Supporting New York’s Patients and Physicians: Response to the Final State Budget
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Colleagues:
While MSSNY and I are grateful to the New York State Legislature and Governor for several important provisions included in and excluded from the final budget, we are also deeply disappointed by the decisions to eliminate the long-standing county medical society physician vetting role within the Workers’ Compensation system and the significant revisions that will impede access to the Independent Dispute Resolution process.
We appreciate the Legislature’s continued funding of the Excess Medical Malpractice Insurance Program for community-based private practice physicians. This program remains one of the most important physician retention and patient access initiatives in New York State. New York continues to have the highest medical liability insurance costs in the nation, particularly for physicians practicing in high-risk specialties and underserved communities. Without this support, many physicians would be forced to reduce services, leave private practice, retire early, or relocate outside New York State, further worsening physician shortages and threatening access to care for patients who rely upon community-based physicians every day.
We thank the Legislature for continuing its support and funding for the Committee for Physician Health (CPH). The CPH program plays a vital role in protecting patients while supporting physicians facing health challenges, including substance use disorders, mental health concerns, and burnout. By providing confidential assistance, monitoring, advocacy, and pathways to recovery, CPH helps physicians safely continue their professional responsibilities while preserving the integrity of the medical profession and protecting patient safety. Continued State support for this program reflects an important recognition that physician wellness is directly connected to the quality and stability of healthcare delivery throughout New York State.
We also applaud the Legislature for rejecting proposals that would have expanded independent practice authority for physician assistants beyond appropriate physician-led team-based care models. Patients deserve a healthcare system that promotes collaboration while preserving the physician-led standard of care that has long served New Yorkers well. Physicians, physician assistants, nurses, and all healthcare professionals play vital roles in delivering patient care, but the complexity of modern medicine requires the extensive education, training, and clinical experience uniquely provided through physician education, residency training, and continued medical education. Maintaining physician-led care teams helps ensure the highest standards of patient safety and quality care.
Additionally, MSSNY and I want to thank state leaders for continuing to support telehealth parity. Telemedicine has become an indispensable tool in expanding access to care, particularly for patients in rural areas, underserved communities, and for individuals with mobility or transportation challenges. Ensuring fair reimbursement for telehealth services allows physicians to continue investing in technologies and systems that improve patient access, continuity of care, and healthcare outcomes.
We further commend the Legislature for enacting meaningful prior authorization reforms. Excessive and unnecessary prior authorization requirements have increasingly delayed medically necessary care, created significant administrative burdens for physician practices, and interfered with the physician-patient relationship. These reforms represent an important step toward reducing delays in treatment and improving patient access to timely medical care. Physicians should be spending more time caring for patients and less time navigating unnecessary insurance barriers. I will continue to support further reforms on prior authorization, hopefully to be addressed in the next legislative cycle.
Additional items supported by MSSNY and me and included in the budget are continued funding the Doctors’ Across New York physician loan repayment program, providing new funding for the MSSNY/NYSPA/NASW Veterans’ Mental Health Training Initiative, and reducing prior authorization requirements in Workers’ Compensation by increasing cost of care threshold from $1,000 to $1,500. Furthermore, the proposal opposed by MSSNY to reduce the pass-through entity tax credit used by many private physician practices was rejected.
At the same time, we are disappointed with provisions ultimately removed or altered during final budget negotiations. MSSNY and I remain opposed to the elimination of the long-standing physician vetting role performed by county medical societies within the Workers’ Compensation system. For decades, county medical societies have helped ensure the integrity, professionalism, and quality of physicians participating in the Workers’ Compensation program through a trusted peer-review process grounded in local medical oversight and accountability. Removing this important safeguard risks weakening confidence in the system and diminishing the important role organized medicine has historically played in protecting quality patient care.
We are also disappointed by the decision to remove Medicaid claims from the Independent Dispute Resolution (IDR) process, as well as other changes that will significantly limit the ability of physicians to challenge pervasive health plan underpayments through the IDR process. Physicians who care for vulnerable Medicaid patients already face significant financial challenges due to chronically inadequate reimbursement rates. Excluding Medicaid-related disputes from IDR protections risks further destabilizing physician participation in Medicaid networks and may ultimately reduce access to care for many of New York’s most vulnerable populations, particularly in our already overstressed hospital emergency departments that often rely upon the availability of on-call specialty physician care.
As president of MSSNY, I remain committed to working collaboratively with the Legislature, the Governor, and all stakeholders to address the ongoing challenges facing New York’s healthcare system by supporting policies that strengthen patient access to care, support the physician workforce, and protect the health and well-being of all New Yorkers.
All the best,
Mark J. Adams, MD, MBA, FACR
MSSNY President
