Andrew Kleinman, MD
March 13, 2015
Weekly Update for New York State Physicians
Volume 15, Number 11
Christina Cronin Southard, Editor
Julie Vecchione DeSimone, Assistant Editor


I am pleased to report to you that the Governor has signed into the one year e-prescribing delay legislation, delaying the implementation date until March 27, 2016.  

This essential bill was made possible by the advocacy of MSSNY and the thousands of physicians who took the time to send a letter to the Governor and their legislators in support of this legislation.  

I would also like to take the opportunity to thank the hundreds of patients who also took the time to send these letters.  And of course, I would like to thank Senator Hannon and Assemblymember McDonald for sponsoring this critically needed legislation.  

Certainly, there remain many logistical issues that need to be addressed before this mandate goes into effect, but we now have a greater amount of time to work through these issues thanks to yours and our combined advocacy efforts.  

This again demonstrates the results of the hard work of our advocacy staff in Albany.

Andrew Kleinman, MD

Please send your comments to  




Governor Andrew Cuomo has signed legislation that would have allowed a one-year delay in the e-prescribing requirement.  The legislation, which passed the New York State Legislature unanimously, will delay implementation of the law until March 27, 2016.

MSSNY appreciates that the governor signed the bill into law and believes that this delay will allow time for prescribers to get their systems up and running and certified by the Drug Enforcement Agency (DEA) so that patient care will not be interrupted.

When the mandate goes into effect on March 27, 2016, it will apply to all prescribers (except veterinarians) and to all medications – both controlled and non-controlled substances.  The mandate was part of legislation to reduce drug diversion and to eliminate prescription problems due to misunderstood handwriting, stolen prescription pads, and “doctor shopping.”

Do Not Wait; Start Process Now

Despite the one-year delay, MSSNY encourages physicians to continue to comply with this requirement as quickly as possible. MSSNY staff will continue to assist individual physicians and practices with information on how to comply with the e-prescribing requirement. MSSNY also has vetted individual software venders, provides that information to MSSNY members, and has entered into an exclusive relationship with DrFirst, a standalone e-prescribing software vendor. Please go to the MSSNY website at: for information on DrFirst, located in the blue tap on the upper right hand corner.

MSSNY, the AMA, and over 20 other statewide prescribers and long term care associations worked together to seek this delay, as many EHR vendors, including several with significant market share in New York State, are not yet certified for electronic prescribing of controlled substances (EPCS) and would not be certified in most cases until after the current March 27, 2015 deadline has passed. This was quite concerning for all prescribers, particularly large-group and institutional prescribers, whose systems must be tested and re-tested to remove operational flaws before the installation and implementation of software updates.  Additionally, there are numerous unanswered questions pertaining to physicians in a nursing home setting.  MSSNY has also pointed to the number of complications that could delay patient receipt of their medications, including the fact that the e-prescribing law will now greatly limit the ability to shop around for the lowest-priced medications.  MSSNY has also presented this issue to the press, and our concerns were highlighted in numerous articles and TV and radio programs about the impact the e-prescribing requirement could potentially have for patients.  

Special Circumstances Where a Paper Prescription May Be Issued after March 27, 2016

There are provisions under the e-prescribing regulations when paper prescriptions can be written, and this includes circumstances where electronic prescribing is not available due to temporary technological or electrical failure.

Temporary technological or electrical failure is defined as  any failure of a computer system, application, or device, or the loss of electrical power to that system, application, or device, or any other service interruption to a computer system, application, or device in such a manner that reasonably prevents a practitioner from utilizing his or her certified electronic prescribing application to transmit an electronic prescription for a controlled substance in accordance with this section and federal requirements.  In the instance of a temporary technological or electrical failure, a practitioner shall, without undue delay, seek to correct any cause for the failure that is reasonably within his or her control.

Any practitioner who issues a paper prescription must file information about the issuance of such prescription with the department as soon as practicable, but in no instance more than 72 hours following the end of the technological or electrical failure that prevented the issuance of an electronic prescription.

A practitioner may write a paper prescription when such practitioner reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient's medical condition, provided that if such prescription is for a controlled substance, the quantity of controlled substances does not exceed a five-day supply if the controlled substance were used in accordance with the directions for use.

A practitioner may also issue a paper prescription if that prescription will be dispensed by a pharmacy located outside the state. 

A practitioner who issues a paper prescription due to concern about the delaying patient care or issues a paper prescription in cases where the prescription is being dispensed by a pharmacy outside the state must notify the NYS Department of Health within 48 hours of the date of issue.

Waiver process

The New York State Department of Health has not yet issued its formal waiver process; however, physicians who are interested in seeking a waiver should immediately contact the department.  The department has indicated that information will be shared about the waiver process with stakeholders and those that have preliminarily contacted DOH. 

Send an email to and provide the following information:

Street address, city, state, zip code
Email address
License number
DEA registration number
Reason you are applying for waiver
Phone number or alternate number

The waiver process, as articulated by the regulations and the law, indicated that a waiver may be issued by the commissioner based upon a showing of a practitioner that his or her ability to issue an electronic   prescription in accordance with this section is unduly burdened by:

a)   economic hardship;

b)   technological limitations that are not reasonably within the control of the practitioner; or

c)    other exceptional circumstance demonstrated by the practitioner.   (DOH has not articulated these circumstances.)

The practitioner's request shall include a sworn statement of facts detailing the circumstances in support of a waiver, and should be accompanied by any and all other information which would be relevant to the commissioner's determination.  The practitioner shall also provide any information which would tend to negate the need for a waiver.  A waiver shall be granted by the commissioner for a specified period of time, but in no event for more than one year.  A practitioner may apply for a    renewal of a previously granted waiver.  Any application for the renewal of a previously granted waiver shall include an updated statement of facts detailing the continuing circumstances in support of the renewal, along with any facts reasonably known to the practitioner which tend to weigh against the granting of a renewal.  
Any renewal granted shall be subject to the same requirements as the original waiver.                                                                          

 We would like to take the opportunity to thank the thousands of physicians who took the time to send a letter to the Governor and their legislators in support of this legislation.  We also would like to thank the hundreds of patients who also took the time to send these letters.  And of course, we would like to thank Senator Hannon and Assemblymember McDonald for sponsoring and shepherding to enactment this critically needed legislation.                       




Each House this week introduced and passed one House budget bills. Below we set forth a description of the provisions within each bill which affect MSSNY members.

1. Both Houses would maintain the physician profile system. The Assembly bill expressly stipulates that the funding of the profile system will come out of existing registration fees as has been done previously. The Senate bill is silent as to who would pay for the system. The Senate requires any changes to the profile on the non-optional information required to be provided be made within thirty days of the change. This is already required by regulation.

2. The Assembly retains the Urgent Care and OBS provisions proposed by the Governor in their entirety. The Senate eliminates the Urgent Care provisions but would require each urgent care practice to utilize and maintain an EHR that connects to the local RHIO (see further description below). With regard to OBS, the Senate bill takes out the language we find problematic except that which would expand the definition of an adverse event to include an emergency department visit within 72 hours of OBS or assignment to observation services and:

  • Requires the Commissioner to convene an OBS workgroup comprised of no less than five physicians currently accredited in OBS and no less than two anesthesiologists, two chiropractors and two podiatrists. The workgroup is to examine the scope of OBS and whether certain surgical procedures not currently provided in this setting should be, whether surgical procedures currently provided in this setting should not be and whether non-surgical procedures involving certain levels of anesthesia should be provided in this setting. The workgroup must consider what other states cover under this accreditation and what Medicare covers in this setting. The workgroup is charged with reporting and recommending any statutory changes they deem appropriate to the legislature.
  • Requires every OBS practice with full accreditation status to be eligible to seek payment from a health plan for costs related to the use of the surgery location or setting and specifies that this fee is in addition to the procedure fee; provided that the plan reimburses a facility fee for the same procedure performed at a hospital or ASC.
  • Requires OBS practices to conduct QI and QA activities and utilize ABMS or equivalent certification, hospital privileging or other equivalent methods to determine competency of practitioners. Specifically protects from disclosure under Freedom of Information Act or Article 3103 of the CPLR (pursuant to litigation) of the information collected, maintained and reported to DOH or the accrediting agencies and maintained by the OBS practice under QI or QA.
  • Requires the accrediting agencies to report data from OBS practices to DOH.
  • Requires OBS practices to utilize and maintain an EHR that connects to the local RHIO (see further description below).

3. The Assembly rejected the retail clinic language proposed by the Governor and opposed by MSSNY. The Senate retained the retail clinic language and expanded upon it by specifically allowing a DTC, community health center, FQHC and a hospital to operate a retail clinic.

4. The Senate would require in two years that all urgent care practices, OBS practices, and hospitals to utilize and maintain an EHR that connects to the local RHIO and requires RHIOs to ensure they are accessible and capable of connecting all hospitals, OBS and urgent care practices and anyone else who wishes to connect to the RHIO. Waivers for economic hardship, technological limitations or other exceptional circumstances would be allowed.   Loans from the State would be available from an HIT/EHR loan program.

The Senate bill conditions any funding for the SHINY (State Health Information Network) on the submission of a plan prepared by DOH in consultation with healthcare stakeholders on how the funds will be used to support providers attaining MU; support DSRIP health information exchange; increase participation in RHIOs; address concern regarding liability of providers that lawfully share data that is misused by other health information exchange participants.

5. Both Houses removed the language from the Executive’s proposal which created receipt of a tax clearance as a condition precedent for eligible physicians to receive Excess coverage. And each House has appropriated $127.4M for the program.

6. The re-appropriations for MSSNY’s Veteran’s Mental Health grants at $150K and $165K are in both bills. The Senate has put $2.25M in a lump appropriation for Veteran Mental Health grants. MSSNY has requested additional money to expand its work in this area.

7. CPH is appropriated in both Senate and Assembly bills at $990,000.

8. In a play reminiscent of last year’s NP expansion, the Senate has included in the Education and Labor budget bill language to authorize chiropractors to partner with physicians which is otherwise a violation of the corporate practice of medicine doctrine. The physicians would remain in control of the LLC. 

9. The Senate and Assembly each added language to their respective one-House Budgets that would extend “prescriber prevails” protections to all drug classes for patients covered through Medicaid managed care plans.

10.  The Senate and Assembly each accepted language proposed by the Governor that would remove application fees for a physician to submit a dispute to arbitration under Workers’ Compensation. 

The Joint Conference Committee process has begun with the expectation that these issues will be finalized and a budget adopted prior to April 1st.  

Only a few weeks remain until the many provisions incorporated in last year’s “surprise medical bill” law go into effect.  Among the new requirements are disclosures that all physicians, hospitals, and health plans will need to make to patients starting April 1.  MSSNY’s General Counsel Donald Moy, Esq. has developed model template disclosure forms for MSSNY members that physicians can use in their practices to comply with new law, which are available

These new requirements include:

Network and Hospital Affiliations

All physicians must provide to patients or prospective patients in writing or on the physicians’ website prior to the provision of non-emergency services:

  • The health care plans with which the provider participates; and
  • The hospitals with which the health care professional is affiliated  

For the model form physicians can use in their practice, click here, Model Form #1

In addition, this participation/affiliation information must be provided verbally at the time an appointment is scheduled. 

Fee Disclosure

Physicians who do not participate in the network of a patient's or prospective patient's health care plan must:

  • Prior to the provision of non-emergency services, inform the patient or prospective patient that the amount or estimated amount the patient will be billed for health care services is available upon request;
  • Upon receipt of a patient or prospective patient’s request, the amount or the estimated amount (in writing) the patient will be billed for health care services, absent unforeseen medical circumstances that may arise when the health care services are provided 

For the model forms physicians can use in their practice, click here, Model Forms #2-A, 2-B and 3

Other Health Care Providers Involved in Providing Patient Care

All physicians who refer or coordinate services for patients with another provider must provide to their patients the name, practice name, mailing address, and telephone number of any health care provider scheduled to perform anesthesiology, laboratory, pathology; radiology; or assistant surgeon services, in connection with care to be provided in the physician's office;

  • as coordinated by the physician; or
  • as referred by the physician. 

For the model forms physicians can use in their practice, click here, Model Form, #4

Other Physicians Involved in Hospital Care

At the time of a patient’s pre-admission testing, registration or admission for scheduled hospital admission or outpatient hospital services, all physicians must provide their patients with the name, practice name, mailing address and telephone number of any other physician whose services will be arranged by the physician and are scheduled at the time non-emergency services are scheduled. 

For the model forms physicians can use in their practice, click here, Model Form #5.

There are also numerous other provisions incorporated into this new law which also take effect of April 1.  For a summary, click here.                                                       




New York Attorney General Eric Schneiderman announced an agreement with EmblemHealth this week requiring it to cover anesthesiology services provided in connection with an in-network preventive colonoscopy, without any cost-sharing by the patient.  Emblem has also issued refunds to hundreds of Emblem members who paid a copayment, coinsurance, or deductible for such anesthesiology services. 

To read the AG’s press release, click here

To read the full agreement, click here

The press release notes that, because colonoscopies necessitate the administration of anesthesia, anesthesia services provided in connection with preventive colonoscopies should likewise be covered without member cost-sharing.  In the past, only certain Emblem plans were structured to adhere to this principle, but even those plans failed to remove cost-sharing obligations for such anesthesia services. The agreement provides that Emblem will cover in full all claims for anesthesiology services provided in connection with an Affordable Care Act-mandated in-network preventive colonoscopy.  

Among the situations highlighted in the settlement document was a situation where Emblem inappropriately imposed cost-sharing responsibilities on a patient who had used an out-of-network anesthesiologist in conjunction with in-network colonoscopy procedure.

The agreement also requires Emblem to send reimbursement checks to members of certain Emblem plans whose claims for anesthesia performed in connection with an in-network preventive colonoscopy were processed subject to member cost-sharing. Reimbursements total close to $400,000. In addition, the agreement provides that Emblem will train its employees, and pay a penalty.                                            

Legislation that would require physicians to take three hours of continuing education on pain management, palliative care, and addiction is now on the Assembly floor for a vote.   Immediate physician action is needed to stop this measure from passing.   Physicians are urged to send a letter urging defeat of this measure:

Assembly Bill 355, sponsored by Assemblywoman Linda Rosenthal, would require three hours of course work every two years for physicians and other healthcare workers.   Under the bill’s provisions, the course work would include each of the following topics:  I-STOP and drug enforcement administration requirements for prescribing controlled substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; prevention, screening, and signs of addiction; responses to abuse and addiction; and end-of-life care.  At this time, there is no Senate version of the bill, but it is expected that there probably will be a similar measure introduced in the near future.                                                         


Assemblymember Richard Gottfried’s bill to bring single-payer health care to New York is now the subject of an economic analysis. The verdict: New York State could save $71 billion by eliminating private insurance, negotiating down drug costs and reducing billing fraud, according to a paper by Gerald Friedman, economics chair of the University of Massachusetts at Amherst.  Vermont last year scuttled plans for single-payer health care after deciding the switch would be too expensive.  The author of the economic study, however, believes that such a scenario is unlikely in New York.  According to an article published this week, Mr. Friedman is quoted as saying that “New York is a lot richer, and would be able to carry out this plan with significantly lower tax rates than other states, like Oregon and Vermont.  Even though health care is expensive in New York, and there’s more health care spending per capita, there is more income [here].”  Vermont’s plan exempted many employers, leaving relatively few who could bear the higher taxes and benefit from the system.  

The $71 billion in savings includes eliminating employers’ and providers’ costs to interact with health plans, reducing billing fraud, and negotiating down prescription-drug costs.  The Gottfried proposal also would raise Medicare and Medicaid rates to those paid by private insurance.  It does not directly address physician and hospital charges.  To pay for the program, the paper suggests a payroll tax of 9% to 16%, split between businesses and employees. Almost 60% of the revenue raised would come from families making more than $200,000 a year.   To read Professor Friedman’s study, click

The state-funded Regents Physician Loan Forgiveness Award Program will grant 80 awards to physicians who agree to practice primary care medicine in an area of New York State designated by the Board of Regents as having a shortage of physicians.  Award amount is based on undergraduate and medical school student loan amounts and loan interest expense.  Award recipients will receive two annual payments of up to $10,000 each year for two years.  Recipients who have incurred more than $20,000 in eligible expenses may apply for an additional two-year award.  The amount of the award received will be based upon the amount of undergraduate and medical school loans and loan interest expense incurred by the physician.  Offers for 2015 awards will begin to be made to eligible individuals in July 2015.  Applicants who are unsuccessful in this competition may compete in subsequent years, provided they continue to meet the eligibility requirements.  The deadline for applications for this year’s awards is June 1, 2015.   

More information is available here.  

To contact the program administration directly with questions: 

PreCollegiate Preparation Programs and Scholarships Unit

NewYork State Education Department
Room 505W, Education Building 
Albany, NY 12234
(518) 474-3719

Physicians from all localities will join forces in the state capital on May 12 to advocate for their patients and profession during the New York Coalition of Specialty Physicians Annual State Lobby Day.  The Coalition, of which MSSNY is a member, is a partnership of surgical and medical organizations committed to battling inappropriate allied-health provider expansion legislation and to advancing bills of importance to all of medicine. 

The day will kick off with a breakfast, legislative briefing, and Q&A session in the Empire State Plaza.  Immediately following, physicians will meet with their elected representatives in the Senate and Assembly. Attendees will be paired with physicians of other specialties and provided with easy-to-understand talking points so they can effectively present their arguments and positions.

Significant changes in the composition and balance of power in the legislature will make this a particularly challenging year for all of medicine, and we need the support and involvement of everyone if we are to succeed in our goal of maintaining the highest quality of care standards for the citizens of New York. 

To register for the event, please click here by April 17:  

New York State Department of Health Commissioner Howard Zucker will host a medical grand rounds on Tuesday, March 31 at the Albany School of Public Health at 6-8 p.m.  The topic is “Your Practice and the NYSDOH  OPMC”. Presenters will be: Keith W. Servis, Deputy Director of Office of Primary Care & Health Systems Management, Director of The Center for Health Care, Quality and Surveillance, Director of Office of Professional Medical Conduct (OPMC) and Paula M. Breen, Deputy Director of Office of Professional Medical Conduct (OPMC) be the presenters.  The University at Albany School of Public Health is located at 1 University Place, Conference Room 110A Rensselaer, New York 12144-3445There is no charge for this event, but advance registration is required. Please register here.

Sandwiches and light refreshments will be served.   A copy of the flyer can be found here.

The Medical Society invites physicians and other health care providers to its live seminar, HCV: Diagnosis, Treatment & Prevention—In the Crosshairs Targeting HCV,  on Thursday, March 26, 2015, from 7:30 - 9:00 a.m. at the Salvatore’s Garden Place Hotel, Fiore Room, 6615 Transit Rd., Buffalo, NY, 14221.   Continental breakfast and registration will begin at 7 a.m.  This program is free to physicians and other health care providers, and complimentary parking in the Salvatore’s Garden Place Hotel is available to participants.

Pre-registration for this event is required at  Click on the “Upcoming” tab and select the registration button to the right of the program.   Or physicians may contact Emily McMullen at the Erie County Medical Society  at  716-852-1810 or by email at or Anna Cioffi at 518-465-8085 or to register. 

Faculty for this event is Michael Mancenido, DO, Infectious Disease specialist.   Dr. Mancenido is a graduate of the UMass Medical School’s Internal Medicine Residency and Infectious Disease fellowship programs.  He completed his undergraduate studies at Georgetown University.  Majoring in biochemistry and studying the liberal arts motivated Dr. Mancenido to choose medicine as a career and ultimately, Internal Medicine/Infectious Diseases.  Dr. Mancenido has been a staff physician at Trillium Health for the past eight years, treating patients with HIV, hepatitis c and primary care needs. The educational objectives are:

  • Describe the epidemiologic features of Hepatitis C, and recognize the risk behaviors and risk exposures that are implicated with Hepatitis C transmission;
  • Implement the current CDC recommendations for testing in select populations and the requirements under New York State public health law;
  • Review the serological and virological assays for screening and diagnosing Hepatitis C and learn the testing algorithm for diagnosing acute and chronic hepatitis c infection;
  • Understand the natural history of untreated chronic Hepatitis C infection and select the most appropriate tests for assessing the degree of liver injury; and
  • Become familiar with the directly acting antiviral agents in the new HCV treatment guidelines, and make the appropriate referrals.

The Medical Society of the State of New York designates this live activity for a maximum of 1.5 AMA/PRA Category 1 credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.                                                                                                      
(CLANCY, HARDIN, CIOFFI)                          

MSSNY will hold its second Medical Matters webinar of the year on March 18, 2015, with a program entitled: Epidemiology 101”.   The March 18th webinar will be held from 7:30-8:30 a.m. and educational objectives for this program include:

  • Recognize the definition of and key concepts in epidemiology;
  • Describe basic statistical measures used commonly in health care. 

Faculty will be William Valenti, MD, chair of MSSNY Infectious Disease Committee and member of the Emergency Preparedness and Disaster/Terrorism Response Committee and Arthur Cooper, MD, MS, vice chair of the Emergency Preparedness and Disaster/Terrorism Response Committee.  Registration is now open for physicians and other health care providers at   Click on the upcoming tab and select the registration button to the right of the program.   For assistance or questions, please contact Melissa Hoffman at or at 518-465-8085.  

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  Medical Matters program has been under guidance of the MSSNY Emergency Preparedness and Disaster/Terrorism Response Committee and is funded through a grant from the state Department of Health.

Additional Medical Matters topics are as follows:

April 15, 2015 - 7:30 a.m.

Understanding NYS Law in a Public Health Emergency

(EAUs, PREP Act, and Waivers)

Faculty: Holly M. Dellenbaugh, Esq.

Division of Legal Affairs, New York State Department of Health

Educational Objectives:

  • Recognize how the government may suspend state and federal laws relating to patient care;
  • Describe how the federal Emergency Use Authorizations may affect patient care during a public health emergency;
  • Review how the PREP Act provides liability protection during a public health emergency.

May 20, 2015 - 7:30 a.m.

Vulnerable Patients in Disasters (Special Populations)

Faculty: Lorraine Giordano, MD

Educational Objectives:

  • Identify the various types of vulnerable patients and the special needs of these populations;
  • Describe the skills to assist these patients in developing personal disaster plans;
  • Identify resources to assist vulnerable patients in times of crisis;
  • Describe the communication mechanisms to meet basic and medical needs during and after a disaster. 

The Medical Society of the State of New York will  offer its final  webinar on “HIV 2015: Diagnosis, Treatment and Prevention-- Current Perspectives” March 24th from 7:30-8:30 a.m.  Physicians and other providers can register for the webinar at:   Click on the “upcoming” tab and select the registration button to the right of the program.  Seating is limited for the webinars; physicians are encouraged to reserve their spot as soon as possible. 

Faculty is William Valenti, MD, chair of MSSNY Infectious Disease, a member of the on Governor Andrew Cuomo’s “Task Force to End the Epidemic 2020,” and co-chair of the Task Force’s Clinical Care Committee.   Educational objectives are as follows: 

  • Apply diagnosis and treatment for all HIV infected individuals;
  • Become familiar with the key points of new HIV testing laws and understand the provisions of the HCV law;
  • Implement the new HIV testing algorithm;
  • Describe the activities that can bring HIV to sub-epidemic proportions and result in individual and community viral load suppression. 

Physicians may also contact Anna Cioffi; or at 518-465-8085 to register.   The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA/PRA Category 1 credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.          


For more information relating to any of the above articles, please contact the appropriate contributing staff member at the following email addresses:






2015 Resolutions Are Due Today; Send Late Submissions to Laurie Mayer
The deadline for submission of resolutions to be considered at the 2015 House of Delegates should be submitted by 5 pm today
Resolutions received after March 13 must go to the Rules committee and there is no guarantee that the Rules committee will allow the late resolution to proceed as business of the House. Authors of resolutions submitted after the deadline will be required to attend the Committee meeting on Thursday, April 30 at 2:00 PM in order to defend the late submission.  Merits of the resolution topic are not discussed.

The proper format for submitting resolutions is installed on the MSSNY website within the HOD pages.  Resolutions should be emailed as word documents. PDF files are unacceptable.  Ensure that we can identify who is sending the resolution in case there are questions.  Please send your resolutions for consideration as soon as possible to:

DOH Presents March 26 Webinar re Harmful Algal Blooms
On March 26th from 11:30 am – 12:30 pm, New York State Department of Health Center for Environmental and University at Albany School of Public Health are offering a free webinar entitled: Health Concerns of Harmful Algal Blooms.

Harmful algal blooms (HABs), often caused by cyanobacteria, have become a national and state concern due to increases in prevalence related to environmental conditions. Human or animal exposure to HABs and their associated toxins can pose a wide range of mild-to-serious health risks, such as dermatitis, gastrointestinal upset, liver damage, and neurological damage.

This webinar will inform physicians, and other healthcare providers about the health concerns associated with HABs by presenting environmental information and reviewing case studies of both humans and animals. Continuing Medical Education (CME) credits totaling 1.0 credit hours will be offered.

Spots are limited, so register today.

Federal Court Keeps Medicare RAC on Hold
The U.S. Court of Appeals for the Federal Circuit issued a decision Tuesday (PDF) that said a lower federal claims court must reconsider how the CMS is procuring new contracts for the RAC program. (Modern Healthcare, 3/12)

RACs audit hospitals, doctors and other providers to ensure Medicare payments are accurate and appropriate. The CMS outsources the program to four private companies—CGI Federal, Connolly, HealthDataInsights and Performant Recovery—and pays RACs a contingency fee for every overpayment found.

The central issue in the bidding dispute is the contingency fee. The CMS started the process to award new four-year RAC deals in 2014. Since the program started in 2008, RACs have been paid after the overpayments are collected from providers, which takes about 41 days, on average.

But in the latest bidding process, the CMS proposed a different payment method. RACs would be paid after a provider's challenge “passed the second level of a five-level appeal process,” according to the CMS. That posed a big hurdle for RACs because providers often appeal the overpayment decisions. And getting past the second level of appeals takes much longer—anywhere from four months to more than a year.

CGI filed a protest against the new payment terms. The company argued that if the CMS wanted to impose the new payment terms, it had to procure contracts through a more time-consuming request-for-proposals process instead of the more straightforward commercial bidding.

Either way, there will be a significant delay for the new contracts. CGI, Connolly, HDI and Performant in December had their contracts temporarily extended through 2015 in light of the contract disputes. However, their ability to audit hospitals and other providers has been severely hampered.



Member Mortgage Benefit  
As a member of the Medical Society of the State of New York (MSSNY), you are eligible for the following discounts:¹ with Merrill Lynch Home Loans™ on residential home loans 
  • 0.25% fee discount to be applied to closing costs and fees on loan amounts less than or equal to $417,000 on all first mortgage products, excluding Home Equity Lines of Credit (HELOC) 
  • 0.50% fee discount to be applied to closing costs and fees on loan amounts greater than $417,000 on all first mortgage products, excluding Home Equity Lines of Credit (HELOC)    100% Financing Strategies available for well qualified borrowers on loan amounts greater than $417,000 
Relationship pricing discounts up to 0.75% available for well qualified borrowers on loan amounts for refinance and new purchases greater than $417,000

Study: Rochester RHIO Reducing Redundancies through Care Coordination
A study, recently published in the American Journal of Managed Care, focuses on the Rochester Regional Health Information Organization, a nonprofit HIE launched in 2006, found that dozens of healthcare providers shared medical imaging data through the Rochester HIE, reducing the odds of redundant medical imaging by 25%.(HealthLeaders 3/11)

"A technology-driven improvement in care that represents both higher quality and potentially lower costs," is suggested by the findings, researchers conclude.

Several dozen healthcare providers, including hospitals, urgent care clinics, and physician practices, are tapping RRHIO data in the HIE's 13-county service area. RRHIO's executive director, Ted Kremer, MPH, says building partnerships with healthcare providers and key community stakeholders has been an essential element of success for the HIE.

"We did outreach with the imaging providers early on and showed them how providing data to our exchange would in turn make it easier to access prior images done elsewhere. We also had strong support from our county public health department charged with managing [tuberculosis] patients, who were moving between treating institutions and care providers," Kremer says.

Developing the RRHIO has been as much about organizing physicians as organizing data. "Where there were early and enthusiastic adopters, we sought to share their positive experiences with other care providers and with community leaders seeking to realize a more efficient healthcare system."

Memorial Sloan Kettering Plans 105,000 Sq. Foot Facility in Nassau County

Memorial Sloan Kettering has plans to open a new multimillion-dollar facility near the Nassau Coliseum in Nassau County.

Sloan Kettering confirmed its plan to spend $140 million to build the 105,000-square-foot facility. Patients would be able to get chemo, radiation and other treatments at the cancer center. Sloan Kettering already has satellite facilities in Commack and Rockville Centre.

The proposal needs to be approved by county lawmakers. 

March National Provider Call Medicare Quality Reporting: 2015 Reporting Once Across Medicare Quality Reporting Programs
The March MLN Connects™ National Provider Call will be held on Wednesday, March 18, 2015 from 1:30 – 3:00 PM Eastern Time. This MLN Connects™ National Provider Call provides an overview of how to report once across various 2015 Medicare Quality Reporting Programs, including the Physician Quality Reporting System (PQRS), Medicare Electronic Health Record (EHR) Incentive Program, Value-Based Modifier (VM), and Medicare Shared Savings Program.

This presentation will help guide providers wishing to report quality measures one time during the 2015 program year and maximize their participation in the various Medicare quality reporting programs. Satisfactory reporters will avoid the 2017 PQRS negative payment adjustment, satisfy the Clinical Quality Measure (CQM) component of the Medicare EHR Incentive Program, and satisfy requirements for the VM, avoiding the VM payment adjustment. Eligible professionals (EPs) participating in these programs are strongly encouraged to participate in this call. A Question and Answer session will follow the presentation. Eligible professionals participating in these programs are strongly encouraged to attend.

How to report once for 2015 Medicare Quality Reporting Programs for:

  • Individual EPs
  • PQRS group practices
  • Medicare Shared Savings Program Accountable Care Organizations (ACOs)
  • Pioneer ACOs

Target Audience: Physicians, Medicare EPs, therapists, medical group practices, practice managers, medical and specialty societies, payers, and insurers.

This MLN Connects Call is being evaluated by CMS for CME and CEU continuing education credit (CE). Refer to the call detail page for more information.



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