NYCMS Member Alert 8/25/16

Vol. 11, Issue 7

Zika:  The NYC Health Department has new guidelines for testing.  Click on:  New Zika Virus Testing Policy in New York City.   
 
CMS's new MACRA (MIPS) program is currently scheduled for January 1, 2017, and physicians have questions.  Will all Medicare physicians be required to participate?  Will an EMR be required?  Will the program concepts be difficult to work with?  What's a good way to prepare in advance?  How heavy will penalties be for nonparticipants?  And so on!   Click on:  MACRA – What it’s all about. 
 
The opioid epidemic:  The U.S. Office of the Surgeon General is sending a letter to all physicians concerning pain treatment, offering a handy pocket guide to the CDC’s Opioid Prescribing Guideline.  Click on:  Letter from the US Surgeon General on the opioid epidemic. 
 
Telemedicine raises many issues, from the ethical/philosophical (what about the laying on of hands?) to the practical (will insurers pay the same as for face-to-face care?).   How will you relate to the new trend?  Click on Telemedicine:  MSSNY President Malcolm Reid, MD, MPP, urges all members to answer a brief survey. 
 
The news about MLMIC:  You may know that Berkshire Hathaway, Inc., proposes to buy the medical liability company, so that it will no longer be a “mutual” owned by physicians.  Read more at:   MLMIC:  Proposed purchase by Berkshire Hathaway.
 
Patients and physicians need our two e-prescribing bills to become law now!  Tell the Governor to sign these bills!  Click on:  Governor still has not signed our two eRx bills – please send him emails now. 
 
Important ICD-10 point:  The “grace” period ends October 1, 2016.  Starting then, you will have to code diagnoses as specifically as possible.  Click on:  CMS updates FAQs on end of ICD-10 Flexibility ("Grace") Period.
 
The 2017 Medicare Fee Schedule:  What’s new in CMS policy for reimbursement for primary care, and what happens now that the SGR is gone?  Click on:  CMS Releases Proposed Medicare Rule for 2017.
 
Fed up with Medicare hassles?  NGS’s quick web-based system helps you investigate problems, and often solve them.  Click on:  The NGSConnex Advantage.
Medicare Advantage Plans pose ongoing challenges.  Click on:  Important point about Medicare Advantage Plan grievance and appeals procedures. 
 
Retired physicians and others who do very little prescribing:  You can easily get a “certification” that exempts you from the e-prescribing requirement.  Click on:  NYS BNE:  How to File for a Waiver Due to Low Volume of Prescriptions.
 
Retired physicians who are renewing their NYS license:  If you don’t receive compensation for your care, license renewal is free.  Click on:  Fee Waivers for Non-Compensated NYS License Renewal. 
 
Events:  HIPAA concerns?  Get an excellent update.  Click on:  Wednesday, September 7, 2016, 6:00 p.m. to 7:00 p.m.:  Free webinar, “2016 HIPAA Update: What A Medical Practice Needs to Know to Stay Compliant.”   Also:  Our endorsed vendor can help you sharpen up your HIPAA compliance program for HIPAA audits or MACRA.  Click on:  HIPAA Secure Now! provides many services to NYCMS members.
Full-day workshop on a topic of great interest:  Click on:  Sunday, October 23, 2016, 8:00 a.m. to 5:30 p.m.:  Touro College of Osteopathic Medicine Presents: Fascial Manipulation and Anatomy: Dissection and Clinical Implication. 
 
 
NYCMS reminds you:  We have a huge variety of member benefits!
 
NYCMS offers members a wide range of benefits – some at special discounts, others FREE. 
 
Our endorsed HIPAA vendor (HIPAA Secure Now!) can help you deal with an OCR audit or prepare for MACRA – or just tighten up your HIPAA compliance so you’ll be ready for whatever comes.  Click on:  HIPAA Secure Now! provides many services to NYCMS members. 
 
Communicating with other physicians:   Click on:  DocBookMD is a HIPAA-compliant smartphone platform, FREE to NYCMS members.   (Now you can use DocBookMD to e-prescribe or text, too.)  You can use DocBookMD to make sure any messages your staffers text or email to you are HIPAA-compliant, too!
 
Make sure your personal and practice finances are in the right hands:  Talk to the experts at Vital Financial Planning Group.  A great way to start is by checking out the college funding plan with JP Morgan and Vital that’s available for Society members.  Check it out at Vital Planning Group offers excellent college savings program. 
 
Also on the financial side:  Click on:  CardConnect (improve credit-card processing), and I.C.System, Inc. (collect what’s due).
 
Health insurance for you and your staff – where to start?   Click on:  Idilus can provide tax, payroll and other employer services – plus health insurance for many practices!   If Idilus (a Professional Employer Organization) does your payroll, you are also permitted to obtain health insurance through the company.  The rates are quite attractive. There’s underwriting, but it’s worth looking into.
 
Communicating with your patients:  Click on:  Three great member benefits:  Workerbee (Web design), PhoneRover (phone messaging), Canopy (medical translating – free!)
 
Office expenses:  We have ways to deal with them.  Click on:  For your office:  Winston (staffing), Superior Office Systems (supplies and equipment for copying), AMP - a wonderful buying club (more supplies), Medelita (uniforms) – and Commercial Tenant Concierge (expert real-estate consultants).
 
Your patients and their prescription needs:  We suggest two FREE ways patients can save money on prescriptions.  Click on:  GoodRx (a website for price comparisons), and NY RX Card (a discount card to use at pharmacies). 
 
Two items of great personal interest:  Click on:  Working Advantage (NYCMS members can get discounts for theater, etc.) – plus, American Safety Institute (10 percent discount on auto insurance).
 
The endorsement by NYCMS of selected vendors is not intended nor should it be construed as personalized legal or financial advice.  Each physician, in conjunction with his/her own advisors, must determine what is appropriate for his/her particular circumstances.  
 
 
 
NYCMS also reminds you…
 
Order your “Doctor on Medical Call” card! Send your check for $25.00, payable to the New York County Medical Society, and your request to: Parking Renewal Program, New York County Medical Society, 31 West 34th Street, Suite 7053, New York, New York 10001.   If you have questions, call (212) 684-4698.
 
Members have free access to Jim McNally:  Our members can speak free of charge with consultant Jim McNally, who heads our NYCMS Third-Party Payer Assistance Program.  Jim can help you disentangle billing, coding and reimbursement problems quickly and efficiently.  Call Susan Tucker at 212-684-4681, or e-mail stucker@nycms.org.
 
Share this e-zine with staff:  Physicians, be sure to share this e-zine with your office manager.   Call 212-684-4681, or e-mail stucker@nycms.org.
  
Make your own member-to-member announcements:  At no charge, you can post announcements about practice relocation, real estate, consulting services and more.  Call Lisa Joseph at 212-684-4698, or e-mail ljoseph@nycms.org.   Also, don’t forget the classified section on our website, www.nycms.org, for places to rent, share or buy; services to use; and people and positions available.   Go to www.nycms.org and check out the MM News Classifieds.
 
 
Events – You’re Invited
 
Wednesday, September 7, 2016, 6:00 p.m. to 7:00 p.m.:  Free webinar, “2016 HIPAA Update: What A Medical Practice Needs to Know to Stay Compliant.”
 
2016 will be a record year for HIPAA fines and penalties. Every entity with a computer network needs to be worried about cyber-security - and medical offices need to be worried the most, since the black-market value of patient information exceeds the value of any other data.  A breach  patient data will hurt you and your patients, disrupt your practice operations, cost you a lot of money and damage your reputation. 
            The HIPAA Security rule provides specific guidelines on how to protect valuable medical information and minimize the risk of a data break.  Find out what the rule says and how you can comply!   Access this free webinar, hosted by HIPAA Secure Now! (our endorsed HIPAA vendor).  This is a "Must See" for you and your office manager.  Please pre-register at (212) 684-4698, or email ljoseph@nycms.org.   Instructions will be sent to you closer to the event.
Or, you can register at:
https://attendee.gotowebinar.com/register/7269886596861729538

Sunday, October 23, 2016, 8:00 a.m. to 5:30 p.m.:  Touro College of Osteopathic Medicine Presents: Fascial Manipulation and Anatomy: Dissection and Clinical Implication            
       
This full-day workshop (AOA: 7.75 Category 1-A CME Hours Approved) will be held at Touro College of Osteopathic Medicine, 230 West 125th Street, New York, NY 10027.  RSVP by September 16, 2016, for Early Bird $200 Rate.  To register:  Go to http://www.nycms.org/files/102316touro.pdf , or call Lisa Joseph at 212-684-4698.                     
                 
 
 
The Legislative Horizon
 
 
Governor still has not signed our two eRx bills – please send him emails now. 
 
NYCMS members:  As you know, patients – and physicians - need the relief they’ll get when our two eRx bills become law.  We need the Governor to sign these bills NOW.  Please send instant email messages to urge him to move.  Just click on the links shown below: 
  1. S. 6779-B (Hannon)/A.9335-B (Gottfried) would ease the heavy reporting burden on physicians - who are now required to email the Department of Health every time they need to issue a paper/phone/fax prescription instead of e-prescribing.  Instead of reporting to the DOH, physicians would be allowed to make a notation in the patient’s chart when they had to invoke one of the three statutory exceptions to the mandatory e-prescribing law.  TO SEND A LETTER, please click here.
 
  1. A.10448 (Schimel)/S. 7537 (Martins) would permit a pharmacy to transfer an e-prescription to another pharmacy – for example, when the initial pharmacy did not have the medication in stock. This bill would make things much easier for patients, and would speed their access to medications.  TO SEND A LETTER, click here.
 
 
Medicare Issues
 
MACRA – What it’s all about
 
CMS's new MACRA (MIPS) program is coming up (currently scheduled for January 1, 2017), and physicians have questions about how it will affect them.  Will all Medicare physicians be required to participate?  Will an EMR be required?  Will the concepts in the program be difficult to work with?  What's a good way to prepare in advance?  How great will penalties be for nonparticipants?  And so on!     
 
We have the program's general outlines, but details will not be known until CMS's "Final Rule" appears in November, 2016.  We do have some concerns, particularly regarding the impact - possibly negative - on smaller practices, and NYCMS and MSSNY are watching the situation carefully.  Once the program has been finalized we will provide more information, and we may ask NYCMS members to help us with lobbying efforts.  Meanwhile, however, we want to let our members know the basics, including ways to prepare. 
 
MIPS is a key part of the legislation known as MACRA, the Medicare Access and CHIP Reauthorization Act of 2015.  Of the two "paths" in MACRA, the one that's appropriate for small practices is MIPS; the one that's appropriate for some large practices is the APMs (Alternative Payment Models), or - for some practices - the AAPMs (Advanced Alternative Payment Models, such as Patient-Centered Medical Homes).  Here we focus mainly on MIPS.
 
Physicians who don't participate in 2017 will be subject to penalties in 2019.  Must you participate?  There are certain categories of physicians who will be exempt from MIPS penalties.  You will be exempt if (1) you are newly enrolled in Medicare, or if (2) your Medicare charges are less than or equal to $10,000, and you have 100 or fewer Medicare patients.  Also, you may be exempt if you will be doing one of the Advanced Alternative Payment Models, which are geared toward larger group practices, faculty practice plans, etc. 
 
Will an EMR be required?  An EMR will be needed for certain parts of MIPS; but there will also be MIPS activities that you will be able to do without an EMR.  The scoring will be complicated, but there is a possibility that you may be able to get "partial credit" if you decide not to use an EMR. 
 
If you would rather not participate, to what extent might the penalties affect your practice finances?  In the beginning, the MIPS penalties may not be much stiffer than those for not participating in PQRS/VBM and/or EHR.  The MIPS penalties won't start until 2019, when the PQRS/VBM and EHR penalties will already have ended - and the first-year MIPS penalties probably won't exceed 4 percent. 
 
How will MIPS work?  Is it extremely complicated, and will it be difficult to learn?  MIPS is actually just a streamlined combination of PQRS/VBM plus the EHR Incentive Program, with some added features - so if you know about PQRS and the EHR Incentive Program, you already know a lot about MIPS.  (Want more details?  Click on:  MIPS information sheet.)
 
And note:  Even a little familiarity with PQRS and the EHR Program will help.  CMS's three existing quality programs are still in operation, with over four months to go.  Physicians who don't participate this year (2016) will be penalized in 2018.  These programs are PQRS; the VBM (Value Based Modifier) Program, sister to PQRS; and the EHR Incentive ("Meaningful Use") Program.  Physicians are wondering:  Can I avoid some 2018 penalties if I start participating in at least one of these programs now?  Will that help me prepare for MIPS?  What do I need to do? 
 
The PQRS program:  If you haven't "done PQRS" in the past, you're being penalized this year - and if you don't get started this year you'll be penalized in 2018.  Would it make sense for you to get your feet wet in this program between now and December 31, 2016?  Getting in now may be a bit complicated, so you'll have to work on PQRS pretty intensively to have a shot at avoiding penalties in 2018. But even if you don't avoid penalties in 2018, it might still be a good idea to plunge into PQRS now:  It will help you understand the basic PQRS concepts, which will make MIPS easier.   (Want more details?  Click on:  PQRS Information Sheet.)
 
(Incidentally, in case you are wondering about VBM:  CMS has been gathering data for this program from physicians' PQRS submissions - physicians have not had to take any active steps for the VBM program.)
 
The EHR Program:  You're being penalized this year if you haven't participated in the EHR Program in the past - and not participating now will mean penalties in 2018.  Of course, many physicians have made the business decision not to put an EHR in their offices, and even those who do have EHRs may have found this program forbiddingly complex.   But if you happen to have an EHR, you might want to try the EHR Program now.  New participants are permitted to pick any 90-day period - and you'll start getting comfortable with the basic EHR concepts, which will make it easier for you to get into MIPS next year.  (Want more details?  Click on:  EHR Program Information Sheet.)
 
 
 
MIPS Information Sheet
 
Is it true that MIPS will be overwhelmingly unfamiliar and complicated?  Actually, MIPS is what you might call a PQRS/VBM/EHR Program “mashup,” plus a few added features - so if you’re already familiar with PQRS/VBM and the EHR Program you probably will not have difficulty with the basic concepts in MIPS.  The details of MIPS are still under discussion - CMS’s Final Rule is due this fall.  But the new program is expected to be generally as described here. 
 
Is it true that all physicians will be required to participate?  No.  There are certain categories of physicians who will be exempt from MIPS penalties.  You will be exempt if (1) you are newly enrolled in Medicare, or if (2) your Medicare charges are less than or equal to $10,000, and you have 100 or fewer Medicare patients. Small-practice physicians:  If you’re not in either of those categories you could be subject to the penalties, but CMS still can’t force you to participate.  CMS can’t stop reimbursing you for your services to Medicare patients.  Larger practices:  If you’re involved in Advanced Alternative Payment Models you will be exempt from MIPS. 
If you would rather not participate, to what extent might the penalties affect your practice finances?  Actually, in the beginning, the MIPS penalties may not be much stiffer than those for not participating in PQRS/VBM and/or EHR.  The MIPS penalties won’t start until 2019, when the PQRS/VBM and EHR penalties will already have ended - and the first-year MIPS penalties probably won’t exceed 4 percent.  Note too:  You may possibly be able to do “part of MIPS.”  Even if you don’t have an EHR and don’t intend to get one, there is a possibility that you’ll still be able to participate in certain portions of MIPS without an EHR and avoid penalties for those portions.  It will depend on complicated scoring details, but you may want to bear this approach in mind.  
Will MIPS be full of PQRS-style gobbledygook?  It’s true that in some ways, MIPS will follow the PQRS/VBM pattern:  You’ll pick “quality behaviors” (or “Measures”) such as screening older women for osteoporosis, and report to CMS on your performance.  And it’s true that you’ll see complicated-looking terms now and then.  But NYCMS will cut through the gobbledygook and explain it all to you.  We’ll show where to get information and what to do.  
 
Do you dread trying to meet the MIPS EHR requirements because Meaningful Use has been so difficult?  Actually, MIPS – which retains the Meaningful Use concepts and goals, calling them Advancing Care Information – will make EHR requirements easier for you.  The scoring will no longer be all-or-nothing, and you’ll be able to pick Measures that show how you use technology in your day-to-day practice.  Also helpful:  The number of Measures will have been reduced from 18 to 11. 
 
Are you wondering about the “added features” in MIPS?   MIPS includes a new category of objectives called the Clinical Practice Improvement Activities objectives.  They include Expanded Practice Access, Beneficiary Engagement, Population Management, Care Coordination, Participation in an APM (Including a Medical Home Model), and Patient Safety and Practice Assessment.
 
How does the MIPS path differ from the path that includes Alternative Payment Models (APMs) and Advanced Alternative Payment Models (AAPMs)?   Physicians who participate in the present APM models such as Accountable Care Organizations (ACOs), Shared Savings, etc., may qualify for financial bonuses.
            Those who will be part of the Advanced Alternative Payment Models (AAPMs), such as the Patient-Centered Medical Homes, will be exempt from MIPS reporting requirements and may also qualify for financial bonuses.  These models, geared toward larger group practices, faculty practice plans, etc., may not be right for your situation – but if you would like information about these alternatives, please contact the NYCMS Third-Party Payer Assistance Program.  Call Susan Tucker at (212) 684-4681, or email stucker@nycms.org.  
 
And, finally, the $64,000 Question: What does an individual physician practice need to do in MIPS? How will I report these new measures, or how will CMS know that I am meeting the performance levels?
            Reporting Quality Measures:  Just as with PQRS, you’ll be able to report on the MIPS Quality Measures right on your claims, or via other avenues.
            Reporting EHR Measures (in MIPS, “Advancing Care Information”):  You’ll report by attesting – making a signed statement – that you have used your EHR to meet the objectives.  You’ll also use attestation for the Clinical Practice Improvement Activities.  And in addition, there will be a category of information – Resource Use - for which you won’t have to do anything.  CMS will gather the information from your claims. 
 
Digging out the details:  If you would like to see what the changes and additions are to the Measures that will be part of the MIPS program, you can review the Proposed Rule located at the link here.
https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-10032.pdf
 
The Proposed Rule is long, but the page references below will guide you.  Keep in mind that these statements may change with the issuance of the Final Rule, probably in November 2016. 
 
2017 MACRA MIPS Tables – Proposed Rule
 
  • Table A = 2017 PQRS = Quality – Pages 773 to 822 & Table F = Deleted 2016 PQRS Measures – Pages 898 to 907
  • Table B = VBM = Resource Use – Pages 823 to 825
  • Table C = 2017 PQRS Cross Cut Measures = Quality – Pages 823 to 824
  • Table D = 2017 New Measures = Quality & Resource Use Pages 825 to 836
  • Table E = 2017 MIPS Specialty Sets = Quality & Resource Use Pages 836 to 898
  • Table G = Measures with Changes – Pages 907 to 945
  • Table H = CPIA – Pages 946 to 962
 
 
 
PQRS Information Sheet
 
PQRS, the “Physician Quality Reporting System,” focuses on physician actions or behaviors designed to improve quality of care.  MIPS uses the term “Quality Reporting” rather than PQRS, but it’s the same concept.  If you are new to PQRS and have never submitted PQRS measures before, it is critical that you begin as soon as possible and submit measures by the end of 2016 in order to avoid penalties in 2018!  You should move fast!
 
 
The PQRS quality actions (“Measures”)
 
What are the quality actions that PQRS focuses on?  Some common-sense ones may already be routine for you – for example, administering a beta blocker for acute myocardial infarction, or doing a complete physical skin exam for melanoma.  Others are more technically oriented - e.g., “Perioperative Care:  Timing of Prophylactic Parenteral Antibiotic.” 
            These actions are called “Measures.”  CMS will measure how frequently you perform them.  In the 2016 PQRS program you are required to choose nine Measures. Under MIPS, starting in the Performance Year of 2017, you’ll only have to choose six.
 
 
Key points:  What you’re supposed to do, which patients are eligible and how to report
 
What are you supposed to do for a Measure?  CMS provides you with a Measure Specification stating exactly what’s required.  Take PQRS Measure 39, “Screening for Osteoporosis for Women Aged 65-85 Years of Age.”  You might wonder:  What sort of screening test are you supposed to do?  The Measure Specification answers that question.  It says: “Performance Met: G8399: Patient with documented results of a central Dual-energy X-Ray Absorptiometry (DXA) ever being performed.”  MIPS Measure Specifications will probably provide details the same way.  
 
For a particular Measure, how do you know which patients or encounters are appropriate, or eligible?  For this osteoporosis screening Measure, the patient obviously has to be a female aged 65 to 85.  But you need more details, so you look at the Measure Specification.  This particular Measure Specification happens to include a requirement concerning the CPT code(s) that you put on the claim.  It states that the code must be one of the following:  99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215.  Here’s what it says:  ______________________________________________________________________________
Denominator Criteria (Eligible Cases) (Note: “Denominator criteria” is CMS’s term for the eligibility requirements of a Measure): 
  
Female patients aged 65-85 years on date of encounter
AND
Patient encounter during the reporting period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215.
_____________________________________________________________________________
If the claim doesn’t contain one of those codes, this encounter won’t be eligible or appropriate for this Measure.  It won’t fit the denominator criteria for this Measure.  
 
 
How do you report to CMS on the PQRS measure?  You use the special code that’s given in the Measures Specification.  For this one, the code is G8399:  
___________________________________________________________________________
Performance Met: G8399: Patient with documented results of a central Dual-energy X-Ray Absorptiometry (DXA) ever being performed.”
___________________________________________________________________________
 
You can put the code right on the claim (a paper claim or a claim generated electronically).  Or you can use other reporting avenues.  You can report electronically, using certified EHR technology.  Or you can report via a Qualified Registry, which collects your clinical data and submits it to CMS on your behalf.  Or you can even report via a Qualified Clinical Data Registry (QCDR), which is like a Qualified Registry but is not limited to measures within PQRS.
 
Choosing your Measures for PQRS
 
For 2016 PQRS, many physicians will prefer to choose a series of Measures that are unrelated (these are called “Individual Measures”).  In 2016, if you want to choose Individual Measures, you will need to choose nine Individual Measures.  Other physicians, however, will prefer to choose Measures that are related and have been preselected by CMS (a series like this is called a “Measures Group”).  Here, you will need to choose one Measures Group. 
            How can you get a general idea of what Measures are available?  The 2016 Measures List is a good place to start.  It’s an Excel file that shows each Measure’s number, title, etc.  Go to: 
https://www.cms.gov/apps/ama/license.asp?file=/PQRS/downloads/PQRS_2016_Measure_List_01072016.xlsx
 
As you check the list, think about which Measures might work for you.  What clinical conditions do you usually treat?  What types of care do you typically provide – preventive, chronic, acute?  In what setting(s) do you usually deliver care – office, emergency department (ED), surgical suite? 
 
Find out more about PQRS! 
 
f you decide you’d like to get started with PQRS now, you’ll need further information.  The NYCMS Third-Party Payer Assistance Program can help – call Susan Tucker at 212-684-4681 or email stucker@nycms.orgWe’ll provide you with information about the rules for choosing Measures, how to deal with the Measures Specification document (some of these documents contain a lot of verbiage), links to information about the various reporting avenues, directions for measures groups, and much more.   
            Also, a good source for many kinds of PQRS information is CMS’s Measures Codes page, at:
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html
 
 
 
EHR Program Information Sheet
 
CMS’s EHR Incentive Program (the “Meaningful Use” program) asks about the extent to which you use your EHR in a “meaningful” way to benefit your patients.  In MIPS, starting in 2017, you’ll see those EHR-based goals under the title “Advancing Care Information,” but it’s still the same concept. 
            If you are interested in participating in the EHR Program this year (2016):  It’s possible that you may only have to participate in the program for any 90-day period from now till December 31, 2016!  That means you may have time to try it out.  If you’re new to the program, your reporting period is any 90-day period in 2016.  If you were already in the program last year (2015), the requirement up to now has been that your reporting period be the entire year (January 1, 2016, through December 31, 2016), but CMS is now considering shortening that period to 90 days, too.  We’ll keep you posted on this. 
            For the remainder of this year’s 2016 EHR Program, all providers are required to work on a single set of objectives and measures, pre-established by CMS.  The ten objectives are:
  • Protecting Electronic Protected Health Information
  • Clinical Decision Support
  • Computerized provider order entry
  • E-Prescribing
  • Medication Reconciliation
  • Using Secure Electronic Messaging
  • Public Health Reporting
  • Health Information Exchange
  • Providing Patients with Patient-Specific Education Resources
  • Providing Patients with Electronic Access to Health Information
 
You can get all the details at: 
 
https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2016_EPTableOfContents.pdf
 
The MIPS program proposes six objectives in the “Advancing Care Information” category, starting in Performance Year 2017:  
Protect Patient Health Information
Electronic Prescribing
Patient Electronic Access
Coordination of Care Through Patient Engagement
Health Information Exchange
Public Health and Clinical Data Registry Reporting
(Note: Clinical Decision Support and Computerized Provider Order Entry are not part of the 2017 MIPS Advancing Care objectives.)
 
One important caveat, looking ahead to MIPS:  HIPAA is crucial in MIPS, particularly the “protecting PHI” aspect of HIPAA.  (PHI is Protected Health Information.) 
             To receive any scoring points at all for the Advancing Care Information (EHR-related) section of MIPS, you will be required to perform a HIPAA risk analysis.  If you don’t do this analysis, whatever other points you have achieved in the Advancing Care Information section will be reduced to zero. 
            NYCMS members can get a good risk analysis at a special rate with our endorsed HIPAA vendor, plus ongoing help with compliance.  For information, how about signing up for the following free webinar?    Wednesday, September 7, 2016, 6:00 p.m. to 7:00 p.m.: “2016 HIPAA Update: What A Medical Practice Needs to Know to Stay Compliant.”  This free webinar, hosted by HIPAA Secure Now! (our endorsed HIPAA vendor), will give you the whole picture.  Please pre-register at (212) 684-4698, or email ljoseph@nycms.org.   Instructions will be sent to you closer to the event.
 
 
Attesting:  How you report to CMS on your objectives
 
To let CMS know your progress, you attest – make a signed statement – that you have used your EHR to meet your objectives.  A special website is provided for this.  
 
 
Find out more about the EHR Incentive Program –
How it works now, and how the concepts will reappear in MIPS!
 
If you decide you’d like to get started with the EHR Program now (for 2016), you’ll need further information.  The NYCMS Third-Party Payer Assistance Program can help – call Susan Tucker at 212-684-4681 or e-mail stucker@nycms.orgWe’ll tell you how to get the details you need.    
 
An overview is at:  
https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2016ProgramRequirements.html
 
The 2016 EP Objectives and Measures are at: 
 
https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2016_EPTableOfContents.pdf
 
 
 
NYS BNE:  How to file for a waiver due to a low volume of prescriptions
 
The New York State Bureau of Narcotic Enforcement (BNE) has developed a process whereby a practitioner can simply certify that he or she will not issue more than 25 prescrip­tions during a 12-month period.  He or she will then not be required to issue prescriptions electronically during that period.
            The practitioner can submit the certification either (1) online through the Electronic Prescribing Waiver (EPW) application on the NYS Health Commerce System, or (2) by submitting Certification Form DOH-5221 to the BNE. 
            A paper Form DOH-5221 can be accessed at the link here: 
http://c.ymcdn.com/sites/www.thenpa.org/resource/resmgr/Miscellaneous/BNE_Electronic_Prescribing_W.pdf
 
To submit the certification online, first log into the HCS System at the link here: https://commerce.health.state.ny.us/public/hcs_login.html .
 
• Under “My Content,” click on “All Applications.”
• Click on “E.”
• Scroll down to Electronic Prescribing Waivers and double-click to open the application. You may also click on the “+” sign to add this application under “My Applications,” on the left side of the Home screen.
• Select the practitioner’s name from the list. If the name appears more than once, select the option that starts with the profession (e.g., Medicine-###### Doe John).
• Provide contact information for the person who should be contacted regarding the Certification.
• Click on “Submit Certification.”
• Enter the “Begin Date” of the 12-month certification period.
• Enter the Mailing Address of the practitioner submitting the certification.
• Click “Submit.”
• Click “Certify.”
You will be returned to the “Waiver Requests and Certifications Summary” screen. The certification period will be displayed.
 
 
CMS releases proposed Medicare Rule for 2017

CMS has released its proposed rule to update the Medicare Part B physician fee schedule, effective January 1, 2017.  To read the CMS summary of highlighted changes, click here.          To read the entire 856-page rule, click here.  (Note:  Pages 788-789 have a chart of the specialty-by-specialty impact of the proposed changes.)  MSSNY will be working with the AMA and the federation of medicine to review the rule and to make comments on key components.
             In addition to MACRA-related changes there will new recognition of primary care,.  through a new emphasis on care management and behavioral health: 
 
  • Primary Care and Care Coordination: The rule would revise payment for chronic care management:  There would be payment for new codes, and also payment for extra care management following the initiating visit for patients with multiple chronic conditions.
  • Mental and Behavioral Health:  CMS proposes to pay for certain behavioral health services provided using the Collaborative Care Model, with a team including a primary care practitioner, a behavioral health care manager, and a psychiatric consultant. There would also be broader payment for other approaches to behavioral health integration services.
  • Cognitive Impairment Care Assessment and Planning: CMS proposes a new code to pay for cognitive and functional assessment and care planning for patients who have cognitive impairment (e.g., Alzheimer’s).
  • Care for Patients with Mobility-Related Impairments: CMS proposes to pay physicians more accurately for services to beneficiaries who have mobility-related impairments.
 
 
   
The NGSConnex advantage


When you need information, you need it fast - your job depends on it. NGS’s web-based service NGSConnex lets you check claim status and beneficiary eligibility, review financial data, submit and monitor an appeal, compare submitted amounts to allowed amounts, access offset information, process re-openings and redeterminations, and much more. 
            If you're not signed up for NGSConnex, take the advantage.  Click on:  sign up today
 
 
Important point about Medicare Advantage Plan grievance and appeals procedures
 
For Medicare Advantage plans, CMS has posted important updates to the Appeals and Grievances process – with important implications if you’re treating a Medicare Advantage patient and a service is likely to be denied as non-covered by the plan.  You should know the following key point:  Before receiving services, a Medicare Advantage patient has the right to an advance determination (a “preservice organizational determination”) of whether those services are covered.
  • If you don’t ask for this prior determination, any funds you have collected may have to be refunded. 
  • Therefore, you should touch base with the Medicare Advantage plans you participate with.  Ask them what forms are necessary, and what process they are using for these advance determinations.  Please note that an Advance Beneficiary Notice cannot be used for Part C beneficiaries.
  •  
A Web-Based Training (WBT) module on this topic is available at the link here:  WBT.



 
The practice environment
 
New Zika Virus Testing Policy in New York City
 
The Health Department is revising its testing recommendations, to focus its resources on testing the highest-priority patients and minimize the burden on New York City providers.
            An increasing number of commercial clinical laboratories now offer testing for Zika virus infection.  Several laboratories now offer rRT- PCR testing, and at least one (LabCorp) offers IgM serology. A current list of commercial laboratories that offer Zika testing is available at http://www.nyc.gov/zika/provider.
            Providers should continue to report positive cases of Zika virus infection in New York City residents who are diagnosed at commercial laboratories or in other jurisdictions, by logging into Reporting Central via NYCMED; by mailing or faxing to 347-396-2632 the paper Universal Reporting Form; or by calling 1-866-692-3641.



Overview:  If Zika virus testing is clinically indicated:  When to use the Health Department for testing, versus when to use commercial laboratories:
 
• Providers should use commercial clinical laboratories for non-pregnant persons with a history of travel to an area with active Zika virus transmission.


• Providers should use the Health Department for the following (providers should call 1-866-692-3641 during business hours to request testing): 

o Pregnant women
o Infants
o Persons with Guillain-Barré syndrome or other neurological complications
o Suspected cases of sexual transmission
o Suspected cases of local mosquito-borne transmission

Note:  The Health Department will continue to provide testing if the provider cannot use a commercial clinical laboratory or the patient is uninsured.
 
 
Details:  When to Use the Health Department for Zika Testing


Use the Health Department Provider Access Line (1-866-692-3641) to order Zika virus testing at the Public Health Laboratory for:


a. A pregnant woman (regardless of symptoms), who:
i. Spent time in an area with active Zika virus transmission while pregnant, or
ii. Had unprotected vaginal, anal, or oral sex with a partner who recently spent time in an area with active Zika virus transmission.


b. A fetus or infant with suspected or confirmed microcephaly or intracranial calcifications (diagnosed prenatally or at birth) whose mother, even if she tested negative for Zika:
i. Spent time in an area with active Zika virus transmission while pregnant, or
ii. During pregnancy, had unprotected vaginal, anal, or oral sex with a partner who recently spent time in an area with active Zika virus transmission.


c. A person who developed Guillain-Barré syndrome or other neurologic manifestation (e.g., encephalitis, paresthesias, or transverse myelitis) after spending time in an area with active Zika virus transmission or had unprotected vaginal, anal, or oral sex with a partner who recently spent time in an area with active Zika virus transmission.


d. Suspected local mosquito-borne Zika virus transmission in New York City in persons older than 5 years, defined as:
i. The presence of 3 or more of the following symptoms: fever, disseminated maculopapular rash, arthralgia, or conjunctivitis, AND
ii. No history of travel to an area with active Zika virus transmission in the past 4 weeks, AND
iii. No history of sex with a person who recently traveled to an area with active Zika virus transmission within the past 4 weeks.


(NOTE: Children 5 years and under are not included, due to the high prevalence of other viral illnesses with symptoms similar to Zika virus infection.  But providers may always call to discuss cases with unusual or worrisome manifestations.)


e. Any other unusual modes of transmission (e.g., sexual, transfusion, laboratory acquired).



Details:  When to Use a Commercial Clinical Laboratory for Zika Testing


Use a commercial clinical laboratory for all other patients requiring Zika testing - specifically, patients who:


a. Are not pregnant, AND


b. Developed one or more of the typical symptoms of Zika infection (e.g., fever, maculopapular rash, arthralgia, conjunctivitis) up to 4 weeks after spending time in an area with active Zika virus transmission.

When interpreting laboratory results, providers should understand that negative results on urine or serum Zika virus RT-PCR tests do not rule out infection.

The Health Department does not recommend testing non-pregnant travelers with no symptoms who returned from areas with active Zika transmission.

If the provider is unable to utilize a commercial clinical laboratory or the patient is uninsured, the Health Department will continue to provide testing. Providers should call 1-866-692-3641 during business hours to request testing.

Providers should continue to report positive cases of Zika virus infection in New York City residents who are diagnosed at commercial laboratories or in other jurisdictions, by logging into Reporting Central via NYCMED; by mailing or faxing to 347-396-2632 the paper Universal Reporting Form; or by calling 1-866-692-3641.


 
MLMIC:  Proposed purchase by Berkshire Hathaway
 
MLMIC (Medical Liability Mutual Insurance Company), which provides coverage for many NYCMS members, has announced that it is expected to be taken over by Berkshire Hathaway, Inc., in the third quarter of 2017.  MLMIC will thus be converted from a mutual company to a stock company.
            We are told that this change should not affect MLMIC’s claims process, nor the setting of MLMIC rates.  (Those functions depend on risk experts and the New York State Department of Financial Services.)
            As a stock company, MLMIC will no longer pay dividends to insureds.  However, once the sale has been finalized, insured physicians will receive a buyout amount.
            MSSNY and NYCMS will evaluate the situation as it develops.  For more information, go to:  www.mlmic.com/faq.
 
 
Letter from the US Surgeon General on the opioid epidemic
UNITED STATES SURGEON GENERAL
Vivek H. Murthy, M.D., M.B.A.
 
August 2016
Dear Colleague,
 
I am asking for your help to solve an urgent health crisis facing America: the opioid epidemic. Everywhere I travel, I see communities devastated by opioid overdoses. I meet families too ashamed to seek treatment for addiction. And I will never forget my own patient whose opioid use disorder began with a course of morphine after a routine procedure.
 
It is important to recognize that we arrived at this place on a path paved with good intentions. Nearly two decades ago, we were encouraged to be more aggressive about treating pain, often without enough training and support to do so safely. This coincided with heavy marketing of opioids to doctors. Many of us were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.
 
The results have been devastating. Since 1999, opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly – almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly 2 million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.
 
I know solving this problem will not be easy. We often struggle to balance reducing our patients’ pain with increasing their risk of opioid addiction. But, as clinicians, we have the unique power to help end this epidemic. As cynical as times may seem, the public still looks to our profession for hope during difficult moments. This is one of those times.
 
That is why I am asking you to pledge your commitment to turn the tide on the opioid crisis. Please take the pledge. Together, we will build a national movement of clinicians to do three things:
 
First, we will educate ourselves to treat pain safely and effectively. A good place to start is this pocket guide with the CDC Opioid Prescribing Guideline. Second, we will screen our patients for opioid use disorder and provide or connect them with evidence-based treatment. Third, we can shape how the rest of the country sees addiction by talking about and treating it as a chronic illness, not a moral failing.
 
Years from now, I want us to look back and know that, in the face of a crisis that threatened our nation, it was our profession that stepped up and led the way. I know we can succeed because health care is more than an occupation to us. It is a calling rooted in empathy, science, and service to humanity. These values unite us. They remain our greatest strength. 
 
Thank you for your leadership.
 
Fee Waivers for Non-Compensated NYS License Renewal


An important point for physicians who have retired and are no longer receiving compensation for medical care they provide:  Under the provisions of Section 6524(10) of the New York State Education Law, you are allowed a waiver of the fee for the registration of your license as a physician in the State of New York.  You must certify to the State Education Department that, for the period of your registration, you will only practice medicine without compensation – and without the expectation or promise of compensation. The waiver of the registration fee is limited to the duration of the registration period that you indicate in your affidavit.  Go to:  
 
http://www.mcms.org/sites/default/files/resources/NC-Affidavit11-02.pdf
 
 
Telemedicine:  MSSNY President Malcolm Reid, MD, MPP, urges all members to answer a brief survey
 
In the August 5, 2016, edition of MSSNY’s e-news, Dr. Reid wrote:   
 
Dear Colleagues:
            According to Medicare.gov, telemedicine (which may also be referred to as “telehealth,” or “virtual healthcare”) “seeks to improve a patient’s health by permitting two-way, real time interactive communication between the patient and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment.”
            With evidence-based telemedicine, clinicians can evaluate, diagnose and treat patients remotely using store-and-forward technology or real-time video conferencing.  Remote practitioners can capture and transmit medical data to share with peers and specialists around the corner or around the world.
            About five years ago, I attended a Council meeting where a physician executive from UnitedHealthcare gave us a presentation informing us that telemedicine was in our near future and it was a good idea whose time had come. When the presentation ended, the room was silent until a Council member spoke up and said that this was an outrage and goes against one of the ancient tenets of medicine—that we had to lay our hands on our patients to examine them. An extended lively discussion ensued and finally, one Councilor had the courage to ask what the logistics of payment for a telehealth exam would be.
            Today, we are well aware that telemedicine is provided throughout New York and is spreading rapidly. From our current and ongoing research, we know that there are different payment arrangements to practitioners who provide this new and vital service— “vital” as in a mother of four children and one of them has a high fever. She should not be expected to pack up the family car for a trip to the emergency room when her fears can be allayed by speaking to (hopefully) a NY physician. In addition, does a patient really need to make a trip to the office when they all they need is a routine prescription refill?
 
Many plans pay equally to the level of service based on the documentation contained in the medical record.
            On July 18, we sent out a survey regarding telemedicine. Since this is a MSSNY hot topic, we are surprised at the low response rate. As we continue to develop our plans for your benefit, you could help us out by completing our 10-question survey. Even better, you can send it on to your colleagues so that we have a clearer picture of our members’ interest.
 
Please take it NOW! Click on:  10-question  telemedicine survey
 
 
CMS updates FAQs on end of ICD-10 Flexibility ("Grace") Period
 
ICD-10 users (that’s just about everyone, of course):  Be aware that starting October 1, 2016, we will no longer be in the “grace period” or “flexibility period” in which insurers were told not to be strict when the provider did not code a diagnosis to the highest level of specificity.  As of October 1, 2016, you will need to use the most specific ICD-10 code available, or your claims will be denied. 
            CMS has updated its FAQs to stress that the ICD-10 Flexibility period will end on October 1, 2016.  See the FAQs noted as “new 08/18/2016” and page 8, at the link below:
https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answers-Related-to-the-July-6-2015-CMS-AMA-Joint-Announcement.pdf
 
 
NYCMS Member Benefits
 
HIPAA Secure Now! provides many services to NYCMS members
 
HIPAA Secure Now! helps you with HIPAA compliance.  As the healthcare system moves from paper to digital, the U.S. Department of Health and Human Services is emphasizing HIPAA much more than before.  HIPAA requires you to protect patient information, and provides specific guidance – yet the same complex HIPAA regulations apply equally to the largest hospitals and the smallest practices. 
        Naturally, most physician practices don’t have a special, dedicated HIPAA expert, but NYCMS has partnered with HIPAA Secure Now! to help our members with all these issues.  You can get a comprehensive, yet affordable, HIPAA compliance service to NYCMS members, at a 10 percent discount.  Everything you need is included: 
—    Risk Assessments
—    Training
—    Policies
—    Documentation Portal
—    HIPAA support and consulting
To talk about what HIPAA Secure Now! can do to take the headaches of HIPAA security out of your small (or large) practice, contact jonathank@hipaasecurenow.com.  And, note the following: 

You can get answers to your HIPAA questions via HIPAA Security Now’s free email “hotline.”  If you have a HIPAA question or issue, just send an email to jonathank@hipaasecurenow.com.
  
You can find out about the HIPAA requirements and HIPAA Secure Now! through a free September 7 webinar, “2016 HIPAA Update: What A Medical Practice Needs to Know to Stay Compliant.”  The webinar will be accessible on Wednesday, September 7, 2016, from 6:00 p.m. to 7:00 p.m.  It’s free, but please pre-register at (212) 684-4698, or e-mail ljoseph@nycms.org.   Instructions will be sent to you closer to the event.
 
You can work with HIPAA Secure Now! if you’ve been targeted for a HIPAA audit.  OCR, the U.S. Department of Health and Human Services’ Office for Civil Rights, is now moving into what it calls “Phase 2 HIPAA audits.” If you’ve been picked for an audit, HIPAA Secure Now! is ready to assist you. 
OCR’s message will say that you have 10 business days to upload specified documents to an OCR portal.  They’re looking for just a sampling of your HIPAA compliance program – but of course, you can’t know in advance what samples they could possibly request!  The best strategy?  Make sure your HIPAA compliance program is in the best shape it can be. You can work with HIPAA Secure Now! on your compliance program, starting immediately. 
 
You can work with HIPAA Secure Now! to prepare for MACRA.  MACRA (the Medicare Access and CHIP Reauthorization Act) is a giant package of regulations, currently proposed and likely to be approved in fall of 2016, that will change Medicare’s fundamental fee-for-service system.  The new MACRA system will tie physician payments to quality and value; the goals are better care, lower costs and improved health.
            Physicians will still be paid on the traditional fee-for-service basis, but their payments may be adjusted depending on their MACRA performance score.  The payment adjustments may start at around 4 percent in 2019; by 2022 they may be as high as 9 percent (plus or minus – depending on the physician’s score).  You will need to start complying with the new MACRA rules starting in 2017; the payment adjustments will be applied starting in 2019. 
            Each practice will be required to have performed a HIPAA Security Risk Analysis – otherwise you’ll get an automatic zero on a sizeable portion of the MACRA challenge.  And, be aware that CMS is explicitly encouraging private payers to implement similar programs.  You can work with HIPAA Secure Now! on your risk analysis. 
 
 
 
Vital Planning Group offers excellent college savings program
 
JPMorgan's NY 529 Advisor-Guided College Savings Program – now available to NYCMS members through Vital Planning Group:  We are pleased to inform you of a new benefit available for NYCMS members and their employees.  Society members can utilize this benefit in one of two ways: You can either sign up for the program directly as a member using the NYCMS Group ID, or offer the program to your practice’s employees using your own Group ID number.  Please view the attached documents to get detailed information on the unique benefits being offered to NYCMS under this program.  
            How to Get Started:  To participate directly in the program:  Contact Alex Tomei at 212-578-3012, or email at alex@vitalplanning.com  at Vital Planning Group to receive an Enrollment Application.
            To establish a Group ID for your practice:  Contact Alex Tomei at 212-578-3012 or email at alex@vitalplanning.comVital Planning Group, to establish a group ID and get enrollment materials.   
            Additional Benefit:  Vital Planning will provide a complimentary college funding analysis to members signing up for the plan. A sample college funding analysis is attached. 
Attachement: Sample Education Analysis
Attachment: JPM Group Plan Guide for EmployeRS
Attachement: JPM Group Plan Guide Employee
 
 
GoodRx (a website for price comparisons), and NY RX Card (a discount card to use at pharmacies)


Be a hero to your patients with GoodRx:  Help your patients and your practice with savings of up to 80 percent on your patients’ prescriptions. Drug prices vary wildly between pharmacies; you can use GoodRx in your practice to educate and empower your patients, whether they’re insured or not.  It’s free – no signup or credit card required.  The result:  Happier, smarter patients who save money and take their meds as prescribed.
            GoodRx finds the lowest prices and discounts.  How?  GoodRx lets the user: (1) Collect and compare prices for every FDA-approved prescription drug at more than 70,000 US pharmacies, and (2) find free coupons to use at pharmacies.  GoodRx also shows the lowest price at each nearby pharmacy.
            The user types in the name of the drug and then hits “Find the Lowest Price.”  To see GoodRx, go to:  http://www.goodrx.com/?gclid=CIqekIimgs4CFYMehgod5GMFBw.
            NYCMS members:  Call the Society at 212-684-4670.

NY RX card:  A discount card that patients can use at pharmacies, for savings up to 75 percent:  The New York RX Card is a 100 percent free, 100 percent confidential point-of-sale prescription discount card that can save your patients up to 75 percent on prescription medications.  It is free to everyone with no minimum nor maximum, no age or income requirements, no enrollment or approval process - and it is accepted at over 68,000 pharmacies, nationwide.
            This card will provide patients with prescription medication savings of up to 75 percent at pharmacies across the country including CVS/pharmacy, Duane Reade, A&P, Hannaford, Kinney, Kmart, Pathmark, Stop and Shop, Target, Tops, Waldbaums, Walgreens, Walmart, Wegmans, and many more. You can create as many cards as you need. We encourage you to give cards to friends and family members. This card is pre-activated and can be used immediately, with no personal information taken or given.
            The NYRX Card works on lowest price logic, to guarantee the best prices on medications.  It won’t lower co-pays or replace existing insurance, but in some cases the New York Rx price is even lower than your patients’ co-pay!  The card can be used during the deductible periods in Health Savings Accounts and High Deductible Plans, lowering out-of-pocket expense on prescriptions. Medicare Part D recipients can use the card to discount prescriptions that are not covered on their plan, as well as to receive discounts on medications that are not discounted when the patient’s prescription spending is in the “donut hole.”
            MSSNY members:  NYRX will mail as many cards you desire directly to your office, with display stands. The cards typically are placed at the patient checkout area.  Additionally, some doctors place them at the check-in area too. Contact rraia@mssny.org for your cards!
 
 
 
Three great member benefits:  Workerbee (Web design), PhoneRover (phone messaging), Canopy (medical translating – free!)
 
WorkerbeeMD is a medical website design company that designs and markets websites for doctors. Your patients are online.  Are you?  A medical practice is a business!  You need to be able to make a strong first impression, increase practice visibility, communicate effectively with patients, optimize your search engine, track website metrics to optimize content, and expand your patient base – all, through a new or redesigned mobile-friendly medical website.  WorkerbeeMD can do it for you, at preferred rates for Society members. 
            WorkerbeeMD will create or upgrade your practice website; it will design, maintain, host and search-engine optimize your website for patients to find you. Communicate with WorkerbeeMD via  contact@workerbeemd.com, (866) 724-6896, or www.workerbeemd.com, for capabilities including:  
  • Access to information that patients can trust
  • Share treatment options and services
  • Display participating insurance providers
  • View physician credentials
  • Appointments can be booked around the clock
  • Access to hours, directions, registration forms
  • Appointments can be booked after hours
 
And, click on this Attachement to see more! 
 
PhoneRover solves your patient communication needs:  PhoneRover makes sure that while your patients are on hold they get the information they need about your practice.  It also helps with appointment reminders, checkup reminders, office closings and more.  Discounted for Society members - AND you get the easy Health on Hold channel at no charge. NYCMS members:  Call the Society at 212-684-4670. 
 
Canopy translator helps you communicate with patients who speak other languages:  NYCMS is pleased to provide its members with the Canopy Medical Translator, a free download for our members that lets you communicate with patients in Spanish, Chinese, Arabic and more.
Canopy has been supported by the NIH (National Institutes of Health) to create a next-gen translator app for medicine.  Don't wait for a translator to show up, or worry about finding a "translator" phone in your hospital. You have the app, and you have the access with Canopy!  To see how Canopy works, watch the video. Society members will get access to the app for free (value of $250). There are a limited number of free licenses, so act fast!  Use access code 9333 to unlock the app after downloading:
For iOS - you can search on the App Store or click here (If using an iPad, switch the search to "iPhone Only"):
https://itunes.apple.com/us/app/canopy-medical-translator/id792808936
      For Android - you can search on the Play Store or click here: https://play.google.com/store/apps/details?id=com.canopyapps.translator&hl=en
 
 
DocbookMC is a HIPAA-compliant smartphone platform, FREE to NYCMS members
 
DocBookMD, designed by physicians for physicians, provides an exclusive HIPAA-compliant professional network that you can use to connect, communicate and collaborate with your Society colleagues, and communicate with Manhattan pharmacies to send e-prescriptions. You can send pictures of x-rays and wounds, reports or other information, and be assured that you are not taking any HIPAA risks. 
Go to your phone and download your free app from the iTunes App Store, or from the Android Market (see directions below).  Once you have downloaded the app to your device, open it up and follow the simple registration steps.  You’ll have access to Society members as well as all Manhattan pharmacies, right on your iPhone, iPad, laptop, and Android. Do you teach medical students or residents? You need this app.  NYCMS members:  Call the Society at 212-684-4670. 
New development:  Texting orders is now permitted - under certain circumstances!  Finally, you can take advantage of the ease and efficiency of communication that mobile text messaging brings.  The Joint Commission has updated its policy and you are now permitted to text orders – as long as you include the components that are required for an order, and use a secure text messaging platform. (The built-in messaging app on your phone just won’t cut it.)  DocBookMD is ready to help you comply.  A secure texting platform must include the following: 
—    Secure sign–on process 
—    Encrypted messaging 
—    Delivery and read receipts 
—    Date and time stamp 
—    Customized message retention time frames 
—    Specified contact list for individuals authorized to receive and record orders
DocbookMD meets and exceeds all of these requirements.  It’s free to all New York County Medical Society members. Learn more at https://www.docbookmd.com/about-us/, and download for free in the Apple App Store or Google Play.
            Need help using the DocbookMD app? The user manual and tutorial videos will walk you through everything you need to know from beginning to end:
·    DocbookMD User Manual
·    DocbookMD Tutorial Videos
If you need your member ID to log in for purchase, contact ljoseph@nycms.org or call the Society’s membership department at (212) 684–4682.
 
 
 
 
CardConnect (improve credit-card processing), and I.C.System, Inc. (collect what’s due)
 
Credit-card processing with CardConnect:  CardConnect (formerly Charge Card Systems) has created a powerful benefit program that goes beyond what other credit-card processors can offer. CardConnect has helped thousands of businesses stay informed and protected, while reducing their processing costs.
CardConnect offers benefits that will control your processing and protect your business.  You get wholesale pricing, a single point of contact, and educational tools to keep you up to date on credit-card processing - at a time when credit-card fraud is at an all-time high.  The savings will boost efficiency for your bottom line, and the CardConnect software will save you time and effort in your sales activity.  This program goes beyond what other credit-card processors can offer, by providing: 
  • Wholesale rates - NYCMS members typically see a 10 to 40 percent reduction in processing fees.
  • Point-to-point encryption - Sensitive payment data is instantly encrypted the moment a customer's card is swiped, meaning that it never hits or is stored within your system
  • Patented tokenization - Taking the protection of encryption one step further, tokenization replaces sensitive payment data with a unique identifier known as a token, which renders cardholder data unreadable and therefore useless to hackers.
  • Superior service - Each NYCMS member receives a single point of contact the moment he or she signs up. 
  • CardConnect now fully integrates with QuickBooks.
  • Additional benefits include:   Next Day Funding (including American Express) and VIP Service.  Any form of payment accepted (all major brands, mobile, ACH & electronic checks).
Give CardConnect the opportunity to provide you with a free, confidential line-by-line savings analysis – plus a cost comparison to your current situation!  We're confident you will be pleased with our ability to enhance your bottom line.  Call 212-684-4670 and ask for the CardConnect member benefit program.          
 
I.C. System, Inc., offers “Value-Added Benefits” for NYCMS members only! If you have a backlog of bad debt - no matter how large or small - or are having trouble with slow-paying, unresponsive insurance carriers, I.C. System, Inc., can help with effective and professional accounts receivable management services, tailored to your specific office needs.  NYCMS members:  Call the Society at 212-684-4670. 
  
 
Idilus can provide tax, payroll and other employer services – plus health insurance for many practices! 
 
Idilus, a Professional Employer Organization (PEO) and physician and hospital consulting company, can provide physician practices with tax, payroll and other human resources services – plus, for many practices, health insurance using a “name brand” national PPO network. 
Be aware that you must sign up for the basic services – at least the payroll processing.  And, the health insurance is underwritten, which means that not every practice will qualify.  But Idilus’s offerings are worth your consideration. 
NYCMS has entered into an exclusive contract with Idilus that allows our members to receive services at pre-negotiated discounts.  Please contact Matt Peterson at 877-545-5666 for more information about Idilus benefits.  
 
 
For your office:  Winston (staffing), Superior Office Systems (supplies and equipment for copying), AMP - a wonderful buying club (more supplies), Medelita (uniforms) – and Commercial Tenant Concierge (expert real-estate consultants).
 
Winston Support Services, LLC, for personnel you can trust:  Don’t put your office in a bind when you need permanent or temporary staff assistance. Winston Support Services, LLC, is JCAHO-certified, and you can be assured that all of its candidates are selected and pre-screened for proper licensure, background checks (criminal and educational), references, skills, and physicals - including PPDs and ten panel toxicology screens. These precautions save you a great deal of time and ensure professional screening results.
If you need someone in your office ASAP, AND you want to make sure that they are perfect for your position, AND you want a NYCMS discount, join and take advantage of your special member rates at Winston Support Services.  Winston has a dedicated hotline for Society members at (212) 687-4667.  Call today and have Ivy Kramer, MSW, CSW, from Winston, meet with you at your office and discuss the many ways Winston can meet your staffing needs efficiently and cost effectively. Call Winston at (212) 687-4667, or email Ivy at ikramer@winstonstaffing.com
 
Superior Office Systems:  Discounts on copying needs:  Superior Office Systems offers a 10 percent discount to members on all Canon products. NYCMS members:  Call the Society at 212-684-4670. 
 
AMP, a wonderful buying club:  Are you a member of AMP?  It’s the Society’s great buying-club benefit that lets you keep your favorite vendors and SAVE on all your office and medical supply needs, as well as other special features.  Update your office or home computer systems with computer equipment and software, available to AMP members and staff through on-line ordering with Insight.  Staff can make personal purchases and receive the same discounts offered to the practice. 
If you’re an AMP member, go right to the website and order at AMP website. Do you still need to sign up?  What are you waiting for?   Contact AMP at 855-267-8700, info@accessmedicalpurchasing.com.  Tell them you’re a New York County Medical Society member and SIGN UP.
 
Medelita offers discounts on designer lab coats and scrubs:  Our partnership with Medelita allows members to save on premium Medelita lab coats and scrubs at a special NYCMS rate. Members, if they wish, can have the NYCMS logo embroidered without any charge for artwork digitization.  Medelita scrubs and lab coats represent a shift from traditional lab coats, offering sophisticated style, performance, fabric and gender-specific sizing and style.  NYCMS members:  Call the Society at 212-684-4670. 
 
Real-estate expertise at your service:  Commercial Tenant Concierge helps healthcare tenants cost-effectively manage real-estate leases.  Experienced real-estate professionals are on call to solve problems related to landlord billing, building services, HVAC complaints, alterations, subleasing, key action dates, and other lease-related issues.  You can subscribe when and if you need the help of Commercial Tenant Concierge, when the time is right for you. If you need assistance with subleasing, verifying landlord bills, resolving billing discrepancies and more, Commercial Tenant Concierge will work for you. NYCMS members:  Call the Society at (212) 684-4670, for referral to Commercial Tenant Concierge.
 
 
Working Advantage (NYCMS members can get discounts for theater, etc.) – plus, American Safety Institute (10 percent discount on auto insurance).
 
Working Advantage means discounts on theaters, sports and more:  Get free access to an internet entertainment website. Save 40 percent on movie tickets and receive discounts on Broadway theater, theme parks, sporting events, seasonal ski tickets, and more.  NYCMS members:  Call (212) 684–4670.
 
10 percent discount from your auto insurer:  You can take the American Safety Institute’s 6 Hour Safe Driving Accident Prevention Program, at a member-only price of $26.00. This online course is approved by the NYS Division of Motor Vehicles, and you can save 10 percent on your New York State automobile liability and collision insurance premiums.  (If you live outside of New York State, check with your own insurance company regarding discounts.) 
Go to the Member Area section at nycms.org.  (Call the Society at 212-684–4670 if you need to know your Members Only sign-in and password.)