::Suffolk County Medical Society/Suffolk Academy of Medicine::

COLLECTIVE NEGOTIATION BILL BEFORE ASSEMBLY HEALTH COMMITTEE

Legislation (A.2474-A, Canestrari) to permit independently practicing physicians to negotiate collectively with health insurance companies is being considered by the Assembly Health Committee at its Thursday, January 19 meeting. Physicians can send a letter to their legislators in support of this legislation by clicking here.

This legislation, which now has 67 co-sponsors, has advanced from the Assembly Health Committee in previous legislative sessions, but has failed to advance further. Identical legislation (S.3186-A, Hannon) is back before the Senate Health Committee after it passed the senate last year.

Such collective action is now prohibited under federal antitrust laws. As a result, with most regions of New York State being dominated by just one or two health plans, most physicians face one-sided contracts from health insurers with little if any opportunity to negotiate. It is the patient, however, who bears the brunt of this market dynamic because the physicians’ inability to negotiate results in the imposition of unnecessary barriers for patients in need of care. These health plan abuses include: cumbersome pre-authorization processes that delay our patients from receiving needed care and testing; arbitrary limitations on necessary prescription medications; and overly aggressive barriers that limit patients’ ability to receive care from the specialist physician of their choice.

An all-out grassroots push is necessary because we anticipate the health insurance industry will do all in their power to stop this measure from going forward. If you want to level the playing field with the health insurers, please make these contacts!

For more information, please contact the MSSNY Division of Governmental Affairs at mauster@mssny.org.

OUT OF NETWORK COVERAGE TRANSPARENCY BILL REPORTED BY

SENATE HEALTH COMMITTEE TO SENATE INSURANCE COMMITTEE

On Tuesday, the Senate Health Committee favorably reported legislation (S.5068A, Hannon) to the Senate Insurance Committee. This measure, which MSSNY strongly supports, would: ( a) prevent insurance companies from selling policies with out of network coverage that fails 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. Identical legislation (A.7489-B, Gottfried) is before the Assembly Health Committee. An earlier version of the bill passed the Assembly last year.
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Medicare Pays Physicians $166 for Initial Wellness Visit

Medicare reimburses physicians $70 for a typical patient visit. However, doctors can earn more than twice that—$166—for conducting a patient's initial wellness visit.

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US Veterans Motorcycle Club of LI

Military Care Package Event January 30^th

please help us get ready!!

Monday - January 30^ththere will be a mass packing to get items over for the Troops serving in Afghanistan.

As the Holidays pass so will a lot of goodwill thoughts, leaving a majority of US Service Members to fend for themselves for well needed supplies. Let’s remember these folks are all sons and daughters, mothers and fathers, brothers and sisters who are putting it all on the line. It’s time for us to show we haven’t forgotten they are there.

So please start collecting items now, get the schools, churches, organizations, clubs, friends, etc and drop them off and/or help us pack:

Bellport Fire Department

161 Main Street, Bellport NY

Monday, January 30, 7 pm - 10 pm (or until finished!!)

We will also need sponsors to help ship out packages; $15 gets a packed box shipped overseas,

Please mail your check to:

USVMCLI

PO Box 675

Bellport, NY 11713

Write "care packages" on the check memo line & make your check payable to USVMCLI

(Please include a note for the receiving Service Member!!!!)

CLICK HERE for Additional Information and Items Needed and feel free to forward this information on to anyone who can help.

Top EHR Implementation Tips From the AMA:

Many practices rush into implementing electronic health record (EHR) systems and other forms of health information technology (IT). With federal incentives now in place, it is especially important for practices to slow down, plan and be strategic about their decisions. Prolonged productivity loss or abandoning a system is the last thing any practice can afford. You and your practice can avoid popular missteps by following a few fundamental rules of thumb. CLICK HERE For the Link.

The Revised Medicare Fee Schedule for

January 1, to February 29, 2012 is online 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: CLICK HERE .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.

The Countdown to Version 5010 Implementation Is Underway

Less than 30 days until Implementation

Did you know that effective January 1, 2012 all covered entities will be required to use the new Health Insurance Portability and Accountability Act (HIPAA) 5010 version for electronic filing?
Did you know that effective January 1, 2012 electronic submitters who are not using version 5010 for HIPAA electronic transactions will have their claims rejected and they won’t receive payment?
Did you know that there are less than 60 days for the version 5010 implementation?

Medical offices and providers should feel the pressure to get their systems ready for the version 5010 implementation. National Government Services has created several helpful resources to assist electronic submitters to prepare for the version 5010 transition. These resources are available on the Version 5010 Implementation page located on the Electronic Submission (EDI) section on the National Government Services Web site.

We have also offered free monthly Webinars for all providers and facilities to join and will continue to offer these free monthly Webinars. However, despite these free education opportunities, medical offices are still not prepared for the version 5010 change. Be proactive and start preparing for version 5010 today!

Thank you,

National Government Services, Inc.

Corporate Communications

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DOCTORS NEEDED:

Suffolk County Medical Reserve Corps

The Suffolk County Medical Reserve Corps is recruiting a cadre of volunteer medical professionals. These volunteers will serve to augment the Suffolk County healthcare system should that system be overwhelmed by a natural or man-made event. Additionally these volunteers will allow medical professionals to be developed, trained and deployed in a coordinated and controlled manner.

How Can I Volunteer?

To volunteer for the Suffolk County MRC, click here and register. After you have completed the registration, you will receive notification from the Suffolk County Volunteer Coordinator about whether you have been accepted into the volunteer program and the next steps. If there is any needed additional information or there are questions about your registration, the Suffolk County Volunteer Coordinator will contact you.

MESF to Launch Education at Sea Program in February

A special CME program entitled “Surviving 2012: Key Physician Practice Management Issues” will be offered on a 10 night Caribbean cruise scheduled for Feb 17-27, 2012 from the Port of New York’s Cape Liberty. The program has been scheduled for the Royal Caribbean Lines Explorer of the Seas and is designed specifically for physicians and office managers. Expert faculty will present a 14 hour CME program focused on critical Practice Management issues facing today’s physician community. Topics include:

Negotiating Sale of Your Practice
Staying Clear of Regulatory Agencies
Ways to Reduce Your Med Mal Risk
What to Do When the Auditors Arrive
Office Legal Issues.
Getting Your EHR to Pay Its Way

The specific cruise was selected because of Royal Caribbean Lines reputation for excellence and fact that it was over the President’s week holiday when many children are out of school. (The ship offers great kid-friendly facilities.) In addition, the cruise was in and out of New York harbor so most participants would not have to fly to reach the ship. Parking is available on the pier adjacent to the ship. Medical, Educational and Scientific Foundation (MESF) President Leah McCormack called the program “the first of what we hope to be an ongoing educational series, plus you get to visit some of the great fun spots in the Caribbean while the Northeast is freezing.” Go to http://www.continuingeducation.net/coursedetails.php?program_number=1110 or call 1-800-422-0711 for more information.

Dr. William Spencer Elected County Legislator in Suffolk County

SCMS congratulates William Spencer, Jr., MD, Treasurer of the Suffolk County Medical Society, on his election as a County Legislator for the 18th district of Suffolk County. He is the first physician to ever hold a position as a County Legislator in Suffolk County. In all likelihood, Dr. Spencer will be asked to chair the Health Section within the Department of Health and Human Services where he will have the ability to draft and introduce legislation that will impact public health and safety.

Dr. Spencer is board certified in otolaryngology, a Diplomat of the American Board of Otolaryngology, and the National Board of Medical Examiners. He is a Fellow of the American Academy of Pediatrics. Dr. Spencer, who is 43, and his wife, Rachel, have three children. He is a graduate of Wesleyan University and the University of Connecticut Medical School and serves as chief of otolaryngology at Huntington Hospital and as an assistant clinical professor at Stony Brook University.

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