Practice Management

Latest News:

3.13.17: Health Commissioner Extends E-Prescribing Waiver Period by One Year

On March 2, Department of Health Commissioner Howard Zucker released a letter extending the waiver period for e-prescribing "for certain exceptional circumstances in which electronic prescribing cannot be performed due to limitations in software functionality." This blanket waiver is effective from March 26, 2017, until March 25, 2018. Before March 25, 2018, the Commissioner will determine whether the software available for electronic prescribing has sufficient functionality to accommodate each of these exceptional circumstances.

The Department further acknowledges that, while many nursing home/residential health care facilities have adopted electronic prescribing, there remain some facilities in which electronic prescribing may not be currently possible due to technological or economic issues or other exceptional circumstances, including a heavy reliance upon oral communications with the prescriber and pharmacy. Those waivers include:
  1. A practitioner prescribing a controlled or non-controlled substance either through an Official New York State Prescription form or an oral prescription communicated to a pharmacist serving as a vendor of pharmaceutical services, by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined by PHL § 2801; and
  2. A pharmacist serving as a vendor of pharmaceutical services dispensing a controlled or non-controlled substance through an Official New York State Prescription form or an oral prescription communicated by an agent who is a health care practitioner, for patients in nursing homes and residential health care facilities as defined by PHL § 2801
There are also ten applicable e-prescription exceptions, mostly involving compound drugs, such as:
  • Prescriptions containing two (2) or more products, which is compounded by a pharmacist;
  • Prescriptions compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous or intraspinal infusion;
  • Prescribing a controlled or non-controlled substance that contains long or complicated directions;
  • Any prescription containing certain elements required by the federal Food and Drug Administration (FDA) that are not able to be accomplished with electronic prescribing;
  • Any prescription containing a controlled or non-controlled substance under approved protocols for expedited partner therapy, collaborative drug management or comprehensive medication management.

To see the full text of all ten exceptions, please click here.

3.13.17: Newly Released FAQ by RM&S
Helps Navigate the New Patient Protections for Step Therapy

In 2016, New York passed a new law to protect patients when health insurance companies utilize Step Therapy protocols. These protocols, also known as “Fail First” protocols, are policies that establish a specific sequence in which prescription drugs for a medical condition are approved for coverage by a health insurance plan for a patient. The new law adds protections for patients when they are required to use step therapy protocols and includes an improved process for a patient to appeal a required step therapy protocol. To assist with navigating the new law, an FAQ was developed by Reid, McNally & Savage, LLC. To access this FAQ, please click here.

2.22.17: Federal Judge Blocks Anthem-Cigna Merger

On February 8, in a significant win for organized medicine and the nation’s patients, federal judge Amy Berman Jackson blocked the proposed Anthem-Cigna merger. The judge found that the merger would have substantially lessened competition for the sale of health insurance to national employers resulting in higher prices and diminished prospects for innovation. Judge Jackson concluded that an enhanced ability to coerce physicians to accept lower reimbursement is not a merger efficiency defense. She determined that it would not benefit consumers and “would erode the relationship between insurers and providers” and “reduce the collaboration” that is essential to innovation in payment and delivery. As of February 13, Anthem has filed a notice of appeal to reverse Judge Jackson's decision. Aetna and Humana also announced on February 14 that they will not appeal a judge’s decision to block their merger on antitrust grounds

2.22.17: CMS Final Rule on Medicare Part B Payment Policies: Find Out What's Changed

The Centers for Medicare and Medicaid Services (CMS) published in the Federal Register the CY 2017 Medicare Physician Fee Schedule Final Rule on November 15, 2016. This final rule updates payment policies, payment rates, and other provisions for services supplied under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017. These include additional codes for chronic care management, prolonged services, and more. ACP's summary of the physician fee schedule rule includes the key Medicare policy changes that physicians should know for 2017. 

Read the summary here.

2.22.17: CMS Extends Meaningful Use Attestation Deadline to March 13, 2017

CMS has extended the deadline to attest to meaningful use for the EHR Incentive Programs for 2016 performance until March 13, 2017. Clinicians must attest by the deadline to avoid a 2018 payment adjustment. To help providers prepare for the 2016 EHR Incentive Programs attestation period, CMS has released an attestation worksheet for eligible clinicians. Physicians can log their meaningful use measures for each objective in the worksheet and use it as a reference when attesting for the 2016 Medicare EHR Incentive Program in CMS’ Registration and Attestation System.

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the negative Medicare payment adjustment. You may demonstrate meaningful use under either Medicare or Medicaid, depending on your patient mix.

To read more, please click here.

2.22.17: Submit PQRS Reporting for 2016 Before It's Too Late!

The Physician Quality Reporting System (PQRS) is open for submission of quality reporting data for the 2016 performance period. Physicians must submit PQRS data on their 2016 performance to avoid receiving negative payment adjustments in 2018. Submission dates vary based on how physicians choose to report, so practices should check with submission vendors for deadlines. Additional details are available on ACP’s PQRS page.

Check your PQRS Reporting Deadline here with ACP's Timeline Tool!

2.3.17: CMS Open Payments System Update

The Open Payments system will be updated shortly. Physicians must register first in order to review any payments and other transfers of value attributed to them. If physicians registered last year, they do not need to register again. If it has been over 180 days since a physician has logged onto the Enterprise Identity Management System (EIDM), the account has been deactivated for security purposes. If an account must be reactivated, physicians and teaching hospitals can contact the Help Desk. Beginning today, the Help Desk has extended hours from 7:30 a.m. – 6:30 p.m. (EST).

The review and dispute period is targeted to start in April 2017, following the close of data submission (the Program Year 2016 data submission window begins on February 1, 2017 and ends on March 31, 2017).

You can learn more about the Open Payments system enhancements by viewing the Open Payments Overview and Enhancements presentation. Additional updated resources are located at:

2.3.17: Ransomware: What to Do When Your Systems are Hijacked
Article courtesy of Health IT Smartbrief

Electronic healthcare security systems were put to the test in 2016, as record numbers of hospitals, facilities and physician practices fell victim to ransomware attacks. The increasing number of ransomware attacks on providers is particularly troublesome because hackers can essentially lock out users from their EHR systems.  Once a system is infected, providers feel compelled to pay the ransom rather than sustaining an interruption to patient care.  For these reasons, providers should learn about the risks of ransomware and develop strategies to prevent and manage such malicious cyber-attacks. 

Preventing ransomware is a complex undertaking, as this particular strain of malware is constantly evolving and infiltrating even those systems that follow recommended security measures.  HHS guidance recommends that providers follow the HIPAA security rule to prevent ransomware infections.  In particular, providers should implement a robust and frequent data backup plan, which would enable providers to restore previous "infection-free" versions of their electronic data.  Providers should also invest in reputable security software (e.g., firewalls, e-mail filters, anti-virus programs) and promptly install updates, which periodically update the software's ability to recognize and detect new ransomware attacks.

To read more, please click here.

2.3.17: New York DOH Weekly Influenza Report

The New York State Department of Health (NYSDOH) collects, compiles, and analyzes information on influenza activity year round in New York State (NYS) and produces this weekly report during the influenza season (October through the following May).

During the week ending January 28, 2017:

  • Influenza activity level was categorized as geographically widespread. This is the sixth consecutive week that widespread activity has been reported.
  • There were 5,235 laboratory-confirmed influenza reports, an 20% increase over last week.
  • Of the 1,873 specimens submitted to NYS WHO/NREVSS laboratories, 406 (21.68%) were positive for influenza.
  • Of the 66 specimens tested at Wadsworth Center, 41 were positive for influenza. 31 was influenza A (31), 2 were influenza A (not subtyped), 4 were influenza B (Yamagata), and 4 were influenza B (Victoria).
  • Reports of percent of patient visits for influenza-like illness (ILI3) from ILINet providers was 9.19%, which is above the regional baseline of 3.00%.
  • The number of patients hospitalized with laboratory-confirmed influenza was 961 a 4% increase over last week.
  • There was one influenza-associated pediatric death reported this week. There have been four influenza-associated deaths this season.

Read the entire report here.

2.3.17: SAMHSA Updates Rules on the Sharing of Identifiable Substance Use Disorder Patient Information

On January 18, 2017, the Substance Abuse and Mental Health Service Administration published its final rule implementing changes to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations. These changes promote data sharing in order to allow patients to access new care delivery models in the evolving health care industry and encourage much-needed research of substance abuse disorders.

Click here to read the full article.

2.3.17: ACP’s High Value Care Initiative

High Value Care improves health, avoids harm, and eliminates wasteful practices or procedures. The ACP’s High Value Care initiative has developed 5 new modules to help physicians understand the and apply the core concepts of high value care. As a member you have free access to these modules that are available online and eligible for CME and MOC credits. 

To learn more about how to eliminate unnecessary health care costs and improve patient outcomes while earning free CME and ABIM MOC patient safety and medical knowledge points, visit High Value Care.

2.3.17: Quality Payment Program Listserv Available Now Through CMS

Have you subscribed to the CMS Quality Payment Program (QPP) Listserv? The QPP listserv will provide news and updates on:

  • New resources and website updates
  • Upcoming milestones and deadlines
  • CMS trainings and webinars

To subscribe, visit the Quality Payment Program portal and select “Subscribe to Email Updates” in the footer. The Education & Tools page includes program resources to help you learn more about eligibility and how to participate.

1.23.17: Track Important Mandates with ACP's Physician & Practice Timeline

Do you need help keeping track of all the important dates associated with government mandates, system changes and requirements? The ACP's Physician & Practice Timeline provides a summary of upcoming important dates to help you keep up with the many government mandates related to regulatory, payment, and delivery system changes and requirements.

The College is providing a new feature, an opt-in text alert service that notifies you of regulatory deadlines. To sign-up for these alerts, simply text ACPtimeline (no space) to 313131 from your mobile phone.

1.18.17: CMS Attestation System For 2016 EHR Incentive Program Now Open Until February 28

The Centers for Medicare & Medicaid Services Registration and Attestation System is now open.

Providers participating in the Medicare EHR Incentive Program must attest to the 2016 program requirements by February 28, 2017 at 11:59 p.m. ET in order to avoid a 2018 payment adjustment. The EHR reporting period was any continuous 90 days between January 1 and December 31, 2016.

If you are participating in the Medicaid EHR Incentive Program, please refer to your state’s deadlines for attestation information.

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the Medicare payment adjustment. You may demonstrate meaningful use under either Medicare or Medicaid.

Reminder: Remember to visit the registration tab in the Registration and Attestation system to ensure your personal information is accurate. For more information on registration, visit the Registration & Attestation page of the EHR Incentive Programs website

Payment Adjustments and Hardship Exceptions

In January 2018, CMS will begin to apply payment adjustments for providers that did not successfully demonstrate meaningful use of EHR technology or apply for and receive a hardship exception for the 2016 program year. CMS will send a separate announcement with more information on the hardship exception application process, once available.  

Attestation Resources

1.18.17: Physicians Billing Medicaid: Your Ordering/Prescribing/Referring Providers Must Revalidate for Claims to be Paid

Federal regulation requires State Medicaid agencies to revalidate the enrollment of all providers every five years. For many providers Medicaid payment is contingent on the ordering/prescribing/referring (OPR) provider also revalidating their enrollment in Medicaid. OPR providers who do not comply with the revalidation requirement will be terminated from the Medicaid Program.

The Department of Health has determined that many providers are at risk for not being paid for their services because the OPR provider has not complied with the revalidation requirement. Because this has the potential to result in significant non-payable claims for you/your facility, we urge you to reach out and encourage your OPR providers to revalidate their enrollment.

Please remember to confirm that your OPR provider is enrolled before rendering service at:

The Claim Adjustment Reason Code for non-enrolled OPR provider on your remittance will be: B7 - This Provider was Not Certified/Eligible to be Paid For this Procedure/Service on this Date of Service.

The required revalidation form and instructions are available at The completed form must be mailed, with all required documentation and fee (if required), to the address provided on page 2 of the form.



1.18.17: Healthcare is Among the Top Three Sectors Facing the Highest Risk of a Targeted Hacking Attack, a Recent ICIT Report Found
Article Courtesy of Health IT Security

With its high dependency on digital records, network connectivity, accessible information, and real-time communication, healthcare is one of the sectors at greatest risk for a Distributed Denial of Service (DDoS) attack, the Institute for Critical Infrastructure Technology (ICIT) explained in a recent publication.

“Obstructions to even an email server could cause delays in treatment, while widespread attacks that holistically render a critical service unavailable, such as an IoT DDoS attack, would pose a serious risk to patient and staff safety,” wrote ICIT Senior Fellow James Scott and ICIT Researcher Drew Spaniel.

Citing research from a previous ICIT brief, the duo explained that healthcare is incorporating, and interacting with connected devices that are often designed without necessary security measures. Previously, this has led to instances such as MRI machines or pacemakers being infected with ransomware.

More organizations are utilizing the internet and IoT devices, but device manufacturers will sometimes “negligently avoid incorporating security-by-design into their systems.” This happens because the manufacturers have not been properly incentivized, and instead pass the potential risk onto the end-user.

To read the entire article, please click here.

12.19.16: End-of-Rotation Handoffs Associated with In-hospital Mortality, Study Finds
Article courtesy of ACP Hospitalist

End-of-rotation transitions may heighten mortality risk in internal medicine inpatient care, a study found.

To examine the association of end-of-rotation house staff transitions with mortality among hospitalized patients, researchers conducted a multicenter cohort study of 230,701 patients admitted to internal medicine services in 10 Veterans Affairs hospitals. Patients who were admitted prior to an end-of-rotation transition and died or were discharged within 7 days following transition were stratified by type of transition (intern only, resident only, or intern and resident) and compared with all other discharges (control). An alternative analysis comparing admissions within 2 days before a transition with admissions on the same 2 days 2 weeks later was also conducted.

The primary outcome was in-hospital mortality. Secondary outcomes included 30-day and 90-day mortality and readmission rates. A difference-in-difference analysis assessed whether outcomes changed after 2011 Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulation changes. The study was published by JAMA on Dec. 6.

To read more, please click here

11.23.16: In Need of Assistance Preparing for the New Value Based Payment Models?

Are you frazzled with your practice transformation efforts?  Could you use some help? Value based payments are just around the corner and the NY Chapter ACP is committed to helping you prepare:

The CMS Transforming Clinical Practice Initiative (TCPI) is designed to support clinician practice transformation over the next 4 years with support from Practice Transformation Networks (PTNS) and Support and Alignment Networks (SANS).

The NY Chapter is working with the ACPSAN to provide the tools and resources that eligible practices need. We can connect you to a Practice Transformation Network that will coach, mentor, and assist you in developing core competencies necessary to transform your practice and thrive in an emerging healthcare environment that emphasizes value of care. The PTN embraces and supports the "quadruple aim" of better care, better health, lower costs, and greater provider satisfaction.

If you are in need of assistance and currently use a 2014 Certified Electronic Health Record and are not currently participating in a Medicare Shared Savings Program, Pioneer ACO program, Multi-Payer Advanced Primary Care Program, or Comprehensive Primary Care Initiative please contact Lisa Noel, Mgr. Practice Support Services at or 518-427-0366.

Last Updated 3.13.17

Practice Management Topics

Alternative Payment Models (APMS)

End of Life Care/
Advance Care Planning


I-STOP/ E-Prescribing

Geriatric Care

Health Information Technology


Legal Counsel's Forum

Medical Marijuana 

Medicare & Medicaid

Opioid Prescription Education

Practice Management Tools

Public Health and Education

Smoking Cessation

Highlighted Topic:

E-Prescribing Resources

NYACP has resources to assist you in all of your ISTOP and E-Rx implementation efforts.

New York Chapter of the American College of Physicians
744 Broadway, Albany NY 12207
Tel: 518-427-0366
Fax: 518-427-1991