1. health and fitness
2. disorders

MEDICAL SOCIETY OF THE STATE OF NEW YORK
NEWS OF NEW YORK
Volume 70 • Number 4 • www.mssny.org
HOD
April 11-13
Providing Information to Assist Physicians in the State of New York
April 2014
Legislature Developing One-House Budgets –
Physicians Should Weigh In Now!
Regarding your practice’s transition to ICD-10,
how far along are you and your staff?
We have not begun the transition
We know we have to do it and are
attempting to schedule training
We have started training but have
a way to go
We have completed training and feel
we are ready for the transition
This is not a concern because my
employer is handling the details
My hospital is providing training
which includes training for my office
Don’t know
A quick survey by MSSNY of physicians in New York State indicates that a
total of two thirds of responders have not begun their transition to ICD-10
or are still attempting to line up training. With a hard deadline of October 1
for the switch, many physician practices are facing potential cash flow issues.
MSSNY will be offering information on ICD-10 training programs in the
coming weeks.
Government Affairs
Doctors Across New York Expansion Bill Moves
In Senate
S.2190-A (Young), a bill that would expand the Doctors Across New York program, which is currently for physicians only, to include dentists without increased
funding, was reported to the Senate Finance Committee. The program, which has
provided physicians to underserved areas of New York State since its inception in
2008, is already seriously underfunded and needs additional funding just to bring
additional physicians to areas of New York State which desperately need them.
By stretching the existing funding to include dentists, this bill would decrease
the number of physicians who could be approved for loan repayment for a commitment to practice in an underserved area of New York State for five years,
or practice support for agreeing to serve in an underserved area for two years.
MSSNY strongly opposed this bill and has been working to have the funding
for the program increased. In the latest funding cycle, only half of the qualified
applicants were able to be accepted because of lack of funding.
Physicians are urged to contact their senator to oppose this bill
(Continued on page 11)
Each house of the New York State Legislature
is developing their one-house budgets to set the
stage for negotiations of the budget for FY 201415, which will begin in earnest next week. There
are many issues in the proposed budget which
will impact upon physicians and their practices.
Please assure that your representatives know your
perspective on these issues. To send a letter to
your representatives on any of these issues, please
visit MSSNY’s Grass Roots Action Center on the
MSSNY website at www.mssny.org. 1. Support Continuation of a Fully
Funded Excess Medical Liability
Program
We are grateful that Governor Cuomo has proposed to continue the Excess Medical Liability
Insurance Program and to fund it at its historical
level of $127.4M.The Excess Medical Liability
Insurance Program provides an additional layer of
$1M of coverage to physicians with hospital privileges who maintain primary coverage at the $1.3
million/$3.9 million level. Until such time as meaningful liability reform is enacted, we must protect
and continue the Excess program so as to assure
that physicians can remain in practice in New York
State. We urge that the Legislature include this
funding and continue the Excess program in the
final budget adopted for 2014-2015.
2. Support Measure to Assure
Patient Access to Physician
of Choice
The proposed budget contains provisions
similar to legislation (S. 2551 and A. 7813)
sponsored respectively by Senator Hannon and
Assemblymember Gottfried to provide greater
transparency of a health insurer’s out-of-network
coverage and to broaden availability of a patient’s
right to go out of network if the insurer’s existing
network is insufficient. These proposals also seek to
assure that out-of-network benefits are more com-
prehensive, transparent and accessible. We urge
enactment of legislation which will assure that our
patients have meaningful coverage of and access to
out-of-network care. We are also urging changes
to the governor’s proposal to assure that insurers
do not force physicians to go through burdensome
procedures in order to be paid fairly for providing
needed emergency care and other critical hospital
care.
3. Prevent the Imposition of
Burdensome and Unnecessary
Regulations on Private Physician
Urgent Care and Office Based
Surgical Practices
The proposed budget would define and regulate
urgent care practices and would require that they
comply with costly and burdensome accreditation requirements. The proposed budget also seeks
to impose considerable reporting requirements
concerning findings of surveys or complaint investigations conducted by accrediting agencies at the
behest of the Department of Health of office based
surgical practices without protecting against the
release of physician identifiable information to
the public. We urge the defeat of burdensome and
unnecessary regulations and reporting requirements
on urgent care and office based surgical physician
practices.
4. Reject Proposal to Allow
Corporately Owned Retail
Clinics in NYS
The limited service retail clinic model raises a
number of concerns, including the potential conflict of interest posed by pharmacy chain ownership
of retail clinics which provides implicit incentives
for the nurse practitioner in these settings to write
more prescriptions or recommend greater use of
over-the-counter products than would otherwise
occur. Urge your legislators to reject the retail clinic
initiative.
(Continued on page 9)
MLMIC Announces 5% Dividend
I am pleased to report that our endorsed carrier, Medical Liability Mutual Insurance Company
(MLMIC), has declared another policyholder dividend
for 2014. The dividend is 5% this year, and will be
applied on July 1 to all physicians who are policyholders on May 1 and maintain continuous coverage through
July 1.
This is the second consecutive dividend MLMIC has
declared (3% last year), and one of several it has declared
in its nearly 40 year history. Most other medical liability
insurers operating in NYS lack the financial strength or
the policyholder-first mission to declare such dividends.
MLMIC puts your needs first, giving you the service
and protection you deserve. It’s at-cost, long-term focus
ensures that you won’t overpay for quality protection, or
worry about the company being there when you need
them. And, their unparalleled claims and risk management expertise provide superior protection, with high
success rates and very satisfied policyholders.
This is why MSSNY has exclusively endorsed
MLMIC as the medical liability insurer for its members.
For more information on MLMIC, including how to
become a policyholder in time to qualify for the 2014
dividend, please visit www.mlmic.com or call your
nearest MLMIC underwriting office: New York City
(800-275-6564); Long Island (877-777-3560); Latham
(800-635-0666); or Syracuse (800-356-4056).
Sam Unterricht, MD
Liz Dears, MSSNY Senior Vice President, Legislative and
Regulatory Affairs, welcomes participants to Lobby Day on
March 11. Seated are MSSNY President Sam Unterricht, MD
(left), and Paul Pipia, MD (right)
Inside News
ICD-10
FAQs����������������page 2
HOD
Resolutions������page 3
Lobby Day
Photos�������������page 8
Council
Notes���������������page 9
eMedNY ICD-10 FAQ
General
1. Where can I find information about ICD -10?
Visit the CMS ICD-10 web site www.cms.gov/icd10 for the
latest news and resources. Providers may also wish to sign up
for CMS ICD-10 Industry Email Updates.
2. What is the compliance deadline for ICD-10?
The ICD-10 deadline is October 1, 2014. For services provided
on or after October 1, 2014, the ICD-9 code sets used to report
medical diagnoses and inpatient procedures will be replaced by
ICD-10 code sets. eMedNY is on track to meet the deadline, and
we expect providers and vendors to be on track as well.
3. What if I do not switch to ICD-10 or the ICD-10 codes
submitted are invalid?
Electronic claims including ePACES, without ICD-10
coding or that have invalid ICD-10 diagnosis and inpatient
procedure codes for dates of service on or after October 1,
2014, will be rejected with a pre-adjudication edit. Paper
claims with the same errors will be denied.
4. Will the eMedNY Call Center assist with ICD-10
coding?
It is the provider’s responsibility to transition and train their
staff on ICD-10 coding. The eMedNY Call Center will assist
callers with rejected or denied claims, due to coding issues.
However, the Call Center will be unable to check ICD-10
codes to determine validity prior to submitting claims.
5. Can submitters transition to ICD- 10 earlier than
October 1, 2014?
Page 2 • MSSNY’s News of New York • April 2014
No. The ICD-10 code sets are effective for dates of service
on or after October 1, 2014. ICD-10 cannot be used on claims
with a date of service or end date of service/discharge date
prior to October 1, 2014.
6. Will submitters use both ICD-9 and ICD-10 codes during the transition?
All systems must be able to accommodate both ICD-9 and
ICD-10 codes for all claims. ICD-9 coding is used for claims
with dates of servicer prior to October 1, 2014 and ICD-10
for claims with dates of service on or after October 1, 2014.
7. Can ICD-9 and ICD-10 be sent on the same claim?
No. Claims must be submitted according to the guidelines
in this FAQ. Claims containing both ICD-9 and ICD-10,
where the Primary Diagnosis, based on Service Date, is not
found in the ICD diagnosis group will edit 00146. Claims
containing both ICD-9 and ICD-10, where the Secondary
Diagnosis, based on Service Date, is not found in the ICD
diagnosis group will edit 00148. Claims with procedure codes
containing both ICD-9 and ICD-10 codes will edit 02087.
8. Are there any changes to the 5010 format for the
ICD-10?
Yes. The ICD-10 value is entered in the same loop and segment as the ICD-9; however the code is identified as ICD-10
using a different qualifier than has been used for ICD-9.
The decimal continues to be implied for ICD-10 as it is in
ICD-9 coding. The qualifiers for ICD-10 are listed below.
9. Does eMedNY have any kind of conversion crosswalk?
QualifierDescription
ABK International Classification of Diseases Clinical
Modification (ICD-10-CM) Principal Diagnosis
ABFInternational Classification of Diseases Clinical
Modification (ICD-10-CM) Diagnosis
ABJInternational Classification of Diseases Clinical
Modification (ICD-10-CM) Admitting Diagnosis
APRInternational Classification of Diseases Clinical
Modification (ICD-10-CM) Patient’s Reason for
Visit
ABNInternational Classification of Diseases Clinical
Modification (ICD-10-CM) External Cause of
Injury Code
BBR International Classification of Diseases Clinical
Modification (ICD-10-CM) Principal Procedure
Codes
BBQInternational Classification of Diseases Clinical
Modification (ICD-10-CM) Other Procedure
Codes
eMedNY does not publish ICD-9, and will not publish ICD10. NY Medicaid will not crosswalk ICD codes. There is ICD
conversion information on the CMS website:
www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/icd10
Billing
10. What if a claim spans the date of service of October
1, 2014?
a. Institutional Claims If the claim is for Clinic APG
Episode of Care or CHHA Episodic services with multiple
dates of service where the through date is on or after October
1, 2014, the claim must be coded as ICD-10 for all dates of
service - even if the episode started before October 1, 2014.
For other types of Rate Based Institutional claims that do
not bill using from and through dates of service, providers
must split their claims to separate ICD-9 claims (prior to
October 1, 2014) from ICD-10 claims (on or after October
1, 2014). For those Institutional providers who bill the first of
the month subsequent to when the service was rendered - the
coding used is determined by the date of service as it appears
on the claim. Therefore, services rendered in September 2014
that are billed as date of service October 1, 2014 must use the
ICD-10 code set.
b. Professional Claims Professional claims must be split
to separate ICD-9 claims (date of service prior to October
1, 2014) from ICD-10 claims (date of service on or after
October 1, 2014). All paper claim forms must conform to the
same instructions set forth for electronic claims.
11. How should a DRG Inpatient claim be coded if the
admission is prior to October 1, 2014 but the patient is
discharged on or after October 1, 2014?
DRG Inpatient claims which are rate codes 2946/2953 and
GME 3130, should be coded according to the discharge date.
If the discharge date is on or after October 1, 2014, the diagnosis and procedure codes must be ICD-10 regardless of the
date of admission.
12. How should non-DRG Inpatient claims (ALC, Detox,
etc.) be coded?
If the non DRG claim will be interim billed with no discharge
date and the end date of service is on or after October 1, 2014,
the coding must be ICD-10. NOTE: This could result in a DRG
claim coded as ICD-10 when the discharge date is on or after
October 1, 2014 while the ALC portion of the stay is coded
as ICD-9 because the ALC occurred prior to October 1, 2014.
13. How should an Inpatient claim for Psychiatric services (rate code 2852) be coded?
An Inpatient claim for Psychiatric services should be coded
according to the discharge date. If the discharge date is on or
after October 1, 2014, the diagnosis and procedure codes must
be ICD-10 regardless of the date of admission. If the claim is
to be interim billed and does not have a discharge date, then the
coding is dependent on the end date of service. NOTE: When
adding interim periods, if the original claim is coded as ICD-9
and the interim period to be added has an end date of service on
or after October 1, 2014, then the adjusted claim with the added
interim period will be coded as ICD-10.
14. Do pharmacy providers billing via NCPDP D.0 need
to notify their software vendors to make any changes for
ICD-10 Diagnosis codes?
Yes, the Diagnosis Code qualifier field will need to allow
for the qualifier for either an ICD-9 or ICD-10 Diagnosis
code to be reported according to the Date of Service.
Trading Partners should refer to the NCPDP D.0 Companion
Guide for further guidance.
2014 Medical Society of the State of New York Annual House of Delegates Resolutions
Availability Of Self-Injectable Epinephrine Devices In
New York State Schools
In an effort to prevent deaths from children and adults having a
severe allergic reaction in a school setting, MSSNY will work to support and develop legislation that requires all schools, both private and
public to stock auto-injectable epinephrine devices in standardized
dosage formulations and to train personnel for administration of this
medication. The auto-injectable epinephrine devices will be used on
children or adults that have a severe allergic reaction, regardless of
whether there is a patient specific prescription. The treating individual
will be covered by the New York State “Good Samaritan” Statutes as
regards to legal liability.
OPMC Inform Physicians Of Unintended Consequences
Physicians need to be made aware that an Office of Professional
Medical Conduct (OPMC) investigation may result in an “OPMC order”
of conditions or restrictions on a physician’s license to practice medicine. The New York State Office of Medicaid Inspector General (MIG)
has the ability to exclude a physician from Medicaid participation,
and possibly Medicare, Tri-Care and Veteran affairs as well as nongovernmental programs on the basis of an OPMC licensure order. An
OPMC licensure restriction may affect a physician’s ability to obtain
medical malpractice coverage and may well make the physician
unemployable. MSSNY will seek regulation to require that the Office
of Professional Medical Conduct (OPMC) inform physicians regarding
potential practice-altering consequences, intended or unintended, that
may result from an OPMC order.
Retirement Of A Physician Medical License
There is currently no way for New York state physicians to “retire”
their medical license with the dignity and respect they have earned. A
retiring physician may only “give up” his/her license by temporary or
permanent surrender. MSSNY will seek legislation to provide for the nondisciplinary retirement of a physician license.
MSSNY To Partner With The “ Choosing Wisely”
Program
Choosing Wisely (www.choosingwisely.org) is an initiative of the
American Board of Internal Medicine Foundation (ABIM) that promotes
conversations between patients and physicians about unnecessary
medical tests. MSSNY wishes to encourage all physicians to practice
medicine in a responsible manner using available scientific evidence
to determine best practices. The New York delegation to the American
Medical Association will encourage the AMA to also sign on as a partner
with the ABIM’s Choosing Wisely program.
Medical Malpractice Insurance Education For
Employed Physicians
As the number of employed physicians increase, so does the need
for education on physicians having adequate medical malpractice
insurance. MSSNY, in collaboration with the Medical Liability Mutual
Insurance Company and the State Insurance Department will seek to
develop a program for employed physicians to inform them about the
importance of adequate malpractice insurance coverage.
Meeting Management Education For Physician
Leaders
MSSNY will develop a meeting management program for physician leaders at all levels so that they have the ability to run meetings
efficiently. MSSNY will encourage all new appointed/elected leaders to
participate in meeting management training.
MSSNY Committee Structure
MSSNY needs to find areas of savings to pass on to members and
eliminate multiple and duplicated committees. MSSNY will analyze its
committee structure with an intention to eliminate any committee not
felt to be contributing directly to MSSNY’s mission and to combine committees wherever possible.
SHIN-NY Connectivity
The State Health Information Network-New York (SHIN-NY) is the
vehicle developed by the state to be the vehicle of connectivity for all
the health information networks in the state. At this time, only a few
Electronic Medical Records (EMR) vendors are capable of meeting the
SHIN-NY standards for connectivity. NYS physicians have already made
a significant commitment to purchase and use EMRs to comply with
existing Federal and organizational mandates. EMR vendors will want to
charge NY physicians for the development of new services so that they
can connect to SHIN-NY. MSSNY will work with the New York eHealth
Collaborative and the SHIN-NY to make sure that physicians do not have
to pay any of the costs associated with connecting to, accessing or
downloading data from the SHIN-NY network.
Encourage Use Of NYS Record Release Form
Medical practices frequently request patient medical records from
other medical practices. MSSNY recommends to physicians that their
office staffs utilize the New York State Authorization for Release of Health
Information Pursuant to HIPAA form (OCA Office Form No. 960).
Patient Consent For Uploading Patient Records To
The SHIN-NY And Rhios
In order to protect a patient’s electronic medical records, MSSNY
will seek legislation that requires patient consent for uploading patient
records to Regional Health Information Organizations (RHIOs) and the
Statewide Health Information Network of New York (SHIN-NY). MSSNY
will also seek legislation to tighten access to patient records so as to
restrict access without patient consent, only when the patient is not
in a conscious or rational state of mind or their legal representative is
unable to provide consent and the healthcare provider documents the
life-threatening reason for having to access the patient record.
Correct Record Access
The State of New York should promote patient record access in accordance with patient/custodial rights and healthcare efficiency through
paper records, digital copies, patient portals, Surescripts Direct, and/or
SHIN-NY; and that the cost of such record access be borne by the payor
of the healthcare at rates sufficient to cover the costs of the technology,
employees and office overhead used to provide the record access.
Regulation Of Marijuana Sale And Use In New York
State
Due to the addictive nature of marijuana, and the selling and marketing of addictive drugs to children, MSSNY resolves that the sale of
marijuana only be transacted by the State of New York at State Addictive
Drug Centers (SAD Centers); that it only be sold at SAD Centers by drug
counselors; that buying marijuana require a SAD license, issued only to
those over 18 years of age that have completed a four hour course on
the effects of marijuana and have participated in a one hour motivational
interview conducted by a drug counselor. NYS law should be changed
so that the only infraction regarding marijuana that is punishable by law
is to make marijuana available to an unlicensed user or to sell it outside
of a SAD Center.
De-Couple No Fault Fee Schedule
New York State No-Fault rates represent some of the lowest reimbursement rates in the US.
This is due to the fact that the No-Fault rates are based on the
Workers Compensation fee schedules. No-Fault insurance is a commercial insurance product and there is no justification in tying the No-Fault
fee schedule to the Workers Compensation fee schedule. By doing this,
physicians are prevented from negotiation with commercial carriers for
their usual and customary rates. MSSNY will seek legislation to be introduced and signed into law in New York State to decouple the No-Fault
fee schedule from the Workers Compensation fee schedule in order to
allow NYS physicians caring for No-Fault recipients to be paid their usual
and customary rates by insurance carriers.
Affordable Care Act And NYS Medical Tort Reform
The new health care exchanges are now covering people previously
uninsured/underinsured. Due to the practice of defensive medicine, the
cost of health care will increase, while physicians are reimbursed at
lower rates under the new healthcare exchanges. Comprehensive tort
reform in New York State (NYS) is needed to reduce excessive malpractice rates and improve access to care in NYS. Comprehensive tort reform
will reduce the practice of defensive medicine and offset the lower payments physicians will receive through the exchange insurance policies.
Support Of Athletic Trainer Legislation
Athletic Trainers (ATs) are often the only medical personnel on sight
to provide emergency first aid in schools and athletic facilities. MSSNY
supports legislation requiring ATs to obtain mandatory CME acquisition
and update their medical competencies commensurate with their skill
and training, all while under the supervision of physicians.
Use Of CT Scans For Early Detection Of Lung Cancer
The United States Preventive Services Task Force (USPSTF) has
determined that there is a high certainty that the net benefit of annual
low-dose CT screening for individuals at high risk for lung cancer-current/former smokers aged 55-79 years, who have significant cumulative
tobacco smoke exposure and have smoked within the last 15 years
would be effective in detecting early lung cancer. MSSNY will support the
USPSTF Grade B recommendation to offer low dose helical CT screening
for lung cancer to patients between 55 and 80 years old who have a 30
pack per year smoking history and currently smoke or have quit smoking within the past 15 years.
DVT And Air Travel
Deep vein thrombosis (DVT) is a serious medical condition that is
associated with long distance air travel. Many passengers, unbeknownst
to themselves, may be at risk for developing DVT while flying. MSSNY
will request that the American Medical Association (AMA) encourage
the Federal Aviation Administration (FAA) and the airline industry alert
passengers to the flight associated risk of deep vein thrombosis (DVT).
MSSNY will also request that the AMA work with the FAA and the airline
industry to provide recommendations to passengers to reduce their risk
of developing DVT.
Internet Review Of Physicians
Currently, patients are able to post physician reviews on websites
anonymously. This anonymity makes it possible for abuse of reviews
by people who may not even be a patient. Even one negative review
can have a profound negative impact on a physician’s reputation
and practice. MSSNY asks that the American Medical Association
seek legislation and /or regulation that would require websites that
host reviews of physicians to obtain the name of the person posting
the review, that this information will be kept on file, and the website
inform the poster that a physician requesting this information from
the website in regard to a review must be provided with the name of
the person writing the review.
Medical Licensing
Medical licensing has been under the control of the New York State
Department of Education since 1843. Assuming the roles of physician credentialing and discipline should once again be handled by the
Medical Society of the State of New York (MSSNY), as it had been from
the time of the inception of the county and state medical societies. This
would increase the unity and purpose of MSSNY and would positively
promote membership in our society. MSSNY, by any and all means
should endeavor to resume the function of physician licensing registration and discipline in New York State.
Protection For Licensed Physicians Not Participating
In Government Healthcare Plans
MSSNY should reaffirm Policies 2012-60, 2013-53 and 2013-54.
These policies will protect the rights of New York State physicians
who are not participating in government healthcare plans as well as
ban discriminatory increases in their license taxes, fees, supplements,
investments, increments etc. as well as protect licensed, non-practicing and privately practicing physicians from governmental regulations
aimed at infringing upon their full rights of medical licensure.
Restriction Of Certifying Boards
The NY State Department of Health and the Accreditation Council
for Graduate Medical Education (ACGME) have a vigorous licensing
process in place for physicians. Specialty Board Certification and MOC
(Maintenance of Certification) by a medical specialty board is voluntary.
MSSNY should take action against payors and hospitals attempting
to limit their physician panels based on specialty board certification.
MSSNY should urge the credentialing committees of payors and hospitals to use specialty board recommendations on practice limitations
as no more than a suggestion or reference, as opposed to guidelines
or policy. MSSNY should also take action to oppose any measure that
would require state licensure to be in any way based on specialty board
certification. MSSNY should also take action to oppose any attempt by a
specialty board or payor to restrict the practice and or reimbursements
of any physician based on specialty board certification.
MSSNY Single-Payer Healthcare Survey
The state of healthcare insurance is changing rapidly in New York
State as well as in the United States overall. In an effort to gage the support/opposition of its members, MSSNY should design and conduct an
objective poll of the collective opinion of the MSSNY members ascertaining both their knowledge of the single payer health care system and their
support/opposition of such a system in the State of New York.
e-Cigarettes To Be Treated The Same As Tobacco
Products
e-Cigarettes are marketed as a safe and healthy alternative to smoking. However, the FDA states that e-cigarettes may contain ingredients
that are known to be toxic and unsafe. There is also the concern that
young adults could become addicted to e-cigarettes, thus opening the
door to tobacco addiction. There is much still unknown about the longterm health risks of e-cigarettes.
MSSNY should urge that e-cigarettes be treated the same as tobacco
products, that the State Health Department, or other appropriate entities, conduct research into the possible risks associated with the use
of e-cigarettes on a long-term basis, that there be strict quality control/
oversight as to the actual ingredients, i.e., nicotine, by products, etc.,
which are being inhaled an that these ingredients be printed on each
e-cigarette package and that appropriate warning labels be included.
Amendment To OPMC Reporting Requirement Associated With Physician Profile Updates
The New York State Physician Profile website (www.nydoctorprofile.
com) was created after former Governor George Pataki signed the New
York Patient Health Information and Quality Improvement Act of 200 to
make it possible for all citizens of New York to obtain information about
physicians. Physicians are required to update their New York State
Physician Profile within 6 months prior to the expiration date of the physician’s registration period. Failure to do so could result in a referral to
the Office of Professional Medical Conduct (OPMC). MSSNY will seek
legislation/regulation to allow a 60-days grace period for physicians
to comply after receiving a warning letter. If a physician still does not
comply after the 60 days grace period, then and only then should it be
considered a reportable event. MSSNY, county and specialty societies
should immediately begin to notify their members about the importance
and urgency of updating their profiles in a timely manner. When a physician registers online to renew his/her license, there be a notification
with a direct link to www.nydoctorprofile.com which must be completed
prior to submission of the registration renewal. For those physicians who
register via paper, a copy of their updated profile must be included and
sent together with the registration renewal.
Raising The Legal Age To Purchase Cigarettes, Cigars
And Electronic Cigarettes To Age 21 In New York State
On November 19, New York City Mayor Michael Bloomberg singed
legislation banning the sale of tobacco products to anyone under the age
of 21 in New York City. Suffolk County Medical Society President and
Suffolk County Legislator William Spencer, MD has introduced a bill in
(Continued on page 5)
April 2014 • MSSNY’s News of New York • Page 3
MEDICAL SOCIETY OF THE STATE OF NEW YORK
NEWS OF NEW YORK
Medical Society
of the State of New York
Sam Unterricht, MD
President
Ted Tanner, MD
Chairman of the Board
Robert B. Goldberg, DO
Vice-Chairman of the Board
Philip A. Schuh, CPA
Executive Vice President
COMMUNICATIONS AND
PUBLICATIONS COMMISSION
Art Fougner, MD, Commissioner
Kira Geraci-Ciardullo, MD, Assistant Commissioner
Paul A. Hamlin, MD
Leah McCormack, MD
News of New York
Published by Medical Society of the State of New York
Vice President, Communications and Editor
Christina Cronin Southard, Editor
[email protected]
News of New York Staff
Julie Vecchione DeSimone, Assistant Editor
[email protected]
Janice Morano, Marketing Relations
[email protected]
Steven Sachs, Web Administrator
[email protected]
Susan Herbst, Page Designer
News of New York
Advertising Representatives
For general advertising information contact
Christina Cronin Southard
Phone 516-488-6100 ext 355
[email protected]
The News of New York is published monthly as the official publication of
the Medical Society of the State of New York. Information on the publication
is available from the Communications Division, Medical Society of the State
of New York, 865 Merrick Avenue, P.O. Box 9007, Westbury, NY 11590.
The acceptance of a product, service or company as an advertiser or as a
membership benefit of the Medical Society of the State of New York does not
imply endorsement and/or approval of this product, service or company by
the Medical Society of the State of New York. The Member Benefits Committee urges all our physician members to exercise good judgment when
purchasing any product or service.
Although MSSNY makes efforts to avoid clerical or printing mistakes,
errors may occur. In no event shall any liability of MSSNY for clerical or
printing mistakes exceed the charges paid by the advertiser for the advertisement, or for that portion of the advertisement in error if the primary or essential message of the advertisement has not been totally altered or substantially
rendered meaningless as a result of the error. Liability of MSSNY to the
advertiser for the failure to publish or omission of all or any portion of any
advertisement shall in no event exceed the charges paid by the advertiser for
the advertisement, or for that portion of the advertisement omitted if the primary or essential message of the advertisement has not been totally altered
or substantially rendered meaningless as a result of the omission. MSSNY
shall not be liable for any special, indirect or inconsequential damages, including lost profits, whether or not foreseeable, that may occur because of
an error in any advertisement, or any omission of a part or the whole of any
advertisement.
MEDICAL SOCIETY OF THE STATE OF NEW YORK
AT YOUR SERVICE
MSSNY’S WESTBURY OFFICE
Main Phone Number......................................516-488-6100
Toll Free Number...........................................800-523-4405
Main Fax Number..........................................516-488-1267
MSSNY Website......................................... www.mssny.org
Extensions for specific services
Alliance.. ........................................................................396
Communications............................................................ 351
Computer Information Systems..................................... 361
Member Benefits/Marketing.......................................... 424
Membership Information............................................... 336
Medical, Educational & Scientific Foundation.............. 350
Office of the Executive Vice President.......................... 397
Ombudsman Claims Assistance..................................... 318
Physician Records/Credentials....................................... 367
Socio-Medical Economics............................................. 332
albany office
Continuing Medical Education...........518-465-8085 ext.17
Public Health Committees.................518-465-8085 ext. 11
Governmental Affairs.....................................518-465-8085
Fax..................................................................518-465-0976
Other Numbers
Committee for Physicians’ Health.................800-338-1833
Dispute Resolution Agency............................516-437-8134
Kern, Augustine, Conroy & Schoppman.......516-294-5432
Page 4 • MSSNY’s News of New York • April 2014
PRESIDENT’S COLUMN
It Has Been A Very Good Year
This year as MSSNY President
has been one of the most challenging since I graduated from
medical school.
I was forced to learn new
things, expand my knowledge on
issues I thought I knew a lot about
and change my point of view on
several controversial topics, as I
Dr. Sam Unterricht developed a wider scope of information. As a dyed-in-the-wool
New Yorker, I thought I knew a lot about the state. Now
that I have actually visited every sector, I can echo the
spirit of that 1990’s ad campaign – I Love New York.
This year has been both the best and worst of times.
Being the head of such an august organization while the
field of medicine has been turned on its head due to the
confluence of historic health care legislation and a “perfect
storm” of socioeconomic forces, has been most exciting yet
perplexing. Because of the high regard in which MSSNY
is held, I have been afforded tremendous respect, but have
also seen the low tactics that our enemies employ. The
ACA , despite all the delays and controversies, continues to
ooze forward, like “The Blob,” a disgusting, ever-changing
monster from some C grade horror movie. One of the few
positives of the ACA is that MSSNY has received much
press exposure, but the horrors of the ACA continue to
unfold, guaranteeing interviews for years to come. The
media attention that has been given to the physician disenrollment and patient disenfranchisement, particularly in
the downstate area, finally shined a spotlight onto a serious
problem for physicians and patients alike. This scandal, for
once, clearly demonstrated that carriers not only bullied
us, but also our beloved patients. Finally, our plight was
exposed in every medium and in the courts – and many
physicians were reinstated. Oh, what a sweet victory!
Even as we recoil from the ACA, we are reminded of
the nine-headed “Hydra” that lurks ever-present, waiting
for us to slay, like Hercules:
1. Fair physician payment so that Medicare and
Exchange patients have access to quality and timely
health care by the most qualified physicians in
adequate networks
2. Adapting to ICD-10
3. Making sense of ACAs, IPOs, risk-sharing and new
practice models
4. Achieving meaningful medical liability reform
5. Protecting our patients from scope of practice threats
6. Controlling ever-mounting, unfunded mandates and
legal pitfalls
7. Fighting for Collective Negotiation
8. Protecting a transparent, useful out-of-network
option
9. Fighting the MOC and MOL machine that is sapping
our strength and resources
Where is Hercules When You Need Him?
In November, MSSNY conducted a survey with over
800 physicians responding. Over one-third of the respondents indicated that they were “seriously considering”
retiring from practice over the next two years; over 37%
indicated that they plan to reduce the services they deliver
over the next two years; and, over 16% indicated that they
were “strongly considering“ leaving the state in the next
two years.
You are Hercules! You are Iolaus, without whose help
Hercules could not have defeated the Hydra. You are the
key component in medicine. You command the respect of
your patients and legislators. You are becoming angrier
and more militant every day. Don’t retire; don’t slow
down; and definitely, do not leave New York. We have just
begun to fight, and, increasingly, win. We need you now
more than ever.
My best wishes to Dr. Andrew Kleinman as our new
president. He is a warrior and a leader of warriors. I wish
him the same exhilarating experience I enjoyed so thoroughly, but may Dr. Kleinman’s year and yours be a bit less
“interesting” than this last one.
myssny paC
Lobby Day and the Importance of Political Action
The Medical Society conducted its
Physician’s Capitol Forum on the evening
of March 10 and its Lobby Day briefing
and visits on March 11. Countless numbers of physicians, alliance members and
staff from across the state representing every major specialty
participated in each event. Hundreds more watched our Capitol
Forum webcast from their offices and home computers. Many
more are able to view the program by visiting MSSNY’s website at www.mssny.org. If you haven’t yet done so, you should
view the program. MSSNY and its members are well-known to
regulators and legislative leaders who participate in forums we
sponsor because of the thoughtful feedback they receive from
the organized medical community.
This year we were fortunate to have Donna Frescatore,
Executive Director of New York’s Health Benefit Exchange
and Troy Oechsner, Deputy Superintendent for Health to discuss issues related to the implementation of the Exchange and
the policies associated with the ACA. MSSNY, through its
President, President-Elect, Vice-President and governmental
affairs staff have been engaged in regular discussion with Ms.
Frescatore and her staff concerning issues related to the: federally required 90 day grace period; unreliability of physician
participation information on plan sites and resulting questions
regarding network adequacy; and the difficulties presented to
physician offices by newly insured patients who either haven’t
yet received their plan identification card or have a card with
incomplete information on it so that the physician office is
unsure of which plan the patient is enrolled with and the plan
coinsurance requirements. Because of MSSNY’s involvement,
it was recently announced that the Exchange is proposing to
change its policies to require that plans
update their physician participation
information monthly and offer access to
products which provide coverage for out
of network services, despite strong opposition by the health insurance industry.
Also at the Capitol Forum was a panel comprised of legislative leaders in the health and insurance arenas including
Senator Kemp Hannon, chair of the Senate Health Committee,
Richard Gottfried, chair of the Assembly Health Committee
and Assemblyman Kevin Cahill, chair of the Assembly
Insurance Committee. Each of these presenters provided a
thumbnail sketch of the direction they were taking on notable
issues including out of network transparency and coverage;
enabling corporate-owned retail clinics; regulation of urgent
care and OBS practices and other issues of importance to all
of organized medicine. The debate was lively and provocative, often eliciting opposing points of view from each of the
speakers. Again, you should really watch the recording when
you get the chance.
I am sure that you are thinking that this sounds very interesting but “How does a Capitol Forum relate to Political
Action”?
Political action is but one component to a three legged stool
which includes knowledgeable lobbyists, effective grassroots
and a political action campaign all of which help to assure that
physicians have a seat at the table as critically important health
care policy is being developed. Your help is desperately needed
to assure that we continue to have the ability to educate our
elected representatives on the importance of our many issues
with a view toward securing our objectives in the future.
The NEWS of NEW YORK ISSN 0028-9264, Periodical POSTAGE PAID at Westbury and other additional mailing offices. The NEWS of NEW YORK is published monthly by the
Communications Division, Medical Society of the State of New York, 865 Merrick Avenue, Westbury, NY 11590. Please address all correspondence to the Editor. POSTMASTER:
Please forward all change of address forms to the Editor, NEWS of NEW YORK, Medical Society of the State of New York, 865 Merrick Avenue, Westbury, NY 11590. Subscription,
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2014 Medical Society of the State of New York Annual House of Delegates Resolutions
(Continued from page 3)
Suffolk County seeking to raise the legal age to purchase cigarettes
from 19 to 21.
MSSNY should seek similar legislation/regulation for the State
of New York, and a similar resolution should be forwarded to the
American Medical Association (AMA) for consideration at its annual
2014 meeting for implementation on a national level.
American Board Of Medical Specialties Should
Adhere To Its Mission
The American Board of Obstetrics & Gynecology, issued a statement
that gynecologists should not be allowed to treat men and that if they
did, they could potentially lose their certification. The statement was
issued in order to protect patients from doctors who may have begun
to practice types of medicine for which they were neither appropriately
trained for nor certified in. MSSNY seeks to adopt as its policy that any
American Board of Medical Specialties (ABMS) Specialty Board should
not attempt to define or to constrain a physician’s professional activity
beyond that which the board may certify. MSSNY should submit a resolution to the annual meeting of the AMA urging that the ABMS notify all
of its member organizations that they should adhere to their mission as
a credentialing body, establishing educational and evaluation standards
for certification in a particular specialty and that scope of practice issues
are not within their purview.
Maintenance Of Licensure (MOL)
The rationale for Maintenance of Licensure (MOL) is that the medical profession is facing increasing demand from the public and health
policy makers for greater accountability and transparency. Although,
MOL is several years away from completion, MSSNY shall oppose
any MOL initiative that creates barriers to practice, is administratively
unfeasible, is inflexible with regard to how physicians practice, that
does not protect physician privacy, and is used to promote policy initiatives (rather than competence) such as participation in health plans,
subscription to data exchanges and specially board certifications.
MSSNY shall submit the above resolution to the American Medical
Association (AMA) at its annual meeting.
Collapse Of Workers’ Compensation And No Fault
Benefits Into Regular Insurance
Under the Affordable Care Act (ACA) most individuals are required to
be covered by health insurance. Workers Compensation Insurance and
Motor Vehicle No-Fault insurance should be collapsed and combined into
an individual’s health insurance to prevent a redundancy of coverage.
MSSNY should seek legislation and regulation to collapse or combine
Workers’ Compensation health benefits into an individual’s ordinary
coverage, without cost share to the injured worker; and to collapse or
combine Motor Vehicle No-Fault health benefits into an individuals ordinary coverage without cost share to the individual and that MSSNY bring
a resolution to the annual meeting of the American Medical Association
to seek federal legislation and regulation on the above resolution.
Physician Liability And Patient Protection Under The
False Claims Act
MSSNY should support legislation and regulation to limit physician
liability under the False Claims Act specifically to those instances where
the practitioner presented or caused another person to have presented
a claim for payment to the federal government; the claim must have
been proven to be false or fraudulent and the practitioner knew of the
claim and that the claim was false or fraudulent. MSSNY should also
support legislation and/or regulation that would compensate patients,
utilizing the proceeds of False Claims Act settlements, for the adverse
economic and/or health impact of any unnecessary, and/or inappropriate treatment that may have resulted in the settlement. MSSNY should
submit a resolution to the AMA to support legislation and regulation on
the above resolution.
Affordable Care
The ACA has ushered in an era of health plans with narrow networks
and high deductibles that may need to be met before benefit dollars
apply. MSSNY should advocate for regulation and legislation to provide
that insurers give reasonable credit for out of network expenses toward
a participants annual deductibles and out of pocket maximums and
that MSSNY submit a resolution to the annual meeting of the American
Medical Association on the above resolution.
Increasing Medical Student And Physician
Interactions
MSSNY has previously worked with medical schools to promote community physicians as mentors. The participation of medical students
in county medical societies would expose them to more specialties.
MSSNY encourages all county medical societies with medical students
training in that county to have a medical student representative on their
boards of directors and that they work with their medical student members to create outreach programs.
Availability Of Treatment Slots For Substance
Abusers
Since the Rockefeller Laws have been repealed, the influx of drug
crime courts mandates to overflow available substance abuse treatment
slots. Because of this, MSSNY should urge the NYS DOH to commission a
study analyzing the projected slots needed from drug crime sentencing
to ensure the system will be equipped to handle the increased volume.
If there is a shortage of treatment slots projected, MSSNY will lobby to
increase the number of slots available to meet the need.
Support Of The MSSNY/ Dr. Duane And Joyce Cady
Honor Fund
The MSSNY/ Dr. Duane and Joyce Cady Honor Fund has been established to benefit medical students in NY State and to educate future
physicians. Because of this, a voluntary donation of ten dollars will be
added to the MSSNY/Dr. Duane and Joyce Cady Honor Fund in 2015 and
future MSSNY dues bills.
Proposal And Plan For Developing And Maintaining
High Quality Healthcare For Our Older Patients In
The New Millennium
Because older Americans are now living longer, they are accumulating more diseases and disabilities. At the same time, the number of
geriatricians in the United States is anticipated to drop to one geriatrician for every 3,798 Americans over the age of 75 by 2030. Due to this
phenomenon, MSSNY will work with the American Medical Association,
the American College of Physicians, the American Academy of Family
Physicians, the American Geriatrics Society and the American Academy
of Hospice and Palliative Medicine to petition the American Board of
Medical Specialties, to definitely re-open the boards for physicians with
high quality training experience and additional education without fellowship to sit for the boards in geriatrics.
Maintaining And Developing High Quality Hospice And
Palliative Care Physician Workforce In The New
Millennium
The Palliative care and Hospice service has improved for patients
with issues such as pain and depression. It has also improved patient
and family satisfaction while reducing costs in Medicare and hospitals
and prolonging life. There is still a need for an estimated 4,487 hospice and 10,810 palliative care physicians to staff the current number
of Hospice and hospital-based palliative care programs at appropriate
levels. MSSNY has worked with the American Medical Association, along
with many other agencies to re-open the boards for physicians with high
quality training experience and additional education without fellow to sit
for the boards in hospice and palliative care.
Raising The Purchase Age Of All Tobacco Products In
New York State
Ninety percent of chronic smokers began their addiction to nicotine as
a teenager or younger and the e-cigarette can also initiate or perpetuate
that addiction. Since these companies are marketing their products to
youth, MSSNY should seek legislation to raise the purchase age in New
York State to 21 years for all tobacco products as well as e-cigarettes
and other unregulated nicotine delivery devices.
Driving While Intoxicated, Impaired Or Distracted By
All Substances
The NY Public Health Law 3306 has created a loophole that allows
drivers who are stopped under the influence of drugs or intoxicants not
listed under a select list of substances to be charged with a lesser crime
then legal punishments that are given out for driving while intoxicated or
impaired. Since persons impaired or intoxicated by any drug should not
drive a motor vehicle and such drivers pose a risk to the public health,
MSSNY should work to clarify the legal definition of driving while intoxicated or impaired and supports programs that educate the public on the
dangers of driving while intoxicated, impaired or distracted.
Exclusion Of Physicians From The New York State
Health Benefit Exchanges
Many sick and infirm patients are losing long-standing relationships with their physicians in situations where the physician is needed
for their case. The Patient Protection and Affordable Care Act of 2010
provides for state-based Health Benefit Exchanges designed to help
residents purchase affordable health insurance coverage, but has been
limited by certain New York health insurers whose provider networks
exclude a large number of physicians. This jeopardizes patients’ ongoing needed treatment and places these patients in dire straits. Because
of this situation MSSNY has petitioned the Governor’s Office to monitor
all termination or exclusion actions that New York insurers take in with
Health Benefit Exchange plans set up under the Patient Protection and
Affordable Health Care Act. MSSNY has also started a public relations
campaign to highlight these exclusionary activities.
Medicare Advantage Terminations Due To The
Affordable Healthcare Act (ACA)
Many private/managed care insurers who administer Medicare
Advantage plans for the federal government have terminated large
numbers of physicians who have been participating in their Medicare
Advantage plans under the Patient Protection and Affordable Health
Care Act of 2010. Due to ongoing deficits in the federal budget, insurers
are likely to continue to terminate more physicians, which may cause
elderly, frail and sick patients to lose long-standing relations with their
physicians. While patients have had the option of switching back to traditional fee-for-service Medicare, that option would require them to pay
for drug coverage and a secondary plan. These exclusionary actions and
resulting matters have led MSSNY to urge the Centers for Medicare and
Medicaid Services (CMS) to prevent the insurers with which CMS has
contracted for Medicare Advantage plans from terminating physicians
from those plans. MSSNY has also urged CMS to set up a system to
monitor determination of the adequacy of individual Medicare Advantage
Plan networks and for them to complete any significant narrowing of
their Medicare Advantage networks by at least six months before any
open enrollment period begins.
Easy Choice Health Plans Payment Issues
Easy Choice Health Plans is a Medicare Advantage insurer that also
is a purveyor of commercial HMO products that operate in New York
State. It was placed in a form of “receivership” under the New York
State Department of Financial Services (NYSDFS) for an interim period,
in which the task of administering unpaid claims and their subsequent
payments. Some physicians have been forced to write off substantial
sums even though those sums were legally and properly owed to them
under the terms of their contracts and interaction between the medical
societies and those federal and state agencies have been successful
in inducing the insurer to pay individual physician’s claims. No global
solution has been found for the insurer’s continuing failure to pay claims
on a timely basis. Because of this matter MSSNY petitioned for CMS
and NYSDFS to launce an investigation into Easy Choice. If the payment
situation with Easy Choice continues, MSSNY should ask CMS to cancel
Easy Choice Health Plan’s contract.
Patient Fact Sheet On Insurer Abuses
Third-party insurers have intruded in the physician-patient relationship and have adjusted their policies and procedures regarding
coverage and reimbursement for cost containment. These policy adjustments have had negative effects on patients, physicians and the delivery
of healthcare. Patients are sometimes not even aware of these negative
changes. MSSNY has developed a series of template-type, patient-centered “Fact Sheets” for members to give to their patients informing them
of these negative chances. MSSNY has also made patients aware of
when the insurer is responsible for a delay, denial or constraint of care.
Protection Of Private Practice
Some companies have taken steps to discourage or exclude private physicians from participating in networks for insurance plans. A
range of physicians in a community means a wider range of patient
choice for treatment options. Private physicians account for 330,000
jobs statewide and are known for outstanding patient care and choice
to thousands of New Yorkers. The MSSNY has supported legislation
that prohibits insurance plans from designing networks which exclude
access to private primary-care physicians and private specialists in a
patient’s community. The MSSNY has also supported legislation that
prohibits hospitals from directing their physicians to stop referring
patients to private practice physicians and from attempting to remove
private practice physicians from insurance company panels.
Access To Timely Care
An adequate health insurance provider network provides reasonable access to both primary care physicians and specialists, but if
the patient waits a long time to see the appropriate physician as
their condition grows worse, then that is not reasonable. MSSNY
supports legislation that requires insurance networks either to provide members with access to an in-network physician who can see
the member within 30 days of the member’s request or to provide
out-of-network benefits with fees based on the FAIRHEALTH data
base, when such timely access cannot be provided.
Dangers Of Youth Football
The National Academy of Sciences released a report noting concerns
about sports-related concussions for youth which found that high school
football players suffer concussions at a higher rate then college football
players. The Pop Warner Youth Football program has reported a decline
in participation and the effect of safety for children who play contact
football is still not fully researched. MSSNY has adopted a policy that
supports the American Academy of Neurology’s extensive research on
youth football including its Sports Concussion Tool Kit and encourages
parental awareness of football’s dangers and careful deliberation in their
permission for children to play the sport.
Thoroughly Informing Patients And Physicians About
Out-Of-Network Benefit Reduction And Cancellation
Insurers are declining to offer health plans that include outof-network benefits. Patients believe they continue to have the
out-of-network coverage that they always have had. Patients have
a right to freedom of choices and the freedom to be fully and effectively informed. The reduction and cancellation of out-of-network
benefits threatens the future existence and availability of a two-tier
medical delivery system that exists in most western industrialized
countries. MSSNY should take all appropriate steps to fully educate
patients about the emerging realities of out-of-network benefits.
Exemption Criteria For Electronic Health Record
Adoption And Cloud-Based Electronic Health Record
Packages
The Centers for Medicare and Medicaid Services have pushed for
the adoption of Electronic Health Records by physicians. Physicians are
now becoming more aware of this requirement and are urged to obtain
EHRs, but are deterred because of the cost and inconvenience of the
system. Some physicians are in good faith with the new procedure but
the American Medical Association has urged CMS to grant an exemption to physicians who are in solo practice and those who are 64 or
(Continued on page 6)
April 2014 • MSSNY’s News of New York • Page 5
2014 Medical Society of the State of New York Annual House of Delegates Resolution
(Continued from page 5)
older by the end of 2014 or who would reach age 62
by 2020. The CMS has declined to include such an
exemption in the Final Rule. MSSNY has asked that
the American Medical Association not give up the fight
for EHRs exemption and continue to petition for CMS.
The MSSNY has also urged the AMA to require that the
CMS grant a “temporary waiver” for physician practice that are in the process of attempting to implement
the new system but due to technical issues outside of
their control will be unable to meet the October 2014
attestation deadline.
Unintended Consequences Of An OPMC
Determination
A physician through settlement or hearing determination can be disciplined by the New York State
Office of Professional Medical Conduct (OPMC) for
professional misconduct and still be allowed to practice medicine in New York. The Office of Medicaid
Inspector General can independently suspend the
physician from the Medicaid program thus rendering
the doctor unemployable. This inconsistency is not
commonly known by the medical community such
that physicians can enter into OPMC settlements
without realizing that the Medical Inspector General
can still terminate them from the Medicaid program
and render them unemployable. MSSNY has worked
to pass legislation that bars the Office of Medicaid
Inspector General from removing a physician from
New York State’s Medicaid program in reliance solely
on a consent order between the physician and the
Board for Professional Medical Conduct.
Preserving Independent PracticePhysician Cooperatives
New healthcare models are too complex and require
too elaborate of an infrastructure for independent physicians to participate in them. New York is launching a
new Fully Integrated Duals Advantage Program pilot
project to provide comprehensive care on a captivated
basis for a subgroup of Medicare/Medicaid dualeligible patients. If this model is successful, it could
expand to over 150,000 dual-eligible New Yorkers.
Because the model is untested for health care, there
is a need for a pilot project to test the concept. MSSNY
is in position to play a proactive role in restructuring
healthcare. MSSNY should use its resources to help
create, on pilot project basis, physician provider cooperative with a centralized infrastructure and a wide
range of physician members.
Medical Cannabis for Seriously Ill Patients
A growing body of scientific literature supports
the use of cannabis in treating certain conditions and
symptoms such as nausea, spasticity, seizures and
pain relief. MSSNY should adopt as policy that the use
of medical marijuana may be appropriate when certified by a licensed physician to treat certain conditions
and symptoms. Physicians that prescribe cannabis
for certain conditions and symptoms shall not be held
criminally, civilly or professionally liable and that the
New York State Department of Health determine what
diseases and medical conditions can be treated with
cannabis. MSSNY should also support continued clinical trials on the use of marijuana for medical purposes.
Protecting Public Health from Elevated
Radon Exposure
Radon originates naturally in bedrock and shale
and is therefore extracted with natural gas during the
“fracking” process. Marcellus Shale gas is higher in
radium and therefore produces more radon. There is
no current technology available to remove or separate radon and its decay products from natural gas
or to inactivate it following emission. Radon and its
decay products (progeny) are known to be the number one cause of primary lung cancer in non-smokers,
and exposure to radon increases the likelihood that
smokers will develop lung cancer. MSSNY should
support policy that limits exposure to radon and its
decay products. MSSNY should also support legislation that protects the public health by ensuring that
New York State is committed to reducing sources of
excess radon emissions, and monitoring radon gas
exposure levels to confirm that these radon gas lev-
els do not exceed the recommended levels set by the
Environmental Protection Agency.
Hospital Closings
Due to economic difficulties, some community hospitals have become part of large hospital networks,
have closed or have had clinical services severely
curtailed. MSSNY should ask the New York State
Legislature to enact laws that require hospitals that
are going to close, or have the level of clinical services
significantly change, to develop a clinical impact statement and that the statement be presented at a public
hearing run by the Health Department. The clinical
statement should document the diminution in services
and outline ways that the community can be compensated or continue to receive these services in other
venues. The public should have a chance to comment
on this document with the Health Department as the
final arbitrator if the removal of the services creates a
danger to the community.
CMS “Two Midnight” Policy
Medicare’s new policy of reimbursing hospitals
for providing in-person services at out-patients
rates, if the person does not remain in the hospital
for more than two nights is having negative financial consequences for the patient when they need
to be placed in a rehabilitation or nursing facility.
MSSNY should ask the AMA to demand that the
Centers for Medicare and Medicaid educate the
public and produce documents that outline the
potential in negative financial consequences of the
“two midnight” policy.
Use Of Guidelines As Absolute Clinical
Judgment By The Provider
Third party payers are using clinical guidelines
based on evidence based medicine in a strict
manner and not allowing for individual clinical
guidelines. MSSNY should resolve that guidelines
are not to be used in an absolute fashion by insurers or providers when a clinical situation does not
fit the guideline precisely and that peer to peer
reviews allow for judicious alteration of guideline
driven care when appropriate.
Changes In Pre-certification For
Medications To Reduce Delays
To facilitate expedient delivery of medications
to patients and control cost and quality of care,
insurance companies have developed mail order
pharmacies to diminish cost and improve patient
access to medications. Insurers should educate
providers with cost comparisons for like products
and urge rewriting of prescriptions as long as quality and intent of treatment is not compromised-as
many patients on a given therapy remain so for
years. MSSNY should resolve that there be a minimum delay for patients to obtain medication and
that pre-certification for medications are kept at an
absolute minimum and that pre-certifications need
not be repeated on an annual basis.
Use Of Patient Satisfaction Surveys To
Determine Payment For Medical Services
Federal payers have decided that patient satisfaction surveys be used to adjust payments to
hospitals and physicians. Such surveys are not
statically valid and quality health care is different
from other consumer services by the nature of
health care. MSSNY should resolve that customer
satisfaction surveys, such as Press-Ganey are not
to be used to determine payment for medical services rendered and that said surveys can be used
to educate providers in an attempt to upgrade
services.
Physicians And Health Care Institutions
As Providers Of Health Insurance
Healthcare providers and their institutions should
be in the business of providing quality care; not
insurance. MSSNY should resolve that providers
and their institutions should not be providers of
health insurance nor promote any specific insurance product. If a healthcare institution does
provide insurance, they should be held to the highest standards and oversight to prevent conflicts
of interest that would impair quality of care. Any
institution in the business of health care insurance
should not have on its governance board employees of the institution providing such insurance.
Page 6 • MSSNY’s News of New York • April 2014
Physician Control Of Treatment
Administration
Physicians are trained in the judicious use of
pharmaceuticals. Certain pharmaceuticals are
approved by third party payers. Dosing of these
drugs require the judgment of trained medical professionals, especially when the dosing goes beyond
the original FDA trials. Due to the expense of testing
pharmaceuticals for dosing or alternate indications, MSSNY should resolve that once a treatment
or medication is approved by a third party payer,
it is within the purview of the trained health care
professional to administer that treatment as he/she
sees fit so long as quality of care measures are met
regardless of cost.
Cost Concerns Used To Downgrade
Physician Designation And Listing On
Insurance Panels
Physicians and other health care providers
cannot know the cost of services beyond their
practices, especially with regard to medication and
designated health services. Third party payers have
used cost as well as quality of care as determinants
to downgrade provider status or to dismiss them
from insurance panels. MSSNY should resolve that
cost concerns not be used to reflexively downgrade
a physician’s designation or listing on insurance
panels and that said cost analysis should be used
only as an education tool for providers and patients
and should not to be used in a punitive fashion.
Workers Compensation And No-Fault
Carriers To Use ICD-10
Currently, ICD-10 coding will be required as of
October 1, 2014 for Medicare, Medicaid and all
commercial payors. Workers Compensation and
No-Fault carriers are currently not required to convert to ICD-10 and may remain with ICD-9 due to
increased costs. There will be significant costs and
inefficiencies borne by medical practices to maintain the ability to code with two systems. MSSNY
should seek legislation at the state level to require
all insurance carriers operating in New York State to
utilize a consistent ICD system.
A Resolution On Gun Violence
Gun violence has become commonplace in the
United States. MSSNY should advocate for tighter
regulations on gun sales, increasing background
checks that would screen for mental illness, include
verifiable character references, and require permit holders to be educated and required to safely
and securely store their guns. MSSNY should also
encourage physicians to add “gun ownership/possession” to the social history in order to intervene
and counsel gun owners on proper safety, security,
and prevention of theft.
Point Of Care Dispensing
More and more states are passing laws that will
permit physicians to dispense prescription drug
medication at the point of care. Current law in
New York State prohibits physicians from dispensing prescription drug medication. MSSNY should
seek legislation that will permit physician point of
care dispensing or prescription medication to their
patients.
Bylaws Amendment To Permit MSSNY
Committee Members To Submit
Resolutions To Annual House Of Delegates
MSSNY should allow the MSSNY Bylaws to be
amended to permit the submission of resolutions
by committees who are duly appointed by the
MSSNY President. MSSNY should amend Article
III, Section 3, Paragraph 3 of the MSSNY Bylaws to
read: Resolutions may be submitted to the House
of Delegates only by members of the House of
Delegates as individuals or by component county
medical societies, district branches, specialty society
delegates, the organized medical staff delegate, the
resident and fellow section delegate, medical student section delegates and medical school delegates
and MSSNY committees.
Application Of Debt Collection
Improvement Act Of 1996
The Debt Collection Improvement Act of 1996
(DCIA) may require Federal Agencies to refer delinquent debts to the Department of Treasury and/or
the Treasury Offset Program even if the affected
ns
physician was not involved in the calculation resulting in such debt.
Medicare will begin collection proceedings for a refund of an overpayment amount; even if due to CMS error, for as low as $.01 with
penalties and interest amounting to as much as 6,740 times the
original debt. A ten dollar overpayment could become $67,400.00.
MSSNY should resolve that CMS’ use of the DCIA of 1996 be applicable from overpayments exceeding $10.00. MSSNY’s House of
Delegates should forward this resolution to the AMA HOD for its
consideration and redirection to the appropriate federal agency for
implementation on a national level.
Protecting Public Health From Natural Gas
Infrastructure
Due to the dangerous nature of high volume hydraulic fracturing
(HVCF) and the potential for numerous health disorders resulting
from HVCF and its accompanying infrastructure, MSSNY should
support a policy to delay activities concerning the expansion of
natural gas infrastructure components until valid information is
available to evaluate the process for its potential impact on human
health and the environment.
MSSNY Support Of The Single Payer Health Care
Legislation
America spends more per capita on health care than any other
country in the world. The current healthcare financing system is
burdensome, inefficient and promotes over-utilization of medical services. MSSNY should support the single-payer health
reform bill (New York State Health bill A. 5389 Gottfried/S. 2078
Perkins). MSSNY should introduce a resolution at the AMA House
of Delegates to support the Expanded and Improved Medicare for
All Bill (National Single Payer Health Care Legislation) in Congress
HR 676 (Conyers).
members in the news
MSSNY Member Leonard Gelman,
MD, New President of AMDA
During remarks at the conference, Dr.
Gelman urged his colleagues to make the
Leonard Gelman, MD, was named 2014most of their knowledge and expertise to pro15 President of The Society for Post-Acute
mote quality, compassionate post-acute and
and Long-Term Care Medicine (AMDA)
long-term care. “There is a lot of experience
during the organization’s recent annual conin long-term care but few experts,” said Dr.
ference in Nashville, TN.
Gelman. “We are the experts.” Dr. Gelman
A member of MSSNY since 1992,
encouraged them to work with AMDA to
Dr. Gelman is medical director of both
extend their expertise into areas such as
Maplewood Manor, a 237-bed nursing home
value-based purchasing, accountable care
in Ballston Spa, and Indian River Nursing
organizations, service bundling, health inforHome in Granville. Additionally, he mainmation technology (including but not limited
tains a private family practice in Saratoga
to electronic health records) and developing
County, where he has practiced for nearly
and implementing quality measures.
30 years.
Dr. Gelman received his Medical Degree
Dr. Leonard Gelman
“No one has done more to ensure that every
from the University of Brussels in Belgium
medical director has access to every tool they
and completed his residency at St. Clare’s
need and [the support of colleagues] to be effective leaders in Hospital in Schenectady, NY. He is board certified in family
their communities,” said 2013-14 AMDA President Jonathan medicine, geriatric medicine, and hospice care and palliative
Evans, MD, CMD, MPH, of Dr. Gelman.
medicine.
Mssny members in the news wanted!
Have you – or a colleague – recently won an award or been recognized by your hospital, community or other organization?
We want to hear about your accomplishments for possible inclusion in our Members In The News feature in News of New York.
Please contact Julie Vecchione DeSimone: [email protected] or 516.488.6100 x340.
Development Of A Transparent And Fair Payment
Process For ERISA Plans
Some union benefit plans often exploit their ERISA preemptions to
delay or avoid payment to providers and deny needed healthcare to
their beneficiaries for the sole purpose of cost savings. These plans
are not regulated by the states or CMS but by the Department of Labor
(Employment Benefits Security Administration) and have ERISA preemptions. MSSNY should introduce a resolution at the AMA House
of Delegates to seek legislation through Congress or through regulation by the Department of Labor which would require ERISA Plans to
develop and administer a transparent and fair process for the payment
of claims to providers, similar to States prompt payment laws and
CMS regulation.
Point Of Care Availability For Blood Glucose Testing
Due to a recent ruling by CMS, finger stick monitors to test blood
glucose for patients other than those who have had a prior diagnosis of diabetes is an off label use and will no longer be a covered
CLIA exempt test. MSSNY should call on the AMA to work with CMS to
seek the maintenance of the CLIA exempt status of point of care glucose testing.
Maintaining Tax Exempt Status For Youth Service
Organizations
In an effort to combat childhood obesity and to provide New York
State youths with outdoor activities, non-profit organizations maintain wilderness camps throughout New York State. These camps
provide much needed outdoor experiences to our youth. There have
been proposals in Albany to remove land tax exemptions from youth
service organizations. MSSNY should oppose any attempt to remove
the tax exempt status of these non-profit youth service organizations
that are so important to the health of our youth and the health of our
environment.
Medical Board Recertification
Medical Board recertification is becoming more and more of a
burden for physicians. MSSNY should support recertification limited only to new knowledge acquired in the preceding periods of
ten to fifteen years. Recertification should be constructed to limit
maximally the financial and bureaucratic burden on physicians.
MSSNY should present this resolution to the next meeting of the
House of Delegates of the American Medical Association.
Requirement For Pharmacist To Label Expiration
Date On Dispensed Medication
It is the practice of many pharmacists to tell patients to discard
medications one year from the date dispensed, although the shelf
life of the stock bottle may be longer. MSSNY should seek legislation that all prescription medications dispensed in the State of New
York be labeled with the expiration date on the stock bottle from
which it is dispensed. MSSNY should bring a similar resolution to
the AMA.
Gun Violence
In an effort to compensate victims of gun violence, MSSNY should
work with the legislature to establish mandatory liability insurance for
owners of all types of guns, just as there is mandatory insurance for
automobile owners, with minimum coverage of $1 million/$3 million
to compensate the victims.
April 2014 • MSSNY’s News of New York • Page 7
2014 Physicians Advocacy Days in Albany
Legislative Panel engages with physicians at MSSNY’s Capitol Forum
MSSNY’s President Elect Andrew Kleinman,
MD, speaks to Lobby Day participants about
out of network insurance issues.
Donna Frescatore, Executive Director of the
New York Health Benefit Exchange, addresses
physicians at MSSNY’s Capitol Forum.
Participants listen to health policy officials at MSSNY’s Capitol Forum
at the Albany Hilton on March 10
NYS’s Deputy Superintendent for Health Troy Oechsner addresses physicians at
MSSNY’s Capitol Forum. Also pictured are MSSNY’s Speaker Jerome Cohen, MD,
and Vice Speaker Kira Geraci-Cohen, MD.
Westchester County Medical Society
members meet with Dean Skelos,
Senate Majority Leader. (left to right):
Gino Bottino, MD, WCMS Board; Kira
Geraci-Ciardullo, MD, MSSNY Vice
Speaker; Senator Dean Skelos; Thomas
Lester, MD, WCMS Vice President;
Robert Lerner, MD, WCMS President;
and Brian Foy, WCMS Executive
Director.
(Left to right) Barbara Ellman, MSSNY’s Associate Director for
Policy; Senator Joseph Griffo, sponsor of the Healthcare Professional
Transparency Act; Dr. Robert Walther, President of the NYS Society
of Dermatology and Dermatologic Surgery ; Lisle Soukup, American
Society for Dermatologic Surgery Association; Mary Ruth Buchness,
MD, Immediate Past President of the NYS Society of Dermatology and
Dermatologic Surgery.
High School seniors who are interested in careers in the
medical profession listen to presentation at MSSNY’s
Lobby Day on March 11.
AMA National Advocacy Conference
MSSNY’s Moe Auster, Vice President, Legislative & Regulatory Affairs,
details key managed care and medical liability reform issues.
Page 8 • MSSNY’s News of New York • April 2014
MSSNY was well represented at National
Advocacy Conference March 4-6 in Washington
DC. (standing, left to right) Moe Auster, MSSNY
VP, Legislative and Regulatory Affairs;
Jim Coulthart, Onondaga County EVP;
Dr. David Halleran, President of the Onondaga
County Medical Society; Phil Schuh, MSSNY
EVP; Dr. John Kennedy, Vice Chair AMA
Delegation; Dr. Jerry Cohen, AMA Council on
Constitution and Bylaws;
(seated, left to right) Senator Charles Schumer;
Dr. Robert Goldberg, Chair AMA Delegation.
Council Notes: March 10th, 2014
• Dr. Frank Dowling presented a memorandum to Council
regarding legislation on non-patient specific scripts for administration of Narcan for use in opiod overdoses. In explaining the
issue, Dr. Dowling noted the considerable increase in heroin use
and overdose deaths in the last several years. He explained that
both the Senate and the Assembly bills would expand the emergency use of Narcan and would allow a prescriber to prescribe,
dispense, or distribute an opioid antagonist directly to a person
at risk of experiencing an opiod-related overdose. The legislation
also allows the prescriber to issue a non-patient specific script to
a family member, or friend of an individual who may be at risk
of an overdose. The bills provide protection from criminal, civil
and professional disciplinary action that could result in prescribing, dispensing or administering an opioid antagonist. Currently,
MSSNY does not have policy on this issue. Council discussed
the issue and passed a resolution to support the emergency use
of Narcan.
• Hope Plavin, Director of Policy and Planning, Office of
Quality and Patient Safety, New York State Department of
Health, delivered an informational presentation on SHIP, the
State Health Innovation Plan. SHIP is a program that promotes
primary care delivery reform, coupled with payment reform, to
improve health, improve care and reduce costs. The program
encourages hospitals, nursing homes, clinics and other key
stakeholders to form local partnerships to transform the delivery
system. These partnerships will seek to transfer the healthcare
delivery system, according to Plavin, by working together to
improve quality and health outcomes while lowering costs. To
date, 800,333 have completed applications and 501,205 have
enrolled. For more information on the SHIP program, visit www.
health.ny.gov/technology/innovation_plan_initiative/
• Ed Amsler, Medical Liability Mutual Insurance Company
(MLMIC), announced another policyholder dividend for 2014.
The dividend is 5% this year, and will be applied on July 1 to all
physicians who are policyholders on May 1 and maintain continuous coverage through July 1.
• Dr. Frank Dowling submitted the Science & Public Health
committee’s report. The Addiction & Psychiatric Medicine
Committee approved a statement from MSSNY Executive
Committee following the Governor’s State of the State address
on the subject of Medical Marijuana:
“MSSNY appreciates and shares the Governor’s concern
regarding the need for further research to determine the potential
effectiveness of marijuana in treating certain medical conditions.
While there is some research to support the use of marijuana for
medical reasons, good controlled research regarding the poten-
tial medical indications and benefits and risks of marijuana and
its key metabolites is needed. Research on medical marijuana
use should use a tightly controlled process through a hospital patient qualification review committee or human research
review committee using sound research principles to develop
and approve study protocols, to select appropriate candidates
and to accrue and review scientific data to see if there is any
truly beneficial effect of medical marijuana on patient care. If
well designed protocols are conducted, then patients may benefit
from the development of good quality research initiatives in this
area. MSSNY will proactively engage with the Governor and his
staff to provide its clinical knowledge and expertise in the area
of psychiatric and addiction disorders and scientific research to
advise on the essential components that will assist in ensuring
the development of good controlled research protocols and equitable patient access to scientifically diverse research designs.”
• The Medical, Educational, and Scientific Foundation of New
York, Inc. reported that the foundation has submitted an application to the Physicians Foundation for a $75,000 grant to extend
the Leadership training program to locations across New York
State. This program would be an abbreviated version of the
Syracuse program and would be offered through county and specialty societies.
Legislature Developing
One-House Budgets
(Continued from page 1)
5. Oppose Proposal Which Would
Allow NPs to Practice
Independently From Physicians
The proposed budget would allow nurse practitioners to practice for six months in collaboration with
an NP who has been in practice for more than three
thousand six hundred hours if (a) the collaborating
physician retires, moves, dies or becomes unqualified to practice and (b) the NP has demonstrated to
the Department of Health that she has made a good
faith effort to find another collaborating physician
but cannot. In addition, the proposal would allow
NPs with more than 3600 hours of practice to collaborate with either a physician or a hospital. We can
fathom no instance where the quality of patient care
can reasonably require the elimination of the written
practice agreement and protocols. Such an expansion
of scope of practice for NPs will inevitably increase
health care costs – not decrease them. Nor will such
proposals address our physician workforce shortage.
Non-physician practitioners wish to practice in the
very same regions of the state in which physicians now
practice. Studies show clearly that they do not choose
to practice in rural or urban underserved communities.
Urge your legislators to reject the proposal to allow
NPs to practice independently from a physician.
6. Support the Elimination of the
Requirement for Written Consent
When Offering an HIV Test
The proposed budget includes a provision to remove
the requirement for a separate, written consent when
offering an HIV test. MSSNY has long advocated
that an HIV test be part of routine medical care and
believes that the separate written informed consent
has been the most often cited barrier to patients getting tested for HIV. Urge your legislators to support
the elimination of the written consent requirement for
an HIV test.
7. Oppose One-Sided No-Fault Reform
The proposed budget would confer upon the
Superintendent of Financial Services an unfettered
right to investigate a health care provider’s office when
the “Superintendent deems it expedient for the protection of the interests of this State.” This may create an
unlimited right of DFS to investigate a doctor’s office
for reasons that may go far beyond reasonable suspicion of fraud. This proposal will undoubtedly have
a huge chilling effect on physicians treating injured
auto accident victims. Urge your legislators to reject
this proposal.
April 2014 • MSSNY’s News of New York • Page 9
Page 10 • MSSNY’s News of New York • April 2014
(Continued from page 1)
Government Affairs
SCHIMMINGER INTRODUCES BILL TO LIMIT
REQUIREMENTS OF BOARD CERTIFICATION
Assemblyman Robin Schimminger (D-Kenmore) has
introduced legislation (A.8979) that would prohibit a hospital
from requiring board certification as a condition of having
staff privileges, and prohibit a health insurance company
from requiring board certification as a condition of being a
participating physician in such plan. The cost of obtaining and
updating board certification status is increasingly becoming
prohibitively expensive for many physicians at a time when
they are already being squeezed between rapidly increasing
office overhead costs and cuts in insurer payment. This legislation would help to assure that board certification remains
aspirational for physicians, but not mandatory, by assuring
that hospitals and health insurance companies cannot impose
such requirements as a condition of participation, and reduce
one barrier to delivering medical care in New York State
WORKING WITH PHYSICIANS WHO OPERATE
URGENT-CARE PRACTICES TO OPPOSE
PROPOSED REGULATION OF THEIR PRACTICES
The proposed State Budget includes provisions which may
adversely impact the ability of physicians to remain in practice
as “urgent care” practices. Physicians should send a letter to
their elected representatives in opposition to this proposal from
MSSNY’s Grassroots Action Center by visiting mssny.org.
Specifically, the budget would define “urgent care” to mean
“the provision of treatment on an unscheduled basis to patients
for acute episodic illness or minor traumas that are not life
threatening or potentially disabling for monitoring or treatment
over prolonged periods.” The proposal prohibits anyone from
operating as an urgent-care practice unless they are accredited
pursuant to regulations to be promulgated. The Public Health
and Health Planning Council (PHHPC) would be specifically
authorized to adopt and amend rules and regulations, subject
to the approval of the commissioner which would establish
standards for referral and continuity of care, staffing, equipment and maintenance, and transmission of patient records.
Advocacy against this proposal includes three main points:
(1) an urgent-care practice is a medical site that is essentially indistinguishable from any other office-based medical
practice, staffed by appropriately licensed and credentialed
physicians; (2) physicians operating urgent-care practices do
so in a safe and effective manner and there have been no demonstrated examples of public-safety risk that justify a need for
new mechanisms of oversight; and (3) physicians operating
urgent-care practices provide their communities with highquality, timely, cost-efficient, and effective care, which is
highly valued by patients seeking access to acute unscheduled
care, in lieu of that which would only be available otherwise
from the hospital emergency room.
ASSEMBLY PASSES BILL TO ENHANCE DUE PROCESS PROTECTIONS FOR PHYSICIANS
Legislation (A.6498, Lavine) recently passed the Assembly
that would provide physicians with necessary due process
protections where health insurers seek to terminate a physician (or other health care practitioners) from its network by
failing to renew the physician’s contract. Current law prohibits a health insurance company from terminating a physician’s
contract without a written explanation of the reasons for the
proposed contract termination and an opportunity for a hearing on the proposed action by a panel comprised by three
persons including a clinical peer in the same or similar specialty. These provisions, however, do not apply to situations
involving the non-renewal of physician contracts.
There have been some instances when it could be reasonably inferred that an insurer sought to remove a physician
from its network for reasons that may be related to these
physicians challenging the insurer’s payment practices or the
physician’s referral of patients to certain needed specialists,
but avoided triggering these important due process protections by simply non-renewing the physician’s contract. This
bill would address this discrepancy.
Identical legislation (S.5762, Hannon) has been introduced
in the Senate and referred to the Senate Health Committee.
ELIMINATION OF CITIZENSHIP REQUIREMENT
BILL PASSES ASSEMBLY
Legislation (A.1160 (Cahill)/ S.981 (Libous), has passed
the Assembly that would remove the citizenship or permanent residency requirement for all professions that still have
it. It was forwarded to the Senate, where it is in the Senate
Higher Education Committee. Of the 50 licensed professions, only 13 currently require citizenship or permanent
residency for licensure, including medicine. MSSNY supports this bill.
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PHYSICIAN EMPLOYMENT
OPPORTUNITIES
Faculty Internist – General Medicine Unit
Unity Health System in Rochester, NY is seeking BC internists to join the core faculty teaching
unit of its outstanding 41 resident Internal Medicine Program. Leadership opportunities possible.
General Medicine Unit (GMU) Faculty physician positions include a mixture of clinical, academic/
educational, administrative, and hospital citizenship responsibilities including:
• Participating in unique ambulatory teaching environment which includes a “4+1” block curriculum. (Educational opportunities include a dedicated ambulatory curriculum with didactic
and clinical teaching sessions, ambulatory morning report, 1:1 faculty to resident teaching and
mentoring.)
• Participating in annual resident recruitment process
• Participating in Morning Report; Attending Rounds; Grand Rounds presentations; and other
teaching activities
• Precepting residents for 6 sessions per week in our ambulatory clinic
• Effectively serving as attending physician for inpatient care of admitted clinic patients
• Participating equitably in after-hours call rotation in support of Unity Faculty Partners (call is 1:6)
• Seeking opportunities to involve residents and other faculty in scholarly work
• Actively participating in staff meetings, and on assigned hospital committees
• Faculty appointment at University of Rochester School of Medicine and Dentistry
Unity Hospital is a suburban, 208-bed community hospital with excellent facilities, quality care,
and a collegial atmosphere. Excellent compensation package including 6 weeks time off, 5 days
CME, and malpractice with “tail” coverage. Unity is a major teaching affiliate of the University of
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Send CV to: Becky Jones, Physician Recruiter, Unity Health System,
1555 Long Pond Rd., Rochester, NY 14626; fax: 585-723-7180
e-mail: [email protected]
OFFICE SPACE RENT/LEASE/SHARE
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Elegant ground floor corner Park Ave office (mid 70’s). Large consult room with windows on Park Ave, treatment room, dedicated secretarial space.
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OFFICE/MEDICAL SPACE FOR LEASE – PRIME LOCATION IN NASSAU COUNTY
OBITUARIES
BRODSKY, Linda; Buffalo NY. Died February 13, 2014, age
61. Erie County Medical Society.
CHAUDHURI, Bijon Kumar; Atlantic Beach FL. Died
February 10, 2014, age 89. Steuben County Medical Society.
COST, Stephen S.; Syracuse NY. Died February 20, 2014, age
90. Onondaga County Medical Society.
COTRONEO, Vincent S.; Buffalo NY. Died February 07,
2014, age 97. Erie County Medical Society.
GORVOY, John D.; New Hyde Park NY. Died February 12,
2014, age 95. Medical Society County of Queens.
KEEGAN, Albert F.; Bryn Mawr PA. Died February 23, 2014,
age 87. New York County Medical Society.
KORNBLAU, Gertrude K.; Roslyn NY. Died February 12,
2014, age 99. Medical Society County of Queens.
KOZINN, Harold A.; Rockville Centre NY. Died November
23, 2013, age 85. Nassau County Medical Society.
MAHLAB, Edward D.; Forest Hills NY. Died February 12,
2014, age 102. Medical Society County of Queens.
MCCONNELL, Michael Martin; Buffalo NY. Died February
07, 2014, age 70. Erie County Medical Society.
MOSBY, George Saml; Hornell NY. Died February 10, 2014,
age 62. Steuben County Medical Society.
SHAHEEN, David John; Titusville FL. Died January 20,
2014, age 93. Medical Society County of Oneida.
SLIMBAUGH, William Paul; Johnson City NY. Died February
11, 2014, age 75. Broome County Medical Society.
SPATOLIATORE, Vincenzo; Brooklyn NY. Died February 28,
2014, age 84. Medical Society County of Kings.
SVERDLIK, Samuel Simon; Fort Myers FL. Died February
02, 2014, age 97. Nassau County Medical Society.
WEIL, Inga Frenkel; Whitestone NY. Died February 12, 2014,
age 99. Medical Society County of Queens.
WEISS, Leonard S.; Wellington FL. Died February 21, 2014,
age 79. Nassau County Medical Society.
1 ARLINGTON AVENUE MALVERNE, NEW YORK
+/-4,100 SF
Property Features: Total Building Size 8,188 SF
New fire alarm system • Multiple entrance/exits • Elevator
Excellent parking: Rear lot plus municipal parking
0.2 miles from Long Island Railroad- Malverne • Close proximity to Southern State Parkway
Nearby major hospitals including: Mercy Medical Center, Franklin Hospital,
NSH/LIJ, South Nassau Communities Hospital
Sublease opportunities available for 1st floor offices
Contact Hillary at: [email protected]
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April 2014 • MSSNY’s News of New York • Page 11