January 2018 Archives

All the Best in 2018
From the Front
Nominations Open in February
Legal Briefs
Dateline:  NYCMS
On the Legislative Agenda: Two Big Events
To the Editor:
You MUST Re–Register for Workers’ Comp  NOW
Workers’ Comp Q&A
McNally’s Corner
No More Handwritten Claims After April 30, 2018
NYSDFS Initiates Lawsuit to Address Unpaid Health Republic Claims 
The Physician Advocacy Program Follow–Up
You Are Invited to the Wilfred C. Hulse Award Lecture
Make Sure to Make Available Patient Records on a Timely Basis
Dues Deductions for 2017 Taxes
New Year and  New Members
Powerful Ways to Promote Workplace Optimism
Are You Reaching Your Potential Patients?  Take This Quiz and Find Out
See What DocBookMD Can Do for You
Idilus Takes Care of HR Headaches and Benefits
Look Into Storage Quarters 
Don't Throw Your Money Away with the Waste
In Memoriam


All the Best in 2018  

The officers, Board of Directors,  and staff of the New York County Medical Society wish you well in the new year.  May you, your families, and your staffs enjoy a happy 2018 and all the best of the season. Thanks to your participation, your Society represents you and your interests in so many spheres of health care in Manhattan today. Call (212) 684–4670 to get more involved or to get assistance for your practice.


From the Front

This feature of MM “NEWS” introduces you to Society leaders as they explain their vision of organized medicine’s activities. This month, read Society President Scot B. Glasberg’s message.
 
Happy new year to our devoted and loyal members of the New York County Medical Society.  It is an honor and privilege to serve this year as your president.  We have an experienced and dedicated leadership which meets on a continual basis to attempt to move the Society in a positive direction into the future.  2017 was a highly successful year for the Society.  We moved our offices to a new location and we remain financially sound.  2018 prepares to present us with many challenges which will face the physicians of New York State as well as the entire House of Medicine. 

These challenges are especially true on the advocacy front.  As we go to press, we wait to see whether Governor Andrew Cuomo will sign the highly regressive Date of Discovery bill which was passed last year by the legislature.  An all–out effort has been put forth to persuade him to veto the bill and convince the legislature that what is truly needed is more comprehensive medical liability reform. 

In addition, we anxiously await the upcoming Governor’s Budget to see how its provisions  will affect the medical community.  Given the expected significant budget deficit this coming year, we know that there will be substantial challenges for physicians ahead.  

We are also following closely the liability climate within New York  State. Your county society has been at the forefront in terms of trying to assess the implications of the potential purchase of MLMIC by Berkshire Hathaway and have attempted to obtain and furnish our members with as much information as possible.  In addition, we are monitoring closely the insertion of a new but long–experienced company, The Doctors Company, as they launch into the New York marketplace.  

On the membership value front, we continue to enhance our endorsed products portfolio as we work  to provide our members with greater and greater value for their dues.  Most recently, we signed an endorsement agreement with a billing company, PS2, which should offer our members expanded possibilities in this arena, as well as offering a significant discount on fees.  Please check our website for a complete list of all of our sponsored partners and look for email introductions of new benefits.

Finally, on a personal note, I wish to reinforce the point that the New York  County Medical Society remains committed to doing everything possible to make your practice environment the most pleasant and effective possible, especially in light of many  bureaucratic and regulatory challenges. I am personally available always to discuss any and all of your concerns or issues moving forward,  and you can reach me at scotbg@gmail.com 


Nominations Open in February

Any active member who wishes to make a nomination for elective office in the New York County Medical Society may do so beginning February 1st, but no later than March 1st. Nominations for officers and delegates to be elected at the next annual election may be made in writing by no fewer than 10 active members in good standing.  (Members must have paid 2018 dues.  Names must be printed next to signatures.)

These positions are open for 2018 – 2019: President–Elect, Vice President, Secretary, Assistant Secretary, Treasurer, Assistant Treasurer, three members of the Board of Medical Ethics, and one Trustee. In addition, there will be nine at–large seats on the Board.

Elections will also be held to fill spots for delegates and alternate delegates to the Medical Society of the State of New York.

Direct nominations to Jessica J. Krant,  MD, MPH, Secretary,  New  York  County  Medical Society,261 West 35 Street, Ste. 504, New York, NY 10001.


Legal Briefs

Are You Authorized to Provide Office–Based Surgery in an Accredited Facility?
 
The following article is by  Scott Einiger, Esq., Society Council.
 
Background
 
Private practices that perform office–based surgery (OBS) as defined by PHL § 230–d must be  accredited by one of the DOH designated accrediting agencies.  (Joint Commission, AAAASF or AAAHC).
 
Multiple aspects of practices seeking to provide office–based surgery are evaluated and surveyed as part of the accreditation process including, but not limited to: the legal structure of the practice; the education, training and licensure of physicians, podiatrists and other health care practitioners providing care to patients; policies, procedures and protocols used to guide selection and care of patients and operations of the practice; physical plant and equipment used in the care of patients, etc.
 
All office locations of the OBS practice must be accredited and any/all new locations where OBS will be performed must be accredited before any OBS procedures are performed.  Once a practice is accredited the question arises: what practitioners are permitted to utilize its space? For example may a practitioner who rents space at an accredited facility utilize its space to perform OBS procedures.
 
Definition of Covered OBS Procedures
 
As set forth on the Department of Health Q and A section of its website: 
 
Examples of procedures that fall under the OBS law include but are not limited to: upper endoscopy, colonoscopy, rhinoplasty, mammoplasty, lithotripsy or vascular access related procedures when accompanied by moderate or deep sedation, major upper or lower extremity nerve blocks, neuraxial or general anesthesia. Most procedures like botulinum toxin injections and minor integumentary procedures are performed with minimal or no sedation therefore can be performed in offices not requiring OBS accreditation. Generally, magnetic resonance imaging (MRI) procedures are not subject to this law. However, MRIs and other imaging studies that involve administration of intravenous contrast must be performed in an accredited OBS office if the patient involved receives moderate or deep sedation, major upper or lower extremity nerve blocks, neuraxial or general anesthesia. 
 
PHL § 230–d indicates that OBS does not include minor procedures and procedures accompanied by minimal sedation. The statute defines minor procedures as: (I) procedures that can be performed with a minimum of discomfort where the likelihood of complications requiring hospitalization is minimal, and (ii) procedures performed with local or topical anesthesia; or (iii) liposuction with removal of less than 500 ml of fat under unsupplemented local anesthesia.
 
Presently PHL § 230–d only applies to physicians, physician assistants and specialist assistants. As of February 17, 2014, the OBS law also applies to podiatrists privileged by the State Education Department to perform ankle surgery. This law does not apply to procedures performed by dentists, or podiatrists not performing ankle surgery or other health care professionals. 
 
Who May Practice in an OBS Setting
 
Only those practitioners who are “part of the practice”, as defined below, may perform procedures or provide anesthesia services in an accredited OBS office. Renting space in and of itself does not permit a licensed practitioner to otherwise perform OBS in an accredited facility.
 
Physicians or non–physician licensed health care practitioners may not perform OBS unless they are part of the practice or affiliated with the practice as employees of the OBS practice or working under a contractual arrangement with the OBS practice to perform procedural and/or sedation/anesthesia services, as applicable. 
 
The contractual agreement must at a minimum spell out the terms of the affiliation between the accredited OBS practice and the affiliated physician or non–physician health care provider(s) and at a minimum require the following: 
 
  1. Credentialing and privileging of all licensed independent practitioners (physicians, podiatrists, nurse practitioners, certified registered nurse anesthetists);

  2. Adherence to the accreditation related policies, procedures and protocols of the accredited practice including but not limited to patient rights, provision of care, infection control and record keeping;

  3. Participation in the quality management and performance improvement activities of the OBS practice, and;

  4. Reporting of adverse events identified in PHL § 230–d (See Q&A 23 above).
 
Physicians/licensed practitioners who are not part of or affiliated with an accredited OBS practice as set forth above may not perform procedures or provide anesthesia services in an accredited setting on their own behalf simply because they have entered into arrangements such as real estate leases that allow them to use space in an accredited OBS setting.  The accrediting agency of the OBS practice must be made aware of all OBS practice affiliations and credentialed/ privileged practitioners.  
 
Failure to properly structure your Accredited facility contractual arrangements with other practitioners in accordance with the law may result in licensure investigations or civil actions that could result in catastrophic liability for both parties. 
 
(1) Public Health Law (PHL) §§ 230–d defines Office–based Surgery as "any surgical or other invasive procedure*, requiring general anesthesia, moderate sedation, or deep sedation, and any liposuction procedure, where such surgical or other invasive procedure or liposuction is performed by a licensee** in a location other than a hospital, as such term is defined in article twenty-eight*** of this chapter, excluding minor procedures**** and procedures requiring minimal sedation
 
(2) Invasive procedures are: procedures performed for diagnostic or treatment purposes which involve puncture, penetration or incision of the skin, insertion of an instrument through the skin or a natural orifice, or insertion of foreign material other than medication into the body.
 
  • Invasive procedures include, but are not limited to, the injection of contrast materials such as used for an MRI or CT scans when these imaging procedures are accompanied by moderate or deep sedation, major upper or lower extremity nerve blocks, neuraxial or general anesthesia.

Dateline:  NYCMS

As a member, you are entitled to attend Society meetings and functions. Keep track of what
is going on by checking this listing in every issue of MM “NEWS.” Members are invited to
attend any of these sessions; however, we suggest that you call (212) 684–4670 to confirm
meeting date and time.
 
Thursday, January 11, 2018, 8:00 a.m. to 10:00 a.m., at Corwin Hall, MEETH , 210 East 64 Street, 2018 Medicare Update: The NGS Perspective, with James D. Bavoso, Manager, Provider Outreach & Education, Jurisdiction K (JK) Medicare Administrative Contractor — National Government Services;
 
Thursday, January 18, 2018, 5:30 p.m. to 8:00 p.m. att the new NYCMS offices, 261 West 35th Street, Suite 504, for a meeting of the Society’s Public Health Committee and a discussion on NYS Medical Marijuana Program:  Features, Limitations, and What Role the Program May Have in Combating the Opioid Crisis.”   Light refreshments.  Please pre—register for limited seating;  
 
 Sunday, January 28, 2018, 9:30 a.m. to 12:00 noon, at New York Academy of Medicine, 1216 Fifth Avenue,  Annual Legislative Breakfast;
 
 Wednesday, March 7, 2018,  Albany Physician Advocacy Day.  Take the Society’s bus to Albany, with discussion en route, talks by key legislators, and visits to Manhattan legislators.  You get background information, a chance to talk about your experience and your patients, and go with a leader.  
 

On the Legislative Agenda: Two Big Events

Join us on Sunday, January 28, 2018, 9:30 a.m. to 12:00 noon, at New York Academy of Medicine, 1216 Fifth Avenue, for the Society’s Annual Legislative Breakfast.   Key legislators will be there — Richard Gottfried, Deborah Glick, Liz Krueger,  and more.  The Society is  co–hosting with New York County Psychiatric Society and the New York Council on Child and Adolescent.

Then, mark your calendars, Wednesday, March 7, 2018, for our Physician Advocacy Day in Albany.  Take the Society’s bus to Albany, with discussion en route, talks by key legislators, and visits to Manhattan legislators.  You get background information, a chance to talk about your experience and your patients, and go with a leader.  

Don’t just wonder about the political environment.  See what’s happening at the source.

Look for more details soon, or call Susan Tucker at (212) 684–4681 or email stucker@nycms.org.  


To the Editor:
 
On August 28, 2017, I received a letter from Emblem Health that informed me of their intent to refuse to renew my agreement as of January 1, 2018.  It was explained that this was not about my quality of care but was in accordance with the agreement, signed in 1997, allowing for unilateral non–renewal with 90 days notice.

I did take advantage of a telephone hearing to request renewal of the Medicare HMO part of the agreement. This included my 10–minute conversation with a panel of three physicians who informed me it was purely a business decision affecting many more physicians than me and was unrelated to quality–of–care issues.  They noted that the fact I was an excellent, devoted physician had nothing to do with the case.  However, at that point they then inquired about some basics about me and my practice: what was my specialty, my office location, what foreign languages were spoken, what special services are provided to make them decide not to refuse renewal of the Medicare HMO part of the agreement. In short, they showed that they had no prior knowledge of my professional status and seemed not to be seriously interested in it.

In the end, they advised me to tell my GHI, HIP, and Medicare HMO patients whom they insure (a large part of my practice), that large corporations often decide to cut surplus for reasons of business efficiency.  It made no difference when I explained that my patients do not see the “business” aspect of my relationship to Emblem Health. For them it is a question of access to excellent medical service, nothing more or less.

I was informed that a decision would be rendered to me in five business days, which have long passed.  I have received no decision to date.

I am writing to inform my colleagues of this letter and to inquire if others have received it. It would be important for large body of so–notified physicians and surgeons to seek more information about this kind of decision making that might restrict access to medical services in a population of patients insured by State, City or Federal employers as well as by public funds. 

I would close by asking what kind of good business practice would rid itself of a very wide range of products and/or services presently available to customers, if such a decision would involve no cost saving whatsoever? It would simply be restricting customer choice, which is usually not a good business decision. 

In summary, this decision by Emblem Health makes no sense whatsoever. Because it might be harmful to the total distribution of health care available to our patients in New York County (and beyond), I have decided to inform the Editor of the Newsletter.

If any colleagues have received such notification from Emblem Health and concur with my conclusions, I would ask that you notify the Editor as well.

Sincerely,
Robert S. April, MD, MA
Fellow American Academy of Neurology,
Fellow New York Academy of  Medicine
Diplomate, American Board of Psychiatry and Neurology
Société de Nerologic Française, à titre étranger 
 

You MUST Re–Register for Workers’ Comp  NOW

The Workers’ Compensation Board has now opened the site for its new registration process, designed to update the list of medical providers who are authorized to treat injured workers. The updated list will help injured workers easily identify Board–authorized providers. 
 
Authorized providers are required to register by January 15, 2018. Providers who have not registered by the deadline will be removed from the public directory of authorized providers, and will become ineligible for the Board’s disputed bill process.
 
How to register:  The Board has directed physicians to use New York State’s existing Health Commerce System (HCS) for the registration process, and for future updates to their registration information. You will need to create an HCS account if you do not already have one. Information on creating an account can be found on the New York State Department of Health website: https://apps.health.ny.gov/pub/top.html.  (Note:  If you do not have computer access to complete the registration online, you may request that a paper copy to be mailed to you.   Call the NYS Workers' Compensation Board Medical Director's Office at (800) 781–2362, option 6.)
 
Are you an existing HCS account user?  
Here’s how to access the WC Registration Form:  
 
  1. Log in at https://commerce.health.state.ny.us.

  2. Select My Content > All Applications from the Main Menu.

  3. Select P from Browse by list, and then add Person-based Electronic Response Data System (PERDS) to your application list by selecting + under the “add/remove” column.

  4. On the top of the page, select Home.

  5. On the home page, select Refresh My Applications List. If PERDS does not appear in My Applications List, call (800)-781-2362, option

  6. Select PERDS on the My Applications list to open it.

  7. Select the Data Entry tab located on the top left of page.

  8. In the Activity field, select WCB Registration from the drop-down list.

  9. The following default values will be shown:
 
ACTIVITY:  WCB Registration
 
FORM:  WCB Registration for Health Care Provider
 
DATA ENTITY TYPE:    WCB Provider
 
DATA ENTITY: Please Select Name
 
10. Select the Search WCB Provider button.
 
Search Entity (Validation of Information):  
 
When you select the Search WCB Provider button, you are brought to the Search Entity page. On this page, please do the following:
 
  1. The Entity ID field must be left blank for your initial registration.

  2. Select the Profession from the drop–down list.

  3. Complete the License Number, Birth Month and Birth Day fields.

  4. Select the Search button.

  5. If your information is correct, an Entity ID is displayed below the blue Search Entity line. Keep this ID number for your records. It is not stored in the registration form.

  6. If the name that appears on the page is the same as it is on your license, click the Select button to proceed. If it is incorrect, select the Name Field Help icon for further assistance.
 
Completing the Registration Form:  
 
When you have completed your registration, be sure to click the buttons that are labeled Save All, Review & Submit, and Submit to DOH. This will ensure that you can be found on the public directory of authorized providers, and that you will remain eligible for the Board’s disputed medical bill process.
 
If you are registering multiple providers on their behalf, do not close the PERDS application after you register the first provider. 
 
For each subsequent provider:
 
  1. Select the Home tab located at the top left of the page (next to the Data Entry tab). 

  2. Follow steps 7 – 10 in the How to Access the Registration Form section. 

  3. Follow steps 1 – 5 described above in the Search Entity (Validation of Information) section.
If you do not have computer access to complete the registration online, you may request that a paper copy be mailed to you.  Call the New York State Workers’ Compensation Board Medical Director's Office at (800) 781–2362, option 6


Workers’ Comp Q&A

Failure to update your Workers’ Compensation information would not necessarily dis–enroll a physician from Workers’ Compensation authorization.  If you choose to resign from the Workers’ Compensation Program, you would not be able to bill and receive payment for care rendered to established workers’ compensation claimants if the care or treatment is related to any workers’ compensation case.
 
To resign from the New York State Workers’ Compensation Program, you need to notify the Workers’ Compensation Board of  your intent to voluntarily resign from the Program.  If a physician chooses to resign from Workers’ Compensation,  he/she must send a letter on the practice’s letterhead, to the Workers’ Compensation Board  at the address below indicating that he/she is voluntarily surrendering his/her Workers’ Compensation  authorization as a treating provider, with an effective date of resignation:
 
New York State  Workers’  Compensation Board
Office of Health Provider Administration
Attn: Ms. Eileen Moss
100 Broadway–Menands
Albany, NY 12241
 
Please note the following questions:
 
Q. What is the consequence of Failure to Treat? 
A.  A provider can be removed from the list of authorized providers. 
 
Q. If a physician can’t take on any new Workers’ Compensation  claimants, would the Workers’ Compensation Board consider this reportable misconduct? 
A. If a provider is removed from the list of authorized providers, it is reportable to the Office of Professional Medical Conduct.
   
Q. What if the practice cannot financially sustain any more Workers’ Compensation  claimants? 
A. As the regulation states, “shall accept and treat such injured employees in a manner corresponding to that accorded other patients in his or her practice, without discriminating against such injured employees because they are or may be covered by the provisions of the Workers’ Compensation Law."  
 
Q. As an example under managed care, doctors may feel they need to close their panel since it is not economically sustainable to take on new plan patients. 
A. The only acceptable reason not to take on new Workers’ Compensation  patients is if the practice is not taking on ANY new patients.  
 
Q. What is the alternative if a physician feels h/she cannot sustain the financial viability of the practice without limiting the number of Workers’ Compensation claimants? 
A. The physician may have to turn in their authorization to treat Workers’ Compensation  patients and cease treating all Workers’ Compensation  patients. 
 
Q. Are you saying that the physician has no discretion to limit the number of Workers’s Compensation  claimants? 
A. The  discretion is limited only to the extent that the doctor may refuse a new Workers’ Compensation patient if the practice is not accepting ANY new patients.
 
The  Medical Society of the State of New York (MSSNY)  has been seeking an update to the Medical Fee Schedule for years. The Workers’ Compensation Board  did propose one revision in 2014 – 2015. However, it was woefully inadequate.  The Society continues to urge the Board for an update for the fees and the codes. 
 

McNally’s Corner

The following is courtesy of James McNally, the Society’s  Third–Party Insurance Help  Program. If you have questions, call the Society at (212) 684–4681.

NGS Medicare 2018 Medicare Fee Schedules Now Available for Download:  The Medicare Physician Fee Schedule for 2018 is now available for download in Excel, and Text formats on the NGS Medicare web site at the link below.

PERLINK"http://tinyurl.com/nzbqm8d"http://tinyurl.com/nzbqm8d 

2018 Medicare  Part B Deductible Announced:  CMS has announced that the annual deductible for all Medicare Part B beneficiaries will be $183 in 2018, the same annual deductible in 2017. Premiums and deductibles for Medicare Advantage and Medicare Prescription Drug plans are already finalized and are unaffected by this announcement. 

Reminder on Health Plan Virtual Credit Card Payments:  According to HIPAA regulations, a health plan cannot require a physician to accept virtual credit card payments. In addition, payment vendors contracted by a health plan to conduct payment activities on their behalf are business associates of the health plan and, as such, are also not permitted to require physicians to accept virtual credit card payments.

A physician has the right to request that a health plan use the Electronic Funds Transfer (EFT) transaction.

If a physician makes the request, the health plan must comply, in accordance with 45 CFR 162.925(a). This provision states that if an entity requests a health plan to conduct a transaction as a standard transaction, the health plan must do so.

If a physician is concerned that a health plan or its business associate has failed to meet the requirements of the HIPAA regulations, a complaint may be filed through the on–line complaint system at the link here.

https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/Enforcements/FileaComplaint.html 

United Healthcare (UHC) Unveils New Physician Website: United Healthcare (UHC) has a new provider website that they say will be your single source for everything from UnitedHealthcare administrative guides and policies to Link self–service tools.  To read more, go to the link here.

https://www.uhcprovider.com/en/resource-library/news/welcome-uhcpro.html 

New FAQ Fact Sheet Released by CMS on the Transition to New Medicare Numbers and Cards:   A FAQ Fact Sheet is now available regarding the upcoming transition to new Medicare Numbers and cards for your patients. To read more, click on the link here.

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TransitiontoNewMedicareNumbersandCards-909365.pdf 

New Medicare Card: Provider Ombudsman Announced:  The Provider Ombudsman for the New Medicare Card serves as a CMS resource for the provider community. The Ombudsman will ensure that CMS hears and understands any implementation problems experienced by clinicians, hospitals, suppliers, and other providers.  Doctor Eugene Freund will be serving in this position. He will also communicate about the New Medicare Card to providers and collaborate with CMS components to develop solutions to any implementation  problems that arise.

To reach the Ombudsman, contact: NMCProviderQuestions@cms.hhs.gov.

The Medicare Beneficiary Ombudsman and CMS staff will address inquiries from Medicare beneficiaries and their representatives through existing inquiry processes. Visit Medicare.gov for information on how the Medicare Beneficiary Ombudsman can help you.  

If you have questions on any of these issues, contact the Society’s Third–Party Insurance Help Program at (212) 684–4681.  


No More Handwritten Claims After April 30, 2018

The Centers for Medicare & Medicaid Services has changed its deadline for the new rule for paper claims — no more handwritten claims to April 30, 2018 for Area 01 (Manhattan),  Area 02 (Bronx, Brooklyn, Nassau, Rockland, Staten Island, Suffolk, Westchester) and Area 03 (Columbia, Delaware, Dutchess, Greene, Orange, Putnam, Sullivan, Ulster). 

Beginning Monday, April 30, 2018, NGS will return to the provider any paper claim submitted with handwriting on the face of the claim that is not in a signature field (the signature fields are boxes 12, 13 and 31). A notice will be attached to the front of the returned claim and you will need to submit a new claim. 

You can use the typewriter for paper claims — even after April 30, 2018, or you can send claims electronically (see below). 

If you use the typewriter, don't forget the Paper Claim Submission Guidelines. You must use the original forms (the red and white CMS 1500 Claim Form). Do not use highlighter, white–out or any other markers on the claim. Avoid script, slanted or italicized type (12–point type is preferred). Do not use an imprinter to complete any portion of the claim form.

Would you like to explore electronic possibilities?  Electronic claims are held in the payment floor for 14 days, whereas paper claims are held in the payment floor for 29 days. Other advantages: increased cash flow and lower administrative costs, ease of billing, added efficiency, accurate claims filing. Here are electronic options you might like to consider:
  
NGSConnex is a free internet–based system, not requiring special software, that lets you create Medicare claims and submit them right on your screen. You can also check eligibility, file appeals, and do many other useful things.  For more information, go to
https://connex.ngsmedicare.com/home/start.swe?SWECmd=Start&SWEHo=connex.ngsmedicare.com

PC–ACE is NGS's free stand–alone software that lets you create and submit Medicare claims, and store demographic information.  For more information, go to the NGS site 
(www.ngsmedicare.com), click on the Claims and Appeals tab, then on Electronic Data Interchange Software.  
  
Your vendor can provide software for electronic claims submission. The Electronic Data Interchange (EDI) page on the NGS website explains how to enroll, and what capabilities your office needs to be able to submit electronic claims. 

Your clearinghouse or billing service can submit claims electronically for you.  

For further information, call Susan Tucker at (212) 684–4681 or e–mail stucker@nycms.org

 
NYSDFS Initiates Lawsuit to Address Unpaid Health Republic Claims 

The New York Department of Financial Services (NYSDFS) has filed a lawsuit against the federal government seeking to recover over $575 million owed to Health Republic as dictated by various components of the Affordable Healthcare Act (ACA) or “Obamacare.” 

As many physicians who are still owed money for outstanding claims know, Health Republic was shut down two years ago after it was determined it was unable to pay its claims.

It has been in liquidation proceedings ever since with over $211 million in outstanding claims to physicians still to be paid.

As more information becomes available on the status of this suit, we will keep you apprised. Until then, your continued patience is appreciated.


The Physician Advocacy Program Follow–Up  

If  you were signed up with the  Physician Advocacy Program, previously run by the Medical Society of the State of New York as a member benefit with Kern Augustine, it is now being administered by the firm of Weiss Zarett Brofman Sonnenklar & Levy, PC. 
 
If  you are a member of the program, your files are now located at the Weiss firm. Call or e–mail:
 
Mathew Levy, Esq.
Weiss Zarett Brofman Sonnenklar & Levy, PC
3333 New Hyde Park Road, #211
New Hyde Park, NY 11042
(516) 926–3320
 mlevy@weisszarett.com


You Are Invited to the Wilfred C. Hulse Award Lecture

All are welcome to the Wilfred C. Hulse Award Lecture, featuring Gabrielle Shapiro, MD, for a discussion of “Child and Adolescent Psychiatrist as Physician Advocate: Empowerment through Collaboration.”   The Hulse Award is given  annually to a member of the New York Council on Child and Adolescent Psychiatry for outstanding contributions to the field of child and adolescent psychiatry
 
Doctor Shapiro, is Clinical Professor, Psychiatry, Icahn School of Medicine at Mt. Sinai, and
Collaborative Care Program Director, The Boriken/East Harlem Health Council.  (She’s also a member of the Board of Directors at New York County Medical Society.)
 
The event is Wednesday, January 17, 2018, 7:00 p.m. to  9:00 p.m. at Lenox Hill Hospital, Einhorn Auditorium, 131 East 76th Street, New York, NY 10021.               
 
Register at http://nyccap.org/hulse_lecture_2017.aspx   (No charge.)


Make Sure to Make Available Patient Records on a Timely Basis
 
The following article is by Jonathan Krasner  from  HIPAA Secure NOW!
 
HIPAA is often described as dealing with CIA – the Confidentiality, Integrity and Access to patient records. In the past, access to patient records often required a written request, accompanied by a response in the mail that could take several weeks. However, in today’s world where electronic systems can provide almost instant action to data, patients expect requests to be fulfilled in a much more timely manner.
 
The HIPAA regulations are behind the times on this. Here is a link to what is required: https://www.hhs.gov/hipaa/for‑professionals/privacy/guidance/access/index.html
 
In this description of an Individual’s Right to access  Health Information, we have this regarding timeliness:
 
In providing access to the individual, a covered entity must provide access to the PHI requested, in whole, or in part (if certain access may be denied as explained below), no later than 30 calendar days from receiving the individual’s request. See 45 CFR 164.524(b)(2). The 30 calendar days is an outer limit and covered entities are encouraged to respond as soon as possible. Indeed, a covered entity may have the capacity to provide individuals with almost instantaneous or very prompt electronic access to the PHI requested through personal health records, web portals, or similar electronic means. Further, individuals may reasonably expect a covered entity to be able to respond in a much faster timeframe when the covered entity is using health information technology in its day to day operations.
 
So technically the requirement is only 30 days! But organizations are encouraged to respond much quicker. At some point in the future, there will be a rewrite of this part of HIPAA, no doubt. However, recognizing that this is a problem, CMS developed a measure in Meaningful Use to require organizations to respond to patient requests for electronic access to records in a more timely manner:
 
For Providers, 4 days: https://www.cms.gov/Regulations‑and‑Guidance/Legislation/EHRIncentivePrograms/Downloads/2016EP_8PatientElectronicAccessObjective.pdf
 
For Hospitals, 3 days: https://www.cms.gov/Regulations‑and‑Guidance/Legislation/EHRIncentivePrograms/Downloads/2016EH_8PatientElectronicAccessObjective.pdf
 

So all that is necessary to meet the Meaningful Use requirements and collect incentives, is to run the reports and make sure that the numbers are accurate —  right? Not so fast. Some Indiana lawyers, whose day–to–day work requires them to make requests for medical records became frustrated when it took a long time to receive records. So what did they do? They filed a lawsuit!
 
Here are the details: https://www.careersinfosecurity.com/lawsuit‑hospitals‑lied‑about‑providing‑quick‑records‑access‑a‑10485
 
The lawsuit claims, among other things, that the hospitals repeatedly were tardy in responding to requests for patient records and that they had accepted Meaningful Use dollars in which they claimed they responded to requests within three days. The lawsuit seeks $1 billion in damages and notes that the hospitals collected $324 million in MU incentive payments. CMS independently audits providers and hospitals on their MU attestations. However, what we have learned from this lawsuit is that outside parties may jeopardize Meaningful Use dollars if they feel that organizations are not meeting their MU obligations in fact.
 
The US has a fragmented healthcare system. One of the goals of Meaningful Use and the implementation of near universal Electronic Health Records was to give patients quick and convenient access to their own records so each person can more easily assist in their own coordination of care. Few people would disagree that this is a worthwhile cause. Making records available on a timely basis is good for your patients and good for your practice. Is your medical records department responding to requests in a timely manner? It might be worthwhile to double check.
 

Dues Deductions for 2017 Taxes

Because lobbying is not tax deductible as a business expense, physicians cannot deduct their total association dues from their income taxes.
 
This year for 2017 taxes, 30 percent of the Medical Society of the State of New York dues, and ten percent of Society dues are not deductible.
 
Donations to MSSNYPAC are not deductible at all, although they are essential to the continued success of physicians to protect their patients and profession in the political process. If you are including a MSSNYPAC contribution with your MSSNY dues, no portion of that membership is deductible.
 

New Year and  New Members

The following nine candidates for membership have been  presented to the Board of Directors of the Society.
 
Ellen Kathleen Casey, MD
Vinnidhy Dave, DO
Krishna Baumet, MD
Bhavana Kranthi, MD
Steven J. McAnany, MD
David Lawrence Nigen, MD
Tajinderdal S. Saraon, MD
Tristan Timothy Sands, MD
Danielle Lauren Scher, MD  


Powerful Ways to Promote Workplace Optimism
 
Physicians, you and your team deserve to enjoy work. The workplace should be a positive influence on people and their lives. Yet for too many it’s just not the case. In one study, 48 percent of employees frequently feel a lot of stress in their work. This adversely affects their well–being. A previous study found that 68 percent of workers feel that their managers are more focused on their own success instead of inspiring their employees. The workplace has become lopsided — too much negativity and not enough optimism.
 
In a nutshell, though, it is a mood in the environment that gives people hope that good things can come from their work. Furthermore, people have meaningful relationships and work that fulfill basic needs.
 
So what, then, can a leader do to cultivate such a vibe? Let's take a look at some actionable ways to find some balance in the lopsided workplace.
 
1. Repair the Relationship with Employees
 
For too long hierarchy has characterized the leader–employee role. This has prevented many leaders from learning about their employees’ aspirations, strengths, interests or family life.
Family life is important here. Work influences a person’s family life. Most do not “turn off” work when they go home for the day. The stressors of the day linger, work emails beckon and project deadlines loom. A powerful way to repair the relationship between you and your employee is to pay attention and do something about how the workplace affects your team’s family life.
 
2. Help Employees Find Purpose 
 
Entrepreneur Aaron Hurst wrote in The Purpose Economy that “[purpose] is fundamentally fueled by our pursuit of the fulfillment of [connection and self–expression.]”
 
While most of us are familiar with understanding the organization’s purpose, it’s not enough. Optimistic workplaces encourage employees to uncover their own purpose.  The savvy leader harnesses this enthusiasm, the passion, to help people grow into who they are. While the Industrial Age leader may see this as “fluffy,”  today's leader recognizes that self–expression can be good for business.
 
Gallup has found that self–expression is a positive outcome when engagement, productivity and personal well–being are part of a person’s work experience. Gallup goes on to explain “focusing on that means working towards a more prosperous world — and perhaps a safer one.”
 
Helping employees find purpose in their work and personal life is key to workplace optimism. The place to start with this is ensuring you spend time learning about your employees’ aspirations and goals, taking you back to the first item listed here.
 
3. Focus on Developing Your Employees 
 
While this may seem obvious, it’s not done enough. Sending people off to training is hardly the only solution. How do you integrate what was learned into the employee’s development plan? What on–the–job assignments are you lining up for your employee to deepen her knowledge, strengths and abilities? And just as important, develop your employees by leveraging her strengths — work that energizes. Training is rarely the only solution to developing your employees.
 
The three items listed above are great starts to cultivating an environment marked by optimism. It takes persistence and a passion for people to thrive in their life, both at work and home. This shift in perspective is key to promote workplace optimism.
 
Have a current temporary or direct hire staffing need for your practice? If so, talk to a staffing firm with a focus on your industry. In this case, Winston Medical Staffing, a JCAHO–certified agency with over 50 years in the industry is the New York County Medical Society’s endorsed medical staffing partner and can help you find the best talent for your company's culture, goals, and specific needs. Winston provides temp, temp to direct hire and direct hire placements. We also have a 24–hour service center for last–minute staffing needs. For more information, feel free to contact Ivy Kramer, MSW, CSW your designated account representative at (212) 687–4667 or email at ikramer@winstonstaffing.com 


Are You Reaching Your Potential Patients?  Take This Quiz and Find Out

 Rate the level of success you have reaching new patients.  Score +1 or -1 for each of these statements.
 
+1 -1 We get new patients from our practice website.
 
+1 -1  My website clearly communicates who we are and what we do.
 
+1 -1   My practice website has unique content that I own myself.
 
+1 -1   My practice website shows up on the first page of Google search results for most important keywords (e.g., specialty, symptoms, procedures, location, etc.).
 
+1  -1  My practice’s social media pages reflect the same design and content as my website and include my correct contact information and top–rated keywords patients are searching.
 
+1  -1  We post at least four updates and tweets per week on our Facebook and Twitter pages.
 
+1  -1  We encourage and facilitate patient online reviews.
 
+1  -1 I have enough positive online reviews, and I’m getting new patients because of that.
 
Be honest with yourself!  Do you have a  perfect “8” practice when it comes to social media and marketing?   You could.   Contact PracticeBuilders at (800) 679–1200, select option 2, and tell them you are a Society member. 

 
See What DocBookMD Can Do for You
 
Are you a user today or has it been a while?   Did you know DocbookMD is a free benefit for members of New York County Medical Society?
 
Sign up here for your free account:  https://registration.docbookmd.com/#/create‑account
  
Features of DocbookMD:
  • Secure messaging built for healthcare
  • Message your Society colleagues
  • Upgrade to the Team plan to add nurses and office staff
  • Access to a directory with  members
  • Messages
  • Unlimited characters
  • Conversation view
  • Attachments
  • Share photos and other files
  • Integration with ShareFile – Attach files that are securely stored in ShareFile
  • Security
  • HIPAA–compliant and HITRUST certified
 
Extras at no additional cost include message archiving and Business Associate Agreement (BAA) signed for every customer.
 
See what DocbookMD can do for you at https://www.docbookmd.com/wp‑content/uploads/2017/08/DataSheet_DBMD.pdf

 
 Idilus Takes Care of HR Headaches and Benefits

The Society offers members access to IdilusHR, an organization that provides custom HR and benefit solutions, to provide a variety of services to benefit both our members and their practices. Among these benefits is a variety of affordable and comprehensive medical insurance solutions In addition, IdilusHR is offering all New York County Medical Society members a 20 percent discount on their administrative fee.
 
It is important to understand that IdilusHR is not an insurance broker but instead a PEO. That means that they are providing a comprehensive HR package that  includes the ability to purchase health insurance and other benefits as large employer  and a lower rate. They charge a fee for their services on a monthly basis. Hopefully the savings resulting from large volume purchasing and reduced accounting and payroll costs will offset a significant percentage of their monthly fee.   (Please note that some people may not qualify for all plan offerings.)
 
 Click on the link below to see how IdiliusHR can solve your HR headaches.  For information, go to   https://www.idilus.com/      Click on the program tab for Sole Prop Program, and then click on the NYCMS Logo.  Enter the code   NYCMS   for the password.  


Look Into Storage Quarters

In its continuing effort to introduce members to services that will help their practice thrive, the New York County Medical Society is pleased to announce the addition of a key Business Partner to help your practice with services you use every day. Storage Quarters is a comprehensive, full service company specializing in document storage, records management, scanning records and imaging, secure document destruction, self storage and on–demand storage.The company specializes in the protection and management of your information. Your business or personal possessions are your most important assets. Storage Quarters customizes
information management solutions to suit your needs and always offer a cost–effective quote. Now, Storage Quarters is offering special savings to New York County Medical Society members.With this new arrangement, Society members will receive discounts on: 
  • Initial pickup and transport of files (NO Charge as opposed to the $39.95 fee non-members pay);
  • Discount on the minimum storage fee (20%) ; 
  • Discount on 1.2 cubic foot box storage (10%); 
  • Discount on destruction charges, (20% off) and more. 
 
Storage Quarters has scanning, storage, shredding services, with a number of easy and professional options for physicians trying to determine how to work with paper files and material in their office.

Contact Storage Quarters and say you are a NY County Medical Society member to insure special pricing. Call (516) 794–7300 or info@storagequarters.com


Don't Throw Your Money Away with the Waste

Citiwaste is now an exclusive provider of medical waste management services offering deep discounts to New York County Medical Society members. Whether sharps, red-bag, chemo, pathology, hazardous, or pharmaceutical waste, Citiwaste  will work with you ro classify and segregate waste streams for best pricing.

In addition, Citiwaste will determine the appropriate service frequency and deliver the supplies you need to package wastes. Guaranteed savings with no fuel, stop, energy, or enviironmental fees. Medical waste manifests available online 24/7 at no charge. One provider for all your medical, hazardous, and pharmaceutical waste.

Protection for your business with complete regulatory compliance. Call David at (718) 372-3887 to learn more about how Citiwaste can save you money.


In Memoriam

Robert Auerbach, MD, died November 8, 2017.  Doctor Auerbach received his MD degree from New York University School of Medicine in 1958.
 
Charles P De Feo, MD, died December 12, 2017.  Doctor DeFeo received his MD degree from Hahnemann University School of Medicine in 1952.
 
Raymond Harrison, MD.  Doctor Harrison received his MD degree from University of Sheffield School of Medicine in 1948.
 
Jacob S. Israel, MD, died November, 2017.  Doctor Israel received his MD degree from New York University School of Medicine in 1949.
 
Virginia Kanick, MD, died November 15, 2017.  Doctor Kanick received her MD degree from Columbia University College of Physicians and Surgeons in 1951.  She was a past officer and member of the Society’s Board of Directors.
 
Ira Laufer, MD.  Doctor Laufer received his MD degree from New York University School of Medicine in 1953.
 
Stanley Reichman, MD.  Doctor Reichman received his MD degree from Chicago Medical School in 1948.
 
Marvin B. Zuckerman, MD, died December 17, 2017.  Doctor Zuckerman received his MD degree from State University of New York Downstate in 1953.