MSSNY Joins Lawsuit Over Out-Of-Network Billing
Friday, November 21, 2025
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Colleagues:
MSSNY acted quickly and brought forth a resolution last week to the American Medical Association to fight Anthem’s attempt to throw non-participating physicians off medical staffs by penalizing these hospitals financially, leading to care fragmentation and an end run around the No Surprises Act, a carefully crafted bipartisan policy.
While Insurance companies continue to deny care and attempt to profit from your despair, MSSNY fights to ensure timely access on behalf of our patients and our profession. Kudos to Dr. Tom Lee, Moe Auster, and our Executive Committee and AMA delegation for this timely action.
If you are not a member, join us in the fight at mssny.org. Help finance the fight at MSSNYPAC.
All the best,
David Jakubowicz, MD, FACS
MSSNY President
CMS Clarifies Telehealth Coverage and Claims Adjustments Following Government Shutdown
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- What’s Happening: CMS has issued an update clarifying that Medicare telehealth services remain payable through January 30, 2026, with retroactive coverage for services provided during the federal government shutdown
- Why It Matters for New York Physicians: Physicians may resubmit telehealth claims impacted by the lapse in payment authorization from October 1–November 10, 2025.
- Impact on You and Your Practice: Claims returned with FISS reason codes WW120 and WW121 are now being processed normally by NGS; providers should review and resubmit any affected claims.
- MSSNY Action: MSSNY continues to monitor Medicare policy updates and advocate for clear, consistent payment processes to protect physician practices.
For New York physicians navigating Medicare billing amid ongoing federal changes, CMS has issued updated guidance on processing telehealth claims affected by the government shutdown. The update clarifies that all Medicare telehealth flexibilities have been retroactively restored through January 30, 2026, ensuring continuity of payment and coverage for services rendered to patients during the lapse.
According to communications received by MSSNY from CMS and National Government Services (NGS), physicians can now resubmit telehealth claims that were previously returned or denied between October 1 and November 10, 2025. These claims, once rejected due to the temporary expiration of telehealth provisions, are now payable under reinstated statutory authority. Practitioners should identify affected claims—particularly those marked with FISS Reason Codes WW120 and WW121, and resubmit them to ensure full reimbursement.
CMS has also updated its Telehealth Frequently Asked Questions to reflect these changes. Of particular note, FAQ #16 confirms that telehealth services provided during the shutdown will be paid as if the lapse never occurred, protecting both physicians and patients from financial disruption.
MSSNY recognizes that administrative changes like these add significant pressure to already overextended practices. As New York physicians continue providing high-quality care amid shifting federal timelines, MSSNY remains a partner and advocate, ensuring members receive timely updates and support in navigating Medicare compliance.
MSSNY Joins Lawsuit Over Out-Of-Network Billing
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The Medical Society of the State of New York has joined a federal lawsuit involving hundreds of health care providers against Claritev, a data analytics firm formerly known as MultiPlan, over the negotiation of out-of-network payments. The lawsuit accuses Claritev of creating a price-fixing system that benefits major health insurers at the expense of providers.
If you are a physician looking for assistance with Multiplan claim adjudication there are several plaintiff firms available. If you are interested in using AGG, the firm MSSNY signed on with, access more information here.
MSSNY Invites Medical Students and Residents and Fellows to Present at the 19th Annual Poster Symposium
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MSSNY, with support from the Medical Education & Scientific Foundation (MESF), is proud to announce the 19th Annual Resident/Fellow and Medical Student Poster Symposium, scheduled for Friday, March 27, 2026, at the Rochester Convention Center. This event is held in conjunction with the MSSNY House of Delegates Meeting, offering participants an opportunity to showcase original work to physician leaders across New York State.
The Poster Symposium is open to MSSNY resident/fellow and medical student members. Eligible participants may submit abstracts in clinical medicine, clinical vignettes, or research across a wide range of specialties and disciplines, including public health, basic science, and the humanities. Thanks to a grant from MESF, the entry fee is reduced to $25—supporting the program and making it accessible to more young physicians.
Submissions will be reviewed by a panel, and the top 50 resident/fellow and top 20 student abstracts will be invited to present their posters in Rochester. Each abstract will be judged on originality, significance, methodology, clarity, and presentation quality.
Key Deadlines and Details:
- Abstracts due by January 6, 2026, at 4 PM (MS Word format).
- Participants must be MSSNY members; medical student and first-time resident/fellow memberships are free.
Accepted participants must attend in person to present and discuss their posters with judges.
Erie County Medical Society Gala Recap
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The Medical Society of the County of Erie (MSCE) welcomed more than 150 physicians, medical students, and community leaders to their 2025 Gala on Thursday at The Twentieth Century Club in Buffalo.
Dr. Willie Underwood, President-Elect of the American Medical Association, MSCE Past President and recipient of the 2025 MSCE Lifetime Achievement Award, gave an inspiring keynote speech.
He discussed the importance of community engagement while supporting the next generation of physicians, and top priority items of the AMA, which include reforming Medicare payments, addressing prior authorization, and improving physician well-being.
Also honored were Dr. Gale Burstein, who received the Outstanding Service Award; and Drs. Fred Archer and Robert Perry, who received the Distinguished Mentor Award.
Dr. Iris Danziger passed the gavel to MSCE’s incoming President, Dr. Michael Terranova.
The Medical Society of the State of New York was represented by Dr. David Jakubowicz, President, and Dr. Thomas Lee, Executive Vice President.
Honoring Leadership and Legacy: Dr. Bonnie Litvack, MD, Recognized for Lifetime Achievement in Medicine
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New York physicians from across the Hudson Valley gathered at the Doctors of Distinction 2025 event to honor healthcare leaders whose service continues to elevate medicine across the region, hosted by New York Medical College (NYMC) in Valhalla. The ceremony celebrated excellence, innovation, and compassion in healthcare across clinical expertise and community leadership.
Among this year’s honorees was Dr. Bonnie Litvack, MD, Director of Women’s Imaging at Northern Westchester Hospital–Northwell Health and 2020–2021 MSSNY President, who received the prestigious Lifetime Achievement Award. Dr. Litvack’s career exemplifies the values at the heart of MSSNY’s mission: advancing medicine, advocating for physicians, and improving patient care for all New Yorkers.
Event speakers emphasized that healthcare leadership “is built moment by moment, decision by decision, through resilience, humility, and connection.” Dr. Litvack’s years of service, both in clinical medicine and organized leadership, reflect those very principles. Her work at MSSNY, especially during the COVID-19 pandemic, helped guide physicians through one of the most challenging periods in modern medicine while advancing key initiatives in public health, equity, and physician well-being.
The evening’s remarks also addressed the dual realities of modern medicine, the promise of technological innovation alongside increasing skepticism toward science and healthcare institutions. As NYMC President Dr. Alan Kadish noted, events like Doctors of Distinction remind us of medicine’s higher calling: to heal, to lead, and to serve with purpose.
MSSNY celebrates Dr. Litvack and all New York physicians who dedicate their lives to excellence in care and leadership in their communities. Together, they embody the strength and integrity that define our statewide medical community.
CCM & RPM: What New York Physicians Need
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For New York physicians managing rising administrative demands, Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) can offer much-needed support for care coordination and chronic disease management. MSSNY’s latest webinar replay breaks down two implementation pathways, in-house vs outsourced and explains how practices can choose the model that fits their workflow, staffing, and compliance needs.
Key Points for New York Physicians
- Outcome: Understand how each model affects patient outreach, documentation, staffing, and reporting.
- Why It Matters: Many practices are seeking ways to support complex patients without adding burden to already stretched teams.
- Impact: Practical guidance helps physicians strengthen coordination, reduce avoidable hospitalizations, and ensure audit-ready workflows.
- MSSNY Support: MSSNY partners with ChronicCare, a member benefit, to offer a turnkey option for practices looking to streamline CCM/RPM implementation.
Together, we are building stronger, more connected pathways for chronic care.
NY Sports Ticket Discounts
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MSSNY members: lock in discounted seats:
- Jets home games
- Select Islanders matchups (Rangers, Devils, Flyers).
- Rangers Healthcare Appreciation Night, Mon, Jan 12 vs. Kraken—each ticket includes a $15 food & beverage credit.
Repeat Imaging More Common with Non-physician Interpreters
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A study in the Journal of the American College of Radiology found higher repeat imaging rates when imaging was interpreted by nonphysicians, compared with radiologists, based on data from nearly 1.4 million Medicare claims. “The reason a study like this is important is that we want to make sure that the people interpreting the imaging are providing useful information,” said Dr. Bonnie Litvack, former president of the Medical Society of the State of New York, who was not involved in the study. “Patient safety trumps everything.”
Full Story: American Medical Association (11/17)
Physician: How ACA has Led to Increased Health Care Costs
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Medical Society of the State of New York member Dr. Daniel Choi explains how the Affordable Care Act has led to “a tremendous amount of health care consolidation,” which has made it difficult for private practices to compete with large health systems. “We know that this contributes tremendously to the cost of care because it’s a basic economic principle: when there’s less competition in the marketplace, prices go up,” Choi says.
Full Story: LinkedIn/Daniel Choi (11/15)
NYRx Update: What Physicians Must Know
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NYRx met with MSSNY to address coverage gaps affecting NY physicians and patients. Key updates include new guidance on Wegovy authorization and the latest PDL changes impacting prescribing and pharmacy workflow.
Fall 2025 Women Physicians Leadership Academy Continues Today!
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The next Women Physicians Leadership Academy session takes place today, November 23, at 9:30 a.m., followed by the final session on December 7. Both sessions will be led by Dr. Lynn M. O’Connor, Director of Colon and Rectal Surgery of New York, Section Chief at Mercy Medical Center and St. Joseph Hospital, and the first Black female Colorectal Police Surgeon for the New York Police Department.
Make Smart Insurance Moves
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Open Enrollment season is here. Let Creative Wealth Planning guide your coverage choices with expert, personalized advice for MSSNY members.
