|
|
The following are excerpts from Dr. Geraci's thank you speech given at the 42nd Annual Medallion Ball held in his honor on May 3 at the Metropolitan in Glen Cove. This year has been an eventful one in our lives. It seems that we live in interesting times, as they say. Every day, a new crisis looms. Some new political or social event requires our immediate attention. Many times the problems that our profession faces are of secondary importance. But I believe it is also a time for great change in many areas. Despite the multitude of items on their agendas, both President Bush and Governor Pataki have made reform of the tort system a goal during their administrations. Your medical society is doing all that it can to keep the urgent need for reform high on the federal and state agenda. Much has been accomplished. Although only a temporary fix, this year, instead of a further cut in Medicare fees, there was actually a small increase. In our state, a dedicated medical malpractice fund has been created to help our lobbying efforts for tort reform and to confront the trial lawyers in their efforts to increase liability limits. Every year we manage to defeat efforts to tax physicians gross revenues here in New York. Locally, in Nassau County, thanks to the efforts of Dr. Felix Monaco, our medical society has been featured on two TV shows, and a third is in the works for this summer. Our radio show, starring Drs. Monaco and Burton Glass reaches out to larger audiences each week. The Medical Society functions, not only because of the activist members of the Executive Committee, but also due to the support of the membership. You know, I've told lots of people that my new life motto is "If it ain't fun, it ain't worth it". I want to thank you all for the honor, the privilege and the fun of being President of the Nassau County Medical Society. Sincerely, President Nassau County Medical Society
P. Jeffrey Lewis, MD, a prominent Buffalo area neurosurgeon, and Independent Health, a Western New York HMO, have reached a settlement in a physician advocacy lawsuit brought by Dr. Lewis more than three years ago. Dr. Lewis filed the suit in response to his exclusion from Independent Health’s panel of participating physicians. Dr. Lewis claimed that Independent Health had refused to renew his participating physician contract because he had acted as a strong and persistent advocate for his patients when they were denied health insurance coverage for spine surgeries he had recommended. During the course of his advocacy, Dr. Lewis referred several patients to the New York State Attorney General’s Office to obtain state assistance in combating Independent Health’s denials. He also organized and led a group of spine surgeons who complained vigorously to Independent Health, to the Attorney General’s Office and to the Department of Health about the process used by the HMO to review requests for authorization of spine surgeries. Dr. Lewis alleged that his exclusion from Independent Health’s panel of participating physicians was in breach of his contract with Independent Health, and that it violated a recently enacted statute (Public Health Law § 4406-d(5)) which prohibits HMOs from dropping physicians from their pool of providers because of advocacy for their patients. In his complaint, Dr. Lewis sought reinstatement as a participating physician with Independent Health. Under the terms of the recent settlement, Dr. Lewis has been reinstated. Dr. Lewis was represented by Hodgson Russ LLP’s Business Litigation Practice Group.
The proactive efforts of physician grassroots action and representation in Albany is credited for the defeat of a host of trial lawyer backed regressive medical liability proposals. Legislation (S.2994, DeFrancisco/A.6637, Weinstein) which would allow for damages for pain and suffering in wrongful death cases, was averted when MSSNY generated hundreds of physician contacts with their legislators. Bills that would establish a date of discovery statute of limitations (A.6544, Weinstien/S.2588, Paterson) and permit the application of pre-judgment interest in personal injury actions (A.6707/S.4244) were strongly opposed by MSSNY and never emerged from committee. Throughout the year, the Trial Bar remained especially focused upon the passage of legislation (S.320, DeFransisco) which would repeal existing contingency fee limitations. Even during the closing moments of the regular session, as reported in a related article on legislation to address the Desiderio decision, the contingency fee repeal was being advanced aggressively by the Trial Bar lobby as a “concession” to the Trial Bar for its willingness to allow a “Desiderio fix” to occur. (see article below) In the end, however, physician efforts and the efforts of the members of the New Yorkers for Civil Justice Reform Coalition prevailed to prevent approval of the contingency fee repeal.
Senate Health Committee Chair Kemp Hannon this week introduced the “Medical Liability Reform Act” (S.469-A). This legislation would enact in a single bill many of the reform provisions that MSSNY has repeatedly argued are needed to restore fairness to the adjudication of medical malpractice claims, including:
The bill is the Senate Rules Committee.
The New York State Assembly, led by Speaker Sheldon Silver (D-NY), approved a host of HMO and health insurance reform bills this year, only to see each of them fail in the Senate due to inaction. Assembly Health Insurance Committee Chairman Richard Gottfried (D-NY) and Insurance Committee Chairman Alexander “Pete” Grannis (D-NY) advanced a number of positive bills through their committees in order to create more protections for consumers from HMO abuses and to help return clinical decision-making authority to physicians. Among the bills passed by the Assembly this year were:
Unfortunately, none of these bills, or any other insurance industry reforms, were considered or approved by the New York State Senate.
At the request of MSSNY, the NYS Society of Orthopaedic Surgeons, Inc., and the New York State Chapter- American College of Emergency Physicians, legislation was introduced earlier this week to assure that payment is made by motor vehicle insurance carriers to physicians and other health care providers for treatment of injuries to an otherwise intoxicated person for medical screening and necessary stabilizing treatment for emergency medical conditions as required by both state and federal law. Under current “no-fault” insurance law,
injuries to intoxicated motorists are not covered by their motor vehicle
insurance. Medical treatment for such individuals is almost always an
emergency situation and it is always provided. Reimbursement for such
services, however, is often not forthcoming from the injured person. The Legislature is expected to return this Fall to address several matters left unresolved during the regular session. MSSNY will work with all interested parties to effectuate passage of this proposal later this year.
Many scope of practice bills were before the Senate and Assembly in the final days of the 2003 legislative session. Following is a list of the results of their consideration of these bills:
We're Glad You Asked! Medical Society Prevents Huge
Expansion As of Friday, June 20th, with the state Senate having adjourned from its regularly scheduled legislative session for the year and the Assembly in its final day of its Session, the Legislature had not approved legislation vehemently opposed by MSSNY and other health care groups which would have exposed physicians (and others) to a huge explosion in civil litigation. The legislation (S.5018-A / A.9033) would have, if enacted, authorized each and every person in the state of New York to bring a civil suit against any person suspected of committing fraud against the state or a local government. MSSNY expressed its long-standing commitment to eliminating health care fraud, but expressed grave reservations regarding empowering millions of New Yorkers to drag thousands of physicians into court to defend themselves against charges of fraud, whether substantiated or not. Medicaid, Child Health Plus and Family Health Plus insurance programs billing and coding procedures are extremely intricate and complicated. Hospitals, nursing homes and healthcare practitioners often make unintended billing and coding errors, which are later corrected. Moreover, the state and federal governments already have broad powers to investigate and prosecute truly fraudulent activities. The Medical Society successfully argued to the Legislature that, especially given the current overbearing tort environment, the state should not be looking to expand unneeded civil litigation, which would impose great expense on health care institutions, practitioners and, ultimately, the health care system.
|
|
|
|
|
|
|
|
