Governor Signs New Opioid Legislation

 

In a three city whirlwind tour of the state, Governor Cuomo this week signed into law legislation designed to arrest the growing opioid epidemic. The effective date of each provision of law varies and is set forth below for your information. Importantly, the new seven day limit on the number of days for which opioids can be prescribed for the initial onset of acute pain will go into effect on July 22, 2016

1.      Mandate to complete three hours of CME training on pain management must be completed by July 1, 2017. Course standards and regulations are being developed. MSSNY in conjunction with OASAS and DOH, has already developed such a course—currently on its website. MSSNY will apply to assure that this course meets the standards developed by the agency.

2.      Inpatient residential coverage without utilization review limitations becomes effective on January 1, 2017.

3.      Requirements that DOH must create and pharmacies must make available information materials regarding the dangers of misuse and the potential for addiction to controlled substances to the public at the time of dispensing controlled substances will go into effect on October 22, 2016.

4.      Requirements that hospitals must coordinate discharge planning for individuals with suspected substance use disorder with SUD programs go into effect on December 22, 2016.

5.      Required use of utilization review tools designate by OASAS goes into effect on January 1, 2017.

6.      Required access to a five day supply for emergency use of medication for substance use disorder and access to buprenorphine and naltrexone for detoxification without prior authorization goes into effect on January 1, 2017.

7.      Involuntary commitment of a person incapacitated for drug or alcohol abuse for up to 72 hours goes into effect on September 22, 2016.

8.      The new seven day limit on the number of days for which opioids can be prescribed for the initial onset of acute pain will go into effect on July 22, 2016.
(DEARS, CLANCY, AUSTER)  

Legislative Package Approved to Address and Arrest Opioid Abuse in NYS
Three measures were introduced and approved by the legislature to comprehensively address and arrest the opioid epidemic in NYS. While MSSNY expressed strong concerns regarding some aspects of these proposals, MSSNY was able to secure modifications that protect clinical discretion and allow for the recognition that every physician practice and the needs of our patients are unique. In addition, the Legislature places new requirements on insurers to provide coverage for needed treatment and on hospitals and pharmacists to disseminate information.

CME Mandate

The legislation requires prescribers authorized to prescribe opioids by the U.S. Drug Enforcement Administration and every prescribing resident under a facility registration to complete three hours of coursework on pain management, palliative care, and addiction by July 1, 2017 and every three years thereafter. With regard to the course, the legislation:

·        recognizes that the course must be approved by commissioner who shall establish standards and review and approve course work; MSSNY this year with the OASAS medical director and representatives from the nurse practitioner and physician assistant associations developed and offered a course – already available through MSSNY’s website (mssny.org)– which MSSNY will seek to have approved in order to assure that its members may comply with July 1, 2017 deadline;

·        establishes that the coursework may be taken online;

·        requires that, upon completion of course, must document by attestation on a form prescribed by the commissioner that he/she has completed the course; and

·        requires the department to allow for an exception process for those (1) who can demonstrate to the department’s satisfaction that there would be no need to complete the course; or (2) that he/she has completed course work deemed by the department to be equivalent to the course work approved by the department. 

While MSSNY was not able to secure a one-time course or sunset we were able to assure that the course can be completed online and that the department would allow for an exception process to be utilized to exempt those for whose practice such a course is not applicable and those who have already taken a course. 

Opioids Limits

The legislation would establish limits on the prescription of a seven-day supply of any schedule II, III, or IV opioid upon initial consultation or treatment of acute pain. The bill gives flexibility to the prescriber to, upon any subsequent consultations for the same pain, issue (up to a thirty day supply) by appropriate renewal, refill or new prescription for the opioid or any other drug. In addition, the legislation:

·        defines “acute pain” to mean pain, whether resulting from disease, accidental or intentional trauma or other cause that the practitioner reasonably expects to last only a short period of time. Such term shall not include chronic pain, pain being treated as part of cancer care, hospice or other end-of-life- care or pain being treated as part of palliative care practices; and

·        limits application of co-pays for the limited initial prescription of an opioid to either (i) proportionate amount between the copayment for a thirty day supply and the amount of drugs the patient was prescribed or (ii) the equivalent to the copay for the full thirty-day supply provided that no additional copays may be charged for any additional prescriptions for the remainder of the thirty-day supply. 

MSSNY advocacy assured that the prescriber, upon any subsequent consultations, has flexibility in prescribing appropriate renewals, refills or new prescription beyond the initial period.Importantly, the term ”consultation” is intended to not require in person examination but can include a phone conversation between prescriber and patient at the conclusion of the initial 7-day supply.  


The 2016 MSI Survey is Here!

 What is the MAC Satisfaction Indicator (MSI)? The MSI is a tool used by CMS to measure provider satisfaction with their MAC. This survey is presented once a year and includes questions on services the MAC provides in these functional areas: Provider Outreach and Education, Provider Telephone Inquiries, Claims Processing, Electronic Data Interchange (EDI) Help Desk, Reopenings and Redeterminations (Appeals), Provider Enrollment, Medical Review, Self-Service Portal and Cost Report and Reimbursement.
 

Who is eligible to participate in the MSI? Medicare providers who receive services from their MAC can participate. This includes Medicare fee-for-service physicians, suppliers, health care practitioners and institutional facilities who serve Medicare beneficiaries across the country.
 

What does this mean to NGS? The MSI allows providers the opportunity to influence CMS’s understanding of Medicare contractor performance. In addition to monitoring NGS’s performance, CMS will use the results for monitoring trends, to improve oversight, and to increase efficiency of the Medicare program. CMS will incorporate the results into our MAC incentive plans. The MSI also provides NGS with more insight into our provider communities and it allows us to make process improvements based on this provider feedback.
 
 
Steps to take the Survey?
1.  Go the www.NGSMedicare.com and click on Banner “The MSI Survey Is Here”

2. Scroll down and select the JK MSI Survey



Click Here For MSSNY's 2016 Legislative Victories


MLMIC Policyholders to Receive 20 Percent Dividend

MLMIC’s Board of Directors has approved a 20 percent dividend for all MLMIC policyholders who are insured as of May 1, 2016, and maintain continuous coverage through July 1, 2016.
MLMIC’s mission is to provide insurance at cost. To offset premiums, we offer dividends to our policyholders whenever we can. Our competitors often promise low initial premiums to attract business, but MLMIC continually operates without a profit motive. Instead, we work to provide much needed relief to our policyholders, while maintaining financial stability.
MLMIC remains a mutual insurer, owned by our policyholders, and we are committed to policyholder-first service. Over the years, MLMIC’s financial strength has allowed us to pay more than $300 million in dividends to our policyholders, an accomplishment unmatched by other insurers.
You can find more about understanding dividends here, and of course you can contact us anytime with questions.

E-Prescribing Waiver Applications Now Available from BNE
With March 27, 2016 as the date that all prescriptions must be electronically submitted, the New York Bureau of Narcotic Enforcement has announced the availability of the Electronic Prescribing Waivers (EPW) application on the Health Commerce System (HCS).
A prescriber must have a HCS account in order to file an electronic prescribing waiver.  Using the HCS account is the quickest way to file the EPW application.
This application allows an institution, medical group practice or an individual practitioner to submit a request for a waiver from the requirement to electronically prescribe. Following are links to instructions for completing the online application on the Health Commerce System, based on the type of requestor:
If you do not have an HCS account, a paper version is NOW available upon request. Please contact the BNE at 1-866-811-7957, option 1.  The paper form is available for applications for institutions, group practices and individual practices and will be sent to requestors.
If physicians experience difficulties with their HCS account,  please call:  1-866-529-1890.
If a prescriber experiences any issues with the on-line Electronic Prescribing Waiver, they should call 1-866-811-7957.
E-PRESCRIBING VENDOR INFORMATION
The Medical Society of the State of New York (MSSNY), New York State’s principal non-profit professional organization for physicians, residents and medical students, and DrFirst, a leading provider of healthcare IT solutions, announced today that MSSNY has selected DrFirst as its official and recommended provider of e-prescribing software to its membership. MSSNY’s decision to search for, evaluate and officially endorse an e-prescribing vendor was spurred by the New York Internet System for Tracking Over-Prescribing (I-STOP) legislation which mandates that all patient medications be e-prescribed beginning March 27, 2016. 
 If you have any questions about the electronic prescribing mandate, please call 1-866-811-7957, option 1.

Alert to Physicians Aggrieved By Health Republic
If you have claims outstanding with Health Republic, please take a moment to click on this link which will bring you to MSSNY’s grassroots action center and a letter which you can send to your elected State Senator and Assemblyman to call for action to assure that physicians and other healthcare stakeholders are paid for services rendered to patients of the now defunct Health Republic.
MSSNY continues to have regular communication with key state officials regarding how the wind-down of Health Republic will occur, and at what level and when payment can expect to be received.  MSSNY also continues to share with key legislators and the media our collective concerns regarding the severe consequences to physicians’ practices as a result of the collapse of Health Republic, and advocating for a special fund to assure physician claims for care provided to HR-insured patients are fully paid.
This includes sharing the results of our survey of nearly 1,000 respondents, which has generated extensive media coverage from across New York State, including the Wall Street Journal and New York  Times. Please add your voice to these efforts to better assure that physicians are not left holding the proverbial bag!

 IMPORTANT NOTICE FOR MEMBERS
In a short while, you will be receiving a packet of materials from the Long Island Health Collaborative (LIHC).
Since the LIHC is a new organization, you may not be familiar with its existence, hence this notification which is being provided to you by YOUR Suffolk County Medical Society.The LIHC is a result of Federal and State initiatives considered vital for improving the general health of the population.  Exercise, in the form of WALKING, has been recognized as a critical predictor of future human health.  Hardly a month goes by without an article on the subject appearing in prominent and respected medical journals.  Some articles conclude a certain amount of walking each day/week is best, others state ANY regular amount of walking, however minimal, has beneficial effects.  For these reasons, the LIHC has decided its premiere efforts should focus on WALKING.  In an attempt to assist physicians in emphasizing the importance of this issue to their patients, they will be sending you materials designed to facilitate your usual discussions with your patients concerning exercise as a part of a Healthy Lifestyle.  One of the packet contents will be a “Recommendation for Walking” Pad. Each individual “Recommendation” contains ample room for individualized comments you may wish to add.  The recommendation and other materials can then be referred to by the patient at home, helping to reinforce your individual concerns. CLICK HERE for Additional Information

NYS Health Plan Points of Contact List

 

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