What Is The Value of Representation?
Every physician benefits from the representational activities of the medical societies. Don’t close your eyes or stay silent as big government, big insurance, big business and big hospitals reshape the healthcare system in their interest. Make sure there’s a strong voice speaking for you and your patients. Be that voice – through membership.
Your Recent Savings Through Medical Society Action:
Physicians have saved as much as $30,000-$60,000 a year through organized medicine’s continuous efforts to avert cuts in the Medicare fee schedule.
No increase in the physician registration fee, despite intense pressures on the State budget and plans to raise the fee by $400.
- Prevented a 9.63% surcharge on radiological and surgical services performed in physician offices. Won passage of legislation requiring the Worker's Compensation Board to update the physician fee schedule. A 30% increase in the Worker's Comp fee schedule for all E&M codes took effect December 1, 2010.
- Achieved payments to physicians for ER care administered to intoxicated drivers, effective January 2011.
- Medicaid fees were increased for primary and preventive care by over $188 million, even as other lines throughout the state budget have been slashed.
- Despite intensifying efforts to expand allied professions’ scope of practice, MSSNY continues to defeat numerous initiatives each year that would put patients at risk by diminishing the role of the physician. Where proposals have passed, they include important stipulations MSSNY added to underscore the distinctive role and qualifications of the physician.
- Absurdly high medical liability premiums could be double what they are now without MSSNY’s numerous legislative wins over the years. Serious reform was nearly achieved in 2011 and MSSNY will continue to pursue it doggedly in the coming session.
- Some of the worst managed care abuses have been reined in through MSSNY’s lawsuits and legislative wins. (See below). Physicians have won $1.6 billion in accommodations and nearly $500 million in direct payments.
- The Ingenix scheme for under-paying out-of-network claims was exposed and toppled — bringing physicians $350 million in a proposed settlement of MSSNY’s lawsuit.
Reining in Managed Care Abuses:
MSSNY secured a two-year time limit on health plan refund demands.
- Secured a 90-day time limit on health plan credentialing review determinations.
- Secured requirements that health plans pay claims more quickly, lengthen the timeframe you have for submitting claims, limit the ability of plans to cut your fee schedules mid-contract, and better protect the ability of patients to receive needed specialized care.
- Killed a contract amendment issued by Empire Blue Cross Blue Shield that would have made a participating physician financially responsible if his/her patient went out-of-network (even without the physician’s awareness of the patient’s decision).
- Upheld and expanded due process for physicians in professional discipline actions.
- In an historic vote the NYS Senate passed legislation this year to allow physicians to negotiate collectively to level the playing field with insurers. The Assembly leadership has committed to work through issues that are holding a companion bill in committee.
Critical Past Performances that Continue to Pay Dividends
- For five years MSSNY defeated repeated attempts to pass an 8% tax on physicians’ gross revenues, until the backers of the proposal finally stopped trying.
- MSSNY defeated a proposed 8.25% tax on cosmetic medical procedures. Had this legislation passed, it would likely have been extended to other surgical procedures. Similar legislation was enacted in New Jersey.
- MSSNY has saved every physician in New York State thousands and tens of thousands of dollars in medical liability premiums, by securing a free second layer of protection and defeating proposals put forth by the trial lawyers year after year that would increase their incomes by expanding physicians’ exposure and driving up premiums drastically.
Educational Programming to Meet Your Need to Keep Current
MSSNY provides quality educational programming on clinical and non-clinical topics at low cost to member physicians and their staff. MSSNY also accredits numerous organizations at the local level to enable them to offer even more programming. This vital service enables you to stay at the top of your profession and your practice to be current with constantly changing legal requirements and payment policies.
Getting Your Point of View Across
MSSNY and your county medical society provide opportunities for you to meet with legislators and regulators and explain the real-world impact of policies that are proposed or under review. Coaching is available. Online tools enable you to communicate with your representatives simply by entering your zip code. Use prepared talking points or express your personal experience or views. The medical societies get your voice heard.