HOFSTRA HOSTING NATIONAL PUBLIC HEALTH WEEK EVENTS

April 8th, 2014

The Greater NY Society of Public Health Educators (SOPHE) will sponsor continuing education credits for CHES and MCHES for attendance at Hofstra’s NPHW Event Series. Approximately 1 Continuing Education credit will be provided for every 1 hour of attendance, up to 16 CE credits. There is a $10 processing fee.

CLICK EACH EVENT TO VIEW THE LOCATION AND FULL EVENT DESCRIPTION

Sunday, April 6

  • 9:00AM -3:00PM – WOMEN’S HEALTH FAIR

Monday, April 7

  • 4:00PM-6:00PM – DENTAL PUBLIC HEALTH: POLITICS, POLICY AND PRACTICE – PANEL DISCUSSION

  • 6:30PM-8:30PM – MANAGING CARE, COST, AND QUALITY IN AN ERA OF UNPRECEDENTED HEALTH SYSTEM CHANGE – PANEL DISCUSSION

Tuesday, April 8

  • 2:00PM-3:30PM – RADIATION SAFETY: HOW EXPOSED ARE YOU? – PRESENTATION AND Q&A

  • 6:30PM-8:30PM – MILLENNIUM DEVELOPMENT GOALS 2015: WHERE DO WE STAND AND WHERE DO WE GO FROM HERE? – GLOBAL HEALTH SYMPOSIUM AND PANEL DISCUSSION

Wednesday, April 9

  • 8:30AM-1:30PM – NASSAU COUNTY MINORITY HEALTH CONFERENCE – FILM VIEWING, PANEL DISCUSSION, AND HEALTH SCREENINGS

  • 2:30PM-4:00PM – LOVE SHOULDN’T HURT: KNOW THE SIGNS AND WHAT TO DO ABOUT DATING VIOLENCE – DOMESTIC VIOLENCE PRESENTATION AND Q&A

  • 4:30PM-10:00PM – PUBLIC HEALTH FILM FESTIVAL – FILM VIEWING AND PANEL DISCUSSION

Thursday, April 10

  • 11:00AM-1:30PM – THINKING OUTSIDE THE BOX: STUDENTS PRESENT STRATEGIES FOR TACKLING CHILDHOOD OBESITY: INTERDISCIPLINARY STUDENT CASE COMPETITION

  • 7:00PM-9:00PM – HEALTH CARE REFORM 2014 AND BEYOND – A SPECIAL PUBLIC LECTURE BY DR. JOHN MCDONOUGH ON THE IMPACT OF OBAMACARE

Friday, April 11

  • 12:00PM-2:00PM – HOW NURSES CAN HELP SAVE HEALTH REFORM – LUNCHEON AND PANEL DISCUSSION

Saturday, April 12

  • 9:00AM – RUN OR DYE 5K

PLEASE VISIT THE SOHPA TABLE IN THE SONDRA AND DAVID S. MACK STUDENT CENTER
April 7-10, 2014
TO LEARN ABOUT THE CAMPUS-WIDE PUBLIC HEALTH CAMPAIGN

All events are free and open to the public

For more information on the event, contact Nicolle Davis via email or 516-463-6467.

National Public Health Week 2014 is brought to you by Hofstra University’s School of Health Sciences and Human Services, Master of Public Health, Master of Health Administration, Hofstra’s Student Society of Public Health Advocates (SOPHA), Hofstra’s Future Healthcare Leaders in collaboration with: Henry Schein, Inc; BAYADA Home Health Care; Nassau County Department of Health; Nassau University Medical Center; North Shore-LIJ Department of Pediatrics; The Safe Center of Long Island; Hofstra University School of Medicine; Hofstra University Gitenstein Institute for Health Law and Policy.

Posted in SEMINARS AND PROGRAMS |

GOV. CUOMO ANNOUNCES PROPOSED BUDGET FOR FY 2014-15

January 27th, 2014


Gov. Andrew Cuomo proposed his $142.1 billion spending plan which will increase spending by 1.7 percent over the previous year. The plan includes a projected surplus of $500 million. Under the Governor’s plan, spending on the state’s Medicaid program is expected to be increased by about 4% to $58.2 billion, an all-funds increase from $55.6 billion. Additional Medicaid Redesign Team (MRT) reforms will be proposed including consolidation of behavioral health services with health and recovery plans and additional funding being made available for affordable housing.

Increased payments would also be made for community providers. Mentioning Brooklyn, the Governor stated that several hospitals in Brooklyn including Brookdale, Interfaith and LICH have been ‘propped up’ until the federal waiver of significant federal funding can be approved. The Governor noted that we have “a crisis in Brooklyn which has more people in it with more than San Francisco and WashingtonDC combined”. He stated that the State budget doesn’t have the resources needed to keep these hospitals open without the federal waiver monies.

EXCESS AND LIABILITY RATE STABILIZATION:
EXCESS MEDICAL LIABILITY INSURANCE PROGRAM CONTINUED THROUGH JUNE 30, 2015
The Excess Medical Liability Insurance Program created in 1985 to ease physician concerns that their liability exposure far exceeded available coverage limitations was continued through June 30, 2015. Unlike last year, no changes to program eligibility or funding cuts have been proposed. Funding for the program is appropriated at the $127.4M level.

Also, the Superintendent’s Authority to Set Medical Liability Rates Continued Through June 30, 2015.

MANAGED CARE:
OUT OF NETWORK IN GOVERNOR’S PROPOSED BUDGET

The bill contains provisions similar to Senator Hannon’s S.2551 to provide greater transparency of a health insurer’s out of network coverage, broader availability of a patient’s right to go out of network if the insurer’s existing network is insufficient, and provisions to assure that out of network benefits are more comprehensive.  However, it is more limited than the Senate proposal in that it would require insurers issuing a group health insurance policy to “make available” coverage for out of network care at the 70% of usual and customary cost of an out of network health care service.

Moreover, it would make all bills for emergency care and other “surprise bills” for hospital care by non-participating providers subject to an arbitration process. (See article below)

HEALTH CARE REFORM ACT:
HEALTH CARE REFORM ACT RE-AUTHORIZED FOR ANOTHER THREE YEARS THROUGH MARCH 31, 2017

First effective on January 1, 1997, HCRA revolutionized the funding and financing of New York’s health care system by allowing hospitals and third-party payors to negotiate inpatient and outpatient hospital rates.  Through several pools of money, HCRA supports many essential “public good” health delivery services and programs throughout the state.  These “public goods” programs are integral to the fabric of our state’s health care delivery system.

$65M APPROPRIATION TO STATE HEALTH INFORMATION NETWORK OF NY (SHIN-NY)
This appropriation from HCRA funds will shore up the operational work and connectivity to and between the regional health information networks. Funding or technology standardization is necessary to assure cost efficient physician connectivity with the SHIN-NY.

AMBULATORY SERVICES:
FOR PROFIT “LIMITED SERVICE” CLINICS LOCATED IN RETAIL ESTABLISHMENTS PROPOSED

he proposed budget would authorize the establishment of limited service clinics within retail establishments owned by publicly traded corporations. These clinics would be staffed by nurse practitioners and would be authorized to provide a limited set of services with no self-referral prohibitions placed on the health professionals from directing patients to make purchases at the retail establishments at which the nurse practitioners or other health professionals are employed. If read in tandem with another proposal on nurse practitioners summarized below, a NP could be allowed to ‘collaborate’ with a hospital and placed by the hospital in a retail clinic owned by a publicly traded corporation to provide services in the clinic with no requirement for physician collaboration.

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Posted in NEWS FROM THE NYS LEGISLATURE |

CUOMO ANNOUNCES PROPOSED BUDGET FOR FY 2014-15

January 23rd, 2014

Today Gov. Andrew Cuomo proposed his $142.1 billion spending plan which will increase spending by 1.7 percent over the previous year. The plan includes a projected surplus of $500 million. Under the Governor’s plan, spending on the state’s Medicaid program is expected to be increased by about 4% to $58.2 billion, an all-funds increase from $55.6 billion. Additional Medicaid Redesign Team (MRT) reforms will be proposed including consolidation of behavioral health services with health and recovery plans and additional funding being made available for affordable housing.

Increased payments would also be made for community providers. Mentioning Brooklyn, the Governor stated that several hospitals in Brooklyn including Brookdale, Interfaith and LICH have been ‘propped up’ until the federal waiver of significant federal funding can be approved. The Governor noted that we have “a crisis in Brooklyn which has more people in it with more than San Francisco and Washington DC combined”. He stated that the State budget doesn’t have the resources needed to keep these hospitals open without the federal waiver monies.

Excess Medical Liability Insurance Program Continued Through June 30, 2015

The Excess Medical Liability Insurance Program created in 1985 to ease physician concerns that their liability exposure far exceeded available coverage limitations was continued through June 30, 2015. Unlike last year, no changes to program eligibility have been proposed. Funding for the program is appropriated at the $127.4M level.

Out Of Network in Governor’s Proposed Budget

The bill contains provisions similar to Senator Hannon’s S.2551 to provide greater transparency of a health insurer’s out of network coverage, broader availability of a patient’s right to go out of network if the insurer’s existing network is insufficient, and provisions to assure that out of network benefits are more comprehensive.  However, it is more limited than the Senate proposal in that it would only require insurers issuing a group health insurance policy to “make available” coverage for out of network care at the 70% of usual and customary cost of an out of network health care service, if requested by the policyholder.

Of significant concern, it would make all bills for emergency care and other “surprise bills” for hospital care by non-participating providers subject to an arbitration process where the insurer would be required to make a “reasonable payment” initially but the physician would be required to take the claim to an independent dispute resolution process where the arbitrator would be required to choose between the plan’s payment or the non-participating physician’s fee (“baseball arbitration”). As part of the arbitrator’s review, they would be required to consider the a) fees paid to the non-par physician in other situations b) fees paid to other non-par physicians providing similar services in the same geographic area c) the circumstances and complexity of the case and d) the usual and customary cost of the service

Health Care Reform Act Re-Authorized for another three years through March 31, 2017

First effective on January 1, 1997, HCRA revolutionized the funding and financing of New York’s health care system by allowing hospitals and third-party payors to negotiate inpatient and outpatient hospital rates.  Through several pools of money, HCRA supports many essential “public good” health delivery services and programs throughout the state.  These “public goods” programs are integral to the fabric of our state’s health care delivery system.

Superintendent’s Authority to Set Medical Liability Rates Continued Through June 30, 2015

$65M Appropriation to State Health Information Network of NY (SHIN-NY)

This appropriation from HCRA funds will shore up the operational work and connectivity to and between the regional health information networks. Funding or technology standardization is necessary to assure cost efficient physician connectivity with the SHIN-NY.

For Profit “Limited Service” Clinics Located in Retail Establishments Authorized

The proposed budget would authorize the establishment of limited service clinics within retail establishments owned by publicly traded corporations. These clinics would be staffed by nurse practitioners and would be authorized to provide a limited set of services with no self-referral prohibitions placed on the health professionals from directing patients to make purchases at the retail establishments at which the nurse practitioners or other health professionals are employed.

Provisions Included To Define “Urgent Care” and To Require Urgent Care Facilities To Obtain Accreditation

Under the Urgent Care proposal, “urgent care shall mean the provision of treatment on an unscheduled basis to patients for acute episodic illness or minor traumas that are not threatening or potentially disabling or for monitoring or treatment over prolonged periods”.  Any physician who holds their practice out to be an urgent care facility must be accredited. The Commissioner is authorized to promulgate regulations effectuating these provisions. It is expected that the recommendations of the Public Health and Health Planning Council (PHHPC) reported in Capitol Update earlier this month will constitute the body of such regulations.

The relevant recommendations by PHHPC on urgent care follow:

Urgent Care would be defined as the treatment of acute episodic illness or minor traumas.  The minimum characteristics/services that a provider must have in order to be considered an urgent care provider include:

·         Accepts unscheduled, walk‐in visits typically with extended hours on weekdays and weekends.

·         X‐Ray and EKG

·         Phlebotomy and Lab Services (CLIA waived tests)

·         Administration of oral (PO), sublingual (SL), subcutaneous (SC), intramuscular (IM), intravenous (IV), respiratory, medication and IV fluids

·         Uncomplicated laceration repair

·         Crash Cart Supplies and Medications; ACLS and PALS protocol capable, as evidenced by staff holding current certification

The term “Urgent Care” would be restricted to those providers offering urgent care services as defined and approved by the Department.  The term “Urgent Care” is to be used in the name and in signage at the provider site and in materials. Commercial terms (e.g. “Convenient Care,” “FastMed,” etc.) could still be used in a provider’s name, but would need to add “Urgent Care.” For example, “FastMed Urgent Care.” The word “emergency” or its variations, such as Emergi‐care” or “Emergent‐care,”cannot be used by urgent care providers or other providers unless licensed by the State as an emergency department.

Providers offering specialized services (e.g. orthopedic services) typically do not offer the defined scope of urgent care services as the model of urgent care described in this report and would not be permitted use the term “Urgent Care.” They are more appropriately characterized as specialty care with walk‐in appointments.

Providers offering the defined scope of urgent care services required, but limiting their practice to a specific population of patients, such as a pediatric or geriatric population, may be allowed to use the term “Urgent Care” but need to specify the specific population serviced in their name, such as “Pediatric Urgent Care” or “Geriatric Urgent Care.”

Private physician offices, including those affiliated with an Article 28, wanting to provide Urgent Care Services need to obtain accreditation by an accrediting organization approved by the Department.  No CON review required. A private physician practice affiliated with an Article 28 may provide Urgent Care Services as a private physician office if they obtain accreditation by an accrediting organization approved by the Department OR they can become an Article 28 through a full CON review.

A provider that wants to provide an Urgent Care Service that requires more than minimal sedation or local anesthesia must seek Office Based Surgery accreditation (pending evaluation of urgent care accreditation requirements for equivalence with OBS accreditation).  This is consistent with current private practice OBS requirements.

Urgent care facilities would be required to: provide a roster of PCHM-recognized primary care providers and Federally Qualified Health Centers to patients seen at these clinics who do not have a primary care provider; prominently display signage that states the services provided; and where applicable, post signage to indicate that prescriptions and over-the-counter supplies, etc., can be purchased from any business and do not need to be purchased on‐site; and utilize an EHR and e-prescribe.

Oversight of Office-Based Surgery To Be Enhanced

The proposed article 7 bill would standardize and limit procedures in an OBS setting; broaden the definition of adverse events; broaden the definition of reportable events and extend reporting timeframes.

Significantly, the proposal would establish a registration process for OBS facilities and to submit certain procedure and quality data as determined by the Department

The Commissioner would be authorized to promulgate these new provisions through regulation.

See below a summary of the recommendations of the PHHPC earlier this month as regards OBS which will likely form the basis of the proposed regulations:

Also recommended is the clarification in the OBS statute that neuraxial and major upper and lower extremity regional nerve blocks are included in the OBS definition; assure that office based anesthesia is defined to include general anesthesia, neuraxial anesthesia, major upper and lower extremity regional nerve blocks, and moderate and deep sedation.  Also, the recommendations would limit OBS/OBA expected procedural time to six hours and limit post‐procedure time to meet safe and appropriate discharge to six hours.

With regard to accreditation and adverse reporting, the report would:

·         Require all physician practices performing procedures (including non‐invasive procedures) utilizing more than minimal sedation to become accredited and file adverse-event reports.

·         Require all podiatry practices performing procedures (involving the foot as well as the ankle) utilizing more than minimal sedation to become accredited and file adverse-event reports.

·         Add “observation of longer than 24 hours within 3 days of OBS” and “unanticipated emergency department visit within 72 hours” to list of reportable adverse events.

·         Extend reporting time to 3 days/72 hours.

The report recommends that accrediting bodies:

·         share the outcomes of survey and complaint/referral investigations and other requested data with DOH upon request;

·          survey OBS/OBA practices and carry out complaint/incident investigations upon DOH request; and

·          utilize American Board of Medical Specialties (ABMS) certification, hospital privileges, or other equivalent determination of competency in assessing credentialing of practitioners to perform procedures and/or provide sedation/anesthesia.

Nurse Practitioners Authorized To Practice in Collaboration With Other NPs

The proposed budget would allow Nurse Practitioners to practice for six months in collaboration with an NP who has been in practice for more than three thousand six hundred hours if: (a) the collaborating physician retires, moves, becomes unqualified to practice and (b) the NP has demonstrated to the Department that she has made a good faith effort to find another collaborating physician but cannot.

Also, NPs with more than 3600 hours of practice would be authorized to collaborate either with a physician or a hospital.

DFS Superintendent Conferred Greater Authority to Investigate No-Fault Fraud

Provide the Superintendent of Financial Services greater authority to investigate No-fault fraud by various health care providers by enabling the DFS Superintendent to make an examination, “including an audit or unannounced inspection” of a provider of No-fault health care services “when the superintendent deems it expedient for the protection of the people of this state”

MSSNY’s Committee On Physician’s Health (CPH) Program Funded at $990,000

Other Proposals:

The spending plan increases education aid by 3.8 percent, or $807 million, to a total of $21.8 million. A statewide universal pre-Kindergarten program would be created, with $1.5 billion in phased-in spending over the next five years. The proposal would spend $100 million in the first year and target the neediest school districts for pre-Kindergarten. If enacted, New York would become the fourth state in the nation to offer statewide universal full day pre-K. His budget also contains language to advance his $2B smart school technology bond act which if passed will appear on the ballot in November.

The budget will include the Governor’s Public Trust Act which will include reforms to Board of Elections, establish new anti-bribery laws and require the disclosure of outside clients. The budget proposal will also include the Governor’s public election financing proposal.

This is a preliminary analysis of the proposed budget. Additional information will be forthcoming from

your Division of Governmental Affairs.

MSSNY will be testifying before the Joint Committees on Senate Finance and Assembly Ways and Means on February 3rd.

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Posted in NEWS FROM THE NYS LEGISLATURE |

Tax DIVERSIFY Your Retirement Income

January 16th, 2014

Who:       Physicians and Dentists

TIME:     8:00P – 10:30P

DATE:     February 20, 2014

PLACE:   Il Toscano @ 42-05 235th St. Flushing, NY  11363

RSVP:     dpena@ft.newyorklife.com  by February 13.

Ana Nicosia: Agent, New York Life Insurance Company

Daniris Pena: Agent, New York Life Insurance Company

Phone number 516-282-6208

This is an informational and insurance sales presentation. Neither New York Life nor its agents provide tax, legal or accounting advice.

Pleae consult yourown professional for tax, legal and accounting advice.

SMRU 502634 (Exp. 04/01/14)

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Posted in SEMINARS AND PROGRAMS |

Medicare EPs Must Attest by February 28 at 11:59 pm ET to Receive 2013 Incentive

January 13th, 2014

If you are an eligible professional (EP), the last day you can register and attest to demonstrating meaningful use for the 2013 Medicare EHR Incentive Program isFebruary 28, 2014. You must successfully attest by 11:59 p.m. Eastern Standard Time on February 28 to receive an incentive payment for your 2013 participation.

You must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.

Medicaid Eligible Professionals
EPs participating in the Medicaid EHR Incentive Program need to refer to their state deadlines for attestation information.

Payment Adjustments
Payment adjustments for EPs will be applied beginning January 1, 2015, to Medicare participants that have not successfully demonstrated meaningful use. The adjustment is determined by your reporting period in a prior year. For more information, visit the payment adjustment tipsheet for EPs.

If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.

Resources

Plan Ahead
Review all of the important dates for the EHR Incentive Programs on the HIT Timeline.

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Posted in MEDICARE UPDATES, NATIONAL HEALTHCARE NEWS |

Empire Provider/Facility Online Services Shutdown – Register for Availity now!

January 10th, 2014

Member eligibility, benefits and claims status functionalities moving exclusively to the Availity Web Portal

Empire is transitioning member eligibility, benefit, and claim status from Provider/Facility Online Services to the Availity Web Portal on March 14, 2014.  Availity, at www.availity.com is your new source to access this valuable information. To avoid any disruption to accessing information electronically, you will want to be fully transitioned to Availity prior to shut down. Please register now and begin accessing this information on Availity.

Note: Electronic transactions submitted via our Enterprise EDI Gateway are unaffected; you may continue to submit all X12 transactions through your current EDI transmission channels.

Availity currently offers Empire providers access to the following functionality:

  • Eligibility and benefits inquiry
  • Claims inquiry
  • Claims submission
  • Secure messaging
  • Patient care summaries
  • Care reminders
  • AIM Specialty HealthSM
  • Direct access to your legacy portal – Link to your existing functionality, i.e. fee schedules, online remittances etc. using the link located under My Payer Portal in the left navigation bar.

How to get started

To register for access to Availity, go to www.availity.com/providers/registration-details/. It’s that simple!

Free Training

Once you log into the Availity Main Menu page, you’ll have access to many resources to help jumpstart your learning, including free live training, on-demand training, frequently asked questions, and comprehensive help topics. To view current training resources, click Free Training at the top of any page in the Availity Web Portal or click http://www.rsvpbook.com/NewYorkandVirginia to find a current schedule of FREE Availity workshops and webinars.

Client service representatives are also available Monday through Friday (8:00am – 7:00pm ET) to answer your questions at 800-AVAILITY (800-282-4548).

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Posted in HEALTH INSURER UPDATES |

Issues with Processing 1500 Paper Claims Filed to National Government Services

January 10th, 2014

Beginning on April 1, 2014, all paper claims filed to NGS Medicare must be submitted using the revised form CMS 1500 Version 02/12.    All paper claim submissions using the older format will be returned to providers as unprocessable after April 1, 2014.

To prepare for the change in claim form, NGS implemented a new Optical Character Recognition System (OCR) in November 2013.   We have been experiencing delays with needed updates to this OCR system.   Unfortunately, this has caused a short term need to manually verify all paper claims data. This has increased the overall inventory of paper claims pending validation.

Until these paper claims are completely entered, we cannot currently respond fully to claim status related questions.   In all likelihood, the claims have been received and are awaiting claim detail entry into MCS.   An extensive effort is underway to expedite processing for these outstanding paper claims.

This issue applies only to the small volume of paper claims received.   The vast majority of electronically submitted claims and the claims submitted using the free features on the Connex portal are being processed, meeting all timeliness requirements. Please checkwww.ngsmedicare.com/Connex for details.

We regret the delay in handling the paper claims submitted.

James D. Bavoso

Provider Outreach & Education

National Government Services

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Posted in MEDICARE UPDATES, NATIONAL HEALTHCARE NEWS |

STDs On Rise Nationwide

January 9th, 2014

The Washington Times (1/9, Wetzstein) reports that the Centers for Disease Control and Prevention Sexually Transmitted Disease Surveillance 2012 report (pdf) released yesterday shows that gonorrhea rates increased in 2012 and syphilis rose 11%, while chlamydia remained relatively flat, although a record 1.4 million cases existed. The report states, “This is the largest number of cases ever reported to the CDC for any condition,” with the National Coalition of STD Directors adding that “rising STD rates have a major negative impact on our ability to address the HIV epidemic.” Public health officials are encouraging sexually active individuals to undergo annual STD screenings, with men who have sex with men (MSM) screened at shorter intervals if partners are not monogamous or use illicit drugs.

Bloomberg News (1/9, Lopatto) reports that the CDC connected this rise in STD infection rates to “inadequate testing among people stymied by homophobia and limited access to health care.” According to CDC STD Prevention Division Director Gail Bolan, “We know that having access to high-quality health care is important to controlling and reducing STDs. Some of our more-vulnerable populations don’t have access. There are a number of men who come in to our clinic for confidential services because they’re too embarrassed to see their primary care doctors.”

The Huffington Post (1/9) quotes the report as recommending “dual therapy with ceftriaxone and either azithromycin or doxycycline” for gonorrhea treatment.

According to Medscape (1/9, Lowes), the report attributes the rise in syphilis entirely to men, particularly MSM.

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Posted in NATIONAL HEALTHCARE NEWS |

What Physicians Need to Know about Coronaviruses

January 2nd, 2014

Dear Colleague:

The Medical Society of the State of New York invites you to join Medical Matters, a series of 6 free one-hour continuing medical education (CME) webinars that will be held on the thirdWednesday of each month from January-June 2014.  In recognition of physician scheduling preferences, MSSNY will deliver its Medical Matters programs at varying times during the morning and evening hours.

The topic of the first program of the spring session of Medical Matters is:

What Physicians Need to Know about Coronaviruses

Wednesday, January 15, 2014

6:30-7:30 p.m.

Faculty: William Valenti, MD

The educational objectives are: 1) Become familiar with the epidemiology and clinical features of coronaviruses, and 2) Understand the physician’s role in the public health response to an infectious disease outbreak.

Registration is required and a listing of Medical Matters topics will be available on the registration site and the MSSNY website.  To register for the January session of Medical Matters, please click here. A copy of the flyer is here.

Physicians throughout New York State can participate in the webinar from their home/office computer. We are confident that you will find these webinars to be both informative and useful to assist you in caring for patients during a public health emergency.

Medical Matters is sponsored by MSSNY’s Committee on Emergency Preparedness and Disaster/Terrorism Response. The program is funded in whole by a DHHS grant entitled “New York State Hospital Preparedness Program”. MSSNY has accredited each webinar for 1 AMA PRA Category 1 Credits™.

Thank you for your time. We hope to see you at the webinars.

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Posted in SEMINARS AND PROGRAMS |

MD’S SUE OBAMACARE INSURER OVER DROPPED DOCTORS

January 2nd, 2014

NEW YORK POST

WASHINGTON — A group of New York doctors is suing insurance giant UnitedHealthcare, charging that it booted doctors from its network to avoid cost hikes imposed by ObamaCare.

The company’s decision to kick more than 2,000 docs from its Medicare Advantage network threatens to harm elderly and disabled patients, according to the filing in Brooklyn federal court.

“By terminating numerous physicians from the . . . network, United seeks to stem financial losses occasioned by reduced federal payments under the Affordable Care Act,” the suit launched by the Medical Society of the State of New York claims.

“This, of course, comes at the expense of physicians,” the suit continues, arguing that the company violated doctors’ contracts by failing to give sufficient notice, among other things.

Tugging at the heartstrings, the suit specifically mentions elderly and disabled patients “who must now either find new physicians (including traveling farther distances to find a participating . . . provider), switch plans to continue treatment with the terminated physicians, or pay significant additional out-of-pocket costs to continue treatment with an ‘out-of-network’ provider.” It accuses United of “shifting the financial burdens imposed by the Affordable Care Act from itself, a multibillion-dollar company,” to providers and patients.

Medical Society President Sam Unterricht told The Post the company’s decision was unfair to patients, since they had to choose a new plan under Medicare Advantage, a private alternative to traditional Medicare, by Dec. 7, when company Web sites still showed doctors who were being kicked out of the network at the start of the new year.

“For some people who are medically fragile it can really be dangerous. There can be gaps in care,” he said.

Unterricht said reduced Medicare Advantage payments to physicians are being used as a cost-saving measure to fund ObamaCare. He said docs would get paid 20 percent or even 40 percent less per patient. “A lot of doctors are not going to be able to accept that and really give good medical care at that kind of a price,” he said.

UnitedHealthcare defended its decision to reduce its roster of doctors. “The changes we are making to our network will encourage higher quality and more affordable Medicare coverage,” UnitedHealthcare said in a statement. “We will remain focused on serving our members and will continue to provide them a broad and comprehensive choice of doctors in New York.”

The Medicare Advantage savings used to help fund ObamaCare shaved nearly $200 billion over a decade under the law. Democrats have long complained that the program amounts to an overpriced subsidy to private companies and a burden to taxpayers.

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Posted in AFFORDABLE CARE ACT, NATIONAL HEALTHCARE NEWS |

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