From the Front

The following are remarks from President Scot B. Glasberg, MD at the Society’s 2017 Annual Meeting.p

First of all, let me thank each and every one of you for the privilege and honor to serve as the 179th president of the New York County Medical Society. It goes without saying that the lineage of this Society is founded in greatness and honor as physicians.

As I think about the current healthcare landscape, I can’t help but empathize with members and nonmembers alike who feel beaten up by the current conditions.  Given the situation in Albany just yesterday as date of discovery legislation passed, I spent some time revising these remarks.  

This dire loss on a revised “Laverne’s Law” for physicians in this State requires some reflection and analysis.  We need to ask ourselves how did this happen, was it avoidable and are there things that we could have done differently. My personal view is that the answer is a resounding “Yes!”  As I sat with Assembly Health Committee Chair Dick Gottfried at our Annual Breakfast in June, I heard him say in passing that we constantly set up meetings with a laundry list of issues without offering any real solutions.  Today I stand before you to say that it is time to start offering solutions to the legislature for our members.  We need to stop being the body of just resistance and “No” and become a body that thinks “out of the box” and is willing to negotiate even with those we are not comfortable sitting with.  What would be the downside of meeting with the trial bar?

In the past, I have been involved with negotiations federally where people laughed at the thought of sitting down with the other side, only to see a tremendously positive outcome once we did.  We need advocacy “wins,”  not just blocks of bad legislation for our members, and this tactic is the only way to do that.  We need to isolate on specific issues, perhaps two or three, and focus on getting wins for our members.  We desperately need a new direction for our advocacy efforts and hopefully this poor performance will serve as a turning point that we can highlight to our members and nonmembers as well in an attempt to increase membership.

I would like to see us at the New York County Medical Society to consider this the “Year of the Member.”  Through our membership benefits committee, we have already started to find more ways to offer value to our members both young and more seasoned.  Our membership numbers are falling consistent with MSSNY’s, so we need to find a way to address this drastic issue. One way is to attempt to find new sources of non–dues revenue, while the other is to continually show our members the value in their membership. These efforts will take action and work, so with that in mind, I plan to start a membership task force with a persity of members to get to work on this issue over the summer.  I spent a morning the other day emailing members who had yet to renew only to learn that there are so many things that we can do to improve the process. Better communications, showing better value, making it easier for members to renew online are just a few. I actually heard one member tell me that she didn’t think that we even cared about her renewal.

On a governance side, much of the county’s structure is a bit antiquated so the County Bylaws Committee will be meeting to try to reinvigorate our structure and function.  We need to refresh and strengthen our governance structure in a way that engages young leaders and keeps them involved throughout their careers.  We need to restructure our committees so that leaders get exposure to a wide variety of different facets and elements of the society.

In July, our central office moves to a new location yielding significant savings for the Society.  This should be looked at as another opportunity and a turning point for our society.  As leaders, we need to look at the most cost–efficient manner to run our society while at the same time yielding the most for our investments for our members.

To come full circle, I believe that the number one service that we provide for our members is our advocacy efforts.  Whether it be at a legislative or regulatory level, our leadership needs to be keenly aware that this is what our members want to see us engaged in.  This includes issues such as liability reform, attempts to obtain the right to collectively negotiate, insurance reform and a host of others.  My goal is to hopefully lay out a plan that is different to our leadership as well as at the First District Branch and at MSSNY that can hopefully change the current dynamics and, if implemented, be able to gain substantive wins for the physicians of the county and the state.  If this past legislative session  has taught us anything, it is that our current tactics and approaches are not working and that we need to redirect our efforts towards new and meaningful strategies that can yield real and palpable results for our membership.

Thank you again for the privilege and honor to serve as your president during this coming year. I look forward to working with each and every one of you to yield a productive year for our members.

From the Board Room

At its meetings on September 11,  and October 16, 2017,  the Board of Directors of the Society did the following:

• reviewed and passed Bylaws amendments to be submitted to the membership at the 2018 Annual Meeting;  

• endorsed the candidacy of Stuart Gitlow,  MD, for the Board of Trustees of the American Medical Association;  

• discussed membership initiatives and benefits, including issues of importance for young doctors and employed physicians and solo practitioners; and

• reviewed the difference between single payer and universal health care coverage and provided input for the upcoming meeting of the MSSNY Legislative and Physician Advocacy Committee.

The next meeting  of the Board is November 22, 2017.

How to Diagnose and Treat Your Online Reviews

The Society’s relationship with Practice Builders bring you access to a great white paper  on “What to Do about Online Reviews.”  Your practice cannot afford to ignore these problematic issues that affect your reputation and how new AND old patients see you.

Don’t forget that how you react to positive reviews can matter as much to the growth of your practice as your reaction to the negative ones.

However, you feel about social media and reviewing sites, according to Practice Builders, “These reviews are quickly becoming the major factor affecting the decision–making process of any patient who visits your practice.”

Learn some steps to take yourself, and check out the article at Diagonse

If you want a review of your website or some advice as to how to use reviews to grow your practice, call Practice Builders at (800) 679–1200, ext. 2028


NY County Medical Society Presents Romayne Award 

At its Annual Meeting on June 22, 2017, New York County Medical Society President Michael  Goldstein, MD, JD, presented  Eugene E. Weise, MD with the  Nicholas Romayne, MD Lifetime Achievement Award,  named for the Society's first president, and recognizing exceptional contribution to the Society.  Doctor Weise, served as president in 2009, and as a fierce critic of the medical liability situation in New York State, much of his attention during his years of leadership was focused on innovative ways to level the playing field for doctors when it came to medical liability.

Doctor Weise is a fellow of the American College of Surgeons, as well as a Fellow of the Royal Society of Medicine in England. He is board certified in ophthalmology, and a graduate of the New York University School of Medicine.  He is affiliated with Manhattan Eye, Ear and Throat Hospital, and New York Eye and Ear Infirmary. He  is a long–time member of the American Academy of Ophthalmology, the New York Society for Clinical Ophthalmology, and the New York Academy of Medicine.   

It was said of Doctor Romayne, who in addition to serving as the Society’s first president was also a founder of the New York College of Physicians and Surgeons, that   “He was unwearied in  toil and of mighty energy, dexterous in legislative bodies, and at one period of his career was vested with almost all the honors the medical profession can bestow.”
In recognition of the caliber of physician this award recognizes, the New York County Medical Society was honored to make Eugene E. Weise, MD, the 2017 Romayne recipient.

The Use of Unlicensed Medical Assistants in the Physician’s Office: Reminder from MLMIC

This article from the Fall 2017 Dateline  is by  Donnaline Richman, Esq., Fager Amsler Keller & Schoppmann, LLP, Counsel to Medical Liability Mutual Insurance Company.  For other Dateline 2017 articles on Social Media: Responding to Unflattering Online Reviews;

The Proper Use of Patient Portals; and a Case Study involving Dermatologist Sued for Employee’s Negligent Laser Treatment, go to MLMIC’s Fall Dateline 2017 at https://www.mlmic.com/wp-content/uploads/2014/04/DatelineFall17.pdf 

A significant number of physicians inappropriately use medical assistants or other unlicensed staff to assist intreating their patients in clinical settingsand private offices and are unaware ofthe dangers of doing so. Although medical assistants can be a valuable part of a physician’s staff, they must only be given appropriate responsibilities and tasks that do not require a license.

It is often presumed that “certified medical assistants” can perform any tasks that they may have learned as part of their medical assistant training or that their physician employer has trained them to perform. However, licensure and certification are not interchangeable. Medical assistants are usually certified by a national organization such as the American Association of Medical Assistants and are not recognized as licensed professionals by the New York State Department of Education. Therefore, they may not perform tasks or duties which are reserved only for licensed medical or nursing professionals.

The New York State Board for Medicine, which governs the practice of physicians, physician assistants, and specialist assistants, has clarified the functions that unlicensed personnel may perform. The Board has provided a sample list of tasks that physicians are permitted by law to delegate to such inpiduals. These tasks include, but are not limited to:

• escorting patients to examination rooms and acting as chaperones in the examination room;¹
• performing clerical tasks, such as assembling charts, assisting with billing, and
• obtaining and maintaining supplies;²
• performing receptionist tasks, such as answering telephones, scheduling appointments (with written guidelines for how soon different types of patients should be seen in the office); and scheduling ordered tests;
• transmitting a prescription for a medication other than a controlled substance to a pharmacy, if  all of the required information is on the prescription (A nonlicensed inpidual may complete information on an electronic prescription); and the prescribing practitioner has carefully reviewed the information prior to signing the prescription;³
• performing health–related tasks;
• measuring vital signs and/or weight (if appropriately trained) and recording them in the patient’s medical record^;4
• performing an EKG, if trained to do so, but not interpreting it;⁵
• collecting laboratory specimens;⁶
• performing phlebotomy, if appropriately trained^;7
• acting as a “second set of hands” under the direct personal supervision of a licensed professional; (For example, medical assistants may maintain a patient’s body part in the position that the practitioner, not the medical assistant, has established while a bandage is applied or sutures are removed);⁸
• entering information for the physician into the computer, which must be reviewed and signed by the physician prior to the completion of the entry;⁹
• using a glucometer;¹⁰ 
• caring for external catheters only;¹¹
• preparing and handing instruments to a practitioner during an office procedure;¹²
• assisting with the placement of braces and prostheses;¹³  and
• removing sutures, “but only when the medical assistant has been trained in the procedure, only when ordered by a physician or other appropriately licensed person, and only under the direct suture–by–suture visual supervision of a physician or other appropriately licensed person.”¹⁴

The above are acceptable tasks for medical assistants only if they have undergone the necessary training and the practitioner has deemed them able to safely and competently perform these tasks. Evidence of competency should be documented in the medical assistant’s personnel file. Additionally, practitioners should periodically reevaluate the skills of a medical assistant, particularly if problems, such as consistently abnormal vital signs, are noted. Finally, licensed emergency medical technicians acting in a hospital, clinic, or private office setting are also restricted to only those tasks deemed acceptable for delegation to medical assistants.¹⁵

The Board for Medicine has also provided a list of tasks that unlicensed personnel or medical assistants may not perform, regardless of training. This list includes, but is not limited to:

• engaging in any activity that could be construed as diagnosis or treatment of a patient, including assessment, evaluation, counseling, giving medical advice or problem solving (such a  activities are considered to be the practice of medicine and/or nursing);¹⁶
• performing telephone triage;¹⁷
• applying or removing casts, or applying sutures (a medical assistant may remove sutures if all of the previously mentioned conditions apply);
• administering or “drawing up” any type of medication, including immunizations, injections, eye drops, allergy shots, and/or nebulizer treatments;¹⁸
• administering oxygen or blood;¹⁹
• performing sterile or invasive procedures or techniques, including urinary catheter insertion;²⁰
• performing any type of respiratory care, including tracheostomy care;²¹
• initiating or documenting prescription refills^;22
• updating a patient’s medication list;²³ and
• initiating or documenting laboratory tests and radiology studies ordered by a physician.²⁴

A common misconception continues to exist that if a physician trains a competent unlicensed person to perform an act or task which is reserved for licensed personnel, the physician may then delegate that task to the unlicensed inpidual. However, this is not true, despite the unlicensed inpidual acting under the direct supervision of the physician.²⁵

Physicians need to be aware that State law defines professional misconduct in two ways that pertain to the use of medical assistants. First, it is professional misconduct to “permit, aid or abet an unlicensed person to perform activities requiring a license.”²⁶  Second, it is professional misconduct if a physician delegates“professional responsibilities to a person” when they “know or has reason to know that such person is not qualified, by training, by experience, or by licensure, to perform them.”²⁷ Therefore, any physician who inappropriately delegates any task or procedure to an unlicensed person risks an investigation by the Office of Professional Medical Conduct (OPMC) and potential charges of professional misconduct, up to and including revocation of the physician’s license. OPMC Counsel has indicated that OPMC investigations are often commenced when a patient is injured due to the inappropriate delegation of tasks to unlicensed inpiduals. 

Improper delegation of duties to medical assistants may also result in malpractice claims or lawsuits by patients. MLMIC has seen an increase in such litigation. 

Finally, medical assistants who perform inappropriately delegated tasks may face allegations of practicing medicine or nursing without a license, and may be charged with a Class E felony.²⁸ The Department of Health may choose to investigate and penalize the physician employer based upon such allegations, and criminal proceedings could potentially be commenced for aiding and abetting medical assistants to “practice medicine without a license.²⁹

In summary, it is in the best interests of both physicians and medical assistants to function solely within the confines of state law and the guidance provided by the New York State Boards for Medicine and Nursing to avoid allegations of professional misconduct, medical malpractice, or even criminal acts against the physicians and the potential consequences to licensure and professional medical liability insurance coverage.

Risk Management Recommendations

• Physicians and other licensed professionals must comply fully with New York State laws governing the delegation of tasks to medical assistants.
• Medical assistants must wear badges identifying themselves by both name and the title “medical assistant.”
• Medical assistants must be allowed access to only those portions of patients’ medical records that are necessary to perform their job function.
• Medical assistants must never be permitted to perform any task that is considered the practice of medicine or nursing, particularly administering or “drawing up” any type of medication or injection.³⁰
• Medical assistants must be strictly limited to performing those tasks deemed acceptable by the New York State Boards of Medicine and Nursing. Further, tasks that are limited to licensed cosmetologists and estheticians must also not be inappropriately delegated to medical assistants.
• Non–licensed inpiduals may complete information on electronic prescriptions. However, all providers must understand that they have assumed a serious risk by allowing non–licensed inpiduals to do so and must carefully review all input prior to signing the prescription and sending it electronically. Providers are ultimately responsible and liable for any and all errors made by medical assistants.³¹
• Physicians’ offices must have a written policy regarding prescriptions and communication with pharmacies, and all staff must know, understand and comply with that policy. When pharmacists question the dosage of a drug written on a prescription, only the licensed provider who prescribed the drug may adjust the dosage. Pharmacists must speak directly with licensed prescribers to avoid errors in communication. 

Several factors should be considered when deciding whether to assign activities to a medical assistant, including:

• Potential for Harm: Is the patient at risk of harm if an unlicensed person performs a particular task or procedure he or she is legally permitted to perform? As the risk of harm increases, a registered nurse should perform the task. The risk of harm for a particular task or procedure may vary from patient to patient.
• Complexity of the Task: What skills are required to perform a particular activity? As the level of skills required grows more complex, a registered nurse should perform the task.
• Problem Solving and Innovation: Activities that require assessment and judgment or special adaptation, an innovative approach for certain patients or evaluation of the outcome, must be performed by a registered professional nurse. 
• Unpredictability of the Outcome: If the patient’s response to an activity is predictable, a medical assistant may be able to perform the activity. If the outcome is unpredictable, or unknown, it should only be performed by licensed personnel.³² 

1Memorandum from Walter Ramos, R.N., J.D., Executive Secretary to the New York State Board of Medicine to Interested Parties (April 2010, modified October 2014). (On file with author).
2Id.
3Letter from Peter D. VanBuren, Deputy Counsel to Bureau of Professional Medical Conduct, to Frances A.
Ciardullo, Esq., (September 7, 2007). (On file with author).
4 E–mail Opinion, State Board for Nursing, December 2014. (On file with author).
5E–mail Opinion from State Board for Nursing, June 2016. (On file with author).
6Memorandum from Walter Ramos, R.N., J.D., Executive Secretary to the New York State Board of Medicine
to Interested Parties (April 2010, modified October 2014). (On file with author).
7Id.
8Id.
9E–mail Opinion Carla Wells, State Board for Medicine, June 2016. (On file with author).
10Guidelines Regarding Utilization of Licensed Nurses (RNs and LPNs) and Unlicensed Assistive Personnel (UAP) in the Delivery of Nursing Care, NYSNA/NYONE, August 2007. (On file with author).
11Id.
12Summary of Tasks Requiring Licensure in the Operating Room, New York State Department of Education, Office of the Professions, August, 2013. (On file with author).
13Guidelines Regarding Utilization of Licensed Nurses (RNs and LPNs) and Unlicensed Assistive Personnel (UAP) in the Delivery of Nursing Care, NYSNA/NYONE, August 2007. (On file with author).
14Memorandum from the Executive Secretary of the State Board for Medicine to Interested Parties, April 2010, modified October 2014. (On file with author).
15 Public Health Law §§ 3001 (1), (5), and (6), Telephone Interview with the New York State Department of
Health Bureau of Emergency Medical Services, November 2010. (On file with author).
16Education Law §§ 6521, 6522, 6902.
17 Memorandum from the Executive Secretary of the State Board for Medicine to Interested Parties, April
2010, modified October 2014. (On file with author).
18Id.
19 Guidelines Regarding Utilization of Licensed Nurses (RNs and LPNs) and Unlicensed Assistive Personnel (UAP) in the Delivery of Nursing Care, NYSNA/NYONE, August 2007. (On file with author).
20 Id.
21 Email opinion, NYS Board for Nursing, June 2, 2016. (On file with author).
22Email opinion, NYS Board for Nursing, December 16, 2014. (On file with author).
23Id.
24Id.
25Memorandum from Walter Ramos, Executive Secretary to the State Board for Medicine to Interested Parties, April
2010. (On file with author).
26Education Law § 6530 (11).
27 Education Law § 6530 (25).
28 Education Law § 6512 (1).
29 Education Law § 6514.
30Education Law § 6522. The practice of medicine is limited to those inpiduals licensed under Education Law Article 131. Education Law § 6903, No person shall use the title “nurse” unless the person is licensed or otherwise authorized under this article. Memorandum from Barbara Zittel, RN, PhD., Executive Secretary to the New York State Board for Nursing, (2001) (On file with author).
31 Letter from Peter D. VanBuren, Deputy Counsel to Bureau of Professional Medical Conduct, to Frances A.
Ciardullo, Esq., (September 7, 2007).
32 Guidelines Regarding Utilization of Licensed Nurses (RNs and LPNs) and Unlicensed Assistive Personnel (UAP) in the Delivery of Nursing Care, NYSNA/NYONE, August 2007. (On file with author).

Don’t Make These Common Tax Planning Mistakes: Especially for Physicians 

Please join Vital Planning Group for the last financial planning workshop of the year, “The Most Common Tax Planning Mistakes Physicians Make.”  Vital has intentionally positioned this workshop well before April, 2018 so that you have time to proactively begin implementing strategies both before 2017 filing and for 2018. Guest speakers Harvey Susnick, CPA and  Steven Kenney are familiar with the challenges and opportunities physicians are faced with today.  Don’t miss it!   Join us on  Tuesday, November 14, 2017, 6:00 p.m. to 8:00 p.m., 277 Park Avenue, 44th Floor, Conference Room A103, New York, NY 10166 (between 47th and 48th Streets).  Light food and  beverages provided.  No charge but advanced registration required.  Register by email: This email address is being protected from spambots. You need JavaScript enabled to view it. or  call Lisa Joseph at  (212) 684–4698.

McNally’s Corner

The following is courtesy of James McNally, the Society’s  Third–Party Insurance Help  Program. If you have questions, call the Society at (212) 684–4681.

•    Emblem Health Issuing Letters Regarding Non–Renewal of Contracts Effective the End of December 2017:   Emblem Health is, again, sending out letters to some of the membership telling them that their contracts will not be renewed effective December 2017. This issue has been in play for several years and, with this latest foray, Emblem now seem intent on “narrowing” its networks to an even greater degree.   If you have received a letter from Emblem Health informing you that your contract with them will not be renewed, contact the Society  through the Third–Party Insurance Help Program.   The Society can provide you with information on how to respond to this onerous development.  You can send a letter to your State Legislator in support of legislation to require due process for non–renewal situations.

Click on the link here.

https://cqrcengage.com/mssny/app/onestep-write-a-letter?3&engagementId=340313

•    Aetna Issues Guidance on How to Access Your Fee Schedule: In accordance with the regulations issued pursuant to the Claims Settlement Practices and Dispute Mechanism Act of 2000 (CA AB1455 for HMO) and to the expansion of the Health Care Providers Bill of Rights (under CA SB 634 for indemnity and PPO products), Aetna is providing you with information about how to access your fee schedule.

— If you’re affiliated with an Independent Practice Association (IPA), contact your IPA for a copy of your fee schedule.

— If you’re directly contracted with Aetna, you can call their Provider Service Center for help with up to ten current procedure terminology (CPT) codes. For requests of eleven or more codes, you can enter the codes on an Excel spreadsheet (include tax ID, contact telephone number, CPT and modifier) and email them to Aetna at This email address is being protected from spambots. You need JavaScript enabled to view it..

— If your hospital is reimbursed through Medicare Groupers, visit the Medicare website for your fee schedule information.

•    New Medicare Cards with New Numbers: Three  Changes You May Need to Make: The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. CMS will begin mailing new Medicare cards with a new Medicare number (currently called the Medicare Claim Number on cards) to your patients in April 2018. 

To view Talking Points that you should use in speaking with your patients about this new initiative, click on the link here.

Patient Talking Points

https://www.cms.gov/Medicare/New-Medicare-Card/New-Medicare-Card-Messaging-Guidelines-July-2017.pdf

The Centers for Medicaid/Medicare Services (CMS)  has assigned all people with Medicare benefits a new, unique Medicare number, which contains a combination of numbers and uppercase letters. People with Medicare will receive a new Medicare card in the mail, and will be instructed to safely and securely destroy their current Medicare card and keep their new Medicare number confidential. Issuance of the new number will not change benefits that people with Medicare receive.  Healthcare providers and people with Medicare will be able to use secure look–up tools that will allow quick access to the new Medicare numbers when needed. There will also be a 21–month transition period where doctors, healthcare providers, and suppliers will be able to use either their current SSN–based Medicare Number or their new, unique Medicare number, to ease the transition. To view the new card (and other important information), go to: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html

•  CMS  Posts  2018  ICD–10–CM Codes Effective October 1, 2017:  The 2018  ICD–10–CM files at the link below contain information on the ICD–10–CM updates for FY 2018 that will be effective on October 1, 2017. These 2018 ICD–10–CM codes are to be used for patient encounters occurring from October 1, 2017 through September 30, 2018.  Click on the link here and then scroll down and click on the second link that says “2018 Code Tables and Index (ZIP, 20MB)”.

https://www.cms.gov/Medicare/Coding/ICD10/2018-ICD-10-CM-and-GEMs.html 

Some of the changes involve new codes for:

• Diabetes mellitus with ketoacidosis;
• Subcategories for heart failure;
• Identification of non–pressure chronic ulcers that have penetrated muscle and bone tissue without necrosis;
• Myocardial infarction type 2; and
• Lumbar spinal stenosis

Note: The 2018 ICD–10–CM guidelines and Conversion table will be posted later, once they are finalized and received from CDC.

In addition, physician should remember from last year that there were several problems where certain insurers failed to upload these files in a timely manner to their claims processing systems for dates of service October 1, 2017 and after. This caused many claims to deny improperly under the incorrect designation of “Invalid ICD–10 code”.

If this occurs again for dates of service after October 1, 2017, please contact us through the Third–Party Insurance Help Program.

•  United Healthcare (UHC) to Delay Commercial Consultation Services Reimbursement Policy: United Healthcare (UHC) was planning a policy change to cease payment for consultation codes 99241–99245 and 99251–99255 for dates of service on and after October 1, 2017.  Organized medicine had voiced their opposition to this onerous change and  requested that UHC provide a rationale for this change in policy.  As a result, UHC has now issued an update stating that they will delay implementation of the policy and additional details about the length of the delay will be outlined in their October 2017 Network Bulletin.

If you have questions on any of these issues, contact the Society’s Third–Party Insurance Help Program at (212) 684–4681.&

March 23  Poster Symposium

Residents, fellows and medical students are invited to participate in the 13th Annual MSSNY Poster Symposium.  Posters in the following categories are eligible:

— Clinical medicine (includes clinical research, health policy, quality improvement, medical education);

— Clinical vignettes; and

— Medical student research.

Submit entries in abstract form to This email address is being protected from spambots. You need JavaScript enabled to view it.  by January  5, 2018, 4:00 p.m.

For further information contact Sandra Bennett atThis email address is being protected from spambots. You need JavaScript enabled to view it.

or (516) 488–6100 ext 383.  Presentations will take place at the Medical Society of the State of New York’s (MSSNY’s)  House of Delegates, Friday, March 23, 2018, 2:00 p.m.  – 4:30 p.m., Adams Mark Hotel, Buffalo, New York.

 All entrants must be:

• Active in a residency/fellowship training program, or medical students;
• Current MSSNY members. Join at www.mssny.org; 
• Able to attend 2018 MSSNY House of Delegates meeting to present and discuss entry (Buffalo New York, March 23, 2018);
• Entrants are responsible for travel and related costs.

The Small & Medium–Sized Practice’s Guide to HIPAA

DocBookMD is your HIPAA–compliant portal on your phone and tablets that let’s you communicate safely with your office staff and other Society members.  Just because you are small, doesn’t make you exempt.   DocBookMD is a free app for Society members.  Check out this valuable guide to HIPAA that is designed for the small and medium practice at:
White Paper Small Practice HIPAA Guide  

The Gang’s All Here: Welcome, New Members

The following 46  candidates for membership have been  presented to the Board of Directors of the Society.  

Avraham Berko, MD
Arielle Bokhour, MD
Sinead Fallon Brady, MD
Daniel Benjamin Buchalter, MD
Steven J. Carbonaro, MD
Eliana Cardozo, DO
Pierre Alex Casthely, MD
Li–Wei Chang, MD
Stephanie I. Cheng, MD
Prince Dhillon, MD
Marylee Hoyle Dilling, MD
Denis Joseph Donovan, MD
Rachel Phyllis Dubroff, MD
Michael Sean Elges, MD
Harry G. Greditzer, IV, MD
Tracy Beth Grossman, MD
Isha Duggal Gupta, MD
Jasmin M. Harpe, MD
Joseph C. Hung, MD
Syed Husain, DO
Amanda Christine Itzkoff, MD
Cyrus Kao, MD
Sang J. Kim, MD
Eliezer Chaim Kinberg, MD
Samuel Aaron Kolander, MD
Raaka Kumbhakar, MD
Gloria Lin, MD
Carl Christian Mabry, MD
Omar Zakaria Maniya, MD
Jeffrey Desmond Markey, MD
Gregory Jennings McWhir, MD
Marissa F. Miyazaki, MD
Daniel Osei, MD
Pantelis Pavlakis, MD
Matthew Pergamo, MD
Ramon Julian Pesigan, MD
Raunain Rahman, MD
Anita Ravi, MD
Pria Shree Rolfes, MD
Daniel Seidman, MD
Taylor Bryan Sewell, MD
Paul Shekane, MD
Etan Paul Sugarman, MD
Michael Chang Tseng, MD
Lisa Wang, MD
Michael Zacchilli, MD 

Risk Management Tips From MLMIC

In the complex and busy world of healthcare delivery, physician practices may overlook basic office procedures that promote patient safety and reduce exposure to liability. This handbook from MLMIC identifies potential risks and provides recommendations to mitigate them. Each tip is designed to address a common issue in the office practice and provide practical guidance on how to employ best practices. These easy–to–implement recommendations are a guide for physicians, other healthcare providers, and staff. The implementation of these recommendations may assist in preventing adverse outcomes, improving patient care, and minimizing liability exposure in the office practice.

To review your copy, click on:   MLMIC Risk Management Brochure, Vol. III  
 

Hats Off 

Congratulations to Society Board Member Gabrielle Shapiro, MD, who in June was the recipient of the New York Council on Child and Adolescent Psychiatry’s Wilfred C. Hulse Award for  outstanding contribution to the field of child and adolescent psychiatry.  Doctor Shapiro is a graduate of New York Medical College and board certified in psychiatry.  She practices at Mt. Sinai, and is a leader with her local and national specialty societies, in addition to the New York County Medical Society.

If you or someone you know deserves a salute, send it to the Society’s Cheryl Malone at This email address is being protected from spambots. You need JavaScript enabled to view it. or fax to (212) 684–4741.

NYCMS Welcomes New Benefit for Your Practice

Citiwaste is now an exclusive provider of medical waste management services offering deep discounts to New York County Medical Society members.

Whether sharps, red–bag, chemo, pathology, hazardous, or pharmaceutical waste, Citiwaste will work with you to classify and segregate waste streams for best pricing. In addition, Citiwaste will determine the appropriate service frequency and deliver the supplies you need to package wastes.

Call David at (718) 372–3887 to learn more about how Citiwaste can save you money.  Tell him you are a New York County Medical Society member. 

• Guaranteed savings with no fuel, stop, energy, or environmental fees.
• Medical waste manifests available online 24/7 at no charge.
• Trusted, local provider, serving New York.
• Sharps containers available at competitive pricing.
• One provider for all your medical, hazardous, and pharmaceutical waste.
• Protection for your business with complete regulatory compliance.

Call David at Citiwaste, (718) 372–3887.

What’s the Diff?

With single payer so much in the news, you and your legislators and patients may need a good reminder of the difference between single payer and universal coverage (which is what many people are actually talking about when they discuss various health care systems around the world).  This link provides a great description —  The Single Payer vs. Universal Coverage Conundrum, Larry Sobal,  May 11, 2017,  on MedAxiom, at:  
https://www.medaxiom.com/blog/the-single-payer-vs-universal-coverage-conundrum

Bylaws Committee Proposes Changes

The Society’s Bylaws Committee, chaired by Milton Haynes, MD, reported on a series of proposed Bylaws changes.   The recommendations were accepted by the Board of Directors at its meeting on September 11, 2017, and the changes will be voted on at the Society’s 2018 Annual Meeting.  

The Committee made the following recommendation, which the Board of Directors  agreed to submit to the membership.

Amendments 1 – 3:  Given changes  in medical discipline and use of the Board of Medical Ethics, the Bylaws Committee discussed whether there was a need for this entity as a standing body that is a component element of the Board of Directors.  It was suggested that current members of the body could be members at large, with the president appointing an ad hoc body as needed.  

Amendment 1 

Article  V

Officers and Terms of Office

Section 4. Board of Medical Ethics

Two members of the Board of Medical Ethics shall be elected each year for a term of two years, the term commencing with the close of the Annual Meeting, except that every second year, three  members shall be elected.   The Board of Medical Ethics will be an Ad Hoc Committee of no less  than five members of the Society, that will be appointed by the President as needed to  investigate any issue of medical ethics or membership termination.

Amendment 2 

Article XII

Board of Medical Ethics

Section 1. Functions of the Board of Medical Ethics

The Board of Medical Ethics shall discuss principles of medical ethics and prepare and submit to the Board of Directors position statements on medical ethics when called on by the Board.    The Board will make referrals to the Office of Professional Medical Conduct, as mandated by public health law, when allegations of professional medical misconduct occur.

Amendment 3

Article XII

Board of Medical Ethics 

Section 2. Meetings of the Board of Medical Ethics

The Board of Medical Ethics shall hold regular meetings as called by the Board of Directors as necessary.  Special meetings may be  called by the chairperson  president or by any three members of the Board. The presence of four members shall make a quorum at any meeting, except for the purpose of electing a chairperson and secretary, when five members are required. The Board of Medical Ethics at its  first regular meeting  following the Annual Meeting each year,  shall elect a chairperson and secretary and fix within the limits aforesaid, the time and place of their regular meetings for the ensuing year.  The Ad Hoc Board of Medical Ethics shall  keep minutes  of their proceedings and report to the Board of Directors monthly or when directed. 

Amendment 4:  Because the Society’s parliamentary authority, Sturgis Standard Code of Parliamentary Procedure, has gone out of print, it was suggested that the Society accept Robert’s Rules of Order as a substitute.

Amendment 4

Article XVI 

Parliamentary Authority

The rules contained in the current edition of Sturgis Standard Code of Parliamentary Procedure Robert’s Rules of Order shall govern the Society in all cases to which they are applicable and not inconsistent with these Bylaws and other special rules of order the Society may adopt. 

Reminder of Some of Your  Society Membership Benefits 

How Do I Protect My Family, My Finances,  My Future?

Expert Financial Planning Help

Vital Planning Group is dedicated to providing thoughtful advice and innovative solutions in the key areas of financial management and wealth preservation. Vital has extensive experience working with medical professionals helping them manage the unique financial arc of their careers. Society members get complimentary consultation and review; complimentary financial needs analysis; discounted financial planning fees; and discounted asset management fees. Education too. Work with people who understand physicians and their financial needs. Call Edward Alferoff at (212) 578-3003 or visit http://www.vitalplanning.com/

Professional Employer Organization (PEO) Gives You Big Time Status 

Even small employers (and solos) can have big employer advantages when they join the Idilus PEO. All human resource issues from payroll to benefit selection and staff manuals are taken care of. You are still in charge, but you have a large HR department behind you. PEO fees are discounted for Society members. If you don’t know what a PEO does, check out http://nycmsbenefits.com/ or call Matt Peterson at Idilus, (877) 545–5666.

Insurance With Service

Mercer is a global consulting leader in talent, health, retirement, and investments. Mercer helps clients around the world advance the health, wealth, and performance of their most vital asset— their people. Mercer’s 20,500+ employees are based in more than 40 countries. Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), a global team of professional services companies offering clients advice and solutions in the areas of risk, strategy, and human capital. There is a small group health insurance plan, great specialty–specific disability, and insurance products you need whether you are employed or not.  Call Mercer at (800) 888–6926 or Sony Hilado at the Society, (212) 684–4682. www.nycmsmemberinsurance.com

Doctor–Driven Liability Coverage 

The Medical Liability Mutual Insurance Company (MLMIC), physician–owned and managed, is the only professional liability insurer we endorse. The company has the country's largest and most experienced professional liability claims department. Call (800) ASK-MLMI or visit our website.

Protect Your On–Line Reputation

Practice Builders has services that are designed specifically to help busy Society physicians like you attract the patients, cases, and payers you prefer, while increasing referrals and protecting your professional reputation online. Society members now will receive discounted consultations and discounted rates on a wide range of Practice Builders’ services, including: online practice reputation management — the unique positive solution for the unfair or disgruntled patient who criticizes online; social media programs; public relations and advertising; custom website development, search engine optimization, and hosting; and more.   For more information on your membership privileges with Practice Builders, call (800) 679–1200, select option 2, and tell them you are a New York County Medical Society member. 

Is Your Phone or Tablet Your Achilles Heel?

Thanks to DocBookMD and the Society, you will have access through a smartphone platform, designed by physicians for physicians, that provides an exclusive HIPAA–compliant professional network to connect, communicate and collaborate with your Society colleagues. Send pictures of x–rays and reports, wounds or other information, and be reassured that you are not taking any HIPAA risks. You will need to have your NYCMS Member ID ready. If you do not know it, call the membership department at (212) 684–4670, or email This email address is being protected from spambots. You need JavaScript enabled to view it.   Then go to your phone and download your free app from the iTunes App Store, or from the Android Market. Once you have downloaded the app to your device, open it up and follow the simple registration steps. Includes access to all Society members as well as all Manhattan pharmacies, right on your iPhone, iPad, and Android.  Your office staff can safely send you office messages, lab reports, x–rays.  Do you teach medical students or residents? You need this app.   (Members Only)

Don’t Make HIPAA Headlines — Get Your Own HIPAA Expert

Every Practice Needs to Be HIPAA Aware and Needs HIPAA Secure Now! HIPAA Secure Now! helps physicians with HIPAA compliance. As the healthcare system moves from paper to digital, the U.S. Department of Health and Human Services is emphasizing HIPAA much more than before. HIPAA requires physicians to protect patient information, and provides specific guidance – yet the same complex HIPAA regulations apply equally to the largest hospitals and the smallest practices. Naturally, most physician practices don’t have a special, dedicated HIPAA expert, but HIPAA Secure Now! can provide the HIPAA compliance services that physicians need:  Risk Assessments; Training; Policies; Documentation Portal; HIPAA support and consulting. Members receive a special Society discount:  Contact HIPAA Secure Now! through Jonathan Krasner, This email address is being protected from spambots. You need JavaScript enabled to view it.

No More Landlord Hassles for YOUR Office

Commercial Tenant Concierge Service provides effective real estate expertise–on demand and at your service. Commercial Tenant Concierge (CTC) helps healthcare tenants cost effectively manage real estate leases. Their experienced real estate professionals are on call to solve problems related to landlord billing, building services, HVAC complaints, alterations, subleasing, key action dates and other lease related issues. Thorough monthly services allow you to subscribe when and if you need their help, when the time is right for you. If you need assistance in verifying landlord bills, resolving billing discrepancies, operational issues such as alterations of your office, subleasing or if you need advice on marketing conditions and opportunities, CTC will work for you. Call the Society at (212) 684–4670 for referral to CTC directly.

How Do I Follow the Rules AND Get Paid ?

Your Coding and Insurer Issue Advisor 

As a Society member you can get expert advice and assistance on managed care contracts, service denials, Medicare, workers' compensation and commercial claims, as well as other reimbursement issues from consultant James McNally, CPC.  Mr. McNally is a seasoned professional (previously with Empire Blue Cross/Blue Shield). For referral call (212) 684–4670.    (**Not available to non–members — worth the price of membership!)

Expert Legal Advice

The Society's Legal Services Program gives members an initial phone consultation on legal issues specific to medical practice at no charge. If additional services are necessary, Einiger and Associates can provide them to members at a discounted fee. Get help on legal issues such as advice on managed care contracts, the Office of Professional Medical Conduct or licensure procedures, and other help. Call (212) 684–4681 for your referral.

Collect What's Due

I.C. System, Inc. (the endorsed collection service of New York County Medical Society) offers "Value–Added Benefits" for members only! If you have a backlog of bad debt, no matter how large or small, or having trouble with slow-paying unresponsive insurance carriers, I.C. System can help with effective and professional accounts receivable management services, tailored to your specific office requirements. Contact I.C. System at  (800) 279–3511.

Where Can I Find Good Services and Good Discounts for My Practice?

Trust the Employees You Hire 

Don’t put your office in a bind when you need permanent or temporary staff assistance. Winston Support Services, LLC is JCAHO–certified, and you can be assured that all of its candidates are selected and pre–screened for proper licensure, background checks (criminal and educational), references, skills, and physicals (including PPDs and ten panel toxicology screens). This saves you a great deal of time and ensures professional screening result. If you need someone in your office ASAP, AND you want to make sure that they are perfect for your position, AND you want a NYCMS discount, join and take advantage of your special member rates at Winston Support Services. Call Ivy Kramer, MSW, CSW your designated account representative at (212) 687–4667 or email atThis email address is being protected from spambots. You need JavaScript enabled to view it. 

Don’t Throw Your Money Away with the Waste

Citiwaste is now an exclusive provider of medical waste management services offering deep discounts to New York County Medical Society members.   Whether sharps, red–bag, chemo, pathology, hazardous, or pharmaceutical waste, Citiwaste will work with you to classify and segregate waste streams for best pricing. In addition, Citiwaste will determine the appropriate service frequency and deliver the supplies you need to package wastes. Guaranteed savings with no fuel, stop, energy, or environmental fees. Medical waste manifests available online 24/7 at no charge.  One provider for all your medical, hazardous, and pharmaceutical waste. Protection for your business with complete regulatory compliance.  Call David at (718) 372–3887 to learn more about how Citiwaste can save you money.

Shred It, Store It, Save Money

Storage Quarters is a comprehensive, full service company specializing in document storage, records management, scanning records and imaging, secure document destruction, self storage and on–demand storage.  Contact Storage Quarters and say you are a New York  County Medical Society member to insure special pricing. Call (516) 794–7300 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Look Good in Your Lab Coats and Scrubs

Our partnership with Medelita allows members to save on premium Medelita lab coats and scrubs at a special NYCMS rate. Members may choose to embroider the NYCMS logo without incurring any artwork digitization costs. Medelilta scrubs and lab coats represent a shift from traditional lab coats, offering sophisticated style, performance, fabric and gender specific sizing and style. For more information, visit http://www.medelita.com or call (877) 987–7979 and mention the Society. To receive your Society discount, go the www.nycms.org and click on the Medelita icon.

Discounts on Office Machines 

Superior Office Systems offers a 10 percent discount to members on all Canon products. Check out fax machines, copiers, and other printing products at (212) 695–5588.

What Do I Do When . . . ?

. . . I’ve Got Parking Ticket Blues  

Get a Doctor–On–Medical Call Placard and use the Society's Parking Review Panel to get help on dismissal of parking ticket in New York City. Call (212) 684–4698 and join members who save on parking fines.  (Members Only) 

. . . I Want to Save Money on Fun 

The Society offers you free access to a unique entertainment discount program, Working Advantage. View a wide variety of discounts on the internet and order online or call. Savings include discounts on movie tickets, theater and musical events, shopping, gifts and an advantage points program where you earn rewards

while you save. Go to www.workingadvantage.com  to view current events and discounts. Call Sony Hilado at  (212) 684–4682 to get your membership number or you can email  This email address is being protected from spambots. You need JavaScript enabled to view it.

. . .  I Want Some Training

The Society sponsors conferences on the topics you think are important. This year, look for the important programs on Medicare, billing and coding, and tax issues.  In addition, check out MSSNY’s Medical Matters Webinar series and other education offerings.  

. . .  I Want Face Time with Legislators

Join us in Albany for Physician Advocacy Day (March 7, 2018) or get active in MSSNYPAC.   

. . .  I Want Face Time with My Fellow Doctors

It’s good to spend time with friends and colleagues.  We provide local chances to do that very thing, so you don’t have to wait for that once–a–year specialty conference.  

Remembering NYCMS Past President Hugh Clark Davidson, Jr., MD

Society Past President Hugh Clark Davidson, Jr., MD, passed away at the age of 93 on August 19.   Doctor Davidson was President of the Society in 1984 – 1985, and also served as President of the First District Branch in 1987.  He was one of the Society’s leaders during the 1985 medical liability crisis in the State  –  in April of that year, over 5,000 physicians in New York marched on Albany.  He was a graduate of the University of Pennsylvania, and was an internist at St. Luke’s–Roosevelt Hospital Center.   Doctor Davidson was pre–deceased by his wife, Metropolitan Opera star Nell Rankin.   He had long service as a Board member, delegate to the Medical Society of the State of New York, and inspiring leader to the New York County Medical Society.

In Memoriam

Hugh Clark Davison, MD, died August 19, 2017.  Doctor Davidson received his MD degree from University of Pennsylvania School of Medicine in 1949.  He was a past president of the New York County Medical Society and the First District Branch of the Medical Society of the State of New York, the Combined Medical Societies of New York City.

Julian B. Hyman, MD, died October 13, 2017.  Doctor Hyman received his MD degree from Albany Medical College in 1947.

David R. Scal, MD, died July 28, 2017.  Doctor Scal received his MD degree from Lausanne Medical School in 1962.

Joseph Brennan Walsh, MD.  Doctor Walsh received his MD degree from Georgetown University School of Medicine in 1966.

Gerald Weintraub, MD, died October 11, 2017.  Doctor Weintraub received his MD degree from New York University School of Medicine in 1954.