Medical Care Long Island

MIND AND MEMORY: WHAT YOU NEED TO KNOW

mcappola — Thu, 19 Jan 2012 17:19:03 +0000

This FREE program is open to the public as a community service

As we age, we worry about memory loss. Should we be concerned if we can’t remember a neighbor’s name, a doctor’s appointment or where we left our keys? With our hectic lives and multi-tasking it’s not unusual to experience a lapse in memory. Attend this workshop to understand what is normal forgetfulness, what causes memory impairment and how to improve your memory. Handouts and refreshments will be available.

This program is sponsored by the Nassau Academy of Medicine

Wednesday, April 18, 2012 at 11:00 AM-12:00 Noon

at the Nassau Academy of Medicine

located at 1200 Stewart Avenue, Garden City, NY.

Pre-registration is recommended. Contact the Academy directly at 516-832-2300, Ext. 13 to register. For directions visit http://www.nacmed.org

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URGENT ACTION Collective Bargain Bill goes to Assembly Health on Jan 19.

mcappola — Wed, 18 Jan 2012 14:34:33 +0000

The Consumer Protection Act - Collective Bargaining - is on the Assembly Health Committee agenda, for Thursday, January 19, 2012. Without your help, this bill will not pass.

Email as many committee members as possible below. Tell them to VOTE YES on A2474a.

Richard Gottfried, Chair

GottfriedR@assembly.state.ny.us

Inez Barron

BarronI@assembly.state.ny.us

Kevin Cahill

CahillK@assembly.state.ny.us

NelsonCastro

Castro@assembly.state.ny.us

James Conte

ConteJ@assembly.state.ny.us

Steven Cymbrowitz

CymbroS@assembly.state.ny.us

Jeffery Dinowitz

DinowitzJ@assmbly.state.ny.us

Christopher Friend

friendc@assembly.state.ny.us

Sandy Galef

GalefS@assembly.state.ny.us

Andy Goodell

goodellA@assembly.state.ny.us

Aileen Gunther

GuntherA@assembly.state.ny.us

Andrew Hevesi

HevesiA@assembly.state.ny.us

Rhoda Jacobs

JacobsR@assembly.state.ny.us

Charles Lavine

mailto:LavineC@assembly.state.ny.us

David McDonough

McDonoD@assembly.state.ny.us

Joel Miller

MillerJ@assembly.state.ny.us

Amy Paulin

PaulinA@assembly.state.ny.us

Cyrstal People-Stoke

PeoplesstokesC@assembly.state.ny.us

Edward Ra
raE@assembly.state.ny.us

Andrew Raia

RaiaA@assembly.state.ny.us

Naomi Riveria

RiveriaN@assembly.state.ny.us

Linda Rosenthal

RosenthalL@assembly.state.ny.us

Robin Schimminger

SchimmR@assembly.state.ny.us

Matthew Titone

TitoneM@assembly.state.ny.us

Lou Tobacco

TobaccoL@assembly.state.ny.us

Suffolk and Nassau Assembly members in red

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Flu Immunization Update for Medicare Physicians

mcappola — Tue, 10 Jan 2012 16:58:22 +0000

Flu Season is Here! While seasonal flu outbreaks can happen as early as October, flu activity usually peaks in January. Remind your patients that annual vaccination is recommended for optimal protection. Medicare pays for the seasonal flu vaccine and its administration for seniors and others with Medicare with no co-pay or deductible. Healthcare workers, who may spread the flu to high risk patients, should get vaccinated too. Don’t forget to immunize yourself and your staff. Protect your patients. Protect your family. Protect yourself. Get the Flu Vaccine—Not the Flu.

Remember – The flu vaccine plus its administration are covered Part B benefits. CMS has posted the 2011-2012 seasonal flu vaccine payment limits at http://www.CMS.gov/McrPartBDrugAvgSalesPrice/10_VaccinesPricing.asp. Note that the flu vaccine is NOT a Part D-covered drug.

For more information on coverage and billing of the flu vaccine and its administration, as well as related educational provider resources, visit http://www.CMS.gov/MLNProducts/35_PreventiveServices.asp and http://www.cms.gov/immunizations.

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Revised Medicare fee schedule for January 1, to February 29, 2012 is up on-line

mcappola — Fri, 06 Jan 2012 15:11:36 +0000

The revised Medicare fee schedule for January 1, to February 29, 2012 is up on-line at:

http://www.ngsmedicare.com/wps/portal/ngsmedicare/!ut/p/c4/04_SB8K8xLLM9MSSzPy8xBz9CP0os3gDr2BnRzdTEwN3YwMjA0_H0FDXMH8jA3dLM_2CbEdFAOFxTSo!/

Please be sure to review your correct NYS payment locality.

Again, as you should know, CONGRESS voted on at least five (5) separate Medicare Physician Fee Schedules for calendar year 2010. This caused the Medicare contractors to reprocess physicians’ claims for the first 5 months of the 2010 year and resulted in some peculiar recovery actions. Please use the following link to locate your elected officials and contact them to urge that 2010 not be repeated: http://www.mssny.org/mssnyip.cfm?c=s&nm=Grassroots_Action The Medicare fee schedule needs to be properly addressed. Fixing the flawed Medicare payment system and protecting Medicare beneficiaries’ access to doctors is vital. Congress must pass legislation permanently reforming the SGR and address this issue once and for all. The pattern of threatened SGR cuts and last-minute Congressional rescues is in itself not a sustainable solution and must be remedied.

Regina

Regina McNally, VP

Division of Socio-Medical Economics

Medical Society of the State of New York

Agreement Ends Stalemate on SGR Cuts

mcappola — Tue, 27 Dec 2011 15:28:17 +0000

24% MEDICARE PAYMENT CUTS DELAYED FOR 2 MONTHS

Below is a press statement issued by House Speaker Boehner, announcing that the House and Senate have reached agreement on a two month extension of important policies that expire on January 1, including a reprieve from the 27.4 percent Medicare physician payment cut that is scheduled to take effect. Legislators plan to approve this proposal before Christmas, and a House-Senate conference committee will convene in January to work on a longer-term agreement. At a press conference, Speaker Boehner said the goal is to extend all the expiring programs for a full year, except for the physician payment cut reprieve which is to be extended for two years.

In a press statement released today, the AMA urged Congress to use this time constructively and develop the permanent solution to the sustainable growth rate formula that all agree is needed.

WASHINGTON, DC – House Speaker John Boehner (R-OH) today issued the following statement:

“Senator Reid and I have reached an agreement that will ensure taxes do not increase for working families on January 1 while ensuring that a complex new reporting burden is not unintentionally imposed on small business job creators. Under the terms of our agreement, a new bill will be approved by the House that reflects the bipartisan agreement in the Senate along with new language that allows job creators to process and withhold payroll taxation under the same accounting structure that is currently in place. The Senate will join the House in immediately appointing conferees, with instructions to reach agreement in the weeks ahead on a full-year payroll tax extension. We will ask the House and Senate to approve this agreement by unanimous consent before Christmas. I thank our Members – particularly those who have remained here in the Capitol with the holidays approaching – for their efforts to enact a full-year extension of the payroll tax cut for working families.”

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Update on the SGR and 2012 Medicare Physician Payments

mcappola — Wed, 21 Dec 2011 16:31:21 +0000

Dateline : December 20, 2012,

The House of Representatives held a series of votes regarding H.R. 3630, legislation that would extend an expiring payroll tax reduction and unemployment insurance benefits, as well as stop a 27.4 percent Medicare physician payment cut that is scheduled to take effect on January 1. The net result was to leave the status of 2012 payment rates in limbo.

Votes on H.R. 3690: As originally passed by the House on December 13 by a vote of 234-193, the legislation would have provided Medicare physician payment updates of 1 percent a year for two years, followed by a return to the current negative trend line produced by the sustainable growth rate (SGR) formula. But, due to disagreements over financial offsets and other policy issues unrelated to the SGR, the legislation could not attract a sufficient number of votes to pass the Senate.

On December 17, the Senate voted 89-10 to pass an amended version of the bill that would extend all the expiring policies, including current Medicare physician payment rates, for two months. The rationale for the short-term extension was to avoid disruptions on January 1 and provide time for further negotiations on financing longer-term extensions.

House action on December 20: Following the Senate’s action, a significant number of House Republicans expressed strong opposition to the two-month extension, and several relevant votes were scheduled for today. Most important of these, the House approved a resolution by a vote of 229-193 to disagree with the Senate and appoint members to a House-Senate conference committee, which would be charged with working out differences between the two versions of the bill.

Prior to the House votes today, the Senate leadership announced that the Senate would not reconvene over the holidays to engage in further negotiations and votes. In addition, members of the House are departing this evening for the holidays, after being informed that they could be called back to Washington on short notice. At this time, it does not appear likely that the outstanding issues will be resolved before January 1.

Outlook for January: On December 19, the Centers for Medicare and Medicaid Services announced that it would hold claims for 2012 physician services for 10 business days, until January 17, to avoid processing payments at the lower rate. After that date claims will be processed on a first in, first paid basis at the reduced rates until the situation is resolved.

The House is currently scheduled to return to Washington on January 17, while the Senate is scheduled to return on January 23. However, there are reports that the House, at least, may move up the date of its return to January 3.

AMA views: The AMA issued strong statements following the House and Senate votes reaffirming its opposition to any short-term patches to the SGR formula, denouncing the political brinkmanship that left the issue unresolved until Congress was adjourning, and calling for a bipartisan effort to repeal flawed and disruptive formula once and for all.

Throughout the year, the AMA has been pursuing a strategy for repealing the SGR that was developed in consultation with state medical societies and national medical specialty societies. We continued to oppose short-term remedies that serve to make future cuts deeper and the cost of permanent payment reform increasingly steep. And, throughout the year, bicameral and bipartisan support has been expressed in Congress for permanently addressing the Medicare physician payment crisis. Nonetheless, physicians and their patients once again find themselves confronting uncertainty and instability. It is long past time for Congress to act decisively and protect access to care for senior citizens and military families that rely on TRICARE—they and their physicians deserve better.

The AMA will provide additional updates on the status of the 2012 payment rates as events unfold. With the expectation that Congress will be in recess, we will defer any new grassroots messaging between now and the New Year. New grassroots messages will be available after January 1 or if Congress decides to return to Washington between the holidays. The AMA’s latest grassroots messages can always be viewed at www.ama-assn.org/go/grassroots, and physicians can reach their federal legislators by telephone using our toll-free physician’ grassroots hotline number: 1-800-833-6354.

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P.O. Boxes No Longer Permitted in Billing Provider Address in 5010 Transactions Jan. 1

mcappola — Wed, 16 Nov 2011 18:57:07 +0000

Do you use a P.O. Box or lock box address as you billing provider address to receive payments? If you submit claims electronically, you will be required use only a street address or physical location as the billing provider address. Continuing to report a P.O. Box in the billing provider address field will cause your claims to reject.

Under the Health Insurance Portability and Accountability Act (HIPAA), all physicians and other health care providers that submit claims electronically are required to transition to the Version 5010 transactions by Jan. 1. One of many data reporting changes in the Version 5010 transactions is the requirement to report only a street address or physical location as the billing provider address.

Practices that wish to continue having payments sent to a P.O. Box or lock box will report this address in the “pay-to” address field.

You may need to work with your practice management system vendor, billing service, or clearinghouse to have this address change made for your claims. Talk to them today to find out if a change is needed and when it will be done. This work needs to be done prior to Jan. 1 to prevent claims rejections and interruptions in your cash flow.

Visit www.ama-assn.org/go/5010 or www.cms.gov/Versions5010andD0 for more information on data reporting changes in the Version 5010 transactions and to prepare your practice for the Jan. 1 deadline.

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Academy of Medicine Donates Millett Funds To Lion’s Club Diabetes Education Board

mcappola — Wed, 16 Nov 2011 18:29:30 +0000

On November 15, the Nassau Academy of Medicine recently presented a check in the amount of $5,850, from the Joseph Millett, MD Memorial Fund to the Lions Club District 20k2 Diabetes Education Board.

Lions Club District 20K2 Treasurer, Thomas Grosso accepted the donation from NAM President Vincent Geraci, Jr. MD, while Helen McQuade, daughter of Dr. Millett was on hand to make the presentation of the ceremonial check.

Lions are an international network of 1.3 million men and women in 202 countries and geographic areas who work together to answer the needs that challenge communities around the world. They are best known for working to end preventable blindness and sponsoring camps for newly diagnosed children with Diabetes.

The Nassau Academy of Medicine was established in 1953 to establish, conduct, operate and maintain and Academy of Medicine to provide educational opportunities and training of a postgraduate nature for members of the medical profession in Nassau County, and to diffuse among people knowledge of the achievements of scientific medicine.

The Joseph Millett, MD, Memorial Fund was created in 1966, following the death of Dr. Millett, to provide an endowment for medical research. At the suggestion of Mrs. Joseph Millett, a donation this donation has been made to an organization such as the Lions Club as Dr. Millett dedicated his medical career to treating diabetes patients.

L. to R.: Joseph Cohn, MD, Greta Rainsford, MD, Mrs. Helen McQuade,

Mr. Thomas Grosso, Vincent Geraci, Jr. MD, Craig Marcus, MD Arnold Prywes, MD

New York Launches Their Medicaid EHR Programs This Month

mcappola — Mon, 14 Nov 2011 16:54:53 +0000

On November 7th, the Medicaid Electronic Health Record (EHR) Incentive Program launched in New York. This means that eligible professionals (EPs) and eligible hospitals in New York will be able to complete their incentive program registration. More information about the Medicaid EHR Incentive Program can be found on the Medicare and Medicaid EHR Incentive Program Basics page of the CMS EHR website.

If you are a resident of New York, and are eligible to participate in the Medicaid EHR Incentive Program, visit your State Medicaid Agency website for more information on your state’s participation in the Medicaid EHR Incentive Program. Click on a State below to access its website.

New York

As of November 7th, 39 states have launched Medicaid EHR Incentive Programs and through October, 23 states have issued incentive payments to Medicaid EPs and eligible hospitals who have adopted, implemented, or upgraded certified EHR technology. CMS looks forward to announcing the launches of additional states’ programs in the coming months.

For a complete list of states that have already begun participation in the Medicaid EHR Incentive Program, see the Medicaid State Information page on the CMS EHR website.

Want more information about the EHR Incentive Programs?
Make sure to visit the EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

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More NY Courts to Focus on Medical Malpractice

mcappola — Mon, 14 Nov 2011 14:15:49 +0000

November 11, 2011 1:15 PM

(AP) ALBANY, N.Y. — New York courts specializing in the state’s 4,000 medical malpractice cases filed each year have begun expanding following the success of a Bronx judge in settling cases early.

The approach, shown to cut court backlogs and save money, has been extended to Brooklyn, Queens and Manhattan, with some Erie County judges getting trained.

“It was proving to be a cost savings to hospitals and directly impacting the indemnity insurance of doctors,” New York Chief Administrative Judge Ann Pfau said.

Starting Dec. 1, Pfau will become coordinating judge of the court system’s medical malpractice segment. The pilot program is using a $3 million federal grant to train more judges in medical issues. Pfau herself will take cases in Brooklyn, where she is an acting state Supreme Court justice in the commercial division. She said it would be good to make the program citywide and makes sense to extend it to Long Island.

Bronx Justice Douglas McKeon, who began focusing on malpractice cases 15 years ago, said he has helped settle more than 1,000 since, with 12 to 15 cases now on the calendar monthly for intense discussions. Once the city’s Health and Hospitals Corp., which runs 11 public hospitals, created its own claims and law department in 2006 and explored settling cases sooner instead of later, the program “really took off,” with a 95 percent settlement rate for the corporation’s cases, he said.

Corporation deputy counsel Suzanne Blundi said they essentially revamped their whole commitment to patient safety, developing systems to improve care, manage claims and decrease payouts, which dropped from $196 million in 2003 to about $130 million last year.

The effort has entailed trying to investigate malpractice claims early on and also expediting settlements, Blundi said.

“If you have a matter that needs to be resolved, getting compensation to the injured person in a timely fashion is important. We see it as a continued relationship with our patients. … OK, there’s an error, and we’re going to help deal with it,” she said.

McKeon said it’s easier for the corporation as a municipal entity. “They don’t have investments they have to get certain returns on. They’re not an insurance company or one of these captive creations some hospitals put together,” he said.

Without close scrutiny by one judge, cases can come back several times before various judges with settlements discussed but doctors refusing to agree, McKeon said. “To me it’s a waste of court resources. … I always felt if you could extrapolate it across the state you could probably save a sizable sum of money.”

Now attorneys generally go through evidence discovery before serious settlement talks begin, Pfau said. “In a malpractice case, all of that discovery is very expensive.”

In one recent case, where a woman was hit by a car, taken to a city hospital and ended up brain damaged, a settlement was reached for about one-sixth of the initial demand and without the hospital admitting liability, Pfau said. At issue was whether the pressure in the patient’s head had been appropriately monitored.

Arthur Levin, director of the Center for Medical Consumers, an advocacy group, said he has questions about the special courts and their negotiated settlements that should be studied. “Even though people are not forced into it, I have no idea how coercive or not the pitch is,” he said.

Leslie Kelmachter, president of the New York State Trial Lawyers Association, said McKeon has put together a very good program, that malpractice issues are often straightforward, and the lawyers can support earlier settlements on behalf of their clients, the injured victims, as long as they are fair. “There shouldn’t be any pressure on the plaintiffs to settle. It should be voluntary,” she said.

It makes sense for the pilot program to target high-population areas with a large number of cases and high hospital malpractice costs, Pfau said. Many cases involve obstetrics and Medicaid patients, sometimes mothers coming to emergency rooms to give birth without any prenatal care, she said.

“What you’re finding is in poorer communities you’re getting higher incidence of this and in poorer communities you’re finding the huge verdicts,” said McKeon, a member of the medical malpractice reform working group of Gov. Andrew Cuomo’s team revamping Medicaid. He said other factors include lawsuits needlessly naming every doctor in a patient’s medical record who had little to do with the case, and preventive medicine’s increase in diagnostic tests, which create more opportunities for poor communications between diagnosing and treating physicians, he said.

Earlier this year, Pfau issued, and the Administrative Board of the Courts approved, new rules for the state trial courts on medical malpractice, calling for settlement conferences 45 days after court papers are filed indicating that the case is ready for trial. Only attorneys fully familiar with the case and authorized to settle it are to appear, and judges may also order insurance representatives and others with an interest to appear.

Federal data showed just over 1,800 medical malpractice payments statewide for $736 million in 2009, down from 2,400 payments for $822 million three years earlier. The New York Public Interest Research Group noted that 10 percent drop occurred even as the number of doctors practicing in the state increased to almost 65,000.

Brian Conway

Vice President, Communications

Greater New York Hospital Association

(212) 506-5477

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