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MSSNY e-news, May 2, 2008 Weekly Update for New York State Physicians This week, I spoke at a healthcare business conference in Westchester that was attended by Assemblyman Adam Bradley, Bill Mooney of the Westchester Business Association, the Insurance Department’s Assistant Deputy Superintendent for Health John Powell and many hospital and corporate leaders. The thrust of the day was about managed care problems--- how difficult it is to run a practice, or any small business in New York and how MCOs, after they finish with us, continue to rake employers over the coals with exorbitant premiums to cover their employees. Some businesses are considering whether or not they should even continue to offer insurance. I like to think of myself as a scientist, which I am by background and training. Scientists often think they are either “above the fray” or they are apolitical. However, I had to “get real”-- I am also a businessman. Every practice is a business, with responsibilities to many employees as well as patients, and every business should have political ties in the community. So, I made it my business to become acquainted with my local legislators. The truth be known, legislators are actually interested in what physicians have to say, not because we are great political theorists, but because we are the caretakers of the people in our communities (their voters). As a critical healthcare provider in your town, what you say has weight. Getting to know our legislators is important. MSSNY does depend on lawmakers in Albany for recognition and solutions to many of our practice problems. Physicians should be involved even if we are a little uncomfortable at first. I know I was. I am now more comfortable because I am also a pragmatist and I realize that, even as individuals, physicians can be a direct link to policymakers. To inflict my final blow of reality, we should all make contributions to MSSNYPAC. Our Division of Governmental Affairs is well aware of each legislator and where they stand on each single MSSNY issue. Even though our knowledge and perspective carry great weight with our legislators, as apolitical force, we are only as strong as our PAC. Our PAC is only as strong as the dollars that support it. I am outright asking you to go to the “Grassroots” section at www.mssny.org and make a meaningful contribution. We must support our PAC. I know our opponents never hesitate to support their PACS. This year, I am not only going to speak to physicians from Niagara Falls to Plattsburgh to Montauk. While I am on the road, I will be speaking to the legislators there as well. After all, I have learned never to miss a roadside opportunity to talk about physician and patient issues. Along the way, I have even met several legislators who I have actually liked and who truly care about doing the right thing for their constitutents. You may, too. Don’t knock it until you’ve tried it.  Michael Rosenberg, MD MSSNY President ------------------------------------------------------------- Capital Update DISCUSSIONS ON MEDICAL LIABILITY REFORM PROPOSALS PICK UP; PHYSICIAN ADVOCACY ESSENTIAL CMS PROPOSES ADDITIONAL CATEGORIES OF MEDICARE NON-PAYMENT FOR “NEVER EVENTS” MEASURE TO BAN USE OF LINDANE FOR LICE IN PERSONS UNDER THE AGE OF SIXTEEN BEFORE ASSEMBLY HEALTH COMMITTEE For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses: BCBS Agrees to Changes in Business Practices Have You Used Your Library Lately? Last Minute Sign-Ups for LI Info Tech Program on May 9 May 7 Is “Legacy Free” Day: An Opportunity to Check NPI Readiness! Medical Schools Group Recommends Ban on Rx Industry Gifts Physicians Urged To Contact Congress to Prevent 10.6% Medicare Cut CMS Sets Alternate Reporting Criteria for Physicians to Participate in PQRI --------------------------------------------------------------------- Weekly Update for New York State Physicians Colleagues: Imagine your biggest supplier strutting into your office once a year asking you to sign a contract that told you that you would be poorly paid for every service that you delivered. If you tried to negotiate any single point, they would repeat one phrase--“Take it or leave it.” If you signed it, you risked insolvency because the payments barely covered your costs (difficult to make up in volume…). If you didn’t sign, you risked insolvency because a significant portion of your business would disappear instantly. It brings to mind Edgar Allen Poe’s famous short story, “The Pit and the Pendulum.” Either choice had extreme consequences. Currently, there is a bill under consideration in Albany that may even the playing field for physicians and our patients.Legislation (A.2177, Canestrari, Gottfried, etc.) that will permit physicians to collectively negotiate critical contract terms with health plans was favorably considered by the Assembly Health Committee in late January. The bill would permit physicians to negotiate with health plans, the plan’s utilization review procedures, medical necessity definitions, administrative and claims payment procedures, and dispute resolution mechanisms. In addition, in a region where a health plan holds a substantial market share (10% of the enrollees or 25,000 lives in a given service area), physicians would be able to collectively negotiate fees, the methodology used by plans to calculate fees, and coding rules. Substantially similar legislation (S.4153, Hannon) is before the Senate Health Committee. Within the past few years, United merged with Oxford. GHI merged with HIP. Physicians do not like insurance mergers. The average person would think that the fewer carriers we deal with, the less paperwork. That is not how physicians view mergers. The fewer insurers, the less leverage we have. Insurers with large market shares do not have to negotiate. Why should they? They have only one group to pay homage to---shareholders----not patients, not physicians and not even the corporations that buy their product for their employees. It’s time to restore some balance. Michael Rosenberg, MD MSSNY President --------------------------------------------------------------------- The Center for Medicare and Medicaid Services (CMS) announced on April 16 the establishment of alternate reporting periods and criteria for satisfactorily reporting quality measures under the Medicare Physician Quality Reporting Initiative (PQRI). PHYSICIANS ARE URGED TO CONTINUE CONTACTS WITH CONGRESS TO PREVENT 10.6% MEDICARE CUT As has been previously reported, physicians face a 10.6% cut in Medicare reimbursement on July 1 unless Congress acts to prevent the cut. The cuts are due to a faulty formula (the Sustainable Growth Rate methodology, or SGR) that produces cuts in physician reimbursement when growth in health care spending exceeds growth in the Gross Domestic Product. Full Story For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses: rabrams@mssny.org gconway@mssny.org ldears@mssny.org mauster@mssny.org pclancy@mssny.org bellman@mssny.org eclinton@mssny.org --------------------------------------------------------------------- Important NPI Date Approaching for Claims and Cash Flow Pursuant to the Health Insurance Portability and Accountability Act (HIPAA), old legacy numbers will not be accepted on any electronic claims after May 23. Claims will only be accepted with a National Provider Identification (NPI) number. That deadline applies to all payers—public and commercial. You know you have to switch to electronic health records (EHR), but don’t know what to buy or what company to buy from? We have done all the work for you—we have vetted the vendors down to six so there are still choices to be made. Each vendor will give a pressure-free breakout session, and physician speakers will tell candid versions of their transition from paper to EHR. Come and bring your staff, too. Free breakfast and lunch. The final three MSSNY Tech Fairs are scheduled at the following locations: · Central NY Area …… Wednesday, April 30 at the Double Tree at Carrier Circle in Syracuse. Click Here to Register for Central New York · Western NY Area…… Friday, May 2 at the RIT Conference Center in Rochester. Click Here to Register for Western New York · Long Island Area….. Friday, May 9th at the Huntington Hilton on Route 110. Click Here to Register for Long Island NATIONAL SURVEY GIVES PHYSICIANS A VOICE If you are concerned about the state of medical practice in America, why not let your voice be heard? The Physicians’ Foundation for Health Systems Excellence (PFHSE), a national group composed of medical society physician leaders and executives, has initiated one of the largest physician surveys ever conducted in the United States. Full Story United Has Dropped Some Doctors in Retainer Practices UnitedHealthcare is dropping physicians with retainer practices from its network. Only fifty percent of all Medicaid claims are successful in receiving reimbursement. Medicaid recently shared with MSSNY the top reasons for denied claims. Full Story MSSNY e-news - April 18, 2008--------------------------------------------------------------------- Hassle Factor Form If you have any complaints regarding insurance carriers, you can go to the Hassle Factor Form found on our website. Not yet a member? MSSNY’s achievements benefit all physicians! Join your colleagues at: http://www.mssny.org/mssnyip.cfm?c=s&nm=Applications Member already? Please forward this to 2 of your colleagues and ask them to join you in supporting the profession. Weekly Update for New York State Physicians Setting Priorities and Getting Started
PHYSICIANS URGE ACTION ON MANAGED CARE REFORM LEGISLATION MSSNY URGES CONGRESS TO REJECT PAYMENT INCREASES FOR MEDICARE MANAGED CARE PLANS UNTIL SGR PROBLEMS ADDRESSED ASSESSMENT, DIAGNOSIS AND MANAGEMENT OF PEDIATRIC ADHD EXPERT PANEL ON PALLATIVE CARE ISSUES HOLDS INITIAL MEETING ----------------------------------------------------------- MSSNY is hosting Continuing Medical Education: The Link to Quality Improvement on Friday, May 9, 2008 from 8:00am to 2:30pm at the Crowne Plaza Laguardia, in East Elmhurst (Queens). This is a one-day seminar on linking Continuing Medical Education with Quality Improvement. It features nationally recognized presenters— Dr. Murray Kopelow from the ACCME, Dr. William Jacott from the Joint Commission and Dr. Alejandro Aparicio from the AMA. Call the MSSNY CME Office at (518) 465-8085 for registration information. Medicare, Medicaid and private insurers should increase payments to geriatric specialists as a means to better train and retain providers for the coming wave of aging baby boomers, the Institute of Medicine said in a new report. Full Story Federal Insurers Add Substance Abuse Services for Screening/Brief Intervention This week, the White House Office of National Drug Control Policy (ONDCP) announced that approximately 5.6 million Federal workers with Federal health insurance will now be covered for a substance abuse prevention and treatment procedure called Screening and Brief Intervention (SBI). ------------------------------------------------------------------------------- Hassle Factor Form If you have any complaints regarding insurance carriers, you can go to the Hassle Factor Form found on our website. Not yet a member? MSSNY’s achievements benefit all physicians! Join your colleagues at: http://www.mssny.org/mssnyip.cfm?c=s&nm=Applications Member already? Please forward this to 2 of your colleagues and ask them to join you in supporting the profession. MSSNY e-news, April 4, 2008Weekly Update for New York State Physicians Volume 8, Number 14 Christina Cronin Southard, Editor mssnye-news@mssny.org Colleagues: In one week I will join many of you at the MSSNY House of Delegates meeting in Rye, New York. The meeting is always an exciting event, as our delegates meet and decide on policy and priorities; then our able staff and leadership must execute these policies. The session lets all of us share issues including those of public health, patient access, managed care, liability and scope of practice. No matter how attuned we may be as individual physicians, I find myself humbled by the collective power of observation and the group wisdom expressed after consideration, deliberation and sometimes contentious debate. There was much work to be done and the “to-do list” sometimes seemed endless. Nevertheless, I am grateful for the having had the opportunity to serve you. This has been an active and challenging year. This year, a few of the issues MSSNY worked on were:
This year hurled by. Never did I anticipate the challenges, demands and satisfaction that I would experience in service to the Medical Society of the State of New York. I am grateful to have worked with such a talented and dedicated staff. We are lucky to have each and every one of them working for us and for our patients. I now know the reality behind the words I have heard from the physicians who preceded me, "I cannot thank everyone by name, because I know that I will forget someone." I will follow that wisdom today as I offer my thanks to them all. I look forward to welcoming Michael Rosenberg, MD, as he takes the position as your president, confident in his knowledge and capabilities as a leader. I am grateful for the confidence you gave to me when you elected me to this position, and I thank all of you for giving me the opportunity to serve the house of medicine.
President --------------------------------------------------------------------- Capital UpdateHealth Budget Approved by Executive For FY 2008-09 Enacted by State Legislature Although negotiations on other aspects of the State Budget for FY 2008-09 have stalled, the Legislature passed a Health Budget for 2008-09. This measure was negotiated with and received prior approval by the Executive. Consequently, no vetoes of any portion of these measures are anticipated. The Legislature restored $273M of the Executive’s proposed $1.1B cost containment initiatives. Additional savings of $75M are anticipated to be achieved through anti-fraud efforts. The overall impact of these cost savings was somewhat reduced by additional allocations achieved through an increase of $70M in the covered lives assessment and an additional $40M in insurance industry assessments. Overall spending in health care, however, was reduced in an amount approximating $800M. MSSNY InitiativesMSSNY has several MSSNY-directed programs for which it sought funding. Among those are: § MSSNY’s coordination of an evaluation of geriatric pilot programs….$75,000 § MSSNY‘s HIV Education Program …………………………………..$98,000, plus reappropriations amounting to $235,000 § Committee on Physicians’ Health…………………………………….$990,000 § Health Information Technology……. which received reappropriations amounting to $8,247,000 MSSNY is also seeking an additional appropriation for the Health Information Technology initiative and its Smoking Cessation Initiative. These requests will be addressed shortly. For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses: --------------------------------------------------------------------- eNewsNEW YORK PHYSICIANS MAKE DC HILL VISITS Several New York physician leaders traveled to Washington DC this week along with MSSNY and county medical society staff to meet with their local Congressional representatives’ offices, key New York Congressional delegation members, and Senators Clinton and Schumer. The meetings took place in conjunction with the American Medical Association’s National Advocacy Conference. Contact to Register Complaints with DEA A number of physicians have contacted MSSNY and the American Medical Association (AMA) to express concern regarding the recent federal Drug Enforcement Administration (DEA) increase in the renewal fee charged to physicians to prescribe controlled substances. The New York City Tech Fair on April 4 was fully subscribed! Three other HIT events are scheduled at the following locations: · Central NY Area…… Wednesday, April 30 at the Double Tree at Carrier Circle in Syracuse. Click Here to Register for Central New York · Western NY Area…… Friday, May 2 at the RIT Conference Center in Rochester. Click Here to Register for Western New York · Long Island Area… Friday, May 9th at the Huntington Hilton on Route 110. Click Here to Register for Long Island Medicare: CMS Issues Final Rule on E-Prescribing Standards On April 2, CMS released a final rule that establishes standards for electronic prescribing under the Medicare prescription drug benefit, CQ HealthBeat (4/2) reports. New York Eliminates Assets Test for Medicare Savings Programs New York has eliminated asset tests for all Medicare Savings Programs (MSP), which pay premiums and most out-of-pocket medical costs for low-income people with Medicare. Full Story---------------------------------------------------------------------MSSNY e-news, March 28, 2008 |
| rabrams@mssny.org | gconway@mssny.org | ldears@mssny.org | mauster@mssny.org |
| pclancy@mssny.org | bellman@mssny.org | eclinton@mssny.org |
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eNews
Poll Shows Seniors’ concerns About Physician Access
A telephone survey of 1,006 adults 18 years of age and older living in the continental United States was conducted by Opinion Research Corporation for the American Medical Association (AMA) from February 22-25, 2008. The margin of error is +/-3%.
• When told about the cuts, 8 out of 10 Americans are concerned that access to care for Medicare patients will be hurt.
• 88% of current Medicare patients (age 65+) are concerned that seniors’ access to care will be hurt because of impending cuts.
• 87% of Americans age 55-64 are concerned that access to care will be hurt because of the impending cuts. The oldest baby boomers turn 62 this year, and will begin relying on Medicare in 2011.
• Nearly three-quarters (73%) of Americans believe Congress should stop the cuts to physicians so they can continue to care for Medicare patients.
• The majority of Americans, 65%, are not aware that Medicare will start cutting payments to physicians this July, and that the cuts will total 15 percent over 18 months.
NYC Information Technology Program Slated for Friday, April 4
Space is filling quickly for the New York City MSSNY Health Information Technology scheduled for Friday April 4 at the Park Central Hotel at Seventh Avenue and 55th Street. The all-day event is open to physicians and office managers. There is no charge and lunch will be served. In addition to a series of presentations from physicians and computer experts who will provide guidance on transitioning to electronic systems, attendees will have the opportunity to meet personally with six EMR firms recommended by MSSNY. Attendees can participate in system demos and discuss their specialized office needs. Click Here to Register
Three other HIT events are scheduled at the following locations:
Central NY Area…… Wednesday, April 30 at the Double Tree at Carrier Circle.
Click Here to Register for Central New York
Western NY Area…… Friday, May 2 at the RIT Conference Center in Rochester.
Click Here to Register for Rochester
Long Island Area… Friday, May 9th at the Huntington Hilton on Route 110.
Click Here to Register for Huntington
Physicians’ Foundation Survey Sent to Every Primary Care Doctor
What is the state of primary care practice in America today? Can primary care physicians continue to provide patient care in the face of rising costs, reimbursement cuts and pervasive government regulations?
MSSNY OMSS Teaching Day Presents Critical Talks
Don’t miss our MSSNY OMSS Teaching Day on Thursday, April 10, 2008, 12 to 5 pm at the Rye Town Hilton (the day before the start of the MSSNY HOD).
Full StoryDon’t Miss Third MSSNY Resident/Fellow Poster Symposium at HOD
Following on the huge success of the past two years’ symposia, the MSSNY Resident and Fellow Section will hold its third research poster symposium on Friday, April 11, 2008, from 2 pm to 5 pm at the MSSNY House of Delegates in Rye in Westchester Ballroom C. For details, contact sbennett@mssny.org or 516-488-6100 ext. 383. Disability Insurance (DI)
In case you become disabled, does your family have enough protection? MSSNY offers an “own occupation” Disability Insurance policy at low cost group rates. Underwritten by the Guardian. Email our insurance program administrator, Endorsed Administrators, Inc. (EAI) at eaijjj@aol.com for benefits & rates.
Hassle Factor Form
If you have any complaints regarding insurance carriers, you can go to the Hassle Factor Form found on our website.
Not yet a member? MSSNY’s achievements benefit all physicians!
Join your colleagues at:
http://www.mssny.org/mssnyip.cfm?c=s&nm=Applications.
Weekly Update for New York State Physicians
Volume 8, Number 11
Christina Cronin Southard, Editor
mssnye-news@mssny.org
Colleagues:
I am writing to bring to your attention a situation that could have a negative impact on the quality of medical education and medical care throughout New York State. New York is a powerhouse for medical education; we have more medical schools (14) and more medical students than any other state in the union. New York State provides rigorous training for the students in these schools. All our medical schools must meet or exceed demanding, rigorous national standards insisted upon – and imposed – by the American Medical Association (Liaison Commission on Medical Education/LCME) or the American Osteopathic Association (Commission on Osteopathic College Accreditation/COCA).
Despite the number and quality of New York physicians that our medical schools produce, however, manpower studies project a physician shortage by the year 2020. In response to these projections, a new medical school just opened in New York last fall, another is in the application stage, and existing New York medical schools have plans for expansion. To properly educate this growing student body, adequate introductory clinical training experiences are needed by first- and second-year students, and core-curriculum training experiences in hospitals and out-patient facilities are needed by those in their third and fourth years.
In addition to the growth in the number and size of New York medical schools, however, there is also a proliferation of medical schools offshore. The educational quality of their programs does not approach that of those in New York State. These offshore schools are proprietary, for-profit institutions. Most are located in the Caribbean, and none meet LCME or COCA accreditation standards. Though not accredited, these offshore proprietary medical schools have begun paying NYS hospitals to guarantee clinical rotations for their third- and fourth- year students. Consequently, they are displacing students from New York’s LCME- and COCA- accredited schools! MSSNY and the Associated Medical School Association of New York are actively engaged in fact finding and expect to report discoveries and recommendations in the near future.
It is already clear to me; medical education should not be used as a revenue source for a hospital’s financial bottom line, especially if accepting such monies results in students from New York’s accredited schools not having the opportunity to be properly trained. Hospitals demand and deserve adequate funding for their operations from sources that don’t jeopardize the quality of the physicians they entrust to patient care.
Moving on to another topic that has been the source of most news headlines and interviews this week – MSSNY and our county medical societies have a long-standing relationship with our Lt. Governor. In particular, New York County Medical Society worked with David Paterson when he was a senator. Regular health care breakfast meetings took place in which all who attended were impressed by his knowledge and commitment to medical education and to health care delivery systems. Though unexpected, we assume his transition to governor will be a smooth one and place our faith in his commitment to the peoples of the state to accomplish these goals.
Robert B. Goldberg, DO
President
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Capital Update
A SHOCKING AND SADDENING TURN OF EVENTS CONCLUDES WITH THE HOPE AND PROMISE OF A NEW GOVERNOR
A tragic series of events this week which rocked Albany, and, indeed, the entire State of New York, has concluded with the resignation of Governor Eliot Spitzer, effective Monday, March 17th. Lieutenant Governor David Paterson will take the oath of office at 1:00 p.m. on Monday, March 17th. Lieutenant Governor Paterson held a press conference on Thursday of this week to state that he is ready to assume the office of Governor and is already working around the clock to fully inform himself concerning the many, many complex issues which will now be before him as Governor. In the short term, the on-time passage of the state budget by April 1st is obviously the most critical challenge before Governor Paterson. The implications of this transition are as of yet unclear. We do know, however, that soon-to-be Governor Paterson is a compassionate individual and an extremely intelligent and thoughtful leader. We know that he is well-liked by legislators on both sides of the aisle, policymakers and pundits alike. It will take time to assure that he and his staff are appropriately informed of the many different facets of our two primary areas of concern: medical liability reform and managed care reform. Your governmental affairs staff has already begun to reach out to Governor Paterson and his staff as we continue to pursue our objectives to redress these and other important concerns of organized medicine. In the meantime, it is essential that physicians and their staff and patients continue the grassroots advocacy efforts which we have already asked you to pursue. In this regard, with respect to medical liability reform, we again ask that you do each of the following:
1) Work with your County and/or Specialty Medical Societies to schedule meetings with each legislator - Republican and Democratic - in your community as a follow up to the Legislative Day/Rally. Remember, this is a marathon, not a sprint, and we need to continue to interact with our legislators on this issue.
2) Work with your County and/or Specialty Medical Societies to schedule meetings with the Media - appear on radio, TV, attend Editorial Board meetings scheduled by the County/Specialty Medical Society and send in Op Ed pieces to the press in your area. A template piece has been provided by MSSNY to your County/Specialty Medical Societies.
3) Facilitate Patient-Legislator interaction using petitions which MSSNY will provide to you.
4) Regularly utilize the convenient grassroots action tools provided by MSSNY:
§ Call the Liability Reform Hotline, 1-866-728-3397, which will generate a faxed letter to the Governor, Assembly Speaker Silver, and Senate Majority Leader Bruno.
§ Urge your patients to call the 1-866 hotline. There is a patient access point that generates a similar patient focused letter to the above-referenced leaders.
§ Send a letter to your local Assemblymember and Senator from the MSSNY website. There is a link on the front page of the MSSNY website to the sample letter. There is also a patient letter on the website.
5) Seek opportunities to speak to community organizations such as your local Chamber of Commerce or Kiwanis, etc. to convey the seriousness of the situation. A template speech has been drafted by MSSNY and can be provided to you upon request.
Your advocacy, coupled with that provided by MSSNY through its physician leaders and Division of Governmental Affairs, is critical to the overall success of our mission to attain meaningful redress of our medical liability situation this year. (DIVISION OF GOVERNMENTAL AFFAIRS)
BUDGET CONFERENCE COMMITTEE DISCUSSIONS TO BEGIN MONDAY
Joint Budget Conference Committees will commence this upcoming Monday following the Assembly and Senate passing their respective one-House Budget proposals this week. The State’s new fiscal year begins on April 1. Among the major problems to be grappled with by the Senate, Assembly and incoming Governor Paterson over the next two weeks is closing a $4.6 billion Budget gap.
Importantly, the Senate’s Budget resolution identified medical liability reform as one of its priority issues to be worked out as part of the State Budget. The Senate’s Budget proposal also included an additional $3 million for MSSNY’s successful physician Health Information Technology Program, funding which had not been included as part of the Executive Budget proposal introduced earlier this year. The Senate’s Budget proposal also maintains $24 million in new funds that had been proposed in the Executive Budget to enhance the delivery of primary care to Medicaid recipients, including through additional reimbursement to physicians and clinics.
Both the Senate and Assembly’s Budget proposals maintained funding for a substantially expanded Physician Loan Repayment Program (“Doctors Across New York”) that had been proposed in the Executive Budget, although the Assembly proposes to expand eligibility to physician assistants, nurse practitioners, dentists and nurse-midwives. Both Houses also included funding for several initiatives of importance to organized medicine that had been contained in the Executive Budget proposal, including continuation of the Excess Medical Malpractice Insurance Program; funding for MSSNY’s Committee for Physician Health, and an additional $100,000 for MSSNY’s HIV “Get Tested, Get Treated” educational program. (DIVISION OF GOVERNMENTAL AFFAIRS)
LEGISLATION ADVANCES TO CONTINUE COMMITTEE ON PHYSICIAN HEALTH
Legislation (A.10052, Gottfried/S.6999, Hannon) to extend for five years the Committee for Physician Health has been passed by the NYS Assembly and will be considered by the Senate Health Committee next week. The CPH program was created in 1983 to allow for the confrontation and referral for treatment of physicians suffering from alcoholism, drug abuse or mental illness. If enacted, this would be the eighth extension of the original three-year demonstration period and covers the period April 1, 2008 to March 31, 2013. The Medical Society of the State of New York strongly supports the continuation of this important program. (DEARS, AUSTER)
AMPAC CAMPAIGN SCHOOL TO BE HELD APRIL 9-13, 2008
The American Medical Association Political Action Committee (AMPAC) has a handful of slots remaining for their 2008 Campaign School, to be held April 9-13, 2008. These programs provide political training for physicians and other friends of medicine who are interested in either seeking public office or in working to elect friends of medicine. The program will be held at the Ritz-Carlton Pentagon City in Arlington, VA, just a short ride from Reagan Washington National Airport. AMPAC covers all costs save transportation to the Washington, DC area for AMA members and their spouses. Non-AMA member physicians are only admitted if space allows and upon the payment of tuition. For more information, contact Jim Wilson, Manager, Political Education Programs, AMA, at 202-789-7465 or jim.wilson@ama-assn.org. Additional information has been sent to county medical society executives across New York State. (AUSTER)
For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:
rabrams@mssny.org gconway@mssny.org ldears@mssny.org mauster@mssny.org pclancy@mssny.org bellman@mssny.org eclinton@mssny.org
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eNews
NYC Information Technology Program Slated for April 4
Space is filling quickly for the New York City MSSNY Health Information Technology scheduled for Friday April 4 at the Park Central Hotel at Seventh Avenue and 55th Street. The all-day event is open to physicians and office managers. There is no charge and lunch will be served. In addition to a series of presentations from physicians and computer experts who will provide guidance on transitioning to electronic systems, attendees will have the opportunity to meet personally with six EMR firms recommended by MSSNY. Attendees can participate in system demos and discuss their specialized office needs.
Hib Vaccine Shortage Requires Deferment of Booster and Prioritization
The recall of certain lots of two of the types of Hib vaccine has created a temporary shortage of Hib vaccine. Consequently, the NYSDOH and the CDC, as well as the American Academy of Pediatrics and the American Academy of Family Physicians, are asking physicians to defer administering the Hib vaccine booster dose that is routinely given to most pediatric patients at age 12-15 months. Exceptions to this request are children at high risk for Hib disease.
High Risk children include those with sickle cell anemia, asplenia, malignancy, HIV infection, immune system disorders and Native Americans.
ALL children should still get the primary series, however – the first 2 doses of PedvaxHIB or the first 3 doses of ActHIB, as long as supplies remain adequate. Physicians should keep track of all children who do not get the complete Hib series and call them back as soon as national supplies are adequate again and individual physicians have restored their own supply.
The NYS Vaccines for Children (VFC) Program is taking steps to help ensure that children receive vaccine to at least meet their minimum needs. This includes prioritizing vaccine for practices that have no supply, limiting the amount and frequency of physician orders, informing physicians of any changes in supply and permitting physicians to borrow from their private supply for VFC patients and vice versa. No borrowing can take place without first contacting the NYS VFC Program, however, at 518-474-4578.
For complete details, go to the NYS-DOH Immunization advisory that was issued on December 26, 2007 and posted on the Health Provider Network website.
To find out which specific lots have been recalled, visit the website of Merck or the FDA.
If you have questions not answered online about the Hib vaccine and/or recommendations for administering it, the NYSDOH asks you to call your local health department or the NYSDOH Immunization Program at 518-473-4437. Telephone questions about vaccine ordering can be directed to the NYS Vaccines for Children VFC Program at 518-474-4578.
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Hassle Factor Form
If you have any complaints regarding insurance carriers, you can go to the Hassle Factor Form found on our website.
Not yet a member? MSSNY’s achievements benefit all physicians!
Join your colleagues at:
http://www.mssny.org/mssnyip.cfm?c=s&nm=Applications.
Member already? Please forward this to 2 of your colleagues and ask them to join you in supporting the profession.
Weekly Update for New York State Physicians
Volume 8, Number 10
Christina Cronin Southard, Editor
mssnye-news@mssny.org
Colleagues:
This past Tuesday’s We-Are-Not-Going-to-Take-It-Any-More Rally in Albany was one of the highlights not only of my year, but of my life. Over 1500 of us came from every sector of the state to be seen and heard by all of our legislators. The featured speakers were Governor Spitzer, Superintendent of Insurance Eric Dinallo, Senator Joe Bruno and Deputy Secretary of Health Denis Whelan, all of whom spoke to the throng that filled two theaters. Although the governor was not able to reveal the recommendations of his Task Force on Medical Liability, it is clear that the governor “gets it.” Mr. Spitzer was obviously sympathetic to the New York physicians’ plight for a solution to the broken tort system and the toll it has taken on us.
We then took our issues onto the steps of the Capitol building and, in spite of the freezing rain, everyone gathered on the steps and chanted, “Enough Is Enough!” And for the many members of ACOG, the additional chant was “Who Will Deliver Your Babies?” To the many television cameras and reporters made a strong statement of our frustration and anger. Then, to cap off the seriousness of our intent, about 200 physicians joined me and took off their white coats and threw them on the Capitol steps.
It was a day full of electricity, energy and purpose. I was so proud to be a part of such a historic event. We fully intend to keep up the momentum with office petitions and material for our patients to take our problem to their legislators.
Now, that I have you all in a positive mode, it is time to pass the plate. Let’s stay on point and keep up the pressure For members, a PAC contribution is in order.. Just visit https://www.mssny.org/logon.cfm?FinishedURL=https%3A%2F%2Fwww%2Emssny%2Eorg%2Fapps%2FPAC%2Findex%2Ecfm%3F For non-members, MSSNY has a blackbox Liability Fund to keep the battle cry loud and clear at https://www.mssny.org/apps/legislat/tortreform.cfm?
As I write this, I am looking at the image of the white coats on the Capitol steps, and I have difficulty seeing through the mist of tears at the what those coats represent—our commitment to the science and the art of caring for our patients. To view the photos from this incredible day visit our home page at https://www.mssny.org/index.cfm
Imagine—it has come to this.
Robert Goldberg, DO
MSSNY President
Capital Update
BY ALL ACOUNTS PHYSICIAN LOBBY DAY AND RALLY SUCCESSFULLY HIGHLIGHTS NEED FOR IMMEDIATE MEDICAL LIABILITY REFORMClose to 2000 practicing physicians descended on Albany this week to advocate for redress of the looming medical liability crisis in New York State. Addressing the crowd which assembled in both the Hart and Swyer theaters in the Egg, MSSNY President Robert Goldberg, DO said that New York State’s physicians can no longer shoulder the burden of the failed liability adjudicative system. “Malpractice litigation is out of control. There are too many suits and too many of them are without any justification whatsoever. We are tired of offensive trial lawyer rhetoric that insults our profession. The liability litigation system has failed, not the health care system. The problem must be fixed now.”
One of the high points of the day was the message delivered to the physicians in a stirring speech delivered by Governor Eliot Spitzer. He stated that his administration was aware of the problems and was working toward developing a meaningful solution. He said that last July, his administration had no choice but to impose the 14% increase because they were facing pent up financial instability of insurers which resulted from years of ignoring the problem. Governor Spitzer pointed to the work of his Task Force which is examining the fundamental questions regarding the medical liability problems we now face. “We’re not ignoring the numbers this year. We’re looking to see what we can get done…. I’m not participating in a rhetorical exercise…so that I can propose something that will go no where so that I can stand in front of you next year and get a standing ovation for having good ideas that didn’t help you…we will soon announce a set of proposals that are real, that are fundamental, and which will put us on a trajectory long term to deal with this issue in a way that will alleviate the pain you have been feeling…this is my pledge to you today”, said Governor Spitzer.
In addition to pledging to work toward medical liability reform, Governor Spitzer described several other initiatives his administration has proposed which would continue to fundamentally transform the health care system in ways that make sense. One such area of reform described by the Governor is his proposal to obtain reimbursement reform in the $46B Medicaid program. He addressed the rhetorical question of why there were so few primary care physicians in New York State. Governor Spitzer said “the answer is simple – “we’re not paying you… physicians work hard and are dedicated, but we can’t ask you to work for free …and yet that’s what we’ve done….clinic rates have been frozen for a decade and physician rates are the second lowest in the country…we will change that”. Governor Spitzer also noted that, as part of his proposed budget, he would take the first step toward universal coverage by assuring under his plan that every child in New York has coverage. The Governor also articulated his recognition of the problems that physicians are increasingly having in their interface with the managed care industry. He said “it is a nightmare… it is difficult… you feel quite rightly that you are put on the wrong end of the negotiating relationship”. The Governor stated that “we are working through those issues with you, with your incoming President, with Gerry Conway and we will get across the finish line”.
The audience also heard remarks by Superintendent Eric Dinallo, Deputy Secretary for Health Dennis Whalen and Senate Majority Leader Joseph Bruno each of whom pledged to work with the Medical Society to resolve the predominant issues of concern to organized medicine.
The morning program was followed by a demonstration on the Steps of the State Capitol. The physicians were joined by Dan Sisto, President of the Healthcare Association and Ken Raske, President of the Greater New York Hospital Association who demonstrated the unity of concern of the healthcare community to the burgeoning medical liability crisis.
Physicians later met with their elected representatives in their offices to discuss these issues in greater detail.
MSSNY Department of Governmental Affairs and Division of Communications wishes to thank all the County and Specialty Medical Society Executives who worked so diligently with us to make this day the success it was.
Legislation supported by MSSNY to better assist patients and their physicians in their dealings with health plans has passed the Assembly and advanced to the Senate for consideration. These bills include:
- A.4607, Gottfried, that would expressly prohibit a number of inappropriate practices that have been used by health plans, including prohibiting the use of so-called “most favored nation” clauses in physician contracts; prohibiting contract provisions that limit physician referrals to out of network providers; prohibiting a health plan from requiring a physician to include a diagnosis on a prescription in order for the prescription to be filled; and prohibiting any policy the “switching” of prescription drugs without the consent of the prescribing provider;
- A.4609, Gottfried that would prohibit a health plan from denying needed treatment for a patient based upon lack of medical necessity unless such denial is reviewed by a physician who is board certified or board eligible as the health care provider providing the care or treatment under review.
- A.3789, Gottfried that would assure that a patient’s physician or other health care provider is notified regarding the denial of a request for care and that an external appeal may be taken to challengethedenial. (AUSTER,DEARS )
Legislation (A.10052, Gottfried) to extend for five years the Committee for Physician Health was reported from the Assembly Health Committee for consideration by the full Assembly. Identical legislation (S.6999, Hannon) has been introduced in the Senate and is before its Health Committee. The CPH program was created in 1983 to allow for the confrontation and referral for treatment of physicians suffering from alcoholism, drug abuse or mental illness. If enacted, this would be the eighth extension of the original three-year demonstration period and covers the period April 1, 2008 to March 31, 2013. The Medical Society of the State of New York strongly supports the continuation of this important program. (DEARS, AUSTER)
LEGISLATION ADVANCES TO ENCOURAGE THE CREATION OF VOLUNTEER PHYSICIAN CLINICS
Legislation (A.9910, Delmonte/S.1562, Farley) is advancing in the Assembly and Senate that would permit, at the discretion of the Commissioner of Health, the creation of volunteer physician clinics across New York State. MSSNY supports this legislation. The bill seeks to build upon the tremendous success of the Schenectady Free Clinic, which has for several years provided free primary care to uninsured patients in Schenectady County. The Schenectady program has been staffed with recently retired physicians who receive liability coverage through a combination of public and private grants. Dr. Clifford Tepper, MD, made a presentation to the MSSNY Council this week highlighting the work of the Schenectady clinic and urging MSSNY’s continued support for this legislation.
Importantly, the legislation would provide that the physicians who provide care at these clinics would be treated as “employees” of the state, meaning that they would be entitled to defense and indemnity liability coverage provided by New York State, in addition to any coverage they may already maintain, in case they are sued for malpractice. This is particularly important for recently retired physicians, who often wish to volunteer to provide care to the uninsured, but cannot because of the high cost of maintaining liability insurance coverage. MSSNY has for several years advocated for either immunity or state indemnity for physicians who volunteer to provide care to the uninsured. Several regions across the State have expressed an interest in establishing these volunteer physician clinics.
The bill was reported from the Assembly Health Committee to the Assembly Ways and Means Committee this week, and was recently reported from the Senate Health Committee to the full Senate.
Similar legistlation passed both Houses in 2006, but was vetoed by the previous Governor.
(AUSTER, CONWAY)CUOMO SUBPOENAS HEALTH INSURERS REGARDING UCR CALCULATIONS
New York Attorney General Andrew Cuomo announced Thursday that he has issued subpoenas against several health insurance companies, including Aetna, CDPHP, Cigna, GHI, HIP United and Well point, according to the Associated Press. The subpoenas are part of a case first announced by AG Cuomo in February challenging that Ingenix, a subsidiary of United Health, inappropriately depressed the “usual and customary” rates paid to out of network physicians, resulting in higher costs for patients who are treated by physicians outside of a health plan network. MSSNY along with the American Medical Association several years ago brought a class action lawsuit against United challenging that Ingenix was using flawed data that resulted in UCR calculations being artificially suppressed. (AUSTER) For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:
| gconway@mssny.org | ldears@mssny.org | mauster@mssny.org | |
| pclancy@mssny.org | bellman@mssny.org | eclinton@mssny.org |
eNEWS
Register Now for MSSNY-Sponsored HIT Programs for NYS Physicians and Office Managers
Dates and locations:
· New York City Area… Friday, April 4th in Manhattan at the Park Central Hotel