said to be a New York City–based physician during a public presentation at an academic medical center earlier this year. The Board of Directors and Board of Trustees of the New York County Medical Society have reviewed these reports, and have voted to make the following statement to our members.

Arthur Cooper, MD, MS
President

Over the past several days, numerous media outlets have reported that violent, prejudicial thoughts were expressed by an individual said to be a New York City–based physician during a public presentation at an academic medical center earlier this year. The Board of Directors and Board of Trustees of the New York County Medical Society have reviewed these reports, and if duly verified, strongly condemn the expression of such violent, prejudicial thoughts, whether made by this physician or any physician, no matter toward whom such thoughts may be directed. Regardless of the circumstances or context of the expression of such thoughts, we find them to be antithetical, and inimical, to the art, science, mission, and values of our profession, and the views of our members. The New York County Medical Society continues its efforts to advance diversity, equity, and inclusion within its own ranks, and to advocate for such changes in all medical and health professions in New York County, New York State, and our nation as a whole.
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If You Don’t Want to Miss a Thing: If you missed our May 27 Grand Rounds, “The Role of Non–Psychiatric Physicians in Identifying and Addressing COVID–Related Mental Health Symptoms,” with Dr. William Tucker, why not listen to this fascinating presentation now? Here’s the link to our recording: https://us02web.zoom.us/rec/share/r7Fd93TLtwPLJx2dYysDlAWkltkH84IQhSWRyLOU6s5s9GdMoA3O7WzlGEDeBcYo.cW4Eaa0FRsoyv-Pc
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Are You in Primary Care? NYCMS is looking at the state of primary care in New York City, hoping to bring useful information to legislators in Albany about issues in medicine. We would greatly appreciate it if you would take a few minutes to answer just a few brief questions, so we can use this information to help doctors practice better in New York. Please click on: https://www.surveymonkey.com/r/RW8JLZG
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What Ifs?

What if a prospective patient is not fully vaccinated? What if staff refuse vaccination? According to The Doctors Company, the Society’s endorsed medical liability company, it is strongly recommended that practices do not turn patients away who are not fully vaccinated or simply because a patient calls with acute respiratory symptoms. All patients should be triaged over the phone or via telemedicine and managed according to CDC recommendations. Refusing assessment/care may lead to concerns of patient abandonment. Screening Criteria: Follow the CDC’s patient screening protocol for early disease detection for patients presenting to your practice.

Can the physician require that staff be vaccinated? There are legal arguments on both sides of the question. However, on a practical level, we do not advise the physician to actually mandate the vaccination because of the very real possibility of litigation, which can tie up resources and energy. Instead, unvaccinated employees can be required to use infection control precautions including PPE and physical distancing. (See covid-19-infection-control-outpatient.pdf (nyc.gov)
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New York State Department of Financial Services (DFS) Extends Emergency Regulation on Telehealth but Eliminates Cost–Sharing Waiver: The DFS issued its latest extension of the emergency regulation related to telehealth coverage for another 30 days (through July 4, 2021). However, with COVID cases greatly reduced, the latest DFS regulation was not a straight extension of current policy. How it’s different: It removes the waiver that exempts patients from incurring out–of–pocket expenses for in–network telehealth services, including co–pays, coinsurances, and deductibles. (Note: Commercial health insurers are still required to cover for audio–only telehealth services.) Click here to read the new policy.

Early in the pandemic, with the support of MSSNY and many other patient advocacy organizations, DFS and the NYS Department of Health (DOH) adopted important telehealth policies, including waiving cost–sharing requirements, permitting coverage for audio–only services, and allowing delivery of services through basic smartphone video technologies. Medicare also followed this general path, waiving the federal statute that limits Medicare’s telehealth coverage to rural areas and significantly increasing the payments for video and audio–only telehealth services.

We are raising concerns to DFS that it may still be too early to reinstate otherwise applicable patient cost–sharing requirements. Though many people are vaccinated, experts anticipate that COVID will remain a threat for the foreseeable future, making continued access to telehealth services critical. MSSNY and the county medical societies will also continue to push for removing barriers to patients’ access to telehealth services; fair payments for these services is essential.
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Great Member Benefit: The Society has partnered with CardConnect to provide custom–tailored, cost-effective payment solutions for members who are already accepting credit cards, or looking to accept them. NYCMS members can expect: Better pricing, omni–channel acceptance, compliance with the PCI (Payment Card Industry) security standards, in–house support, security you can count on, faster funding, and real–time reporting – and there’s no contract to sign. For a custom quote or more information, contact Mark Bristow, (914) 506–1984, This email address is being protected from spambots. You need JavaScript enabled to view it.. For flyer, Click Here.
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Wednesday, June 16, 2021, at 7:30 a.m.: MSSNY Medical Matters Webinar:“The Lingering Pandemic: Long COVID Symptoms & Treatments,” with William Valenti, MD, chair of MSSNY’s Infectious Diseases Committee. Click here to register for this webinar and CME.

Free Webinars from the Columbia University Masters & Certificate Programs in Bioethics: Wednesday, June 30, 5:30 p.m. – 7:30 p.m.: “Why Do Some Hospital Employees Hesitate to Get Vaccinated Against COVID, and How Should We Respond?” RSVP HERE. Sponsored by the Empire State Bioethics Consortium, with Johanna Crane, PhD (Albany Medical College), Jennifer Breznay, MD, MPH, (Maimonides Medical Center), Kara Simpson, LCSW (Jacobi Medical Center) and Loui Voigt, MD (Memorial Sloan Kettering Cancer Center).

Monday, July 19, 6:30 p.m. – 8:00 p.m.: “Race and Bioethics: Amplifying Diverse Voices” RSVP HERE. With Harriet Washington (Columbia University, and author, Medical Apartheid), Keisha Ray, PhD (Univ. of Texas Health/McGovern Medical School), and Joanne Suarez, MBE (Founder and Director, LatinX Bioethics).
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Five New Podcasts Related to the COVID Pandemic: Check out these podcasts from MSSNY. Newly added: COVID-19 & the Mental Health of Children and Teens, with child and adolescent psychiatrist Dr. Linda Chokroverty. Click here to listen.
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In Memoriam: Society Past President Samuel H. Madell, MD, passed away at the age of 96 on June 2. Doctor Madell served as Society president in 1986 – 1987. He had a number of positions at the Society, including MSSNY Councilor for Manhattan and the Bronx, and delegate to the MSSNY House of Delegates. He was past president of the New York Roentgen Society, and served on the Board of Directors of MLMIC. Doctor Madell, a board–certified radiologist, was a graduate of the Columbia University College of Physicians and Surgeons. Doctor Madell was a true leader in organized medicine, at a time when both the medical economic environment and professional organizations were changing. We salute him and his contributions.

 

June 4, 2021

CME Grand Rounds and Annual Meeting, June 23, 2021, 6:00 p.m.: The Society’s next Virtual Grand Rounds Presentation will be Wednesday, June 23, 2021, 6:00 p.m. to 7:00 p.m., immediately followed by the Society’s 2021 Annual Meeting at 7:00 p.m. Join us for the free CME hour and then the Annual Meeting, as we thank Doctor Arthur Cooper for his successful presidency and welcome Doctor Keith LaScalea to a new term. Register HERE. for Specialty Updates for Non–Specialists: “Clearing the Fog: Acute and Chronic Neurological Effects of COVID–19.” The Westchester Academy of Medicine and the New York County Medical Society gratefully acknowledge the Clifford L. Spingarn, MD Educational Memorial Fund for the support of this CME activity.

Speaker: Mark Milstein, MD, Director of the Adult Neurology Residency Training Program at Montefiore, and Associate Professor of Neurology and Medicine at Albert Einstein College of Medicine.

Learning Objectives: Participants will be able to:
Distinguish between acute and chronic neurological symptoms of COVID–19;
understand the hypothesized pathophysiology of neurological symptoms of COVID–19; and
summarize current research and proposed therapies for chronic neurological symptoms of COVID–19.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and the New York County Medical Society. The Westchester Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians. The Westchester Academy of Medicine designates this live webinar activity for a maximum of 1.0 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


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Keep Sending Messages: The 2021 New York State Legislative Session has just a few more days to go! Much can happen at the very last moment, and often does.

Urge legislators to reject legislation that could lead to huge new increases in medical liability insurance. Click here: Reject Expansion of Recoverable Damages in Wrongful Death Actions. A.6770 is now in the Assembly Codes Committee and its counterpart, S.74–A, is in the Senate Finance Committee. This bill would greatly expand the types of damages awardable in wrongful death actions, creating untenable increases in New York’s
already excessive medical liability costs.

Urge legislators to oppose legislation that rejects physician–led team care. Click here: Protect Physician-Led Team Care for Patients. S.3056–A, now before the full Senate, would eliminate statutory requirements for nurse practitioners (NPs) to maintain collaborative arrangements with a physician practicing in the same specialty, and would also eliminate the requirement for a newly practicing NP to maintain a written collaborative agreement with a physician. The “same–as” legislation (A.1535–A) is in the Higher Education Committee.

Also Developing in the Legislature: Legislation allowing pharmacists to provide all immunizations: S.4807A/A.6476, now on the Senate floor and in the Assembly Rules Committee, would allow pharmacists to administer all immunizations that had been recommended by the CDC’s Advisory Committee on Immunizations Practices. Pharmacists can play an increasing role in enabling patients to receive necessary vaccines but S.4807A/A.6476 would not only greatly expand the list of vaccines that pharmacists could administer to adults, it would also remove the State Legislature’s future discretion to add or subtract vaccinations to/from that list.

A.336–A/S.2966–A, which requires co–prescribing of naloxone in certain instances, has passed the Assembly and is now on the Senate floor. This bill requires physicians and providers, for each year’s first opioid prescription to a patient receiving 90 MME or more, to also co–prescribe an opioid antagonist. The bill was recently amended to increase the threshold from 50 MME to 90 MME (thus applying to a far smaller cohort of patients), but some chronic pain patients might feel stigmatized as “drug addicts.” Moreover, many physicians are already co–prescribing an opioid antagonist to certain patients based on the physician’s clinical judgment; and, per NY’s eRx law, the co–prescription would go to the pharmacy automatically, eliminating choice for the patient and handing a windfall to the drug manufacturer.

S.4640/A.273, now on the floor in both houses, would require a prescriber before prescribing an opioid for a neuromusculoskeletal condition, to consider, discuss, and refer or prescribe alternative services, such as chiropractic, massage therapy or behavioral therapy. Not only would this legislation duplicate existing laws, it would create huge new documentation requirements, further disincentivizing physicians from prescribing pain controls to patients who really need them.
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Good News — Legislature Passes Bill to Restrict Mid–Year Formulary Changes: The Assembly has passed legislation (A.4668) which would significantly limit insurers’ ability to move medications to higher cost–sharing tiers for their prescription drug formularies during a policy year. The “same–as” bill (S.4111) passed the Senate earlier this Session. This legislation has been revised from a version that the Governor vetoed two years ago; now, it would prohibit a mid–year formulary change for a patient who had been on the medication at the beginning of the policy year, or for whose condition the medication was part of a treatment regimen.
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Legislature Approves Bills to Expand Medication–Assisted Treatment: The Legislature has passed multiple bills to expand the availability and coverage of medication–assisted treatment (MAT), to assist New Yorkers suffering from substance use disorder. The first bill (S.1795/A.533) would establish MAT programs for inmates in state and county correctional facilities; the second bill (S.649/A.2030) would require Medicaid to cover MAT without prior authorization. (Similar requirements exist for commercial health insurance plans.)
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More Health Insurer Reforms: A.1741/S.5299 – Would enable third–party financial assistance programs to count towards patients’ deductible and out–of–pocket maximum requirements. Passed Senate and on Assembly floor. A.4177/S.2528 – Would provide due process protections for physicians whose network participation contract has been unilaterally non–renewed by an insurance company. On Assembly and Senate floor. A.7129/S.6435–A – Would enact a number of reforms to address prior authorization hassles, including limiting an insurer’s ability to require a physician and patient to repeat a previously obtained prior authorization. On Senate floor and Assembly Insurance Committee. A.6256/S.5055 – Would require parity in payment for delivery of care via telehealth, as compared to delivery of care in person. On Senate floor and Assembly Insurance Committee.
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MSSNYPAC is the Political Voice of New York State Physicians: The strength of MSSNYPAC requires NY’s physicians to be “all in” when it comes to safeguarding the medical profession, assuring patients’ access to needed care, and investing in the present and future viability of medical practices. Physicians cannot afford to give up their seat at the discussion table, especially now, when well–funded opposing interest groups (including trial lawyers and insurance companies) are pushing hard to expand medical liability and increase their control over clinical decision–making. Join or renew your MSSNYPAC membership today. Online: www.mssnypac.org/contribute. Phone/text: (914) 933–7722. Mail: PAC Remittance Form.


NYS Department of Financial Services (DFS) Announces New “Mental Health Matters” Initiatives: More than one in five New Yorkers has symptoms of a mental health or substance use disorder each year; and several studies have shown that the ongoing COVID–19 pandemic has worsened mental health and substance use disorders, especially for people of color and low–income New Yorkers. We do have laws concerning the coverage of treatment for mental health and substance use disorders: State law requires insurers to cover these treatments, and both Federal and State law require health insurers to cover these treatments at the same level as other health conditions. Nevertheless, insurers do not always comply. The DFS has announced new plans:

New regulation to protect consumers from misinformation in insurers’ provider directories. DFS will propose a regulation requiring insurers to hold patients harmless, when the insurer’s provider directory incorrectly lists a provider as participating in an insurer’s network.

Monitoring insurers’ compliance with parity laws. DFS will launch an “Up–Front Review of Cost–Sharing”: Before selling policies, insurers must prove that under those policies, co–payments or coinsurance will not be higher for mental health and substance use disorder benefits than they are for medical benefits.

DFS will investigate:

Potential parity violations, including violations involving cost–sharing requirements.

Rates of approvals of services, and medical necessity denials.

Network adequacy — the number and type of mental health and substance use disorder providers who are in network.

MSSNY, working together with the New York State Psychiatric Association and other specialty societies, will monitor the rollout of these important new policies and provide additional details as they are available. Read about it here: Mental Health Matters.
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2021 MIPS Exception Windows Now Open: Applications are now open for the MIPS Promoting Interoperability Performance Category Hardship Exception and Extreme and Uncontrollable Circumstances Exception for the 2021 Performance Year. Submit your application to CMS by December 31, 2021.
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Dr. Lorna Breen Health Provider Act Moves Forward in U.S. Senate: This measure (S. 610/H.R. 1667) would fund grants for projects addressing provider suicide, burnout, mental health conditions, and substance use disorders, and encourage healthcare professionals to seek treatment for mental and behavioral health issues.

Doctor Lorna Breen, as the emergency room director at the New York– Presbyterian Hospital, spent long hours and dedicated her life to the care of her patients. During the worst of the pandemic, in spring 2020, she helped to oversee care to an overwhelming number of patients in need. Hospitals all over the country felt the stress of the pandemic, and physicians and other professionals were overworked, overwhelmed, and suffering symptoms of burnout; few were prepared for the overwhelming impact the virus would bring to those who were providing care under the most harrowing conditions. With the mounting pressure and stress, Doctor Breen sadly took her own life. The bill is supported by MSSNY, American College of Emergency Physicians, The Joint Commission, and the American Osteopathic Association.
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Wednesday, June 16, 2021, at 7:30 a.m.: MSSNY Medical Matters Webinar: “The Lingering Pandemic: Long COVID Symptoms & Treatments,” with William Valenti, MD, chair of MSSNY’s Infectious Diseases Committee. Click here to register for this webinar.

 

 May 28, 2021

June 3 Deadline for Yankee Tickets for Healthcare Workers:
Join your fellow healthcare professionals and the New York Yankees for a fun–filled day at Yankee Stadium for select games in May and June.
Healthcare professionals and their families will enjoy up to 50% savings on their tickets! Offer expires on June 3, 2021. Learn more HERE.
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Latest Developments in the NYS Legislature:

We oppose A.336–A/S.2966–A, which requires the co–prescribing of naloxone in certain instances, has moved to the Assembly Rules Committee and to the Senate floor. For the first prescription of each year to a patient who was receiving 90 MME or more, physicians and other providers would also be required to co–prescribe an opioid antagonist. Among our objections: The bill was recently amended to apply to a smaller cohort of patients, but there is still concern that patients might fear stigma as drug addicts. Many physicians are already co–prescribing an opioid antagonist for certain patients, based on clinical factors. In addition, with New York’s mandatory eRx law, the co–prescription would be automatically e–transmitted to the pharmacy and filled – an automatic extra cost to the patient and a windfall for the drug manufacturers.

We oppose S.4640/A.273, now on the floor in both houses, require physicians to document that they have discussed with patients many specific alternatives to prescribing an opioid for a neuro–musculoskeletal condition — alternatives such as chiropractic, massage therapy or behavioral therapy. Existing laws already require physicians and prescribers to use the CDC Guidelines for Prescribing Opioids for Chronic Pain when assessing patients for opioid use. Those guidelines require prescribers to discuss the benefits and risks of opioids with patients, and the availability of non–opioid therapies; prescribers must also make sure patients are started on the lowest possible dosage. By listing so many specific alternatives, S.4640/A.273 could create huge new documentation requirements, further dis–incentivizing physicians from prescribing pain–control medications for patients who truly need them.

We oppose S.4807/A.6476–A, now on the NYS Senate floor and in the Assembly Higher Education Committee, would let pharmacists administer all immunizations that have been recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP). Pharmacists can be extremely important in getting protective vaccines to more people, but we are concerned that this legislation goes too far. Not only would it greatly expand the number of vaccines that pharmacists could administer to adults, it would also remove the state legislature’s discretion to modify that list, turning over that discretion to the federal government. This across–the– board bill could create problems. It would increase from seven to 16 the number of ACIP–schedule vaccines a pharmacist could administer, and whatever vaccines the ACIP may add in the future. In addition, many of these immunizations are given as a series with specific time parameters, and calling back a patient is sometimes difficult even where contact information is available.

We support S.75 (Hoylman)/A.279 (Gottfried) would require all physicians and other providers to report adult immunizations to the NY State Immunization Information System (NYSIIS) and the New York City Immunization Registry (CIR). The bill, which is on the Senate floor and has moved to the Assembly Codes Committee, builds off the 2014 law that required all child immunizations to be recorded in the registries.
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Keep Sending Messages! Legislators’ offices count the number of “pro” and “con” communications that come in.

The Senate is considering a bill to streamline the prior authorization process. Send a letter in support here: Prior Authorizations are harming our ability to provide proper, timely care

Tell legislators to oppose proposals that would reject physician-led team care: Just click on Protect Physician-Led Team Care for Patients (p2a.co). S.3056–A, still on the Senate floor, could jeopardize patient safety and lead to uncoordinated, siloed care by eliminating any statutory requirements for nurse practitioners (NPs) to maintain collaborative arrangements with a same–specialty physician, and also by eliminating the requirement for a newly practicing nurse practitioner to maintain a written collaborative agreement with a physician.

Oppose legislation that would greatly increase medical liability insurance: Just click here: Reject Expansion of Recoverable Damages in Wrongful Death Actions. S.74–A and A.6770 would create untenable increases in New York’s already excessive medical liability costs, by greatly expanding the types of damages awardable in wrongful death actions.
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How Valuable is Telehealth: A new report jointly developed by the AMA and Manatt Health Strategies looks at measurements of virtual care’s value, including clinical outcomes, health equity, clinician experience and patient experience — versus environmental variables such as the type of practice and the type of payment arrangement. The report offers four real–world examples of how to use the framework to evaluate telehealth, and six scenarios to show how the framework can be applied to a new program. Read the report at: Return on Health: Moving Beyond Dollars and Cents in Realizing the Value of Virtual Care
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How Many Physicians Now Work Outside of Private Practice: More than 50 percent of patient–care physicians worked outside of physician–owned medical practices in 2020, according to this newly released biennial analysis of physician practice arrangements by the American Medical Association (AMA) found HERE. The AMA survey data show that 49.1% of patient care physicians worked in physician–owned practices, down from 54% of physicians in the 2018 AMA survey. This is the first time the share of physicians in private practices has dropped below 50% since the AMA analysis began in 2012. The new AMA analysis illustrates the wide variety of practice types, sizes, and ownership arrangements in which physicians work. Due to this diversity, no single practice type, size, or ownership structure can or should be considered the typical physician practice, according to the analysis.
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American Board of Medical Specialties (ABMS) Seeks Comments on Draft Standards for Continuing Certification: ABMS has opened an 80-day “Draft Standards for Continuing Certification – Call for Comments” to obtain input and feedback from all stakeholders who possess, use, or rely upon the board certification credential as an indicator of a diplomate’s professionalism and proficiency in specialty knowledge and skills. Feedback received will guide and inform the development of the final Draft Standards for Continuing Certification (“Draft Standards”), which will be considered by the ABMS Board of Directors in October. Submit your comments by 11:59 p.m. CST on Thursday, July 8, 2021.
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MIPS News: CMS has announced that in light of the impact of the pandemic, the 2020 MIPS Cost Performance Category will be re weighted to 0% of the final score even if eligible physicians or groups submitted 2020 data in other MIPS categories. For over a year, the AMA has been recommending that CMS zero out this category during the pandemic for several reasons, including concerns that decreases in patient visits and increases in the costs of caring for COVID–19 patients could unfairly penalize physicians.
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Wednesday, June 23, 6:00 to 7:00 p.m., NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “Clearing the Fog: Acute and Chronic Neurological Effects of COVID–19,” with Mark Milstein, MD, Director of the Adult Neurology Residency Training Program at Montefiore and Associate Professor of Neurology and Medicine at Albert Einstein College of Medicine. Learning objectives: Participants will be able to: Distinguish between acute and chronic neurological symptoms of COVID–19; understand the hypothesized pathophysiology of neurological symptoms of COVID–19; and summarize current research and proposed therapies for chronic neurological symptoms of COVID–19. Registration information coming soon.

 

May 21, 2021

Only a few weeks to go in this year’s session!  Oppose legislation that would reject physician-led team care:  Just click on Protect Physician-Led Team Care for Patients (p2a.co).  S.3056-A, now on the NY Senate floor, could jeopardize patient safety and lead to uncoordinated, siloed care - by eliminating any statutory requirements for nurse practitioners (NPs) to maintain collaborative arrangements with a same-specialty physician, and also by eliminating the requirement for a newly practicing nurse practitioner to maintain a written collaborative agreement with a physician.  The “same-as” legislation, A.1535-A, is in the Higher Education Committee.  We must stress that while NPs are essential to ensure that patients receive the care they need, it is crucial that ongoing team-based care, in collaboration with a physician, be maintained so that patients receive the highest quality care. Instead of removing these requirements, the standards for physician-NP collaboration should be strengthened so that potentially complex cases can be better recognized and treated.

            MSSNY joined with several specialty societies in a letter to Senators raising strong objections to this bill.   Physicians complete 4 years of medical school plus 3-7 years of residency (including 10,000-16,000 hours of clinical training) - exponentially more than the education and training received by nurse practitioners. But the issue is more than just the vast difference in hours of education and training – it is also the difference in rigor and standardization between medical school/residency and nurse practitioner programs. Not surprisingly, a recent survey of 500 New Yorkers concluded that 75% want a physician to be involved in their diagnosis and treatment decisions.

         The recently concluded State Budget extended for another year (until June 30, 2022) the existing law that permits nurse practitioners with more than 3,600 hours of experience to practice without a written collaborative agreement, provided that they maintain evidence of “collaborative relationships” with a physician in the same specialty practiced by the NP. The bill now in the Senate would go much farther. 


 

Oppose legislation that would greatly increase medical liability insurance:  Just click here:  Reject Expansion of Recoverable Damages in Wrongful Death Actions.  Proposals (S.74-A, A.6770) are before the Senate and Assembly Judiciary Committees that would create untenable increases in New York’s already excessive medical liability costs, by greatly expanding the types of damages awardable in wrongful death actions.  These measures could lead to a liability premium increase of nearly 50% - translating to tens of thousands of dollars in new insurance costs for many physicians who are already paying tens of thousands, to hundreds of thousands, of dollars per year.  At any time, these increases could jeopardize patients’ access to care at community hospitals and physicians’ offices; now, with so many practices just recovering from the pandemic’s huge drop in patient visits and revenue, legislation that could lead to such premium increases would be unconscionable.

 


Senate Health Committee considering bill to streamline prior authorization process:  Please send a letter in support here: Prior Authorizations are harming our ability to provide proper, timely care.  MSSNY has joined with 15 other patient and physician advocacy organizations in support of S.6435-A (Breslin)/A.7129 (Gottfried), which is in the Senate Health Committee. The bill would help to simplify the prior authorization process, reduce barriers, and protect patients’ access to prescription medications and tests needed for accurate diagnosis.  A recent Annals of Internal Medicine study concluded that for every hour a physician spends on delivering care to a patient, two more are spent on administrative tasks; a just-released AMA survey reported that 94% of responding physicians said that the prior authorization process had delayed patients’ access to care, and 90% of the respondents indicated that prior authorization had led to somewhat, or significant, negative outcomes.  Patients with chronic conditions have complex medical needs.  Their health depends on following strict treatment regimens, and timely access to treatment and medications is critical.  All patients, moreover, need to know that they’ll receive treatment in a timely manner, and that their care and treatment will be covered by their insurance plan.

 

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MSSNY continues the fight for health insurer reforms:  MSSNY and several patient and physician advocacy groups continue pushing for much-needed improvements.  The Senate has now passed S.5299 (Rivera), letting patients count third-party financial assistance programs toward meeting their deductible costs; the “same-as” legislation, A.1741 (Gottfried), is before the full Assembly. Meanwhile, the Assembly Ways & Means Committee has advanced to the Assembly floor legislation (A.4668, Peoples-Stokes), significantly limiting health insurers’ ability to make adjustments to their prescription drug formularies during a policy year. The “same-as” legislation (S.4111, Breslin) recently passed the Senate.  Other bills being advanced by MSSNY include:

  • 4177/S.2528 – Due process protections for physicians whose network participation contract is unilaterally non-renewed by an insurance company. On Assembly and Senate floor.
  • 7129/S.6435-A – Addressing prior authorization hassles, including health insurers’unfair and burdensome requirements that physicians and patients re-obtain previously obtained authorizations. In Assembly Insurance and Senate Health Committees (see above).
  • §951/S.1575 – Letting independently practicing physicians jointly negotiate network participation terms with market-dominant health insurance companies. In Assembly and Senate Health Committees.

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Elective procedures:  New DOH Guidance eliminates pre-surgery COVID-19 testing for individuals who are vaccinated.  A copy of the guidance is here.  Now, pre-elective procedure COVID -19 testing will not be required for patients who are fully vaccinated, or have recovered from laboratory-confirmed COVID-19 during the previous three months.  And, there is no need to test asymptomatic recently recovered patients to prove that they are now negative. However, pre-elective procedure testing remains encouraged by NYSDOH for all asymptomatic patients scheduled for elective surgery/procedures. 

 


Revised NYS COVID 19 Guidance (May 13) expands immunization to 12-15 years of age; Vaccine Tracker reporting no longer required.  For a copy of the May 13 guidance, Click Here. The new guidance allows physicians and other providers enrolled in the NYS and NYC COVID-19 vaccination programs to provide immunizations to individuals aged 12-15 years of age using the Pfizer COVID-19 vaccine. The guidance also includes the following:

            Vaccine Tracker: Reporting to the NYS COVID-Vaccine Tracker is no longer required.

            Universal doses: New York State has moved to a “Universal Dose” administration process for all multi-dose COVID-19 vaccine types. All doses are now considered universal doses, which means that doses can be used as either a first dose or a second dose, regardless of whether they were originally shipped to providers as a first dose or a second dose.  First and second doses may also be drawn interchangeably from the same vial. 

             Responsible wastage: While enrolled, providers must continue to follow best practices to use every dose possible; they should try not to miss opportunities to vaccinate every eligible person when people are ready to get vaccinated.  (If you have any questions, please contact This email address is being protected from spambots. You need JavaScript enabled to view it..)  And note: The DOH says:  “With all doses being a universal dose, please utilize a first in, first out rule to manage inventory. This includes storing newly received vaccine in the freezer until it is needed.”     

 

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Health Republic liquidation:  Do you have outstanding claims?  A MSSNY survey of physicians’ practices showed that 42% had outstanding claims:  11% were owed $100,000 or more, 20% were owed $25,000 or more, and 49% were owed $5,000 or more.  A $220.8 million settlement has been reached, which will allow the Liquidator to pay all policyholder-level claims in full.  MSSNY will continue pushing for a Health Guarantee Fund - a safety net for patients and physicians against similar health-insurer liquidations that could occur in the future.  Meanwhile, MSSNY is working with the NYS Department of Financial Services to ascertain when, and how, outstanding payments will be distributed to satisfy Health Republic’s financial obligations.  For more information on that, check here


For Our Members From New York County Medical Society:  

Free CME Program: Thursday, May 27, 6:00 to 7:00 p.m. for the First Installment of NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “The Role of Non–Psychiatric Physicians in Identifying and Addressing COVID–Related Mental Health Symptoms,” with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. When COVID–19 arrived, physicians had no prior experience with the physical manifestations of the disease, much less its mental health effects. As the science develops, physicians are learning about treating the disease’s physical problems (pulmonary, neurological, etc.), and knowledge about the mental health problems is also increasing. Doctors outside the specialty of psychiatry may find it useful to receive an overview of the mental health issues now being associated with COVID, so that they can look for problems with their recovering patients and take appropriate steps in their practice. They may also be interested in learning how to provide basic emotional support and primary–care–level counseling to patients suffering from specific symptoms (anxiety, depression, etc.) experienced by many of the general public as well as COVID patients, and how to determine when patients may need psychiatric treatment because of COVID–related experiences.    

Learning objectives: Recognize the range of COVID–related mental health symptoms that exist; assess COVID–related mental health symptoms in the course of a routine office visit; and determine which COVID–encountered symptoms necessitate referral to a psychiatrist. 

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and the New York County Medical Society. The Westchester Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians. 

The Westchester Academy of Medicine designates this live webinar activity for a maximum of 1.0 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

Register HERE.


Wednesday, June 23, 6:00 to 7:00 p.m.: NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “Clearing the Fog: Acute and Chronic Neurological Effects of COVID-19,” with Mark Milstein, MD, Director of the Adult Neurology Residency Training Program at Montefiore, and Associate Professor of Neurology and Medicine at Albert Einstein College of Medicine.  

Learning objectives: Participants will be able to: Distinguish between acute and chronic neurological symptoms of COVID–19; understand the hypothesized pathophysiology of neurological symptoms of COVID–19; and summarize current research and proposed therapies for chronic neurological symptoms of COVID–19. Registration information coming soon.


Screening During the Pandemic: The New York State Cancer Consortium’s Colorectal Cancer Action Team and the New York State HPV Coalition are sponsoring a webinar on Tuesday, May 25, 2021, from 12:00 noon to 1:00 p.m., on cancer screening and HPV vaccination. Speakers will cover national data, offer specific strategies, and share new resources to promote a return to screening, and will also promote earlier–than–usual HPV vaccination. A copy of the flyer and registration can be found here


Wednesday, May 26, 2021, at 7:30 a.m.: “Triage in a Disaster Event.” Click here to register. This CME program, part of MSSNY’s Medical Matters CME series, features Arthur Cooper, MD, (New York County Medical Society President) and Zachary Hickman, MD. Innumerable disaster events have been taking place all around us; learn about how to perform triage when you find yourself in proximity to different types of disaster.


Did You Miss “Beyond Tuskegee: COVID–19 Vaccine Equity and Confidence?” Check out the forum presented by the Kings County Medical Society with the Provident Clinical Society and Region 1 National Medical Association. Click here to watch: https://m.youtube.com/watch?v=_4A_uYIDZZE&feature=youtu.be.


 

In Memoriam

Naomi De Sola Pool, MD.  Doctor Pool received her MD degree from New York University School of Medicine in 1943. 

Paul Post, MD.  Doctor Post received his MD degree from Hahneman University School of Medicine in 1975. 

Kathryn F. Prescott, MD, died July 25, 2020.  Doctor Prescott received her MD degree from New York University School of Medicine in 1950. 

Nisar Ali Qurashi, MD, died March 2020.  Doctor Quraishi received his MD degree from University of Dacca Medical School in 1969. 

Jack Grant Rabinowitz, MD.  Doctor Rabinowitz received his MD degree from University of Bern in 1955. 

Harry Reiss, MD.  Doctor Reiss received his MD degree from University of Toronto School of Medicine in 1947. 

Melvin Rosenzweig, MD.  Doctor Rosenzweig received his MD degree from University of  Rijksuniveriteit in 1959. 

Richard A. Ruskin, MD, died February 3, 2020.  Doctor Ruskin received his MD degree from Duke University School of Medicine in 1943. 

Irving Sarnoff, MD.  Doctor Sarnoff received his MD degree from Cornell University Medical College in 1942. 

Leonard Shengold, MD, died January 16, 2020.  Doctor Shengold received his MD degree from SUNY Downstate in 1951. 

George Lewis Siegel, MD.  Doctor Siegel received his MD degree from Albany Medical College in 1959. 

Paul S. Slosberg, MD.  Doctor Slosberg received his MD degree from New York University in 1952. 

Irwin Solomon, MD.  Doctor Solomon received his MD degree from SUNY School of Medicine, Buffalo in 1948. 

Apostolos Tambakis, MD, died December 4, 2020.  Doctor Tambakis received his MD degree from Aristotelian University of Thessaloniki, Greece in 1953. 

Michael L. Tapper, MD, died March 6, 2020.  Doctor Tapper received his MD degree from Columbia University College of Physicians and Surgeons in 1970. 

Bjorn Thorbjarnarson, MD.   Doctor Thorbjarnarson received his MD degree from University of Iceland School of Medicine in 1947. 

Wolfgang Tretter, MD. Doctor Tretter received his MD degree from University of Heidelberg in 1952. 

Arthur S. Verdesca, MD.  Doctor Verdesca received his MD degree from Columbia University College of Physicians and Surgeons in 1955. 

Gerald S. Weinberger, MD.  Doctor Weinberger received his MD degree from New York University School of Medicine in 1948. 

David Harold Woldenberg, MD.  Doctor Woldenberg received his MD degree from Chicago Medical School in 1958. 

John L. E. Wolff, MD, died March 22, 2020.  Doctor Wolff received his MD degree from Temple University School of Medicine in 1952. 

Natalie Yarrow, MD.  Doctor Yarrow received her MD degree from Virginia Commonwealth University in 1940. 

Charles G. Zaroulis, MD, died March 20, 2021.  Doctor Zaroulis received his MD degree from University of Virginia School of Medicine in 1965.

 

 

 May 14, 2021

 

Send a message to Congress on Keeping Expanded Telehealth Services: Click on: Tell Congress to make expanded telehealth services permanent. During the pandemic, telehealth services emerged as a critical tool to provide patients with care while supporting physical distancing efforts and reducing the spread of infection by avoiding unnecessary outpatient visits. In response, Congress acted to temporarily expand access to Medicare covered telehealth services to all Medicare beneficiaries, by authorizing HHS (the U.S. Department of Health and Human Services) to waive outdated statutory restrictions on where telehealth services may be provided; and since then, physicians have continued to provide high–quality care via telehealth, using new digital tools. The Telehealth Modernization Act of 2021 (H.R. 1332/S. 368) has now been introduced in both the House and Senate to make expanded access to telehealth services permanent. This proposal would lift the rural–only restriction; and, it would add any site where a patient is located as a potential originating site, ensuring that all Medicare beneficiaries may receive covered Medicare telehealth benefits, including at home and via mobile technologies. A companion proposal, the CONNECT for Health Act (H.R. 2903/S. 1512), would provide HHS with permanent authority to waive these restrictions, similar to the authority the agency has for the duration of the COVID-19 public health emergency.
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Nurse Practitioners Seek To Remove Collaborative Arrangements With Physicians: We strongly opposes S.3056–A, which has now on advanced to the floor of the New York State Senate. Please send a letter right now, urging legislators to oppose this legislation – click here. This proposal, also in the Assembly Higher Education Committee (A.1535-A), could jeopardize patient safety and lead to uncoordinated, siloed care. It would eliminate any statutory requirements for nurse practitioners (NPs) to maintain collaborative arrangements with a physician practicing in the same specialty, and would also eliminate the requirement for a newly practicing NP to maintain a written collaborative agreement with a physician. NPs are essential components of our healthcare system, helping to ensure that patients receive the care they need; but we must let legislators know that maintaining ongoing team–based care in collaboration with a physician is crucial for making sure that patients receive the highest quality care. Instead of removing these requirements, the standards for physician–NP collaboration should be strengthened, so that potentially complex cases can be better recognized and treated.

In the recently finalized State Budget, a provision was enacted that extended for another year (until June 30, 2022) the existing law that permits NPs with more than 3,600 hours of experience to practice without a written collaborative agreement, provided that they maintain evidence of “collaborative relationships” with a physician in the same specialty practiced by the NP. The proposal on the Senate floor goes far beyond that measure.

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Payment Parity for Telehealth Services: We must keep communicating with New York State legislators on parity for telehealth. Click here: Urge Legislators to Support Payment Parity in Telehealth. A.6256/S.5505 would ensure that payments to physicians for telehealth services (including video and audio–only visits) are on par with payments received for in–office appointments.
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NYS Department of Health Issues Updated Guidance on the Administration of COVID–19 Vaccines: The updated guidance (here) addresses the issue of offering second doses of COVID–19 vaccines to people who received their first shot from a different provider. A DOH compilation of all updated guidance notices can be found here: Update
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COVID Disaster Relief: MSSNY has established three separate funds for disaster relief donations under the Medical Educational and Scientific Foundation (MESF). Proceeds will go directly to organizations providing direct aid in areas of need. Please click on a link below to direct your donation:

COVID-19 India Relief Fund: Donations will be sent to organizations assisting India with urgent needs, including oxygen equipment, medications, PPE, testing supplies, and ventilators.
COVID-19 General Relief Fund: Donations will be sent to US or international organizations where the need is greatest.

General Disaster Relief Fund: Donations will be held and distributed when needs arise.

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For Our Members From New York County Medical Society:

Free CME Program: Thursday, May 27, 6:00 to 7:00 p.m. for the First Installment of NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “The Role of Non–Psychiatric Physicians in Identifying and Addressing COVID–Related Mental Health Symptoms,” with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. When COVID–19 arrived, physicians had no prior experience with the physical manifestations of the disease, much less its mental health effects. As the science develops, physicians are learning about treating the disease’s physical problems (pulmonary, neurological, etc.), and knowledge about the mental health problems is also increasing. Doctors outside the specialty of psychiatry may find it useful to receive an overview of the mental health issues now being associated with COVID, so that they can look for problems with their recovering patients and take appropriate steps in their practice. They may also be interested in learning how to provide basic emotional support and primary–care–level counseling to patients suffering from specific symptoms (anxiety, depression, etc.) experienced by many of the general public as well as COVID patients, and how to determine when patients may need psychiatric treatment because of COVID–related experiences.

Learning objectives: Recognize the range of COVID–related mental health symptoms that exist; assess COVID–related mental health symptoms in the course of a routine office visit; and determine which COVID–encountered symptoms necessitate referral to a psychiatrist.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and the New York County Medical Society. The Westchester Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians.

The Westchester Academy of Medicine designates this live webinar activity for a maximum of 1.0 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Register HERE.
______________________________________________________________

Wednesday, June 23, 6:00 to 7:00 p.m.: NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “Clearing the Fog: Acute and Chronic Neurological Effects of COVID-19,” with Mark Milstein, MD, Director of the Adult Neurology Residency Training Program at Montefiore, and Associate Professor of Neurology and Medicine at Albert Einstein College of Medicine.

Learning objectives: Participants will be able to: Distinguish between acute and chronic neurological symptoms of COVID–19; understand the hypothesized pathophysiology of neurological symptoms of COVID–19; and summarize current research and proposed therapies for chronic neurological symptoms of COVID–19. Registration information coming soon.
_____________________________________________________________

Screening During the Pandemic: The New York State Cancer Consortium’s Colorectal Cancer Action Team and the New York State HPV Coalition are sponsoring a webinar on Tuesday, May 25, 2021, from 12:00 noon to 1:00 p.m., on cancer screening and HPV vaccination. Speakers will cover national data, offer specific strategies, and share new resources to promote a return to screening, and will also promote earlier–than–usual HPV vaccination. A copy of the flyer and registration can be found here.
______________________________________________________________

Wednesday, May 26, 2021, at 7:30 a.m.: “Triage in a Disaster Event.” Click here to register. This CME program, part of MSSNY’s Medical Matters CME series, features Arthur Cooper, MD, (New York County Medical Society President) and Zachary Hickman, MD. Innumerable disaster events have been taking place all around us; learn about how to perform triage when you find yourself in proximity to different types of disaster.
______________________________________________________________

Did You Miss “Beyond Tuskegee: COVID–19 Vaccine Equity and Confidence?” Check out the forum presented by the Kings County Medical Society with the Provident Clinical Society and Region 1 National Medical Association. Click here to watch: https://m.youtube.com/watch?v=_4A_uYIDZZE&feature=youtu.be. ______________________________________________________________

In Memoriam

Richard H. Hamilton, MD. Doctor Hamilton received his MD degree from New York Medical College in 1947.

Antoine C. Harovas, MD. Doctor Harovas received his MD degree from Albany Medical College in 1960.

Pauline G. Hecht, MD. Doctor Hecht received her MD degree from New York University School of Medicine in 1954.

Arthur D. Heller, MD. Doctor Heller received his MD degree from Jefferson Medical College in 1978.

Ida Hutmacher, MD, died February 25, 2020. Doctor Hutmacher received her MD degree from University of Kursk in 1945.

Robert Jaffe, MD. Doctor Jaffe received his MD degree from University of Pennsylvania School of Medicine in 1946.

Sherwin Allen Kaufman, MD. Doctor Kaufman received his MD degree from Cornell University Medical College in 1943.

Jay Alan Kavet, MD, died April 4, 2020. Doctor Kavet received his MD degree from Universidad Autonoma de Medicina Guadalajara in 1975.

Donald F. Klein, MD. Doctor Klein received his MD degree from SUNY Downstate in 1952.

Isadore Kreel, MD. Doctor Kreel received his MD degree from University of Toronto School of Medicine in 1954.

Jerry J. Lasser, MD. Doctor Lasser received his MD degree from Albany Medical College in 1954.

Tak–Ching K. Lau, MD. Doctor Lau received his MD degree from Sun Yat Sen University in 1952.

Peter C. Leggiadro, MD. Doctor Leggiadro received his MD degree from University of Rome in 1959.

Camille Mallouh, MD. Doctor Mallouh received her MD degree from St Joseph University School of Medicine Beirut, Lebanon in 1957.

Robert Emmet Martin, MD. Doctor Martin received his MD degree from New York University School of Medicine in 1964.

Robert B. Mellins, MD. Doctor Mellins received his MD degree from Johns Hopkin University School of Medicine in 1952.

Alvin Mund, MD. Doctor Mund received his MD degree from New York University School of Medicine in 1944.

Michael J. Neely, DO, died December 1, 2020. Doctor Neely received his MD degree from Ohio University College of Medicine in 1997.

David Newman, MD. Doctor Newman received his MD degree from SUNY Downstate in 1958.

Gideon G. Panter, MD, died December 23, 2020. Doctor Panter received his MD degree from Cornell University School of Medicine in 1960.

Keun Soo Park, MD. Doctor Park received his MD degree from Seoul National University College of Medicine in 1949.

Demetrius Pertsemlidis, MD, died June 10, 2020. Doctor Pertsemlidis received his MD degree from University of Hamburg in 1959.

Martin M. Pincus, MD, died February 18, 2020. Doctor Pincus received his MD degree from Hahneman University School of Medicine in 1975.

Irene Basilio Pineda, MD. Doctor Pineda received her MD degree from University of Santo Tomas, Philippines in 1962.

 

 

 

May 7, 2021

 

Info Blocking Rule Examples Needed — Take the AMA Survey: The AMA is gathering perspectives, stories, and examples of patient harm relating to the release of PHI (protected health information). Recently, ONC (the Office of the National Coordinator for Health Information Technology) implemented regulations requiring physicians to make available a variety of medical information such as lab tests, clinical notes or medications, when this information is requested by or on behalf of the patient. Physicians who interfere or impose any delays might be deemed to be violating new rules concerning “information blocking.” Organized medicine has major concerns about the specific timing of the new rules, which require physicians to release information to patients immediately—in many cases, before the physician has reviewed the information and without regard to whether such release could be mentally or emotionally distressing to the patient.

For example, a CT scan radiology report indicating that a “malignancy could not be ruled out” must be sent to the patient’s portal or smartphone app right away, even if the oncologist has not yet viewed the study or read the report. If this report were sent to a parent of an infant ahead of a holiday weekend, that parent could unnecessarily spend days in deep emotional distress before being able to talk to the infant’s physician. Patient access to medical information is important, but there are many ethical, professional, and practical concerns involved. The AMA is surveying for your real–world examples, scenarios, and instances where the release of reports or notes without vital context or prior review could cause (or has caused) emotional or mental harm. If you have examples, please send them to Ela Cameron at This email address is being protected from spambots. You need JavaScript enabled to view it..
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Resolution of Health Republic Case: New York’s Department of Financial Services (DFS) has announced a settlement of $220,838,583 in the case of the liquidation of Health Republic Insurance of New York. The settlement will allow the Liquidator to pay all policyholder–level claims in full, including those of many New York hospital systems and other health care providers; it is also expected that there will be sufficient assets to pay New York State and local government claims of approximately $19.1 million, plus a substantial portion of general creditor claims. Organized medicine in New York State counts this settlement as a major victory for physicians.

Health Republic, a not–for–profit health insurer providing affordable health insurance under the federal Patient Protection and Affordable Care Act (ACA), had participated in a number of ACA programs to address the uncertainty of underwriting in the initial years of the new health insurance marketplace. But in the ACA’s first three years, the Federal Government had failed to honor its obligation to pay full balances that were due under the “Risk Corridors” program. The DFS Superintendent commenced this lawsuit in 2017, demanding that the Federal Government pay its obligations under this Check on the claims submitted to the liquidator at the Health Republic Insurance of New York Liquidation Website.
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Legislative Priorities Continue:

Telehealth Payment Parity (A.6526/S.5505): Click on: Urge Legislators to Support Payment Parity in Telehealth. A.6526 (Woerner, Gottfried)/S.5505 (Rivera, Harckham) would require that insurers’ payments for physicians’ telehealth services be on par with payments for in–office services. Insurers’ payments for care via telehealth have been much smaller than payments for in–office visits, creating a barrier to care for many patients and adding to the strain on physicians’ practices.

Consolidated Billing Proposal (A.3470-A/S.2521-A)! Click on: Allow Physicians to Bill Patients Separately From Hospitals (p2a.co). There’s a provision in this bill that would bar a physician with a “financial or contractual relationship” with a hospital from separately billing a patient for costs not covered by the patient’s insurance, such as the deductible. Many patients’ insurance policies impose enormous deductibles; physicians need to be able to secure this important part of their revenue correctly and in a timely fashion, but the current bill language doesn’t allow for that.

Stop Interference in the Doctor/Patient Relationship: Tell legislators to vote “NO” on “Alternative Treatments” Discussion Requirement (S.4640, Rivera). This bill, on the Senate Health Committee agenda, would require physicians and other practitioners to “consider, discuss and refer or prescribe” alternative treatments such as chiropractic, massage therapy or behavioral therapy before prescribing an opioid medication. The companion measure, A. 273 (Gottfried), is in on the Assembly floor for a vote. This legislation sets up new documentation requirements and could deter physicians from prescribing pain medications for patients who truly need them. A 2018 New York State law already requires that all chronic pain prescriptions be consistent with the CDC’s chronic pain guidelines; those guidelines direct prescribers to seek alternatives to prescribing opioids, in consultation with their patients. Do not add more layers in an attempt to micro manage the physician/patient visit. Contact our Manhattan members of the Senate Health Committee — Brian Benjamin, (518) 455–2441, This email address is being protected from spambots. You need JavaScript enabled to view it. and Brad Hoylman, (518) 455–2451, This email address is being protected from spambots. You need JavaScript enabled to view it.. Tell them to oppose S.4640.
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A “Heads Up” about Coordination of Benefits (Parts A & B Crossover Claims): Due to an April 8 – 15 systems issue, Medicare failed to send Part A and Part B crossover claims to some supplemental payers. The underlying problem was corrected on April 16, but the glitch still affects claims that were finalized through approximately April 25 (electronic claims), and May 11 (paper claims). If some of your patients’ secondary insurers were involved, what should you do? You should bill those insurers directly, the way you normally would if the Medicare claims had not been crossed over. To see a list of insurers to which NGS ordinarily sends crossover claims, click here: supplemental payer (ZIP). A “Downloads” rectangle will appear near the top right corner of your screen; click on “COBA_crossover_issue.”

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Medicare Accelerated and Advanced Payments Recoupment Has Started: The COVID–19 Accelerated and Advance Payments (AAPs) were an advance of up to three months of Medicare payments, to help physician practices early in the COVID–19 pandemic. They were loans that had to be repaid, and at first the repayment terms were somewhat stiff; but the AMA and the Federation have strongly advocated for improved terms, and Congress and CMS did adopt those revised terms in 2020. CMS recently began automatic recoupment, by offsetting regular Medicare reimbursements. Key points:

  • Repayment begins one year from when the Medicare advance payment was received rather than the 120 days required under the original terms.
  • The per–claim recoupment amount has been reduced from 100% to 25% for the first 11 months, and then 50% for an additional six months.
  • If there is still an outstanding balance after that 17-month recoupment time frame, NGS (National Government Services) will issue a demand letter requiring repayment subject to an interest rate of 4%. (This is a decrease from the original interest rate, which was 10.25%.)
  • At any time, physicians may repay in full by contacting NGS.
  • Are you in a group (under one Tax ID number) with other providers, each of whom has an individual PTAN (Provider Transaction Access Number)? If you yourself did not receive an Accelerated/Advanced Payment (AAP) but your remittance advice shows that NGS is recouping a payment from you, reach out to your other group providers to determine which PTAN originally received an AAP.

NGS has provided a YouTube video, at COVID-19 Accelerated and Advanced Payment, Repayment and Recoupment Process, with a quick overview of the AAP program and the repayment steps plus an image of the remittance advice, showing how to tell if a recoupment was related to COVID–19 AAPs.
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For Our Members From New York County Medical Society:

Free CME Program: Thursday, May 27, 6:00 to 7:00 p.m. for the First Installment of NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “The Role of Non–Psychiatric Physicians in Identifying and Addressing COVID–Related Mental Health Symptoms,” with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. When COVID–19 arrived, physicians had no prior experience with the physical manifestations of the disease, much less its mental health effects. As the science develops, physicians are learning about treating the disease’s physical problems (pulmonary, neurological, etc.), and knowledge about the mental health problems is also increasing. Doctors outside the specialty of psychiatry may find it useful to receive an overview of the mental health issues now being associated with COVID, so that they can look for problems with their recovering patients and take appropriate steps in their practice. They may also be interested in learning how to provide basic emotional support and primary–care–level counseling to patients suffering from specific symptoms (anxiety, depression, etc.) experienced by many of the general public as well as COVID patients, and how to determine when patients may need psychiatric treatment because of COVID–related experiences.

Learning objectives: Recognize the range of COVID–related mental health symptoms that exist; assess COVID–related mental health symptoms in the course of a routine office visit; and determine which COVID–encountered symptoms necessitate referral to a psychiatrist.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and the New York County Medical Society. The Westchester
Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians.

The Westchester Academy of Medicine designates this live webinar activity for a maximum of 1.0 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Register HERE.

Wednesday, June 23, 6:00 to 7:00 p.m.: NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “Clearing the Fog: Acute and Chronic Neurological Effects of COVID-19,” with Mark Milstein, MD, Director of the Adult Neurology Residency Training Program at Montefiore, and Associate Professor of Neurology and Medicine at Albert Einstein College of Medicine.
Learning objectives: Participants will be able to: Distinguish between acute and chronic neurological symptoms of COVID–19; understand the hypothesized pathophysiology of neurological symptoms of COVID–19; and summarize current research and proposed therapies for chronic neurological symptoms of COVID–19.

Registration and more information coming soon.
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May 11, 2021, 11:00 a.m. to 12:00 noon: Workers Comp Webinar, “OnBoard: Limited Release for Health Care Providers.” OnBoard is a new claims system that will replace the WCB’s paper based claims system(s) with a single, web–based platform. You’ll get new electronic self–service features for interacting with the Board, plus more access to real–time claim data. Many of the paper forms will be replaced by easy–to–use eForms. A limited release of the OnBoard system is planned for summer 2021. To access the webinar: On May 11,
go to Upcoming Webinars (ny.gov). You’ll see the OnBoard webinar listed on that page; select "Join Webinar.”

This webinar will describe preparatory steps that are necessary, so that you’ll eventually be able to access the new Limited Release system. If you haven’t taken these steps already, here’s what you’ll need to do: (1) Obtain a NY.gov user ID and passport, and (2) register for the WCB’s Medical Portal. The webinar will show you how. You may also want to look at the NYS Workers CompensationBoard - Home Page; it contains an updated Medical Portal section, with information on registering for the Portal and descriptions of useful features, including the Drug Formulary and the MTG (Medical Treatment Guideline) Lookup Tool.
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Educational Opportunities from MSSNY:

Wednesday, May 12, 2021, at 7:30 a.m.: “Substance Use Disorders (SUDs) in Veterans.” Click Webinar Registration - Zoom to register. This CME program, part of MSSNY’s Veterans Matters CME series, features presenter Thomas Madejski, MD. For more information, contact Jangmu Sherpa at
 This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.

Wednesday, May 26, 2021, at 7:30 a.m.: “Triage in a Disaster Event.” Click here to register. This CME program, part of MSSNY’s Medical Matters CME series, will have as faculty Arthur Cooper, MD, and Zachary Hickman, MD. Innumerable disaster events have been taking place all around us; learn about how to perform triage when you find yourself in proximity to different types of disaster. Educational objectives: Describe the importance of immediate bleeding suppression during a disaster event; describe the SALT methodology for triage and where to access SALT training; and recognize the importance of both mass casualty and bio–event triage.
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In Memoriam:

Salah Al–Askari, MD, died March 12, 2020. Doctor Al–Askari received his MD degree from University of Baghdad College of Medicine in 1951.

Robert Jean Campbell, MD, died May 22, 2020. Doctor Campbell received his MD degree from Columbia University College of Physicians and Surgeons in 1948.

Noel Lee Cohen, MD. Doctor Cohen received his MD degree from University of Utrecht in 1957.

Howard Cooper, MD. Doctor Cooper received his MD degree from University of Amsterdam Medical School in 1962.

Louis Zucker Cooper, MD. Doctor Cooper received his MD degree from Yale University School of Medicine in 1957.

Maurice Morton Davidson, MD. Doctor Davidson received his MD degree from University of Maryland School of Medicine in 1961.

Edward Alfred Davies, MD. Doctor Davies received his MD degree from New York University School of Medicine in 1957.

Alan Philip De Mayo. Doctor De Mayo received his MD degree from Albany Medical College in 1953.

Allan Eliot Dumont, MD. Doctor Dumont received his MD degree from New York University School of Medicine in 1948.

Jeffrey Escher, MD, died April 26, 2020. Doctor Escher received his MD degree from Universidad Libre de Bruxelles in 1980.

Irving M. Etkind, MD. Doctor Etkind received his MD degree from University of Tennessee School of Medicine in 1956.

Eleanor Eaton Faye, MD, died January 7, 2020. Doctor Faye received her MD degree from Stanford University School of Medicine in 1950.

Frieda Feldman, MD, died January 12, 2020. Doctor Feldman received her MD degree from New York University School of Medicine in 1957.

Frederic Fenig, MD, died April 16, 2020. Doctor Fenig received his MD degree from SUNY Upstate Medical University in 1969.

Mary Fowkes, MD, died November 15, 2020. Doctor Fowkes received her MD degree from SUNY Upstate in 1999.

Walter Futterweit, MD, died February 2, 2021. Doctor Futterweit received her MD degree from New York University School of Medicine in 1957.

Andrew Robert Ganz, MD. Doctor Ganz received his MD degree from New York Medical College in 1966.

Seymour Gendelman, MD. Doctor Gendelman received his MD degree from George Washington University School of Medicine in 1964.

Gabriel Genkins, MD. Doctor Genkins received his MD degree from New York University School of Medicine in 1952.

Ervin Alexander Gombos, MD. Doctor Gombos received his MD degree from University of Zagreb School of Medicine in 1951.

S. Howard Gorfinkel, MD, died January 3, 2020. Doctor Gorfinkel received his MD degree from New York University School of Medicine in 1964.

 

April 30, 2021

Register Today for Thursday’s Free NYCMS CME Program: “Telehealth in the Age of COVID–19 & Beyond,” Thursday, May 6, 2021, 6:00 to 7:00 p.m. Register HERE. Join NYCMS for this free CME webinar with The Doctors Company (TDC), the Society’s endorsed medical liability company. David Feldman, MD, Chief Medical Officer of TDC Group of Companies and Senior Vice President, Healthcare Risk Advisors (and Society member) will discuss:

— How telemedicine as a practice tool has evolved from prior to the pandemic until the present.
— Issues surrounding licensing, security and billing.
— Current changes in federal government and payer regulations.
— The impact of technology on the future of telehealth and the medical record in general.

The Doctors Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians. The Doctors Company designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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Parity NOW! We have a bill calling for telehealth payment parity (A.6526 (Woerner, Gottfried)/S.5505 (Rivera, Harckham)), so contact your legislators now. Click on: Urge Legislators to Support Payment Parity in Telehealth. This proposal would require that insurers’ payments for physicians’ telehealth services be on par with payments for in–office services. The Assembly bill is before the Assembly Insurance Committee, and the Senate bill is before the Senate Finance Committee.

The COVI–19 pandemic brought new ways of delivering care, pushing thousands of physicians to increase their capacity to provide care to their patients remotely. But insurers’ payments for care via telehealth have been much smaller than payments for in–office visits, creating a barrier to care for many patients. A survey by the New York Medical Group Management Association (NY MGMA) showed that only 23% of all health plans paid for telehealth visits at the same rate as for in-office visits; of members surveyed, 25% said that most plans paid significantly less for in–office visits; and depending on the health plan, physicians were compensated at as little as 30% the rate of in–person appointments. For audio–only visits, most payers reimbursed 80% less than for in–office visits.

This proposal would apply not only to commercial insurance, but also to telehealth services in the state’s Medicaid Fee for Service, Medicaid Managed Care, and Child Health Plus programs — crucial to achieving true equity in health care access. Unless there is parity across all systems, Medicaid providers may not have the financial capacity to provide telehealth services to beneficiaries of all sorts, including low–income patients and those with transportation or child–care challenges. Support this measure by clicking HERE.
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Change Needed in Consolidated Billing Proposal (A.3470–A/S.2521–A): Click on: Allow Physicians to Bill Patients Separately From Hospitals (p2a.co). This proposal has many well–intended components, but it also has a seriously problematic provision — that would bar a physician or other provider with a “financial or contractual relationship” with a hospital from separately billing a patient for costs not covered by the patient’s insurance, such as the deductible. Many patients’ insurance policies impose enormous deductibles; if physicians could not secure this important part of their revenue correctly and/or in a timely fashion, some might have to sell their practices and become employees of hospitals, and others might leave the state.

The consolidated bill would have to be sent within seven days of the patient’s discharge from the hospital, before it was clear what expenses would actually be covered by the patient’s insurance. Non–employed physicians would be at the hospitals’ mercy, because the legislation does not specify when payments to hospitals from this “single bill” would be distributed to the physicians, or how those payments would be calculated. This prohibition will fall most adversely on physicians on the front lines of the pandemic, many of whom are facing an enormous drop in patient volume due to a significant amount of delayed care.
To tell your legislators to vote “NO,” click HERE.
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Tell Legislators To Stop Interfering in the Doctor/Patient Relationship: Tell legislators to vote “NO” on “Alternative Treatments” Discussion Requirement (S.4640, Rivera). This bill, on the Senate Health Committee agenda, would require physicians and other practitioners to “consider, discuss and refer or prescribe” alternative treatments such as chiropractic, massage therapy or behavioral therapy before prescribing an opioid medication. The companion measure, A. 273 (Gottfried), is in on the Assembly floor for a vote.

This legislation sets up new documentation requirements and could deter physicians from prescribing pain medications for patients who truly need them. 2018 New York State law already requires that all chronic pain prescriptions be consistent with the CDC’s chronic pain guidelines. Those guidelines direct prescribers to seek alternatives to prescribing opioids, in consultation with their patients. Do not add more layers in an attempt to micro manage the physician/patient visit. Contact our Manhattan members of the Senate Health Committee — Brian Benjamin, (518) 455–2441, This email address is being protected from spambots. You need JavaScript enabled to view it. and Brad Hoylman, (518) 455–2451, This email address is being protected from spambots. You need JavaScript enabled to view it.. Tell them to oppose S.4640.
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Doctors Are Fighting Insurer Strategies: We continue to look for insurance reforms that make it easier for patients to receive the care and medications they need. With less than two months left in the Legislative Session, the focus is on:

A.951/S.1575: To enable independently practicing physicians to jointly negotiate network participation terms with market–dominant insurance companies.

A.1741/S.5299: To let third–party financial assistance count towards helping patients meet their deductible costs.

4111/S4668: To limit insurers’ ability to modify their prescription drug formularies during a policy year.

A.4177/S.2528: To provide due process protections for physicians whose network participation contract is unilaterally non–renewed by an insurance company.

Soon to be introduced: Legislation (similar to A.3038/S.2847 of 2020) to address prior authorization hassles, including the one where the insurer requires a “repeat” of a prior authorization that has already been obtained. A December, 2020, survey of 1,000 practicing physicians found: Almost 70% reported that insurers had either reverted to past prior–authorization policies, or had never relaxed those policies during the height of the pandemic. More than nine in ten physicians (94%) reported care delays while waiting for health insurers to authorize necessary care, and nearly one–third (30%) reported that prior–authorization requirements had led to a serious adverse event for a patient in their care.
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Public Health Emergency extended through July 19, 2021: The U.S. Department of Health & Human Services (HHS) has announced that the Public Health Emergency (PHE) declaration for COVID–19 will be renewed for another 90 days, beginning on April 21 (the date on which the PHE was previously scheduled to expire) and extending through July 19, 2021. Among the emergency measures linked to the PHE: Many nationwide “blanket” waivers, and also state–specific Medicaid waivers. These waivers expand Medicare telehealth coverage; suspend many federal oversight and reporting requirements; and enhance providers’ ability to establish alternative sites of care, or to practice across state lines.
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For Our Members From New York County Medical Society:

Free CME Program: Thursday, May 27, 6:00 to 7:00 p.m. for the First Installment of NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “The Role of Non–Psychiatric Physicians in Identifying and Addressing COVID–Related Mental Health Symptoms,” with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. When COVID–19 arrived, physicians had no prior experience with the physical manifestations of the disease, much less its mental health effects. As the science develops, physicians are learning about treating the disease’s physical problems (pulmonary, neurological, etc.), and knowledge about the mental health problems is also increasing. Doctors outside the specialty of psychiatry may find it useful to receive an overview of the mental health issues now being associated with COVID, so that they can look for problems with their recovering patients and take appropriate steps in their practice. They may also be interested in learning how to provide basic emotional support and primary–care–level counseling to patients suffering from specific symptoms (anxiety, depression, etc.) experienced by many of the general public as well as COVID patients, and how to determine when patients may need psychiatric treatment because of COVID–related experiences.

Learning objectives: Recognize the range of COVID–related mental health symptoms that exist; assess COVID–related mental health symptoms in the course of a routine office visit; and determine which COVID–encountered symptoms necessitate referral to a psychiatrist.

This activity has been planned and implemented in accordance with the Accreditation Requirements and Policies of the Medical Society of the State of New York (MSSNY) through the joint providership of the Westchester Academy of Medicine and the New York County Medical Society. The Westchester Academy of Medicine is accredited by MSSNY to provide Continuing Medical Education for physicians.

The Westchester Academy of Medicine designates this live webinar activity for a maximum of 1.0 AMA PRA Category I Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Register HERE.
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Check Out Seminars with Vital Planning: Find out how to make a financial plan and demystify estate planning, at upcoming webinars on May 19 and June 16 at 12:00 noon with Vital Planning. Register HERE.
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Educational Opportunities From Our Sister Societies:

From Westchester County Medical Society, Tuesday, May 4, 2021, 7:00 p.m.: “The Common Thread: The Human Experience” —a Patient Engagement and Cultural Competence Training Program. Email This email address is being protected from spambots. You need JavaScript enabled to view it. to register. In this virtual CME event, with presenter Mauvareen Beverley, MD, discuss and identify how changes in behavior have a beneficial effect on patient engagement, the patient experience and health outcomes of vulnerable populations, and more.

From Queens County Medical Society, Tuesday, May 11, 2021, 7:00 p.m. to 8:00 p.m.: “What a Physician Should Know About Cancer Genetics: How to Optimize Patient Care.” Register at: Webinar Registration - Zoom

From Nassau County Medical Society, Wednesday, May 12, 2021, 6:00 to 7:00 p.m.: “Controlled Substance Prescribing via Telemedicine.” Register at: Webinar Registration - Zoom. Dr. Edward Rubin, Long Island pain management specialist, is the Immediate Past President of the New York Society of Interventional Pain Management and is affiliated with North Shore LIJ and Winthrop Hospital. For more information or registration assistance, please email This email address is being protected from spambots. You need JavaScript enabled to view it. or call (516) 832-2300.

From Nassau County Medical Society, May 6th, 13th, 19th & 27th, 2021, at 6:00 p.m. each session: A virtual meditation series, “Mindfulness in the Medical Profession.” Register at: Webinar Registration - Zoom. Nassau County Medical Society is partnering with Northwell Health’s Center for Wellness and Integrative Medicine, an educational, wellness, and retreat center dedicated to the evolution of mind, body, and spirit. Meditation is a mindfulness tool that physicians can take with them beyond these virtual classes, to implement in their everyday lives.
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Educational Opportunities from MSSNY:

Wednesday, May 5, 2021, at 6:00 p.m.: “Social Media in Medicine: A Beginners’ Guide to Social Media for Physicians.” Register here for this virtual webinar, with MSSNY Vice President Parag H. Mehta, MD, and MSSNY YPS Chair Daniel E. Choi, MD. Topics include: Introduction to popular social media physician communities: #MedTwitter, Instagram, YouTube, TikTok; and how to establish a social media presence and grow your audience.

Wednesday, May 12, 2021, at 7:30 a.m.: “Substance Use Disorders (SUDs) in Veterans.” Click Webinar Registration - Zoom to register. This CME program, part of MSSNY’s Veterans Matters CME series, features presenter Thomas Madejski, MD. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.

Wednesday, May 26, 2021, at 7:30 a.m.: “Triage in a Disaster Event.” Click here to register. This CME program, part of MSSNY’s Medical Matters CME series, will have as faculty New York County Medical Society President Arthur Cooper, MD, and Zachary Hickman, MD. Innumerable disaster events have been taking place all around us; learn about how to perform triage when you find yourself in proximity to different types of disaster. Educational objectives: Describe the importance of immediate bleeding suppression during a disaster event; describe the SALT methodology for triage and where to access SALT training; and recognize the importance of both mass casualty and bio–event triage.
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Hiring Qualified Medical Personnel for Your Office? Check out Winston Medical Staffing. Read more HERE, and then contact Ivy Kramer at Winston who can provide your Society discount AND the right employees for your practice. Contact Ivy at This email address is being protected from spambots. You need JavaScript enabled to view it. or call her at (212) 687–4667.

 

April 23, 2021

Urge Legislators to Revise the Consolidated Billing Proposal: Please click here: Allow Physicians to Bill Patients Separately From Hospitals (p2a.co). This legislation, “The Patient Medical Debt Reduction Act,” has many well–intended components, but it also has a seriously problematic provision — one that would bar a physician or other provider with a “financial or contractual relationship” with a hospital from separately billing a patient for costs not covered by the patient’s insurance, such as the deductible. The consolidated bill would have to be sent within seven days of the patient’s discharge from the hospital, before it is clear what expenses will actually be covered by the patient’s insurance. Non–employed physicians would be at the hospitals’ mercy, because the legislation does not specify when payments to hospitals from this “single bill” would be distributed to the physicians, or how those payments would be calculated. Many patients’ insurance policies impose enormous deductibles; if physicians could not secure this important part of their revenue correctly and/or in a timely fashion, some might have to sell their practices and become employees of hospitals, and others might leave the state. This prohibition will fall most adversely on physicians on the front lines of the pandemic, many of whom are facing an enormous drop in patient volume due to a significant amount of delayed care. Fight this legislation today by clicking HERE.
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Oppose Mandate to Co–Prescribe Opioid Antagonist: A bill in the Assembly and Senate would require doctors who prescribe opioids for the first time for a patient in a calendar year to also be required to co–prescribe an Opioid antagonist. Regardless of how appropriate it might be for many patients, this across the board mandate is not only concerning but unnecessary. New York State already permits non–medical persons to administer naloxone to prevent another person’s Opioid/heroin overdose from becoming fatal, and physicians and other prescribers can already provide patients with a script for naloxone. Furthermore, it means an automatic additional cost for the patient. When the prescriber co–prescribes the Opioid antagonist, that prescription, too, will automatically be e–sent to the pharmacy, and the patient will be charged a co–pay (if their insurance covers the prescription), or the full price. Contact Manhattan’s Senate Health Committee members: Brian Benjamin (518) 455–2441, This email address is being protected from spambots. You need JavaScript enabled to view it.) and Brad Hoylman (518) 455–2451, This email address is being protected from spambots. You need JavaScript enabled to view it.. Contact Manhattan’s Assembly Ways & Means Committee members: Deborah Glick (518) 455–4841,This email address is being protected from spambots. You need JavaScript enabled to view it.,, Robert Rodriguez (518) 455–4781, This email address is being protected from spambots. You need JavaScript enabled to view it., and Rebecca Seawright (518) 455–5676, This email address is being protected from spambots. You need JavaScript enabled to view it.. Tell them not to support S.2966.
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Scope of Practice and Patient Safety — Podiatry Edition: Expand Podiatry Scope (S.2019) would expand the scope of practice of podiatrists. Although it purports to just make “technical changes” to the practice of podiatry, it actually has a far greater impact, including:

  • Allowing those in training not to have direct/onsite supervision by another podiatrist or orthopaedic surgeon, as they learn and practice ankle surgery.
  • Permitting any podiatrist to care for wounds above the foot and ankle that are not related to the patient’s original course of treatment.
  • Lowering the threshold for education and training for those seeking advanced ankle surgery privileges, in contrast with standards deemed acceptable by the State Department of Education and agreed upon by the professions.
  • Authorizing podiatrists to practice up to the knee and outside of their scope of practice.

Contact Manhattan’s Senate Higher Education Committee member, Senator Robert Jackson (518) 455–2041, This email address is being protected from spambots. You need JavaScript enabled to view it. and state you are opposed to this bill.
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Scope of Practice and Patient Safety — Pharmacist Edition: S.2529/A.3033 would allow pharmacists to perform non–invasive laboratory tests without physician coordination. The bill does not support the continuum of care that has become essential in today’s medical practice; it would lead to care that is “siloed” rather than integrated, and undermine the development of physician–led “medical homes”; it could even be a backdoor attempt to allow for the establishment of retail clinics in pharmacies. Contact Manhattan’s Senate Health Committee members: Brian Benjamin (518) 455–2441, This email address is being protected from spambots. You need JavaScript enabled to view it.) and Brad Hoylman (518) 455–2451, This email address is being protected from spambots. You need JavaScript enabled to view it.. Contact Manhattan’s Assembly Higher Education Committee members: Deborah Glick (518) 455–4841, This email address is being protected from spambots. You need JavaScript enabled to view it., Harvey Epstein (518) 455–5506, This email address is being protected from spambots. You need JavaScript enabled to view it.) and Richard Gottfried (518) 455–4941, This email address is being protected from spambots. You need JavaScript enabled to view it.). Tell them not to vote for this bill.
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Workers’ Compensation (WC) and Telehealth: In March 2020, the WC Board responded to the COVID–19 pandemic by amending their rules to allow telehealth so that patients could receive health care while maintaining social distancing. Since then the rules have been expanded and renewed several times. A new Notice of Emergency Adoption is in effect, which will apply for 90 days (from April 13, 2021). “Telemedicine, using two–way audio and visual electronic communication, or treatment via telephone, may be used by [WC] authorized providers where medically appropriate for social distancing purposes due to the outbreak of COVID–19 during the state of emergency…or [where], irrespective of purely social distancing considerations, in the clinical judgment of the authorized provider, the potential risk of COVID–19 infection to an individual patient outweighs any real or perceived incremental benefit derived from an in–person versus remote or virtual appointment.” Coding: If the services were by telemedicine, use modifier 95 and indicate the place of service as 11. If they were by telephone, indicate the place of service as 02. For details, go to the WCB’s web page: Emergency Adoption of Amendments to 12 NYCRR 325-1.8, 329-1.3, 329-4.2, 333.2, and 348.2 (COVID-19 Telemedicine).
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Citizen Public Health Leaders Training Program for Physicians and Patients: Governor Andrew Cuomo and the New York State Department of Health have announced a free online public health training course to help build public health awareness. This course, developed by Cornell University in partnership with New York State, provides information on public health preparedness, COVID–19, and vaccines. It’s an interesting and engaging tool designed to educate the public and empower more New Yorkers with accurate information. Citizen Public Health Leaders, trained via the course, will be able to serve as reliable resources in their family and community. More information is available here: ny.gov/citizenpublichealth? Email This email address is being protected from spambots. You need JavaScript enabled to view it. with questions.
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For Our Members From New York County Medical Society

Free CME Program: “Telehealth in the Age of COVID–19 & Beyond,” Thursday, May 6, 2021, 6:00 p.m. – 7:00 p.m. Join the New York County Medical Society for this free CME webinar with The Doctors Company (TDC), the Society’s endorsed medical liability company. David Feldman, MD, Chief Medical Officer of TDC Group of Companies and Senior Vice President, Healthcare Risk Advisors (and Society member) will discuss:

— How telemedicine as a practice tool has evolved from prior to the pandemic until the present.
— Issues surrounding licensing, security and billing.
— Current changes in federal government and payer regulations.
— The impact of technology on the future of telehealth and the medical record in general.

Learning Objectives: (1) To implement (even if incrementally) telemedicine visits into practice in a manner that is safe and patient-friendly; (2) to apply techniques including “web–side manner” and the pre–visit workflow, so as to optimize communication and understanding during telemedicine visits; and (3) to assess practices’ capabilities to initiate telemedicine visits, including virtual platform, staff capabilities, patient readiness, and visit appropriateness.

The Doctors Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education to physicians. The Doctors Company designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Register HERE.

Save the Date for the First Installment of NYCMS Grand Rounds: Specialty Updates for Non–Specialists: “The Role of Non–Psychiatric Physicians in Identifying and Addressing COVID–Related Mental Health Symptoms,” with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. Thursday, May 27, 2021, 6:00 p.m. – 7:00 p.m. When COVID–19 arrived, physicians had no prior experience with the physical manifestations of the disease, much less its mental health effects. As the science develops, physicians are learning about treating the disease’s physical problems (pulmonary, neurological, etc.), and knowledge about the mental health problems is also increasing. Doctors outside the specialty of psychiatry may find it useful to receive an overview of the mental health issues now being associated with COVID, so that they can look for problems with their recovering patients and take appropriate steps in their practice. They may also be interested in learning how to provide basic emotional support and primary–care–level counseling to patients suffering from specific symptoms (anxiety, depression, etc.) experienced by many of the general public as well as COVID patients, and how to determine when patients may need psychiatric treatment because of COVID–related experiences.

Learning objectives: Recognize the range of COVID–related mental health symptoms that exist; assess COVID–related mental health symptoms in the course of a routine office visit; and determine which COVID–encountered symptoms necessitate referral to a psychiatrist.

Registration and more information coming soon.
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Educational Opportunities From Our Sister Societies:

From Nassau County Medical Society: April 28, 2021, 6:00 p.m. to 7:00 p.m. “Reading the Fine Print of Health Literacy.” Register at: Webinar Registration - Zoom. Deepen your knowledge about how people who struggle with finding, understanding, and using the information to make health–informed decisions can access resources and get the support they need.

From Westchester County Medical Society, Tuesday, May 4, 2021, 7:00 p.m.: “The Common Thread: The Human Experience” — Patient Engagement and Cultural Competence Training Program. Email This email address is being protected from spambots. You need JavaScript enabled to view it. to register. In this virtual CME event, with presenter Mauvareen Beverley, MD, discuss and identify how changes in behavior have a beneficial effect on patient engagement, the patient experience and health outcomes of vulnerable populations, and more.

From Queens County Medical Society: May 11, 2021, 7:00 p.m. to 8:00 p.m.: “What a Physician Should Know About Cancer Genetics: How to Optimize Patient Care.” Register at: Webinar Registration - Zoom
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Educational Opportunities From MSSNY:

Wednesday, May 5, 2021, at 6:00 p.m.: “Social Media in Medicine: A Beginners’ Guide to Social Media for Physicians.” Register here for this virtual webinar, with MSSNY Vice President Parag H. Mehta, MD, and MSSNY YPS Chair Daniel E. Choi, MD. Topics include: Introduction to popular social media physician communities: #MedTwitter, Instagram, YouTube, TikTok; and how to establish a social media presence and grow your audience.

Wednesday, May 12, 2021, at 7:30 a.m.: “Substance Use Disorders (SUDs) in Veterans.” Click Webinar Registration - Zoom to register. This CME program, part of MSSNY’s Veterans Matters CME series, features presenter Thomas Madejski, MD. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.

 

April 16, 2021

U.S. House Passes Legislation to Prevent 2% Medicare Cut Until 2022: The U.S. House of Representatives has now overwhelmingly approved legislation to extend until the end of the year the 2% Medicare sequester moratorium that had expired on April 1. This bill, designed to prevent ill–timed Medicare cuts to physicians and other care providers, had passed the U.S. Senate in late March; President Biden is expected to sign it into law. To avoid making payments with reduced amounts, CMS has been holding off on processing April Medicare claims. We’ll let you know when regular processing has resumed.
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New York Now Has a Recreational Marijuana Law: How is it all supposed to work? Governor Andrew Cuomo has signed into law a bill legalizing the sales and use of recreational marijuana in New York State. The bill creates a regulatory system to oversee the cannabis industry, allows limited home growth, and expunges an undetermined number of criminal records. For the Governor’s statement and a summary, click on: Governor Cuomo Signs Legislation Legalizing Adult-Use Cannabis (ny.gov). Among other key components, the bill:

— Directs that 20% of the funding generated from the state cannabis tax revenue is to be set aside for drug treatment and education; 40% is to be set aside to assist communities that have, historically, been disproportionately affected by marijuana laws; and another 40% is to go toward state education funding.

— Creates an Office of Cannabis Management at the state level, and a Cannabis Control Board to promulgate regulations. The task: Overseeing licensing, cultivation, production, distribution, and sales in New York’s recreational and medical marijuana (and cannabinoid hemp) markets. Governor Cuomo is to have three appointments to the Control Board (including the chairperson), while the Legislature is to have two appointments.

— Sets a 13% tax rate on retail sales of cannabis products. Of that, 9% of the 13% would go to the state and 4% would be directed to localities, with counties to receive one quarter and the municipality to receive the remainder.

— Permits possession outside the home of three ounces of the drug, and 24 grams of concentrate. Five pounds is allowed to be kept at home, but must be stored away from children.

— Expands the medical cannabis program, lengthening the list of health conditions for which a prescriber will be permitted to certify a patient to receive medical cannabis.

— Establishes a time line: Legal sales of adult-use marijuana will be permitted sometime in 2022 — although prior to 2022 cities, towns and villages can pass a resolution to prohibit dispensaries and social consumption locations within their municipality.

Just days after the governor signed the “Marijuana Regulation and Taxation Act,” the administration launched the website for the new Office of Cannabis Management. The website provides information on the new office’s regulatory structure, plus resources for New Yorkers seeking medical cannabis practitioners, care givers, and medical cannabis IDs. It also offers information for businesses seeking licensure in the adult–use and cannabinoid hemp industries.

Throughout the debate over the last few years, MSSNY and many other groups (including the NYS PTA, the NYS Association of County Public Health officials and a number of law enforcement associations) warned of the need for additional research into marijuana’s traffic–safety impact and its impact on physical and mental health. As the law is implemented, MSSNY will continue to work closely with these organizations and various state agencies to strengthen the emphasis on protecting public health. For more information, go to: New York Set to Legalize Marijuana for Adult, Recreational Use After Cuomo, Lawmakers Strike Deal (wmht.org)
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Collaborative Practice by Nurse Practitioners with Physicians: The final Budget includes a provision to extend for an additional year (until June 30, 2022) the existing law that permits certain nurse practitioners to practice without a written collaborative agreement with a physician, provided they have proof of “collaborative arrangements” with physicians in the NP’s specialty. MSSNY has advocated for much stronger collaboration requirements for nurse practitioners in order to protect patients. Meanwhile, legislation (A.1535/S.3056), strongly opposed by MSSNY, has also been introduced that would go in the opposite direction. Proof of these collaborative arrangements would no longer even have to be maintained.
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Help for the Pressures of Practice: MSSNY’s Peer2Peer program is here to help with the stresses of COVID–19 and practice in general. If you want a sympathetic ear, contact the program at (844) P2P–PEER or This email address is being protected from spambots. You need JavaScript enabled to view it., not for treatment, but casual conversation, to talk it out with someone who understands. You will received a one–time confidential discussion with a peer supporter. The peer supporter is a trained medical professional who will not provide actual psychiatric treatment, but will simply share experiences, listen without judgment, validate your feelings, and provide you with support, empathy and perspective. Peer supporters can provide information on specific organizations that can support you (if you wish), and can provide you with positive coping skills. They can also help connect you to professionals if you feel you need more focused assistance. Any physician, resident, or medical student who wishes to chat with a peer supporter, may contact MSSNY(note: all calls and emails will remain strictly confidential). Please know that whatever your situation, you are not alone. MSSNY P2P is here to help. Check out the attached poster for more information.
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Discussions Regarding End–of–Life, Palliative, and Other Care for Seriously and Chronically Ill Patients: FAIR Health offers providers a new, free Shared Decision Making Website. The term “shared decision making” refers to discussions between patients (and/or their caregivers) and clinicians about care decisions, in which clinical evidence is used as a basis and risks and outcomes are balanced with patients’ preferences and values — plus related issues such as costs. FAIR Health has now launched an educational website, fairhealthprovider.org, offering free resources and tools to facilitate shared decision making.
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AMA Seeks Information Info Blocking: The Info Blocking rules are about obstructions in the flow of EHI (electronic health information), and you, as a physician, have probably met some of these obstructions — e.g., difficulties accessing patient records from other providers, connecting your EHR system to a local health information exchange, or migrating from one EHR to another. However, what if EHI is released too fast? Recently, ONC (the Office of the National Coordinator for Health Information Technology) implemented rules requiring physicians to make a variety of medical information (lab tests, clinical notes, medications, etc.), available to patients immediately—often before the physician has reviewed the information, and without regard to whether releasing the information could be mentally or emotionally distressing to the patient. For example, a radiology report of a CT scan saying a “malignancy could not be ruled out” must be sent to the patient’s portal or smartphone application even if the oncologist has not yet viewed the study or read the report; if this report were sent to an infant’s parent ahead of a holiday weekend, that parent could unnecessarily spend days in deep emotional distress before being able to talk to the physician. Similarly, adolescents often confide in their clinicians as a “safe space,” and the release of information against their wishes could provoke significant emotional or psychological distress, even where the adolescent doesn’t fear physical abuse. Although the AMA strongly supports patient access and engagement, the automatic and immediate release of all reports and office notes could raise many ethical, professional and practical concerns. The AMA is urging OCR to broaden its definition of “harm” to include emotional and mental distress, and is collecting physicians’ perspectives, stories, and examples of patient harm, related to the release of protected health information (PHI), and how this release might sometimes cause emotional or mental distress. Do you know of such scenarios? Please send your examples to Ela Cameron, at This email address is being protected from spambots. You need JavaScript enabled to view it., by April 30.
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Events From NYCMS: Thanks to the Society's relationship with The Doctors Company, our endorsed medical liability insurer, Society members are invited to four virtual sessions as part of its risk management conference. This year, New York–based Healthcare Risk Advisors (HRA), a subsidiary of The Doctors Company, is holding their annual risk management conference over four virtual sessions. Join them for the next session on Wednesday, April 21, 2021, 4:00 p.m. to 5:00 p.m., Bite-Sized Coping During Times of Uncertainty. Category I CME Credit. RSVP HERE.

Date Postponed: The NYS Workers Compensation Board plans a webinar for NYCMS members about the new “OnBoard” online claims system, but the date has been postponed (it was to have been Wednesday, April 28). The new system will offer improved and expanded access to real–time claim data, new electronic self–service features for interacting with the Board, and a reduction in the amount of paper forms. We’ll keep you posted on the new date.

Wednesday, May 5, 2021, at 6:00 p.m.: The Society and The Doctors Company (TDC) will present a CME webinar, Telehealth in the Age of COVID–19 & Beyond, with Doctor David Feldman, Chief Medical Officer of TDC Group of Companies and Senior Vice President, Healthcare Risk Advisors. Sign up information to come.

Thursday, May 27, 2021, at 6:00 p.m.: Look for the initial entry in the Society's Grand Round Series, The Role of Non–Psychiatric Physicians in Identifying and Addressing Covid-Related Mental Health Symptoms, with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. Sign up information to come.
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Educational Opportunities from our Sister Societies: From Nassau County Medical Society: Reading the Fine Print of Health Literacy, April 28, 2021, 6:00 p.m. to 7:00 p.m. Register at: Webinar Registration - Zoom

From Queens County Medical Society: What a Physician Should Know About Cancer Genetics: How to Optimize Patient Care, May 11, 2021, 7:00 p.m. – 8:00 p.m. Register at: https://nyph.zoom.us/webinar/
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From MSSNY: April 21, 2021, at 7:30 a.m.: COVID–19 & Mental Health of Children and Teens. Click here to register for this webinar. The COVID–19 pandemic has affected the entire population’s mental health; this program, part of MSSNY’s Medical Matters CME series, is about how children and teens have been affected. Linda Chokroverty, MD will serve as faculty.

Thursday, April 22, 2021, 7:30 a.m.: Military Culture: Everything Physicians Need to Know about Veterans as Patients. Click HERE to register for this live webinar, part of MSSNY’s Veterans Matters series; view the program flyer HERE. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.

DATE CHANGE: Social Media in Medicine is Now Wednesday, May 5 at 6:00 p.m. MSSNY Vice President Parag H. Mehta, MD, and MSSNY YPS Chair Daniel E. Choi, MD, present Social Media in Medicine: A Beginners Guide for Physicians. Register now for Virtual Webinar.
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From Vital Planning: Retirement Income Planning, Tuesday, April 20th @ 12pm
It's never too early to plan for retirement but there is a point it can be too late.
Join us for a discussion on:
— Envisioning your retirement now
— Potential risks
— Strategies to consider
— How to build and execute your vision

Register HERE.

 

 April 9, 2021

State Budget Final with Some Key Victories: Following months of advocacy by MSSNY, NYCMS and other Societies, there are some good results to announce: The Excess Malpractice Insurance Program was extended. Physician due process in OPMC issues was protected, as were Medicaid “Prescriber Prevails” and physicians’ ability to apply for e–prescribing waivers. Pharmacy scope changes were rejected, and cuts to MSSNY’s Committee for Physician Health were addressed. What about telehealth? The final State Budget includes an expansion of site locations where telehealth services can be provided and received; and, happily, it deletes a provision we strongly opposed, that would have established an “interstate compact” of out–of–state health professionals to provide telehealth services to New York patients. Unfortunately, the final Budget did not include “parity” for the payment of telehealth services. The parity issue will be addressed in the weeks to come – watch for updates on S.5505 (Rivera)/A.6256 (Gottfried).
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NYS DOH Revised Return–to–Work Protocol for Healthcare Personnel (HCP): Effective April 1, 2021, asymptomatic, unvaccinated HCP who have been exposed to COVID–19 may return to work after completing a 10–day quarantine without testing, subject to certain other conditions. Asymptomatic, exposed HCP who are fully vaccinated (two weeks or more after the last dose of vaccine, with no outer time limit), or who have recovered from recent SARS–CoV–2 infection within the past three months (within three months after the symptom onset date of first positive diagnostic test if asymptomatic during illness), are not required to test, quarantine, or take leave from work following exposure provided certain conditions are met. Asymptomatic HCP, arriving in New York State from other US states and territories, are not required to test or quarantine and may return to work accordingly. (Note: For special requirements for nursing home HCP, and for HCP who have traveled internationally, be sure to read the advisory.) To read the new health advisory, click HERE.
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Check the Status of Your Medicare Accelerated or Advanced Overpayment: NGS Medicare has provided a link where you can check the status of your Medicare Accelerated or Advanced Overpayment. Then check out this webinar from National Government Services (NGS). On April 15, 2021, 10:00 a.m. to 11:00 a.m., NGS will offer “COVID–19 Medicare Part B Advanced Payment, Repayment and Recoupment Process.” Click on Register here. If you requested accelerated or advanced payments from Medicare due to the COVID–19 public health emergency, this learning session is for you. CMS expanded the accelerated and advance payment program for financial hardship relief during the COVID-19 public health emergency; now, those payments need to be repaid to the Medicare Trust Fund. During the recoupment period, CMS will hold back a portion of new Medicare claims from providers—25 percent during the first 11 months of recoupment and 50 percent during the six months—until the payments advanced last year are recouped. Providers are required to have paid back the advanced payments in full, 20 months after they received the first payment. If they fail to do so, CMS will charge interest of four percent on the remaining balance. This webinar will review the repayment and recoupment process and address your questions.
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The Information Blocking Regulations Are Now in Force: As of April 5, there are general rules for physicians and special rules for vendors regarding your EHR. Noncompliance means a physician might lose MIPS points, and vendors might face financial penalties. These regulations are about patients’ electronic information (EHI) — how smoothly EHI must flow and how careful physicians and vendors must be not to block that flow or set up barriers or obstacles. For example, physicians must not delay in dealing with patients’ requests for e–records. Vendors must not deliberately “design in” features that hinder interoperability between their systems and other systems, or charge excessive fees for connecting to the local HIE (health information exchange), or make it difficult for you to switch to another vendor.

New regulations for EHI access, exchange and use have now been released by ONC (the Office of the National Coordinator for Health Information Technology, part of Health and Human Services), and the AMA has created a two–part educational resource for you. Part 1 explains what information blocking is, lists key terms, gives examples of information–blocking practices and talks about exceptions (they do exist). Part 2 starts you on the path to compliance, with questions, ideas for a compliance program, and next steps. Meanwhile, the dialogue continues; not everyone is satisfied with the new rules and what they could mean. The AMA is working to reduce the complexity and costs required for compliance, and is urging HHS not to create any additional consequences for physicians. The AMA is also concerned that HHS' rule forces physicians to release office notes and test results before reviewing the information with the patient.
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New Office of Cannabis Management Website Will Offer Names of Cannabis Practitioners: Just days after the governor signed the “Marijuana Regulation and Taxation Act,” which legalized cannabis for adult recreational use in the State, the administration launched the website for the new Office of Cannabis Management, which will oversee licensing, cultivation, production, distribution, and sales in New York’s recreational and medical marijuana (and cannabinoid hemp) markets. The website provides information on the new office’s regulatory structure, plus resources for New Yorkers seeking medical cannabis practitioners, care givers, and medical cannabis IDs. It also offers information for businesses seeking licensure in the adult–use and cannabinoid hemp industries.
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Two MSSNY Podcasts: “A Discussion on COVID Vaccine for Patients” and “How to Talk to Patients About Vaccine Hesitancy, may be helpful to you and your patients (see flyer attached). These podcasts, part of efforts to improve immunizations, are connected to MSSNY’s public health programs on emergency preparedness and patient education grants. MSSNY podcasts are heard on Spotify, Apple, Iheartradio, Google, Castbox, etc.
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Events From NYCMS: Thanks to the Society's relationship with The Doctors Company, our endorsed medical liability insurer, Society members are invited to four virtual sessions as part of its risk management conference. This year, New York–based Healthcare Risk Advisors (HRA), a subsidiary of The Doctors Company, is holding their annual risk management conference over four virtual sessions. Join them for the next session on Wednesday, April 21, 2021, 4:00 p.m. to 5:00 p.m., Bite-Sized Coping During Times of Uncertainty. Category I CME Credit. RSVP HERE. RSVP


Wednesday, April 28, 6:00 p.m.: The New York State Workers Compensation Board (WCB) will present a webinar for NYCMS members, about the WCB’s new “OnBoard” claims system. The new system will offer improved and expanded access to real–time claim data, new electronic self–service features for interacting with the Board, and a reduction in the amount of paper forms. You can watch the webinar and then send questions to the OnBoard mailbox. Sign up information is coming soon.

Wednesday, May 5, 2021, at 6:00 p.m.: The Society and The Doctors Company (TDC) will present a CME webinar, Telehealth in the Age of COVID–19 & Beyond, with Doctor David Feldman, Chief Medical Officer of TDC Group of Companies and Senior Vice President, Healthcare Risk Advisors. Sign up information to come.

Thursday, May 27, 2021, at 6:00 p.m.: Look for the initial entry in the Society's Grand Round Series, The Role of Non–Psychiatric Physicians in Identifying and Addressing Covid-Related Mental Health Symptoms, with Doctor William Tucker, Clinical Professor of Psychiatry at Columbia P&S. Sign up information to come.
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Educational Opportunities From Our Sister Societies: From Nassau County Medical Society — Alcoholism As a Disease: Addiction Research and Recovery, April 15, 2021, 6:00 p.m. to 7:00 p.m. Register at: Webinar Registration - Zoom. Reading the Fine Print of Health Literacy, April 28, 2021, 6:00 p.m. to 7:00 p.m. Register at: Webinar Registration - Zoom

From Queens County Medical Society: What a Physician Should Know About Cancer Genetics: How to Optimize Patient Care, May 11, 2021, 7:00 p.m. – 8:00 p.m. Register at: https://nyph.zoom.us/webinar/
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April 15, 2021, 1:00 to 4:30 p.m.: Healthy New York Summit, presented by City&State New York. Register HERE. The COVID–19 pandemic brought unprecedented challenges to New York, while also exposing many existing flaws in our healthcare system. City&State says: “Join us on April 15th as we gather health care decision makers and policy experts to address the future of health policy— including pandemic response, affordable care, health equity, mental health, innovative programs, and more.”
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From MSSNY: April 21, 2021, at 7:30 a.m.: COVID–19 & Mental Health of Children and Teens. Click here to register for this webinar. The COVID–19 pandemic has affected the entire population’s mental health; this program, part of MSSNY’s Medical Matters CME series, is about how children and teens have been affected. Linda Chokroverty, MD will serve as faculty.

Wednesday, April 21, 2021, at 6:00 p.m.: Social Media in Medicine: A Beginners’ Guide to Social Media for Physicians. Register here for this virtual webinar, with MSSNY Vice President Parag H. Mehta, MD, and MSSNY YPS Chair Daniel E. Choi, MD. Topics include: Introduction to popular social media physician communities (#MedTwitter, Instagram, YouTube, TikTok), and how to establish a social media presence and grow your audience.

Thursday, April 22, 2021, 7:30 a.m.: Military Culture: Everything Physicians Need to Know about Veterans as Patients. Click HERE to register for this live webinar, part of MSSNY’s Veterans Matters series; view the program flyer HERE. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.
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RIP Loretta Polight Lewis

The New York County Medical Society mourns the loss of Loretta Lewis, who worked for the Society for 25 years before her retirement, and passed away this week. As much as Loretta enjoyed the 16 years she spent resting and enjoying time with her family, friends, and church after her career here, she still kept up with Society news about "her" doctors. Under five executive directors and 25 presidents, she worked on the newsletter, parking review, membership, office management, and workers' compensation applications, among so many other projects. She was the always friendly voice on the phone, helping members and their staffers. Loretta's smiling face at the registration table was a familiar sight at Society events. She would walk a member through the parking ticket review process — there are still a number of you out there who remember Loretta telling you how to write "a strong letter" for the committee to review. Society advertisers loved her, as she made sure that their classifieds came out just right. She had infinite patience with members of the public calling for referrals or general help. She treated every member as if he or she were her favorite member — and in fact, they all were! Loretta was very proud of the time she spent at New York County Medical Society and of the physicians she worked with. The Society was very lucky to have her as a faithful employee. She leaves a loving family and many friends, and we offer our condolences to all who are missing her, just as we are.

 

March 5, 2021

Last Chance Sign Up: Help for Dealing with Your Work and Your Life: The Society is happy to announce that you will be able to take Stanford University School of Medicine’s Compassion Cultivation Training (CCT) course, which includes 14 hours of CME. Note: Final four seats are available, so register HERE

CCT is an approach to dealing with today’s stress and burnout, which helps you re–frame your cognitive perspectives and also your way of handling people — including yourself. (Of course, some of the big problems physicians are facing today, such as financial strain and EMR overload, can’t be solved so fast; but if you can meet daily pressures with more resilience, that will help.) The CCT course, with psychologist Bornali Basu, Ph.D., of NYU School of Medicine’s Department of Psychiatry, spans eight weeks – eight two-hour sessions with lectures, group discussion, interactive exercises and more. The dates: March 9, March 16, March 23, March 30, April 6, April 13, April 20, April 27. The time: From 7:00 p.m. to 9:00 p.m. each session. You can earn 14 hours of CME (must attend the entire course to earn CME credit), and will pay only $216.00 for the entire eight–session series. Grab one of the final seats — this course gets rave reviews. Monday is your last day to Register.
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Physician Legislative Advocacy Day a Virtual Triumph: Who says you have to actually arrive with 40 people on a bus to have an effective advocacy day? On Tuesday, March 2, 2021, New York County Medical Society members reached out to New York State legislators with their usual savvy and panache, even though we did it all by Zoom.

The New York State Budget for 2021 – 2022 is to be finalized by the end of March. The State Senate and Assembly are now each working on their “one–house budgets,” which will be fought over and finally combined in the next few weeks. This year the budget issues include an unusually large number of items of concern to physicians, including:

— serious threats to the Excess Layer Medical Liability Program and the MSSNY Committee for Physician Health;
— attacks on due process for physicians in OPMC proceedings;
— Bids to expand pharmacists’ scope of practice, which could jeopardize patients’ relationships with their own local doctors and further erode the concept of the “medical home;”
— complex, tricky plans for telehealth expansion (there’s a “Trojan Horse” – possibly LESS coverage for telehealth provided by patients’ own local doctors);

In addition, physicians are alarmed by a proposal to “merge” physician bills into hospital bills. Finally, physicians are urging that supplies of vaccine be routed to physician offices that want to immunize their vulnerable patients.

We thank the two leaders of our own NYCMS Afternoon Legislative Open House — President Arthur Cooper, MD, and Government Affairs Committee Chair Paul Orloff, MD — for their gracious and tireless guidance through nine back–to–back, half–hour visits with legislative guests. Thanks to the doctors who joined them for intense questions, and brought the experience of their patients and practices to the forefront. See you next year on the bus?
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CMS Waives MIPS Penalties for 2022 Amid Public Health Emergency: The Centers for Medicare/Medicaid Services (CMS) has announced that it will not impose Medicare payment penalties in 2022 related to performance in MIPS (the Merit Based Incentive Payment System), due to the significant disruptions in 2020 as a result of the pandemic. The AMA has strongly advocated for this automatic relief from MIPS penalties. : The Extreme and Uncontrollable Circumstances Hardship Exception policy will be applied to MIPS–eligible clinicians who do not submit any MIPS data for the 2020 performance period, and they will not be subject to the 2022 payment penalty. Eligible clinicians who do submit data in at least two MIPS categories will override the hardship exception. They will be eligible to earn a bonus from the exceptional performance bonus pool (or potentially be subject to a penalty).
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Taxonomy Codes: What Are They, How Do You Use Them, and How Can You Find Out More? NGS (National Government Services) has recently received a number of inquiries on the proper use of taxonomy codes. A taxonomy code is a unique 10–character code that designates your classification and specialization, and enables you to identify your specialty at the claim level. The taxonomy code is not required, but it is strongly recommended that you use it. It helps immensely in the processing of claims, by identifying which PTAN (Provider Transaction Access Number) the processing system is to select in order to adjudicate a claim. More information is located at taxonomy codes.
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Have You Used the Workers’ Compensation Board’s New MTG Lookup Tool Yet? This useful new online tool lets you quickly determine whether a particular condition or treatment/test combination is “Recommended,” “Not Recommended” or “Conditional,” according to the Workers’ Compensation Board’s Medical Treatment Guidelines (MTGs). When you select a treatment or the name of a test, the tool will show you the relevant section of the full MTGs for that condition. It will also produce a Verification Summary document (PDF) that confirms that a lookup was completed, provides treatment recommendations for that condition, and displays patient–specific case information. You can keep this document, or attach it to any request for service or medical bill to an insurer, as verification that the treatment adheres to the MTG recommendations. The MTG Lookup Tool is available for the following MTGs:

— Elbow injuries
— Foot and ankle injuries
— Hip and groin injuries
— Hand, wrist and forearm injuries (including Carpal Tunnel Syndrome)
— Occupational Interstitial Lung Disease
— Occupational/Work–Related Asthma
— Post–Traumatic Stress Disorder
— Major Depressive Disorder

The full MTGs are available on the Board’s website HERE and accessible via the Medical Portal. To access the Medical Portal and these resources, visit the wcb.ny.gov, and select “Medical Portal” from the Online Services menu at the top of the home page. __________________________________________________________________

Extended Deadline to Weigh in on Telehealth Services: We are working on policy initiatives in Albany concerning the expansion of telehealth services. We need the most up–to–date information on how physicians are being compensated for care delivered virtually. MSSNY asks you to please take a few minutes to fill out the Survey Monkey questionnaire HERE. Deadline extended to March 12, 5:00 p.m.
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From The Doctors Company: Latest White Paper from the Society’s Endorsed Medical Liability Insurance Company Tells Us What’s Next — Before COVID–19, Outlier Medical Malpractice Verdicts Were Rising—What’s Next? Richard E. Anderson, MD, FACP, Chairman and Chief Executive Officer, The Doctors Company, talks about severity increases, outlier verdicts, and how COVID–19 and consolidation in health care have affected verdicts. Read all about it HERE.

 

February 26, 2021

All-Star Double Header March 2 (Virtual) Advocacy Day: Morning (8:00 a.m. to 11:00 a.m.): MSSNY’s program, with MSSNY staff, key legislators and people from the Governor’s office. Afternoon (12:00 noon to 4:30 p.m.): NYCMS Open House: come in and meet our Manhattan legislators.


It’s time for us to focus on the state legislative session and start asking our Manhattan legislators about tough issues – why community physicians aren’t getting supplies to vaccinate their patients, what the legislators think about a series of potentially destructive budget proposals from Governor Cuomo, and many other questions. On March 2, starting at 12:00 noon, we’re going to open up our own NYCMS Zoom Meeting to our individual Manhattan legislators’ offices. Each legislator will be with us for 20 minutes, followed by a 10–minute break. (The schedule is coming soon.) You can start right in with us at 12:00 noon or whenever you wish. There will be talking points on the screen. Leaders will kick off the discussion, but we are looking for your comments, questions, and experiences as well. You’ll get background information in advance, and you’ll get our Zoom link as March 2 draws near. Here’s all you need to do:

— Sign up with MSSNY at Webinar Registration - Zoom, if you haven’t done this already.

— Send a brief email to Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. – “I’ll be at the Open House” – with your name and email address, so that we can send you background information and your special Afternoon Open House Zoom link.

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What’s On the Agenda? First, why community–based physicians are crucial for helping to get vulnerable populations vaccinated. Other issues that are particularly serious, given the extra pressure physicians have been under during the past year, are listed in the attachment. Some highlights:

— Proposals that would let pharmacists provide more care without coordination with the patient’s physician.

— A proposal prohibiting billing by hospital–based physicians.

— A proposal to curtail physician due process protections.
— A proposal to place huge new costs on community physicians for Excess Layer coverage.

— A proposal to expand telehealth coverage that might actually lessen coverage instead.

— A proposal to legalize recreational marijuana. (Governor Cuomo has recently amended his initial proposal, allocating $100 million for social equity funding and refining criminal penalties for improper marijuana sales. However, MSSNY continues to oppose legalizing the recreational use of marijuana.)
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Get Vaccine to the People: Click HERE to urge Governor Cuomo and the New York State Legislature to ensure that community–based physicians are part of our “all hands–on–deck” effort to provide COVID–19 vaccination to their patients! MSSNY and other state medical societies have joined together to urge that the Biden Administration and state governments ensure that community–based physicians can receive the COVID–19 vaccine to immunize their patients. Joining in the statement were the: Connecticut State Medical Society, Massachusetts Medical Society, Medical Society of New Jersey, Pennsylvania Medical Society, and the Ohio State Medical Association. The statement says in part: “ Community–based physicians care for thousands of patients each, and can quickly identify those patients who are most at risk of getting COVID–19 or having complications due to their comorbidities. More importantly, patients feel comfortable with their physicians, with whom they can discuss the vaccine, and address any vaccine hesitancy, and feel comfortable in the office setting.”
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New York State Education Department (NYSED) Warning: Beware of a scam involving telephone calls from individuals posing as NYSED employees or law enforcement officials to defraud and extort victims. They are looking for your social security number and an immediate bond payment on the (supposed) grounds that the doctor’s license has been suspended and payment is required to reverse the suspension and avoid further charges. Note: NYSED will never telephone or fax any individual to request a bond fee or payments related to an ongoing investigation of professional misconduct. If you receive such a phone call, please hang up immediately and report it to the proper law enforcement authorities.

These people are good actors, and they use “spoofing” technology so that phone calls and faxes appear to come from real government agencies. They make quiet threats about sharing information, keep you on the phone so you can’t gather your thoughts or another opinion, and seem incredibly convincing, according to doctors who experienced it. They have a great deal of information about you, and all that seems to be missing is your social security number.

If you have lost money in such a scam, immediately notify your bank and file a report with the FBI at Internet Crime Complaint Center(IC3) | Home Page. This must be done quickly, usually in less than 72 hours, for even a very slight chance of recovering any money sent by bank wire transfer. You should also file a report with your local police precinct and notify the Federal Trade Commission. Visit Identity Theft Recovery Steps | IdentityTheft.gov to learn how to mitigate your chances of becoming a victim of identity theft. And, if you wish to check the status of your current registration and ability to practice, use the OP website: NYS Professions - Online Verifications (nysed.gov)
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COVID Developments in Children: The February 16 New York Times reports, “COVID–Linked Syndrome in children is growing, and cases are more severe. The condition, which usually emerges several weeks after infection, is still rare, but can be dangerous.” Read more HERE.
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Sign Up Now for the Society’s CME Physician Wellness Course Beginning March 9: The Society is happy to announce that you will be able to take Stanford University School of Medicine’s Compassion Cultivation Training (CCT) course, which includes 14 hours of CME. Note: Registration for this event is limited, so please register HERE

CCT is an approach to dealing with today’s stress and burnout, which helps you re–frame your cognitive perspectives and also your way of handling people — including yourself. (Of course, some of the big problems physicians are facing today, such as financial strain and EMR overload, can’t be solved so fast; but if you can meet daily pressures with more resilience, that will help.) The CCT course, with psychologist Bornali Basu, Ph.D., of NYU School of Medicine’s Department of Psychiatry, spans eight weeks – eight two-hour sessions with lectures, group discussion, interactive exercises and more. The dates: March 9, March 16, March 23, March 30, April 6, April 13, April 20, April 27. The time: From 7:00 p.m. to 9:00 p.m. each session. You can earn 14 hours of CME (must attend the entire course to earn CME credit), and will pay only $216.00 for the entire eight-session series.
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More Help for the Weary: If you or someone you know is struggling with everyday life stressors, reach out to the MSSNY's P2P program to be connected with a peer supporter to help! Email: This email address is being protected from spambots. You need JavaScript enabled to view it. or call (844) P2P–PEER ((844)727–7337) and request that you be connected with a peer supporter. MSSNY now offers to physicians, residents and medical students a completely confidential and anonymous opportunity to talk with a peer about some of their life stressors so that physicians may relate to a peer 24 hours a day/7 days a week. In addition to offering a trained, empathetic ear, peer supporters may provide information on specific resources that can offer further support, provide positive coping skills, or connect physicians to professionals for more focused assistance when needed. MSSNY has nearly 50 trained peer supporters across NYS who are a phone call away. Email: This email address is being protected from spambots. You need JavaScript enabled to view it. or call (844) P2P–PEER ((844)727–7337)
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Expanding Telehealth: We are working on policy initiatives in Albany concerning the expansion of telehealth services. We need the most up–to–date information on how physicians are being compensated for care delivered virtually. Please take a few minutes to fill out the Survey Monkey questionnaire at https://www.surveymonkey.com/r/MSSNY_Telehealth_Survey? The deadline to participate in the survey is 5:00 p.m. on Friday, March 5.
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Welcome to Our New Endorsed, Full–Service Practice Helper — Devington Technologies: The Society has endorsed Devington Technologies, a “one–stop shop” for all your medical practice needs. Service includes all aspects of billing and collections for insurance plans and patients, including:

— Charge entry review & edits & modifiers;
— Claims transmissions;
— Claims rejection corrections;
— Insurance EOB remittance posting;
— Insurance collection appeals;
— Insurance denial resolutions;
— Patient statement billing;
— Customized monthly billing performance tracking & reporting.

The fee for services will be determined by the client’s claim volume/revenue. However, all NYCMS members will receive $500 off their first invoice from Devington. Contact David Feiner at (212) 967–0601, ext. 211, This email address is being protected from spambots. You need JavaScript enabled to view it.. Make sure you tell him you are a Society member!

The New York County Medical Society receives a small commission from the opening of new accounts, which does not affect the price of services to you.

 

Febuary 19, 2021

COVID Vaccine Eligibility Widened: The pool of those eligible to receive the vaccine now includes those under age 65 with certain comorbidities – but community–based physicians are still not part of the effort, despite our urging. Click here to contact the governor and your legislator today!

The Governor has announced that New Yorkers with certain comorbidities and underlying conditions are now eligible to receive the COVID19 vaccine, and has said that excess vaccine supply meant for hospital workers can be used for New Yorkers with those comorbidities and underlying conditions. (For a list of the comorbidities and conditions, see the attachment, “NYS Vaccine Eligibility.”) But community–based physicians are still not included in the effort! Several hundred community–based physicians have signed up through the New York State Immunization Information System (NYSIIS), only to be told that no vaccine is available for community–based physicians. These physicians practice in a wide range of communities throughout the state, and MSSNY has warned that the state Department of Health (DOH)’s plan to limit immunizing patients with comorbidities to a state–run COVID–19 site — often far away — could adversely impact the poor, individuals of color and patients with comorbidities (populations that may particularly need swift immunization). We have asked the DOH and the Governor’s office for an estimated time frame for community–based physicians to start receiving vaccine to immunize these patients, but have yet to receive a reply.
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Proof for Vaccination Eligibility: Many patients are asking their own doctors for proof of vaccination eligibility. Here’s what the NYS DOH has said about forms of proof, as of February 15 (see attached NYS Guidance for Facilities):

Individuals who are eligible due to their work or employment status: Proof may include an employee ID card or badge, a letter from an employer or affiliated organization, or a pay stub (depending on the specific priority status), or individuals may display proof of work via an app (e.g., Uber, Lyft, DoorDash, etc.).

Individuals who are eligible due to their age: Proof may include: A driver’s license or non–driver ID, a birth certificate issued by a state or local government, a consulate ID, a current U.S passport or valid foreign passport, a permanent resident card, a Certificate of Naturalization or Citizenship, a life insurance policy with birthdate, or a marriage certificate with birth date.

Individuals with certain comorbidities or underlying conditions: At state–operated mass vaccination sites, any of the following proof is acceptable to prove eligibility: A doctor's letter, medical information evidencing comorbidity, or signed certification. Note: Local health departments are authorized to determine what forms, or combination thereof, of the proof options listed above, are required in their jurisdiction. We have asked the State for clarification as to what is allowable for a doctor’s note, in order to relieve demand on practices.
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Your Help Needed to Fight Proposal to Prohibit Billing by Hospital–Based Physicians: You are urged to contact your legislators to urge them to substantially revise A.3470–A/S.2521–A, “The Patient Medical Debt Reduction Act.” This legislation has many components, but one seriously problematic component would prohibit a physician or other provider with any “financial or contractual relationship” with a hospital from separately billing a patient for a course or episode of treatment in the hospital. This provision would not appear to prohibit continued separate billing to insurance companies and other payers, but a single hospital and physician bill would be required when a bill is sent to a patient for costs not covered by the patient’s insurance. The consolidated bill would have to be sent within seven days of the patient’s discharge from the hospital, before it is clear what expenses will actually be covered by a patient’s insurance.

This provision would put non–employed physicians at the mercy of the hospitals where they practice, since it is not clear how payments to hospitals from this “single bill” would then be distributed to the physicians. In an era when patients’ insurance policies are imposing enormous deductibles, even more physicians might have to sell their practices and become hospital employees in order to receive timely and adequate payments. This prohibition would most adversely affect physicians who are on the front lines of the pandemic, many of whom are facing an enormous drop in patient volume due to a significant amount of delayed care. It would be one more factor driving physicians out of New York State toward other states with more favorable practice environments. Click HERE to send a letter TODAY.
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Tuesday, March 2, 2021, is MSSNY’s Virtual Lobby Day: Sign up for interesting talks and small–group meetings. You’ll be able to ask legislators your own questions, up close (via the Zoom format, which can be quite personal). To register, click here: Webinar Registration – Zoom.

In the morning: We’ll hear from key lawmakers and members of the Governor’s administration (CME credit)

In the afternoon: We’ll have virtual small–group visits (20 minutes) with our own legislators. We want them to meet our individual members, and hear what we think about bills that could be bad for physicians and patients including:

— Hospital bills: Will the physician’s bill have to be included as part of the hospital bill (see above)?

— Telehealth: Will Governor Cuomo continue to ignore the crucial need for payment parity? Will insurers get away with the “fast one” they may be trying to pull: Steering patients toward telehealth from national telehealth networks, rather than their own community doctors?

— Scope of practice: Will pharmacists gain more prescribing authority – without coordinating with the patient’s doctor?

— Due process in OPMC proceedings: Will an allegation be able to be publicized before the investigation has been concluded – despite the damage to the physician’s reputation?

— The Excess Layer Program: Will it be cut 50 percent, as the Governor recommends?

— “Prescriber Prevails”: Will it be repealed – jeopardizing patients’ access to needed medications?

— Recreational marijuana: Should it be legalized – regardless of negative reports from other states?

Join hundreds of your colleagues from around the state on March 2. Sign up on Webinar Registration – Zoom.
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Sign Up Now for CME Physician Wellness Course beginning March 9: The Society is happy to announce that you will be able to take Stanford University School of Medicine’s Compassion Cultivation Training (CCT) course, which includes 14 hours of CME. Note: Registration for this event is limited, so please register HERE

CCT is an approach to dealing with today’s stress and burnout, which helps you re–frame your cognitive perspectives and also your way of handling people — including yourself. (Of course, some of the big problems physicians are facing today, such as financial strain and EMR overload, can’t be solved fast; but if you can meet daily pressures with more resilience, that will help.) The CCT course, with psychologist Bornali Basu, Ph.D., of NYU School of Medicine’s Department of Psychiatry, spans eight weeks – eight two-hour sessions with lectures, group discussion, interactive exercises and more. The dates: March 9, March 16, March 23, March 30, April 6, April 13, April 20, April 27. The time: From 7:00 p.m. to 9:00 p.m. each session. You can earn 14 hours of CME (must attend the entire course to earn CME credit), and will pay only $216.00 for the entire eight-session series.
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Welcome to MSSNY’s New Executive Vice President: We sadly say farewell to the excellent Philip Schuh (who is retiring after 30 years, and in fall 2020 received the AMA’s lifetime achievement award for medical executives), and happily welcome new MSSNY EVP, Troy Oechsner, JD. Mr. Oechsner, currently a partner at the law firm Manatt Phelps & Phillips, LLP, served as the Deputy Bureau Chief of the Health Bureau of the NYS Office of Attorney General. He also served as Deputy Superintendent of Health Insurance for the NYS Department of Financial Services (DFS), where he had a prominent role in the formulation of New York’s landmark Surprise Medical Billing Law.

Mr. Oechsner is highly respected in state health circles including consumer groups, elected officials, state offices and hospital associations, and those contacts will be an asset in building coalitions to achieve meaningful victories for physicians and patients. (Back in the day, he was a popular speaker at some New York County Medical Society events!)

 

January 22, 2021

Governor Releases Budget Proposal with Tough Provisions: Governor Andrew Cuomo has now released his proposed 2021 – 2022 State Budget, addressing a two–year $14.9 billion deficit and a four–year $39 billion deficit. He says that $6 billion will likely be received from the federal government, and he also proposes new revenue sources — $500 million through mobile sports betting and $350 million through the sale of adult–use cannabis, plus higher taxes for New Yorkers with income over $5 million per year. However, $15 billion will still be needed. The Governor hopes for additional funding from the federal government, but is considering litigation to make sure New York receives its fair share.

His Budget proposal does include some positive items, including:

— A call for state oversight over Pharmacy Benefit Managers (PBMs);
— Measures to expand the manufacturing of personal protective equipment (PPE); and
— Additional reimbursements for New York State Essential Plan providers, plus premium coverage to keep “enrolleds” enrolled.

However, the Budget also contains problematic initiatives, several of which the State Legislature has already rejected in previous Budget cycles:

Requiring the 16,000 or so physicians who are insured through the Excess Medical Malpractice Insurance program, to bear 50 percent of the cost of a policy. This proposal — by last spring’s Medicaid Redesign Team — was advanced during State Budget negotiations last March, but was rejected by the Legislature. Please send your legislators a letter/tweet in opposition here: Don't Balance the Budget on the Backs of Physicians (p2a.co).

Significantly reducing due process for physicians about whom a complaint is filed with the OPMC. The Commissioner of Health would be able to publicly identify (and even summarily suspend) a physician against whom a complaint had been filed before the conclusion of the investigation and hearing. This move, too, was proposed in last year’s Budget and rejected by the Legislature. Please send your legislators a letter/tweet in opposition here: Reject Governor's Physician Disciplinary Proposal (p2a.co).

Permitting pharmacists to act as “referring healthcare providers” for patients who need medications for asthma and disease self– management, and also letting pharmacists order certain lab tests for these patients.

Greatly expanding the existing physician–pharmacist collaborative drug therapy program by allowing pharmacists to prescribe, and also by including nurse practitioners in the program. This measure was also proposed in last year’s Budget and rejected by the Legislature.

— For an additional six years, continuing certain nurse practitioners’ authority to practice without written collaborative agreements with physicians (if there’s proof of “collaborative arrangements” with physicians in that practice specialty).

Imposing a 20 percent cut on the appropriation for MSSNY’s Committee for Physicians’ Health.

Organized medicine in New York State strongly objects to many parts of the Governor’s proposal, and will push the Legislature to reject these initiatives when the final Budget is enacted on March 31.
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NYCMS Members: Fight back! You can come right in and talk to the legislators (via Zoom) in these two great events:

ADVOCACY HOUR, Thursday, February 4, 2021, at 7:30 p.m., with Deborah Glick, Chair, NYS Assembly Committee on Higher Education; Richard Gottfried, Chair, NYS Assembly Committee on Health; and Linda Rosenthal, Chair, NYS Assembly Committee on Social Services. Register HERE. We have pivoted our usual winter legislative breakfast and turned it into a virtual hour event, co–hosted by The New York County Medical Society, the New York County Psychiatric Society, and the New York Council on Child and Adolescent Psychiatry. Physicians want the legislators to hear our issues — telehealth, liability, scope of practice and more. We’ll also ask the legislators: What one new law do YOU think we most desperately need and how can we help you?

ALBANY LOBBY DAY, Tuesday, March 2, 2021, starting at 8:00 a.m. This event will be virtual this time, but with the Zoom format it can still feel very personal. To register, click here: Webinar Registration – Zoom. CME will be available for the morning session (8:00 a.m. to 11:00 a.m.) In the morning we’ll hear from key lawmakers and members of the Governor’s administration, and in the afternoon we’ll have virtual small-group visits with our own legislators. We’ll discuss the Governor’s difficult Budget proposals; the vaccine rollout; medical economic issues including telehealth, prior authorizations and the Single Payer proposal; liability; scope of practice; and more. All these issues are even more urgent amid the exhaustion, burnout and financial stress that so many physicians are experiencing. Join hundreds of your colleagues from around the State on March 2! Sign up on : Webinar Registration – Zoom. Stay tuned for information about the afternoon Zoom visits we will be setting up with legislators that day.
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Wednesday, February 10, 2021, 6:00 p.m.: “The COVID Crisis: Present and Future” a Zoom conference with Stephen S. Morse, MD, Professor of Epidemiology and Director, Infectious Disease Epidemiology Certificate Program, Columbia University Medical Center. Hosted by the NYCMS Committee on Public Health, this conference is open to all NYCMS members. Look for sign–up information next week.
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Access the Correct New Medicare Fees: The UPDATED version of the 2021 Medicare Fee Schedule has now been posted on the website of NGS (National Government Services). Go here for the UPDATED version of the 2021 Medicare fee schedule HERE. The version originally posted in December was modified early in January to reflect big changes (improvements!). If you need detailed instructions for navigating to the new fees, email This email address is being protected from spambots. You need JavaScript enabled to view it..
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Tuesday, January 26, 2021, 12:00 noon – 1:00 p.m., “Handling COVID–19 Employee Vaccinations, Updated Leave Entitlements & Addressing Violations of COVID–19 Protocols,” presented by Garfunkel Wild. REGISTER HERE
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Get the Latest Medicare Information on Wednesday, January 27, 2021, 8:00 a.m. to 10:00 a.m.: “Medicare Update 2021 – Everything You Want to Know” with James Bavoso, Manager of Provider Outreach & Education at NGS (National Government Services). You can register for this virtual session HERE. We recommend that you register now, to save time on the registration page. When you register, you’ll receive a reminder email one day before — plus another reminder email one hour before, which will include a link to the session. This link will take you right into the webinar. So that you can ask questions, log into the webinar and then use the dial–in number that pops up. (That way, you avoid the microphone problem — some attendees have laptops without microphones, and some attendees aren’t familiar with using the microphone.)
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Tuesday, January 26, 2021, at 7:30 a.m.: CME Webinar: “Veterans Matters: PTSD in Returning Veterans.” Click HERE to register for the program! View the program flyer HERE. Faculty: Frank Dowling, MD. Educational Objectives: Identify diagnostic criteria for PTSD, discuss medical and psychiatric comorbidities of military–related PSTD, discuss evidence-based treatment modalities for PTSD (including medications and psychotherapy), and discuss strategies to help veterans overcome stigma to seek and accept treatment for military–related trauma. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.
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Thursday, January 28, 2021, 5:30 p.m. to 6:30 p.m.: Webinar: “Physician Evolution: Transforming from Clinician to Administrator,” hosted by the Connecticut Association of Healthcare Executives. Free of charge. To register, click on: Webinar Registration - Zoom. With the increasing challenges facing healthcare, there is a growing need for dynamic physicians to transition into administrative leadership roles. Physicians bring a unique perspective that is integral to success of any organization. Speakers: Dr. Justin Lundbye, Senior Vice President and Chief Medical Officer, Waterbury HEALTH; Dr. Mary O’Connor, Professor of Orthopaedics and Rehabilitation, Yale University School of Medicine; and Dr. Peter Yu, Physician–in–Chief, Hartford HealthCare Cancer Institute. Moderators: Arpit M. Chhabra, MD, Director of Education, Radiation Oncologist, New York Proton Center; and Stephen Liebowitz, MHA, Senior Associate, BRG (a health analytics company).
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Friday, February 5, 2021, at 7:30 a.m.: MSSNY Webinar: “COVID–19 & Mental Health of Physicians and Other Healthcare Providers,” with Dr. Craig Katz. Click here to register. Over the past year the COVID–19 pandemic has contributed to countless health problems, not the least of them related to mental health for physicians and other healthcare providers, as well as for patients. Dr. Katz’s recent Webinar on patients’ mental health conveyed much good sense and compassion, and this one should do the same. For additional information or assistance with registration, contact Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..
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New NYCMS Member Benefit! Grow Your Practice with PayLo. PayLo has changed the face of payment processing — the most cost-effective solution for Healthcare practices across the country. Medical Specialties of all types are discovering a better way to process credit cards. PayLo’s proprietary technology allows medical offices to apply a small service fee to each sale they make and provide a discount to customers who pay in cash. Service fees go toward business operational expenses, giving owners more revenue at the end of the month to grow their businesses. Let PayLo help your business grow and enjoy low–cost processing solutions. For more information, contact Mark Bristow, (914) 506–1984, This email address is being protected from spambots. You need JavaScript enabled to view it.. Click HERE to learn more.
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More PPP Funds With Help from Flushing Bank: Flushing Bank, endorsed by the New York County Medical Society, will work with any Society member in need of Paycheck Protection Program (PPP) funding. Key points:

— Flushing Bank highly recommends that you work with your CPA to ensure proper completion of Application & Documentation Delivery. (If you need a CPA, Flushing can recommend specialists in this area who would be happy to consult.)
— Flushing will be using a third–party vendor to submit applications. The Borrower will use a link Flushing provides directly. The link is entirely self–directed. Any applicant must have the ability to go online, navigate the link (self–directed), and submit a completed/signed application (and any required documentation) directly via the Link. Flushing will be able to monitor an applicant’s progress and generally assist, but this is self–directed.

If you are interested, reach out directly to Denis Healy at Flushing Bank, via phone or email, in order to receive the link. Make sure to say you are a member of the New York County Medical Society. Flushing will then send the link directly to you once the Bank Portal is open. Contact Denis Healy at Flushing Bank — even if you don't bank with Flushing — at This email address is being protected from spambots. You need JavaScript enabled to view it. or call his office number (646) 923–9525; or cell (917) 923–2152.

 

 

January 15, 2021

More PPP Funds With Help from Flushing Bank: Flushing Bank, endorsed by the New York County Medical Society, will work with any Society member in need of Paycheck Protection Program (PPP) funding. Key points:

— Flushing is targeting Tuesday, January 19, for first–time PPP Borrowers, and later next week for PPP 2 (2nd Draw).
— Flushing Bank highly recommends that you work with your CPA to ensure proper completion of Application & Documentation Delivery. (If you need a CPA, Flushing can recommend specialists in this area who would be happy to consult.)
— Flushing will be using a third–party vendor to submit applications. The Borrower will use a link Flushing provides directly. The link is entirely self–directed. Any applicant must have the ability to go online, navigate the link (self–directed), and submit a completed/signed application (and any required documentation) directly via the Link. Flushing will be able to monitor an applicant’s progress and generally assist, but this is self–directed.

If you are interested, reach out directly to Denis Healy at Flushing Bank, via phone or email, in order to receive the link. Make sure to say you are a member of the New York County Medical Society. Flushing will then send the link directly to you once the Bank Portal is open. Contact Denis Healy at Flushing Bank — even if you don't bank with Flushing — at This email address is being protected from spambots. You need JavaScript enabled to view it. or call his office number (646) 923–9525; or cell (917) 923–2152.
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Communicate With Our NYS legislators! Two Great Events for All NYCMS Members Are Coming Up: Join us for Advocacy Hour, Thursday, February 4, 2021, at 7:30 p.m., with Deborah Glick, Chair, NYS Assembly Committee on Higher Education; Richard Gottfried, Chair, NYS Assembly Committee on Health; and Linda Rosenthal, Chair, NYS Assembly Committee on Social Services. We have pivoted our usual winter legislative breakfast and turned it into a virtual hour event, co–hosted by The New York County Medical Society, the New York County Psychiatric Society, and the New York Council on Child and Adolescent Psychiatry. Physicians want the legislators to hear our issues — telehealth, liability, scope of practice and more. And we’ll also ask the legislators: What one new law do YOU think we most desperately need? And how can we help you? To register, go HERE.

Join us on Tuesday, March 2 for Albany Physician Legislative Day. This event, MSSNY’s Annual Physician Advocacy Day, will be virtual this time (via Zoom). To register, click here: Webinar Registration – Zoom. In the morning we’ll hear from key legislators and members of the Governor’s administration, and in the afternoon we’ll have virtual visits with our own lawmakers. We’ll discuss proposals that are of great concern — particularly since the Governor and the State Legislature are looking to save tens of billions of dollars in the State Budget. Among the challenges: Proposals for cuts in many healthcare programs; proposals to inappropriately expand the scope of practice of many types of non-physicians; proposals to mandate how physicians provide care — and more. Join hundreds of your colleagues from around the State on March 2! Sign up on: Webinar Registration – Zoom.
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Vaccine Update, New York City, January 15, 2021: If physicians continue to face challenges in identifying where they should receive their second dose, please let the Society know the name of the institution where the first dose was received. We will collect this information so MSSNY can share it with the New York State Department of Health. (Call (212) 684–4670 or email This email address is being protected from spambots. You need JavaScript enabled to view it. )

Patients are encouraged to call the COVID–19 Vaccination Hotline, from 7:00 a.m. to 10:00 p.m., seven days week, to help New Yorkers determine if they are eligible and schedule vaccination appointments. The number is: (833) 697–4829 (833) NYS–4–Vax). This will enable patients to jointly schedule family appointments. Eligible individuals can make vaccination appointments by visiting nyc.gov/vaccinefinder and searching for sites by address or ZIP code. (Phase 1a health care workers who are employed by hospitals, etc., can also contact their facility to be vaccinated.)

Eligible categories have been expanded again. Now, in addition to NYS’s COVID–19 vaccination Phase 1a group, people in the following select groups of Phase 1b are eligible to be vaccinated: People aged 65 and older, first responders and support staff of first responder agencies, corrections staff, pre–K to grade 12 teachers and staff, group childcare providers and staff, public transit workers, public–facing grocery store workers, in–person college instructors, and residents and at–risk staff of group residential homeless shelters. Again, those who are employed may want to check with their employers — some employers are arranging for vaccinations.

What about priorities? The DOHMH states that even though eligibilities have been expanded, health care workers and others in Phase 1a should continue to be prioritized for vaccination. Which health care workers are in the Phase 1a category? High–risk hospital workers; EMS workers and workers in FQHCs; urgent care providers; coroners/medical examiners; individuals administering COVID–19 vaccines; outpatient/ambulatory front–line, high–risk health care workers of any age who provide direct in–person patient care; staff who are in direct contact with patients (e.g., reception staff); and front–line, high–risk public health workers who have direct contact with patients, including those conducting COVID–19 tests, handling COVID–19 specimens and administering COVID–19 vaccinations. This includes, but is not limited to: Doctors (and their staff) who work in private medical practices or hospital–affiliated medical practices or public health clinics; registered nurses; specialty medical practices of all type; dentists and orthodontists and their staff; psychiatrists and psychologists and their staff; physical therapists and their staff; optometrists and their staff; pharmacists and pharmacy aides; home care workers and hospice workers.
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You Can Now Access the Correct New Medicare Fees: The UPDATED version of the 2021 Medicare Fee Schedule has now been posted on the website of NGS (National Government Services). Go here for the UPDATED version of the 2021 Medicare Fee Schedule HERE. The version originally posted in December was modified early in January to reflect big changes (improvements!). If you need detailed instructions for navigating to the new fees, email This email address is being protected from spambots. You need JavaScript enabled to view it..

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Get the latest Medicare information on Wednesday, January 27, 2021, 8:00 a.m. to 10:00 a.m.: “Medicare Update 2021 – Everything You Want to Know!” with James Bavoso, Manager of Provider Outreach & Education at NGS (National Government Services). You can register for this virtual session HERE. We recommend that you register now, to save time on the registration page. When you register, you’ll receive a reminder email one day before, plus another reminder email one hour before, which will include a link to the session. This link will take you right into the webinar. We also recommend: So that you can ask questions, log into the webinar and then use the dial–in number that pops up. (That way, you avoid the microphone problem — some attendees have laptops without microphones, and some attendees aren’t familiar with using the microphone.) Topics will include:

— The COVID–19 Public Health Emergency (PHE)
— Telehealth
— E/M (Evaluation & Management) coding changes in 2021
— The 2021 Medicare Physician Fee Schedule
— Final Policy, Payment, and Quality Provisions Changes to the Fee Schedule for 2021 — CMS’s Quality Payment Program and MIPS
— Contact information/Resources
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How to Address the Doctor Shortage? Society Trustee and past president Michael Goldstein, MD, JD’s letter to the editor in the January 10 issue of the Wall Street Journal, addresses elements affecting the physician shortage, including more physician retirements, obsolete antitrust laws, and government micro management of health care. Read all about it at https://www.wsj.com/articles/how-to-address-the-doctor-shortage-11610305469
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The NYS Department of Health Has Reached out to NYCMS, Saying “Your Members Would Make Great Volunteers:” Please support the critical effort to vaccinate New York during this challenging time!” (You will receive the vaccine too, of course.) New Yorkers are known for their generosity and willingness to lend a hand, especially in times of crisis. Over 15,000 New Yorkers have registered with ServNY, a program for volunteers to put their skills and professional experience to work volunteering in communities during emergencies, such as natural disasters and public-health crises. How ServNY works: Once a volunteer registers, ServNY collects and confirms his or her data — contact information, licensure, credentials, training history, emergency response experience, and personal skills. Volunteers are free to accept or decline assignments. They can be called upon to help before, during, and after emergencies. ServNY also provides volunteers with information about training and exercises. To learn more about the COVID–19 Vaccine distribution in NYS, please visit ny.gov/vaccine.
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MSSNY Is Partnering with “Let’s Get Immunized NY,” a campaign to provide New Yorkers with reliable and trustworthy immunization information and encourage them to get recommended vaccines. The campaign will work for more access to immunization and more public awareness of vaccination’s public–health benefits; it will also address vaccine–access disparities, especially in medically underserved areas and communities with low immunization rates. Among the participating organizations: The NYS Chapter of the Academy of Family Physicians; the NYS American Academy of Pediatrics, NYS Chapters 1, 2, & 3; the NYS Association of County Health Officials (NYSACHO); the March of Dimes; the NYS Public Health Association; The Business Council and the NYS Farm Bureau. For more information, go to http://www.letsgetimmunizedny.org .
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Governor Andrew Cuomo Unveils Plan to Expand Telehealth Services: At his initial State of the State address, Governor Cuomo announced plans to expand telehealth coverage in 2021. Key proposed reforms include adjusting reimbursement incentives to encourage telehealth, eliminating outdated regulatory prohibitions on the delivery of telehealth, removing outdated location requirements, addressing lack of technical proficiency through training programs for both patients and providers, and establishing other policies that incentivize the use of telehealth. However, we are awaiting further details — likely to be in next week’s Executive Budget proposal —as to how exactly these expansions would occur. More on the Governor’s proposals here:
Governor Cuomo Announces Proposal to Expand Access to Telehealth for All as Part of 2021 State of the State | Governor Andrew M. Cuomo (ny.gov)


Early in the pandemic, the Governor and state agencies took very important steps to help patients get needed treatment from their physicians, virtually, by removing several barriers to care through telehealth. Not only was this an important lifeline for patients and physicians, it has also helped transform how care is delivered in New York. In the 2021 legislative session, MSSNY will advocate for: Continuing expanded coverage for telemedicine services; requiring payment parity between telemedicine visits and in–office visits; requiring payment parity for video services; and requiring insurers to cover audio–only visits. MSSNY has teamed up with specialty societies, the Healthcare Association of New York State (HANYS), communication centers, and many other organizations, to send the following letter to legislators and the Governor: click here.
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Proposal to Legalize Recreational Marijuana: Governor Andrew Cuomo has announced a proposal to create an Office of Cannabis Management, to regulate both the medical use and the adult recreational use of marijuana. This proposal will be part of the Governor’s 2021 – 2022 New York State budget. Although he has estimated that the proposal would generate more than $300 million in tax revenue, that revenue is not expected to be generated for several years.


MSSNY opposes the legalization of recreational marijuana — sharing this position with a number of organizations, including with the New York State Association of County Health Officials (NYSACHO), the Mental Health Association of New York State, the NYS PTA, and Smart Approaches to Marijuana (SAM). The National Institute of Drug Abuse (NIDA) reports that COVID–19 is a respiratory illness that attacks the lungs; it is a serious threat to anyone who smokes or vapes tobacco or marijuana products. With the COVID–19 pandemic, MSSNY believes this measure would create even greater stress on New York State’s public-health system. MSSNY has joined with the state medical societies of Delaware, New Jersey, New York, Ohio and Pennsylvania to express concerns about state governments’ efforts to legalize marijuana for recreational use. A copy of the coalition’s press release can be found here.
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Assemblyman Gottfried Reintroduces Physician–Friendly Legislation: Assemblyman Richard N. Gottfried (D–Manhattan), Chair of the New York State Assembly Health Committee, has reintroduced three bills that we have supported for several past legislative cycles. Thanks to Chairman Gottfried for his continued leadership on these important bills, and will keep members informed as these bills advance this session:


A.832: Prohibit or restrict a number of HMO rules and strategies that negatively impact physicians’ ability to provide the highest quality of care.
A.951: Permit certain collective negotiations between physicians and health–insurance plans, under close supervision by the state.
A.879: Allow health plans to deny payment for covered benefits only after review by a physician (or other healthcare professional) who is (1) licensed in New York State, and (2) board–certified in the same (or similar) specialty as the treatment under review.
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Check Out the Following Events:

January 20, 2021, 7:30 a.m., Medical Matters: COVID–19 & Mental Health of Patients . Click here to register .


February 5, 2021, at 7:30 a.m., Physician Wellness/Medical Matters: COVID-19 & Mental Health of Physicians and Other Healthcare Providers - Click here to register.
For additional information or assistance with registration, contact Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..

January 20, 5:00 p.m. to 6:00 p.m.: CME Zoom event, The Intersection of Heart Failure and Cardio–Oncology, part of the New York–Presbyterian Hospital Heart Failure Education Series. Register at: NewYork-Presbyterian Heart Failure Series (smartsheet.com)

— January 21, at 2:00 p.m.: Webinar, First Read’s Coronavirus Update (Part I), presented by the Office of the Counsel to the Mayor. “We launch January 21st with our HEALTH event, which will speak about New York City’s response to the COVID–19 pandemic, in particular the City’s historic contact tracing, quarantine, and vaccine distribution efforts. Discussion topics will include the legal issues related to these topics and a discussion of the vaccine rollout plan. To attend the webinar (free of charge), please register here.

January 26, at 7:30 a.m.: CME Webinar: Veterans Matters: PTSD in Returning Veterans. Click HERE. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.

 

 

January 8, 2020

Join Us for Advocacy Hour, Thursday, February 4, 2021, at 7:30 p.m.: Our guests are Deborah Glick, Chair, NYS Assembly Committee on Higher Education; Richard Gottfried, Chair, NYS Assembly Committee on Health; and Linda Rosenthal, Chair, NYS Assembly Committee on Social Services. We have pivoted our usual winter legislative breakfast and turned it into a virtual hour event, co–hosted by The New York County Medical Society, the New York County Psychiatric Society, and the New York Council on Child and Adolescent Psychiatry. Physicians want the legislators to hear our issues — telehealth, liability, scope of practice and more. We’ll also ask the legislators: What one new law do YOU think we most desperately need? And how can we help you? To register, go HERE. 

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Vaccine for New York City Community–Based Physicians and Staff: Community–based physicians can now make appointments to receive the COVID–19 vaccine at one of the locations listed on the web page of the NYC Department of Health and Mental Hygiene (DOHMH) — click on vaccination locations and related scheduling. To make an appointment, some of these locations ask you to enter your information online, and some locations ask you to call them on the phone. We have learned that some physicians have been able to set up appointments fast, and some have even received the vaccine. The City plans to ramp up capacity at these sites and add sites over the coming weeks; MSSNY encourages physicians to check that web page regularly, as it’s where the most up–to–date information will be posted. (Note: Doctors who are on a medical staff or affiliated with a hospital, employed or not: The New York State Department of Health (DOH) has stated that you will receive your vaccination from the hospital. Priority is to be given based on exposure risk and personal health risk factors, NOT based on employment status.)

You also can become a vaccine provider in your own practice. You will have vaccine for yourself, your staff and your patients. This goal is doable, but you and/or your staff will have to manage the vaccine and the recipients.

Managing the Vaccine: You will not receive a shipment unless you commit to:

— Using each shipment within a week;
— Complying with strict priority and cold chain requirements; and
— Reporting every shot within 24 hours (online or via EMR), and much more.

Managing the Recipients: You must make plans for:

— Scheduling appointments;
— Enforcing safety requirements (masks, social distancing);
— Checking each recipient’s proof of eligibility or priority status, making sure that each recipient actually receives the second shot, and much more.

Preliminary Requirements: You must be currently registered with New York City’s CIR (Citywide Immunization Registry), and you must sign the Vaccination Program Provider Agreement. For more information, email Susan Tucker, This email address is being protected from spambots. You need JavaScript enabled to view it.

You can volunteer at another location via New York State’s volunteer management system, ServNY. For more information, email Susan Tucker, This email address is being protected from spambots. You need JavaScript enabled to view it..
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Wondering About the 2021 Medicare Fee Schedule? The UPDATED version of the 2021 Medicare Fee Schedule has NOW been posted on the website of NGS (National Government Services). The version originally posted in December was updated when in the past few weeks, big changes (improvements!) were made. When Congress approved the recent pandemic relief package, it included provisions to reduce the Medicare payment cuts that had been slated to take effect on January 1. The fees have been updated due to the year–end legislative package that was signed into law by the President, which:

— Added $3 billion to provide for a one–time, one–year increase of 3.75% to each code in the 2021 Medicare Physician Fee Schedule to support physicians and other professionals in adjusting to the policy changes for evaluation and management (E/M) services being implemented in January 2021, and to provide relief during the COVID–19 public health emergency.

— Delayed the implementation of the new complexity code (G2211) that the Centers for Medicare & Medicaid Services finalized in the 2021 Medicare Physician Fee schedule for three years. The new complexity code is unnecessary and disrupts the relativity of the Medicare Physician Fee Schedule.

These actions together would wipe out much of the payment cuts, while further increasing payments for E/M codes. In addition, this law suspended the 2% Sequestration payment reduction applied to all Medicare Fee–For–Service (FFS) claims to March 31, 2021.

On a negative note, Congress did not direct CMS to apply the planned E/M payment increases to the post–op visits included in the global period for surgical codes. An argument will be made that CMS is violating the statute that prohibits Medicare from paying physicians differently for the same work.

Go here for the UPDATED version of the 2021 Medicare Fee Schedule
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A Good Thing — Additional $284 Billion for the Paycheck Protection Program: Congress acted on end–of– year COVID–19 legislation and provided more funding for small businesses and permitting a second forgivable PPP loan for the hardest–hit, including physician practices. First–time applications can be made too. How the “PPP Second Draw Loans” Work: Eligibility for the PPP “second draw” is defined as: Small businesses that have no more than 300 employees, and demonstrate at least a 25 percent reduction in gross revenues between comparable quarters in 2019 and 2020. The maximum loan size is 2.5X average monthly payroll costs, up to $2 million. Borrowers receive full loan forgiveness if they spend at least 60 percent of their PPP second–draw loan on payroll costs, over a time period of their choosing between 8 weeks and 24 weeks. Easier loan forgiveness procedures: Borrowers can select their loan forgiveness covered period between 8 weeks and 24 weeks, and the forgiveness application process is simplified for smaller loans up to $150,000. We’re watching for instructions as to how physicians can apply, and will keep you posted.
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Not Such a Good Thing— Surprise Medical Billing Dispute Resolution: Unfortunately, the unpleasant “surprise” in the year–end COVID relief package is a component having to do with Surprise Medical Billing dispute resolution. MSSNY has long supported efforts to add federal protections to help prevent patients from receiving unexpected bills. However, the final federal version is greatly tilted in favor of health insurance companies and is inconsistent with New York’s far more balanced approach to addressing surprise medical bills for patients who are insured under state–regulated plans.

The new federal surprise bill provisions will apply to patients insured by ERISA plans, and New York’s approach will continue to be followed for out–of–network claims from patients insured in state–regulated plans. In some ways, the federal standards in the new law are similar to New York’s well–regarded approach, but there are also significant differences about which organized medicine has expressed serious concerns.

The measure would ensure that patients are “held harmless” from surprise out–of–network medical bills. As per New York’s law, patients would be required to pay only the in–network cost–sharing amount (co–payment, coinsurance, deductibles) for:

— Out–of–network emergency care;
— Certain ancillary services provided by out–of–network providers at in–network facilities; and
— Out–of–network care provided at in–network facilities without the patient’s informed consent.

However, unlike New York’s law, the federal provision calls for a 30–day open negotiation period in which out–of–network physicians and payers may try to settle out–of–network claims. If this 30–day negotiation period is unsuccessful, either the physician or the health plan must initiate an independent dispute resolution (IDR) process within four days of the end of the 30–day period.

The federal IDR process is similar to New York’s in that the IDR entity will choose whether the insurer’s suggested payment, or the physician’s, will prevail, and the IDR entity will consider numerous sources of information brought by either party, such as the provider’s training and experience, patient acuity, and the complexity of furnishing the item or service. However, (1) The IDR entity is not permitted to consider either provider charges or usual and customary charges, and (2) the IDR entity is required to consider the market–based median in–network rate. The AMA and MSSNY are analyzing the implications of this measure, and we will keep you posted. Meanwhile, you may want to look at the AMA summary of the COVID relief package at Topline-Summary-of-Select-Provisions-of-Consolidated-2020-Omnibus-Legislation-12-21-20.pdf (mssnyenews.org).
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Discover Many New Medicare Rules, Issues and Capabilities, Wednesday, January 27, 2021, from 8:00 to 10:00 a.m.: NYCMS invites you to “Medicare Part B 2021 Update” with James Bavoso, Manager, Provider Outreach & Education at NGS (National Government Services). Topics will include:

• The COVID–19 Public Health Emergency (PHE)

• Telehealth

• E/M (Evaluation & Management) coding changes in 2021

• The 2021 Medicare Physician Fee Schedule

• Final Policy, Payment, and Quality Provisions Changes to the Fee Schedule for 2021 — CMS’s Quality Payment Program and MIPS

• Contact information/Resources

You can register right now for this virtual session HERE.

 

 

December 26, 2020

2020 Comes to an End: Time to Pay Your 2021 Dues. Don’t forget to send in your dues payment, or go to www.mssny.org (use the Membership link across the top of the home page) to pay your 2021 dues to start out the new year.
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Vaccinating Doctors: Physicians who are providing in–person care to patients are designated 1a and will be receiving the vaccine as it becomes available. New York State is expecting approximately 500,000 to 600,000 doses in the next couple of weeks, but there are two million people in the 1a category. In regards to your own vaccination, for doctors that are on a medical staff, employed or not, you will receive your vaccination from the hospital. Priority is to be given based on exposure risk and personal health risk factors, NOT based on employment status.

MSSNY has communicated with top officials at the Department of Health and the Governor’s office in charge of vaccine distribution concerning other vital questions: Where do doctors not affiliated with a medical staff get vaccinated? How, when, and where do the office staff of community doctors get vaccinated? If a community–based physician practice has applied to be a vaccine distributor, will they be getting vaccine now for themselves and their other 1a staff? Keep watching for updates as we learn more.
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Discover Many New Medicare Rules, Issues and Capabilities, Wednesday, January 27, 2021, from 8:00 to 10:00 a.m.: NYCMS invites you to “Medicare Part B 2021 Update” with James Bavoso, Manager, Provider Outreach & Education at NGS (National Government Services). Topics will include:
• The COVID–19 Public Health Emergency (PHE)

• Telehealth

• E/M (Evaluation & Management) coding changes in 2021

• The 2021 Medicare Physician Fee Schedule

• Final Policy, Payment, and Quality Provisions Changes to the Fee Schedule for 2021 — CMS’s Quality Payment Program and MIPS

• Contact information/Resources

You can register right now for this virtual session HERE.
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Join Us for Advocacy Hour, Thursday, February 4, 2021, at 7:30 p.m.: We have pivoted our usual winter legislative breakfast and turned it into a virtual hour event with key legislators, co–hosted by The New York County Medical Society, the New York County Psychiatric Society, and the New York Council on Child and Adolescent Psychiatry. It’s going to be:

• Intense – a one-hour “Speed Talk.”

• Interactive – you’ll be able to weigh in before, during and after the lawmakers’ comments.

• Revealing – you’ll get a special look at their personalities and concerns.

Physicians want the legislators to hear our issues — telehealth, liability, scope of practice and more. But we’ll also ask them: What one new law do YOU think we most desperately need? And how can we help you? Save this date! Registration coming soon!

 

 

December 18, 2020

Contact Congress TODAY: Surprise Bill legislation is in play in Washington, DC right now. Go to: Urge Congress to Prevent Medicare Cuts, Expand Lifeline Programs and Oppose One-Sided Surprise Bill Proposals (p2a.co). Your instant message will be completed and sent immediately.

Congress is at a critical tipping point on a number of issues as they try to finalize a year–end spending package. Among the proposals in the mix is a very bad federal version of the surprise bill law which would prohibit consideration of charge data in its defined IDR process. This approach would tilt the process enormously in favor of insurers, and have a significant negative downstream effect on all participating physicians as well. It would not pre–empt New York's law, but it would definitely apply to all ERISA claims and create a precedent for New York to change its more balanced law. Says MSSNY President Bonnie Litvack, MD: “Let’s be clear. The new House–Senate committees’ surprise billing legislative agreement is a flat–out giveaway to already enormously profitable insurance companies at the expense of community physicians on the front lines during the pandemic. If this proposal were to be enacted, it would reduce patient choice in New York by compelling even more private practice physicians into forced employment arrangements. We are disappointed that Congress did not look to New York’s well–regarded surprise medical bill law as a model of balance.”

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Attention, NY City Physicians Who Want to Administer COVID Vaccines: If you would like to administer COVID vaccines, you must enroll in the NYC COVID–19 Vaccination Program. The New York City Department of Health and Mental Hygiene is now enrolling private practices, independent pharmacies and other facilities that will immunize adults in the NYC COVID–19 Vaccination Program. Click on the links below to review the letter and instructions on how to sign the COVID–19 Vaccination Program Provider Agreement in the online Citywide Immunization Registry (CIR):

General Provider Letter from NYCDOH
Provider Agreement Letter
Vaccination Agreement – Access Instructions

As more information emerges, the Society will pass it along to all our members. Meanwhile, for questions, please call the Provider Access Line at (866) 692–3641 or email This email address is being protected from spambots. You need JavaScript enabled to view it.. Periodic updates will be sent to keep you informed, and
the COVID–19 Vaccine Webpage will be updated frequently.

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Fight Cuts in Physicians’ Medicare Payments. Support H.R. 8702/S. 5007 NOW! Under current law, CMS is required to make budget neutrality adjustments to the Medicare physician payment schedule whenever changes in relative value units (RVUs) generate a payment increase or decrease by $200 million. This year, the current pandemic has helped to trigger an adjustment that would mean dramatic cuts for frontline physicians — and unfortunately, without Congressional action before January 1, 2021, this nightmare scenario will become reality.

Fortunately, Congress is listening! Bipartisan legislation has been introduced in the House to address these concerns, and now a group of Senators, led by Sen. John Boozman (R–AR), has introduced a companion bill in the Senate. The “Holding Providers Harmless from Medicare Cuts During COVID–19 Act” (H.R. 8702/S. 5007) would freeze payments at 2020 rates for services scheduled to be cut in 2021, for a period of two years – while allowing the scheduled E/M increases to take place. Analyses of this approach show improved overall impact numbers for all physician specialties. Momentum is building, but time is running out; if Congress does not act in the next few days these budget neutrality adjustments will negatively impact many physician practices across the country!

Please contact your Senators and member of Congress, ask them to support the "Holding Providers Harmless from Medicare Cuts During COVID–19 Act" (H.R. 8702/S. 5007), and request the bill’s inclusion in a larger, end–of–the–year legislative package today.
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Medicare’s 2021 Physician Fee Schedule Now Available: You can view the whole 2021 Medicare fee schedule, or zero in on one code at a time at the NGS site. For step–by–step navigation instructions, see the attachment, “How to Access the 2021 Medicare Physician Fee Schedule.”

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Flu Shots in 2021: The Centers for Medicare/Medicaid Services (CMS) CMS has a web page that gives you links for everything you need to know about flu shots in 2021 — payment rates, coding, frequency, coverage and more. Go to https://www.cms.gov/flu-provider.
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MSSNY and Specialty Societies Speak out about Telehealth Laws and Regulations: On December 15, a coalition of 15 medical societies (including MSSNY) sent to New York State legislators, and the Governor, an urgent plea for “more robust telehealth policies in the wake of the COVID–19 pandemic.” Needed are: Payment parity (reimbursements for telehealth services should equal those for office visits); parity between commercial payers and Medicaid (Medicaid fee for service and Medicaid managed care); uniform coverage and reimbursement for “audio–only” telehealth services; extension of telehealth provisions after the pandemic; and more. As the letter points out, “The first wave of the COVID-19 pandemic forced many health care practices to operationalize telemedicine in a way that had not previously been done to meet patient care needs safely. The Department of Financial Services (DFS) and the Department of Health (DOH) instituted very important emergency rules that offered more flexible policies to ensure patients could access telehealth services. As we enter into a new surge of COVID–19 infections across the state, and importantly, a new paradigm in providing patient–centered care, these policies must be made permanent to ensure patient access to services in the future and that we continue to have a robust physician workforce able to meet the demand in their communities.” The letter contains many interesting details and ideas. See the attachment, “Telehealth Sign–On.”
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Patient Safety: Everyone is extremely careful — but it still helps to have a reminder. The Doctors Company, the Society’s endorsed medical liability company, has put together an excellent, detailed set of tips and resources, with many links, comments and caveats. Topics include documentation, screening, office layout, telehealth triage, COVID testing, disinfection and many other issues. See the attachment, “Important Patient Safety Points from The Doctors Company.” To learn more about the Doctors Company, call (800) 421–2368 or visit thedoctors.com.

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Discover Many New Medicare Rules, Issues and Capabilities, Wednesday, January 27, 2021, from 8:00 to 10:00 a.m.: NYCMS invites you to “Medicare Part B 2021 Update” with James Bavoso, Manager, Provider Outreach & Education at NGS (National Government Services). You can register right now for this virtual session HERE.


Topics will include:


— The COVID–19 Public Health Emergency (PHE)
— Telehealth
— E/M (Evaluation & Management) coding changes in 2021
— The 2021 Medicare Physician Fee Schedule
— Final Policy, Payment, and Quality Provisions Changes to the Fee Schedule for 2021 — CMS’s Quality Payment Program and MIPS
— Contact Information/Resources
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Join Us for Advocacy Hour, Thursday, February 4, 2021, at 7:30 p.m.: We have pivoted our usual winter legislative breakfast and turned it into a virtual hour event with key legislators, co–hosted by The New York County Medical Society, the New York County Psychiatric Society, and the New York Council on Child and Adolescent Psychiatry. It’s going to be:
— Intense – a one-hour “Speed Talk.”
— Interactive – you’ll be able to weigh in before, during and after the lawmakers’ comments.
— Revealing – you’ll get a special look at their personalities and concerns.
Physicians want the legislators to hear our issues — telehealth, liability, scope of practice and more. But we’ll also ask them: What one new law do YOU think we most desperately need? And how can we help you? Save this date! Signup coming soon!


If You Need a Refuge: As a “Thank You” to NYC’s heroes (first responders and medical staff), New York’s beautiful Royalton Hotel is offering special rates starting at just $99 nightly. Whether you need to quarantine, be closer to work or just take a much–needed break with a good book near the fireplace, the Royalton will pamper you. For more information, contact This email address is being protected from spambots. You need JavaScript enabled to view it.; you can also read up on the Royalton New York right here. This offer is based on availability, and is good for hotel stays now through March 31, 2021. The offer must be booked directly on www.royaltonhotel.com; offer does not apply to third–party bookings. Valid identification credentials must be shown at check–in to receive the discount and room upgrade. To read about the offer, go HERE.
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Join the Discussion: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:


— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness
Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.

 

 

December 11, 2020

Provider Relief Fund (PRF) Phase 3 Recipients — Get Ready for Reporting Deadline February 15, 2021: With the end of the 2020 reporting period just ahead and the PRF’s online reporting system scheduled to open on January 15, 2021, the time is now to prepare your calculations for lost revenues and expenses attributable to coronavirus. On October 22, 2020, the U.S. Department of Health and Human Services (HHS) announced that the latest PRF application period had been expanded to include provider applicants that had not yet received PRF distributions, such as residential treatment facilities, chiropractors, eye and vision providers, and certain behavioral health providers. (Read HERE.)

Reporting requirements: Generally, providers must report healthcare–related expenses attributable to COVID–19 that have not or will not be reimbursed by other sources, along with PRF payment amounts (not fully expended on healthcare–related expenses), that will be applied to lost revenues because of COVID–19. Read a good one–page summary HERE. See HERE for reporting requirements guidance.
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Wednesday, December 16, 2020, at 7:30 a.m.: Live CME Webinar, “COVID–19 from a Physician–Patient Perspective,” part of MSSNY’s “Medical Matters” series. To register and learn more, go HERE.
For more information, contact Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..

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Free Offer for Members from Practice Builders: Digital healthcare marketing firm Practice Builders, endorsed by the New York County Medical Society, offer online reputation management, comprehensive web design and development, SEO (search engine optimization), social media patient engagement, and a host of other digital healthcare marketing solutions. As a Society member, you can have a complimentary Website/SEO evaluation (otherwise valued at $200). To access this evaluation, click here and fill in your details. You can also drop a line to Alisa O’Keefe, VP of Sales, This email address is being protected from spambots. You need JavaScript enabled to view it., or call her directly at (800) 679–1200, ext. 2028.
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The Doctors Company Warns Litigation for COVID–Related Claims on the Horizon: The Doctors Company, the only endorsed medical liability insurer for the New York County Medical Society, says that federal and state law provides some immunity, but doctors still need to be prepared just in case any claims are filed – perhaps with such allegations as:

— Delayed or missed diagnosis due to lack of patient follow–up.
— Failure to triage/assess including testing issues, resulting in missed Covid–19 diagnosis/intervention.
— Failure to immunize.
— Delayed care in office visits, testing, labs, and procedures.
— Failure to adhere to infection control protocol, and/or to deal with lack of PPE.
— Limited healthcare resources (hospital beds, ventilators, etc.)

It’s a good idea to start a diary or timeline now, describing how COVID–19 events developed in your practice and community. Points might include: Was your practice ever unable to obtain PPE? What was the infection rate within your community at a given time? Did you follow infection control protocols per CDC (Centers for Disease Control and Prevention) guidelines? The Doctors Company provides a sample checklist of important record–keeping elements HERE, and recommends keeping this in an administrative diary.
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Hats Off: Physician wellness is in the air for members we congratulate this week.

What are the habits, techniques, and philosophies of people who successfully manage their stress, while thriving physically and mentally? Don't Mess with Stress™--A Simple Guide to Managing Stress, Optimizing Health, and Making the World a Better Place, by Jill R. Baron, MD, is available at Amazon. Doctor Baron is chair of the Society’s Physician Wellness Committee and Society treasurer.

Another member of the committee, Steven Mandel, MD, was the recipient of the Ernest L Rothschild Leadership Award presented by the METNY region of the United Synagogue of Conservative Judaism. Doctor Mandel, who is a neurologist and past president of the New York Occupational and Environmental Medical Association, was recognized for his activities promoting health and wellness to the community.
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And Speaking of Physician Wellness, Peer to Peer Help Is Available: MSSNY’s Peer2Peer program is here to help with the stresses of COVID–19 and practice in general. If you want a sympathetic ear, contact the program at (844) P2P–PEER or This email address is being protected from spambots. You need JavaScript enabled to view it., to contact, 24 hours a day, 7 days a week, not for treatment, but casual conversation, to talk it out with someone who's going through the exact same thing.
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Special Offer for Manhattan Physicians Under 50 in Active Practice: MSSNY is offering a special disability plan open to members of the New York County Medical Society under age 50 in active practice. You must apply before January 15, 2021. Regardless of your health, with no physical exam or blood work, you can apply for the policy, which provides $4,500/month ($54,000/year) in Disability Benefits, pays for up to seven years and has a 90–Day Waiting Period. Apply on line at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (800) 333–5440.
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Join the Discussion: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:

— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness

Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.

 

 December 4, 2020

What Do You Need to Know About COVID Vaccines? Initial quantities will be relatively small. (Governor Andrew Cuomo has said New York will receive 170,000 doses of the Pfizer vaccine by December 15). Where will these shipments go? Because of the Pfizer vaccine’s special storage requirements, the initial shipments will be to sites with robust cooling capabilities (minus 94 degrees Fahrenheit), where relatively large numbers of people may be vaccinated at once (e.g., hospitals). Storage of the Moderna vaccine will not be quite as difficult. That vaccine, once thawed, can be kept in normal refrigeration for a month.

What about distribution to physicians’ offices? The city and state health departments are implementing a phased approach to provider enrollment and will notify private practice physicians as each new group is opened for enrollment. MSSNY understands that this will occur for private practicing physicians soon. The best way to prepare is to make sure your New York City practice is registered with the Citywide Immunization Registry (CIR).

What capabilities will be required in physicians’ offices, and how will the New York State Department of Health (DOH) assess those capabilities? We are awaiting information on this question, but we do know that as part of the sign–up process, physicians will be asked to fill out a questionnaire with detailed questions about their practice — gauging their interest in providing the vaccine to patients, and asking questions about practice size, location, storage ability, etc.

How do I sign up to become a vaccine distributer? Step One: You must be registered if you are in New York City in the Citywide Immunization Registry (CIR), or otherwise in the NYS Immunization Information System (NYSIIS). Step Two: You must then enroll in the COVID–19 Vaccine Program. Step Three: You must order the vaccine through CIR if you are in New York City, or otherwise NYSIIS. For details on all three steps, see the Attachment, “Steps to Become a COVID–19 Vaccine Distributor.”

What about coding, billing and fees? The CPT Editorial Panel has approved a unique CPT code for each of two coronavirus vaccines, as well as administration codes unique to each of those vaccines. The new CPT codes clinically distinguish each coronavirus vaccine, in order to aid tracking, reporting and analysis in support of data–driven planning and allocation. These CPT codes are being made available before the vaccines themselves are publicly available, in order to facilitate updating of health care electronic systems across the U.S. (Details are in the attached PDF, “Covidvaccines.”) CMS’s instructions for billing are HERE. Note particularly: When COVID–19 vaccine doses are provided by the government without charge, you should only bill for the vaccine administration. Don’t include the vaccine codes on the claim when the vaccines are free. CMS’s information on fees is HERE. The Society will soon provide information on how the commercial insurers will handle these details.
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MSSNY’s Physician Survey on COVID–19 Vaccine Hesitancy Is Still Open: This survey is being conducted following media reports that patients – and even some healthcare workers themselves(!) — may not participate in getting the vaccine. After questions about patients’ attitudes, obstacles, messaging, etc., the survey gets into some intriguing areas, such as how New York State should go about picking locations for vaccine Points of Distribution. Crowds? Languages? Attitudes? Accessibility? You can help MSSNY, using your local knowledge and expertise, taking this brief salver (if you have not already done so). Please take the survey here.
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Medicare’s 2021 Physician Fee Schedule’s Final Rule Is Released: It’s a mixed bag, but we must fight damaging cuts in payments. The Centers for Medicare/Medicaid Services has now released the 2021 Medicare Physician Fee Schedule Final Rule, which provides long–overdue increases for office visits (E/M services) but also imposes significant cuts in other areas. Physician action is needed right now. MSSNY has set up a grassroots letter for physicians to send to Senators Schumer and Gillibrand, as well as members of Congress, to urge Congress to “waive budget neutrality” and prevent those cuts from going forward. Please click HERE. MSSNY has also been working with the AMA and other state medical societies, urging Congress to stop these steep cuts while letting the positive E/M changes go forward.

Last year, in the 2020 Final Rule, CMS finalized an important policy change when it adopted new CPT guidelines saying that office and outpatient E/M visit levels could be based on either medical decision–making or physician time, and also significantly increased payments for most office and outpatient E/M visits. (See HERE.) However, per the law’s budget–neutrality requirement, significant increases in Medicare physician payment rates had to be offset by across–the–board decreases. So, in this situation, the increased E/M fees had to be balanced by an approximate 5% payment reduction (which affects providers who do not report office visits). Due to other policy changes, that reduction was ultimately doubled to more than 10%. On top of that, another budget–neutrality offset was required (this one, $3 billion), to balance a new “Visit Complexity” code (G2211).

CMS has now finalized these budget–neutrality adjustments, despite the AMA/Federation consensus that CMS ought to waive the budget–neutrality requirements in light of the COVID–19 public health emergency. The adjustment’s severity can be seen in the changes in the conversion factor (a key part of fee calculations): The 2021 physician payment conversion factor is $32.41, a decrease of $3.68 from the 2020 conversion factor, which was $36.09. (That’s a 10.2% decrease.) The 2021 anesthesia conversion factor is $20.04, a decrease of $2.15 from the 2020 conversion factor, which was $22.20.

Organized medicine is urging Congress to avert these cuts. Physicians are experiencing substantial economic hardships due to the COVID–19 public health emergency. Moreover, payments for hospital visits, critical care visits, and home visits are among those being slashed; we are extremely concerned that these cuts may directly affect care to COVID–19 patients.
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What About Other Medicare Final Rule Coding & Billing Details? The G2211 add–on code for visit complexity (to be listed separately in addition to an E/M visit with an established patient) – The definition is, “Visit complexity inherent to E/M associated with primary medical care services that serve as the continuing focal point for all needed health care services.” Note: This code was formerly GPC1X, but was finalized as G2211 effective January 1, 2021. Post–operative visits won’t get the 2021 increases: The 2021 E/M increases will not be applied to post–operative visits in the global surgical payment. Additional COVID needs (CPT 99072) won’t be paid for separately: CPT 99072 remains a bundled service (not a separately paid service), at least, on an interim basis. The AMA did establish this code, to be used for “Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non–facility service(s), when performed during a public health emergency as defined by law, due to respiratory–transmitted infectious disease,” and some physicians hoped that now that the code existed, Medicare would pay separately for COVID–related items such as extra PPE. But as of now, Medicare will not pay separately for these items.
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Telehealth Provisions in the Final Rule: It had been proposed that CMS make certain telemedicine services permanent, and keep certain other policy changes, for all geographic locations after the Public Health Emergency (PHE) ends. But the new Final Rule’s focus is only on improving rural telehealth access. So, barring Congressional action, telehealth services covered now under the federally declared Public Health Emergency (PHE), and those services that have been made permanent, will only apply to rural areas once the PHE has ended. _________________________________________________________________

Changes in MIPS: For MIPS (the Merit–Based Incentive Payment System, part of CMS’s Quality Payment Program), physicians will have to meet certain minimums in 2021 in order to avoid the 2023 penalty, which will be 9%. We’ll report on those minimums soon. We do know now that because of the COVID emergency, CMS has limited certain other MIPS changes. The 2021 threshold for passing is only 60 points (up from 45 points). The weight of the finalized 2021 cost category is 20% (up from 15% in 2020). The weight of the finalized 2021 quality category is 40% (down from 45% in 2020).
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Interested in Learning How to Use Social Media? MSSNY is planning an upcoming Zoom “Social Media in Medicine” presentation, for physician members who are interested in getting involved with social media. If you’d like to participate, please contact This email address is being protected from spambots. You need JavaScript enabled to view it. for more information.
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Physicians and Staff — Go Back to School at Medicare University: At this two–day virtual conference, Tuesday, December 8, and Wednesday, December 9, you can attend as many FREE sessions as you like. NGS (National Government Services) hosts the wonderful assortment of 75–minute sessions, which cover Part A, Part B and FQHC. Each session starts with a thorough presentation, then moves on to Q&A. Learn about “2021 Medicare Changes,” “Top Claim Rejections,” “Preventive Services,” and many other crucial topics. Go to NGS Medicare University 2020 Virtual Conference to find a complete list and schedule of the sessions. Just click on each session you’re interested in, to register for that session.
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MSSNY CME Webinar, “Steps to Physician Wellness and Resiliency,” on Thursday, December 10, 2020, 7:30 to 8:30 a.m.: You can register here for this presentation with Speaker Frank Dowling, MD. Please click here to view the flyer for this program. For additional information or help with registration, contact Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..
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Wednesday, December 16, 2020, at 7:30 a.m.: MSSNY Sponsors Live CME Webinar, “COVID–19 from a Physician–Patient Perspective.” Faculty: Lorraine Giordano, MD and Parag Mehta, MD. Registration link is in the following links and attached flyer: For more information, contact: Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085 https://mssny.zoom.us/webinar/register/WN_vBK_4GE5ToCfJDDJ6mvi2w.
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Special Offer for Manhattan Physicians Under 50 in Active Practice: MSSNY is offering a special disability plan open to members of the New York County Medical Society under age 50 in active practice. You must apply before January 15, 2021. Regardless of your health, with no physical exam or blood work, you can apply for the policy, which provides $4,500/month ($54,000/year) in Disability Benefits, pays for up to seven years and has a 90–Day Waiting Period. Apply on line at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (800) 333–5440.
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Use Your Talents: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:

— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness

Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.

 

November 27, 2020

Information for Private Practice Physicians Regarding COVID–19 Vaccine: If you wish to serve as a distributor of COVID–19 vaccine to patients, you will need to take the following steps. (This information was provided in the November 19, 2020, webinar of the NYS Department of Health.)

Step One: Register for the Immunization Information System

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

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


(Providers located outside of New York City can find out about NYSIIS HERE).

Step 2: Enroll in the COVID–19 Vaccination Program

In addition to registering with NYSIIS or CIR, physicians will need to enroll in the COVID–19 Vaccine Program.

  • The New York State Department of Health (NYSDOH) and the New York City Department of Health and Mental Hygiene (NYC DOHMH) are implementing a phased approach to provider enrollment. They will notify private practice physicians as each new group is opened for enrollment. MSSNY understands that this will occur for private practice physicians beginning next week.
  • Providers in New York City will enroll in the New York City COVID–19 Vaccination Program through the CIR. (Providers in New York State, outside of New York City, will enroll in the NYS COVID–19 Vaccination Program through the Health Commerce System.)
  • Networks with facilities or providers in both New York City and New York State should enroll their facilities or providers outside of New York City in the NYS COVID–19 Vaccination Program through the Health Commerce System, and enroll facilities or providers in New York City in the NYC COVID–19 Vaccination Program through the CIR.

Step 3: Ordering, Receiving and Administering Vaccine

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

We will provide more information as it becomes available.
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Saturday, December 5, 2020, 8:30 a.m. – 11:30 a.m.: Veterans Mental Health Training Conference. Register HERE for the program! This virtual conference, co–hosted by MSSNY, the New York State Psychiatric Association and the New York State Chapter of National Association of Social Workers, has the following educational objectives:

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

The conference includes two panels. Panel 1 (9:15 – 10:10 a.m.) is titled “The Challenges: The Health & Mental Health Issues Facing Veterans & Their Families Amid Pandemic, & Efforts to Address.” Keynote Speaker: Joe Geraci, Lt. Colonel, U.S. Army; LMHC. Panelists: Frank Dowling, MD (MSSNY); Gretchen Foley, MD; and Sharon Bailey, Major, USAF (Ret.), LCSW–R. Invited legislators: Senator Carlucci, Assemblywoman Gunther. This panel will focus on challenges faced by veterans related to the COVID–19 pandemic, including factors that exacerbate mental health and substance use disorder, suicidal ideation, and self-medication trends. The focus of this panel will be to discuss short term impacts that have emerged as a result of COVID–19, as well as longer term effects of global fear, stress, and isolation, including the re–triggering of Post–Traumatic Stress symptoms.


Panel 2 (10:30 – 11:20 a.m.) is titled “What Has Helped: The Successes, Including Veterans Sharing What Has Made a Difference in Transition, & Clinicians Sharing Best Practices for Identification, Treatment & Referral.” .Panelists: Malene Ingram, MD & Colonel, U.S. Army (MSSNY); Marianne Goodman, MD; Mike Shurmatz, U.S. Army (Ret.), LMSW; Ben Pomerance, Esq., Deputy Director for Program Development for NYS Division of Veterans’ Affairs. Invited Legislators: Senator Brooks, Assemblywoman Barrett . This panel will focus on what has been most helpful for veterans who have been struggling during the COVID-19 pandemic. Speakers will discuss what is most effective in terms of improving overall mental health, decreasing anxiety, minimizing substance misuse, and reducing the risk and prevalence of suicide in the veteran community. Speakers will share what practices have been most effective, as well as what areas to focus on for screening, treatment, and best–fit referrals. Click HERE to learn more, or contact This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.
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Physicians and Staff: Go Back to School at Medicare University: At this two–day virtual conference, Tuesday, December 8, and Wednesday, December 9, you can attend as many FREE sessions as you like. NGS (National Government Services) hosts the wonderful assortment of 75–minute sessions, which cover Part A, Part B and FQHC. Each session starts with a thorough presentation, then moves on to Q&A. Learn about “2021 Medicare Changes,” “Top Claim Rejections,” “Preventive Services,” and many other crucial topics. Go to NGS Medicare University 2020 Virtual Conference to find a complete list and schedule of the sessions. Just click on each session you’re interested in, to register for that session.
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MSSNY CME Webinar, “Steps to Physician Wellness and Resiliency,” on Thursday, December 10, 2020, 7:30 to 8:30 a.m. : You can register here for this presentation with Speaker Frank Dowling, MD. Please click here to view the flyer for this program. For additional information or help with registration, contact Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..
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Wednesday, December 16, 2020, at 7:30 a.m.: MSSNY Sponsors Live CME Webinar, “COVID–19 from a Physician–Patient Perspective.” Faculty: Lorraine Giordano, MD and Parag Mehta, MD. Registration link is in the following links and attached flyer: For more information, contact: Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085 https://mssny.zoom.us/webinar/register/WN_vBK_4GE5ToCfJDDJ6mvi2w.

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Special Offer for Manhattan Physicians Under 50 in Active Practice: MSSNY is offering a special disability plan open to members of the New York County Medical Society under age 50 in active practice. You must apply before January 15, 2021. Regardless of your health, with no physical exam or blood work, you can apply for the policy, which provides $4,500/month ($54,000/year) in Disability Benefits, pays for up to seven years and has a 90–Day Waiting Period. Apply on line at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (800) 333–5440.
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Join In: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:

— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness

Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.

 

November 23, 2020

Recreational Marijuana Battle Has Started Again: The New York State Governor’s office has announced that the legalization of recreational use marijuana will again be part of the state’s 2021 budget proposal - and MSSNY is again gearing up to fight it. Says MSSNY: “We are very concerned that the long-term public health costs associated with hospitalizations and treatment for psychiatric/addictive disorders could significantly outweigh any revenues that…states anticipate would be received from the legalization of cannabis… We are in the midst of a world-wide pandemic and we already know that smoking or vaping marijuana can increase patient risk for more severe complications from COVID-19. Additionally, there are concerns about the secondary effects on adults and young people from COVID-19 regarding the increased rates of addiction due to the stress of isolation, boredom, and decreased access to recovery resources… We must proceed cautiously and pay close attention to the public health impacts in states where legalization has occurred.”

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No Patient Cost-Sharing for Telehealth: The NYS Deadline Has Been Extended to January 9. The New York Department of Financial Services (DFS) has announced that it has extended its existing, critically important policy for requiring New York State health insurance plans to cover Telehealth services without patient cost-sharing for another 60 days - to January 9. What about later than that? Says MSSNY: Despite hopeful news about vaccines, “experts anticipate that COVID-19 will remain a public health threat for the foreseeable future, so it is reasonably likely that this expanded Telehealth coverage policy will be extended beyond January.”

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Watch for Other Developments Concerning Telehealth/Telemedicine Policy: The DFS had issued a circular letter earlier this year, requiring insurers not only to waive telehealth cost-sharing, but also to cover audio-only services. The DFS said “telemedicine services” should be deemed to include services provided via basic smartphone and video technologies. Now, the battle is over permanent provisions:

- Permanent Medicare coverage for telemedicine
- Permanent “payment parity” (remote visits vs. in-office visits) - an issue with the commercial insurers
- Permanent, adequate coverage for video services, and for “audio-only” services (Note: Early this summer, Governor Cuomo signed legislation requiring Medicaid coverage for “audio-only” telemedicine)
MSSNY will continue working with outside partners and key lawmakers to further these policy changes.


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Medicare Fees Are in Jeopardy – We Must Keep Pushing Congress! Please send a letter to your Representative, and to Senators Schumer and Gillibrand, by clicking here. And, read more about the problem in a joint letter to Congress, sent by MSSNY and other medical societies. As the letter puts it: CMS’s Proposed Rule for the Medicare Physician Fee Schedule “would increase payments for Evaluation and Management (E/M) codes—increases that are sorely needed, and which we support. However, in doing so, CMS is bound by statute to remain budget neutral—to offset any increases by making corresponding decreases. To meet these requirements, CMS has proposed a drastic, nearly 11% decrease to the conversion factor that determines all Medicare payment rates. These cuts will be harmful to primary care physicians (PCPs) and other medical specialty types. For example, while the positive E/M changes were meant to give PCPs a significant increase, having a conversion factor decrease of 11% means that those benefits are diminished—especially in face of increased cost and decreased reimbursements during the COVID-19 pandemic.” We mustn’t let this happen! Join in the fight by clicking here.

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Physicians and Staff: Go Back to School at Medicare University! At this two-day virtual conference, Tuesday, December 8, and Wednesday, December 9, you can attend as many FREE sessions as you like. NGS (National Government Services) hosts the wonderful assortment of 75-minute sessions, which cover Part A, Part B and FQHC. Each session starts with a thorough presentation, then moves on to Q&A. Learn about “2021 Medicare Changes,” “Top Claim Rejections,” “Preventive Services,” and many other crucial topics. Go to NGS Medicare University 2020 Virtual Conference to find a complete list and schedule of the sessions. Just click on each session you’re interested in, to register for that session.

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MSSNY Is Offering a CME Webinar, “Steps to Physician Wellness and Resiliency,” on Thursday, December 10, 2020, 7:30 to 8:30 a.m. You can register here for this presentation. Speaker Frank Dowling, MD, will address these educational objectives:

Review the warning signs that stress, depression, anxiety, or substance use may impact work or personal life.

Identify strategies to increase personal empowerment toward making positive change, including self-assessment tools.

Recognize self-monitoring strategies for stress-related problems, and know when to seek professional assistance.
Please click here to view the flyer for this program. For additional information or help with registration, contact Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..

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NYCMS Medical Students, Here’s Something Just for You: Kaplan is giving away three chances for their USMLE prep package, at https://kaplanquizzes.com/bts2/signup.php?t=usmle&sba=nycms. If you win, you can give a duplicate of the prizes to someone else, too. (Kaplan calls this their “Thanksvigeaway.”)


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MIPS Milestones: CMS would like to remind you of important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines:


December 31, 2020 – Has the COVID-19 public health emergency made it hard for you to comply with one or more categories for the 2020 MIPS performance year? You can request that a specific category be reweighted to zero. Using the “Extreme and Uncontrollable Circumstances” policy, CMS will allow you to submit an application now. Get it in by December 31, and be sure to cite COVID-19 as the reason for your application. CMS will let you via email whether your request has been approved or denied.

January 4, 2021 – 2020 MIPS performance year data submission window opens.

March 1, 2021 – Deadline for CMS to receive 2020 claims for the Quality performance category. Claims must be received by CMS within 60 days of the end of the performance period. (Check with NGS for more specific instructions.)

March 31, 2021 – 2020 MIPS performance year data submission window closes.

 

November 16, 2020

Are You Interested in Providing COVID –19 Vaccine to Patients When It Becomes Available? MSSNY President Bonnie Litvack, MD, who’s on the Governor’s Vaccine Distribution and Implementation Task Force, states that you will need to be enrolled in the New York State Immunization Information System (NYSIIS). You must first complete a questionnaire for the NYS Department of Health. This questionnaire, which can be found here, will assess your interest in providing the vaccine to patients; ask about practice size, location, storage ability, etc.; and start you on the NYSIIS enrollment process. The questionnaire is for physicians whose patients are adults only. (Physicians who immunize children in New York City must enter the data in the Citywide Immunization Registry, at https://www1.nyc.gov/site/doh/providers/reporting-and-services/citywide-immunization-registry-cir.page.) Note: Physicians who are already enrolled in NYSIIS must also complete the questionnaire. More information about NYSIIS and how to enroll in this system can be found here.

Under New York State’s COVID–19 Vaccination Program plan, the State’s vaccine distribution approach will be based solely on clinical and equitable standards, prioritizing individuals who are at higher risk of exposure, illness and/or poor outcome. It is likely that initial vaccine distributions from the federal government will be for high–risk populations and essential healthcare workers. To assist in this effort, New York State is relying not only on community–based providers, but also on local health departments, long–term care facilities, community health centers, rural health clinics, pharmacies and hospitals.

Concerns have been expressed by the public about the safety and efficacy of the COVID–19 vaccine. The Governor has appointed an array of experts to counsel the State on the vaccine’s safety, and to help craft a positive message to patients.
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Please contact your Senators and member of Congress and ask them to support the Telehealth Modernization Act of 2020 (H.R. 8727/S. 4375) Today! With the 2020 election behind us, the House and Senate will soon return to Washington, D.C., for one final “lame duck” session of the 116th Congress. As our country continues to struggle under the massive strain of the pandemic, this will be the last opportunity to pass crucial COVID–19 relief legislation this year.

During the pandemic, telehealth services emerged as a way in which physicians could provide care to patients, while supporting physical distancing efforts and reducing the spread of COVID–19 and other infectious diseases by limiting unnecessary in–person visits. In response, Congress temporarily expanded all Medicare beneficiaries’ access to Medicare–covered telehealth services, authorizing HHS to waive outdated statutory restrictions on the locations where telehealth services could be provided. Now, the challenge is to make this expanded access to telehealth services permanent. The bipartisan Telehealth Modernization Act of 2020 (H.R. 8727/S. 4375), recently introduced in both the House and Senate, would lift the rural–only restriction and add any site where a patient was located (including his/her home) as a potential originating site. The bill would also permit the use of mobile technologies as appropriate

The evidence is in. The success of telehealth technology adoption during the COVID–19 public health emergency has shown that Medicare–covered telehealth benefits should be available to all Medicare patients, regardless of where they live or how they access broadband services. Expanded telehealth is working for our patients. Let’s fight to keep it that way!
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Tell Congress This Too! Contact Congress and ask them to support the bipartisan “Holding Providers Harmless from Medicare Cuts During COVID–19 Act” (H.R. 8207). As physicians continue to battle the worsening COVID–19 pandemic, the last thing they should have to worry about is cuts to their Medicare payments. Unfortunately, if Congress does not act soon, they may have to. The problem: Because E/M fees are slated to go up, budget neutrality rules require CMS to adjust other fees for a range of specialties. Some fees will go up, some down; but overall, the COVID–19 pandemic’s negative impact on physician practices will be compounded. H.R. 8207, addressing these concerns, would freeze payments at 2020 rates for services scheduled to be cut in 2021 for a period of two years, while allowing the scheduled E/M increases to take place. Overall impact numbers would be improved for all physician specialties. Be sure to contact your member of Congress yourself about this issue, and ask your colleagues to do so too.
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MSSNY intends to oppose abusive “restrictive covenant” provisions. MSSNY Council has approved a resolution whereby: MSSNY will support legislation to prohibit a “restrictive covenant” provision in an employment contract between a health system and a physician (or, a contract between an MSO and a physician), that limits the physician’s ability to deliver care in the same region after he or she leaves the health system or medical practice. New York County Medical Society has championed a similar resolution for several years.
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Monday, November 23, at 7:30 a.m.: Live CME Webinar, “Suicide in Veterans.” Click HERE to view the flyer and register. In this program, which is part of MSSNY’S Veterans Matters series, speaker Jack McIntyre, MD, will focus on the following educational objectives: Address the causes and warning signs of suicide and suicidal behavior among veterans; explore evidence–based diagnostic, intervention and treatment options; and identify barriers to identification and treatment in military culture and methods to overcome them. For more information, contact Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.
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Consider Bringing a Summer Intern into Your Practice Management. To satisfy their MHA degree requirements, students in Cornell University’s graduate Health Administration program are seeking 10–week summer administrative internship spots. Summer interns can help with any administrative projects in your office, and can even fill in for summer coverage of your administrative team members. In addition, they hope for opportunities to observe and participate in the typical process workflow in a medical group. Cathy Bartell, MHA, is the Associate Director of Cornell’s Health Administration program and says, “I managed practices for 15 years and I am happy to collaborate with you on your needs before presenting your internship to our students.” Call her temporary remote phone, (860) 670–6331.
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Your EMR, Billing System And/or Other Technology: Time to Do Your Security Risk Assessment. The federal Office for Civil Rights (OCR) says you should do this checkup on your HIPAA compliance and other security issues (e.g., encryption) at least once a year — in fact, if you want to comply with CMS’s MIPS Promoting Interoperability requirements, you must complete your Assessment by the end of 2020. On HealthIT.gov, the website of the federal Office of the National Coordinator for Health Information Technology (ONC), you’ll find a free, downloadable Security Risk Assessment tool that will make the task a lot easier. It’s an interactive questionnaire that lets you evaluate your practice’s level of HIPAA compliance, and suggests remedies for areas of potential exposure. Click on Security Risk Assessment.
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Practice Fusion Users: Have you been hit with a separate fee for using the AMA CPT code system – and how much is that fee? A MedPage Today article says: “Physicians who use the Practice Fusion electronic medical record (EMR) will have to pay separately for CPT code licensing fees next year — and there has been confusion over the price.”
“CPT codes are owned and managed by the American Medical Association, and licensing fees are typically wrapped up into the cost of the EMR itself, so physicians rarely see them…[But now,] the EMR vendor is passing on the cost to the user for 2021. AMA says the cost to license its CPT codes is $17 per user per year, but some physicians told MedPage Today they were initially asked to pay $300, despite being in solo practice.” (Kristina Fiore, “Some Docs Will Pay Separately to Use CPT Codes Next Year,” MedPage Today, November 10, 2020.)
If you use Practice Fusion and have information to share about your experience, contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it..
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Workers’ Compensation New Requirements: As you get used to using the CMS–1500 form, be aware of this requirement. Effective July 1, 2021, all Workers Comp Board–authorized health care providers need to:

— Register for XML submission HERE with your NPI number. If you fail to do so, your bill may be rejected. The registration process takes time, and the Board recommends that you get started soon. (XML stands for Extensible Markup Language, an industry–standard format. The XML Forms Submission project was created so that data could be submitted to the Board in this format.)

— Sign, notarize and return the XML Submission Agreement to the Workers’ Compensation Board. A separate agreement is required for every treating provider.

— Submit Form CMS–1500 and the medical narrative/attachment electronically, through an approved XML submission partner.

— Attach the Explanation of Benefits, with the insurer’s claim Adjustment Reason Codes (CARCs) HERE to Form HP–1, the Request for Decision on Unpaid Medical Bill(s).

Form CMS–1500 background: As you are aware, the Board is transitioning to using the Form CMS–1500, which will streamline the medical billing process and reduce paperwork requirements. The more straightforward billing process should ensure more timely payments and fewer billing disputes, leading to better and more timely care for injured workers.

Presentation for providers: A September, 2020 recorded presentation for providers HERE answers several of the most frequently asked questions regarding the Board's transition to Form CMS–1500, as well as the Board's implementation of the Expanded Provider Law.

Form CMS–1500 Training Video: The Board has developed a training video to showing how to use the form and the required narrative reports to bill for services to workers’ compensation patients. Go HERE to view.

Resources: You can visit the Board’s website for an overview and more HERE.

Contact: For Form CMS–1500 feedback and questions, email This email address is being protected from spambots. You need JavaScript enabled to view it.. For clinical feedback and questions, email This email address is being protected from spambots. You need JavaScript enabled to view it..
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Be A Part of Organized Medicine’s Discussion: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:

— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness

Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.
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Visit the NYCMS Classifieds and browse — jobs, spaces, professional services. You never know what you’ll find.

 

 

November 6, 2020

Time Frame Eased for Reporting COVID–19 Tests: The Governor's latest Executive Order (November 3, 2020) contains a provision that will allow physicians and other professionals 24 hours to report COVID and flu test results to the New York State Department of Health, rather than three hours as required in the Commissioner's September 21 notice. It’s still not ideal, but it is an improvement, and the Medical Society of the State of New York continues the monitoring of the situation around the State and suggesting that the reporting of positive results is more important than negative results.
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MSSNY Receives Grant to Fight Non–Physicians’ Scope–of–Practice Expansion: MSSNY has received a grant from the AMA’s Scope of Practice Partnership to fight non–physician practitioners’ bids for complete independent practice and promote physician–led team care. The Governor’s Executive Order, issued this past March and continued since then, waived otherwise applicable statutory collaboration and/or supervision requirements. Certain non–physician groups see the Executive Order as a chance to achieve legislation that would permit independent practice, but the American Medical Association (AMA) and state and specialty medical societies believe that team–based care, led by physicians, is best for quality and safety.

Physicians very much value non–physician professionals’ enormous contributions toward patients’ access to needed care. However, it is imperative that existing requirements for physician collaboration and/or oversight be ensured and enhanced. Physician–led teams are the best way to improve patient experience and population health, lower overall costs, and improve professional satisfaction. The AMA grant will help patients and legislators recognize our concerns about legislation that would detour care delivery away from a team–based system.
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PPE Survey Update: Several months ago, MSSNY sent a survey to physicians asking them about challenges in procuring personal protective equipment (PPE). It’s time to provide updated information to policymakers on difficulties on securing PPE as the pandemic continues. Help out by taking this brief survey HERE.

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Thursday, November 12, 2020, at 5:00 p.m.: Zoom Webinar, “The Pandemic, Politics and Policy – A Guide to the Markets,” hosted by Vital Planning Group. Register at https://financialguide.zoom.us/webinar/register/WN_vo0OogcNRjePH-3EHsZClw. Guest speaker Jordan K. Jackson, from J.P. Morgan, and host Alex Tomei, financial planner with Vital, will discuss how the stock market can rise and the economy can grow — even though the pandemic is continuing to affect global economies. Don’t let your political views influence your investment decisions!
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November 14 – 15, 7.5 CME from the New York State Neurological Society’s Annual Virtual Meeting. Topics include Headache Management; Neurological Issues/Complications in Pregnancy; Diversity and Workplace Issues; Neuro–Oncology; Functional Movement Disorders; Concussion/TBI Management; and Neuromuscular Ultrasound. Hear three prominent Neurology Department Chairs talk about the New York City COVID Experience. Learn more HERE.
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Wednesday, November 18, 2020, at 7:30 a.m.: Webinar, “COVID–19: Stories from the Frontline,” with NYCMS’s own Erick Eiting, MD, MPH, MMM. Register here! Dr. Eiting, an emergency department physician at Mt. Sinai Downtown, will share his experiences from the first days of the COVID–19 pandemic. In this presentation, part of MSSNY’s Medical Matters series, the educational objectives will be: Examine the timeline of the COVID–19 pandemic; discuss best practices and need vs. supply for personal protective equipment (PPE); and outline adaptive measures taken to remedy shortfalls in staffing and equipment. Doctor Eiting is vice–chair of MSSNY Committee to Eliminate Healthcare Disparities and a member of the Emergency Preparedness and Disaster/Terrorism Response Committee. To view the flyer for this program, please click here. For additional information or assistance with registration, email Melissa Hoffman at This email address is being protected from spambots. You need JavaScript enabled to view it..
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Wednesday, November 18, 2020, at 6:00 p.m.: Live Webinar – “Vaccines: What You Need to Know.” Register here ! Join the Nassau County Medical Society for this live webinar with Bruce Farber, MD, Chief of Infectious Diseases at Long Island Jewish Medical Center and North Shore University Hospital. Dr. Farber will provide an update on current vaccines and what to expect in the near future.
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Workers’ Comp: New Medical Guidelines Go into Effect January 1, 2021. You can get training now with free CME. To register for the training courses and receive CME accreditation, go HERE. Each training provides an overview of the General Guideline Principles, conditions associated with the body part or disease, and treatment recommendations. The conditions: Elbow injuries; foot and ankle injuries; hip and groin injuries; hand, wrist and forearm injuries (including carpal tunnel syndrome); occupational interstitial lung disease; occupational/work–related asthma; post–traumatic stress disorder; and major depressive disorder. For more information, please visit the Board's website or call (877) 632–4996. You can also email This email address is being protected from spambots. You need JavaScript enabled to view it..
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Can You Do Telemedicine in Workers’ Comp? Yes, the Workers’ Compensation Board has adopted emergency amendments to allow telemedicine in some additional circumstances, due to the outbreak of COVID–19.
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FBI Warning on Imminent Cybercrime Threat to Hospitals, Physician Practices: The Federal Bureau of Investigation (FBI) and two federal agencies are warning of an “imminent cybercrime threat” to US hospitals and health care providers, noting that several hospitals across the country have already been hit. In a joint advisory, the Cybersecurity and Infrastructure Security Agency (CISA), FBI and the U.S. Department of Health and Human Services (HHS) said they have “credible information” that cybercriminals are taking new aim at health care providers and public health agencies as the COVID–19 pandemic reaches new heights. “Malicious cyber actors” may soon be planning to “infect systems with Ryuk ransomware for financial gain,” on a scale not yet seen across the American healthcare system. Hospitals, physician practices, and public health organizations should take “timely and reasonable precautions to protect their networks from these threats.” The agencies recommend several mitigation steps and best practices for health care entities to reduce their risk, including the following:

— Be sure to patch operating systems, software, and firmware as soon as manufacturers release updates.
— Regularly change passwords to network systems and accounts; avoid reusing passwords for different accounts.
— Use multi–factor authentication where possible.
— Disallow the use of personal email accounts.
— Set antivirus and anti–malware solutions to update automatically; conduct regular scans.

The AMA and the American Hospital Association (AHA) have created two resources to help physicians and hospitals guard against cyber threats. Those resources and additional cybersecurity information can be found at the AMA’s cybersecurity webpage.
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Medical Societies Raise the Alarm on Legalizing Recreational Marijuana: Once again, the medical societies of Delaware, New Jersey, New York, Ohio, and Pennsylvania have joined to express mutually concerns about state governments’ efforts to legalize marijuana for recreational use. They have issued this statement: “Legalization continues to present serious public health concerns…it continues to be considered across many states…New Jersey voters will consider legalization of cannabis through a ballot referendum on Election Day, and the New York State Governor’s office has announced that the legalization of recreational use marijuana will be again be part of the state’s 2021 budget proposal.


We appreciate the enormous challenges state policymakers face to address burgeoning budget deficits, but we strongly believe that further detailed research must be undertaken and assessed regarding the effects legalization of cannabis will have on important public health markers, such as emergency department visits and hospitalizations, impaired driving arrests, and the prevalence of psychiatric and addiction disorders. We are very concerned that the long-term public health costs associated with hospitalizations and treatment for psychiatric/addictive disorders could significantly outweigh any revenues that these states anticipate would be received from the legalization of cannabis…”
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Add to the Discussion: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:

— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness

Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.
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Visit the NYCMS Classifieds and browse — jobs, spaces, professional services. You never know what you’ll find.

 

October 30, 2020

The “Info Blocking” Deadline Postponed to April: The ONC (Office of the National Coordinator for Health Information Technology) now states that providers won’t be required to come into compliance with the 21st Century CURES Act’s information–blocking provisions until April 2021. (Certain requirements for technology developers have been delayed until then as well.) ONC Chief Doctor Don Rucker says “We are hearing that while there is strong support for advancing patient access and clinician coordination . . . stakeholders also must manage the needs being experienced during the current pandemic. To be clear, ONC is not removing the requirements advancing patient access to their health information that are outlined in the CURES Act. Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on COVID–19 response.”

The CURES Act aims at better interoperability and better patient access to records, and sets new technical standards regarding software design, workflow, secure sharing of medical information and other issues. Hospitals, tech companies and others, already under tremendous strain from COVID, had said that compliance by the previous date of November 2, 2020, might be impossible, and the postponement is good news. Nevertheless, you may still want to find out about the requirements you’ll eventually have to meet, and the AMA has created a two–part educational resource that will help. For background, click on Part 1: What is Information Blocking. For steps to take, click on Part 2: How do I comply with Information Blocking and where do I start?. For more details, see the AMA’s summary of the information blocking rules HERE.

The AMA notes the following:

  • “Physicians may implicate the info blocking rule if they knowingly take actions that interfere with exchange, access and use of EHI [electronic health information], even if no harm materializes. A physician organization, for instance, may have a policy that restricts access to patient lab results for a certain amount of time. Even if patients are not aware there is a delay between when the results are available to the physician and when they are made available to the patient, a practice that is merely ‘likely’ to interfere with the access, use, or exchange of EHI could be considered info blocking . . . High–risk info blocking actions include interfering with patients who seek to access their own EHI, providers who seek EHI for treatment or quality improvement, payers who seek EHI to confirm a clinical value; or patient safety and public health.”

 

  • “Examples of potential violations include:

— Formal restrictions: Provider or office policy requires staff to obtain a patient’s written consent before sharing any EHI with unaffiliated providers for treatment purposes.

— Technical limitations: A physician disables the use of an EHR capability that would enable staff to share EHI with users at other systems.

— Isolated interferences: A physician has the capability to provide same-day EHI access in a format requested by an unaffiliated provider—or by the patient—but takes several days to respond.”
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New CPT Code Not Valid Under Medicare: If you have heard of the new CPT Code 99072 for extra expenses that are COVID–related (e.g., PPE), please be aware that this code is NOT payable under Medicare. The Centers for Medicare/Medicaid Services (CMS) has announced that CPT Code 99072, which addresses personal protective equipment (PPE), is a bundled service and will not be payable by Medicare. You are not permitted to bill the beneficiary separately for the PPE services provided, nor should you issue an ABN.
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Scam Alert: The Medical Society of the State of New York warns of e–mail spoofing from MSSNY.org addresses: Some MSSNY members may have received an e–mail “spoof” in the last day or two requesting donations to a GoFundMe page. Please be aware that MSSNY does not send GoFundMe pages. This is a scam, and the e–mail should be immediately deleted.

The most common method for spammers and scammers to get your attention is now e–mail impersonation [“spoofing”]. It is a low–tech approach that is easy to implement and takes advantage of the fact that many users check e–mail primarily on a mobile device. The senders forge the name of the e–mail address they are using, substituting a name [that is familiar] to the sender.

Because mobile e–mail clients are constrained by the size of the screen of the device, they will omit the e–mail address and just show the name of the sender. Depending on the operating system of the phone in question, there are various methods to display the sender’s e–mail address. Most of them just require you to tap on the sender’s name and you will see more info about the sender. Once you do that, it’s easy to tell that this is not genuine, especially if you are familiar with the alleged sender. The second type of name spoofing is to use the actual e–mail address of the sender to further add legitimacy. These attacks are more uncommon because they are narrower in focus and targeted against a single person. Security professionals call this “spear phishing.”

Methods of protection against becoming a victim: Most spam and scam e–mails fail the simple test of, “Why is so and so sending me this?” Ask that question. If you are still unsure, contact the suspect sender directly. Do not hit “reply” on the suspicious e–mail. Most of these emails imply some sort of exigent circumstance. Don’t be in a hurry to respond.

Do your due diligence and examine the e–mail. Once you click on the sender’s name and see that it is overwhelmingly suspicious, the scam is almost over.
Always be generally suspicious of anything sent in an e–mail. MSSNY, your credit card company, the local police, the FBI, your bank, etc., will never contact you via e–mail about an emergency and will never request restitution or resolution in the form of an iTunes gift card.
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Time to Vote — Here Are Helpful MSSNY Tools: With early voting already in progress
in New York State, please check out the bi-partisan list of 24 members of the New
York State Assembly, New York State Senate and New York Congressional delegation
who received the endorsement of MSSNYPAC for re–election. Each has
demonstrated themselves to be champions of issues to preserve the ability of
patients to continue to receive needed and timely physician care.

Consider joining MSSNYPAC by going HERE. You’ll receive a copy of
MSSNY’s “Legislator Scorecard,” which provides physicians with the voting
and co–sponsorship records of state legislators on 10 key bills that were strongly
supported or strongly opposed by MSSNY. To request your copy, contact
This email address is being protected from spambots. You need JavaScript enabled to view it.

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Three–Hour Testing Requirement Won’t Work: MSSNY and state specialty societies continue to urge the New York State Health Department and the Governor’s office to provide flexibility for reporting results of COVID–19 and Influenza tests performed in physicians’ offices. A survey by these societies found that many physicians will be unable to provide these critically needed tests because of the regulation. Without sufficient time to report results, physicians fear being unable to comply and then facing significant penalties for failure to do so.
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New Tool for UHC Preauthorizations: Although no one likes dealing with commercial insurers’ prior authorization rules, United Healthcare (UHC) is making the job a little easier with its Prior Authorization and Notification tool, so you’ll be able to check by procedure code to see if a prior authorization is required. You can check up to five CPT/HCPCS codes at a time, and you can also include a diagnosis code if you wish.
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Tuesday, November 3, 2020, at 7:30 a.m.: CME Webinar, “TBI in Returning Veterans,” hosted by MSSNY and Nassau County Medical Society. Click HERE to view the flyer and register for the program! You can also learn more by contacting Jangmu Sherpa at This email address is being protected from spambots. You need JavaScript enabled to view it. or call (518) 465–8085.
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Wednesday, November 4, 2020, 10:00 –11:00 a.m. (alternate date Wednesday, November 18): Free Webinar, “2021 Update on NYS’s Paid Family Leave Requirements.” Click here to REGISTER New York’s landmark Paid Family Leave system provides employees with job–protected, paid time off from work, to bond with a new child, care for a seriously ill family member, or help when a spouse, domestic partner, child or parent is deployed abroad on active military service; and to use if the employee, or minor dependent child, is subject to a mandatory or precautionary order of quarantine or isolation due to COVID–19. This one–hour, online session discusses the Paid Family Leave benefit, including important information regarding COVID–19, updates for 2021, and resources to help you share information with your employees. The webinar is provided by the NYS Workers’ Compensation Board. You can find complete details at PaidFamilyLeave.ny.gov, and the Employer Page also contains helpful resources.
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What About New York State’s NEW Paid Sick Leave Law: Need to know more about New York State’s new paid sick leave law, which became effective September 30? Here is more information you need from the New York State Department of Labor: https://www.ny.gov/new-york-paid-sick-leave/new-york-paid-sick-leave#eligibility. If you have questions about hiring — new rules, workplace changes, or how to get the right staff for your office — Ivy Kramer at Winston Resources, NYCMS’s endorsed healthcare personnel company, can help. need. Send an email and to Ivy and let her know you are a Society member at This email address is being protected from spambots. You need JavaScript enabled to view it..
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Be A Part of It: One of the great benefits of membership in the New York County Medical Society is the opportunity to participate in committees (virtually right now). With a wide range of topics, NYCMS’s committee structure encourages members to gravitate toward areas they are particularly interested in. Members can meet colleagues, share ideas, hear expert presentations and find ways to help the whole physician community (and help patients). Groups meeting by Zoom include:

— CME
— Diversity, Equality, Inclusiveness
— Employed Physicians
— Government Affairs
— Public Health
— Public Relations
— Social Media
— Wellness

Our NYCMS Committees bring our members together and provide a forum for all perspectives. Contact Susan Tucker at This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us what sounds right for you.

 

 

 

 

 

Members