1.12.18: ADA Releases Updated Standards of Diabetes Care Recommendations
The American Diabetes Association (ADA)'s 2018 update to its Standards of Medical Care in Diabetes makes several notable new recommendations, including a target blood pressure below 140/90 mm Hg for most patients with hypertension, integration of continuous glucose monitoring into care, and routine screening for type 2 diabetes in high-risk youth.
The standards of care were published online Dec. 8 and are available as a supplement to the January 2018 Diabetes Care.
Important changes and updates for patients with diabetes and cardiovascular disease include the following:
12.22.17: Reporting Patients Who Should Not Drive: An FAQ
Laurie Cohen, Esq. of Nixon-Peabody, NYACP's Legal Counsel has developed as list of Frequently Asked Questions updating members on how to handle patients who should not be driving due to temporary or permanent impairment.
The New York State Department of Motor Vehicles (DMV) may suspend or place restrictions upon an individual’s driver license or learner permit if it has reason to believe the individual has a medical condition that may interfere with his or her ability to safely operate a motor vehicle. To that end, the DMV solicits reports by individuals, including police officers, licensed physicians and others, of individuals with medical conditions that may affect his or her driving. Before making such a report, you should review this guidance to ensure that doing so does not violate your patient’s privacy rights, including those pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Forms for such cases are available through the DMV and can be accessed here.
Below is a sample of the frequently asked questions:
Q: Do I have a duty to report to the DMV when I have a patient whose medical condition could affect his or her driving?
A: No. In New York State, a physician is not required to report to the DMV any patient’s medical condition and should not do so in the absence of the patient’s written consent or unless otherwise permitted or compelled to do so, for example, pursuant to a court order.
Q: Am I permitted to make a report to the DMV if I have a patient whose medical condition could affect his or her driving?
A: It depends. If your patient consents in writing, you may disclose his or her protected health information. This circumstance could arise if your patient is involved in a motor vehicle accident, after which time he or she is asked to supply medical documentation to demonstrate his or her fitness to drive. Without your patient’s written consent, and in the absence of one or more circumstances for which disclosure without patient consent is expressly permitted, you may not disclose his or her protected health information.
12.22.17: Six Steps to Ensure Your Readiness as an Employer for Paid Family Leave on January 1
Starting January 1, 2018, nearly all private employees in New York State will be eligible for Paid Family Leave (PFL).
Physicians play an important role in implementing PFL, both as employers administering these new mandatory benefits for your staff, and in documenting patient eligibility
To help with the transition, here are six easy steps to help ensure your practice is ready for PFL on January 1:
For more information on how you can prepare for Paid Family Leave, please visit the Department of Health website here.
12.22.17: New York State Department of Health Announces New Medical Marijuana Regulations
On December 8, 2017, the New York State Department of Health announced the filing of regulations that will improve the state's Medical Marijuana Program for patients, practitioners and registered organizations. These regulations, which will go into effect on December 27, 2017, allow for the sale of additional medical marijuana products, an improved experience for patients and visitors at dispensing facilities and the ability for the Department to approve new courses that will allow prospective practitioners to complete their training in a shorter amount of time.
Under the new regulations, registered organizations (ROs) are allowed to manufacture and distribute additional products including topicals such as ointments, lotions and patches; solid and semi-solid products, including chewable and effervescent tablets and lozenges; and certain non-smokable forms of ground plant material. All products are subject to rigorous testing, and the Department reserves the right to exclude inappropriate products or those which pose a threat to public health.
The new regulations also allow prospective patients and practitioners to enter dispensing facilities to speak directly with RO representatives, learn about products and get information about the medical marijuana program. In addition, people other than designated caregivers may accompany patients to dispensing facilities.
Physicians will soon be able to take a shortened version of the currently available four-hour courses required to certify patients for medical marijuana. The Department will work with course providers to offer a two-hour course, which is a typical length for other medical education courses.
The regulations also streamline the manufacturing requirements for medical marijuana products, broaden the capability of registered organizations to advertise, amend security requirements and clarify laboratory testing methods.
Other recent enhancements to New York's Medical Marijuana Program include authorizing five additional registered organizations to manufacture and dispense medical marijuana, adding post-traumatic stress disorder and chronic pain as qualifying conditions, empowering nurse practitioners and physician assistants to certify patients and permitting home delivery.
As of December 8, 2017, there are 38,642 certified patients and 1,358 registered practitioners participating in the program.
For more information on New York's Medical Marijuana Program, please click here.
12.22.17: New NY Department of Health Flu Surveillance Shows That Flu Season is Ramping Up
The New York State Department of Health (NYSDOH) collects, compiles, and analyzes information on influenza and produces this weekly report during the influenza season (October through the following May).
This is the first surveillance report to categorize influenza as geographically widespread.
During the week ending December 9, 2017:
12.22.17: NYACP Manhattan/Bronx Governor Election Results
Jitendra Barmecha, MD, FACP has been elected by the members Manhattan/Bronx Region to serve as Governor-elect Designee.
Dr. Barmecha is Vice President of Medical Informatics and the Chief Medical Informatics Officer at St. Barnabas Health in the Bronx. He has been an active participant in ACP and the New York Chapter for over a decade, serving as the Bronx District President, Bronx District Councilor, and as the Chair for the former ACO/PCMH Committee. In addition, he was awarded the NY Chapter Laureate Award in 2010 for outstanding commitment to excellence in medical care, education, and service to the community and the College.
Louis Morledge, MD, FACP, ran for the Governorship as well, and we applaud him for his past and continuing service to the Chapter. He is a general internist in private practice as part of the three provider practice in midtown Manhattan, and is the Honorary Police Surgeon for the New York City Police Department. As a leader in ACP and NYACP, he has been a member of the Health and Public Policy Committee, the Small Practices Committee, and the Budget and Finance Committee. He served as the Manhattan District President and is currently Councilor for the Manhattan/Bronx District-at-Large.
Dr. Barmecha will start his term as Governor-elect after the Annual Business Meeting in New Orleans, LA on April 21, 2018. Dr. Barmecha will take office as Governor in April of 2019.
Please join us in congratulating both Dr. Barmecha and Dr. Morledge for their dedication and continuing commitment to their colleagues.
12.11.17: ACP and CDC Issue Recommendations for Hepatitis B Screening, Vaccination, and Care
ACP and the CDC have released an ACP High Value Care Task Force paper to present best practice statements for hepatitis B vaccination, screening, and linkage to care. Reducing chronic hepatitis B infections by screening at-risk adults, increasing hepatitis B vaccination rates, and linking infected persons to care is a public health priority, ACP and the CDC advise. An excerpt:
Clinicians should vaccinate against hepatitis B virus (HBV) in all unvaccinated adults (including pregnant women) at risk for infection due to sexual, percutaneous, or mucosal exposure; health care and public safety workers at risk for blood exposure; adults with chronic liver disease, end-stage renal disease (including hemodialysis patients), or HIV infection; travelers to HBV-endemic regions; and adults seeking protection from HBV infection.
12.11.17: High Value Care: Complete CME and MOC Requirements at Home from the ACP Online Learning Center!
HVC cases aim to improve health, avoid harms, and eliminate wasteful practice and can be completed in 30 to 60 minutes on your computer, tablet, or smart phone. You can review the clinical cases online, answer the associated questions, and read through critiques, as well as download take-home tools that will help you incorporate HVC principles into your practice. Both adult and pediatric cases are available.
Topics covered include:
Don't Delay! 2018 is right around the corner! Find out More About ACP High Value Care here.
12.11.17: Attention All Physicians Who Treat Workers’ Compensation Patients:
Authorized providers are required to register by January 15, 2018. Providers who have not registered by the deadline will:
The up-to-date list will ensure that an injured worker can easily identify Board authorized providers.
How to Access the Registration Form (for existing HCS Users)
Complete the Registration Form
1. Select the Home tab located at the top left of the page (next to the Data Entry tab).
If you do not have computer access to complete the registration online, you may request a paper copy be mailed to you by contacting the NYS Workers' Compensation Board Medical Director's Office at (800)-781-2362, option 6.
12.11.17: CMS Now Offers Accredited CME Courses Online for the Quality Payment Program
Two new accredited online courses are now available for CMS:
A new Quality Payment Program 2017: Merit-Based Incentive Payment System (MIPS) Advancing Care Information (ACI) Performance Category Web-Based Training (WBT) course is available through the MLN LMS. Learn about:
This course is the seventh course in an evolving curriculum on the Quality Payment Program, where participants will gain knowledge and insight on the program all while earning valuable continuing education credit.
The Centers for Medicare & Medicaid Services designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit for this course expires August 1, 2020. AMA PRA Category 1 Credit™ is a trademark of the American Medical Association.
A second new course, Quality Payment Program: Merit-Based Incentive Payment System Participation in 2017 Web-Based Training (WBT) course, is also available through the MLN LMS. Learn about:
This course is the eighth course in an evolving curriculum on the Quality Payment Program. Keep checking back with us for updates on new courses. First time participants will need to register for the MLN Learning Management System. Once registered, you will be able to access additional courses without having to register. For information on how to login or find training, please visit our MLN Learning Management System FAQ sheet.
The Centers for Medicare & Medicaid Services designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit for this course expires November 1, 2020. AMA PRA Category 1 Credit™ is a trademark of the American Medical Association.
To take the course, please click here. (username and password required)
12.11.17: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 and produces this weekly report during the influenza season (October through the following May).
During the week ending November 25, 2017:
11.22.17: ACP Updates "Living with Diabetes" Patient Guidebook
ACP has updated its popular guidebook, “Living with Diabetes: An Everyday Guide for You and Your Family,” with new visuals and a redesigned layout that’s easier for patients to read. This award-winning guidebook helps patients learn about and manage diabetes. Topics include diet, exercise, monitoring blood sugar, the importance of foot exams, and managing insulin and other medicines.
11.10.17: CMS Finalizes Quality Payment Program Rule for Year 2 to Increase Flexibility and Reduce Burdens
On November 2nd, the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment for the second year of the Quality Payment Program (calendar year 2018), as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as well as an interim final rule with comment.
CMS listened to feedback from the health care community and used it to inform policy making. As a result, the Year 2 final rule continues many of the flexibilities included in the transition year, while also preparing clinicians for a more robust program in Year 3. CMS wants to ensure that the program consists of meaningful measurement while minimizing burden, improving coordination of care, and supporting a pathway to participation in Advanced Alternative Payment Models (APMs).
9.15.17: Stand Together to Prevent Falls: Annual Falls Prevention Day is September 22
Resources for Patients:
9.15.17: Information for Physicians and Patients on New York’s Step Therapy/Fail First Reform Law
Governor Cuomo signed legislation on December 31, 2016 that would add new protections for patients when their health insurance plans require them to go through “step therapy” or “fail first” protocols when accessing prescriptions drugs to treat a medical condition(s). The new law took effect on January 1, 2017 but was applicable to “health insurance plans delivered, issued for delivery, or renewed after that date”.
Through stakeholder collaborations, several resource fact sheets have been prepared for both physicians and patients. These documents were created in a Q&A format for the purpose of explaining the law, providing details about requirements and compliance by health insurance plans, and dispensing valuable information about the appeals process.
To read these Fact Sheets, click on the following:
These documents have been provided through a joint collaboration with Reid, McNally, and Savage LLC, and Cary Collaborative Strategies.
9.15.17: The Advanced Primary Care Initiative: What You Need to Know
The Advanced Primary Care (APC) initiative is part of the State Innovations Model (SIM) Grant by the Centers for Medicare and Medicaid Innovation (CMMI), the focus of which is to transform healthcare delivery in New York and shift to value-based care.
The APC Program provides free practice transformation technical assistance to eligible practices to enable them to deliver high-quality, coordinated care, earn payment incentives, and thrive under value-based payment arrangements, including MIPS Quality Payment Program (QPP).
There are 16 Practice Transformations Agents across New York that are contracted to provide free practice transformation technical assistance to you through on-site, remote and collaborative learning and coaching. The complete listing of the available transformation agents, regions served and contact information can be found here.
Resources will continue to be posted to the Alternative Payment Model section of NYACP’s Practice Management page as they become available. You can access the Alternative Payment Model Page here.
“The project described was supported by Funding Opportunity Number CMS 1G1CMS331402 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.”
8.3.17: New York Establishes a No-Cost Pilot Drug Take-Back Program
Nationwide, 80% of lakes, rivers and streams now contain low levels of pharmaceuticals. Chronic exposure to low levels of medications in the environment, even expired medications, has been shown to harm the fertility of fish and other aquatic animals. Most current municipal wastewater treatment technology is ineffective in intercepting drugs when they are flushed down the toilet. Moreover, unwanted prescription drugs that remain in consumers’ homes are at risk of being abused.
For these reasons, New York State is funding a one million dollar drug take-back program to encourage health care entities to provide for the safe, convenient and effective collection of unused drugs. Health care entities who sign up early can get the costs of their drug take-back programs covered for the first two years of operation.
8.3.17: August is National Immunization Awareness Month
August is National Immunization Awareness Month, and in the interest of increasing immunization rates, NYACP offers internists the following resources:
ACP advises adults to get an annual flu vaccine and to use that opportunity to discuss with their internist other vaccinations they might need, including Tdap, pneumococcal, HPV, hepatitis B, and herpes zoster.
ACP encourages internists to assess their patients' vaccination needs at each office visit to ensure they are up to date on the last recommended adult immunization schedule issued by the Advisory Committee on Immunization Practices, published in Annals of Internal Medicine.
In addition, here are useful immunization links from the New York State Department of Health (NYSDOH):
7.20.17: Acronym List
Below is an acronym list detailing various acronyms in the medical field.
7.18.17: New Medical Marijuana Course from the New York State Department of Health
The New York State Department of Health (NYS DOH) has approved a second course for practitioners on the medical use of marijuana. The four-hour course will be offered by The Medical Cannabis Institute (TMCI Global). The first course was approved in October 2015 and is provided by The Answer Page.
Both courses are available online so that practitioners can take them at their convenience, and both provide continuing medical education (CME) credits. Practitioners are only required to complete one of these courses in order to register with the Department to certify patients for the medical marijuana program.
Practitioners who wish to register with the Department and certify their patients for the Medical Marijuana Program must complete one of the available approved courses. The Department also streamlined the process for practitioners to register with the program. All practitioners who newly register with the Department will be listed publicly online, unless they opt-out during the registration process, in order to help patients find participating practitioners.
A list of practitioners registered with New York's Medical Marijuana Program who have consented to be publicly listed is available on the Department's website.
For more information on New York's Medical Marijuana Program, visit: https://www.health.ny.gov/regulations/medical_marijuana/.
7.18.17: Health Advisory on Legionellosis
While legionellosis is diagnosed year-round, the incidence of illness usually increases during the summer and early fall. Investigations into potential time-space clusters of cases above baseline incidence are currently ongoing in Niagara and Onondaga Counties. Additionally, a cluster of legionellosis cases in New York City’s Lenox Hill area is being investigated by the New York City Department of Health and Mental Hygiene.
7.18.17: CMS’ Open Payments Program Posts 2016 Financial Data
Applicable manufacturers and Group Purchasing Organizations (GPOs) collectively reported $8.18 billion in payments and ownership and investment interests to physicians and teaching hospitals in 2016.
On Thursday, July 13, the Centers for Medicare & Medicaid Services (CMS) published the Program Year 2016 Open Payments data, along with newly submitted and updated payment records for Program Years 2013, 2014, and 2015. They can be read here.
The Open Payments program requires that transfers of value by drug, device, biological, and medical supply manufacturers to physicians and teaching hospitals be published on a public website.
In Program Year 2016, applicable manufacturers and GPOs reported $8.18 billion in payments and ownership and investment interests to physicians and teaching hospitals. This amount is comprised of 11.96 million total records attributable to 630,824 physicians and 1,146 teaching hospitals.
Payments in the three major reporting categories are:
Over the course of the Open Payments program, CMS has published 40.77 million records, accounting for $24.94 billion in payments and ownership and investment interests.
In addition to publishing the Open Payments Data, CMS has incorporated new features and enhancements to the Open Payments Search Tool.
6.29.17: Healthcare Providers: Get Ready for New Medicare Cards
Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.
CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems physicians use now. CMS will start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.
CMS is committed to helping providers by giving them the tools they need. Based on feedback from healthcare providers, practice managers and other stakeholders, CMS is developing capabilities where doctors and other healthcare providers will be able to look up the new MBI through a secure tool at the point of service. To make this change easier for you and your business operations, there is a 21-month transition period where all healthcare providers will be able to use either the MBI or the HICN for billing purposes.
Beginning in April 2018, Medicare patients will be issued new cards.
Here are 5 steps to help your physicians get ready:
To learn more, click here.
Last Updated 12.22.17
NYACP has resources to assist you in all of your ISTOP and E-Rx implementation efforts.