NYCMS Member Alert 6/26/16

Vol. 11, Issue 4

End of the legislative session - our score is good!  For bills we secured, click on Legislation addressing physicians’ e-prescribing issues passes both houses; Legislation for physicians to override insurers’ “Step Therapy” medication protocols passes legislature; and Legislative session produces Administrative Simplification bills.  
 
For bills we defeated, click on:  Legislation changing the Statute of Limitations does not pass; CVS Health’s Retail Clinic bill fails – again; Legislation for proactive discipline and fingerprinting of health professionals fails; and Scope of Practice and Allied Health Provider bills fail.
 
For the legislative package on the opioid epidemic, with aspects we approve of (though we still have some reservations), click on:   Legislation to address opioid abuse in NYS.
 
Our legislative successes occur thanks to YOU, the doctor who called, emailed, visited and wrote to New York State legislators.  When we put out a call to action, we count on our members to work on behalf of our profession, whether through MSSNYPAC contributions or through a quick response to legislative activity.  Thanks.  Your efforts mean everything.
 
NYCMS helps you - with classic benefits such as our invaluable parking assistance (click on To order your “Doctor on Medical Call” card), and with great new offerings such as HIPAA facts, a HIPAA hotline and a full compliance program from our endorsed vendor, HIPAA Secure Now!  (Click on Watch this space:  Exciting new items coming from HIPAA Secure Now!)  And here’s another excellent new member benefit:  Click on JPMorgan's NY 529 Advisor-Guided College Savings Program – Now available to NYCMS members through Vital Planning Group. 
 
Come to an interesting panel discussion about urgent care centers, other changes in the healthcare delivery system and changes in the way physician are paid.  NYCMS President Michael Goldstein, MD, is one of the speakers.  Click on Monday, June 27, 2016, 8:00 a.m. – 12:00 noon:  Crain's Health Care Summit: Disruption at the Doctor's Office.
MLMIC is a strong ally to us.  Click on Why MLMIC?
 
E-prescribing can be a burden – but in certain situations, you don’t have to e-prescribe.  Get details and more in our FREE new “members only” booklet.  Click on New NYCMS e-prescribing booklet.   And before you tackle the whole booklet, get a quick overview of the most important exceptions to the eRx mandate.  Click on:  The three statutory exceptions (technical, out of state and “impracticality of access/patient harm”) – You must report to the NYS DOH, and here’s an easy way to do it.  And, click on:  The “Dr. Zucker list” of additional exceptions (nursing homes, plus a few other very limited exceptions – no report needed).
 
Medicare and CMS’s various programs continue to benefit physicians, but also to challenge them.  Be aware of the July 1, 2016, deadline for applying for the EHR (“Meaningful Use”) Hardship Exception (click on The Meaningful Use Hardship Exception and the July 1, 2016, deadline).  Help your diabetic patients continue with Medicare’s mail-order program (click on Medicare’s national mail-order program for diabetes testing supplies).   Be alert to problems with Medicare Advantage Plans (click on Medicare Advantage Plans:  The uneasy partnership of commercial insurers with the government).  And don’t forget that there are Medicare requirements even for “opt-outs” (click on “Opt-Outs” who are Ordering/Referring Providers:  Your enrollment questions answered). 
 
 
NYCMS Reminds You:
 
To order your “Doctor on Medical Call” card
 
Send your check for $25.00, made 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 up 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
 
Monday, June 27, 2016, 8:00 a.m. – 12:00 noon:  Crain's Health Care Summit: Disruption at the Doctor's Office
 
Changes in the way doctors are paid and the settings in which patients receive care are forcing physicians to make hard choices about their careers—and their businesses.  In this Health Care Summit, “Disruption at the Doctor’s Office,” Crain’s will bring together doctors from practices large and small, as well as urgent-care providers, to examine how they are adapting to upheavals in health care and the implications for costs and quality.  The event will be held at the New York Athletic Club, 180 Central Park South, NYC.  NYCMS members are invited to attend at a special discount:  NYCMS members’ admission is $200 per person.  For details and registration, go to:  http://www.crainsnewyork.com/events-calendar/details/4/3403876Enter promo code "nycms" for discounted tickets.  For questions: Ashlee Schuppius, crainsevents@crainsnewyork.com , 212.210.0739. 
Panel Discussion: Surviving Health Care Reform:    A litany of state and federal reforms are changing the way private physicians get paid and radically reshaping the way they do business. Doctors are increasingly getting reimbursed based on the quality, not the quantity, of their treatments, while health systems and medical groups are snatching up solo practitioners who no longer want to jump through insurers’ hoops. Crain’s brings together panelists from all sides of the equation to share how to survive and thrive in this new environment.

Richard Morel, M.D., MMM, Medical Director & Vice President, WESTMED Medical Group
Sumir Sahgal, M.D., Chief Medical Officer, Founder, Essen Health Care
Adam Stracher, M.D., Director of the Primary Care Division of the Weill Cornell Physician Organization; Assistant Dean of Clinical Affairs and Associate Professor of Clinical Medicine

Panel Discussion: Urgent Care Upstarts:  Urgent-care centers are becoming as commonplace as banks or coffee shops. Drugstore walk-in clinics are providing easy access to flu shots and blood-pressure checks. Both offer short waits and extended office hours that are changing patients’ expectations for what to expect at the doctor’s office. Critics say the emergence of these clinics has fractured the doctor-patient relationship and driven up health care spending, even as urgent-care companies say they’d like to work with doctors, not compete against them. Crain’s brings the various stakeholders to the table to discuss how these new configurations are changing patients’ expectations and the economics of primary care.
Michael Goldstein, M.D., J.D., President, New York County Medical Society
Todd Latz, Chief Executive Officer, GoHealth Urgent Care
Richard Park, M.D., Chief Executive Officer, CityMD


 
 
The Legislative Horizon
 
Legislation addressing physicians’ e-prescribing issues passes both houses


MSSNY is pleased to report that both Houses of the Legislature have passed three bills which, if enacted into law, would address many e-prescribing concerns.  These measures will be sent to the Governor, and MSSNY and NYCMS will keep you apprised of the action taken.
            The first bill, S. 6779 (Hannon)/A.9335-B (Gottfried), would ease the onerous reporting burden on physicians every single time that they need to issue a paper prescription in lieu of e-prescribing.  The bill would provide a much better alternative – the prescriber would simply make a notation in the patient’s chart that he/she had invoked one of the three statutory exceptions!
The second bill, A.9837 (Gottfried)/S. 7334 (Hannon), would let e-prescriptions be transmitted to a secure centralized site, from which the pharmacy could download them when the patient came to the pharmacy. The patient would be under less pressure to decide during the office visit which pharmacy he or she would use; he or she could shop around, and change his/her mind for any reason.  Also helpful:  On the patient’s request, the prescriber would print out a paper copy of the prescription.  The paper copy would make it easier for the pharmacy, and would be useful for the patient as a reminder.
The third bill, A.10448 (Schimel)/S. 7537 (Martins), would authorize a pharmacy that did not have a particular medication in stock to transfer the prescription to another pharmacy. (Currently, e-prescriptions cannot be transferred by one pharmacy to another; the patient has to return to or call the prescriber’s office to ask that he/she transmit the e-prescription to another pharmacy – so that the patient is needlessly burdened, and timely access to the medication is delayed.)
 
Legislation for physicians to override insurers’ “Step Therapy” medication protocols passes legislature

Both houses have passed legislation (A.2834-D, Titone/S.3419-C, Young) permitting physicians to request and be granted an override of an insurer’s step therapy medication protocol when doing so is in the best interest of their patients’ health.  The bill must be approved by the Governor for it to become law.
An insurer would be required to grant a physician’s override request if one or more of the following was present: (1) the drug required by the insurer is contraindicated or could likely cause an adverse reaction; (2) the drug required by the insurer is likely to be ineffective based upon the patient’s clinical history; (3) the patient has already tried the required medication, and it was not effective or caused an adverse reaction; (4) the patient is stable on the medication requested by the physician; and/or, (5) the medication is not in the best interests of the patient’s health.
The insurer would have to decide within 3 days of the override request, and furthermore, would be required to grant the request within 24 hours if the patient had a medical condition that would seriously jeopardize his/her health if he/she did not receive the requested medication.  If the physician’s override request for an override were denied, he/she could formally appeal the decision via the plan’s appeal mechanism and via an external appeal.


Legislative session produces Administrative Simplification bills


The Assembly and Senate passed legislation (A.501-E, Cusick/S.2545-D, Lanza) reducing from 90 to 60 days the time in which a health insurer would be required to finish reviewing a physician’s application to participate in the insurer’s network, and also reducing from 90 to 60 days the time in which a physician, in some situations, could become “provisionally credentialed” if the plan did not finish its review.  The bill would also eliminate current ambiguous statutory language that lets an insurer delay the decision after these deadlines have passed.  
            The Assembly and Senate also passed legislation (A.6983-A, McDonald/S.4721-A, Hannon) directing the NYS Department of Health and the NYS Department of Financial Services to work for greater uniformity in the standards that insurers use when physicians ask them to cover patients’ needed prescription medications.
            Both bills must be signed by the Governor to become law. 
 
 
Legislation changing the Statute of Limitations does not pass
 
The State Legislature left Albany without taking action on legislation (A.285-A and A.10719-A/S.6596-B) that would have substantially lengthened New York’s medical liability statute of limitations.  MSSNY and NYCMS thank the many physicians who warned legislators that this bill could jeopardize patients’ access to care - unless tort reforms were also enacted to offset the huge premium increase that was threatened.   This summer and fall, MSSNY will continue to talk with legislators about the need for comprehensive changes in our dysfunctional medical liability adjudication system.


CVS Health’s Retail Clinic bill fails - again

CVS Health, which operates the retail-based health clinic subsidiary MinuteClinic (as well as CVS Pharmacies, plus a pharmacy-benefit manager, mail-order pharmacies and specialty pharmacies), tried to secure passage of legislation (S. 5458, Hannon, and the very similar A. 1411, Paulin) permitting corporate-owned retail clinics to be set up statewide without the establishment of public need (something the current law’s “certificate of need” provisions normally require).
            Previously, MSSNY had succeeded against the retail-clinic proposal in the executive budget, but in May the Senate passed a similar proposal (S. 5458, Hannon).  This past week, the Assembly considered a similar bill, but it failed to garner the necessary votes.
            In states outside of New York, convenience-care clinics, or “retail clinics,” operate in big-box stores such as Walmart and also in CVS retail pharmacies. The clinics are a growing phenomenon across the nation; they are particularly popular with affluent young adults who live within a one-mile radius of the clinic.  Usually staffed by nurse practitioners, the clinics provide episodic treatment for such uncomplicated illnesses as sore throat, skin infections, bladder infections and flu.  Physicians feel strongly that these clinics threaten the quality of patient care, and that they threaten physician practices’ ability to survive financially.  The clinics should not be allowed to proliferate in New York.                                                      
            Another significant concern is the potential conflict of interest posed by pharmacy chains’ ownership of retail clinics.  In these settings, there are implicit incentives for the nurse practitioner or physician’s assistant to write more prescriptions or recommend greater use of over-the-counter products than would otherwise occur.  And meanwhile, the self-referral prohibitions and anti-kickback protections that apply to physicians are not applicable to retail clinics; the result could be significant additional costs to the healthcare system.
 
 
Legislation for proactive discipline and fingerprinting of health professionals fails

The end of the session saw the defeat of well-intended legislation (S.7791, LaValle and A.10532, Glick) addressing alleged lax disciplinary procedures by the New York State Education Department’s Office of Professions.  (That Office normally disciplines all licensed health professionals except physicians, physician assistants and specialist assistants.)  In the bill’s initial version, it would have required the State Education Department to do initial fingerprinting and background checks on all newly licensed health professionals, including physicians.  Those provisions were discarded; other provisions, however, were retained, including a summary suspension process and a requirement that disciplinary action be taken in NYS if similar action had been taken in another state. Those provisions would have applied to all health professions - including physicians, physicians’ assistants and specialist assistants, even though they are already subject to such processes under OPMC.
            At MSSNY’s request, the Senate amended its bill to remove the applicability to physicians; the bill was then passed by the Senate. The Assembly, however, did not make those amendments and did not advance the bill. It is anticipated that the bill will be re-introduced next year.
 
Scope of Practice and Allied Health Provider bills fail


By the end of the legislative session, MSSNY, our physicians, and specialty societies had succeeded in defeating numerous scope of practice and allied health provider bills.  The majority of this legislation is likely to return next year.  Since the two-year session cycle ends this year, any bill being re-introduced next year will be assigned a new bill number and will be assigned to its committee of origin.
            Our combined efforts helped to ensure that the following bills will not become law this year:
  • Athletic Trainers Scope Bill – A.1266 (Lavine)/S.4499 (Funke) would have established licensure requirements and expanded the scope of practice for athletic trainers to include the ability to examine, evaluate, assess, manage, treat and rehabilitate neuromusculoskeletal injuries, including concussions and spinal-cord injuries. This bill passed the Senate, but died in the Assembly Higher Education Committee.
  • Podiatry Scope Bill – A.719 (Pretlow)/S.6990 (Amedore) would have permitted a podiatrist to care for any wound up to the knee that was “related to” a condition of the foot or ankle, and would have removed the requirement that a podiatrist be “directly supervised” by an advanced NYS-licensed podiatrist or physician.  This bill remains in the Higher Education Committees in the Assembly and Senate.
  • Two Corporate Practice bills would have allowed non-physician providers to form Limited Liability Partnerships with physicians:
    • 8153 (Peoples-Stokes)/S.5862 (Lavalle) would have permitted non-physician Title Eight licensed health professionals to form limited liability companies with physicians. This bill remains in the Assembly Higher Education Committee and the Senate Corporations, Authorities, and Commissions Committee.
    • 4391 (O’Donnell)/S.215 (Martins) would have permitted doctors of chiropractic to form limited liability companies with physicians. This bill remains in the Assembly Higher Education Committee and the Senate Corporations, Authorities, and Commissions Committee.
  • Nurse Anesthetist “Title Bills” – A.140 (Paulin)/S.7166 (Gallivan), 3835 (Morelle)/S.35 (DeFrancisco), and A.3941 (Gottfried)/S.2048 (Hassell-Thompson) would have provided for the certification by the NYSED of certified registered nurse anesthetists (CRNAs), and would have further supported the CRNAs’ efforts to apply to CMS for a waiver of  the physician supervision requirement. With the exception of A.140, which advanced to third reading in the Assembly, the various bills remain in their respective houses’ Higher Education Committees.
  • Nurse Anesthetist Reimbursement Bill – A.7722 (Cahill)/S.2955 (Ritchie) would have authorized health-insurance reimbursement for certified nurse anesthetists providing anesthesia services, and would have further supported the CRNAs’ efforts to apply to CMS for a waiver of the physician supervision requirement. The bill remains in both the Senate and Assembly Insurance Committees.
  • Optometry Prescribe bill – A.9961 (Paulin)/S.7440 (Funke) would have allowed optometrists to prescribe certain oral prescriptions.   Because negotiations produced an agreement between the New York State Ophthalmological Society (NYSOS) and the New York State Optometric Association (NYSOA), MSSNY took no position on this legislation. While the bill passed the Senate, it did not pass the Assembly.
 
Legislation to address opioid abuse in NYS


Three measures were approved by the legislature to comprehensively address the opioid epidemic in NYS.  While MSSNY expressed strong concerns regarding some aspects of these proposals, we were able to secure modifications that protect clinical discretion and take into account the fact that every physician practice is unique – and every patient’s needs are unique, too.  In addition, the measures place new requirements on insurers to provide coverage for needed treatment, and on hospitals and pharmacists to disseminate information.
 
CME Mandate:  The legislation requires prescribers who are authorized to prescribe opioids by the U.S. Drug Enforcement Administration, and every prescribing resident under a facility registration, to complete three hours of course work on pain management, palliative care, and addiction - by July 1, 2017, and every three years thereafter.  While MSSNY was not able to secure a one-time course or sunset, we were able to assure that the course can be completed online.  We also secured an exemption process for those who have already taken an equivalent course, and for those to whose practice the course work would not be applicable.  Specifically, the legislation:
 
  • Recognizes that the course must be approved by the Commissioner of Health, who shall establish standards and review and approve course work.  This year, MSSNY (with the NYS Office of Alcoholism and Substance Abuse Services (OASAS), the nurse practitioners’ association and the physician assistants’ association), developed and offered a course – already available through MSSNY’s website (mssny.org) – which MSSNY will seek to have approved, to assure that MSSNY members may comply with the July 1, 2017, deadline.
 
  • Establishes that the course work may be taken online.
 
  • Requires that, upon completion of the course, the person completing it must document by attestation on a form prescribed by the Commissioner that he/she has completed the course; and
 
  • Requires the Department of Health to allow an exception process for anyone who can demonstrate to the Department’s satisfaction (1) that there would be no need to complete the course; or (2) that he/she has completed course work that the Department deems equivalent to the course work approved by the Department. 
 
Opioids Limits:  For patients with acute pain, the legislation would establish a 7-day supply limit for the prescription of any schedule II, III, or IV opioid, upon initial consultation or treatment of the pain. The bill does have some flexibility:  MSSNY advocacy assured that the prescriber, upon any subsequent consultations, would have options with regard to providing appropriate renewals or refills, or issuing a new prescription beyond the initial period.  Also important:  It is intended that the term “consultation” not require an in-person examination.  “Consultation” can include a phone conversation between the prescriber and the patient at the conclusion of the initial 7-day supply. 
            Specifically, the legislation provides that upon any subsequent consultation for the same pain, the prescriber would be permitted to issue up to a 30-day supply - by appropriate renewal or refill, or by a new prescription for the opioid or any other drug. In addition, the legislation:
 
  • Defines “acute pain” to mean pain, whether resulting from disease, accidental or intentional trauma or other cause, that the practitioner reasonably expects to last only a short period of time. “Acute pain” shall not include chronic pain; pain being treated as part of cancer care or as part of hospice or other end-of-life care; or pain being treated as part of palliative-care practices.
 
And, the legislation: 
 
  • Limits the application of co-pays for the limited initial prescription of an opioid, to either (1) an amount that is proportionate to the difference between the co-payment for a 30-day supply and the co-payment for the amount of drugs the patient has been prescribed, or (2) the equivalent of the co-pay for the full 30-day supply, provided that no additional co-pays may be charged for any additional prescriptions for the remainder of the 30-day supply. 
 
Insurance Coverage for Substance Abuse Treatment:  The legislation requires insurers to provide coverage that they currently do not provide for substance abuse and treatment services. Generally speaking MSSNY policies support timely access to medical care and treatment, and these provisions are consistent with that approach.  Specifically, the legislation includes provisions to:
 
  • Require insurers to (1) provide insurance coverage, without prior authorization, for inpatient services for the diagnosis and treatment of a substance-use disorder as long as needed; and (2) only conduct a utilization review, including retrospective review, commencing on or after the fifteenth day;
 
  • Require insurers to use an objective diagnostic tool that has been approved by the New York State Office of Alcoholism and Substance Abuse Services (OASAS), and that is consistent with the treatment service levels within the OASAS system (the legislation gives insurers until December 31, 2016, to ensure that their review tools comply with the OASAS standards);
 
 
  • Require insurers to provide at least five days of coverage, without prior authorization, for medications necessary for the treatment of a substance-use disorder;
 
  • Eliminate prior authorization under Medicaid, and by commercial carriers, for access to buprenorphine or injectable naltrexone;
 
  • Require insurers to provide coverage for the prescription of opioid antagonists to any person (e.g. parent, guardian, sibling) under the same policy as the treated addicted individual; and
 
  • Extend the period in which individuals may be held at treatment facilities for drug treatment, from 48 to 72 hours. During that time, the patient must be reevaluated regularly.  In addition, upon patients’ discharge from the facility, they must be given a discharge plan to ensure a continuum of care, including information on how to access additional treatment services. 
 
Information to Patients:   Patients need to know about the risks associated with controlled substances, and about addiction services that are available in their community. MSSNY succeeded in eliminating a proposal requiring a prescriber to provide consultation regarding the addictive nature of opioids, and also a proposed requirement that the patient sign a form attesting that he/she had received this counseling from the prescriber. Specifically, the bill would:
 
  • Require the Commissioner of the Office of Alcoholism and Substance Abuse Services (OASAS) to create educational materials that a pharmacist would disseminate to a consumer, at the time the consumer received his/her controlled substances prescription, concerning the risks of using controlled substances and the warning signs of addiction, and providing contact numbers for New York State’s HOPEline; and
 
  • Require hospitals to develop protocols for substance-use disorder patients, including informational materials to be distributed to patients upon their discharge and procedures for the identification, assessment, and referral of individuals with a substance-use disorder.
 
 
Why MLMIC? 
 
For over 40 years, Medical Liability Mutual Insurance Company (MLMIC) has put policyholders’ interests first.  MLMIC’s mission has always been to provide the highest quality liability insurance at the lowest possible cost, consistent with long-term viability. MLMIC charges premiums that are specialty- and territory-specific, without a profit motive or high operating expenses.
  • When MLMIC’s financial results turn out better than expected, the company declares dividends to share the favorable results with its policyholder owners.
  • To help insureds avoid claims, MLMIC develops effective risk management programs that provide CME credits plus a 5 percent premium discount, and also enable insureds to qualify for free excess insurance funded by New York State.  
  • If a MLMIC policyholder gets a claim, the company vigorously defends the standard of care, closing the vast majority of cases without a loss payment.
          
Today, MLMIC is the leading medical and dental liability insurer in New York State, insuring approximately 15,000 physicians, 5,000 mid-level and allied health practitioners,
4,000 dentists and 40 hospitals. MLMIC remains a mutual insurer owned by its policyholders.
 
For more information, visit MLMIC.com or call (800) ASK-MLMIC.
 
 
 
The Practice Environment:  The E-Prescribing Mandate
 
New NYCMS e-prescribing booklet 
 
NYCMS is delighted to announce its new, FREE members-only information booklet, "New York State's E-Prescribing Law:  Major Rules and Practical Information."  In this booklet – with updates on our December 2015 booklet, plus many new items and tips – we answer many e-prescribing questions you’ve wondered about but have been too annoyed to ask:   
·        Do I have to e-prescribe all the time?  When can I issue a paper/fax/phone prescription? 
·        I've heard that if I issue a paper/fax/phone prescription, I'm required to e-mail the NYS Department of Health (DOH).  What's the least aggravating, least time-consuming way to do it?  
·        What if the pharmacy refuses to fill the prescription if I don't e-prescribe? 
·        What if my patient is old and frail and can't give me the information about her pharmacy right that minute? 
·        I prescribe very rarely, due to the nature of my practice.  Can I get out of the e-prescribing requirement?  How? 
·        I'm retired, and mainly prescribe for my family.  Can I get out of the requirement?  How?
·        I've heard that all controlled substance prescriptions must be e-prescribed.  Is that true? 
·        I've heard I can always phone in a prescription for a controlled substance as long as it's for a 5-days-or-less supply.  Is that true? 
·        Can my staff do the e-prescribing for me?
And many other questions that may have occurred to you…about mail-order pharmacies, faxes and a range of other topics.  
 
The booklet, based on MSSNY information and the April, 2016, Frequently Asked Questions document posted by the New York State Bureau of Narcotic Enforcement (BNE), is full of "how-tos."  We tell you how to go about researching e-prescribing systems; how to register your controlled-substances e-prescribing system with the BNE; how to create a template to make exception reporting less time-consuming; how to apply for the one-year general waiver; how to obtain the certification for physicians who issue 25 (or fewer) prescriptions per year; how to fax a prescription the proper way - and much more. 
            If you haven’t done so already, get the new booklet!  We recommend that you use the e-mail format since it includes important e-links you will need, but we can also send you the booklet via US Mail if you wish.   Just call Susan Tucker at 212-684-4681 or e-mail stucker@nycms.org.   Be sure to let us know the physician's name, e-mail address, US mail address and phone number - thanks.  
 
 
 
The three statutory exceptions (technical, out of state and “impracticality of access/patient harm”) – You must report to the NYS DOH, and here’s an easy way to do it
 
As long as you send an e-mail report to the NYS DOH at erx@health.ny.gov, you have the option of not e-prescribing in the following three circumstances:  
  1. If you are experiencing a temporary technological or electronic failure; or
  2. If the prescription is to be filled out of state (including mail-order houses located out of state); or
  3. “Impracticality of access/patient harm”:  If the situation is one where you reasonably determine that it would be impractical for you to issue an e-prescription “in a timely manner” AND the delay could adversely affect the patient’s medical condition (note:  for a controlled substance, only a 5-day supply is permitted.)  Examples:  It is the middle of the night and you cannot quickly get to your e-prescribing system.  Or:  The patient speaks limited English or is a frail elderly person, so that it is difficult to identify the pharmacy to which the e-prescription would be sent. 
The timing of your report:  For the above three major exceptions, you are required to send an e-mail report to erx@health.ny.gov within the following time frames:   
For technological or electronic failure, you must report within 72 hours. 
For the out-of-state exception, you must report within 48 hours. 
For the “impracticality of access/patient harm” exception, you must report within 48 hours.   
 
The contents of the report:  You need not include information about the medication, dose, etc., or the number that appears on the paper prescription.  But you should include:  Physician’s name, license number, phone number, work addresses (e-mail and US mail) – and THE PATIENT’S INITIALS (only). 
 
An easy way to prepare:  Start with the BNE’S template:  We recommend that you create an e-mail template for informing the DOH that you have issued a paper/fax/oral prescription.  You can prepare most of your message in advance by using the language shown below, which has been approved by the NYS Bureau of Narcotic Enforcement (BNE).  In advance, you fill in your own practice data (physician’s name, etc.).  Then, when the time comes for a specific prescription, you complete the message by filling in the patient’s initials and choosing the appropriate exception.  Finally, you send the completed message to erx@health.ny.gov.
 
Template for informing the Department of Health
concerning the issuance of a paper/fax/oral prescription
 
Send completed document to: erx@health.ny.gov
 
Reason for issuing paper/fax/oral prescription [Note to the physician and staff:  When it’s time to issue a specific prescription, check the appropriate box]:
 
ð        Temporary technological or electrical failure  [PHL § 281 (3)(b)]
 
ð        Prescription to be dispensed by a pharmacy located outside NYS [PHL § 281 (3)(e)]
 
ð        Physician reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner and such delay would adversely impact the patient’s medical condition [ PHL §281(3)(d)].    (If prescription issued for this reason is for a controlled substance, the quantity may not exceed a five day supply.)
 
Patient’s initials:  [Note to the physician and staff:  You should fill in the patient’s initials when it’s time to issue a specific prescription]:
 
Physician’s name: [Note to the physician and staff:  You can fill in this item, and the following information, in advance]:
 
Physician’s license number:
 
Office Phone number:
 
Office Address:
 
Office e-mail address:
  
 
 
The “Dr. Zucker list” of additional exceptions (nursing homes, plus a few other very limited exceptions – no report needed)
 
In a March 16, 2016, letter to practitioners and pharmacists, NYS Health Commissioner Howard Zucker, MD, issued a list of special circumstances that constitute exceptions to the e-prescribing mandate, in addition to the three statutory exceptions that we have discussed above (technical, out of state, and “impracticality of access/patient harm”).  (Confusingly, Dr. Zucker calls his list a “blanket waiver,” but it is not like the one-year general waiver and it does not exactly “blanket” all situations.)
            For the exceptions on Dr. Zucker’s list, you are not required to report to the Department of Health that you have issued a paper, fax or phone prescription. 
            Dr. Zucker’s list includes exceptions for practitioners prescribing in nursing homes.  It also includes exceptions that are necessary because of the limitations of today’s software:
 
There is an exception if the prescription is for an opioid antagonist that allows a non-patient-specific prescription;
 
There is an exception if the prescription is for a controlled or non-controlled substance –
  
  • That contains two or more products, which is compounded by a pharmacist; or
  • That is to be compounded for direct administration by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion; or
  • That contains long or complicated directions; or
  • That requires a prescription to contain certain FDA-required elements that cannot be accomplished with electronic prescribing; or
  • That is under expedited partner therapy, collaborative drug management, or in response to a public health emergency that would allow a non-patient-specific prescription; or
  • That is under a research protocol
Dr. Zucker's letter also contains four exceptions that apply to pharmacies. 
           
Questions that remain:  What are "long and complicated directions"? How would you know if a prescription involved non-e-prescribable elements required by the FDA?  What are other specifics?  We'll keep searching for more information and keep you posted. 
           
To see the full text of Dr. Zucker’s letter, click on: 
https://www.health.ny.gov/professionals/narcotic/electronic_prescribing/docs/2016-03-16_blanket_waiver_letter.pdf
 
 
Medicare Issues
 
Medicare Advantage Plans:  The uneasy partnership of commercial insurers with the government
 
Records requests from United Healthcare Medicare Solutions:  Members have reported receiving multiple computer-generated requests for the medical records of their United Healthcare (UHC) Medicare Solutions patients.  These requests state that payment is being withheld pending review of these records.  In essence, the physician is being subjected to a prepayment review!  But, interestingly enough, these requests have been received by multiple specialties.  So, it appears that no one group of physicians is being targeted.
Calls to the UHC Customer Service Representatives have been met with vague answers as to why these letters are being generated and sent.  However, the letters have been going out in such a large volume, and to so many different types of practices, that a contact with UHC senior staff has been needed to determine exactly what had prompted this activity.  The UHC senior staff were asked what had generated these letters and for what purpose - and what steps physicians can take to have themselves removed from what, essentially, seems to be a formal “prepayment audit” status.  Unfortunately, UHC did not provide a formal response. 
            So, next, a contact with CMS was initiated. (Why CMS got involved at this point:  UHC’s “Medicare Solutions” plans are in the overall Medicare Advantage category, and Medicare Advantage plans must adhere to the same prepayment-review process as FFS Medicare contractors – they must notify the physician in advance, provide detailed information on what prompted the review, and outline plans for corrective action if necessary.)  CMS is in contact with UHC and the affected physicians, and a number of those physicians have been removed from prepayment review. 
            We are still awaiting a global response, and waiting to hear about any potential remedial action.  We’ll keep you posted.
 
Termination by the VSNY Choice Health Plan:  Letters to your patients and to legislators: 
The Visiting Nurse Service’s VSNY Choice Health Plan, a Medicare Advantage/HIV Special Needs plan, has recently terminated some physicians – narrowing their network as so many other plans have done.  They are, at least, allowing for an appeal process (as they must per regulations).  The appeal may be a formality, but if you can show that your patients may possibly be harmed if their care is interrupted, it may be worth your while to appeal.  Meanwhile, you may want to send the following letters to your patients and to legislators (modify this letter to fit your own practice): 
 
To my VNSNY Choice Patients:
If you or your family members are participating in the Visiting Nurse Service of New York Choice Health Plan (VNSNY Choice), you may have recently seen a letter or, you may have heard that I will no longer be part of that plan’s network. We want to make it clear that the decision to remove me was made by the insurer, not by my office.  Unfortunately, the insurer is removing a number of physicians as well. I am appealing the insurer’s decision, but we do not know if the appeal will be granted.
I take very seriously the issue of access to care for my patients and everyone in the community, and I will still be able to care for you, if you choose another Medicare option.  You do have the option of choosing to enroll in _______________Plan, another plan in which I participate. You can visit www.medicare.gov or call 800-MEDICARE for more information.
You also have the option of switching to “Traditional Medicare”; I will be able to see you within that system.  Once again, you can visit www.medicare.gov or call 800-MEDICARE for more information.  Bear in mind that Medicare patients are not eligible to purchase insurance through the NYS Health Exchange.
In addition, if you were to switch to Traditional Medicare, you may also need to purchase a Medigap/Supplemental to Medicare plan (unless you happen to have retiree coverage through a former employer), plus a Medicare Part D product for your prescription drugs. If you do not take those two steps, your out-of-pocket expenses could increase significantly.
 If you are upset with VNSNY Choice’s decision to drop me from its network, you can call the New York State Department of Financial Services at 1-800-342-3736 to file a complaint, or file a complaint using the information below. Government officials are required to assure that VNSNY Choice offers you a comprehensive network of physicians and hospitals to assure you receive the care you need.
 
 
Template letter to a legislator: 
 
Dear Senator/Congressman ___________:
 
This letter is to alert you to a pattern that is becoming widespread here in New York State that could have a huge impact upon our patients’ continued access to needed care.  As you are aware, many plans are “deselecting” many individual physicians from Medicare Advantage plans by terminating their contracts. I write you today about a termination letter this office has received from Visiting Nurse Service of New York Choice Plan (VNSNY Choice).
 
Elderly, frail and sick patients are losing longstanding relationships with their physicians. This is happening not just where the physician has a small number of patients in the plan, but also where the physician has literally hundreds of patients in the plan. And it’s happening even where the physician performs special procedures that aren’t done by many other physicians, or is part of a special, necessary program in the geographic area.
 
Plans cite various reasons for their decisions like “federal and state initiatives” but we have serious concerns about the adequacy of the networks that result, and about the threat to New York citizens’ access to quality care. This problem must be investigated further.
 
 
The Meaningful Use Hardship Exception and the July 1, 2016, deadline
 
The deadline for CMS’s 2015 Meaningful Use hardship exception is July 1, 2016.  Some of us are confused!  Here’s a little background: 
 
What do they mean by the “Hardship Exception deadline”?  If you didn’t meet the 2015 Meaningful Use requirements – for one of the reasons that CMS considers “hardships,” described below – you need to claim that hardship so you won’t get penalized (by 3 percent) in 2017.  The deadline for submitting your application to claim the hardship is July 1, 2016.  CMS has indicated that it will be liberal in granting hardship exceptions!
 
What do they mean by “hardship for 2015”?   It could be one of a number of legitimate circumstances.  For example, perhaps you switched EMRs in 2015.  Or perhaps you had system or vendor problems that kept you from meeting the requirements; for example, perhaps you couldn’t meet the Patient Engagement requirement because your system didn’t have a patient portal.    
            And/or:  Perhaps your EMR could perform all the functions, but your environment wasn’t ready.  Examples: 
  • You were ready to report to your local public health department, but they weren’t ready to take your reports.
  • You were ready for a patient to receive a secure electronic message (or send one to you), but no patient was ready for that process. 
And/or:  Perhaps:  There were certain requirements that you couldn’t meet during the first nine months of 2015 because the requirements were just too difficult.  Finally, in October, 2015, CMS eased up on those requirements.  You were then able to meet the less-tough requirements in October, November and December, 2015. 
 
What type of hardship should you claim?  You should claim hardship exception category number 2.2.d (“extreme, uncontrollable circumstance”).   This category addresses system problems, and also CMS’s delay in finalizing certain rules till October, 2015. 
 
Where can you get the application and where should you send it?  Instructions are at:  https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/HardshipInstructions.pdf  
 
The application itself is at:  https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/HardshipApplication.pdf            
 
What if you’re not sure if you met the 2015 requirements – although you think you did?  It’s a good idea to apply for the hardship exception anyway.  If it turns out that you didn’t meet the requirements, the hardship exception will cover you so you won’t be penalized.  On the other hand, if you did meet the requirements, your attestation is still valid and you will still be eligible for incentive payments. 
 
What about participating in the EHR program this year (2016)?  You must comply with specific Measures that are included in certain overall Objectives (see links below).   If you’re just starting out now, your reporting period is any continuous 90-day period in 2016.  If you were already in the program last year (2015), your reporting period is the entire year (January 1, 2016, through December 31, 2016).  You must also attest (make a signed statement) that your EMR meets and is capable of performing the Meaningful Use Objectives, and that you are or have been using the EMR for the requisite amount of time.   
 
An overview is at:   https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2016ProgramRequirements.html
 
The Objectives with their component Measures are at:  https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_ObjectiveMeasuresTable-.pdf
 
If you’re just starting out, note that for certain Measures, you may be permitted to meet alternative requirements that may be easier. 
 
 
Medicare’s national mail-order program for diabetes testing supplies
 
If you have diabetic patients enrolled in Original Medicare who want their testing supplies delivered to their homes, you should know that Medicare is continuing its National Mail-Order Program. This program, which includes all parts of the U.S., is designed to help beneficiaries get quality supplies while also saving money.  The Medicare beneficiaries are required to use a national mail-order supplier that has a contract with Medicare.  For the latest information, go to:        
https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/NationalMailOrderPartnerArticleJune2016.pdf
 
 
“Opt Outs” who are Ordering/Referring Providers:  Your questions answered
 
Now available:  Medicare’s fact sheet, “The Medicare Enrollment Guidelines for Ordering/Referring Providers.”  Learn about the three basic requirements for ordering and referring, and how to enroll in Medicare as an ordering/referring provider.  Go to:  
 
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/CMS1247538.html?DLPage=1&DLEntries=10&DLFilter=ordering&DLSort=0&DLSortDir=ascending


Full-length articles:  Member benefits and educational opportunities
 
 
DOH announces updates to Medical Marijuana course

Practitioners who wish to register with the NYS Department of Health and certify their patients for the Medical Marijuana Program are required to complete the four-hour department-approved online course on the medical use of marijuana developed by TheAnswerPage, an established online medical education provider.  The DOH has now announced updates to this course, with additional information on the use of medical marijuana in each of the conditions covered in the Compassionate Care Act (based on available scientific evidence). 
            The cost to take the course is $249. Practitioners taking the course will earn 4.5 hours of CME credit upon successful completion of the course.  The new material is also accessible through TheAnswerPage’s website, at no extra cost, for those who have already taken the course (before these updates were released).     
            The course may be accessed here.  For further information, visit the department’s web page for more information about becoming a registered practitioner. 


 
MSSNY announces Zika podcast with DOH; physicians can listen now


MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response has conducted an audio podcast with Dr. William Valenti and Dr. Elizabeth Dufort to discuss the Zika Virus.  The podcast discusses the epidemiology of Zika virus.  It also provides information on disease transmittal, diagnosis and the measures that the New York State Department of Health has taken to guide and protect all New Yorkers.  Listen to this timely and important podcast here.
Panelists:  William Valenti, MD, Chair, MSSNY Infectious Disease Committee;
Elizabeth Dufort, MD, F.A.A.C.P., Medical Director, Division of Epidemiology, New York State Department of Health.
 
 
View Zika webinar; program now archived on MSSNY’s CME site


The Medical Matters program “Zika Virus—An Evolving Story” is now archived to the MSSNY CME website; physicians and other health care providers can view it free of charge by logging into http://cme.mssny.org.  The webinar, conducted by MSSNY and the New York State Department of Health, featured Dr. William Valenti, chair of MSSNY’s Infectious Disease Committee and member of the MSSNY’s Emergency Preparedness and Disaster/Terrorism Response Committee, and Dr. Elizabeth Dufort, medical director, Division of Epidemiology from the New York State Department of Health.
            The MSSNY CME site requires new users to register, but once physicians and other healthcare providers have registered, they will have a personalized training page to take them to this webinar and other course work located on the site.   New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.   Click on the tool bar menu located at the top of the page and click on “My training” to view and take the various courses. 
            MSSNY has over 50 programs at this site; physicians are able to earn continuing medical education credits for each course. The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.


 
 
Free webcast:  Diagnosing TBI in your office


Hospital data reveal that in New York State, over 550 persons per day sustain a brain injury caused by stroke, traumatic brain injury (TBI) or other factor(s).  Even a “mild” brain injury can result in lifelong disability, especially if proper treatment is not received.
            To promote recognition and treatment of brain injury, SUNY Albany’s School of Public Health has produced a webcast for practitioners, “Recognizing and Treating Mild Brain Injury,” featuring a one-page, evidence-based TBI diagnostic tool.  This webcast is available free of charge from the CDC website.  You can log on to the training at:  http://www.albany.edu/sph/cphce/phl_0415.shtml
 
 
Information on the opioid epidemic and how you can help your patients
“With 44 Rx Opioid Related Deaths A Day, What Can One Physician Do?”  The Medical Society of the State of New York announces that its website has resources, tools, best practices, and voluntary education programs to help physicians to better understand the opioid epidemic.  The Medical Society is one of eight state societies that is part of the AMA’s Task Force to Reduce Opioid Abuse.   Established in 2014, this task force believes that physicians have a professional obligation to reverse the nation’s opioid epidemic. The task force has embraced five concepts for implementation throughout the nation:
  • Increase physicians’ registration and use of effective PMPs
  • Enhance physicians’ education on effective, evidence-based prescribing
  • Reduce the stigma of pain and promote comprehensive assessment and treatment
  • Reduce the stigma of substance use disorder and enhance access to treatment
  • Expand access to naloxone in the community and through co-prescribing
MSSNY recognizes the severity of this public health epidemic and is committed to implementing solutions to combat it.  In New York, we have already reduced the incidence of doctor shopping by 86% because physicians are checking the Prescription Monitoring Program prior to prescribing a controlled substance. MSSNY also supported legislation to increase access to naloxone to reduce deaths from overdose.  MSSNY also supports efforts increase voluntary education and training for physicians on safe prescribing practices.             
 
According to IMS data, New York has seen substantial decreases in the number of prescriptions written for oxycodone, hydrocodone and other controlled substances. New York’s utilization rate for these medications is below other states that currently require prescriber education of opioid medications.
 
But there’s more to do. The MSSNY website provides information on best practices that physicians may find helpful when considering a controlled substance and common recommendations found in opioid prescribing guidelines, including tools such as opioid calculators. Additionally, there are free continuing medical education programs through the PCSS-O and prevention and other information for your patients.  To learn more, click here.
MSSNY representatives to the AMA Task Force to Reduce Opioid Abuse are MSSNY Councilor, Frank Dowling, MD and Pat Clancy, MSSNY Vice President for Public Health and Education. Further information can be obtained by contacting Pat Clancy at pclancy@mssny.org.
 
 
CME:  MSSNY’s Opioid Webinar Series
 
The Medical Society of New York has archived its opioid webinar series on its continuing medical education website athttp://cme.mssny.org.  The course was developed by MSSNY, the NYS Office of Alcoholism and Substance Abuse Services (OASAS) and the New York State Department of Health’s Bureau of Narcotic Enforcement.  The webinars are:
  • Webinar 1 Pain Management at the Crossroads: A Tale of Two Public Health Problems
  • Webinar 2 Rational Opioid Prescribing: Is this Possible for Chronic Pain?
  • Webinar 3 Treatment of Opioid Use Disorders and Webinar For Pain Patients w/Substance Use Disorders.
  • Webinar 4 Pain Patients w/Substance Use Disorders
The MSSNY CME site requires new users to register, but once registered physicians and other health care providers will have a personalized training page to take the webinars and other course work located on the site.  New registrants to the site will create a username and password, which should be retained and be used for continued access to the site. Once registered and logged into the site, physicians will be taken to an instruction page.  Click on the tool bar menu located at the top right of the page and click on “My training” to view the physician’s individualized training page. The courses are listed under: A Webinar Series on Opioid Use, Treatment, and Addiction. 
            The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
            The Medical Society of the State of New York designates this enduring activity for a maximum of 1.0 AMA/PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.
 
MSSNY’s CME site has over 50 programs.  If you are a new user, the site will require you to register (including creating a username and password), but you’ll then have a personalized training page through which you can take the webinars and other course work located on the site.  When you have logged onto the site, you will be taken to an instruction page.  Click on the tool bar menu at the top of the page, and then click on “My training” to view and take the various courses.  MSSNY has over 50 programs at this site and physicians are able to earn continuing medical education credits for each course. The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The online program has various programs with the number of continuing medical education credits, but the majority of the programs are for 1.0 AMA/PRA Category 1 credit™.  Further information on all these programs may be obtained by contacting Pat Clancy at pclancy@mssny.org.                                                                                                                                
MLMIC releases Proactive Risk Management Follow-Up Program VI 

MLMIC has an ongoing commitment to helping physicians and other healthcare practitioners improve the quality of patient care and reduce potential liability exposure in their practices. The company has developed a new online risk management CME program for policyholders, titled “Proactive Risk Management Follow-Up Program VI (Follow-Up VI)” and now available at MLMIC.com.  Expert physicians, healthcare attorneys, and MLMIC Claims and Risk Management representatives discuss current physician liability issues, including risks connected with advertising, electronic medical records, voice recognition software, diagnosis errors, and “challenging” patient behaviors.  The program also addresses recent trends in back disorder claims. For further information, call MLMIC’s Risk Management Department at (212) 576-9601.   
 
Now available from MSSNY:  Archived CME webinars on hepatitis and HIV
 
MSSNY has archived two recent Continuing Medical Education programs on Hepatitis and on HIV, free to physicians and other health care providers, at http://cme.mssny.org/.  Educational objectives of “HIV 2015: Diagnosis, Treatment and Prevention--Current Perspectives”:
  • Apply diagnosis and treatment for all HIV-infected individuals;
  • Become familiar with the key points of new HIV testing laws and understand the provisions of the HCV law;
  • Implement the new HIV testing algorithm; and
  • Describe the activities that can bring HIV to sub-epidemic proportions and result in individual and community viral load suppression.
 
Educational objectives of MSSNY “HCV: Diagnosis, Treatment & Prevention—In the Crosshairs Targeting HCV”:
  • Describe the epidemiologic features of Hepatitis C, and recognize the risk behaviors and risk exposures that are implicated with Hepatitis C transmission;
  • Implement the CDC’s current recommendations for testing in select populations and the requirements under New York State public health law;
  • Review the serological and virological assays for screening and diagnosing Hepatitis C, and learn the testing algorithm for diagnosing acute and chronic Hepatitis C infection;
  • Understand the natural history of untreated chronic Hepatitis C infection and select the most appropriate tests for assessing the degree of liver injury; and
  • Become familiar with the directly acting antiviral agents in the new HCV treatment guidelines, and make the appropriate referrals.
 
Physicians can access the Medical Society of the State of New York educational programs on http://cme.mssny.org/.
 
 
MSSNY offers 50 online CME programs free of charge
 
MSSNY now offers 50 online CME courses for physicians and other health care providers.   In the Medical Matters section, recent courses include such topics as Isolation and Quarantine, Epidemiology 101, and Ebola.  In the Advocacy Matters section, courses include Two-Factor Authentication – which is important in the E-prescribing requirement that will go into effect on March 27, 2016.   Physicians can access these educational programs at http://cme.mssny.org/.
 
 
Watch this space:  Exciting new items coming from HIPAA Secure Now!
 
Since HIPAA is an issue for all of our members, we have decided to publish some informational articles from our friends at our endorsed vendor HIPAA Secure Now!  Look for these articles in upcoming issues of MM “NEWS,” and for educational webinars on HIPAA compliance in the future.  HIPAA Secure Now! provides a free HIPAA Hotline for NYCMS members; if you have a HIPAA question or issue, just send an email.   HIPAA Secure Now! can also provide you with a complete, affordable and easy-to-use HIPAA compliance service. NYCMS members get at 10% discount.  If you are interested in finding out more, please contact Jonathan Krasner at jonathank@hipaasecurenow.com.
 
JPMorgan's NY 529 Advisor-Guided College Savings Program – Now available to NYCMS members through Vital Planning Group 
We are very 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 sign up for the program directly as a member using the New York County Medical Society Group ID, or you can offer the program to employees of your practice 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
 
 
 
Idilus can provide tax, payroll and other employer services – plus other benefits for many physician practices  
 
Idilus is a Professional Employer Organization (PEO) and physician and hospital consulting company, which 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.  You must sign up for the basic human resources services, and the health insurance is underwritten (so not every practice will qualify), but Idilus’s offerings are worth your consideration.  NYCMS has entered into an exclusive contract with Idilus that allows members to receive services at prenegotiated discounts.  Please contact Matt Peterson at 877-545-5666 for more information about Idilus benefits.  
 
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.  
 
 
MSSNY members only: Your patients can save up to 75% on prescriptions


With the rising cost of both generic and name-brand medications, your patients could all use some help these days!  The New York RX Card, MSSNY’s newest Member Benefit, is a 100% free and 100% confidential point-of-sale prescription discount card that can save your patients up to 75% on your prescription medications.  It is free to everyone with no minimum nor maximum uses, no age or income requirements, no enrollment or approval process - and it is accepted at over 68,000 pharmacies, nationwide.
            This card will provide you with Rx medication savings of up to 75% at more than 68,000 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!  It 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 their prescriptions that are not covered on their plan, as well as to receive discounts on medications that are not discounted when in the “donut hole.”
            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!
 
Canopy translator makes it easier to communicate with patients   
 
NYCMS is pleased to provide its members with the Canopy Medical Translator, a free download for our members.  Canopy has been supported by the NIH 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!  It lets you communicate with patients in Spanish, Chinese, Arabic, and more. To see how it 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  
PhoneRover solves your patient communication needs
 
PhoneRover makes sure that your patients have the information they need about your practice when they’re on hold, as well as giving you ways to reach out for appointment reminders, checkup reminders, office closings and more.  Discounted for Society members - AND you get the easy computer Standard Health on Hold channel at no charge. NYCMS members:  Call the Society at 212-684-4670. 
 
 
Be a hero to your patients with Good Rx
Help your patients and your practice with savings of up to 80 percent on your patients’ prescriptions. Use GoodRx in your practice to educate and empower your patients, whether they’re insured or not. The result: happier, smarter patients who save money and take their meds as prescribed. NYCMS members:  Call the Society at 212-684-4670.,
 
 
Collect what’s due
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 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. 
 
 
Doctor–driven liability coverage
The Medical Liability Mutual Insurance Company, physician–owned and managed, is the only professional liability insurer we endorse.  NYCMS members: Call the Society at 212-684-4670. 
 
 
Use your website and make an impression
WorkerbeeMD (http://www.workerbeemd.com) is a medical website design company focusing on designing and marketing websites for doctors. WorkerbeeMD will design, maintain, host and search-engine optimize your website for patients to find you. Medical website design and development, hosting, maintenance and search engine optimization provided with preferred rates for Society members. Our Immediate Past President, Dr. Joshua Cohen, has personally utilized this partnership and uses his website to educate and interact with patients.  For an example of what WorkerbeeMD can do for you, you can see Dr. Cohen’s website at http://nyheadachespecialist.com.  So:  For those of you (NYCMS members) who are looking to increase practice visibility and expand your client base through a new or redesigned mobile-friendly medical website:  Call the Society at 212-684-4670 to be referred to Workerbee.

 
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. 
 
 
10 percent discount from your auto insurer
 
Take The American Safety Institute’s 6 Hour Safe Driving Accident Prevention Program, at a member-only price of $26.00. The on–line 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 for your Members Only sign–in and password at (212) 684–4670 if you don’t know it.)
 
 
Working Advantage means fun discounts
 
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.
 
 
Free HIPAA–compliant communications
 
Thanks to DocBookMD and the Society, you will have access through a smartphone platform,
designed by physicians for physicians, that provides an exclusive HIPAA–compliant professional network to connect, communicate and collaborate with your Society colleagues. Send pictures of x–rays and reports, wounds or other information, and be reassured 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.  Once you have downloaded the app to your device, open it up and follow the simple registration steps.  Includes access to all 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. 
 
 
Insurance with service
The Society offers health insurance coverages through Mercer. Access a complete line of products for disability, life, and business overhead.   NYCMS members:  Call the Society at 212-684-4670. 
 
 
Real-estate expertise at your service
 
Commercial Tenant Concierge (CTC) helps healthcare tenants cost-effectively manage real estate leases. Their 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 their help, when the time is right for you. If you need assistance with subleasing, verifying landlord bills, resolving billing discrepancies and more, CTC will work for you. NYCMS members:  Call the Society at (212) 684-4670, for referral to CTC.
 
 
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 may choose to embroider the NYCMS logo without incurring any artwork digitization costs. Medelilta 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. 
 
 
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). This saves you a great deal of time and ensures 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 SupportServices.  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
 
 
Sign up with AMP now
 
Are you a member of AMP?  It’s the Society’s great new 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.
 
 
Credit-card processing with CardConnect (formerly Charge Card Systems)
 
CardConnect has created a powerful benefit program that goes beyond what other credit-card processors can offer. Our endorsed partnership with NYCMS allows us to administer certain benefits to members. We offer wholesale pricing, a single point of contact, and the educational tools that will keep you up to date on credit-card processing.
             Typically, this exclusive NYCMS member benefit offers a 10- to 40 percent reduction in processing fees. Not only will these savings boost efficiency for your bottom line, but our software will save you time and effort put into your sales activity.  Give CardConnect the opportunity to provide you with a line-by-line analysis and a cost comparison to your current situation!  Call 212-684-4670 and ask for the CardConnect member benefit program. 
            We have created an endorsed benefit for NYCMS members that will control your processing and protect your business. This program goes beyond what other credit card processors can offer by providing: 
  • Wholesale Rates - NYCMS members typically see a 10% - 40% reduction in processing fees.
  • Point-to-Point Encryption - Sensitive payment data is instantly encrypted the moment a customer's card is swiped, meaning 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 member receives a single point of contact the moment they sign up. 
At a time when credit card fraud is at an all-time high, CardConnect (formerly Check Card Systems), has helped thousands of businesses stay informed and protected - all while reducing their processing costs. Now, we would like to offer NYCMS members a complimentary and confidential savings analysis. Find out if you're paying too much for processing by faxing a recent statement to 845-230-6672 or call Mark Bristow at 845-368-1545.
We're confident you will be pleased with our ability to enhance your bottom line.
            CardConnect now fully integrates with QuickBooks.   NYCMS members have been saving up to 40 percent on their current fees by transitioning their processing to CardConnect.  Additional benefits include:   Next Day Funding (including American Express) and VIP Service.  Any form of payment accepted (all major brands, mobile, ACH & electronic checks).
             Are you paying too much for processing?  Send a recent merchant statement to 913-953-5348 for a confidential & free line-by-line analysis.  Contact Eric Cole, Business Development Manager, at 877.948.9733 | ecole@cardconnect.com
 
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, and track website metrics to optimize content.  Workerbee can do it for you!  Communicate with Workerbee 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