Medical Care Long Island » NEWS FROM THE NYS LEGISLATURE

Contact Gov. to Assure Coverage for Treatment to Intoxicated Drivers

mcappola — Mon, 26 Jul 2010 14:30:27 +0000

Physicians are urged to contact the Governor in support of a measure (S.7845, Breslin/A.11116, Dinowitz) passed by the Legislature to require No-Fault carriers to cover the costs of providing emergency care to intoxicated drivers. MSSNY strongly supports this legislation. The bill would at last rectify an anomaly in the law whereby under federal law physicians and hospitals are required to provide emergency care to all patients, but a separate state law permits insurers to deny coverage for care provided to intoxicated drivers. As a result, many physicians have experienced the situation where they are not paid for providing this often-life saving treatment. Perhaps most importantly this bill would eliminate the current disincentives to testing patients for alcohol and better assure that patients can obtain the counseling they need. Please indicate your support for this legislation by asking the Governor to sign this measure into law.

The bill was delivered to the Governor for his consideration this past Monday, so by law he must take action by the end of next week. Physicians can send a letter to Governor Paterson by clicking here.

GOVERNOR PATERSON ANNOUNCES “EXTRAORDINARY” SESSION ON WEDNESDAY 7/28

mcappola — Mon, 26 Jul 2010 14:22:17 +0000

Governor Paterson has just announced that he will be calling the legislature into “extraordinary session” on Wednesday to “consider legislation to complete the state budget.” He stated: “The State budget is 15 weeks late, we have yet to close our $9.2 billion current year deficit or reduce our out year gaps, and have no plan to address an additional billion dollar problem that may arise if the Federal government does not provide FMAP contingency funds. New Yorkers cannot afford to wait any longer for a final State budget.” Governor Paterson will call the Legislature into extraordinary session on Wednesday, July 28, at 6 p.m., to consider legislation required to complete the State budget, as well as other critical policy issues that were not addressed in the regular session of the State Legislature.

URGENT – Defeat the HIV Testing Bill

mcappola — Tue, 22 Jun 2010 13:42:06 +0000

We are asking you to call your legislators in Albany regarding the HIV Testing Bill. Assemblymembers can be reached at 1-518-455-4100 and Senate at 518-455-2800. Immediate action is necessary. The bill is being sponsored by Assemblymember Richard Gottfried and Senator Thomas Duane. To send an email see article below.

We met with Assemblyman Gottfried this morning and it is his intent to move the bill forward.

This bill would require mandatory offering of HIV testing to persons 13-64 by primary care physicians in all practice settings, including the private physician office.

A Bill introduced this late is session, means that it may move quickly.

The Bill is in the Senate Rules Committee and in the Assembly Health Committee. We urge you to contact your representatives and urge defeat of this proposal.

BILL REQUIRING PHYSICIANS TO OFFER AN HIV TEST INTRODUCED IN NYS LEGISLATURE; PHYSICIANS URGED TO CALL LEGISLATORS

A bill mandating the offering of an HIV test in all clinical settings, including the private physicians offices, has been introduced in the Legislature by Senator Thomas Duane and Assemblymember Richard Gottfried. S.8227/A.11487 has gone directly to the Senate Rules Committee and to the Assembly Health Committee. The introduction of this legislation indicates a disturbing trend in the interference by the New York State Legislature into the physician-patient relationship. The bill would require that all primary care physicians, defined in the bill as family medicine, general pediatrics, primary care, internal medicine, primary care obstetrics or primary care genecology, to offer an HIV test to all patients ages 13 to 64. The bill does allow for oral, informed consent when the test being given is a Rapid HIV test. Written informed consent is still needed for the blood test, however, consent would be included in the signed general consent for medical care and remains in effect until it is revoked. Under the measure, an opt-out provision for HIV testing must be included in the consent form. The bill does contain provisions for occupational exposure and testing of the source patient/release of information that MSSNY supports, however, the overall bill provisions are cause for strong concerns. Physicians are urged to call their legislators and urge that this measure be defeated. Senators can be reached by calling 518-455-2800 and Assemblymembers can be reached at 518-455-4100. E-mail addresses for each member can be obtained by logging on to the Senate/Assembly website at: www.nysenate.gov/senators or http://assembly.state.ny.us

PHYSICIAN GRASSROOTS ACTION IN SUPPORT OF COLLECTIVE ACTION LEGISLATION ESSENTIAL

mcappola — Mon, 14 Jun 2010 13:44:01 +0000

With the scheduled end of session only days away time is running out for the Legislature to pass legislation (A.4301-B, Canestrari/S.5204-A, Breslin) that would permit physicians and other health care providers to collectively negotiate patient care contract terms with health insurance companies. The bill is before the full Senate after having been unanimously favorably reported by the Senate Health Committee, and is before the Ways and Means Committee in the Assembly. In this regard, all physicians are urged to call and write their legislators to urge that this measure be brought to a vote in the Assembly and Senate, and enacted. Physicians can send a letter from the MSSNY Grassroots Action Center site.

Such collective action is now prohibited. As a result, most physicians face one-sided contracts from health insurers with little, if any, opportunity to negotiate. At a time when New York State and all New Yorkers are reeling from the financial tumult of the last two years, health insurer profiteering must end. This bill will assure that physicians are able to provide their patients the care they need and deserve, and receive fair compensation for providing this care.

In addition to Assemblyman Canestrari, the following members of the Assembly from Nassau County have officially co-sponsored this legislation: Schimel and Hooper.

While the extensive support given to this bill through co-sponsorship is helpful, it is not in of itself enough to achieve passage. If you want to see this legislation become reality, physicians must continue to articulate to their legislators the need for this legislation and they must do this in overwhelming numbers!

BUDGET EXTENDER BILL ENACTED BY LEGISLATURE INCLUDES SUBSTANTIAL REDUCTIONS TO VARIOUS HEALTH CARE PROGRAMS; HITS HOSPITALS HARD

mcappola — Mon, 14 Jun 2010 13:29:04 +0000

As part of the Budget extender passed Monday by the State Legislature to keep the state government operating through June 13, the Legislature included $775 million in cuts to state programs for the full fiscal year (April 1, 2010 through March 31, 2011) that begin to address the $9.2 billion state Budget deficit.

The legislation included significant cuts to various sectors of the health industry, including particularly hospitals, nursing homes and home care. The health care cuts in the bill passed by the Legislature included, among other things:

> Eliminating the 1.7% trend factor for the rest of the fiscal year for hospitals, nursing homes and home care ($99 million savings);

> Modifying the distribution of indigent care reimbursement to hospitals ($72 million savings);

> Eliminating funding for innovations in Graduate Medical Education ($37 million savings)

> Limiting reimbursement for preventable readmissions to hospitals, nursing home rate appeals and drug costs and payments to nursing homes to hold beds vacant ($36 million savings);

> Repealing of various public health programs, including Private and Public Umbilical cord blood banking program, Shaken Baby Syndrome > > > Public Education program and the Reflex Sympathetic Dystrophy Program;

> Discontinuing HCRA funding for the infertility grant program, disease management demonstration program and long term care education and outreach;

> Modifying the Elderly Pharmaceutical Insurance (EPIC) to require prescribers to file an intent to appeal a Part D denial of drugs while permitting up to a 90-day emergency supply pending the appeal; and

Very importantly, savings of $70 million due to passage of legislation supported by MSSNY (see related article) that will require the State Insurance Department to approve health insurance premiums and require health insurers to meet an increased medical loss ratio.

The Governor has indicated that the next proposed Budget extender will contain cuts to mental health and human services program. Further Budget extenders could include other aspects of the Governor’s proposed Budget, including cuts to education and various revenue raisers. Some legislators have indicated their intent to vote against further Budget extenders, prompting fears by some of a government “shutdown” in the absence of enactment of a further Budget extender. However, negotiations between the Governor and the legislative leaders have significantly picked up in intensity hopefully moving us towards enactment of a complete 2010-11 State Budget.

PHYSICIAN COLLECTIVE NEGOTIATION LEGISLATION ADVANCES TO SENATE FLOOR

mcappola — Mon, 07 Jun 2010 14:49:22 +0000

The Senate Health Committee this week unanimously voted to report to the Senate floor legislation (S.5204-A, Breslin) that would permit physicians to collectively negotiate contract terms with health insurance companies under close supervision by New York State. Identical legislation (A.4301-B, Canestrari) is before the Assembly Ways and Means Committee.

With just 2+ weeks remaining in the legislative session, all physicians are urged to continue to call and write their respective legislators to request that this legislation be brought to a vote and approved by the full Assembly and the full Senate. Immediate focus should be placed on the members of the Assembly Ways and Means Committee to ask that the bill be brought to a vote before the Committee and reported to the Assembly floor. Members of the Committee include:

Assemblymember

Earlene

Hooper

Albany (518) 455-5861

District (516) 489-6610

NEW YORK COALITION OF SPECIALTY CARE PHYSICIANS LOBBY DAY

mcappola — Tue, 18 May 2010 15:08:25 +0000

The NYS Coalition of Specialty Care Physicians, a recently formed group which includes MSSNY and nine specialty societies, held a State Lobby Day on May 11, 2010. The Lobby Day kicked off with a briefing of the attending physicians on the scope of practice bills as well as the bills that affect all physicians, which include the Physician Collective Negotiation and the Medical Liability Reform bills. Physicians and staff from MSSNY and the specialty societies involved then went to appointments which had been scheduled for them with Legislators, from the District where their office is located. A tri-fold information sheet, which gave information and the Coalition’s position on each of a number of scope of practice bills as well as on the general bills was left behind with each Legislator with which they met. Bills highlighted in the tri-fold include:

Podiatry Scope of Practice (A.2518-A Pretlow/S.2992-A Klein) – Oppose

Naturopath Scope of Practice (A.1370 Hoyt/S.1930 LaValle) – Oppose

Dental Scope of Practice ( A.4656-A Morelle/S.2937 Klein) – Oppose

Optometry Scope of Practice (A.3718 Paulin/S.2667 Valesky) – Oppose

Midwife Scope of Practice (A.8117 Gottfried/S.5007 Duane) – Oppose

Physical Therapy Scope of Pratice (S.4631 Oppenheimer/A.4302 Canestrari) – Oppose

Corporate Practice of Multiple Professions (S.7484 Huntley/A.8897 Pretlow) – Oppose

Corporations: Limited Medical Service Practices (A.10150 Paulin) – Oppose

Hearing Aid Access ( S.7670 Schneiderman/A.10056 Dinowitz & Kellner) – Support

Physician Collective Negotiations (S.5204 Breslin/A.4301-A Canestrari) – Support

Medical Liability Reform (S.6799 Hannon/A.6184 Schimminger) – Support

All physicians are urged to contact their Legislators to express their position on these bills as well. The phone numbers are 518-455-4100 (Assembly) or 518-455-2800 (Senate). Ask for your Legislator’s office and make your voice heard.

MSSNY SEEKS FURTHER LIMITS ON ABUSIVE HEALTH INSURER AUDITING PRACTICES

mcappola — Mon, 10 May 2010 14:46:51 +0000

MSSNY staff, joined by attorney Michael Schoppman, met with Assembly Insurance Committee Chair Joseph Morelle this week to highlight the need for legislation to further restrict the ability of health insurance companies to make exorbitant refund demands of physicians.

Schoppman, an attorney with the Kern Augustine Conroy and Schoppman P.C. law firm, has authored a white paper that MSSNY has shared with key legislators and the State Insurance Department entitled Physicians’ Rights: The Misleading and Misapplication of New York State Insurance Law §3224-b by New York Health Plans. Meaningful first steps were taken in 2006 to address abusive health plan refund demands by enactment of a law which limits to 2 years the time within which a health plan can demand a refund from a physician. However, the law has some exceptions to this time limit that have been exploited by some health plans to evade the law, including specious allegations of “abusive billing”.

Several bills supported by MSSNY have been introduced to address this problem, including:
A.10850 (Gottfried), which would enact a number of important reforms including:

Reducing from two years to one year the time limit in which a health plan can demand a refund from a health care provider except where there has been reasonable evidence of fraud or intentional misconduct;

Eliminating the “abusive billing” exception;

Eliminating the ability of a health insurer to demand a refund by using the grossly unfair practice of extrapolation of a relatively few claims;

Prohibiting a health plan from threatening to sanction a physician or other health care provider including a report to a relevant disciplinary body as a result of such physician or other health care provider challenging an overpayment recovery demand.

A.9720 (Bing)/S.7474 (Breslin), which would require a health insurer to reimburse a physician for legal and expert expenses when a health plan inappropriately alleges abusive billing in an audit.

Physicians are asked to communicate their support for these bills to their local legislators.

IMMEDIATE PHYSICIAN ACTION ON COLLECTIVE NEGOTIATION URGED

mcappola — Mon, 10 May 2010 14:41:30 +0000

All physicians are urged to contact their legislators in support of legislation (A.4301A, Canestrari/S.5204, Breslin) which would permit physicians to engage in collective negotiation with health insurers under close state supervision. This bill is vitally important to physicians and patients in our ongoing efforts to restore fairness to the current grossly inequitable situation which allows insurers to virtually dictate all of the terms of their contracts with physicians and other health providers.

This bill obviously is strongly opposed by the health insurance industry. It is currently in the Assembly Ways and Means Committee and the Senate Health Committee. All physicians are requested to contact their legislators in support of this legislation: Assembly (518) 455-4100 - Senate (518) 455-2800 . Moreover, physicians can send a letter in support of this and other managed care reform initiatives by clicking here.

Physicians are also asked to speak to their patients about health insurers’ dominance and the negative consequences which this dominance has for patients seeking needed care. Physician action now is vitally important.

MEMORANDUM IN OPPOSITION to 9.63% HCRA SURCHARGE

mcappola — Thu, 29 Apr 2010 18:48:49 +0000

ESTABLISHMENT OF A 9.63% HCRA SURCHARGE ON OFFICE-BASED SURGICAL AND RADIOLOGICAL PROCEDURES

As contained in the Governor’s Health Budget Art. VII bill (A.9708/S.6608)

This measure contained within the Health and Mental Hygiene Article VII bill would extend the 9.63% HCRA surcharge to services billed as surgery or radiology services which have been provided in physician offices or in urgent care facilities. The Medical Society of the State of New York opposes this provision and urges that that it be removed from the State Budget.

We agree that health insurance companies, which have made extraordinary profits over the last several years, must re-invest these profits back into the healthcare system. They cannot continue to extract from the healthcare delivery system the equity in that system which is essential to its future growth. In this regard, MSSNY supports the proposal contained in the proposed State Budget that would restore the authority of the State Insurance Department (SID) to approve proposed increases in health insurance premium rates, as well as increasing to 85% the minimum medical loss ratio for the nearly 2 million individuals enrolled in small group and individual health insurance policies.

However, while this surcharge would be imposed on the health insurer, not the physician, we are very concerned with the potential that this surcharge will simply be passed through to the physicians who are providing this care through substantial payment reductions and/or to their patients through imposition of higher cost-sharing obligations. Simply put, individual physicians and even group practices lack sufficient leverage now enjoyed by much of the hospital sector to forestall or prevent a possible 9.63% cut in their payment which might be imposed by health insurers to offset the surcharge imposed on them.

Many physician practices today are barely solvent. There are a number of reasons for this, including rapidly escalating practice costs led by the extraordinary cost of medical liability insurance. At the same time, physicians are confronted with declining practice revenue. Radiologists in particular will suffer significant Medicare cuts as a result of the federal health care reform bill. Already in every region of New York State, we are experiencing a significant shortage of critically needed physicians in a number of specialties. The impact of this one proposal, if the proper protections are not established preventing health insurers from passing on these costs, could cause an even larger number of physicians to retire early, alter their practices, or relocate their practices outside of New York State. Access to need surgical and radiological care must be protected.

Based upon the foregoing, your medical society opposes this component of the Governor’s Budget and urges that it be removed.