August 17, 2016 

Your Chapter in Action!


Practice Management

New Letter from the NYS Department of Health Regarding Detox and Treatment of Opioid Addiction
 

Legislation Enacted Regarding Drugs Used for Detoxification or Maintenance Treatment of Opioid Addiction in Medicaid Fee-for-Service (FFS) & Medicaid Managed Care

Per changes to Social Services Law section 364j, and Public Health Law section 273, prior authorization is not allowable for initial or renewal prescriptions for preferred or formulary buprenorphine or injectable naltrexone when used for detoxification or maintenance treatment of opioid addiction. Food and Drug Administration (FDA) and Compendia supported frequency, quantity and/or duration limits may continue to be applied.

To obtain preferred/formulary drug listings and plan limitations please see the following websites:


Final Call for Input on Physician Perspective On Physician-Assisted Suicide and the 2016 Fall Board of Governors Resolutions

Perspective on Physician-Assisted Suicide Survey

Legislation on Physician-Assisted Suicide (PAS) became law in California on June 9, 2016 and in Oregon it has been legal since 1997. There are three (3) legislative bills that were introduced in the NYS legislative session, with various definitions on "death with dignity" and the means for patients to request assistance. Click here to read the most recent bill.  ACP has been opposed to PAS since 2000, with reaffirmations in 2004 and 2011. With discussion heightening around this topic at a national and state level, NYACP is seeking input from members on PAS.

We hope you will help us by taking the short 9-question survey here.


Last Chance for Input for 2016 Fall Board of Governors Resolutions

Every member has the opportunity to provide input regarding the development of policies and positions of ACP and the Chapter through the resolutions process. The New York Chapter leadership requests your input on the proposed resolutions to be acted on at the ACP Board of Governors (BOG) Fall meeting in September 2016.

Members interested in submitting comments on any or all of the resolutions must do so using our online comments page no later than Friday, August 19, 2016
Please review this copy of the ACP BOG Fall 2016 Resolutions first.  Then, to submit a comment please visit our easy-to-use response form at: http://www.nyacp.org/i4a/survey/survey.cfm?id=141

You may select:  Support; Do Not Support; or Support with AmendmentIf you select support with an amendment, you will be asked to enter specific language to be added or deleted.

Please note that the New York Chapter Resolutions have been extracted since they have previously been acted upon by NY Chapter members.


Important News From MLMIC Regarding Berkshire Hathaway

On July 18, 2016, MLMIC’s policyholders and organizational partners were informed through a public announcement of their plans to join the Berkshire Hathaway Family of Companies.  MLMIC, “the largest underwriter of medical professional liability insurance in New York” is moving forward with an acquisition by National Indemnity Company, a subsidiary of Berkshire Hathaway, Inc.  This is pending regulatory and policyholder approval.  The final transaction is expected to occur during the third quarter of 2017.

MLMIC views this acquisition as a very positive step enabling them to best serve policyholders and to offer an even higher level of financial security.  MLMIC expects “to expand its offerings, with more customized policy limits, risk sharing features and services to groups, facilities and other large accounts”.

MLMIC's core of physician driven protocols and decision making will remain and MLMIC will continue to be a valuable membership benefit.  NYACP looks forward to continuing our strong organizational partnership.  More information about MLMIC's recent announcement can be found in this FAQ.


Attention Hudson Valley Region Physicians:
Unique Payment Opportunity Through Comprehensive Primary Care Plus (CPC+) Available

The New York Chapter ACP along with the NYS Department of Health and participating payers, CDPHP, MVP and Empire Blue Cross Blue Shield is conducting a one-hour webinar  to learn more about a unique payment opportunity being offered by CMS. Comprehensive Primary Care Plus (CPC+), a multi-payer program that will include 5,000 primary care practices nationwide, begins in January 2017. CPC+ is an advanced primary care medical home model that rewards value and quality by offering an innovative payment structure to support delivery of comprehensive primary care.

New York State is one of only 14 regions selected for this initiative. If you practice in the Hudson/Capital Region area and are interested in learning more you can register for one of two sessions:

  • Tuesday August 30th from 12:00 - 1:00 pm (Register)
  • Tuesday August 30th from 6:00 - 7:00 pm (Register)

New ACP Modules For Patient-Centered Care

ACP Practice Advisor now offers three new modules:

  • Improve Patient Access
  • Care Coordination
  • Avoid Unnecessary Testing

These modules address key attributes and expectations of Patient-Centered Medical Homes and are applicable to all practices and specialties interested in providing patient-centered care. All are eligible for CME and MOC credit.

To receive credit, users must complete the module’s Practice Biopsy, initiate quality improvement activities in the practice, and complete a second Practice Biopsy at least 30 days after the first is completed.

For more information on Practice Advisor and a description of the modules, visit https://www.practiceadvisor.org/Modules/building-the-foundation.


Member Benefits

NYACP Career Link Job Posting

NYACP's Career Link connects physicians looking for employment with opportunities throughout the state. Here is the newest posting:

Associate Director, Hospitalist Program

Position Summary:

The Associate Director will work closely with the Director, Hospitalist Team, Skilled Nursing Facility Physicians, Physicians of South Nassau Communities Hospital (SNCH) and the staff to manage all aspects programs for SNCH. This role will be crucial in executing the strategies and tactics to help SNCH continue its history of success.

Primary Responsibilities:

  • Quality Management  
  • Utilization Management
  • Disease Specific and Chronic Care Programs
  • Credentialing and Peer Review
  • Hospital and Skilled Nursing Facility Collaborative Efforts
  • Compliance and Oversight of all Delegated Functions
  • Coordination and Implementation of Cost Efficiency Programs

Opportunity Features:

  • Provide leadership while partnering closely with the CMO/Medical Director
  • Utilize your self-directive, growth oriented, and excellent customer service skills
  • Attractive compensation package includes; salary and incentives
  • Health benefits, CME, and more!              

Qualifications:

  • M.D. or D. O. degree with at least 4-5 years clinical practice experience
  • Current New York medical license without restrictions
  • Board Certification by the American Board of Medical Specialties
  • In – depth knowledge of medical delivery systems, utilization management, quality management, peer review, credentialing, benefits interpretation, physician relations and member services
  • Excellent interpersonal, leadership and persuasive communication skills
  • Knowledge and experience in the operations of a prepaid delivery system
  • Good analytical skills and the ability to manage for results

Please send CVs to:

Aaron E. Glatt, MD, FACP, FIDSA, FSHEA
Chairman, Department of Medicine
South Nassau Communities Hospital
One Healthy Way
Oceanside, NY 11571
aaron.glattmd@snch.org

For more opportunities, please visit NYACP's Career Link page.


Education

NYACP Dr's Dilemma Competition Teams -
Submissions are now closed!

The following 16  teams will be competing in the Chapter’s Dr’s Dilemma Competition on Saturday, November 5th at the Resident and Medical Student Forum at Mount Sinai Medical Center.

  1. Coney Island Hospital
  2. SUNY Upstate Medical University
  3. St. John’s Episcopal Hospital
  4. Lincoln Medical and Mental Health Center
  5. Rochester General Hospital
  6. Mount Sinai Medical Center
  7. John. T. Mather Memorial Hospital
  8. Interfaith Medical Center
  9. Sister’s of Charity Catholic Health Systems
  10. Staten IslandUniversity Hospital
  11. St. Barnabus Hospital
  12. UHS Wilson Medical Center
  13. Maimonides Medical Center Hospital
  14. Montefiore Wakefield Campus
  15. Montefiore New Rochelle Hospital
  16. NY Presbyterian /Queens

All members are invited to attend and cheer on their team! The winning team will represent New York in the ACPIM17 Competition in San Diego next year!


The Chapter will be highlighting the winning abstracts from the Chapter’s Poster competition during the NYACP Scientific Session on Saturday, June 4, 2016.

Winning Abstract: Resident Clinical Vignette Category: Thyroid Storm Mimicking Intra-Abdominal Sepsis in a Young Female
Author: Nabeel AlQsous, MD,Unity Hospital, Rochester, NY
Additional Authors: Quintos  A , Naidu  Y , Aldaoud M , Wohlgemuth I, Prajali Sharma

Case description

A 38 year old female with past medical history of recurrent kidney stones presented to the emergency department with 1 day history of lethargy, confusion, and severe abdominal pain. She was febrile with temperature of 38.9 and tachycardic with heart rate 140 bpm, CBC showed white count of 13,000/Ml and Lactic acid of  69 mg/dL. Initial impression was surgical abdomen, surgery and critical care consults were obtained. Abdominal computed tomography scan on admission was unremarkable with no stones, obstruction, or perforation.

Urinalysis was negative for any hematuria or signs of infection, Patient was started on broad spectrum antibiotics and IV crystalloids for presumed sepsis.
Persistent symptoms and worsening tachycardia ( heart rate >160 bpm) along with confusion prompted ICU admission and further evaluation. Although the patient did not have overt signs of an underlying thyroid disorder, (exophthalmos, lid lag, goiter) , laboratory work confirmed the suspicion , TSH levels were <00.1 and T3 levels were 447. The patient was diagnosed with a thyroid storm and was started on beta blocker and Methamizole. Final cultures were negative and all antibiotics were stopped.Patient’s symptoms resolved and she was discharged home to follow up with endocrinology.

Discussion

Recognition of thyroid storm can be difficult, because signs are non-specific and symptoms can mimic other causes of severe illness such as acute abdomen. The patient described here had no history of thyroid disease and did not have the typical examination findings.

The incidence of thyroid storm is reported to be less than 10% in patients hospitalized for thyrotoxicosis, but the fatality rate is reportedly 20-30%, if this disease is not treated promptly. Abdominal pain of recent onset can be a challenging clinical problem. Any patient presenting with fever , tachycardia and confusion needs prompt, thorough evaluation in an attempt to rapidly identify and treat the cause of the symptoms. In such cases, the differential diagnosis includes intra-abdominal sepsis due to bacterial contamination or chemical irritation, mechanical obstruction of hollow viscera, vascular disturbances such as embolism or thrombosis, metabolic causes such as diabetic ketoacidosis and other less common conditions.

Thyroid storm should be considered in the differential diagnosis of patients presenting with acute abdomen and signs of sepsis.
The purpose of this case report is to alert clinicians about atypical thyrotoxicosis presentations which, if overlooked, can rapidly progress to life-threatening multi-organ failure.


Upcoming 2016 District Meetings

SAVE-THE-DATE
Nassau District Meeting: Wednesday, September 14, 2016
A MULTIPLE SMALL FEEDINGS OF THE MIND (1) Changes to MOC and (2) Navigating New Diabetes Medications
Akbar Restaurant - 2 South Street, Garden City NY 11530
6:00pm  Registration  •  6:30pm  Dinner and Educational Program

Meeting Flyer Register Here

SAVE-THE-DATES
Friday, September 23, 2016 - Sunday, September 25, 2016

CURRENT TOPICS IN PRIMARY CARE AND NEUROLOGY: Update for the Primary Care Practitioner
The High Peaks Resort - 2384 Saranac Avenue, Lake Placid, NY 12946
Sponsored by:  Albany Medical College's Dept. of Medicine, Dept. of Neurology and the Office of CME
In collaboration with:  Hudson Valley Capital District of the New York Chapter American College of Physicians

Brochure and Registration Information

SAVE-THE-DATE
Thursday, September 29, 2016 - Brooklyn District Meeting
A MULTIPLE SMALL FEEDINGS OF THE MIND

Gargiulo's Restaurant - 2911 West 15th Street, Brooklyn NY 11224
6:00pm  Registration  •  6:30pm  Dinner and Educational Program
More information will be posted to the NYACP Education Page shortly.

SAVE-THE-DATE
Wednesday, October 19, 2016 - Syracuse District Meeting
A MULTIPLE SMALL FEEDINGS OF THE MIND:  (1) Physician Burnout and (2) Hormone Replacement

6:00pm  Registration  •  6:30pm  Dinner and Educational Program
More information will be posted to the NYACP Education Page shortly.
 
Friday, October 21- Saturday, October 22, 2016
11th Annual Mid-Atlantic Hospital Medicine Symposium

The Bonnie M. Davis, MD and Kenneth L. Davis, MD Auditorium, 2nd floor,
1470 Madison Avenue (Between 101st & 102nd Streets), New York, NY 10029.
 Brochure and Registration Information


New York Chapter of the American College of Physicians
744 Broadway, Albany NY 12207
Tel: 518-427-0366
Fax: 518-427-1991
Email: info@nyacp.org