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Home » In the News » MSSNY enews » Archives » enews020510 | |
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February 5, 2010
Weekly Update for New York State Physicians Volume 10, Number 5 Christina Cronin Southard, Editor mssnye-news@mssny.org www.mssny.org Dear Colleagues, Where do you go to find the hottest discussions on medical issues at the end of January? Last weekend I went to Lake Placid, where the temperature reached -25 degrees, for the 11th Annual Meeting of the MSSNY 3rd and 4th District Branches as well as the Annual Winter Meeting of the New York State Academy of Family Physicians. Then, on Tuesday evening, NY County Medical Society President, Dr. Eugene Weise, and I addressed the Executive Committee of the Society of Practitioners at ColumbiaUniversity in the Bronx.
At all three assemblies, physicians expressed their continuing concerns about the uncertain prospect for health system reform. The consensus is that there is room for improvement. The threat of a 21% Medicare payment cut on March 1 is most urgent. The potential for a significant increase in liability premiums on July 1 is a close second. Meanwhile, the number of uninsured grows daily, and we encounter in our offices patients whose out-of-pocket costs have grown dramatically this year.
In his January 26 letter to President Obama and members of Congress, AMA President Dr. Jim Rohack added an eighth “bullet point” to the seven for which the AMA has been advocating over the past several months, that being, “Modify antitrust enforcement policies to empower physicians to implement clinical integration and quality improvement initiatives.” There is an opportunity in this area that, even without legislation, the Federal Trade Commission and Department of Justice might modify the 1996 Statements of Antitrust Enforcement Policy in Health Care in order to allow physicians to collectively negotiate.
On January 22, Dr. Eric Nielsen, MSSNY member and Chief Medical Officer of Greater Rochester Independent Practice Association (GRIPA), spoke at the Cornell Health Policy Symposium in WashingtonDC. With key members of the FTC and DOJ in attendance, Dr. Nielsen described the difficulties that GRIPA has had, even with a favorable FTC advisory opinion, in securing contracts with insurers for its clinically integrated group.
With much work needing to be done, I ask you again to set aside Tuesday, March 9, to join us in Albany for the Annual MSSNY Legislative Day. Call your county medical society to arrange transportation. If your clinical commitments preclude your attending that day, contribute some of your earnings that day to MSSNYPAC.
Dave Hannan, MD, MPA
Capital Update MSSNY ALBANY LEGISLATIVE DAY: MARCH 9, 2010
Come to Albany. See your legislators. Make sure health policies enacted in New York State reflect the views, expertise, and interests of the physicians. Please register with your County Medical Society and ride the bus to participate in the 2010 MSSNY Lobby Day and Rally. Already confirmed speakers include: Commissioner of Health, Richard Daines, MD; Superintendent of Insurance, James Wynn; Senate Health Committee Chair, Thomas Duane; Assembly Health Committee Chair, Richard Gottfried; Senate Insurance Committee Chair, Neil Breslin; Senate Democratic Conference Leader, John Sampson; and Senate Majority Leader, Dean Skelos. Governor David Paterson and Attorney General Andrew Cuomo have also been invited to speak.
(DIVISION OF GOVERNMENTAL AFFAIRS)
LEGISLATION ADVANCES TO REQUIRE GREATER EXPERTISE FOR HEALTH PLAN DENIALS
Legislation (A.723, Gottfried) passed the Assembly this week that would require a coverage denial decision made by a health plan to be made by a physician board-certified in the same or similar specialty as the physician who typically provides the recommended treatment. MSSNY strongly supports this legislation. Under current law, the only qualification required for a person who, on behalf of a health plan, may contradict the treatment recommendation of the patient’s treating physician is that such reviewer be a licensed physician.
Therefore, the person reviewing the treatment request may not have the sufficient training or experience necessary to decide whether the treatment that has been requested is appropriate. As a result, care that may be needed for the patient may be unnecessarily delayed or denied while the patient has to resort to taking an External Appeal to attempt to receive the care that has been recommended. Similar legislation (S.3450, Oppenheimer) is before the Senate Health Committee. Please call your Senator 518-455-2800 to express your support for this legislation. (AUSTER, DEARS, CONWAY)
The House of Representatives this week passed a Resolution to raise the federal debt limit that includes, in effect, authorization for up to $82 billion in spending for a Medicare SGR fix that will not have to be offset by other revenue raisers or cuts. The resolution passed the Senate last week.
The purpose of the resolution is to reinstitute a rule for new spending that requires that any new spending or tax cuts be offset by corresponding spending cuts or tax increases, known as “Pay-go”. Several limited exemptions were made to this rule including, importantly, an exemption for fixing the flawed Medicare physician SGR reimbursement formula. As physicians are well aware, this flawed formula will cause a 21% cut to Medicare physician reimbursement on March 1 unless Congress acts to prevent the cut.
The $82 billion “Pay-go” exemption makes it easier for Congress to enact a multiple year fix to this problem. However, an additional $130 billion in offsets from other sources will still be required in order to enact a permanent repeal of the SGR formula.
It will still be up to Congress to enact separate legislation to stop the SGR cuts prior to March 1, 2010. In this regard, physicians are urged to continue to call the AMA’s Grassroots Hotline 1-800-833-6354, to urge Senators Schumer and Gillibrand, as well as their respective Representative to enact legislation that provides a long-term fix of the flawed Medicare SGR formula. (AUSTER, CONWAY)
Syracuse physiatrist Jeffrey Kahn, MD, participated on behalf of MSSNY in a contentious roundtable convened by Assembly Insurance Committee Chair Joseph Morelle (D-Rochester) to discuss proposals to reform the No-Fault system. Dr. Kahn is chair of the MSSNY Workers Compensation and No Fault committee. Other public officials participating in the roundtable included New York State Insurance Superintendent James Wrynn and several members of the New York State Assembly. In addition to Dr. Kahn, participating in the roundtable included the New York State Trial Lawyers Association and numerous representatives of auto insurance companies and insurance agents. MSSNY was the only health care provider association participating in the forum.
It was noted that auto insurance premiums had increased 55% since 2004, and suspected cases of No-Fault fraud had increased 33% since 2006. Not surprisingly, in a quest to address No-Fault fraud, the insurance companies called for much stricter oversight of and additional burdensome paperwork for physicians who submit No-Fault claims that would have far reaching implications beyond simply addressing the No-Fault fraud that does currently exist.
Dr. Kahn noted the need for additional efforts to address true fraud where it is occurring, noting that “Staged automobile accidents leading to fake injuries, billing for testing or treatment which never occurred, and the criminal networks which may include health care providers, adjustors, attorneys, automobile repair shops, and other who promulgate such illegal behavior should and must be eradicated, with effective prosecution applied.” However, Dr. Kahn noted MSSNY’s serious concern with proposals that could increase the frequency of insurance company abuses, and called for legislation to address those abuses that already exist: “It is also our position that those in the insurance industry who treat honest physicians and patients as if we too are criminals, issuing denials in an arbitrary and capricious manner, based on their own internal policies which conflict with or distort Regulation 68 mandates, within a system which provides those who are harmed with too little in the way of effective recourse.”
Dr. Kahn also noted the potential for physicians to avoid treating patients injured in auto accidents if the No-Fault administrative hassles became too great. He noted the action of the Workers Compensation Board last week in suspending the requirement of physicians to use the new expanded C-4 medical report form due to a significant shortage of physicians to treat injured workers in the Rochester area which arose since the Board required use of the new C-4 forms last year.
Chairman Morelle noted to the participants that they were just at the beginning of the process to develop No-Fault reform legislation, and that MSSNY would play an important part as legislation is developed. Senate Insurance Committee Chair Neil Breslin also held a public hearing this week examining the issue of No-Fault fraud, for which MSSNY provided a copy of Dr. Kahn’s comments to the roundtable. (AUSTER, CONWAY)
MSSNY representatives including Andrew Merritt, MD, Chair of the MSSNY Health Care Delivery Executive Committee, Daniel Feldman, MD, Chair of the MSSNY Medical Care Insurance Committee and, Steven Schwalbe, MD, Chair of the MSSNY Interspecialty Committee met this week with James Figge, MD, Medical Director, DOH Office of Health Insurance Programs and John Morley, MD, Medical Director, DOH Office of Health Systems Management Services, to describe potential changes to the state’s official prescription forms. One change being required by the center for Medicaid & Medicare Services (CMS) will, when implemented, require physicians and other prescribers to include their NPI number on the prescription.
This requirement already exists for Medicare Part D prescriptions. MSSNY advocated for a delay sufficient to assure appropriate notice and time for incorporation of a field for the NPI on the official state prescription form. Moreover, MSSNY recommended making such a requirement applicable for eprescribing systems coincident with similar requirements being imposed, as of January 1, 2011, as part of the American Reinvestment and Recovery Act (ARRA). A second suggestion discussed at the meeting relates to recommendations made by the Board of Pharmacy which would require a prescription form to include a diagnosis code. It is argued that such a requirement would improve patient safety by enabling pharmacies to know the indicator for which the prescription is made, thereby reducing medical error. MSSNY recommended that such a provision should be voluntary and not mandatory on the prescriber. MSSNY also urged that the Department consult with physicians and providers who treat patients with mental health disease and HIV, as well as patient advocacy groups, to assure appropriate privacy concerns are addressed. All parties agreed to continue to discuss the potential ramifications of this provision.
(DEARS, AUSTER, PUCHERELLI)
SANOFI PASTEUR H1N1 PREFILLED SYRINGES
All lots of Sanofi Pasteur H1N1 vaccine in prefilled syringes should be administered by February 15 because of concerns over reduced potency, the CDC reported on Wednesday. The expiration includes Sanofi Pasteur's 12 million doses of H1N1 vaccine in prefilled syringes. The announcement does not affect multidose vials. (ELLMAN, CLANCY)
The Medical Society of the State of New York is conducting a series of free online WebEx webinars for its new course “H1N1: Prevention and Control.” As of last week, the instances of H1N1 are still above pandemic levels. Physicians are encouraged to participate in one of these webinars in preparation for the possible third wave of the pandemic. Physicians will not even have to leave their home or office to participate as the webinar will be conducted via telephone and the internet. The Medical Society of the State of New York will provide two hours of Continuing Medical Education (CME) credits for those who attend. The webinars will be held on the following dates:
February 25th from 7:30-9:30 AM
March 5th from 7:30-9:30 AM
March 18th from 6:00-8:00 PM
April 14th from 5:30-7:30 PM
April 23rd from 1:00-3:00 PM
In order to attend, you must pre-register by email with Peter Maggiore at pmaggiore@mssny.org. Please contact Peter if you have any questions regarding the program or the WebEx system. The webinar will provide physicians with updated information on the H1N1 virus, diagnostic testing, influenza vaccines, antiviral medications, and infection control. There will also be an opportunity at the end of the presentation to ask our faculty presenter any questions you might have. Additionally, there will be an interactive Clinical Management of Patients segment in which the presenter will pose a hypothetical clinical case and then discuss how you should diagnose, treat, and care for the patient. The Faculty for the webinar are physicians from the Medical Society’s Committee on Emergency Preparedness and Bioterrorism Response. (CLANCY, MAGGIORE)
The New York State Department of Health AIDS Institute and the Institute for Family Health is offering free certification training for all primary care providers in NYS on Buprenorphine Treatment for Opioid Dependence on Saturday, Feb. 27, 2010 at Casperkill Recreation Center, 2330 South Road (Rt. 9), Poughkeepsie, NY 12601. Registration preference will be given to physicians outside of New York City. The program, which is presented in collaboration with the American Psychiatric Association, is entitled, “Buprenorphine and Office-based Treatment of Opioid Dependence”.
It will offer 8.0 hours of Continuing Medical Education Credits for physicians. The program is recommended for physicians with experience and/or interest in treating opioid dependence. It is also recommended for psychiatric, primary care, HIV, pain, and addiction medicine physicians. Program objectives include: understand the rationale and need for opioid pharmacotherapy in the treatment of opioid dependence ; describe buprenorphine protocols for all phases of treatment and for optimal patient/treatment matching; understand the legislative and regulatory history of office-based treatment; understand the pharmacological characteristics of opioids; identify common co-morbid conditions associated with opioid dependence; understand treatment issues and management of opioid dependence in adolescents, pregnant women, and patients with acute and/or chronic pain; describe the resources needed to set up office-based treatment with buprenorphine for patients with opioid dependence. Faculty are: Petros Levounis, MD, MA, Director, the Addiction Institute of New York; Edwin A. Salsitz, MD, FASAM, Medical Director, Office-based Opiod Therapy, Department of Medicine, Beth Israel Hospitaly; Susan Whitley, MD, Assistant Professor of Psychiatry and Behavioral Sciences and Family and Social Medicine, Albert Einstein College of Medicine. Registration will begin at 7 a.m. and physicians are asked to bring a photo identification, DEA numbers and state medical license number. Pre-registration is required as space is limited. The registration form can be obtained at www.ceitraining.org. (CLANCY) This is your last opportunity to register for CDPHP and MSSNY’s continuing medical education seminar for physicians on Saturday, February 27, 2010, from 8 a.m. to 3:30 p.m. in the Ferris Ballroom at the Hilton Garden Inn/The Rensselaer, 235 Hoosick Street, Troy. Register online or download a registration form and fax to (518) 641-3205 by Friday, February 12th. Earn up to 5.25 CME credits while experiencing interactive, informative discussions about meaningful use and the patient centered medical home model of care. (CLINTON, DEARS)
The Medical Society of the State of New York will conduct a continuing medical education programs on “HIV in the Marginalized and Underserved Populations: A Case-Based Approach” in Ulster and Suffolk counties. The free dinner seminar is open to all physicians who register and will offer one CME credit. Physicians who attend the one hour seminar will learn that: the US HIV/AIDS epidemic affects marginalized and underserved populations disproportionally; about the barriers this populations encounter when seeking HIV testing and treatment; about approaches to HIV testing in primary care settings following the CDC Revised Recommendations for HIV Testing and about approaches that are effective and culturally appropriate. There will also be case histories that will be discussed.
The Suffolk County Medical Society will co-host the program on Wednesday, February 10, 2010 at the Holiday Inn, 3845 Veterans Memorial Highway, Ronkonkoma, NY. Faculty for this program will be Linda Efferen, MD. Physicians may register by contacting the SuffolkCounty Medical Society at scms@optonline.net or by calling (631)851-1400. The program is supported by the New York State Department of Health. (CLANCY) eNews STATE LOBBY DAY IS ON MARCH 9—ONLY FOUR WEEKS AWAY!
Call Your CountySociety to reserve a seat! ALERT! Updating Your Medical Directory Questionnaire Online
We are alerting all physicians that MSSNY will be placing the Medical Directory Questionnaire form online at the MSSNY website within the next three weeks. When posted, all physicians will be able to access only their specific personal information through this form at www.mssny.org. MSSNY will continue to send out alerts to notify you when the questionnaire becomes available. Since this form will only be available online, you are urged to please review the information listed on your questionnaire so that your biographical information at the MSSNY website will be correct and up-to-date.
Looking for Abstract Reviewers for HOD Poster Symposium
You can do this in the comfort of your home.
The MSSNY RFS will be holding its fifth Resident and Fellow Research Poster Symposium at the HOD on April 16, 2010. We are now looking for abstract reviewers to read through and score, according to a specific scoring system that will be sent to you, a number of submitted abstracts. The deadline for submission of abstracts is February 16, at which time we will send them to volunteers for review.
The more volunteers we get, the fewer each will be asked to review – but we don’t expect that anyone would get more than 8 – 12.
If you would like to participate as an abstract reviewer, please contact sbennett@mssny.org.
Headache and Facial Pain Symposium on April 18 in Manhattan
The 22nd Annual Symposium on the Treatment of Headaches and Facial Pain will be held on Sunday, April 18, 2010 at Beth Israel Medical Center, NY - Podell Auditorium. This event is jointly sponsored by the New York Headache Foundation and BethIsraelMedicalCenter's Department of Pain Medicine and Palliative Care & the Alan and Barbara Mirken Department of Neurology.
Program Director: Alexander Mauskop, MD, email DrMauskop@NYHeadache.com Registration information: ksgaston@chpnet.org 212-420-4713. MSSNY has communicated with DEA officials who explained that doctors who are planning to take controlled substances to Haiti in support of disaster relief efforts need to obtain authorization from the DEA.
There is an article on the US Department of Justice website that explains the procedure to obtain an emergency authorization from the DEA. The DEA asks that doctors expedite the request at least 48 hours in advance of the mission to Haiti. Relief to Haiti Can Be Claimed on 2009 Tax Forms
A new federal law enacted on Jan. 22 enables taxpayers who give money to charities providing relief in Haiti to claim the charitable deduction on the 2009 tax return.
The new law applies only to cash contributions (as opposed to property). The contributions must be made specifically for the relief of victims in areas affected by the Jan. 12 earthquake in Haiti. The law applies to contributions made after January 11, 2010 and before March 1, 2010. Taxpayers have the option of deducting these contributions on either their 2009 or 2010 returns, but not both. For further information visit this website.
National Government Services (NGS) is offering two teleconferences in February at no charge to help providers understand the changes in Medicare coding and payment for consultation services. Providers from all NGS sites and of all specialties should plan on attending one of these sessions.
During this informative 90-minute session, NGS will provide a number of educational resources to assist physicians and their staffs with complying with these new requirements. A question and answer period will be offered at the end of the presentation.
Consultation Code Teleconferences
Date:Tuesday, February 9, 2010
Time:11:00 am -12:30 pm, ET
Conference ID: 53002191
Participant Dial-In Number: 866-837-0303
Date:Wednesday, February 17, 2010
Time:12:00 -1:30 p., ET
Conference ID: 53004391
Participant Dial-In Number: 866-837-0303
Registration for this session is not required. Visit the NGS website for details at www.NGSMedicare.com. Choose your business type and your state. Choose either Part A or B in the Calendar of Events.
Over 70 young physicians attended the latest networking event arranged through the MSSNY Young Physicians Section and sponsored by the North Shore-Long Island Jewish Health System. Designed to help young physicians develop referral and social networks and to expand their understanding of issues impacting their careers, these events continue to grow in popularity.
The informative presentation and Q&A session conducted by North Shore LIJ CEO Michael Dowling, speaking from his broad experience in healthcare management and state government, offered insight into the future of healthcare. Mr. Dowling addressed such topics as health system reform, state and federal budget implications for medical practice, and relationships with health insurers.
Asked how physicians can respond to negative forces affecting them and their patients, Mr. Dowling recommended membership in MSSNY as the means for physicians to develop professional consensus and wield their collective power.
Please click here to read the brochure. MSSNY President-Elect Leah McCormack, MD, reinforced that message in brief remarks highlighting the results of a MSSNY-commissioned study on the Economic Impact of the Private Practice Physicians in the State of New York. The study demonstrates the enormous impact of physicians on the local, state and national economy.
Private practice physicians are the seventh largest industry in New YorkState, with each physician employing an average of eight other workers. Salaries paid and products and services bought by private practice physicians are a huge contributor to the economy. MSSNY will make use of the report’s specialty and county-specific data to inform policy makers and thought leaders of the importance of a supportive environment for medical practice to prevent the loss of qualified physicians.
Event organizers David Podwall, MD, Bruce Rutkin, MD and Ian Storch, DO, created and shared lists of participants, their specialties and their contact information to support networking. Dr. Podwall, chair of MSSNY’s Young Physicians Section, noted that members can also participate in an online searchable directory of young physicians through MSSNY’s website.
MSSNY CEO Rick Abrams detailed information on MSSNY’s strong lobbying efforts in Albany and in Washington, DC, and noted the excellence of MSSNY’s lobbyists in representing the profession’s interests.
Participants were urged to join their colleagues in traveling to Albany on March 9 for MSSNY Lobby Day to learn more and demonstrate their solidarity on political issues. County medical societies can provide details on transportation and arrange for young physicians to join their physician leaders in appointments with local legislators.
Administer Sanofi Prefilled Syringe Vaccine by February15 – On February 3 the CDC announced that all remaining Sanofi Pasteur H1N1 vaccine in prefilled syringes should be administered by February 15, regardless of the expiration date printed on the package. The vaccine may have reduced potency after then; as was the case in a previous recall of several lots of Sanofi vaccine, there is no concern about safety. Physicians can continue to administer all Sanofi vaccine in multi-dose vials and Novartis and CSL vaccine in pre-filled syringes, however.
All H1N1 Vaccine Administrations Must Be Reported – Regardless of brand or type, however, ALL H1N1 vaccine administrations must be reported.
Information on how to report vaccine administered outside of NYC is in the NYSDOH document, Instructions for Ordering 2009 H1N1 Influenza Vaccine - Quick Guide and on its “H1N1 Vaccine Ordering and Reporting Information” webpage.
Information on how to report vaccine administered within the five NYC boroughs can be found on the NYSDOHMH reporting webpage, its CIR
webpage or by calling 212-676-2312.
All of these documents, plus additional H1N1 information can be accessed from MSSNY’s “Novel H1N1 Latest Updates” link on its home webpage at www.mssny.org.
Influenza Activity Currently Low – The upside of the pandemic caused by the 2009 H1N1 influenza virus, which was first identified last April, is that fear – and effective public health campaigns – persuaded more people to get influenza vaccine (for some, seasonal but not H1N1) and to adopt preventative hygiene practices, such as hand washing. More seasonal vaccine was administered this year than in any previous year, and as of January 31, 2010 – despite the fact that this is the traditional seasonal flu season – the CDC reported: “low” visits to doctors for influenza-like illness (ILI); leveled-off hospitalization rates; no widespread influenza activity in any state; and most the reported influenza viruses are H1N1, not seasonal.
In their most recent surveillance reports, the NYSDOH and NYSSDOH reported similar results. The NYSDOHMH reported (2/3/2010) that influenza activity was below the expected level for this time of year. No new deaths from the previous week were reported. The number of deaths attributable to all types of influenza between 8/30/2009 and 1/30/2010 in the five New York City boroughs was 39. In the rest of the state, the total (1/23/2010) number of deaths attributable to the H1N1 virus since 4/24/2009 was 88 (plus 8 more pediatric deaths from unidentified influenza subtype).
Lancet Retracts Study that Linked MMR Vaccine to Autism
On February 2, the Lancet “fully” retracted a paper it published in 1998 that linked autism to the measles-mumps-rubella (MMR) vaccine and set off the initial formation of anti-vaccine groups that claim vaccines cause autism. The Lancet decision followed a British medical panel’s conclusion that the study’s lead author, Dr. Andrew Wakefield, violated basic research ethics rules, subjected children (only 12 in the study) to painful and unnecessary invasive tests, and failed to reveal conflicts of interest that included a patent on a replacement vaccine and financial backing from parents suing the MMR manufacturers.
Athenahealth: Integration with Billing/Clinical Services
Do you want to spend more time with your patients and less time worrying about accounts receivable? athenahealth offers a low-cost, web-based CCHIT-certified software system that is constantly updated by its patented database of insurance and clinical rules. Their program will increase the percentage of claims paid at their contracted rate and keep your bottom line fine tuned. MSSNY members may qualify for a 6% discount on athneaCollector, too. Contact athenahealth.com/mssny or call 800-981-5085.
Advertise with MSSNY by going to our website at mssny.org and clicking “Online Classifieds” or “Medical Job Board.” 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 |
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