Archive for September, 2010



Thursday, September 30th, 2010

Wednesday Workshops are Free for NCMS/NAM Members and staff  * **

NAM/NCMS Member & Staff:  Register at 516-832-2300 ext 13 or at

* Non-member payments: $20/person: Non-refundable

**Non-member fees may vary and some lectures may  include an attendance charge for members depending on the the topic and speakers.

Payable to Nassau Academy of Medicine 1200 Stewart Ave.  Garden City, NY 11530


NOTE: Light Refreshments Available — Please Pre-Register



The Private Practice of Medicine:  Dinosaur or Thoroughbred?

Seismic shifts in the practice environment are occurring rapidly. On an almost daily basis, your Medical Society and its legal counsel are fielding important questions from physicians:

  • Should I remain in private practice?
  • Should I consider selling my practice? If so, what issues should I be aware of, and how do I proceed?
  • If I sell my practice and become employed, what will be different? What, if anything, will remain the same?

On the evening of February 1st, come hear Michael Schoppmann, Esq, Partner, Kern Augustine Conroy & Schoppmann, P.C. speak on these and other critically important and related issues. As many of you already know, Mike is a very engaging speaker and one of the preeminent healthcare lawyers in America.

Nassau Academy of Medicine

1200 Stewart Ave. Garden City

Presented by

Michael Schoppmann, Esq,

Partner, Kern Augustine Conroy & Schoppmann, P.C.

WEDNESDAY February 1, 2012

Sign in 6:30 pm           Program 7:00 pm – 8:30 pm

Directions available on this website

To register: call 516-832-2300 ext 13 or e-mail request to



JANUARY 11, 2012

9:00A – 11:00A

Nassau Academy of Medicine

1200 Stewart Ave. Garden City

Directions available on this website

To register: call 516-832-2300 ext 13 or e-mail request to

Posted in SEMINARS AND PROGRAMS | No Comments »

Documentation Requirements when “Scribes” are Utilized

Wednesday, September 15th, 2010

Physicians may on occasion utilize the services of scribes to assist with documentation during a clinical encounter between the physician and patient. The scribe is present during the encounter and records in real time the actions and words of the physician as they occur. Scribes may not interject their own observations or impressions into the medical record.

The physician is ultimately responsible for all documentation and must verify that the scribe’s note accurately reflect the service provided.

The scribe’s note should also include:

  • The name of the scribe and a legible signature
  • The name of the physician providing the service
  • The date the service was provided
  • The name of the patient for whom the service was provided

The physician’s note should indicate:

  • Affirmation of that physician’s presence during the time encounter was recorded
  • Verification that he/she reviewed the information
  • Verification of the accuracy of the information
  • Any additional information needed

In a teaching facility setting attending physicians may employ scribes, but residents or fellows may not, since the creation of the medical record is inherent to the training programs programs (paid for under Graduate Medical Education [GME] program) and to the medical care delivered by these residents.

Signature requirements detailed in the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-08, Medicare Program Integrity Manual, Chapter 3, Section, (1 MB) as well as the specific documentation requirements for any service provided must be followed.

Thank you,
National Government Services, Inc.
Corporate Communications

Posted in MEDICARE UPDATES | No Comments »

Don’t Miss Claims Filing Deadline for United HealthCare Settlement

Tuesday, September 14th, 2010

Have you submitted your Claims Information Request Authorization Form and returned it to the Settlement Claims Administrator?
All claims must be postmarked no later than October 5, 2010.

To assist you in completing your Claim, you can request a report from the Settlement Claims Administrator that lists the Covered Out-Of-Network Services or Supplies that you provided January 1, 2002 through May 28, 2010.

However, you must authorize the Settlement Claims Administrator to send you this information
. You must complete and sign the authorization form on the bottom of page 15 of the Claim Form to:

United HealthCare Class Action Litigation
c/o Berdon Claims Administrator, LLC
P.O. Box 15000
Jericho, New York 11853-0001
About the Litigation
MSSNY, the AMA and other parties filed a class action lawsuit against Defendants and alleged that Defendants provided insufficient reimbursement amounts for Covered Out-of-Network Services or Supplies including by:
· using a flawed database (the “Ingenix Databases) in determing reimbursement for Covered Out-Of-Network health benefits;
· using the out-of-network policies to reduce reimbursement amounts improperly for covered out-of-network health benefits; and
· inadequately disclosing the use of the Ingenix Databases and their out-of-network reimbursement policies.
There are Two Settlement Agreements
1)       The Cash Settlement – The Settlement establishes a Cash Settlement Fund in the amount of $350 million plus accrued interest. If the Settlement Agreement is finally approved by the Court, members of the Settlement Class who submit a timely Claim Form will be entitled to payments from the Cash Settlement Fund.
2)       Business Practice Initiatives – As part of the Settlement Agreement, and consistent with the terms of the separate “Assurance of Discontinuance” entered into with the New York State Attorney General, Defendants have agreed to certain commitments regarding their reimbursement practices and procedures for out-of-network healthcare benefits. United Health Group and its affiliates have agreed that they (a) will stop using the Ingenix Database that MSSNY and AMA allege are flawed, and, in their place, will use a New Database independently established and operated by a consortium of New York State university-level schools of public health led by Syracuse University; and (b) will contribute $50 million towards the funding and implementation of the New Database (in addition to the $350 million payment to the Cash Settlement Fund). The New York State Attorney General has entered into similar “Assurance of Discontinuance” agreements with the largest health insurers in the state, resulting in total contribution of nearly $100 million to support the New Data Base. The Report from the Settlement Claims Administrator may help you to complete the Claim Form.
Because the deadline to submit the Claim Form is October 5, 2010, it is very important to submit your Claims Information Request Authorization Form as soon as possible, if you haven’t already done so.

For more information, go to:
Berdon Claims Administration, LLC
Toll Free#: 1-800-443-1073 begin_of_the_skype_highlighting 1-800-443-1073 end_of_the_skype_highlighting
Facsimile: (516) 222-0271

Posted in HEALTH INSURER UPDATES | No Comments »

Workers Compensation Board Announces Physician Fee Increase

Thursday, September 2nd, 2010

September 1, 2010

Chair Robert Beloten Statement on Medical Fee Schedule

Health care providers in the workers’ compensation system have not seen an adjustment to their payment rates since 1996. As a first step to address this, today I am proposing a regulation that will provide for a 30 percent increase to the Evaluation and Management codes in the medical fee schedule.

In addition, over the next twelve months, we will undertake a comprehensive review and revision of the Medical, Podiatry, Psychology and Chiropractic fee schedules.

I believe that these actions will help the Board recruit and retain the best doctors in New York, helping to ensure injured workers receive swift, quality medical care now and into the future.



Information on the 2010-2011 Influenza Season

Wednesday, September 1st, 2010

August 30, 2010
Dear Influenza Vaccine Provider:
This letter is intended to encourage you to continue to vaccinate against influenza and to provide you with information on the 2010-2011 influenza season.
For those providers who have previously administered influenza vaccinations to your patients, we hope that you will strongly consider continuing in your role as a vaccine provider. You should review your influenza vaccine purchasing options and assess the needs of your
practice or organization. For more information on distributors and influenza vaccine availability, please visit the following websites:
 New York State Vaccines for Children Program
 Influenza Vaccine Distributor Information
 Influenza Vaccine Availability Tracking System (IVATS)
On February 24, 2010 vaccine experts voted that everyone 6 months and older should get flu vaccine each year starting with the 2010-2011 influenza season. The Center for Disease Control’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted for “universal” flu vaccination in the U.S. to expand protection against the flu to more people. Please also note that the following virus strains will be contained in the trivalent seasonal influenza vaccine for the 2010-2011 seasonal influenza:

  • A/California/7/09 (H1N1)-like virus (pandemic (H1N1) 2009 influenza virus)
  • A/Perth /16/2009 (H3N2)-like virus
  • B/Brisbane/60/2008-like virus

A higher dose formulation of an inactivated seasonal influenza vaccine (Fluzone High- Dose, manufactured by sanofi pasteur, licensed by FDA on December 23, 2009) for use in people age 65 years and older will also be available in the 2010-11 influenza season. Fluzone High-Dose contains four times the amount of influenza antigen compared to other inactivated seasonal influenza vaccines. Studies are underway to assess the relative effectiveness of Fluzone High-Dose compared to standard dose inactivated influenza vaccine, but results from those studies will not be available before the 2010-11 influenza season. The ACIP has not expressed a preference for Fluzone High-Dose or any other licensed inactivated influenza vaccine for use in people age 65 and older.
All children 6 months through 8 years of age are recommended to receive 2 doses of 2010-11 flu vaccine unless they meet the following conditions (in which case, only 1 dose of influenza vaccine is needed):

  • at least 1 dose of 2009 H1N1 vaccine last flu season, and at least 1 dose of seasonal vaccine prior to the 2009-2010 flu season


  • at least 1 dose of 2009 H1N1 vaccine last flu season, and 2 doses of seasonal flu vaccine last flu season

If possible, the first dose should be given as soon as vaccine becomes available. The second dose should be given 28 or more days after the first dose. We strongly encourage you to continue in your vaccination efforts against influenza and plan for this upcoming influenza season. Should you need further assistance, please call the NYSDOH Bureau of Immunization at 518-473-4437.
Guthrie S. Birkhead, M.D., M.P.H.
Deputy Commissioner
Office of Public Health

Posted in FLU/IMMUNIZATION UPDATES | No Comments »