MSSNY Pulse - September 25, 2026 - MEDICAL SOCIETY OF THE STATE OF NEW YORK ORGANIZED 1807

Prior Authorization: Progress, But We Are Not There Yet

Friday, September 25, 2026

Prior Authorization: Progress, But We Are Not There Yet

Click to Enlarge

Colleagues:

For years, physicians have been telling us the same thing: prior authorization has become one of the most frustrating and burdensome aspects of practicing medicine. What was originally intended to ensure appropriate utilization of healthcare services has evolved into an administrative obstacle that too often interferes with our ability to provide timely care to our patients.

The problem has become so significant that even health insurers are beginning to recognize the need for change. UnitedHealthcare recently announced its intention to reduce the number of healthcare services subject to prior authorization. While that is encouraging, physicians know that announcements alone will not solve the problem.

MSSNY has been working with the American Medical Association and numerous other physician and patient advocacy organizations to address these burdens. In a recent MSSNY survey, nearly 80% of physicians reported that the number of prior authorizations they are required to obtain has increased significantly over the past five years. Even more concerning, one in three physicians reported that prior authorization delays had resulted in serious adverse events for their patients. The administrative burden associated with these requirements is also an important contributor to physician frustration and burnout.

We have been advocating for meaningful reforms at both the state and federal levels. Among other things, MSSNY has supported legislation that would prohibit a health plan from requiring a prior authorization to be repeated once it has already been granted. We have also supported federal legislation designed to shorten the time Medicare Advantage plans have to respond to prior authorization requests.

Although these broader reforms have not yet crossed the finish line, New York State has taken several important steps this year that deserve recognition.

One of the most significant changes is a new requirement that state-regulated health plans cannot impose prior authorization more than once a year for a physician-recommended course of treatment for chronic conditions, including prescription medications. Importantly, that one-year period begins when the health plan approves the treatment. The new law also imposes significant new transparency requirements on health plans regarding which services are the biggest cause of headaches for physician practices and their patients.

New York has long published an annual consumer guide for health insurance coverage which includes cumulative numbers regarding grievances, patient and physician complaints, and appeals of denied services. What was not included was the total number of prior authorizations and denied prior authorizations. Beginning in 2027, New York’s Consumer Guide to Health Insurance will provide information on the number of prior authorization requests submitted, approved, and denied, as well as the number of denials that were appealed and the outcomes of those appeals.

Perhaps equally useful will be the ability to see what services are generating these requirements. Health plans will have to report the 25 CPT codes associated with the highest number of prior authorization requests, including approval rates and information about denials that were subsequently reversed on appeal. For the first time, physicians, patients, and policymakers will have greater visibility into where these requirements are being imposed and how often they are ultimately overturned.

There are other meaningful provisions as well, including improved access to information about prescription formularies and expanded protections allowing patients to continue seeing physicians they trust when they change health plans.

These reforms represent real progress. But I believe we need to be clear: progress is not the same as solving the problem.

Physicians should not have to repeatedly prove that a treatment they have already determined is medically necessary remains medically necessary. We should not need to spend hours navigating an insurer’s bureaucracy to obtain care that our patients need. And physicians treating patients should not have to fight with insurance companies over decisions that should be based on the physician’s knowledge of the patient and the best available medical evidence.

That is why MSSNY will continue to advocate for additional reforms. These include eliminating repeat prior authorizations, establishing meaningful “gold card” programs for physicians whose requests are consistently approved, and ensuring that physicians reviewing prior authorization requests are licensed in New York and practice in the same specialty as the physician providing the patient’s care.

The Governor and Legislature are beginning to recognize what physicians and patients have experienced for years. But lasting change will require continued advocacy. As your MSSNY President, I encourage physicians to continue telling us about the prior authorization requirements that make no sense. If an insurer has created an unnecessary barrier to your patient’s care, MSSNY needs to hear about it. Individual examples may seem small, but collectively they demonstrate the scope of the problem and give us the evidence we need to advocate for change.

We have made progress. Now we need to keep pushing until prior authorization serves its intended purpose, ensuring timely and appropriate care, rather than becoming an impediment to it.

All the best,

Mark J. Adams, MD, MBA, FACR
MSSNY President

MSSNY Introduces Legislation to Require Timely Workers’ Compensation Payments

Click to Enlarge

At the request of MSSNY, legislation has been introduced in the New York State Assembly to strengthen protection for physicians and other medical providers who treat injured workers and face delays in payment for workers’ compensation services. Assembly Bill A11714, introduced September 16, 2026, at the request of Assemblymember Harry Bronson and referred to the Assembly Committee on Labor, would amend Section 13-g of the Workers’ Compensation Law to increase the financial consequences for employers, workers’ compensation insurance carriers, and self-insured employers that fail to timely pay medical bills.

Under current law, a bill for medical care or supplies generally must be paid, or the provider must receive an explanation for non-payment within 45 days. When a bill is ultimately determined to be due and owed, the Workers’ Compensation Board may include interest of up to 1.5% per month in the award. A11714 would increase interest to 3% per month when an award is not paid within 15 days after it is rendered.

The bill would also establish enhanced penalties for a “pattern or practice” of non-payment. A medical provider or supplier could ask the Workers’ Compensation Board to determine whether such a pattern exists. If the Board finds that a pattern or practice exists and payment is due, the bill will require interest of between 3% and 5% per month, based on factors including the severity, duration, and frequency of the non-payment and the number of providers affected. In cases involving egregious or repeated violations, the Board could also impose a civil penalty of up to 25% of the amount due. The bill defines a pattern or practice to include three or more violations within a 12-month period, as well as other repeated conduct demonstrating a systemic failure to comply with the law’s payment requirements.

MSSNY supports efforts to ensure that physicians and other medical professionals providing workers’ compensation care are reimbursed in a timely manner. A11714 would not change the existing process for disputing the value of, or responsibility for a medical bill, but would strengthen the financial consequences for delayed payment once an obligation has been established or where repeated non-payment is demonstrated. MSSNY is now working to secure a Senate sponsor for companion legislation.

CMS Releases 2025 MIPS Final Scores- Physicians Have 60 Days to Contest Their Score

Click to Enlarge

The Centers for Medicare & Medicaid Services (CMS) has released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2025 performance year. 2025 final score determines the payment adjustment eligible clinicians (ECs) and group practices will receive in 2027. 2027 MIPS payment adjustments will be available in approximately one month. If an EC or group practice believes CMS calculated their final score or 2027 payment adjustment incorrectly, you must file a targeted review with CMS within 60 days.

The targeted review opens with the release of final scores (now) and will close 30 days after the release of MIPS payment adjustments. CMS will announce the release of MIPS payment adjustments through the QPP listserv in approximately one month. CMS generally requires documentation to support a targeted review request, which varies by circumstance. A CMS representative will contact you about providing any specific documentation required. If the targeted review request is approved and results in a scoring change, CMS will update your final score and/or associated payment adjustment (if applicable), as soon as technically feasible.

Examples of reasons to file a targeted review:

Data were submitted under the wrong TIN or National Provider Identifier (NPI).
You have Qualifying APM Participant (QP) status and shouldn’t receive a MIPS payment adjustment.
Performance categories weren’t automatically reweighted even though you qualify for reweighting due to extreme and uncontrollable circumstances.

To access your MIPS final score and performance feedback and request a targeted review:

Sign in using your HARP credentials (ACO-MS credentials for Shared Savings Program ACOs); these are the same credentials that allowed you to submit your 2025 MIPS data.
Click “Targeted Review” on the left-hand navigation.

Please note, unfortunately, targeted review decisions are final and aren’t eligible for further review by CMS.

CMS Would Like to Hear from You Regarding MIPS Value Pathways (MVPs)
CMS is conducting an MVP adoption survey and is seeking input from practices on whether you have reported an MVP for Payment Year (PY) 2025, are preparing to report for PY 2026, or have not yet begun adopting an MVP. The AMA encourages physicians and practices to complete the survey, especially if you are concerned with CMS’ proposal in the 2027 Medicare Physician Fee Schedule Proposed Rule to sunset traditional MIPS and require MVP reporting only starting in 2029. The AMA will continue to strongly advocate against mandatory MVP reporting and the need to maintain traditional MIPS along with reforms to the program to reduce administrative burden and make the program more relevant.

Participation in the survey is voluntary and confidential. Responses will be reported to CMS in aggregate to protect the identity of individuals, groups, and entities. Eligible clinicians may receive Improvement Activity (IA) credit for completing the survey. Take the survey by clicking on this link: The MVP Adoption Survey. If you have questions, contact: [email protected]

MSSNYPAC Endorsements for Election Approved at September 17 MSSNY Council Meeting

Click to Enlarge

At its September 17 meeting, the MSSNY Council affirmed the below candidate endorsements from the MSSNYPAC Political Action Committee recommended at its September 2 MSSNYPAC Executive Committee meeting. The recommendations were based upon recommendations of the MSSNYPAC State Candidate Evaluation Subcommittee and Federal Candidate Evaluation Subcommittee at its July 27 and August 12 meetings, respectively. Each of the 39 members listed below has demonstrated themselves to be champions of issues of importance to physicians and the patients they treat.

NEW YORK STATE ASSEMBLY

Assemblymember Harry Bronson, 138th District (D – Monroe County) – Led the effort over multiple years to oppose adverse Executive Budget proposal to eliminate county medical society vetting of applications for Workers’ Compensation participation, and support for efforts to reduce hassles for claim processing in Workers’ Compensation. Chief sponsor of MSSNY-supported legislation (A.10023) to prohibit non-compete clauses in physician employment contracts. Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (A.8052), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember David DiPietro, 147th District (R-Erie & Wyoming Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Supported legislation to reduce health plan prior authorization hassles (A.3789) and create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember Christopher Friend, 124th District (R-Broome, Chemung and Tioga Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986).

Assemblymember Scott Gray, 116th District (R-Jefferson & St. Lawrence Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986) and create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember Steve Hawley, 139th District (R-Erie, Genesee, Monroe & Orleans Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063) and increased scope of practice for chiropractors (A.4706). Sponsor of legislation to impose limits on non-economic damages in medical liability actions (A.2305). Also, supported legislation to reduce health plan prior authorization hassles (A.3789), legislation to create interoperability between I-STOP and a physician’s EMR (A.8849), and legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986).

Assemblymember Josh Jensen, 134th District (R-Monroe County) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986) and create interoperability between I-STOP and a physician’s EMR (A.8849). Moreover, during State Budget hearings, asked numerous questions highlighting concerns with various adverse Executive Budget proposals relating to Excess Liability Insurance and Independent Dispute Resolution.

Assemblymember Anna Kelles, 125th District (D – Cortland & Tompkins Counties) – A strong vocal opponent to adverse Executive Budget proposals that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Also supported legislation to reduce health plan prior authorization hassles (A.3789), prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (A.8052), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

John Lemondes, 126th District (R-Cayuga & Onondaga Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to reduce health plan prior authorization hassles (A.3789), prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), and create interoperability between I-STOP and a physician’s EMR (A.8849). He is a regular attendee of MSSNY’s Physician Advocacy Day Lunch program.

Assemblymember John McDonald, 108th District, (D-Albany, Rensselaer, and Saratoga Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to reduce health plan prior authorization hassles (A.3789), legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (A.8052), and was the chief sponsor of legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember Brian Miller, 122d District (R-Herkimer, Madison, Oneida, and Otsego counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember Andrew Molitor, 150th District (R-Chautauqua & Erie Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember Amy Paulin, 88th District (D-Westchester) – Chair of the New York State Assembly Health Committee and chief sponsor of legislation (A.2526) to permit independently practicing physicians with right to collectively negotiate with health insurers, legislation (A.6773) to eliminate adverse statutory post-service consent for payment requirement (put on hold by the Governor), and legislation to continue required insurance telehealth payment parity (A.1691). Led effort to enshrine into law requirements for health insurers to utilize physicians of same specialty during internal appeals of denied pre-authorizations or claims. Also strongly opposed Executive Budget proposal to require physicians to bear 50% of Excess Medical Malpractice Insurance cost, and proposal that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Strong proponent for Budget proposal that reduces health insurer prior authorization hassles. Moreover, she has consistently presented and answered questions from physicians during MSSNY’s Annual Albany Physician Advocacy Day.

Assemblymember Michaelle Solages, 22nd District (D – Nassau County) – Led efforts over multiple years to strongly oppose adverse Executive Budget proposals that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Chief sponsor of MSSNY-supported legislation to increase Prompt Payment fines on health plans (A.9265), and legislation to require health plans to honor a patient Assignment of Benefits to an out-of-network physician (A.9281). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (A.8052), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember Matthew Simpson, 114th District (R-Essex, Fulton, Saratoga, Warren & Washington Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to reduce health plan prior authorization hassles (A.3789), legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Assemblymember David Weprin, 24th District (D-Queens County) – Assembly Insurance Committee Chair and chief sponsor of legislation (A.3789) to reduce health insurer pre-authorization hassles, as well as legislation (A.3885) to help preserve out of network health insurance coverage in NYSHIP health benefits. Also strongly opposed Executive Budget proposal to require physicians to bear 50% of Excess Medical Malpractice Insurance cost, and proposal that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Strong proponent for Budget proposal that reduces health insurer prior authorization hassles. He has consistently presented and answered questions from physicians during MSSNY’s Annual Albany Physician Advocacy Day.

Assemblymember Carrie Woerner, 113th District (D-Saratoga, Warren & Washington Counties) – A leading proponent over several years of legislation to continue health insurer payment parity for healthcare services delivered via telehealth (continued in State Budget until 2028). Also supported legislation to reduce health plan prior authorization hassles (A.3789), prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (A.8052), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849). She is a regular attendee of meetings of the Saratoga County Medical Society.

NEW YORK STATE SENATE

Senator Jamal Bailey, 36th Senate District (D – Bronx County) – Senate Insurance Committee Chair, and Chief Sponsor of legislation to increase health insurer Prompt Payment penalties (S.5323) and legislation (S.4163) to require greater transparency of health insurer prior authorization requirements. Also strongly opposed Executive Budget proposal to require physicians to bear 50% of Excess Medical Malpractice Insurance cost, and proposal that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911), and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401). He has consistently presented and answered questions from physicians during MSSNY’s Annual Albany Physician Advocacy Day.

Senator Samra Brouk, 55th District (D – Monroe County) – Co-Chief champion for continued funding for the Veterans Mental Health Training Initiative (VMHTI), a joint program between MSSNY, the NYS Psychiatric Association and the National Association of Social Workers to expand physician and other care provider awareness and training of mental health services for veteran patients. Also supported legislation to reduce health plan prior authorization hassles (S.9651), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator George Borello, 57th District (R-Allegany, Cattaraugus, Chautauqua, Genesee & Wyoming Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423) and legislation that increased scope of surgical privileges for podiatrists (S.6693). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Patricia Canzoneri – Fitzpatrick, 9th District (R – Nassau County) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423) and legislation that increased scope of surgical privileges for podiatrists (S.6693). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Jeremy Cooney, 56th District (D-Monroe County) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423) and legislation that increased scope of surgical privileges for podiatrists (S.6693). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Pat Fahy, 46th Senate District (D-Albany, Montgomery & Schenectady Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Patrick Gallivan, 60th District (R-Erie) – Organized Senate Republican conference opposition to several adverse Budget proposals, including legislation to require the 16,000 physicians receiving Excess Medical Malpractice Insurance coverage to pay 50% of the cost, and legislation that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Also supported legislation to reduce health plan prior authorization hassles (S.9651), legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Joseph Griffo, 53rd District (R-Chenango, Herkimer, Madison, and Oneida Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Assemblymember Grace Lee, running for Senate 27th District (D -New York County) – A strong vocal opponent to adverse Executive Budget proposals that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986) and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

Senator Gustavo Rivera, 33rd District (D-Bronx) – Chief sponsor of numerous bills supported by MSSNY, including legislation (S.3359) to provide payment parity for telehealth-delivered health care services, legislation (S.1911) to provide physicians with greater due process when their participation contract is non-renewed from a health insurer, legislation (S.7913) to prohibit health insurers and hospitals from requiring a physician to maintain board certification as a condition of participation. As Chair of Senate Health Committee, also strongly opposed Executive Budget proposal to require physicians to bear 50% of Excess Medical Malpractice Insurance cost, and proposal that significantly restricted physician ability to challenge health plan underpayments through the Independent Dispute Resolution process. Strong proponent for Budget proposal that reduces health insurer prior authorization hassles. He has consistently presented and answered questions from physicians during MSSNY’s Annual Albany Physician Advocacy Day.

Senator Thomas O’Mara, 58th District (R-Allegany, Chemung, Schuyler, Seneca, Steuben, Tioga & Yates Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423) and legislation that increased scope of surgical privileges for podiatrists (S.6693). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Christopher Ryan, 50th District (Onondaga & Oswego Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423). Also supported legislation to reduce health plan prior authorization hassles (S.9651), legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Jessica Scarcella-Spanton (D – Kings & Richmond Counties) – Co-Chief champion for continued funding for the Veterans Mental Health Training Initiative (VMHTI), a joint program between MSSNY, the NYS Psychiatric Association and the National Association of Social Workers to expand physician and other care provider awareness and training of mental health services for veteran patients. Also supported legislation to reduce health plan prior authorization hassles (S.9651), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401). Opposed legislation that increased the scope of surgical privileges for podiatrists (S.6693).

Senator Toby Stavisky, 11th District (D-Queens) – As Chair of Senate Higher Education Committee, she has thoughtfully considered MSSNY and specialty society concerns with the litany of bills that would inappropriately expand the statutory scope of practice of numerous health care professionals. In particular, she led efforts to exclude from the State Budget proposals to permit many Physician Assistants to practice without physician supervision and was integral to efforts to prevent passage of legislation that would have greatly increased the scope-of-practice of chiropractors (S.5860). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401).

Senator Daniel Stec, 45th District (R-Clinton, Essex, Franklin, St. Lawrence, Warren & Washington) – Opposed legislation which would have greatly increased liability premium costs for physicians (S.4423). Also supported legislation to reduce health plan prior authorization hassles (S.9651), legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (S.2105), legislation to require due process protections when a physician’s participation contract with a health plan is non-renewed (S.1911) and legislation to create interoperability between I-STOP and a physician’s EMR (S.9401). Moreover, is a regular participant in the annual 3rd/4th MSSNY District Winter meeting.

Assemblymember Chris Tague (R – running for Senate District 51 – Broome, Chenango, Delaware, Otsego, Schoharie, Sullivan & Ulster Counties) – Opposed legislation which would have greatly increased liability premium costs for physicians (A.6063). Also supported legislation to prohibit health plan payment by Virtual Credit Card in the absence of express physician consent (A.3986), and legislation to create interoperability between I-STOP and a physician’s EMR (A.8849).

NEW YORK CONGRESSIONAL DELEGATION

Rep. Tim Kennedy (D–26th District/Erie & Niagara Counties) – Co-sponsor of legislation to:

Provide greater Medicare payment stability (HR 8163)
Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
Expand the number of Conrad-30 slots that each state may make available for IMG physicians (HR 1585)
To exempt physician applicants of $100,000 fee for H-1B Visas (HR 7961)

He also voted against HR 1, legislation that substantially reduced eligibility for Medicaid and other publicly funded health insurance programs.

Rep. Mike Lawler (R–17th District/Dutchess, Putnam, Rockland, and Westchester) – Chief sponsor of legislation to exempt physician applicants from $100,000 fee for H-1B Visas (HR 7961) and co-sponsor of legislation to:

Provide greater Medicare payment stability (HR 8163)
Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
Expand the number of Conrad-30 slots that each state may make available for IMG physicians (HR 1585)
Require CMS to report, and provide resources for states, on coverage of remote physiologic devices and related services (e.g., blood glucose monitors) under Medicaid (HR 4977)

Rep. John Mannion (D-22d District (Madison, Oneida & Onondaga Counties)

Provide greater Medicare payment stability (HR 8163)
Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
Exempt physician applicants from $100,000 fee for H-1B Visas (HR 7961)

He also voted against HR 1, legislation that substantially reduced eligibility for Medicaid and other publicly funded health insurance programs.

Rep. Grace Meng (D – 6th District/Queens County) – Co-sponsor of legislation to:

Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
Expand the number of Conrad-30 slots that each state may make available for IMG physicians (HR 1585)
Exempt physician applicants from $100,000 fee for H-1B Visas (HR 7961)

She also voted against HR 1, legislation that substantially reduced eligibility for Medicaid and other publicly funded health insurance programs.

Rep Joe Morelle (D–25th District/Monroe and Orleans Counties) – co-sponsor of legislation to:

Provide greater Medicare payment stability (HR 8163)
Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
To exempt physician applicants of $100,000 fee for H-1B Visas (HR 7961)

He also voted against HR 1, legislation that substantially reduced eligibility for Medicaid and other publicly funded health insurance programs. He has maintained a strong relationship with local physicians and MSSNY physician leadership. In addition, he spoke at the 2026 MSSNY HOD and played a significant role in pushing back against components of the No Surprises Act that would have made the federal IDR process for resolving out of network disputes even more difficult for physicians to navigate.

Rep. Josh Riley (D-19th District/Broome, Chenango, Columbia, Cortland, Delaware, Greene, Otsego, Sullivan, Tioga, Tompkins and Ulster Counties) – Co-sponsor of legislation to:

Provide greater Medicare payment stability (HR 8163)
Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
Expand the number of Conrad-30 slots that each state may make available for IMG physicians (HR 1585)
Exempt physician applicants from $100,000 fee for H-1B Visas (HR 7961)

He also voted against HR 1, legislation that substantially reduced eligibility for Medicaid and other publicly funded health insurance programs.

Rep. Tom Suozzi (D-3rd District/Nassau County) – Chief co-sponsor of legislation (A8163) to provide greater Medicare payment stability and co-sponsor of legislation to:

Reduce prior authorization hassles in Medicare Advantage (HR 3514)
Provides long-term Medicare coverage of telehealth services (HR 4206)
Expand the number of Conrad-30 slots that each state may make available for IMG physicians (HR 1585)
To exempt physician applicants from $100,000 fee for H-1B Visas (HR 7961)

He also voted against HR 1, legislation that substantially reduced eligibility for Medicaid and other publicly funded health insurance programs. In addition, in 2021, as a member of the Ways & Means Committee, Rep. Suozzi played a significant role in pushing back against components of the No Surprises Act that would have made the federal IDR process for out of network disputes even more difficult for physicians to navigate. He has maintained a strong relationship with local physicians.

Advocacy in Action

Click to Enlarge

Physicians, community leaders, and elected officials come together at the Erie County Medical Society Legislative Breakfast to discuss key issues affecting medicine and patient care in New York.

MSSNY President Dr. Mark Adams addresses attendees at Erie County Medical Society legislative breakfast.

MSSNY 8th District Councilor Dr. Stacey Watt speaks with attendees during the Erie County Medical Society legislative breakfast.

Physician Input Needed for 2027 NYS Legislative Session

Click to Enlarge

As MSSNY gears up for the 2027 New York State legislative session, we need your help! Please take a few minutes to take the 2027 legislative survey. If the hyperlink above does not display or work, copy and paste this link into your browser: https://www.surveymonkey.com/r/66LSXSV.

Coalition Sues Administration Over Medicaid Work Requirements

Click to Enlarge

A coalition of physician groups, individual Medicaid enrollees, and the city of Columbus is joining forces to sue the feds over regulations governing the rollout of work requirements at the beginning of next year. The lawsuit alleges that the tight requirements could impact individuals with diabetes, cancer, HIV, substance use disorders, disabling mental health conditions, and other serious or complex medical conditions.

Last Chance to Serve on a MSSNY Committee in 2027

Click to Enlarge

MSSNY invites members interested in serving on a committee to complete the Committee Interest Form.

Please note: if a committee does not appear on the form, it is not currently accepting new members for 2027.

Please submit all forms by Wednesday, September 30th at 4:00 pm. Forms received after this deadline will not be considered. MSSNY’s president-elect will review all applications early in 2027. Approved appointments will be presented to MSSNY’s Council at either the April or June meeting. Once approved, your appointment will start immediately.

NYSED License Scam Alert

Click to Enlarge

The New York State Education Department Office of the Professions is warning licensees about a vishing scam impersonating SED employees or websites to collect licensure and personal information.

Physicians and practice staff should not provide information in response to suspicious calls, emails, or messages. Verify directly with the Office of the Professions before responding to help protect licensure records and avoid administrative risk.

Report suspicious communications when appropriate. Verify First

MSSNY’s Dr. David Podwall Makes Cameo on Last Week Tonight with John Oliver

Click to Enlarge

MSSNY member and Nassau County Medical Society Board Member Dr. David Podwall’s CBS New York interview on Change Health was recently featured on Last Week Tonight with John Oliver. Dr. Podwall brought a physician’s perspective to the national conversation surrounding UnitedHealthcare, healthcare delivery, and patient access. Watch now (25:00)!

Upcoming MSSNY Webinars Support Physicians Across Every Career Stage

Click to Enlarge

September 29: Leadership Pearls from Business School & Life Experiences. Register now.

October 20: Physician Employment Agreements: What to Know Before You Sign. Register now.

Step into Your Next Chapter Wisely

Click to Enlarge

Before recruitment season ramps up, ensure your next contract aligns with your goals. Resolve helps MSSNY members negotiate from strength.

Review Your Contract →

MSSNY Pulse – September 25, 2026

Prior Authorization: Progress, But We Are Not There Yet

Friday, September 25, 2026

Prior Authorization: Progress, But We Are Not There Yet

Read more

MSSNY Introduces Legislation to Require Timely Workers’ Compensation Payments

Read more

CMS Releases 2025 MIPS Final Scores- Physicians Have 60 Days to Contest Their Score

Read more

MSSNYPAC Endorsements for Election Approved at September 17 MSSNY Council Meeting

Read more

Advocacy in Action

Physician Input Needed for 2027 NYS Legislative Session

Coalition Sues Administration Over Medicaid Work Requirements

Last Chance to Serve on a MSSNY Committee in 2027

NYSED License Scam Alert

MSSNY’s Dr. David Podwall Makes Cameo on Last Week Tonight with John Oliver

Upcoming MSSNY Webinars Support Physicians Across Every Career Stage

Step into Your Next Chapter Wisely

Find by Category

About MSSNY

Hot Links

Featured Member Benefits