NON PHYSICIAN SCOPE OF PRACTICE BILLS MOVING IN LEGISLATURE – PHYSICIAN ACTION NEEDED NOW!!!

June 13th, 2011

Despite compelling arguments against them, all three bills highlighted in last week’s Capital Update were reported by the Senate Higher Education Committee to the Senate floor this week. Physicians engage in discussions with elected officials and urge no further action on a number of bills now winding their way through the legislative process. This is true even for bills that in past years died in one House or the other. Please take action on the following:

1. Nurse Practitioner Scope of Practice: Status: On Senate Floor; In Assembly Higher Education Committee.

Legislation (S.3881, Hannon/A. 2157, Gottfried) was reported earlier this week by the Senate Higher Education Committee to the floor of the Senate. This measure would authorize a nurse practitioner to perform any function in conjunction with the making of a diagnosis of illness or physical condition, or the performance of therapeutic and corrective measures within a specialty area of practice lawfully performed by the NP that a statute authorizes or directs a physician to perform that function.  The bill is both ambiguous and contradictory. It fails to clearly articulate the additional functions being authorized. Moreover, it appears to equate the work of a nurse practitioner with that of a physician as it fails to relate the NP’s authority to perform such services back to the written practice agreement and written practice protocols required in subparagraph (3)(a) of Section 6902.

Physicians are urged to call their senator immediately at 455-2800 to oppose this bill. Physicians can also send a letter in opposition to this bill by clicking here:

http://www.capwiz.com/mssny/issues/alert/?alertid=49316526&type=ST

2. Nurse Practitioner Scope of Practice- Death Certificates: Status: On Assembly Codes

Committee Agenda; In Senate Higher Education Committee.

Legislation (A.1747, Gunther/S.325, Montgomery) was reported earlier this week by the Assembly Higher Education Committee to the Assembly Codes Committee. This measure would allow nurse practitioners to sign death certificates.  Under the law the death certification process does not simply involve ascertainment and certification of the fact of death. Ultimately, accurate death certification is a public health issue with two principal goals—(1) to be certain that the individual death is investigated adequately and (2) to provide the best possible data to the public jurisdictions charged with overseeing the public health.  The physician certifying a death is often the last scientist who will ever think about diseases the person had, and how he/she came to die. When there is doubt about a death or the circumstances surrounding it, the physician should not certify it. Large epidemiologic and public health decisions are made based upon death certificate data, and much public health research is based on death certificates. To permit other individuals, with less medical and scientific training than physicians, to certify the death of an individual would seriously decrease society’s protection of the individual and its commitment to public health.

Physicians are urged to call their assemblymember immediately at 455-4100 to oppose this bill. Physicians can also send a letter in opposition to this bill by clicking here:

http://www.capwiz.com/mssny/issues/alert/?alertid=49331501&type=ST

3. Extension of Pharmacist Authority to Immunize: Status: On Senate Floor and in Assembly Ways & Means Committee.

Legislation (S.3807-A, Fuschillo/A.8030, Paulin) was reported earlier this week by the Senate Higher Education Committee to the Senate Floor. This measure would extend a law enacted in 2008 and due to sunset in 2012 until 2016. The law authorizes a licensed pharmacist to administer vaccines for flu and pneumococcal disease to adults, and emergency treatment of anaphylaxis pursuant to a non-patient specific regimen prescribed by a licensed physician or certified nurse practitioner.  In order to administer immunizing agents, the pharmacist is required to attain a certificate from the Education Department. Importantly, the 2008 law which authorized pharmacists to administer these vaccines called for a report to be issued by the Commissioner of Health on or before December 31, 2011 which would evaluate the effectiveness and impact of implementation of the law upon the supply and geographical distribution of such immunizing agents among health care providers in New York State. We are not aware that such report has yet been issued and consequently believe that the bill is premature and unnecessary since the law is not due to expire until March 31, 2012.

Physicians are urged to call their senator immediately to oppose this bill at 455-2800. Physicians can also send a letter in opposition to this bill by clicking here:

http://www.capwiz.com/mssny/issues/alert/?alertid=49381501&type=ST

4. Chiropractor-Physician Ownership of LLC: Status: On Senate Floor; In Assembly Corporations Committee.

Legislation (S5012, Fuschillo/A.7403, V. Lopez) was reported earlier this week by the Senate Higher Education Committee to the Senate Floor. This measure would allow doctors of chiropractic, licensed under Title VIII, Article 132 of the education law, to form partnerships with medical doctors.  This specific legislation is new this year and should receive much more attention and study before it is approved by either house of the Legislature.

Physicians are urged to call their senator immediately to oppose this bill at 455-2800. Physicians can also send a letter in opposition to this bill by clicking here:

http://www.capwiz.com/mssny/issues/alert/?alertid=49334506&type=ST

5. Dental Scope of Practice: Status: On Senate floor; In Assembly Higher Education Committee.

Legislation (S.3059 Libous, Klein, Maziarz/A.2820 Morelle) is on the Senate floor and can be acted upon at any time. This bill would permit non-physician oral and maxillofacial surgeons to perform a wide range of medical surgical procedures involving the hard or soft tissues of the oral and maxillofacial area, including many cosmetic surgery procedures.

MSSNY has long opposed this bill and has been joined in opposition by the American Medical Association, The American Society of Plastic Surgeons, the American Academy of Otolaryngologists – Head and Neck Surgery, the American Academy of Dermatology, the American College of Surgeons, the American College of Physicians, the American Congress of Obstetricians and Gynecologists – District II, the New York Ophthalmological Society, the New York State Society of Orthopaedic Surgeons, and the New York Chapter of the American College of Surgeons.

Physicians are urged to call their senator immediately to oppose this bill at 518-455-2800.  Physicians can also send a letter in opposition to this bill by clicking here.

6. Podiatric Scope of Practice: Status: Passed Senate; In Assembly Higher Education Committee.

Legislation (A.3475 Pretlow/S.3758 Libous) which would expand the scope of practice of podiatrists beyond the treatment of the foot, and in so doing, remove language that restricted the podiatrist from treating other parts of the body, was recently passed by the Senate and has been referred to the Assembly Health Committee.

Currently, podiatrists are authorized to diagnose, treat, operate, and prescribe for any disease, injury, deformity or other condition of the foot.  This bill expands the scope of podiatrists to include any disease, injury, deformity, or other condition of the ankle and the soft tissue structures of the leg below the knee.  In addition, the bill allows for the treatment of systemic conditions that present in local manifestations, presumably those affecting the lower leg.

Physicians MUST WEIGH IN against this measure by calling members of the Senate (518-455-2800) and by sending a letter to their elected representatives by clicking here:

http://www.capwiz.com/mssny/issues/alert/?alertid=45271501&type=ST

7. Naturopath Licensure: Status: In Senate Finance Committee and Assembly Higher Education Committee

Legislation (S.1803 LaValle/A.1937 Hoyt) which would license naturopaths and allow them to prescribe, administer, diagnose, and treat patients is in the Senate Finance Committee.  The bill authorizes the use of the title “naturopathic doctor” or “doctor of naturopathic medicine,” which will mislead the public and convey the false impression that the naturopathic practitioner is, in fact, the equivalent of a licensed physician.  The legislation does not require disclosure that the naturopath is not practicing medicine and that the services provided will not automatically be covered by health insurance.

MSSNY continues to oppose this bill and urges that physicians call their senator immediately to express their opposition to it at 518-455-2800 and by sending a letter to their elected representatives by clicking here:

http://www.capwiz.com/mssny/issues/alert/?alertid=45363501&type=ST

8. Nurse Practitioner Independent Practice: Status: Bill remains in Committee

Legislation (A.5308 Gottfried/S.3289 Young) that would eliminate the requirement for a written practice agreement and collaborative relationship with a physician has been introduced in both houses of the Legislature and, for now, remains in the Higher Education Committee in each House. MSSNY opposes this legislation for concern for the quality of patient care.

Physicians are urged to send a letter to their respective Assembly and Senate representatives by clicking here.

Posted in NEWS FROM THE NYS LEGISLATURE |

OUT OF NETWORK COVERAGE TRANSPARENCY LEGISLATION – PHYSICIAN ADVOCACY NEEDED

June 13th, 2011

With just a little over a week left in the 2011 Legislative Session, all physicians are urged to contact their senators to ask that they pass legislation (S.5068, Hannon) that would a) prevent insurance companies from selling policies with out of network coverage that fail to provide significant coverage for such costs, and b) better assure transparency of health insurance policies that provide out of network coverage by requiring all such policies to be based upon a percentage of the new FAIR Health database.  Physicians can contact their senators by calling 518-455-2800, and asking for their senator. Physicians can send a letter to Governor Cuomo and their local legislators in support of this legislation by clicking here.

This issue is important for all physicians, not just physicians who do not participate with insurance companies.  In most cases, physicians have little or no ability to negotiate patient care and other terms with a health insurer.  Often the only leverage a physician has in these negotiations is to simply decline to participate.  If health plans are permitted to make grossly inadequate payments for out of network care, they would have no incentive whatsoever to negotiate in good faith with any physician.  The “right to walk away” would essentially be meaningless.

Identical legislation (A.7489, Gottfried) has passed the Assembly.

Not surprisingly, the insurance industry has aggressively opposed this legislation.   To overcome this opposition, all physicians are urged to call in to their local legislators to ask that this problem be fixed.

Posted in NEWS FROM THE NYS LEGISLATURE |

CONTINUED GRASSROOTS EFFORTS URGED TO DEFEAT LIABILITY EXPANSION LEGISLATION

June 13th, 2011

As we head into the final days of the 2011 Legislative Session, legislation is being aggressively sought by trial lawyers to increase liability exposure against physicians and drive up the already unsustainably high cost of liability insurance coverage.  The Legislature has failed to address this problem. They cannot be permitted to worsen it by passing any of these bills which, if enacted, would exacerbate the serious access-to-care problems that already exist within New York’s fragile health care system.  Continued physician advocacy in opposition to these bills is essential.

MSSNY is working with the Greater New York Hospital Association and the Healthcare Association of New York State on a campaign to prevent the enactment of these bills, including establishing a joint petition in opposition to these bills that physicians can sign by clicking here: http://www.medmaltruth.org/.  Physicians can also send their own letter to legislators in opposition to these proposals and support for medical liability reform by clicking here.

The bills include legislation that would:

• Create a “date of discovery” rule for the statute of limitations (S.5242, Fuschillo/A.4852, Weinstein) – Estimated to increase premiums by 15%.
• Expand “wrongful death” damages (S.2540, DeFrancisco/A.4851, Weinstein)– Estimated to increase premiums by 53%.

• Permit the awarding of pre-judgment interest (A.4929, Brennan) – Estimated to increase premiums by 27%.
• Eliminate the limitations on contingency fees (S.2541, DeFrancisco) – Estimated to increase premiums by over 10%.
• Prohibit ex-parte interview of plaintiff’s treating physician (S.3296-A, DeFrancisco/A.694-A, Lancman)
• Require that, when a medical liability lawsuit is brought against two or more defendants, a non-settling defendant must elect prior to trial to reduce their liability by either 1) the balance of the jury award to the plaintiff or 2) by an equitable share determined by the jury (S.3766, DeFrancisco/A.625, Weinstein).

Please act now to prevent a health care access disaster!

Posted in NEWS FROM THE NYS LEGISLATURE |

NOW IS THE TIME! PHYSICIAN ACTION NEEDED TO ENACT COLLECTIVE NEGOTIATION BILL

June 13th, 2011

You can make the difference.  With next week the last full week remaining in the 2011 Legislative Session, all physicians must continue to call and write their legislators to urge that legislation (A.2474-A, Canestrari/S.3186-A, Hannon) be enacted to permit independently practicing physicians to come together under close state supervision to collectively negotiate their participation contracts with health insurers.   In addition to phone calls (Assembly: 518-455-4100/Senate: 518-455-2800), physicians can send a letter from the MSSNY Grassroots Action Center by clicking here.

This week S.3186-A was unanimously reported from the Senate Health Committee to the Senate Finance Committee.  A.2474-A is currently in the Assembly Ways and Means Committee.

Posted in NEWS FROM THE NYS LEGISLATURE |

ANGRY RESPONSE FROM MSSNY TO BUDGET AGREEMENT

March 29th, 2011

To All New York Physicians

Physicians across New York are more than disappointed that Governor Cuomo, the New York State Senate and Assembly reached a budget agreement yesterday that did not contain caps on non-economic damages. We are angry, disgusted and feel betrayed by this unconscionable decision.  The budget agreement did not embody the medical tort reform principles of balance and shared sacrifice that would have brought economic stability to hospitals and physicians.

“The medical liability component of the budget was essential to restore fiscal stability to our healthcare system,” said Leah McCormack, MD, President of the Medical Society of the State of New York. “The consequences of this missed opportunity will devastate our healthcare system for the next decade. There is a basic lack of understanding by our legislators of economic sustainability— that there will be fewer physicians available to render care to our neediest patients. This deal potentially decimates the already fragile New York health care system.”;

Under these circumstances, the Medical Society no longer endorses the Governor’s Medicaid Redesign Team Plan. We could not have been more clear that MSSNY would endorse the Medicaid Redesign Plan “if, and only if, the Medical Liability Reform proposals remain(ed) intact.”;

We urge the Governor and the Legislature to reverse the decision.

Dr. McCormack commented, “MSSNY will be reevaluating its political efforts and taking a long look at our priorities. It is no longer business as usual.”

Posted in NEWS FROM THE NYS LEGISLATURE |

Statement of the Medical Society of the State of New York on the Medicaid Redesign Team Report

March 9th, 2011

Statement of the Medical Society of the State of New York on the Medicaid Redesign Team Report and its Inclusion in Governor Cuomo’s Proposed 2011-2012 Budget

The Medical Society of the State of New York will support the report of the Medicaid Redesign Team, as incorporated into Governor Cuomo’s Budget Amendments, if, and only if, the Medical Liability Reform proposals remain intact. The Medical Society of the State of New York has decided to support this Report for one overriding reason –Medical Liability Reform. Medical liability reform is the linchpin of successful reform; Medical Liability Reform is Medicaid Reform. Without Medical Liability Reform, specifically, the $250,000 cap on non-economic damages, the Re-design Plan is not sustainable. Without medical liability reform, the Medical Society will not support this report.

Like many of our colleague organizations, the Medical Society of the State of New York has concerns with some of the recommendations in the Report. We will continue to advocate for the physicians and patients of New York State. We will seek changes in the Medicaid program to address inadequate physician payments; unwarranted non-physician scope of practice expansions; and insurer surcharges on payments for physicians’ services. We look forward to working with Governor Cuomo, the Legislature, and other like-minded organizations to achieve meaningful medical liability tort reform and Medicaid reform.

Posted in NEWS FROM THE NYS LEGISLATURE |