Are You Prepared for Your Next Contract Negotiation?
Friday, February 21, 2025
What’s Happening with the DOJ and UnitedHealth?
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Colleagues:
In response to previous President Pulse messages, MSSNY has received an amazing outpouring of UnitedHealth complaints, all of which we have forwarded to the appropriate authorities. Many doctors have contacted us to ask what is happening with their complaints. Although MSSNY cannot speak for the DOJ, we can inform you of what the DOJ is telling the media. On Friday, the Wall Street Journal reported that the DOJ has broadened their investigation of UHC and is now looking at their Medicare billing practices.
This is one of many examples of how MSSNY is making your voice heard.
I have said this before, and I repeat this now: we are punching above our weight. Imagine what we could accomplish if more physicians became members, and if more donated to the PAC. Click here to donate to MSSNYPAC.
Also, our Lobbying Day in Albany is scheduled for Tuesday, March 11. Do come. Hear from important Albany legislators and departmental officials who are being invited to speak to us. Visit your representatives in their Albany offices. For more information and to register today, click here.
All the best,
Jerome C. Cohen, MD
MSSNY President
New York State’s Prescription Monitoring Program (PMP): Now Available at MSSNY CME Website
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Most prescribers in New York State are legally required to consult the Prescription Monitoring Program (PMP) Registry every time they write a prescription for Schedule II, III, and IV controlled substances. The New York State PMP has been in place since 2013. It is time for all prescribers and their designees to update their knowledge of best practices and requirements for using the PMP properly and consistently. If you or your colleagues missed the recent live webinar, it is of paramount importance that you go to the MSSNY CME website: https://cme.mssny.org and view this course.
Educational Objectives are:
- Increase prescriber awareness of the continued opioid epidemic
- Describe the benefits of the New York State (NYS) Prescription Monitoring Program (PMP) Registry and how to use it effectively as a tool to monitor patients’ prescription history
- Explain NYS Public Health Law related to NYS PMP Registry and how it impacts prescribers
Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at [email protected].
The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Strengthening Patient Engagement: Beyond Digital Communication
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As physicians navigate increasing patient volumes and mounting administrative burdens, meaningful patient engagement often takes a backseat. While digital tools such as automated reminders and follow-up messages can help streamline communication, they frequently feel impersonal and ineffective. With physician shortages limiting in-person interactions, finding new ways to foster meaningful connections with patients is critical to improving health outcomes.
Genuine engagement goes beyond routine communications. It involves empowering patients to take an active role in managing their health. Research on the Patient Activation Measure (PAM) suggests that patients who feel confident in their healthcare decisions experience significantly fewer emergency room visits. By encouraging patients to take ownership of their health, physicians can help drive better long-term outcomes.
Many patients, however, face social and economic barriers that prevent them from fully engaging in their care. Issues such as food insecurity, childcare challenges, and financial constraints often lead to delayed treatments and missed follow-ups. To address these underlying challenges, physicians can help by connecting patients with community resources such as food banks, housing assistance, and social workers.
Building trust is another essential component of engagement. Many patients hesitate to disclose their struggles with health literacy or financial hardship out of embarrassment or fear of judgment. Providers can foster stronger relationships by leading empathetically and incorporating peer mentors or care coordinators into their practice. Patients with chronic conditions, for instance, may benefit from connecting with mentors who have successfully managed similar diagnoses.
Physicians can create a more supportive healthcare environment by redefining patient engagement as an ongoing partnership rather than a series of administrative tasks. Meeting patients where they are, addressing their unique challenges, and cultivating trust will not only enhance the physician-patient relationship but also lead to better health outcomes overall.
Shifting Physicians’ Focus From “Engagement” to “Activation” (Jordan, Medical Economics, 2/17).
New App Simplifies Navigation of Developmental Disability Services in New York
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For medical professionals serving patients with intellectual and developmental disabilities, explaining and coordinating support services often presents a significant challenge. A new app called Abilibee is changing the landscape by providing a comprehensive, user-friendly platform to help families navigate the complex system of care and support services across New York State.
Developed by Abilities First, a trusted Hudson Valley nonprofit provider organization, with initial funding from the Council for Developmental Disabilities, Abilibee serves as a digital companion for families, offering step-by-step guidance from early childhood through mature adulthood. The app includes curated resources and planning tools designed to empower families in advocating for their needs throughout various life transitions.
Since its launch in late 2024, Abilibee has gained significant traction among parents, caregivers, self-advocates and professionals. Currently serving over 500 active users statewide, largely through word-of mouth, the app has also proven valuable to care providers, with 35% of users being agency members such as care managers and provider professionals. This adoption rate underscores the app’s utility in supporting healthcare providers as they guide patients and families through complex care systems.
“When my husband and I were walking to the car after getting our son’s diagnosis, we just looked at each other and said, ‘now what?’ shares one parent. “You must have been reading my mind when you created this app.” Abilibee was designed for this impact on families facing new diagnoses and transitions in care.
Abilibee’s Key Features:
- Comprehensive resource library
- Step-by-step transition guides
- Planning and organizational tools
- Multi-language support
Abilibee is free to users. Content is continuously enhanced based on user feedback. Medical professionals can offer Abilibee to their patients as a resource for navigating the developmental disability support system in New York State.
For more information about Abilibee, visit www.abilibee.org. Physicians interested in receiving rack cards about Abilibee for distribution to patients can contact [email protected].
Make America Healthy Again Commission on Chronic Disease Launched
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President Donald Trump has signed an executive order establishing the Make America Healthy Again (MAHA) Commission, appointing newly confirmed Health and Human Services Secretary Robert F. Kennedy Jr. as its chair. The commission aims to address the root causes of chronic diseases, initially focusing on childhood health concerns. The initiative seeks to overhaul national health policy by examining the impact of diet, environmental factors, medical treatments, and corporate influence on public health.
The commission will assess various contributors to chronic disease, including the American food system, exposure to chemicals, and pharmaceutical treatments such as antidepressants, stimulants, and weight-loss drugs. Within 100 days, it will release an assessment of the childhood chronic disease crisis, followed by a strategic report outlining policy recommendations. This move follows recent National Institutes of Health budget cuts, which temporarily lost billions in biomedical research funding before a federal judge blocked the policy shift. The commission will work with agencies such as the Food and Drug Administration, Centers for Disease Control and Prevention, and the Department of Veterans Affairs to explore new approaches to healthcare delivery and coverage options.
Kennedy, a vocal critic of the pharmaceutical industry and vaccine mandates, has pledged to reshape the national conversation on health. While his confirmation was controversial, key Senate figures stated they would monitor his adherence to mainstream scientific consensus.
Trump Creates MAHA Commission on Chronic Disease, Chaired by RFK Jr (Tong, Fiercehealthcare, 2/13).
MSSNY Continues Push to Fix Medicare Payments to Physicians and Urges New York Congressional Delegation to Protect Medicaid
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MSSNY is continuing its advocacy to New York’s Congressional Delegation to restore steep cuts to Medicare payments as well as to prevent proposed cuts to New York’s Medicaid program. Last week, several MSSNY physician leaders took several days away from their practices to travel to DC to meet with New York’s Congressional delegation on both of these issues.
The bi-partisan Medicare Patient Access and Patient Stabilization Act of 2025 (H.R.879) would reverse the latest round of Medicare payment cuts and provide a positive update until the end of the year to account for cuts that have been implemented since January. Together with the AMA and the federation of medicine, MSSNY is urging that these provisions be included in the healthcare package in the Continuing Resolution (CR) to keep the government funded, which expires in March.
Physicians face a 2.8% cut in Medicare payments in 2025 — the fifth consecutive year of cuts—while the cost of running a practice continues to rise. The Centers for Medicare & Medicaid Services (CMS) estimates that the Medicare Economic Index (MEI), which reflects practice cost inflation, will increase by 3.5% in 2025, yet physician payments continue to decline. Physicians’ Medicare reimbursement has now been reduced by 33% since 2001 when adjusted for inflation in practice costs.
At the same time, MSSNY is working together with several patient and health care provider groups NY-Delegation-Letter-Protect-Medicaid-January-2025.pdf to urge our Congressional delegation to oppose deep proposed cuts to the Medicaid program and other essential publicly financed health insurance programs. These cuts under serious discussion would have a significant domino effect, resulting in steep cuts in New York State for programs that currently help patients and their physicians.
MSSNY will continue to track both of these issues and provide updates as they progress.
Physician Advocacy Continues on Key State Budget Priorities; New Issue Arises on CPH in 30-Day Amendments
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MSSNY physician leaders and advocacy staff continue to advocate to the State Senate and Assembly on the numerous proposals impacting medical care delivery in Executive Budget proposal for the 2025-26 Fiscal Year.
Last week, MSSNY Immediate Past-President Paul Pipia, MD, testified Joint Legislative Public Hearing on the 2025 Executive Budget Proposal at a joint Senate-Assembly hearing examining the Healthcare portion of the Governor’s Executive Budget.
This week, the Governor proposed a series of amendments to her initial Budget submission (“30-day amendments”). Of significant concern, as part of an initiative to transfer the registration of physicians and PAs from the Education Department to the Health Department, there is a proposal that would appear to eliminate the $30 component of the $600 physician biennial registration that is earmarked specifically for MSSNY’s Committee for Physicians Health (CPH) program. No explanation is provided for this proposed change. MSSNY strongly opposes this change and is urging the Legislature to reject this transfer of registration authority.
In addition, MSSNY Continues to Strongly Oppose:
- Requiring physicians to pay 50% of the Excess Medical Malpractice Insurance cost – a $40,000,000 imposition on the 16,000 physicians with Excess coverage, which would be on top of the already outrageously high medical liability insurance premiums they already pay. Please send a letter opposing this measure here: Reject Physician Cost-Share for Excess Insurance Program
- Eliminating the right of physicians to appeal Medicaid Managed Care underpayments to IDR. This provision could further impair the ability of hospitals to maintain already strained on-call specialty care services. Please send a letter opposing this measure here: Retain Physicians’ Right to Use Independent Dispute Resolution Process in Medicaid Managed Care Claims
- Eliminating the historical role of county medical societies in vetting physicians to participate in the Workers’ Compensation (WC) program. This proposal does not meaningfully address the reasons physicians refrain from participation in WC and could result in some situations where an injured worker’s claim is impeded due to lack of sufficient knowledge of the often-cumbersome WC process. Please send a letter opposing this measure here: Preserve Role of County Medical Societies in Workers’ Compensation Application Process
- Eliminating the requirement for physician supervision of the healthcare services provided by Physician Assistants (PAs) despite legislation enacted last year (and not even effective until mid-February) to significantly expand the responsibilities of PAs. Please send a letter opposing this measure here: Preserve Physician-led, Team-based Healthcare
- Permitting psychiatric NPs to certify involuntary commitment of patients.
- Permitting pharmacists to prescribe and order medications to treat nicotine dependence.
- Increasing prior authorization burdens in Medicaid by eliminating “prescriber prevails” protections in Medicaid.
MSSNY Supports:
- $990,000 Funding for MSSNY’s Committee for Physicians Health (CPH) program allocated in the Aid to Localities Budget.
- Funding to help increase woefully inadequate Medicaid physician reimbursement.
- Addressing the unworkable provider financial consent requirement enacted last year (currently “on hold”) that consent for payment from the patient be received after services are delivered.
- Directing DOH to undertake a comprehensive review of New York’s outdated health plan network adequacy standards.
The problematic initiatives included in this Budget proposal is another critical reason for physicians to come to Albany for the Annual Physician Advocacy Day on March 11 where they will have an opportunity to interact with numerous legislators who will determine what will remain in the State Budget, and what will come out.
Join Us for MSSNY Physician Advocacy Day on March 11, 2025
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Make your voice count on MSSNY’s Physician Advocacy Day! We encourage physicians across New York to participate in this vital event, where your advocacy can help shape policies that impact your practice and patient care. Key issues this year include preserving the availability of Excess Medical Liability Insurance coverage, preserving physician rights to appeal Medicaid managed care underpayments to dispute resolution, preserving the historical role of county medical societies to review applications to Workers’ Compensation, and protecting patients by opposing the removal of the important oversight of patient care by physicians.
MSSNY’s advocacy will be crucial in confronting these challenges by directly engaging lawmakers and facilitating discussions between physicians and legislators. Scheduled for Tuesday, March 11, 2025, in Albany, the event comes at a pivotal time as the state legislature finalizes its one-house budgets and enters negotiations with the Governor. There will be a morning program where physicians will hear from key legislative leaders on their priorities for health care legislation in New York State while also answering questions from physicians. In the afternoon, attendees will have meetings with their local Assembly members and Senators in meetings organized by their county medical societies.
The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Medical Society of the State of New York designates this live activity for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Join us and stand up for the future of healthcare in New York! Please Register today: Physician Advocacy Registration
MSSNY Part of Growing Wave of Support for Medical Aid in Dying
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The Medical Society of the State of New York is among the growing list of organizations supporting passage of medical aid in dying legislation, which has been debated in the Legislature for nearly a decade. Some lawmakers foresee passage this year, with Assembly member Amy Paulin saying, “I think that people need to have choices. At their most vulnerable point in life they shouldn’t be forced to go to New Jersey, California or Oregon to get those choices. They should have them right here in New York State.”
Full Story: Newsday (Long Island, N.Y.) (tiered subscription model) (2/19)
MSSNY Update: Advocacy Day & CME Webinars
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Tune in to the MSSNY podcast for key updates on Physician Advocacy Day on March 11 and upcoming CME webinars. Stay informed and get involved in shaping healthcare policy. Listen now to stay ahead!
Are You Having Issues Getting Medicare Advantage Telehealth Services Covered?
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MSSNY has fought for state and federal laws that have helped to ensure that NYS insurance and Medicare plans cover telehealth provided services at the same rate as in-person services and is advocating that the upcoming federal Budget resolution continues to provide Medicare coverage for telehealth delivered services. It should be noted that these laws do not apply to self-insured plans.
MSSNY is hearing from physician members that they are having issues getting Medicare Advantage telemedicine services paid. We are monitoring the situation and will provide an update in next week’s Pulse.
If you are having issues getting telehealth services paid, please reach out to Heather Lopez.
Upcoming Webinars: Essential Learning for Physicians
Virtual Drill: An In-Depth Look at Recovery (February 26, 7:30 AM)
With more than 488 mass shootings and 27 major weather events in 2024, disaster recovery remains a critical issue. This webinar, led by Craig Katz, MD, and Tom Henery from the New York State Department of Health, will analyze emergency response scenarios and best recovery practices at the individual and systems levels. Participants will learn about psychological first aid, disaster chain of command, and key resources for post-crisis recovery. Earn up to 1.0 AMA PRA Category 1 credit Register now.
Navigating the Independent Dispute Resolution Process (February 24)
Understanding the Independent Dispute Resolution (IDR) process is crucial for physicians facing unfair reimbursements under the No Surprises Act and New York’s No Surprise Law. This webinar will provide an essential guide to disputing inadequate payments, evaluating claims, and securing fair compensation for out-of-network services. Protect your practice’s financial health by mastering the IDR process. Register now.
Women Physicians Leadership Academy Returns in March
MSSNY’s Women Physicians Leadership Academy, led by Dr. Tochi Iroku-Malize, continues with two dynamic virtual sessions: Enhancing Physician Wellness and Wellbeing on March 2 and The Importance of Networking on March 15. These sessions provide actionable strategies for leadership development, career growth, and professional well-being. Participants who complete all three sessions will earn up to nine CME credits. Secure your spot and invest in your future as a leader in medicine. Register today.
Are You Prepared for Your Next Contract Negotiation?
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