Why High-Earning Physicians Outgrow the 401(k)
Friday, October 31, 2025
MSSNY Fights for New York Physicians: Pushing Back Against Aetna’s Downcoding Policy
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Colleagues:
MSSNY is pushing back against Aetna’s new downcoding policy, which automatically reduces the level of Evaluation and Management (E/M) codes on physician claims without reviewing the supporting documentation. This week, I sent a formal letter to Aetna demanding that the insurer immediately withdraw this policy, citing its potential inconsistency with state insurance law, AMA CPT coding standards, and its harmful impact on New York physicians and their patients:
Dear Dr. Golash:
On behalf of over 20,000 physician and medical student members of the Medical Society of the State of New York (MSSNY), we write to urge that Aetna reevaluate its reimbursement policy, Evaluation and Management (E/M) Program Claim & Code Review. The policy appears to state that claims for higher-level services for certain physicians will be downcoded based solely on the data submitted on the claim form. Several physicians have brought concerns to our attention about the implementation of this policy.
MSSNY strongly opposes automatic or unwarranted downcoding of claims, and we strongly disagree that changing the E/M CPT code to a lower level would result in improved claims accuracy.
It is also unclear how Aetna’s reimbursement policy is being sufficiently disclosed to physicians, to align with nationally recognized standards for coding and billing, or to consider CPT coding criteria in determination of level of service, and in doing so it increases administrative burden and costs for both physicians and Aetna. Downcoding to a lower level is in effect changing the medical record to a CPT code that was not initially billed by the physician’s office. Read the full letter here.
All the best,
David Jakubowicz, MD, FACS
MSSNY President
Why High-Earning Physicians Outgrow the 401(k)
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Traditional retirement plans weren’t built for physicians at the peak of their earning years. Contribution limits, early-withdrawal penalties, and required minimum distributions can make even a strong 401(k) feel restrictive. MSSNY’s Physician’s Life Income Plan (PLIP), developed with Financial Strategies Group LLP, offers a modern alternative designed around physicians’ real-world financial lives.
The Challenge
Many New York physicians reach a point where they can no longer meaningfully grow tax-advantaged savings. Roth IRAs and 401(k)s impose annual ceilings and require minimum distribution (RMDs) that shrink long-term flexibility.
The Solution
The PLIP uses a specialized accumulation strategy built on institutional life-insurance architecture to provide:
- No income or contribution limits
- Tax-advantaged growth and withdrawals
- No required minimum distributions
- More than 80 institutional investment options
- Asset protection
Why it Matters
Every physician protects patients daily, but few protect their own wealth effectively. The PLIP helps safeguard income, family, and legacy while optimizing lifetime tax efficiency. It helps physicians put their income to work, like a trusted partner who keeps earning even when they’re off the clock.
A Growing Movement
When 401(k)s first appeared four decades ago, few professionals understood them. Today, they’re everywhere. In ten years, every physician may know the PLIP name. Through MSSNY, you can grow your wealth now, before it becomes standard.
Next Step → Explore the PLIP and register for the next informational session.
It’s Time to Reclaim Public Trust in Medicine
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Note: MSSNY member Robert Dracker, MD submitted this opinion piece. If you are a member and would like to contribute an article for consideration in our newsletter, please contact us at [email protected].
I became a doctor 43 years ago when I proudly graduated from the Upstate College of Medicine in Syracuse, New York. Having subsequently trained in Pediatrics, Hematology/Oncology, and Transfusion Medicine. I initially was Director of Transfusion Medicine at the University Hospital for 5 ½ years, after which I decided to return to private practice medicine to care for children in need. In my over 30 years in practice, I have committed myself to caring for the children in my community, both medically and in a scientific manner.
NEVER have I ignored my primary responsibilities in providing health care to those in need, while also performing clinical studies and having served on many organizations and committees, including the New York State Office of Professional Conduct. I have had the honor of serving on the FDA Pediatric Advisory Committee for 14 years, during which time I witnessed the honest and stalwart activity of a government organization committed to the health and welfare of the public. I will soon serve my third term as president of the Onondaga Medical Society and served three terms as president of the SUNY Medical College of Medicine Alumni Foundation.
What has motivated me has been ensuring the role of future and current physicians to care for their patients in a moral and committed manner. I am also the Chairman of the Medical Society of the State of New York’s Heart, Lung, and Cancer Committee, through which I have called for advocacy on behalf of patients to rebuild trust in their physicians and to advocate against the increasingly politically motivated medical misinformation campaign. It is time we re-take ownership of public trust and leadership on behalf of our patients. We can no longer sit idly by as patients are alternatively educated by drug company advertisements on TV and through social media, nor allowing them to be influenced by politicians with little or no medical education or knowledge.
Healthcare and medical information are the purview of physicians and must not be passively relinquished.
Now Streaming: HBO’s Country Doctor Spotlights America’s Rural Health Crisis
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The HBO Original Documentary Short Country Doctor, now streaming on HBO Max, captures the growing rural healthcare crisis through the story of Dr. James Graham, the only physician serving the small town of Fairfax, Oklahoma. Directed by Emmy winners Shari Cookson and Nick Doob, the film offers an unfiltered view of one doctor’s fight to sustain care amid hospital closures, staff shortages, and financial strain.
As over 140 rural hospitals have closed since 2010, Dr. Graham’s work underscores the dedication and isolation of physicians in underserved areas. For New York physicians, particularly those serving rural and upstate communities, his story resonates as a reminder of the vital role advocacy, equitable resource distribution, and physician-led solutions play in preserving access to care.
Don’t Lose Your Edge—Renew MSSNY Today
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Every advantage counts. Your MSSNY membership is your leverage in a changing healthcare landscape—your voice in Albany, your protection from payer overreach, your access to exclusive benefits that others pay thousands for.
Miss renewal, and you lose influence, protection, and savings.
MSSNY Urges Governor Hochul to Veto Bill Expanding Wrongful Death Damages
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Write to Governor Hochul today and urge her to veto S.4423/A.6063!
New York physicians are again facing legislation that would dramatically expand liability costs. The proposed bill, S.4423/A.6063, would exponentially increase damages awardable in wrongful death cases, without any cost controls or offsets.
Independent actuarial analyses show this measure could drive medical liability premiums up nearly 40%, with OB-GYNs seeing increases of over $76,000 annually and surgeons facing hikes exceeding $60,000. The result would devastate small practices, reduce patient access, particularly in rural and underserved areas, and accelerate physician shortages.
Governor Hochul previously vetoed similar legislation, warning it would raise costs for patients and strain an already distressed healthcare system. Those concerns remain unresolved.
MSSNY, joined by 45 county medical societies, strongly urges the Governor to veto this bill again and instead pursue balanced tort reform that protects both patients and physicians.
MSSNY Physician Leaders Working to Improve Patient Care Delivery Through MSSNY Committees and CME programs
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