S A V E T H E D A T E
SCMS Annual Meeting - Friday, June 9, 2017
Call Your Senator and Senate Leadership This Week in Support of
Legislation to Prohibit "Conversion Therapy" for Minors:
Urge Bill Be Brought to the Senate Floor for a Vote
Before the End of Session
With only a few weeks left in the Legislative Session, it is imperative SCMS members call their NYS Senators and NYS Senate leadership this week as legislation is pending.
This measure prohibits licensed physicians and mental health professionals from engaging in efforts to change a minor's sexual orientation, so-called "conversion therapy," as well as defining such efforts as professional misconduct.
While the Assembly previously passed the legislation, your voice is needed to urge the NYS Senate to follow suit before the end of the session!
The American Psychiatric Association has concluded that same-sex orientation does not need to be changed and "efforts to do so represent a significant risk of harm by subjecting individuals to forms of treatment which have not been scientifically validated and by undermining self-esteem when sexual orientation fails to change. No credible evidence exists that any mental health intervention can reliably and safely change sexual orientation; nor, from a mental health perspective does sexual orientation need to be changed."
ACTION NEEDED THIS WEEK
Senate Majority Leader John Flanagan - Albany Office Number: (518) 455-2071 and urge the bill be made a priority for passage before the end of session.
Your Senator - To find out who your Senator is, enter your address at: https://www.nysenate.gov/find-my-senator. Call the Senate switchboard at (518) 455-2800 and ask to be connected to your Senator's office.
Centers for Medicare & Medicaid Services
Today is the Last Day of Open Payments Physician and Teaching
Hospital Review and Dispute Period Before the 2017 Data Publication
* Extended Help Desk Hours Today
Today is the Last Day of Open Payments Physician and Teaching Hospital Review and Dispute Period Before the 2017 Data Publication
Physicians and teaching hospitals have until 11:59 p.m. tonight to review data reported by drug and medical device makers about them and, if necessary, dispute the payments before the data is made public on June 30, 2017. If you are a physician who served as a principal investigator on a research study, you may see the payments associated with that research study listed under your name. This does not necessarily mean the payments are attributed to you.
To review and dispute data, physicians and teaching hospitals must register in the Open Payments system. CLICK HERE for detailed instructions.
MIPS Participation Status Letter
CMS is reviewing claims and letting practices know which clinicians need to take part in the Merit-based Incentive Payment System https://qpp.cms.gov/learn/qpp (MIPS), an important part of the new Quality Payment Program (QPP). In late April through May, you will get a letter from your Medicare Administrative Contractor https://www.cms.gov/Medicare/Medicare-Contracting/Medicare-Administrative-Contractors/MedicareAdministrativeContractors.html that processes Medicare Part B claims, providing the participation status of each MIPS clinician associated with your Taxpayer Identification Number (TIN).
* Bill more than $30,000 in Medicare Part B allowed charges a year and
* Provide care for more than 100 Part B-enrolled Medicare beneficiaries a year
QPP intends to shift reimbursement from the volume of services provided toward a payment system that rewards clinicians for their overall work in delivering the best care for patients. It replaces the Sustainable Growth Rate formula and streamlines the "Legacy Programs" - Physician Quality Reporting System, the Value-based Payment Modifier, and the Medicare Electronic Health Records Incentive Program. During this first year of the program, CMS is committed to working with you to streamline the process as much as possible. Our goal is to further reduce burdensome requirements so that you can deliver the best possible care to patients. Learn more about the Quality Payment Program https://qpp.cms.gov/
MSSNY To Host Upcoming Veterans Health Care Training Program on Long Island: Includes CME Training for Primary Care Physicians
The Medical Society of the State of New York, the New York State Psychiatric Association, and the National Association of Social Workers – New York State Chapter are hosting a two day conference on Long Island on Friday, May 5 and Saturday, May 6, 2017 at the Clarion Hotel & Conference Center, located at disorders among returning vetThe conference will consist of interactive seminars and panel discussions focusing on the current and evolving healthcare needs of veterans. MSSNY will be conducting three CME accredited trainings for primary physicians and specialists, covering PTSD and TBI in returning veterans, suicide among returning veterans, and substance useerans.
There is no cost, but separate registration is required for both the trainings and conference.
Share Your Comments With CMS on MSI and QPP
The MAC Satisfaction Indicator (MSI) is designed to measure your satisfaction as a Medicare provider with the performance of your Medicare Administrative Contractor (MAC). Share opinions on 2017 MAC Satisfaction Indicator with CMS.
STATE BUDGET ENACTED – MSSNY ADVOCACY RESULTS IN THE REMOVAL OF MANY PROBLEMATIC PROVISIONS
The New York State Legislature completed passage of a $153 Billion State Budget last night, 9 days after the State due date of April 1, and after several weeks of “round the clock” negotiations on an extraordinary number of difficult issues including raising the age of criminal responsibility, ride-sharing, education funding, emergency Budgetary powers, a Medicaid prescription drug price cap and Workers Compensation reform. While the Legislature passed a two-month Budget extender last week, this final Budget deal overrides that legislation.
Thanks to strong advocacy by MSSNY physician leaders, MSSNY member physicians, county medical societies, and the many specialty societies with whom MSSNY works closely, the final Budget enacted DID NOT contain several objectionable provisions that had been opposed by MSSNY. The final Budget:
· Deleted a proposal opposed by MSSNY that would have required a physician to receive a “tax clearance” as a pre-condition of receiving Excess Medical Liability Insurance coverage, while assuring that the more than 20,000 physicians who currently receive Excess coverage continue to receive such coverage;
· Deleted a proposal opposed by MSSNY that would have expanded burdensome prior authorization requirements by repealing statutory provisions that assure that the prescriber has the final say for all prescriptions for fee for service Medicaid patients as well for several drug classes for patients covered through Medicaid managed care;
· Deleted a proposal opposed by MSSNY that would have permitted pharmacists to enter into “comprehensive medication management protocols” with nurse practitioners to manage, adjust and change the medications of patients with a chronic disease or who have not met clinical goals of therapy;
· Deleted a proposal opposed by MSSNY to create a Regulatory Modernization Team that could have empowered state agencies to override existing scope of practice laws without legislative approval;
· Substantially revised provisions to permit Medicaid to sanction or remove a health care practitioner who violates a statutory limit on opioid prescribing, by assuring that a prescriber has appropriate due process protections before a sanction is imposed.
· Continues necessary funding for MSSNY’s Committee for Physician’s Health and MSSNY’s Veterans Mental Health Care educational program;
· Deleted several problematic elements that had been under serious consideration to be included in Workers’ Compensation Reform package enacted as part of the Budget, including provisions that would have:
o Limited injured worker choice of treating physician by expanding the required use of Workers Compensation PPOs;
o Removed the authority of county medical societies to recommend physicians to be approved to be WC-authorized providers or IMEs;
o Expanded the penalties that the Board could impose on WC-authorized physicians;
o Expanded the list of authorized health care providers in Workers Compensation, without any requirement for several of these providers to collaborate with a physician.
It should be noted that the final package includes a number of notable reforms that will have a significant long-term impact on New York’s Workers Compensation system including provisions that will:
Various Seminar Locations and Dates Running from May 5, 2017-June 23, 2107
Percentage Arrangements With Billing Companies
By Ellen F. Kessler
The New York State Medicaid Fraud Control Unit (“MFCU”) has recently embarked on a campaign to recover thousands of dollars of Medicaid payments plus interest from various health care providers who pay billing companies a percentage of collections for their billing services.
MFCU has been sending letters to Medicaid providers in New York State demanding the return of payments where Medicaid discovered that the providers used billing companies who were paid on a “percentage of collections” basis. This demand by Medicaid is not based on a claim of overpayment or improper billing methodology by the provider. Rather, Medicaid relies on an arcane provision found in the Medicaid rules1 which states that:
“A provider of medical care services or supplies may employ a business agent, such as a billing service or an accounting firm. Such agent may prepare and send bills and receive MA payments in the name of the provider only if the compensation paid to the agent is:
1. Reasonably related to the cost of the services;
2. Unrelated, directly or indirectly to the dollar amounts billed and collected; and
3. Not dependent on actual collection of payments.”
Thank You Dr Miller For Your Tireless Effort to Make This Happen
East Meadow School District first in NY to stock nebulizers
East Meadow School District marks a milestone as first in the state to begin a comprehensive program under New York public health law, allowing schools to have nebulizers on hand as rescue aids for severe asthma attacks.
Steps you can take NOW to prepare your practice
2017 Medicare Electronic Health Record (EHR) Incentive Program Payment Adjustment Fact Sheet for Eligible Professionals
Overview of the Program
As part of the American Recovery and Reinvestment Act of 2009 (ARRA), Congress established payment adjustments under Medicare for eligible professionals that are not meaningful users of Certified Electronic Health Record (EHR) Technology. Eligible professional (EP) that do not successfully demonstrate meaningful use for an EHR reporting period associated with a payment adjustment year will receive reduced Medicare payments for that year. The Medicare payment adjustments began on January 1, 2015 for EP and sunset in 2018 per the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
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