NYS Society of Orthopaedic Surgeons Recent News

Call for Abstracts! Now Open for the 2026 Competition

Mon, 30 Mar 2026 19:10:24 GMT

We are excited to announce that the New York State Society of Orthopaedic Surgeons (NYSSOS) is now accepting submissions for its Poster Competition, which will take place at our Annual Symposium on Friday and Saturday November 20th & 21st, 2026 at the Saratoga Hilton in Saratoga Springs, NY

This competition provides a unique opportunity for fellows, residents, and medical students interested in orthopaedics to showcase their research, clinical case reports, or advocacy efforts. We welcome submissions in the following categories:

Clinical Case Reports: Highlighting new disease entities or unusual clinical features of known conditions.
Research: Focused on clinical or laboratory-based research related to orthopaedics.
Quality, Advocacy, and Public Policy: Addressing health systems improvement, patient safety, quality of care, or advocacy efforts in orthopaedic care.

To submit an abstract and review detailed submission guidelines:

Fellows and Residents
Medical Students

Please note that all abstracts must follow the structure outlined in the competition regulations.

AAOS encourages members to stand up for prior authorization reform

Babette Atkins — Mon, 13 Oct 2025 17:40:35 GMT

Even with the government shutdown, Congress continues to work on key bills, including the Improving Seniors’ Timely Access to Care Act (H.R. 3514). This legislation is just shy of a House majority, and AAOS members’ voices can help tip the scales.

Members can send a letter to Representatives who have not yet co-sponsored the legislation asking for their support in reducing delays and administrative burden for patients and surgeons.

Take Action: https://aaos.quorum.us/campaign/143794/

AI in the healthcare setting

Babette Atkins — Sat, 11 Oct 2025 17:42:21 GMT

AAOS staff recently attended a presentation on the liability implications of artificial intelligence (AI) in healthcare settings by Perry Nielsen Jr., a Stanford biodesign policy fellow. His talk addressed technical challenges of using generative AI and the risk of incorrect or misleading AI-generated outputs. Nielsen emphasized that physician liability can be mitigated by ensuring proper use of AI, applying clinical judgment, and appropriately documenting it.

From a legislative perspective, he shared that Congress is eager to regulate the use of AI, though he acknowledged that stakeholders are cautious of both over- and under-regulation.

Nielsen anticipates that government agencies will continue to focus on early-stage pilot programs using AI, such as the Wasteful and Inappropriate Service Reduction (WISeR) model from the Centers for Medicare & Medicaid Services.

New York State Governor Hochul's AI initiatives focus on expanding the state's AI research capabilities through the Empire AI Consortium, implementing responsible AI regulations and safety features, and supporting workforce training and small businesses.

Key projects include enhancing the Empire AI supercomputing center, establishing AI Departments at SUNY campuses, creating new safety standards for AI companions, and offering technical assistance and workforce development programs to help New Yorkers adapt to and benefit from AI.

Downcoding and payment reform efforts

Babette Atkins — Fri, 10 Oct 2025 17:30:49 GMT

Automatic downcoding occurs when insurers unilaterally reduce the level of a billed Evaluation and Management (E/M) service or procedure code without reviewing the physician’s supporting documentation. Instead, claims are automatically flagged and adjusted by internal algorithms based on coding guidelines or statistical norms. The outcome is reduced reimbursement, even when the billed service level was appropriate and supported by the medical record.

This practice has serious implications. For physicians, it means lost revenue, time-consuming appeals, and increased administrative workload. For patients, it threatens the sustainability of physician practices, particularly in underserved areas where margins are already thin. Automatic downcoding also raises broader concerns about fairness and transparency in claims adjudication, as it bypasses medical judgment and disregards the physician’s expertise. As of October 1, Cigna and Aetna are automatically downcoding claims.

States attempting to tackle downcoding have sought out different avenues for the process. New York Senate Bill S4833 categorizes downcoding as an adverse decision — enabling policy prescriptions for adverse decisions, such as in prior authorization, to be applicable for downcoding.

In California, Cigna has agreed to temporarily pause a novel and controversial downcoding policy that would have automatically downcoded any higher-level evaluation and management services.

MSSNY is contacting physicians statewide to assess the impact of insurance companies’ automatic downcoding, a growing concern that undermines fair reimbursement and burdens physician practices.

By sharing your experiences, you will help MSSNY document the scope of this issue and determine whether further advocacy, regulatory engagement, or legal action is warranted. Submit your experiences here

How Has Prior Authorization Impacted Your Practice and Patients?

Babette Atkins — Fri, 26 Sep 2025 19:01:24 GMT

Throughout AAOS’ Combined National Orthopaedic Leadership Conference/Fall Meeting, members recorded firsthand accounts of how prior authorization delays and denials affect patient care. Individual stories are a powerful tool that resonate with lawmakers and physicians alike. Members can add their voices by submitting a short video or written account via the AAOS Advocacy Action Center.

Watch and example

Share your story

All CMS-1500 Bills Must Now Be Submitted Electronically

Babette Atkins — Fri, 01 Aug 2025 22:36:27 GMT

Starting today, all health care providers in the workers' compensation system, regardless of office size or patient population — must submit the CMS-1500 universal billing form electronically, through a Board-approved electronic submission partner in order to be paid for services.

This mandate applies to each individual provider in a practice who treats workers’ compensation patients. If you have not already done so, simply contact a Board-approved electronic submission partner to arrange for electronic submission of your CMS-1500 forms. Take action now to ensure uninterrupted payment for your services in treating injured workers.

Going forward, the workers’ compensation payer can deny payment of services if the CMS-1500 form was not submitted through a Board-approved electronic submission partner and the Board will not enforce payment.

Learn more: https://www.wcb.ny.gov/CMS-1500/

CMS-1500 electronic submission mandate is fast approaching! Learn more in the WCB webinar series

Babette Atkins — Tue, 10 Jun 2025 17:48:08 GMT

With the CMS-1500 electronic submission mandate fast approaching, the Workers’ Compensation Board (Board) is continuing its CMS-1500 webinar series tomorrow for providers. Effective August 1, 2025, the Board is requiring health care providers, regardless of office size or patient population, to submit the CMS-1500 universal medical billing form electronically through a Board-approved electronic submission partner.

After August 1, 2025, the Board will not act on, or enforce payment of, paper CMS-1500 forms and workers’ compensation payers can deny them, which means the submitting provider will not be paid. To ensure uninterrupted payment for services, the Board urges all providers to transition to electronic submission now. For more information, join one of our upcoming webinars.

Each one-hour webinar session will cover:

A brief overview of CMS-1500
The significant benefits of electronic submission, already available
Currently authorized submission partners
The submission process

The sessions are free and there will be time at the end for questions. Register here.

June

Wednesday, June 11, 2025
12:00 p.m. – 1:00 p.m.
Wednesday, June 25, 2025
12:00 p.m. – 1:00 p.m.

July

Wednesday, July 16, 2025
12:00 p.m. – 1:00 p.m.
Wednesday, July 23, 2025
12:00 p.m. – 1:00 p.m.

More information

Visit the CMS-1500 section of the Board’s website for more information.

If you are not currently working with an electronic submission partner, this fact sheet will guide you through the process step-by-step.

The What Providers Need to Know section of the Board’s website walks health care providers through the workers’ compensation system with the following topics:

Getting started
Treating Injured Workers
Billing for Services
Provider Updates – featuring the latest news for the provider community

If you have not already, be sure to sign up to receive Board news straight to your inbox, including updates on the progress of this initiative, upcoming webinars, and more.

Questions?

Email CMS1500@wcb.ny.gov.

Having trouble?

If you are having trouble registering or attending these webinars, check out these Webinar FAQs.

You're Invited: NYSSOS Member Town Hall – Help Shape Our Future

Babette Atkins — Mon, 02 Jun 2025 17:02:11 GMT

As we chart the course for NYSSOS’s 2026–2029 Strategic Plan, we want to hear directly from you. Please join us for a Virtual Member Town Hall where you can share your ideas, priorities, and concerns, and help shape the future of orthopaedic advocacy, education, and community in New York State.

June 18, 2025
7:30pm - 8:30pm EST
Registration link

This informal session will be hosted by NYSSOS leadership and is open to all members. It’s your chance to be part of the conversation as we build a bold and responsive plan for the years ahead.

We encourage all members to also complete our short strategic planning survey here

Thank you for being an active voice in the NYSSOS community.

Call for Abstracts! Now Open for the 2025 Competition

Babette Atkins — Wed, 28 May 2025 17:30:20 GMT

We are excited to announce that the New York State Society of Orthopaedic Surgeons (NYSSOS) is now accepting submissions for its Poster Competition, which will take place at our Annual Symposium on Saturday, September 6, 2025 at the Turning Stone Resort in Verona, NY.

This competition provides a unique opportunity for medical students interested in orthopaedics to showcase their research, clinical case reports, or advocacy efforts. We welcome submissions in the following categories:

Clinical Case Reports: Highlighting new disease entities or unusual clinical features of known conditions.
Research: Focused on clinical or laboratory-based research related to orthopaedics.
Quality, Advocacy, and Public Policy: Addressing health systems improvement, patient safety, quality of care, or advocacy efforts in orthopaedic care.

To submit an abstract and review detailed submission guidelines, please click here

Please note that all abstracts must follow the structure outlined in the competition regulations.

MLMIC's Albany Report: NEW YORK STATE ENACTED 2025-26 BUDGET

Babette Atkins — Wed, 28 May 2025 15:16:49 GMT

Legislative developments impacting the New York medical
and dental professional liability insurance marketplace

On May 8, more than a month after the April 1 fiscal deadline, the New York State (NYS) Legislature completed work on the state budget.

The Governor and the Legislature agreed to a budget for the 2025-26 state fiscal year that totals $254 billion, which reflects a $2 billion spending increase from Governor Hochul’s proposed executive budget.

The final budget contains six items of interest to the NYS medical community - learn more

New York Expands Access to Workers' Compensation Care by Authorizing Residents and Fellows to Treat Injured Workers

Babette Atkins — Mon, 19 May 2025 15:52:10 GMT

In a move to enhance healthcare access for injured workers, New York State has enacted legislation permitting resident and fellow physicians in Accreditation Council for Graduate Medical Education (ACGME)-accredited programs to provide treatment under supervision within the state's workers' compensation system.

This change, effective immediately, allows approximately 20,000 resident and fellow physicians across nearly 70 teaching hospitals in New York to participate in the care of injured workers. The initiative aims to alleviate provider shortages and improve timely access to quality medical care for those affected by workplace injuries.

Key Provisions:

Supervised Practice: Residents and fellows can treat injured workers under the supervision of a physician authorized by the New York State Workers' Compensation Board.
Billing Procedures: Services rendered by residents and fellows are billed by the supervising physician using the appropriate modifiers, ensuring compliance with the Official New York Workers' Compensation Medical Fee Schedule.
Clinical Documentation: Treatment notes must clearly identify the resident or fellow providing care, the supervising physician, and include specific information regarding the work-related nature of the condition, the patient's work status, and the degree of temporary disability.

For more information and resources, visit the New York State Workers' Compensation Board's official page for residents and fellows: https://apps.wcb.ny.gov/content/main/hcpp/residents-fellows.jsp

and the Subject Number 046-1756

https://www.wcb.ny.gov/content/main/SubjectNos/sn046_1756.jsp

NYSSOS Joins Own the Bone® Organizational Alliance

Babette Atkins — Wed, 07 May 2025 16:28:26 GMT

We’re proud to share that the New York State Society of Orthopaedic Surgeons (NYSSOS) has been welcomed as the newest member of the Own the Bone® Organizational Alliance, a program of the American Orthopaedic Association (AOA). As part of this alliance, NYSSOS supports efforts to improve bone health by promoting coordinated care that goes beyond routine fracture treatment and ensures patients are educated about osteoporosis prevention and management.

May is National Osteoporosis Awareness and Prevention Month, an opportunity for health professionals, advocates, and patients to bring attention to this silent disease. According to the National Institutes of Health, more than 53 million Americans have osteoporosis or are at high risk due to low bone mass.

Hospitals and practices are encouraged to show their commitment to bone health this month by:

Sharing Own the Bone’s featured LinkedIn posts thanking providers
Promoting steps for osteoporosis prevention in their communities

NYSSOS members can get involved by encouraging their institutions to participate in Own the Bone or by leading local efforts to raise awareness about fracture prevention, patient education, and coordinated post-fracture care. Participation not only supports improved patient outcomes but also helps demonstrate your leadership in advancing musculoskeletal health across New York State.

Member institutions can access the Own the Bone Media Kit, which includes sample press releases, event ideas, and other promotional tools. The kit is available under the Public Relations Tools section of the Own the Bone website. Star Performer institutions receive expanded access and customized resources.

To learn more or to get involved, contact the Own the Bone staff or visit www.ownthebone.org.

President's Message - Leading with Purpose in a Time of Change

Babette Atkins — Tue, 06 May 2025 18:26:08 GMT

The New York State Society of Orthopaedic Surgeons (NYSSOS) has been actively engaged on multiple fronts to support the interests of orthopaedic surgeons and the patients we serve.

Last month, NYSSOS members traveled to Albany to meet with lawmakers and advocate for key legislative priorities. We were well received, and several legislators signed on to bills we discussed shortly after our meetings—a clear and encouraging sign of growing support for the issues that matter to our profession. This was a significant victory and a testament to the value of persistent, respectful advocacy.

We also recently met with representatives from the New York State Podiatric Medical Association, who are seeking to expand their surgical scope of practice beyond current limits. NYSSOS expressed strong concerns about proposals that would allow podiatrists to perform procedures such as total ankle replacements and pilon fracture treatments. While our discussions were productive, our message was clear: patient safety must remain the top priority. We shared this view directly with both state Assemblymembers and Senators and will continue to do so.

Last month we shared a message encouraging a vote of "No" on the proposed AAOS bylaw amendments. This recommendation followed a thorough review of both the existing bylaws and the proposed changes. One of our most pressing concerns is a provision that would allow the AAOS Board of Directors to remove any Fellow "with or without cause", a change we believe undermines transparency and due process.

While we respect and support the broader mission of AAOS, we are concerned these proposed bylaw changes may adversely impact members and the organization. Following our outreach, we had a thoughtful discussion with Dr. Ned Amendola, President of AAOS as well as received a written response. He acknowledged our concerns and shared that several other state societies have expressed similar reservations.

As with any important decision, differing opinions are expected, and in fact, they reflect the very spirit of advocacy and professional engagement that strengthens our field.We remain committed to working with the AAOS to foster unity within the orthopaedic community. We believe our strength lies in working together, sharing knowledge, supporting one another, and advocating for the highest standards of care for our patients.

The NYSSOS Board encourages all Fellows of the AAOS to read the bylaw documents carefully and make an informed decision when the ballots are released. We believe this is an important vote and will have significant ramifications for all members of the AAOS.

Your voice matters. If you missed the email to NYSSOS members regarding our concerns or would like to see AAOS response letter please feel free to contact membersupport@nyssos.org

Rick Weinstein, MD
NYSSOS President

A Weekend Worth the Trip: 2025 NYSSOS Annual Meeting Preview

Babette Atkins — Mon, 28 Apr 2025 17:56:23 GMT

We look forward to welcoming you to the 2025 Annual Meeting of the New York State Society of Orthopaedic Surgeons. This year’s conference offers a chance to stay current on key issues in orthopaedic care while connecting with colleagues in a beautiful setting.

We’ll gather at Turning Stone Resort Casino in Verona, New York, just west of Syracuse. With its nationally recognized golf courses, full-service spa, tennis and pickleball courts, and excellent dining options, it’s an ideal location to bring a colleague, guest, or family member.

Meeting Highlights:

Friday, September 5 – Welcome Reception
Saturday, September 6 – Full Day of Educational Programming + Chair Reception
Free time before and after to enjoy the resort or connect with colleagues

Please note: Our agenda is currently in development and will feature timely topics, expert faculty, and discussion relevant to your practice.
You can view the preliminary agenda here: https://nyssos.org/Agenda

Registration Now Open
Register Here

Reserve Your Room
A limited number of rooms are available at a special NYSSOS group rate of $399/night. To book, call 1-800-771-7711 and reference the NYSSOS Annual Meeting. Rooms must be reserved by August 14, 2025 to secure the group rate.

Upcoming Vote to Amend the Bylaws of the AAOS

Babette Atkins — Sat, 26 Apr 2025 20:05:41 GMT

The New York State Society of Orthopaedic Surgeons (NYSSOS) is sharing the information below concerning the upcoming vote to amend the Bylaws of the AAOS which will have an impact on governance and voting within the AAOS organization.

NYSSOS leadership has been involved in trying to amend these recommendations over the past 6-8 months. While some adjustments to the initial recommendations have been made for which we are thankful, NYSSOS remains concerned with several provisions:

The proposed changes give the Board of Directors the right to remove any Fellow with or without cause by simple majority vote.
The Board of Councilor's structure, composition, and duties will be subject to Board approval.
The proposed changes eliminate the Board of Councilors’ formal authority under the bylaws to submit resolutions to the Fellowship.
The Board of Councilors will no longer have a seat on the nominating committee.

Following a thorough review by the NYSSOS Board, NYSSOS recommends a NO vote on the proposed bylaw changes from the American Academy of Orthopaedic Surgeons (AAOS). We stand in alignment with our colleagues at both the California and Florida Orthopaedic Societies, who also oppose the current version of the proposed changes.

We encourage you to review all of the proposed amendments carefully and vote when the ballots are released. For questions or clarifications, AAOS leadership is available at governance@aaos.org or you may contact NYSSOS at info@nyssos.org.

Summary of Concerns

We recognize the need for modernization and organizational efficiency, however we remain concerned about the implications these changes may have on democratic governance and member representation. We agree that it is important to adapt to current and future circumstances, but it is critical to remember the purpose of AAOS is to support the members.

With that in mind, we find the suggested changes may have consequences and affect the members of the AAOS in several ways:

The proposed changes give the Board of Directors the right to remove any Fellow with or without cause by simple majority vote. While the AAOS states this is intended for rare or extreme circumstances, this is an over-reach of power and lacks appropriate checks and balances. The concern is that this will stifle discussion and discourage members from voicing dissent, all values of a healthy, democratic organization.

Cited in: Proposed Association Bylaws Article 2, Section 2.4: Resignation and Removal “The Board of Directors may terminate the membership of any member with or without cause by a majority vote of the entire Board of Directors.”

The Board of Councilors (BOC) was created to give members and state societies a voice in AAOS. While the BOC is currently advisory, the proposed changes would decrease the ability of the BOC to serve in its purpose and loses its independence from the Board of Directors.

Cited in: Proposed Association Bylaws Article 10 Advisory Groups The BOC and BOS shall be aligned under the Board as advisory councils. Their structure, composition, and duties will be subject to Board approval.

The proposed changes eliminate the Board of Councilors’ formal authority under the bylaws to submit resolutions to the Fellowship. This may weaken an established mechanism for grassroots member advocacy to influence AAOS policies and gives the Board of Directors discretion over whether member-driven proposals move forward. In the past the resolutions process has brought great changes to the AAOS that have benefited all the members. The concern is that this will make it much harder for Fellows to bring resolutions to the membership and to a vote.

Cited in: FAQ Section - How Will Resolutions be Handled Resolutions process is no longer part of the Association Bylaws (Article VII) and will be handled in a separate procedure book which will not be subject to a member vote to change.

In the proposals, the restructured nominating committee will have 4 of 8 members appointed directly by the Board of Directors. The Board of Councilors will no longer have a seat on the nominating committee.

Cited in: FAQ Section – Board Nominations Process and Proposed Association Bylaws Article 8

Learn More about the AAOS Board of Councilors: https://www.aaos.org/about/meet-aaos/leadership-governance/board-of-councilors/

Anyone interested in learning more about the proposed AAOS governance changes can visit the website: https://www.aaos.org/about/meet-aaos/proposed-governance-changes/

What is the Board of Councilors:

The Board of Councilors (BOC) represents the grassroots of the orthopaedic profession. Its 90-plus members are elected by state and regional orthopaedic societies. They also represent Puerto Rico, the U.S. military, Canada, and four regional societies. The BOC serves as an advisory body to the AAOS Board of Directors and a resource to AAOS committees.

In addition, the BOC manages AAOS' relations with the state and regional orthopaedic societies. This includes conducting a wide range of programs to strengthen and support the state and regional societies organizationally.

Advancing Osteoporosis Care: A Call for Advocacy, Action, and Collaboration

Babette Atkins — Tue, 22 Apr 2025 16:18:10 GMT

The New York State Society of Orthopaedic Surgeons (NYSSOS) is proud to present an evening of critical conversation and clinical strategy on Thursday, May 22, 2025, in Brooklyn. Titled "Breaking Barriers, Not Bones: Advancing Osteoporosis Care in Orthopedic Surgery," this complimentary dinner symposium brings together leaders in orthopaedics to confront one of the most urgent, yet often overlooked, public health challenges of our time: osteoporosis.

Osteoporosis is a chronic, progressive disease that affects over 54 million Americans and leads to more than 2 million fractures annually in the United States alone. Alarmingly, 1 in 2 women and up to 1 in 4 men over 50 will suffer an osteoporosis-related fracture in their lifetime, yet most go undiagnosed and untreated. After a first fracture, patients are up to 86% more likely to suffer a second fracture, and subsequent fractures are 2 to 3 times more costly to the healthcare system than initial ones. Despite these dire statistics, only a small fraction of patients receive appropriate osteoporosis therapy following a fragility fracture.

This evening event will provide clinical tools and policy, focused insights to close this dangerous treatment gap. Participants will gain:

Strategies for early diagnosis and treatment - Tools to implement interdisciplinary fracture liaison services (FLS)
Policy guidance to support local and state-level advocacy
Resources to strengthen post-fracture care pathways

The United States consistently ranks among the lowest in treatment rates after osteoporotic hip fractures compared to peer nations. With the number of hip fractures projected to rise by 80% by 2050, the time for coordinated action is now. Models like Post-Fracture Care (PFC) programs have proven successful across health systems, reducing re-fracture rates, improving patient outcomes, and saving costs.

NYSSOS is committed to driving this change statewide, bridging the clinical care gap and advocating for sustainable healthcare policy that prioritizes bone health in vulnerable populations.

We invite you to be part of this change. Join us on May 22nd at Marco Polo Ristorante in Brooklyn for an evening of learning, networking, and mobilizing around a shared mission: preventing fractures before they happen.

For more details and registration, visit: https://nyssos.org

Protecting Orthopaedic Practice: Advocacy & OrthoPAC Update

Babette Atkins — Fri, 11 Apr 2025 16:08:18 GMT

Advocacy in Action

On April 7th, NYSSOS members from across the state came together in Albany for a highly successful Advocacy Day. With over 27 meetings held with legislators and their staff, we walked the halls of the Capitol to ensure your voice was heard on the most pressing medical-legal issues affecting orthopaedic practice in New York.

Key Issues Discussed:

Oppose S4423 / A6063 – The Grieving Families Act
This bill could increase malpractice insurance premiums by nearly 50%, making it harder to maintain a viable practice in New York.
Support S1608 / A2305 – Strengthen Certificate of Merit Requirements
Improves case legitimacy and transparency by reinforcing disclosure rules for expert witnesses in malpractice suits.
Support Workers’ Compensation Reform
Advocating for fair reimbursement and policies that encourage physician participation in the system.
Support A3789 – Utilization Review Standards
Seeks to streamline the administrative burden of utilization reviews and improve care delivery timelines.
Protect Scope of Practice – Oppose Unchecked Expansion
We remain vigilant about proposals that expand podiatric surgery beyond appropriate training standards, which could jeopardize patient safety and the integrity of orthopaedic care.

Legislative Connections & Recognitions

This year’s Advocacy Day also featured meaningful conversations during our OrthoPAC reception with Senator Jessica Ramos, Senator Jessica Scarcella-Spanton, and Assemblymember Sarah Clark. During our awards breakfast, we proudly presented Assemblymember Michaelle Solages with the 2024 Legislator of the Year Award for her leadership in advancing legislation to license athletic trainers and for supporting efforts to gather data on podiatric surgical privileges prior to any changes in scope of practice.

As a Society, we are committed to strengthening relationships with lawmakers. If you are interested in hosting or joining in-district meetings with your representatives, please let us know, we’re here to support you.

Support the OrthoPAC of New York

Your involvement makes a difference. The OrthoPAC of New York helps amplify our voice in Albany, and your contributions fuel that work. Every dollar supports our advocacy on behalf of orthopaedic surgeons statewide. Contribute today!

Make Your Voice Heard: Submit Resolution Ideas to NYSSOS by Feb. 4!

Babette Atkins — Thu, 30 Jan 2025 16:29:51 GMT

Every member of the New York State Society of Orthopaedic Surgeons has the opportunity to provide input regarding the development of policies and positions impacting orthopaedic surgeons and we encourage you to get involved!

Did you know?

Resolutions propose a course of action to change policy, laws and regulations at the state and federal levels.

Working with NYSSOS Board of Directors, NYSSOS members have prepared and advocated for Resolutions at the Medical State Society of New York (MSSNY) House of Delegates meeting that have covered a variety of issues including:

Prior Authorization Reform
Availability of Testing to Diagnose Periprosthetic Joint Infections
Fair Health Transparency
Use of High Molecular Weight Hyaluronic Acid to treat Knee Osteoarthritis
Pathology Specimens

Please submit your resolution ideas or requests for the society to co-sponsor a pending resolution by Tuesday, February 4, 2025 to NYSSOS' delegate, John Olsewski, MD and Babette Atkins, Executive Director via info@nyssos.org.

Optimizing Prescription Monitoring: What Orthopaedists Need to Know About New York’s PMP Registry

Babette Atkins — Tue, 21 Jan 2025 20:56:12 GMT

The New York State Department of Health (NYSDOH) Bureau of Narcotic Enforcement (BNE) is taking important steps to improve practitioner utilization of the Prescription Monitoring Program (PMP) Registry. This essential public health tool plays a vital role in saving lives, improving patient care, and keeping New York State communities healthy.

Legal Requirement:

In New York State, providers are required by law to consult the PMP Registry before writing a prescription for a controlled substance, with a limited number of exceptions. *

In January 2024, the NYSDOH BNE distributed a survey to identify barriers to checking the PMP Registry and opportunities for improvement of provider compliance with New York State law. Based on responses to this survey, educational materials were developed to bridge gaps in knowledge around PMP Registry use.

To refresh your knowledge on the PMP Registry, please follow this link to view the first of such materials:

New York State Prescription Monitoring Program (PMP) Registry: Legal Duty to Consult.

* 10NYCRR Part 80 Section 80.63(2)

The Challenges of Treating “Snowbird Patients”

Babette Atkins — Fri, 17 Jan 2025 14:34:48 GMT

Snowbird patients - those who travel to warmer states for the winter - pose unique challenges for healthcare providers.

Read advice from MLMIC experts on how to navigate these issues.

NYS WCB: CMS-1500 Webinar on January 15, 2025

Babette Atkins — Mon, 13 Jan 2025 14:52:54 GMT

The Workers’ Compensation Board (Board) continues its CMS-1500 webinar series this week, providing guidance to health care providers ahead of the August 1, 2025, deadline to electronically submit the CMS-1500 universal medical billing form through an approved electronic submission partner.

Webinar Details
Date: January 15, 2025
Time: 12:00 p.m. – 1:00 p.m.
Register Here

What You’ll Learn
This free, one-hour session will cover:

An overview of the CMS-1500 form
Benefits of electronic submission
Available submission partners
The submission process

There will also be a Q&A session at the end.

Additional Resources

Visit the CMS-1500 section of the Board’s website for more details.
Explore the What Providers Need to Know section to navigate the workers’ compensation system, including topics like billing, treating injured workers, and provider updates.
Sign up for email or text updates to stay informed about this initiative, future webinars, and provider news.

Questions or Issues?
Email: MDO@wcb.ny.gov
Check the Webinar FAQs for troubleshooting help.

Reminder: Update Your Physician Profile in Your Health Commerce System Account

Babette Atkins — Sun, 12 Jan 2025 15:15:18 GMT

Have you recently checked your Physician Profile in your Health your Health Commerce System Account? Maintaining an up to profile is part of your re-registration process.

Key requirements:

Your Physician Profile must be updated every two years
Updates must be completed within the six months prior to your re-registration date

How to Check:

For more information about the New York State Physician Profile requirement, click here.

MSSNY Hosts Women Physicians Leadership Academy Spring Sessions

Babette Atkins — Sat, 11 Jan 2025 16:00:00 GMT

Registration is now open for MSSNY’s MESF Women Physicians Leadership Academy!

Dr. Tochi Iroku-Malize will lead three virtual sessions on Saturday, February 1st, Sunday, March 2nd, and Saturday, March 15th, from 7:45 a.m. to 11:15 a.m.

These sessions will focus on Designing Your Medical Career, Enhancing Physician Wellness and Wellbeing, and The Importance of Networking. Upon completing the three sessions, participants can earn up to nine continuing medical education (CME) credits.

To register, please see the links below:

NYS Medical Students Can Submit Abstracts to NYSSOS Poster Competition

Babette Atkins — Thu, 12 Sep 2024 17:47:14 GMT

We are excited to announce that the New York State Society of Orthopaedic Surgeons (NYSSOS) is now accepting submissions from medical students to our poster competition, which will take place at our Annual Meeting on November 9, 2024, at the Opus Westchester in White Plains, NY.

Clinical Case Reports: Highlighting new disease entities or unusual clinical features of known conditions.
Research: Focused on clinical or laboratory-based research related to orthopaedics.
Quality, Advocacy, and Public Policy: Addressing health systems improvement, patient safety, quality of care, or advocacy efforts in orthopaedic care.

Abstract Submission Guidelines:

Abstracts are limited to 450 words and should clearly state the purpose, methods, results, and conclusions of the study.
All submissions must be submitted online by Friday, September 20, 2024. Late submissions will not be accepted.
At least one co-author must be a NYSSOS member and you must be enrolled in a NYS medical school.
Selected abstracts will be chosen for poster presentation at the Annual Meeting. Registration fee to attend the meeting for medical students is: $75.00
One submission per author is allowed.

To submit an abstract and review detailed submission guidelines, please visit https://www.surveymonkey.com/r/nyssosmedstudent.

Please note that all abstracts must follow the structure outlined in the competition regulations.

This is a wonderful opportunity to present your work to a distinguished audience of orthopaedic professionals and gain valuable feedback.

We encourage you to participate and showcase your contributions to the field of orthopaedics.

Submit a Challenging Case to this Year's Annual Meeting

Babette Atkins — Wed, 28 Aug 2024 14:49:36 GMT

We are excited to announce a new addition to this year’s New York State Society of Orthopaedic Surgeons Annual Meeting and Symposium scheduled for November 9, 2024 at the Opus Westchester in White Plains, NY.

Alongside our traditional clinical sessions that focus on optimizing patient care and enhancing your practice's business management strategies, we are introducing an opportunity for you to engage with your peers like never before.

Submit a Challenging Case for Group Discussion!

This is your chance to present a complex or unique case that you've encountered. You'll have 15 minutes to present your case, followed by a moderated discussion, allowing you to gain insights and perspectives from fellow orthopaedic surgeons.

To be considered for presentation, please use this online form.
https://www.surveymonkey.com/r/Q8QYP9H

Help Shape NYSSOS Advocacy Priorities – Your Voice Matters!

Babette Atkins — Tue, 27 Aug 2024 20:11:30 GMT

Our member's insights and experiences were crucial to guiding the NYS Society of Orthopaedic Surgeons (NYSSOS) advocacy efforts this year. We remain committed to representing our orthopaedic community's interests effectively in 2025, and to do that, we need to hear from you directly.

We invite you to take a few minutes to complete this brief 5-question survey. Your responses will help us identify the key advocacy priorities that matter most to you and your practice. This is your opportunity to influence the direction of our efforts in Albany and beyond.

https://www.surveymonkey.com/r/advocacypriorities

Thank you for your time and continued commitment to our society. Together, we can ensure the voice of orthopaedic surgeons and their patients across New York State are heard loud and clear.

Federal Court Blocks FTC’s Non-Compete Ban Nationally

Babette Atkins — Wed, 21 Aug 2024 13:54:44 GMT

Legal Alert provided by Garfunkel Wild

A Texas Federal Judge issued a decision blocking the FTC’s proposed ban on non-compete agreements, which was set to go into effect on September 4, 2024.

The Court found that the FTC improperly exceeded its authority by creating a new rule banning non-compete agreements.

The FTC has said that it is seriously considering appealing the Court’s ruling, and that it would continue to review non-compete agreements on a case-by-case basis for enforceability.

For now, however, the non-compete ban is stalled and will not go into effect on September 4, 2024.

What does this mean going forward?

Don’t wait—the final deadline to submit your abstract is 9/13

Babette Atkins — Tue, 13 Aug 2024 20:19:19 GMT

Mark your calendars: Submissions will be accepted through September 13, 2024.
Submit Your Abstract

Whether your passion lies in groundbreaking research, clinical excellence, or the critical intersections of quality, advocacy, and public policy, we want to see your work. This is your moment to shine, present your ideas to an audience of your peers, and gain recognition for your contributions to the orthopaedic field.

Not only can residents submit an abstract, but for the first time, physicians who are engaged in a full-time fellowship program in orthopaedic surgery are eligible to submit an abstract and have a chance to present their posters.

We are aware this date may conflict with residents who may be taking their OITE exams, therefore we are offering the opportunity for a chance to display your research in our online gallery. Please indicate this option on the submission form.

If your abstract is selected, you’ll have the unique opportunity to present your poster at the Annual Meeting, where a team of judges will review all entries. The top four posters will move on to an oral presentation round, with 1st, 2nd, and 3rd place up for grabs!

This is not just a competition—it's a platform to elevate your work and connect with the best minds in orthopaedics. We can't wait to see the innovative and impactful projects you bring forward.

What Authorized Providers Need to Know about the Workers' Compensation Board

Babette Atkins — Wed, 06 Mar 2024 17:50:39 GMT

Recently, the NYS Workers' Compensation Board made a presentation highlighting recent improvement initiatives.

For those who were not able to make it, or participants who would like to review the information, they have posted a copy of the slide deck on the Board’s website. A recorded version is also available for you to view on demand.

More information

Be sure to visit their Provider Updates section of the Board’s website, where they regularly share updates on what’s new and important for providers to be aware of.

You can also email MDO@wcb.ny.gov with questions.

MSSNY Podcast - What’s Expected for the 2024 Legislative Session

Babette Atkins — Fri, 05 Jan 2024 19:57:33 GMT

Listen to MSSNY’s January 5 podcast as MSSNY’s Senior Vice-President & Chief Legislative Counsel Moe Auster discusses What’s New for 2024 and the Governor’s Veto decision on the Grieving Families Act.

The Undeniable Power of Grassroots Advocacy

Babette Atkins — Sat, 30 Dec 2023 18:25:13 GMT

Our combined efforts have secured a major victor underscoring the undeniable power of grassroots advocacy.

Governor Hochul has heeded our collective voice and vetoed The Grieving Families Act A6698, a piece of legislation that posed significant threats to our healthcare community.
> Read her veto message here.

By working with our medical professional colleagues, MLMIC and other community stakeholders to prevent the passage of A6698, we have shielded our healthcare providers from potential hardships, ensuring they can continue delivering high-quality care without the looming specter of increased malpractice payouts and unnecessary legal complexities.

To each member who participated in our grassroots campaign, THANK YOU! Your commitment has been the driving force behind this monumental achievement. Your voices, stories, and advocacy efforts have not only influenced policy but have demonstrated the impact that a united grassroots movement can have on shaping the future of our healthcare delivery in NY.

As we celebrate this success, let's remember the strength we possess when we join forces for a common cause. Our grassroots advocacy has proven once again that change starts from the ground up.

We look forward to continuing this journey together as we advocate for the best interests of orthopaedic surgeons, their patients and musculoskeletal care in New York.

Garfunkel Wild Alert: OIG Releases New General Compliance Program Reference Guide

Babette Atkins — Mon, 13 Nov 2023 16:45:42 GMT

On November 6, 2023, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released its General Compliance Program Guidance (GCPG), the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance.

The GCPC will help all individuals and entities involved in the health care industry, including but not limited to physicians and hospitals, home health agencies and hospices, durable medical equipment (DME) suppliers, nursing facilities, Medicare Advantage Organizations (MAOs), and third-party medical billing companies to self-monitor compliance with applicable Federal laws and program requirements as part of their efforts to prevent, detect, and address fraud, waste, and abuse in the health care system.

Learn more

NYSSOS Congratulates Resident Poster Contest Winners

Babette Atkins — Fri, 27 Oct 2023 18:41:25 GMT

Resident physicians play a crucial role in advancing musculoskeletal medical research and innovation. Their work often forms the basis for groundbreaking discoveries and improvements in healthcare. Medical research conducted by residents in training provides numerous benefits that include: fresh perspectives, clinical relevance in care settings, evolution ofskill sets, collaborative learning, advancement of specific medical disciplines and specialties, promoting a culture of mentorship in the medical field, and professional growth.

Their dedication to both patient care and research plays a pivotal role in the development of new treatment modalities, improved patient outcomes, and enhanced medical education. Therefore, it is essential to recognize and support the efforts of resident physicians in their pursuit of medical research.

Resident posters are used to summarize and display key areas of interest studied by the resident. The winners were selected from a field of orthopaedic residents who submitted poster abstracts from across the state.

First place was awarded to Dustin Morgan, MD, from the University at Buffalo, for his presentation entitled:Multidisciplinary standardized protocol decreases time to antibiotics for open fractures: a resident-drive quality improvement initiative.

Second place was awarded to Urvi Patel, MD, from the University of Rochester, for her research:Intramedullary nail versus plate fixation for diaphyseal humerus: a retrospective comparative analysis.

The third place award was awarded to Matthew Barra, MD, from the University of Rochester, for his reserach: Posterior tibial slope should be considered with coronal plane alignment of the knee classification.

NYSSOS President Samuel Flemister, MD, said: “Orthopaedic Residents are engines of innovation that help drive the science and practice of orthopaedic medicine. All of the entries were brilliantly executed and reflected the tremendous contributions residents make to our profession. Congratulations to our winners, and to all participants, for their handwork and commitment to further advancing orthopaedic care.”

NYS Workers Compensation Board: What Physicians Need to Know webinar series continues!

Babette Atkins — Wed, 20 Sep 2023 15:29:57 GMT

The Workers’ Compensation Board (Board) is pleased to continue its webinar series for health care providers with a presentation specifically for Board-authorized providers who are currently able to treat New York State’s injured workers.

Over the past several years, the Board has been working to make the workers’ compensation system better for injured workers, better for businesses, and better for health care providers.

They've undertaken several initiatives to improve health care and enhance the experience of treating providers by streamlining the workers’ compensation process and reducing the amount of paperwork.

Board-authorized providers are encouraged to join this webinar to review pertinent information, as well as new initiatives underway at the Board. We will also leave time at the end of the presentation to answer your questions.

Registration is not required. To join, please select the "Join webinar" link below. Add it to your calendar so you don't forget!

Wednesday, October 11, 2023
12:00 P.M. - 1:00 P.M.
Join webinar
Add to your calendar!

More information

Be sure to visit the What Providers Need to Know page on our website to stay aware of new and important updates for health care providers. Visit the Providers webpage and select the ‘Provider Updates’ quick link.

You can also email MDO@wcb.ny.gov with questions.

Having trouble?

If you are having trouble attending this webinar, check out these Webinar FAQs

The Impact of Prior Authorization Process on You and Your Patients

Babette Atkins — Thu, 31 Aug 2023 21:19:29 GMT

Prior authorizations impose overwhelming burdens that cause unnecessary delays in needed care for patients. Delays in the authorization of prescriptions, tests, or procedures can cause needless anxiety for patients already stressed by uncertainty regarding their condition, particularly those with chronic conditions who have complex medical needs and depend on following strict treatment plans.

NYSSOS, working in collaboration with MSSNY and many of our specialty colleagues are advocating for changes to legislation and regulation to ease these burdens.

Resources

Read the NYSSOS support memo on expediting the prior auth process

AAOS Tip Sheet for navigating the process

We understand that the prior authorization process can be lengthy and burdensome. That's why AAOS created a Tip Sheet to help! It includes tips for physicians seeking approval, next steps if you've been denied, as well as guidance for peer-to-peer review.

AAOS Template letter to fight an appeal

AAOS created a template to help get you started with an appeal. Be sure to make copies of everything sent with the appeal for your records and use tracking if you're sending the appeal via mail.

Top 5 Roundup - Medical Malpractice Insurance News (Provided by MLMIC)

Babette Atkins — Mon, 14 Aug 2023 14:07:16 GMT

Five Things to Consider When Choosing a Medical Liability Insurance Carrier

Selecting the right medical liability insurance carrier is an important decision. It’s critical to evaluate claims experience, financial strength, policies, cost and more!

> MORE

Aging in Place: Addressing the Needs of Elder Patients in the Home Setting

In this CME course, a panel of physician and legal experts will discuss the complexities of caring for elderly patients in the home setting, including liability risks and risk-management tips.

> MORE

The Mouse, the Code and EMTALA

In this case study, MLMIC examines the Emergency Medical Treatment and Active Labor Act and its application, providing a legal analysis and important takeaways for hospitals.

> MORE

Best Practice Tips for Disposing of Paper Medical Records and Imaging

MLMIC reviews regulatory and HIPAA requirements for destroying medical records while outlining options for disposal.

> MORE

Engage at Any Age: Providing Safe Medical Care for the Aging Population

Understanding the physical and social environments of elderly patients will help providers address this population’s health concerns, improve outcomes and minimize exposure to professional liability claims.

> MORE

For convenient access to MLMIC articles, industry news and risk management resources, please visit the new MLMIC Insider

________________________________________________

The New York State Society of Orthopaedic Surgeons (NYSSOS) is proud to announce a new endorsement with the MLMIC Insurance Company. This new partnership will provide NYSSOS members with an array of unique resources including innovative risk management presentations designed to help NYSSOS members manage risk, reduce exposure, and prevent adverse outcomes. In addition, NYSSOS members will be able to tap into MLMIC Analytics that uncover outcome trends and potential risks using MLMIC’s exclusive claims and adverse event analysis service.

NYSSOS Advocacy Day Attendees Briefed by State Health Department and Office for Aging Officials on New York's "State Master Plan for Aging"

Babette Atkins — Tue, 25 Apr 2023 22:45:03 GMT

NYSSOS Advocacy Day attendees took part in a direct briefing from top state officials concerning the status of the nascent State Master Plan for Aging. Governor Hochul signed an Executive Order in November of 2022 mandating the creation of the master plan, which is to include the development of strategies for government, the private sector, and the non-profit sector to support older New Yorkers.

The briefing to NYSSOS members was provided by NYS Office for Aging Chief of Staff John Cochran and NYSDOH Center for Aging and Long Term Care Bureau Director Karisa Capone.

The briefing and accompanying dialogue focused on strategies to address challenges related to communication, coordination and innovative care.

Engagement of the musculoskeletal community was emphasized by the presenters, who indicated that orthopaedic physicians“can play an important role in the care and identification of older patients, as well as their caregivers, that are in need of supports and services to help enable them to remain in their community of choice.”

According to the presenters, strategies than can be supported by the orthopaedic community include:

Addressing social determinants of health, and promoting healthy aging, including falls and fall injury prevention.
Employing alternatives to opioids for pain management to limit delirium and adverse medication interactions.
Developing partnerships with local Departments of Health, the aging services network and community based service providers to facilitate aging in place and successful post-acute care discharge outcomes.
Promoting social and recreational opportunities to increase mobility, including use of walkable, bikeable, transit-friendly communities.
Use of multi-disciplinary care models that foster aging in place.

NYSSOS will be represented on the Master Plan by its legislative and advocacy chairperson, John Reilly, MD, and will continue to work with state officials to monitor and assist in developing Master Plan orthopaedic elements that are effective, reasonable and sustainable.

To learn more about New York’s State Master Plan for Aging visit: https://www.ny.gov/programs/new-york-states-master-plan-aging

NYSSOS Members Meet in Albany With Several Key Legislative Leaders To Advance Musculoskeletal Priorities

Babette Atkins — Fri, 21 Apr 2023 13:05:48 GMT

A team of NYSSOS leaders representing every corner of the state concluded a dynamic day of meetings on April18, converging in Albany for the NYSSOS 2023 Advocacy Day.

The team of orthopaedic surgeons collectively met with top several lawmakers, including those who chair the committees most important to advancing NYSSOS legislative agenda including:

Senate Insurance Committee Chair Neil Breslin - Senate sponsor of “Gold Card” legislation
Assembly Insurance Committee Chair David Weprin
Assembly Higher Education Chair Pat Fahy
Assemblymember John T. McDonald III - Assembly sponsor of “Gold Card” legislation
Senate Health Committee Director Tony Kergaravat
Assembly Health Senior Policy Adviser Mark Kissinger and Committee Coordinator Sherri Salvione

The topics addressed in the various discussions with the lawmakers and their staff focused on a number of NYSSOS’ legislative priorities, including:

Supporting legislation to reform insurance company prior authorization practices, including passage of the Breslin/McDonald sponsored “Gold Car” bill.
Supporting legislation to establish important qualifications for clinical peer reviewers by requiring them to be licensed in New York, and in the same or similar specialty as the treating physician.
Supporting legislation that would authorize licensure of athletic trainers, including provisions for athletic trainers to work under the supervision of a physician.
Opposing several separate proposals that would broaden the scope of practice for a number of non-physician professionals, including podiatrists, physician assistants, chiropractors and physical therapists. The general message relayed to lawmakers was that increasing scope of practice without commensurate education and training is unsafe.
Advocating for a thoughtful and comprehensive approach to reforming medical malpractice insurance practices.

NYSSOS is grateful to the members who traveled to Albany to advocate on behalf of the musculoskeletal community.

Access the NYSSOS 2023 legislative agenda, and tools you can use to contact your lawmakers, can be found at: https://nyssos.org/takeaction.

NYSSOS Advocacy Leads To Key Revisions To Proposed Workers Comp Rule on Intraoperative Neurophysiology Monitoring

Babette Atkins — Mon, 10 Apr 2023 13:02:26 GMT

NYSSOS is pleased to report that the Workers Compensation Board (WCB)has revised a proposed rule on intraoperative neurophysiological monitoring to address numerous concerns raised by NYSSOS. As a result, the revised proposed rule now aligns with the current standard of practice and the standards of professional medical societies andpayers (including the Centers for Medicare and Medicaid Services), and assures that this critical service continues to be available for injured workers undergoing surgical procedures.

Based on concerns expressed by NYSSOS, the revised proposed rule includes important changes to several provisions. Among other provisions, the revised proposed rule:

Removed the requirement that the monitoring physician be in constant attendance and available for actual on-premises assistance.
Replaced the requirement for being on premises with a requirement that the Monitoring Physician be a WCB-authorized provider credentialed or with guest privileges where the procedure is being performed.
Removed reference to “available to provide actual on premises assistance.”
Deleted prohibition on using billing code 94941.
Added language clarifying that remote IOM billing shall not exceed the amount billed using code 95940

The revised rule is now subject to a 45-day public comment period.

To read the revised proposed rule CLICK HERE.

To read NYSSOS's letter to WCB supporting the revised proposed regulation and urging its final adoption CLICK HERE.

NYS DOH Issues Health Advisory for Elective Surgery

Mon, 13 Mar 2023 18:01:57 GMT

On February 28, 2023, the New York State Department of Health issued updated guidance regarding elective surgery pre-procedure testing for SARS-CoV-2. > Access the advisory: click here.

CDC guidance states that SARS-CoV-2 viral testing of asymptomatic patients before elective surgery or procedures by hospitals, ambulatory surgery centers, office-based surgery practices, and diagnostic and treatment centers, is at the discretion of the facility.

Pre-procedure testing to identify asymptomatic infection might continue to be useful in some situations, including when performing higher-risk procedures. Pre-procedure testing can also help inform the type of infection control precautions used (e.g., room assignment, cohorting, or personal protective equipment) to prevent unprotected exposures.

This advisory supersedes all previous guidance pertaining to elective surgery pre-procedure testing for SARS-CoV-2.

NYSDOH recommends that all healthcare settings continue to adhere to the infection prevention and control guidance issued by the Centers for Disease Control and Prevention (CDC).

See: Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease2019 (COVID-19)Pandemic).

General questions or comments about this advisory can be sent to:

covidhospitaldtcinfo@health.ny.gov, or icp@health.ny.gov

STATEMENT ON JOINT LEGISLATIVE BUDGET HEARING TESTIMONY ON GOVERNOR HOCHUL’S 2023-2024 HEALTH CARE BUDGET PROPOSAL

Babette Atkins — Tue, 28 Feb 2023 17:25:32 GMT

By NYSSOS President Samuel Flemister, MD

(Based on Written Testimony Submitted Earlier Today)

Governor Hochul ’s 2023-2024 Executive Budget proposal contains a number of elements that are of particular interest to orthopaedic care providers as they relate to our ability to sustain access to the best possible patient care.

We are grateful to see the proposed extension of the excess medical malpractice program through June of 2024. This program is essential to New York ’s ability to maintain a workforce of physicians that can meet current and future service demands. We would ask the Governor and Legislature to extend this program for more than just one year, however, since many physicians base their practice location decisions on multi-year environmental forecasts, including medical malpractice costs, which are already the highest in the nation in New York.

Additionally, NYSSOS supports the investments made by the Executive to aid in the recruitment and retention of skilled medical staff. We are indeed facing a staffing crisis that demands urgent government action, and we prevail upon the Legislature to make any additions possible to these efforts.

NYSSOS is also supportive of the Governor’s proposals to promote the avoidance of tobacco products. Tobacco has been shown to have detrimental musculoskeletal effects, both directly through smoking and passively through secondhand smoke inhalation.

There are other provisions in the Governor ’s proposal, however, that are of great concern relative to their likely impact on the quality and availability of care.

Chief among these concerns are plans to eliminate physician supervision requirements for Physician Assistants with 8,000 or more “primary care” practice hours. This action will significantly diminish the quality, safety and reliability associated physician-led care, especially for vulnerable populations. The promise of more effective and cost-efficient care rests not on the idea of physician extender independence, but rather on better practice integration of these skilled providers under the existing supervisory structures that are paramount to both care quality and patient safety. We therefore urge the Legislature to reject this proposal and to prioritize building healthcare teams with appropriate safeguards and increased transparency.

Similarly, NYSSOS is concerned with the potential unintended consequences of the Governor’s proposal regarding ‘Site of Service Reviews.’ This is a complicated proposal that deserves further study and scrutiny before any changes are enacted. NYSSOS believes the timeline for enacting the state budget stifles the opportunity for deliberative discussions and this proposal should be considered outside of the budget process.

Lastly, the Governor ’s proposal to submit certain private practice matters to state review and approval may pose a considerable threat to the organic evolution of medical services, especially in communities where the need for care is most acute. Minimally, we would ask the Legislature to remove this policy matter from the omnibus budget legislation and carefully consider its implications as a stand alone proposal. Within any context however, as written, we would urge the Legislature to reject it.

###

About NYSSOS: Representing more than 800 orthopaedists across New York State, NYSSOS advocates for orthopaedic surgeons, patients and musculoskeletal health in New York State. NYSSOS is the orthopaedic community’s primary source of information and expertise concerning: legislative/regulatory advocacy (local, state and federal levels); practice trends and change; leadership training for national, state, and local issues and opportunities; assistance with establishing and maintaining a practice; and familiarity with state practice guidelines impacting the profession and patient care. Learn more at www.nyssos.org

Statement on Governor Hochul’s State of the State Address

Babette Atkins — Thu, 12 Jan 2023 00:15:34 GMT

By NYSSOS President Samuel Flemister, MD

The Governor’s address and accompanying book contained a number of measures that are of great interest to the orthopaedic community. Her initiative to focus on helping seniors live healthy and independent lives is an imperative. As NYSSOS members can attest, mobility is the greatest factor in maintaining independence, and helping seniors remain mobile and active is a singular focus of New York’s orthopaedic physicians as New York is home to the fourth largest population of older adults that continues to grow. We are eager to help the Governor succeed.

Other initiatives contained in the Governor’s message that are timely and necessary include proposals to address staff shortages, reform the certificate of need process, as well as proposals to expand insurance coverage.

Perhaps most notable is the Governor’s call to establish a Commission on the Future of Health Care. New York must adapt for the 21st century leveraging team-based care led by physicians, the power of technology and telehealth and lessons learned from the COVID-19 pandemic. We look forward to being part of these important discussions with other stakeholders, which must also address insurance and prior authorization reform and achieving comprehensive medical malpractice reform. These discussions are important as we seek to assure continued access to care for patients, reduce healthcare disparities and strengthen the healthcare workforce, systems and ecosystem.

NYSSOS recognizes the State of the State is the first step followed by the release of the Executive budget proposal and looks forward to discussing these important issues with the Governor and Legislature.

###

OP-ED By NYSSOS President Calls on Governor to Veto Wrongful Death Expansions

Babette Atkins — Wed, 11 Jan 2023 19:20:41 GMT

As reported in a recent Times Union news story, Governor Hochul continues to contemplate signing a measure (S74a/A6770) that would significantly alter New York’s wrongful death laws. As written, S74A, known as the “Grieving Families Act,” vaguely identifies who’s eligible to recover damages in wrongful death claims and the types of losses and damages for which plaintiffs may receive compensation. The legislation would impact all areas of liability, including medical liability, and lacks important payout caps adopted by many of the nearly 40 other states with these types of laws.

It’s no secret that New York’s medical liability system is broken, failing both practitioners and patients. It’s wasteful, costly, inefficient and inconsistent. Based on those concerns, the New York State Society of Orthopaedic Surgeons (NYSSOS) for years has joined a vast chorus of organizations in calling for the development of a comprehensive package of medical liability reforms that improve patient access to care, enhance patient-physician communication, facilitate improvement of patient safety and quality of care, reduce defensive medicine, decrease liability costs, and fairly compensate negligently injured patients.

S74A will do little to facilitate these goals. In fact, one recent actuarial study has estimated that this legislation could increase New York ’s already high medical liability premiums by as much as 40%. Moreover, Deiderich Healthcare ’s 2020 report identified New York as the national leader in malpractice payouts, which in 2019 exceeded $661 million dollars. The study further found New York second in the nation on a per capita basis in payouts. Advancing the legislation as written will only fuel more unpredictable and inequitable compensation amounts from case to case that are not necessarily related to medical negligence or adverse events.

But the most troubling issue with the legislation is not the dollars, it’s the impact that these already high costs have on patient care. More than 30 hospitals already receive extraordinary financial assistance from the state to sustain patient care services, and if this bill is signed in its current form, we risk hospital, emergency room, primary care and urgent care closures. These consequences will most severely impact safety net care providers in underserved communities, placing those with below average access to quality care at risk and compromising the social equity the bill’s proponents seek to achieve.

The Governor should use a veto as an important pause to reconsider a more balanced approach and bring New York into alignment with other states that have applied necessary and reasonable restrictions to similar legislation. Otherwise, the bill will reverse the state’s current investments in its health care workforce, threaten retention and growth in this sector of our economy and harm New Yorkers across the state by jeopardizing access to vital health care services. This would include orthopaedic high risk patients such as the elderly or persons with physical trauma.

For these reasons, NYSSOS has joined with numerous other organizations and industries to urge Governor Hochul to veto this bill. We also encourage policy makers to address liability reform with a more thoughtful and balanced approach to achieve comprehensive reform as other states have recently done, proving that consensus can be forged to protect patients as well as the health care system and physicians.

To provide a more meaningful context, consider that in her inaugural address Governor Hochul pledged to address what she termed “the affordability crisis in New York State.” This is a critical concern as a new census report found New York had the greatest population loss of any state between July 2021 and July 2022, with 180,000 New Yorkers leaving. Enacting S74a will only further incentivize an exodus the state can ill afford by driving insurance cost increases in nearly every sector, including health insurance, automobile insurance, and virtually every type of liability insurance.

A veto of S74A provides the Governor with a clear opportunity to address this crisis. We encourage her to do so, swiftly.

Samuel Flemister, MD, President of the New York State Society of Orthopaedic Surgeons, and Board Certified Orthopaedic Surgeon

Appeared in

NYVT Media (1/11/23)
Buffalo News (1/17/23)

AAOS Board of Directors Approves the Update to the CPG on the Surgical Management of Osteoarthritis of the Knee

Babette Atkins — Fri, 06 Jan 2023 14:33:08 GMT

The AAOS approved an update to the 2015 Clinical Practice Guideline (CPG) for the Surgical Management of Osteoarthritis of the Knee.

This CPG updated 18 of the 38 evidence-based recommendations included in the 2015 CPG.

This update resulted in 10 strong and six moderate recommendations for the surgical management of skeletally mature patients diagnosed with osteoarthritis of the knee.

View the new CPG

Legislative Update: Governor Signs Opioid Alternative Law; Vetoes Clinical Peer Review Measure with commitment to revisit issue in 2023 Legislative Session

Tue, 03 Jan 2023 19:20:58 GMT

Amid a torrent of recent bill signings, Governor Hochul signed into law a measure (S4640/A273) mandating physicians treating painful neuromusculoskeletal conditions to consider, discuss, and, if appropriate, refer or prescribe non-opioid treatments before prescribing an opioid.

NYSSOS aggressively opposed this measure along with many other stakeholders due to its inherent interference with the physician-patient relationship and negation of the physician's expertise regarding treatment for neuromuscular problems. The enactment of this law was one of five bills signed by Governor Hochul to enhance access to care and treatment for substance use disorders. NYSSOS will continue to work with policymakers to mitigate the impact of the measure

In the meantime, NYSSOS is seeking clarity from state regulators concerning compliance and general implementation information. We will share any guidance provided by the state as soon as it becomes available.

In another action, Governor’s Hochul vetoed a bill (A879/S8113) that would have established important qualifications for clinical peer reviewers, who insurers and health plans use to make medical necessity determinations. The legislation would have required the reviewer to be a physician licensed in New York State and of the same or similar specialty as the physician who would typically manage the medical condition or disease or provide the treatment under review. Under current law, the reviewer does not have to be a physician licensed in New York State or have board certification and/or eligibility in the same or similar specialty.

NYSSOS joined with other organizations, including the Medical Society of the State of New York (MSSNY), to advocate in support of this measure. The governor’s veto message included a number of reasons for rejecting the measure, chief among them the concern that it would “pull specialists out of health care and into claims review, removing them from hospitals and specialty care offices” and thus exacerbating the current health care workforce crisis. The governor indicated that she planned to revisit the issue in the upcoming legislative session. NYSSOS will continue to partner with MSSNY and other organizations to address the inadequacies and inequities of current claims review processes and broader insurance and prior authorization reform.

Alert: Online Tracking Technologies Can Lead to HIPAA Violations

Babette Atkins — Fri, 16 Dec 2022 16:01:28 GMT

The Department of Health and Human Services, Office of Civil Rights (“OCR”) has published a Bulletin which officially states that incorporating certain tracking technologies into websites and mobile applications may cause HIPAA violations that could result in breach notification obligations as well as penalties. This includes platforms and services provided by companies like Meta (formerly Facebook) and Google.

Covered Entities need to take immediate steps to identify their uses of tracking technologies and whether there are appropriate safeguards in place to prevent inappropriate use or disclosure of PHI.

Learn More

NYSSOS Issues Statement of Protecting All Students from Concussions

Babette Atkins — Wed, 23 Nov 2022 12:42:00 GMT

NYSSOS STATEMENT ON GOVERNOR HOCHUL’S SIGNING OF LEGISLATION PROTECTING NON-PUBLIC SCHOOL STUDENTS FROM CONCUSSIONS

By Babette Atkins, NYSSOS Executive Director

“Today, Governor Hochul signed into law legislation (S973/A8425) requiring non-public schools to abide by the Concussion Management Awareness Act of 2011. NYSSOS has been a strong advocate of this legislation.

“Under the new law, non-public schools must now meet the same concussion training and protocol standards as public schools, including: requiring biennial training for coaches, physical education teachers, nurses and athletic trainers on the signs and symptoms of concussions and the guidelines for returning to school; requiring the immediate removal of a student from athletic activities if it is believed they have sustained a mild traumatic brain injury; authorizing schools to establish concussion management teams; and other provisions.

“NYSSOS is grateful to Governor Hochul, Assemblymember Burke, Senator Gaughran and the Legislature for providing these necessary protections for non-public school students.

“While this legislation represents real progress in our efforts to assure students across all educational settings have the protections they deserve, more needs to be done. We look forward to continuing our work with policy makers to afford every reasonable protection possible.”

###

Governor Hochul Signs Concussion Protocols for Non-Public School Settings

Babette Atkins — Tue, 22 Nov 2022 18:18:21 GMT

Today, Governor Hochul signed into law legislation requiring non-public schools to abide by the Concussion Management Awareness Act of 2011. NYSSOS has been a strong advocate of this legislation (S973/A8425).

Under the new law, non-public schools must now meet the same concussion training and protocol standards as public schools, including: requiring biennial training for coaches, physical education teachers, nurses and athletic trainers on the signs and symptoms of concussions and the guidelines for returning to school; requiring the immediate removal of a student from athletic activities if it is believed they have sustained a mild traumatic brain injury; authorizing schools to establish concussion management teams; and other provisions.

NYSSOS and our partners worked with Legislative leaders to ensure passage of the legislation, and after its passage in the Senate and Assembly sent a formal letter to Governor Hochul requesting that she sign the bill into law.

We are grateful to the Governor and the Legislature for providing these necessary protections for non-public school students.

NYSSOS Immediate Past President John DiPreta, MD Makes Two Important Visits to State Legislative Allies

Babette Atkins — Fri, 18 Nov 2022 20:15:19 GMT

NYSSOS Immediate Past President John DiPreta, MD made two important visits to state legislative allies this week to recognize their strong leadership on critical musculoskeletal policy initiatives, and to accept a special message from the lawmakers marking NYSSOS’ 50th Anniversary.

Assemblymember John T. McDonald III, RPh, (pictured in the blue suit) stands with Dr. DiPreta and holds the 2022 NYSSOS “Advocate of the Year” award, presented to him for his work in helping to ensure all patients have access to musculoskeletal care.

Senator Neil Breslin (grey suit and red tie), who co-sponsored with Assemblymember McDonald prior authorization reform legislation known as the “gold card” bill, presents to Dr. DiPreta a New York State Senate Proclamation honoring NYSSOS for its 50 years of service to the musculoskeletal community. Assemblymember McDonald also presented a New York State Assembly Citation to mark the NYSSOS milestone.

NYSSOS is grateful to Senator Breslin and Assemblymember McDonald for their leadership and support, and we look forward to a productive year of sound and effective health care policy in 2023.

What We're Reading - Election Day

Babette Atkins — Tue, 08 Nov 2022 19:00:21 GMT

Midterm election could shift balance of power in state legislature. On the eve of the midterm elections, much of the political focus in New York is on the race for governor and some key Congressional races…(nystateofpolitics)

For Election Day, here's what to know and what to watch. A primer on everything from absentee ballot-counting to the races that matter..(timesunion)

Board of Elections: NY poll workers prepped with de-escalation training. Threats to democracy have remained a top issue for voters this year as a Russian businessman Monday admitted to interfering in U.S. elections and says he'll continue to do so…(spectrumlocalnews)

Ballot questions New York voters will be asked on Election Day. New Yorkers filling out their ballots on Election Day will find more than just candidates…(pix11)

Voting law changes allow formerly incarcerated New Yorkers to vote. This midterm election could be the first year that formerly incarcerated New Yorkers have their voice heard since their convictions due to a 2021 law that reformed voting laws in the state…(nystateofpolitics)

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What We're Reading: Health as a Right, Medicare Cuts, Transparency and Tuberculosis

Babette Atkins — Fri, 28 Oct 2022 15:58:37 GMT

Biden visit highlights dueling Hochul, Zeldin plans for New York's economy. The race for governor of New York this years been dominated by a debate over public safety, crime and how to fairly treat people accused of breaking the law…(nystateofpolitics)

Oregon could be 1st state to make health care a human right. Oregon voters are being asked to decide whether the state should be the first in the nation to amend its constitution to explicitly declare that affordable health care is a fundamental human right…(apnews)

Hospitals test the goodwill of Congress on Medicare cuts. Hospitals are pleading with Congress to postpone looming Medicare pay cuts, citing what they say has been an extraordinarily difficult year…(axios)

YouTube Health expands validation process for health information. As it attempts to combat health disinformation, YouTube is allowing certain healthcare professionals to apply for verification…(modernhealthcare)

WHO: Tuberculosis cases rise for the first time in years. The number of people infected with tuberculosis, including the kind resistant to drugs, rose globally for the first time in years, according to a report Thursday by the World Health Organization…(apnews)

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www.capitalhealthconsulting.com

DOH Advisory Letter: Cultural Competency CME Requirements due November 1st

Babette Atkins — Thu, 27 Oct 2022 16:48:42 GMT

The New York State Department of Health has extended its completion deadline for the cultural competency CME requirements to November 1, 2022 for physicians and other network providers of Medicaid Managed Care plans.

The requirement stems from the Mainstream Medicaid Managed Care, HIV Special Needs Plans, and Health and Recovery Plans Model Contract Section 15.10(c) requires that the MMCP “...ensure the cultural competence of its provider network by requiring Participating Providers to certify, on an annual basis, completion of State-approved cultural competence training curriculum, including training on the use of interpreters, for all Participating Providers’ staff who have regular and substantial contact with Enrollees.”

DOH’s notification indicates the requirement can be fulfilled through courses offered by US Department of Health and Human Services (HHS), Office of Minority Health, Think Cultural Health. Only 1 of the 3 courses is necessary to fulfil the requirement.

Access a previously published DOH letter to Health Plan Administrators with more details about the requirements.

What We're Reading - Governor Debate, Vaccinations, Concussion Protocols

Babette Atkins — Thu, 27 Oct 2022 16:08:32 GMT

Fact Check: Gubernatorial debate between Zeldin and Hochul. The first and only gubernatorial debate is in the books…(cnycentral)

Governor Hochul Announces Steps to Protect New Yorkers from Respiratory Illnesses This Fall and Winter. Governor Kathy Hochul today announced steps the New York State Department of Health is taking to raise awareness of and protect New Yorkers against respiratory virus infections that are spreading this fall and expected to continue through the winter…(governor.ny)

Can independent voters make the difference in New York governor's race? For Tim Dunn, neither Democratic Gov. Kathy Hochul nor her Republican opponent, Lee Zeldin, offer much for independent voters like him…(nystateofpolitics)

Covid, Flu, RSV: Hospitalizations Rise as Wave of Viruses Hits New York. New Yorkers are falling ill with new variants of Covid and old illnesses like flu and RSV that masking and other precautions once held at bay…(nytimes)

Concussion protocols are based on research of mostly men. What about women? Lindsay Simpson still has questions about her concussions…(npr)

Capital Health Consulting LLC
136 State Street, Suite 501 | Albany | NY | 12207
www.capitalhealthconsulting.com

Assemblymember John T. McDonald III, RPh Recognized As NYSSOS “Legislator of the Year”

Babette Atkins — Wed, 21 Sep 2022 14:18:31 GMT

(Albany, New York) The New York State Society of Orthopaedic Surgeons (NYSSOS) today announced that it has selected Assemblymember John T. McDonald III, RPh, as the 2022 NYSSOS “Legislator of the Year.”

The award was presented to Assemblymember McDonald at the NYSSOS 2022 Annual Meeting and Symposium, entitled “50 Years of Service and Innovation,” which marks NYSSOS’ 50th anniversary.

Assemblymember McDonald was selected for the award based on his strong commitment to developing balanced and thoughtful solutions to the complex issues that abound in the arena of health care policy.

In particular, he has been a strong supporter of reducing administrative and regulatory burdens to better ensure patients everywhere have access to quality, comprehensive musculoskeletal care in New York State. His sponsorship this year of much needed prior authorization reforms (A.9908A) is just the most recent example of his leadership in crafting sound health care policy.

In presenting the award, NYSSOS President John DiPreta, MD, said of Assemblymember McDonald: “His is a voice of reason, compassion and firsthand knowledge that has been an indispensable element of New York’s efforts to meet the challenges of our healthcare system. On behalf of the New York State Society of Orthopaedic Surgeons, it is with great pleasure that we recognize Assemblymember John T. McDonald III as the 2022 NYSSOS Legislator of the Year.”

Assemblymember John T. McDonald III, RPh, said: "Thank you to the New York State Society of Orthopaedic Surgeons (NYSSOS) for the honor of being named as your ‘Legislator of the Year.’ As a health care professional and legislator, I believe that my experience as a pharmacist is an asset when considering and shaping legislation. Congratulations to NYSSOS on your 50th anniversary and I hope you have productive meeting and symposium.”

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NYS WCB Notification Use of the CMS-1500 Form is Mandatory

Babette Atkins — Mon, 08 Aug 2022 19:44:40 GMT

This is a reminder that mandatory use of the CMS-1500 form went into effect on July 1, 2022, for professional services and durable medical equipment bills/reports. Facility-based services may continue to be billed on a UB-04 or CMS-1450.

You can read more about the requirements and form changes in the GovDelivery dated June 27, 2022.

Important: In the medical narrative attachment that accompanies the CMS-1500 form, health care providers must indicate (either at the top of the narrative, or otherwise prominently displayed) the injured worker’s temporary impairment percentage, current work status, and the causal relationship of the injury or illness.

If any of these elements are missing, the medical narrative report may be found legally defective, which means the injured worker may not receive benefits and you may not be paid for rendered services. You can use the Board’s medical narrative template to ensure you capture these elements.

Additional Resources

Visit the Workers' Compensation Board’s (Board's) website for CMS-1500 news, FAQs, and more. The Board has also created a special webpage dedicated to sharing timely updates on various Board initiatives with a health care provider focus. Visit What Providers Need to Know to view the latest!

For CMS-1500 feedback and questions, email CMS1500@wcb.ny.gov. For clinical feedback and questions, email provider@wcb.ny.gov.

NYSSOS Members Encouraged to Sign up for Orthopaedic Advocacy Week

Babette Atkins — Tue, 05 Jul 2022 15:15:20 GMT

AAOS leadership, in conjunction with the Office of Government Relations, is hosting a second annual Orthopaedic Advocacy Week from August 1-5. Similar to the inagugural event in 2021 (see recap infographic), this completely virtual opportunity is designed to offer members simple, minute-long ways advocate for priority healthcare policy issues.

All AAOS members in the U.S. are invited and encouraged to particiate. We need the engagement of members nationwide to amplify the orthopaedic voice!

This year, we will focus our advocacy efforts on the following issues:

Prior authorization reform
Scope of practice protections
Increased workplace safety from violence
Preserving Medicare reimbursement

Below is a preview of the daily themes and related calls-to-action, which will be emailed to those who sign up and also available from this webpage during Orthopaedic Advocacy Week:

Monday, August 1: Amplify Across Social Media
Tuesday, August 2: Growing Support with Grassroots
Wednesday, August 3: Shaping Policy through Rulemaking
Thursday, August 4: The Economic Impact of Orthopaedic Surgeons
Friday, August 5: Get Invested with Orthopaedic PAC

Sign up by July 29 to participate, encourage your colleagues to do the same, and let's get ready for #OrthoAdvocacyinAction!

NYS Workers Compensation Board - Beginning July 1st: CMS-1500 Form Becomes Mandatory Tomorrow

Babette Atkins — Tue, 05 Jul 2022 15:00:12 GMT

In order to increase health care provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) made a strategic decision to transition toward making the CMS-1500 a required form.

Providers have indicated that the unique paperwork requirements currently in the workers' compensation system are time consuming to complete. To reduce the administrative burden and increase provider participation, the Board will consolidate and eliminate certain medical billing forms and convert to the CMS-1500, the universal claim form used by medical providers to bill the Centers for Medicare and Medicaid Services (CMS) as well as health insurers.

The initiative will leverage providers' current medical billing software and medical records while promoting a more efficient workers' compensation system.

The Board replaced the following forms with the CMS-1500:

Doctor's Initial Report (Forms C-4, EC-4)
Continuation to Carrier/Employer Billing Section (Form C-4.1)
Doctor's Progress Report (Forms C-4.2, EC-4.2)
Ancillary Medical Report (Forms C-4AMR, EC-4AMR)
Doctor's Narrative Report (Form EC-4NARR)
Occupational/ Physical Therapist's Report (Forms OT/PT-4, EOT/PT-4)
Psychologist's Report (Form PS-4)
Ophthalmologist's Report (Form C-5)

The CMS-1500 must be submitted with a detailed narrative report to be considered a valid submission The Board has developed a template that providers can use to create the medical narrative report that accompanies provider submissions of the CMS-1500. A sample of the template can be found on the CMS-1500 Requirements page.

Survey Finds Inefficiency, Care Delays and Patient Harm Caused by Prior Auth

Babette Atkins — Thu, 12 May 2022 19:07:22 GMT

STATEWIDE SURVEY OF ORTHOPAEDIC SURGEONS FINDS INEFFICIENCY, CARE DELAYS AND PATIENT HARM CAUSED BY “PRIOR AUTHORIZATION” REQUIREMENTS

Findings Align With Recent AMA Survey; Provide Powerful Evidence Supporting Reform Proposal Introduced by Senator Breslin and Assemblymember McDonald

Albany, New York — The New York State Society of Orthopaedic Surgeons (NYSSOS) today released the findings of a statewide survey of NYSSOS member orthopaedic surgery practices concerning their experiences in complying with “prior authorization” requirements implemented by insurance companies.

The survey results were consistent, with nearly every respondent reporting that the requirements delayed needed care and often caused preventable harm, debilitation and pain for patients.

As healthcare utilization has increased, programs such as prior authorization have been implemented with the intention of ensuring more cost effective care. However, as these programs have proliferated, patients often experience unnecessary delays and denials for care deemed necessary by their treating physician. In addition, the indiscriminate growth of these practices has created enormous administrative burdens for orthopedic surgeons, limiting the time they have available to provide direct patient care.

Specifically, the survey found:

- 97% of respondents reported that prior authorization fails to achieve its intended purpose of reducing healthcare costs.

- 88% reported having patients abandon care due to delays associated with prior authorization.

- 94% had patients experience a deterioration of prognosis or quality of life due to prior authorization delays.

- 96% had patients experience sustained or increased pain and/or symptoms due to prior authorization delays.

- 89% had patients experience a delayed return to employment due to prior authorization delays.

- 97% say that removing prior authorization would result in more expedient care for their patients.

- 94% say that removing prior authorization would improve the quality of care their patients receive.

- 94% say the administrative burden prior authorization places on their practice has gotten worse in recent years.

The complete NYSSOS survey findings, which can be found at: https://nyssos.org/News/12777960, are very similar to the findings of a recent nationwide American Medical Association (AMA) survey concerning the same issue https://www.ama-assn.org/system/files/prior-authorization-survey.pdf.

A proposal has been introduced recently in the state Legislature to address this issue. The bill, S.8299/A.9908-A, introduced by Senator Neil Breslin (D-Albany) and Assemblymember John T. McDonald III, RPh (D-Cohoes), would create what is known as a “Gold Card” program that would provide an exemption from prior authorization for health care professionals who receive at least 90 percent approval for a particular health care service over a six-month period. NYSSOS strongly supports this legislation.

Senator Neil D. Breslin, Chair of Senate Committee on Insurance, said: “Current prior authorization requirements result in notable delays in medical care, interfere with continuity of care, while at the same time, impose unnecessary administrative work on health care professionals. The Gold Card bill that I am sponsoring will make sure patients receive the treatment they need in a more timely fashion, resulting in a higher quality of care.”

Assemblymember John T. McDonald III, RPh said, "I sponsor the Gold Card bill to help streamline the prior authorization process and ease the burdens that patients face when accessing care. When someone is facing a medical issue, we want to make it easier for the patients to receive necessary treatment and for providers to provide the care needed. I believe this is a commonsense measure that would address some of the challenges that too many face, and builds toward a better healthcare system."

A similar proposal was recently enacted into law in Texas. https://www.ama-assn.org/practice-management/sustainability/new-physician-gold-card-law-will-cut-prior-authorization-delays

NYSSOS President Dr. John DiPreta said: “It ’s time that we confront a growing problem that is present in virtually every treatment room in our state. The proliferation of prior authorization activities is causing unnecessary delays in care, harming patients and driving avoidable administrative burdens for practitioners. We are calling on state leaders to end the unnecessary patient suffering and debilitation that is directly caused by current prior authorization practices, and we are hopeful that the solution proposed by Senator Breslin and Assemblymember McDonald quickly makes its way through the Legislature and is delivered to the Governor ’s desk.”

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The Need for Prior Authorization Reform

Babette Atkins — Thu, 12 May 2022 16:29:08 GMT

Delayed musculoskeletal care comes at a tremendous cost not only to the patient in terms of quality of life and productivity but to the overall health care system. According to the American Public Health Association, musculoskeletal conditions are a leading cause of disability in the U.S. accounting for more than 130 million patient visits to health care providers annually and the number one reason individuals to see their physician.[1]

Despite relatively low peer-to-peer denial rates, insurer’s prior authorization and utilization reviews continue to focus on micromanagement aspects of care, typically driven by financial factors. These techniques are in direct conflict with the patients interests since the results pose unnecessary delays in routine musculoskeletal care and treatment.

In April 2022, NYSSOS conducted a statewide survey of its membership concerning their experiences in complying with “prior authorization” requirements implemented by insurance companies.

The survey results were consistent, with nearly every respondent reporting that the requirements delayed needed care and often caused preventable harm, debilitation, and pain for patients. Specifically, the survey found:

- 97% of respondents reported that prior authorization fails to achieve its intended purpose of reducing healthcare costs by denying truly ineffective or unnecessary care.

- 88% reported having patients abandon care due to delays associated with prior authorization.

- 94% had patients experience a deterioration of prognosis or quality of life due to prior authorization delays.

- 96% had patients experience sustained or increased pain and/or symptoms due to prior authorization delays.

- 89% had patients experience a delayed return to employment due to prior authorization delays.

> See the complete results

"Gold Card Legislation"
A proposal has been introduced recently in the state Legislature to address this issue. The bill, S.8299/A.9908-A, introduced by Senator Neil Breslin (D-Albany) and Assemblymember John T. McDonald III, RPh (D-Cohoes), would create what is known as a “Gold Card” program that would provide an exemption from prior authorization for health care professionals who receive at least 90% percent approval for a particular health care service over a six-month period. NYSSOS strongly supports this legislation.

“It ’s time that we confront a growing problem that is present in virtually every treatment room in our state. The proliferation of prior authorization activities is causing unnecessarily delays in care, harming patients and driving avoidable administrative burdens for practitioners. We are calling on state leaders to end the unnecessary patient suffering and debilitation that is directly caused by current prior authorization practices, and we are hopeful that the solution proposed by Senator Breslin and Assemblymember McDonald quickly makes its way through the Legislature and is delivered to the Governor ’s desk.” - John DiPreta, MD, FAAOS, NYSSOS President.

[1]https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policydatabase/2014/07/08/14/21/musculoskeletal-disorders-as-a-public-health-concern

NYSSOS Calls on Legislature to Include Telehealth Payment Parity in Final Budget

Babette Atkins — Tue, 15 Mar 2022 19:10:32 GMT

Statement from New York Physician & Hospital Organizations Calling on Legislature to Include Telehealth Payment Parity in Final Enacted Budget for FY 2022-23

The New York State Society joined its fellow physician and hospital colleagues in calling on the legislature to include telehealth payment parity. Ensuring fair payment for Telehealth services through payment parity is necessary to ensure this patient care delivery mechanism can continue to be offered by community based physician practices. We look forward to working with lawmakers to provide additional expertise and resources on the importance of unfettered patient access to Telehealth services as they negotiate the final budget.

Dr. John DiPreta, President of the New York State Society of Orthopaedic Surgeons

“Greater access to Telehealth services provides numerous benefits including increased patient access to orthopaedic surgeons and surgical teams, reductions in patient travel burden, improvements to clinical workflows and practice efficiencies, and enhanced follow-up. These benefits have proven especially advantageous to vulnerable populations and patients with impairment who may lack appropriate transportation or access to specialty care. We are encouraged that patients have embraced the technology and convenience of telemedicine and we anticipate its adoption will continue post-pandemic. We therefore urge the Assembly to join with the Governor and Senate in supporting Telehealth payment parity."

For the full press release visit: https://www.mssnyenews.org/special-announcements/press-releases/statement-from-new-york-physician-hospital-organizations-calling-on-legislature-to-include-telehealth-payment-parity-in-final-enacted-budget-for-fy-2022-23/

NYSSOS Board Members Named to American Academy of Orthopaedic Surgeons Leadership Positions

Babette Atkins — Fri, 04 Mar 2022 20:21:47 GMT

NYSSOS Board Members Dr. Barry Kraushaar and Dr. Matthew DiCaprio Named to American Academy of Orthopaedic Surgeons Leadership Positions

(Albany, New York) The American Academy of Orthopaedic Surgeons (AAOS) has appointed two members of the New York State Society of Orthopaedic Surgeons (NYSSOS) Board of Directors to national leadership posts.

Matthew DiCaprio, MD, has been named chair of the AAOS Board of Councilors Communications Committee. Dr. DiCaprio is professor of orthopaedic surgery, director of orthopaedic oncology, and professor of pathology at Albany Medical Center. He is also a member of the NYSSOS Board of Directors where he chairs the Membership Committee.

The AAOS Communications Committee supports AAOS’ strategic plan by advising on the development and implementation of communications programs designed to enhance the image of the orthopaedic surgeon ’s role in the highest quality of musculoskeletal patient care and to engage members of the Academy at all stages of their careers.

Also tapped for an AAOS leadership post is NYSSOS Board of Directors member Dr. Barry Kraushaar, who has been appointed as Vice Chair of the AAOS State Orthopaedic Societies Committee. Dr. Kraushaar is a dual-board certified orthopedic surgeon and sports medicine specialist, and serves as an AAOS Board of Councilor representative for New York.

In his capacity as committee vice chair, Dr. Kraushaar will aid AAOS in pursuing strategies to strengthen and foster development of state orthopaedic societies, and administering and monitoring the effectiveness of the AAOS State Orthopaedic Society Assistance Fund.

John DiPreta, MD, NYSSOS President, said: “Dr. DiCaprio and Dr. Kraushaar exemplify the leadership qualities that abound in New York’s orthopedic physician community. Their appointment to AAOS national leadership positions is apt recognition of their continuing contributions to advancing musculoskeletal care.”

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Healthcare Top Priority in Governor's State of the State Address

Babette Atkins — Wed, 05 Jan 2022 22:00:00 GMT

STATEMENT ON GOVERNOR HOCHUL’S 2022 STATE OF THE STATE ADDRESS

By John DiPreta, MD, President, New York State Society of Orthopaedic Surgeons

"Governor Hochul’s State of the State address was a thoughtful and hopeful articulation of the opportunities that abound in New York State when our government acts not as a barrier to progress, but as a partner in achieving it.

“The Governor made clear that health care is among her top priorities in the new year. Many challenges await her within that arena, as do many perspectives. We are hopeful that her policy and budget priorities will be founded on demonstrable, evidence-based approaches to care provision that will best ensure New Yorkers have access to the highest quality care delivered by the most qualified professionals.

“The New York State Society of Orthopaedic Surgeons will remain committed to being a productive partner and technical resource to the Governor and her team as, together, we address the challenges before us.”

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Governor Hochul Announces $10 Billion Healthcare Plan

Babette Atkins — Wed, 05 Jan 2022 20:30:28 GMT

Governor Kathy Hochul today announced a $10 billion multi-year investment in healthcare, the largest in State history, to rebuild and grow the healthcare workforce and strengthen the healthcare system as part of the 2022 State of the State. The plan will invest $10 billion in New York State’s healthcare sector, including more than $4 billion to support wages and bonuses for healthcare workers, and will invest in the healthcare workforce development pipeline to meet the current and increasing demand for medical professionals. > Read more

Governor Hochul's State of the State Shows Healthcare as a Priority

Babette Atkins — Wed, 05 Jan 2022 20:25:10 GMT

STATEMENT ON GOVERNOR HOCHUL’S 2022
STATE OF THE STATE ADDRESS

By John DiPreta, MD, President, New York State Society of Orthopaedic Surgeons

“Governor Hochul’s State of the State address was a thoughtful and hopeful articulation of the opportunities that abound in New York State when our government acts not as a barrier to progress, but as a partner in achieving it.

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The Impact of Delaying Elective Surgeries

Babette Atkins — Fri, 03 Dec 2021 14:30:00 GMT

STATEMENT ON STATE’S ORDER TO DELAY “ELECTIVE” SURGICAL PROCEDURES THAT TAKES EFFECT TODAY

By John DiPreta, MD, President, New York State Society of Orthopaedic Surgeons

“Governor Hochul’s order to begin limiting certain surgical procedures is well-intended policy that unfortunately may do more to increase the suffering of New York’s patient population. The intent of the order is to reserve hospital capacity for potential COVID patient surges. However, as a blanket policy, it fails to consider and incorporate several critical factors.

“Primarily, it’s important to challenge the notion that certain procedures are ‘elective’ — a term that often is misunderstood to indicate that such procedures are ‘optional’ and therefore not critically important to a patient’s health and well being. For many patients, orthopaedic surgical procedures are essential interventions that resolve profound pain and debilitation that undermine both the physical and mental health of those who suffer.

“Unfortunately, due to policies earlier in the pandemic that prohibited ‘elective surgeries,’ and despite enhanced safety protocols and progress in the fight against COVID-19, thousands of patients in New York State with debilitating pain were not allowed to receive treatment, and were also hesitant to engage or re-engage with the healthcare system resulting in delays to care. These delays in surgeries and procedures ultimately resulted in prolonged pain and suffering, significant medical deterioration, and materially impacted patients’ prognoses, morbidity and/or treatment plans. It is important the Legislature, the Executive and regulatory partners understand how detrimental framing ‘elective surgeries’ as optional interventions has become for patients.

“Secondarily, the order unintentionally sends an erroneous signal that accessing healthcare of any kind presents a danger to the patient. Providers have instituted broad and effective COVID-19 protocols that have resulted in demonstrably safe access to care. Nevertheless, we saw volumes across many service lines, including primary care and chronic disease management, fall off significantly as the pandemic evolved. Thousands of seriously and chronically ill patients stopped or limited their pursuit of care vital to their lives and livelihoods. That cost has yet to be fully measured or understood, and should not be exacerbated.

“Lastly, as a blanket state policy the order is generally unnecessary. Providers and hospitals are most knowledgeable about their patients’ needs and their communities’ status and needs, including relative to COVID-19. They should be the ultimate decision makers regarding the appropriate site of service for their patients, keeping in mind quality, safety, and associated risks. With state guidance and coordination, hospitals and ambulatory surgical facilities can best determine the appropriate level of elective cases that can be performed while also maintaining pandemic response readiness.”

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Cannabis Use Associated With Prolonged In-Hospital Length of Stay, Higher Complication Rates, and Increased Healthcare Expenditures

Babette Atkins — Fri, 19 Nov 2021 22:46:48 GMT

RECENT PUBLIC HEALTH STUDY PRESENTED AT NYSSOS ANNUAL MEETING FINDS LINK BETWEEN CHRONIC CANNABIS USE AND UNFAVORABLE JOINT REPLACEMENT SURGERY OUTCOMES

Cannabis Use Associated With Prolonged In-Hospital Length of Stay, Higher Complication Rates, and Increased Healthcare Expenditures

Albany, New York — A new study by researchers at the Maimonides Medical Center found a significant association between cannabis use disorder and unfavorable outcomes following total knee replacement. The study’s preliminary findings were unveiled at the New York State Society of Orthopaedic Surgeon’s (NYSSOS) annual meeting and symposium on October 22 by Dr. Miriam D. Weisberg, an orthopedic resident at the Maimonides Department of Orthopaedic Surgery, who was part of a team of researchers led by Maimonides’ research fellow Dr. Rushabh M. Vakharia.

The researchers collected data on more than 50,000 patients who had undergone total knee replacement surgeries, known as total knee arthroplasty, or TKA. Almost 10,000 of these patients had a clinical diagnosis of cannabis use disorder (CUD), which is generally defined as the persistent use of cannabis leading to impairment and social hinderance. The aim of the study was to determine whether cannabis use disorder patients undergoing primary TKA have higher rates of in-hospital lengths of stay, complications and increased healthcare costs.

The study concluded that:

- The majority of patients undergoing TKA with cannabis use disorder are between 45-65 years old.

- CUD patients were found to have nearly twice as long of an in-hospital length of stay following surgery (about 4-days compared to 2-days). This was also found to be increasing over the 8-year study period.

- CUD patients were 1.5 times more likely to have a medical complication, such as pneumonia, respiratory failure or heart attack, within 90-days following surgery.

- CUD patients were found to be up to 56 percent more likely to experience prostheses-related complications, such as loosening or infection, compared to their counterparts, within two years of their knee replacement.

- Day of surgery costs and total global 90-day episode of care costs were found to be nearly 20 percent higher in the CUD group compared to the case-matched cohort.

NYSSOS President Dr. John DiPreta said: “The study strongly suggests that all of the impacts of broader cannabis use are not yet fully understood, and that more research and diligent impact analysis is necessary as we move forward. We are hopeful that the state’s cannabis policy makers and regulators move cautiously, and more importantly, reflect on the health of all New Yorkers as they implement New York’s legalized cannabis program to ensure that any potential unanticipated consequences of increased cannabis use are effectively addressed and, if possible, mitigated. To that end, we stand ready to provide any assistance possible as it relates to the musculoskeletal health of New Yorkers and these consequences of cannabis use.”

The Maimonides research was one of several studies presented at the NYSSOS annual meeting and symposium. The full Maimonides study has been submitted for publication to the Journal of the American Academy of Orthopaedic Surgeons and is currently under review.

NYSSOS Convenes Multidiciplinary Web Conference on Concussion Managment

Babette Atkins — Wed, 20 Oct 2021 15:35:18 GMT

NYSSOS TO CONVENE NOVEMBER 9TH MULTIDISCIPLINARY WEB CONFERENCE TO ADDRESS CONCUSSION MANAGEMENT

Experts to Share Strategies on Recognizing Concussions and Providing Proper Treatment, Especially Among School Aged Children

Virtual Program Provided in Conjunction With the Brain Injury Association of New York State, Sports Medicine Concepts and Syracuse Orthopedic Specialists Will Provide Critical Guidance to a Wide Range of Education, Athletics and Medical Professions

Albany, New York — The New York State Society of Orthopaedic Surgeons today announced plans to convene a multidisciplinary virtual conference on November 9th to share evidenced-based approaches to recognizing concussions and providing proper treatment, especially among school-aged children.

The webinar event, which is also sponsored by the Brain Injury Association of New York State (BIANYS), Sports Medicine Concepts, and Syracuse Orthopedic Specialists, is targeted to a wide variety of education, athletics and medical professions, including: athletic trainers; athletic directors; school nurses, counselors, psychologists, social workers, and medical directors; teachers; primary care physicians; concussion clinics; physical therapists; speech and language therapists; pediatricians; occupational therapists and orthopaedists, among others.

Child and adolescent head injuries are far more common than previously thought. According to the federal Centers for Disease Control and Prevention, 11.7 percent of children aged 15 to 17 have experienced a serious head injury, creating a clear and emergent call to action.

The primary goal of the November 9th virtual conference is to provide each professional discipline with an understanding of its shared role in the concussion management care circle, and to actively apply concepts learned from the day's event.

NYSSOS President Dr. John DiPreta said: “Orthopaedists are focused on the health of the entire musculoskeletal system, including the head, spine and associated nervous system. The focus in recent years on concussion injuries at the professional athletics level has generated a far broader realization that athletes at every age and level must be protected from concussion injuries, and just as importantly, that the education, athletic and medical professionals who respond to and/or treat concussions are fully up to date on the most effective concussion recognition and treatment strategies available.”

Program elements of the conference include:

• Initial Assessment, Acute Management and Typical versus Prolonged Recovery, including: recognizing signs and symptoms of concussion; selecting and utilizing appropriate sideline assessment tools; identifying appropriate care and red flags for immediate referral/emergency transport; identifying “typical” recovery times/stages; and selecting appropriate referrals and rehabilitation tools to manage prolonged recovery.

• The Concussion Management Care Circle, with learning objectives that include: defining components of multidisciplinary concussion management teams; identifying rolls and responsibilities of each profession within the care circle; creating interdisciplinary communication plans; creating a concussion protocol that can address different severities of concussion; identifying strategies to manage patient expectations; and patient-provider communication.

• Navigating New York State Legislation and Regulations, with learning objectives that include: demonstrating understanding of the differences between state legislation, local guidelines, and specific organization policies; creating a concussion protocol that adheres to local and state regulations for your profession and patient population; and demonstrating understanding of pending legislation.

A full program agenda including faculty and eligibility for continuing education credits can be found at https://nyssos.org/concussion/

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STATEMENT ON THE APPOINTMENT OF DR. MARY T. BASSETT AS NEW YORK STATE COMMISSIONER OF HEALTH

Babette Atkins — Wed, 29 Sep 2021 15:34:02 GMT

STATEMENT ON THE APPOINTMENT OF DR. MARY T. BASSETT AS NEW YORK STATE COMMISSIONER OF HEALTH

By NYSSOS President John DiPreta, M.D.

“The orthopaedic community welcomes the appointment of Dr. Mary T. Bassett as New York State’s new Commissioner of Health. Muscloskeletal health and the associated quality of life issues central to orthopaedic care are critical elements of a comprehensive and accessible health care system.

“We look forward to working with Dr. Bassett to continue our efforts to address disparities in care that undermine the muscloskeletal health of many underserved communities. Many complex and fundamental issues impact these matters, including insurance company practices that restrict care, and proposed policy changes that create barriers for orthopaedic physicians. We hope to work with DOH and the Legislature to address these concerns in the coming year.

“In addition, building on the work of NYSSOS and that of our national group, the American Academy of Orthopaedic Surgeons, we are eager to work with Dr. Bassett to build more diversity among the orthopaedic physician ranks to better address the needs of all communities.

“Governor Hochul has pledged to rely on health experts to advise her in making appropriate, evidence-based decisions for all New Yorkers. We believe such a foundation is essential for crafting effective health policy, and we are committed to helping her fulfill that pledge.”

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COVID Health Care Worker Mandates: New York, New Jersey And Connecticut

Babette Atkins — Fri, 20 Aug 2021 14:14:43 GMT

By Order dated August 18, 2021, the New York State Commissioner of Health is requiring that healthcare workers in general hospitals (i.e., hospitals that provide inpatient care 24 hours a day) and nursing homes be vaccinated against COVID-19, except for those with bona fide religious or medical exemptions. These healthcare workers, including employees, students, volunteers and medical staff, are required to have at least one dose of an approved vaccine by September 27, 2021. It does not appear that applicable health care workers will be permitted to undergo regular testing in lieu of vaccination. On September 2, 2021, there is an opportunity for health care facilities impacted by the announcement to present evidence that failure to comply will not constitute a danger to the health of the people of the State of New York.

Learn more

New York State Society of Orthopaedic Surgeons Selects Altfest as its Preferred Wealth Management Education Provider

Babette Atkins — Mon, 28 Jun 2021 15:44:51 GMT

The New York State Society of Orthopaedic Surgeons (NYSSOS) is pleased to announce it has selected Altfest Personal Wealth Management as the preferred wealth management education provider for its members.

NYSSOS is the premier organization representing the orthopaedic community in New York. The Society serves orthopaedic specialists, subspecialists, fellows, residents and their patients by helping to create an optimal practice environment in which to provide quality and efficacious orthopaedic care.

“Our relationship with Altfest demonstrates further NYSSOS’ commitment to deliver value to its members throughout their professional lifecycle and beyond,” said NYSSOS’ president, Dr. John DiPreta. “Our partnership with Altfest enables members to receive custom tailored financial planning and investment management education as well as complimentary consultations. As the professional and personal demands on our members increase, we find it important to provide needed support and services to promote their education, resilience, and well-being. Our relationship with Altfest underscores this commitment to our members.”

Andrew Altfest, CFP®, President of Altfest Personal Wealth Management, said, “We are honored to have been selected by NYSSOS. Since its founding in 1983, Altfest has served the distinct financial planning and investment management needs of physicians. As NYSSOS’ partner, we will offer members timely, helpful, and usable financial planning information through a variety of means, including webinars, and email communications. We encourage members to take advantage of our educational content, which includes topics such as creditor and asset protection, student debt management, and tax reduction strategies, as well as our complimentary consultations.” “Given our many years of service to doctors,” Altfest continued, “we well understand the crucial part financial planning education plays in promoting their personal wellness. Altfest is gratified to have been chosen for this important role.”

To learn more about NYSSOS, including its benefits for orthopaedic surgeons, please visit www.nyssos.org. To learn more about Altfest, including its educational webinars, other informative content, and complimentary consultations for orthopaedic surgeons, please visit www.altfest.com/physicians or contact Jesse Frehling at jfrehling@altfest.com.

Governor Cuomo Announces New York Ending COVID-19 State Disaster Emergency on June 24

Babette Atkins — Wed, 23 Jun 2021 21:30:00 GMT

Governor Andrew M. Cuomo today announced that New York will end the state disaster emergency declared on March 7, 2020 to fight COVID-19. Given New York's dramatic progress against COVID-19, with the vaccination rates, and declining hospitalization and positivity statewide the state of emergency will expire after Thursday, June 24.

Federal CDC guidance will remain in effect, which includes masks for unvaccinated individuals, as well as all riders on public transit and in certain settings, such as health care, nursing homes, correctional facilities, and homeless shelters.

State and local government health departments will still be able to ensure mask rules and other health precautions are adhered to in those settings.

We will keep you abreast of any guidance coming out of the New York State Department of Health.

Be advised: DOH Commissioner Dr. Howard Zucker Issues Statement on Johnson & Johnson Vaccine

Babette Atkins — Tue, 13 Apr 2021 15:40:51 GMT

NYS Department of Health Commissioner Dr. Howard Zucker released the following statement regarding the Johnson & Johnson vaccine:

"Today the CDC and FDA issued a statement recommending a pause in the use of the Johnson & Johnson vaccine out of an abundance of caution. New York State will follow the CDC and FDA recommendation and pause the use of the Johnson & Johnson vaccine statewide immediately today while these health and safety agencies evaluate next steps. All appointments for Johnson & Johnson vaccines today at New York State mass vaccination sites will be honored with the Pfizer vaccine.

"As the CDC and FDA have said, any adverse events related to the Johnson & Johnson vaccine 'appear to be extremely rare' and, 'People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.'

"I am in constant contact with the federal government and we will update New Yorkers as more information becomes available."

OrthoInfo Helps Doctors Educate Patients

Babette Atkins — Mon, 12 Apr 2021 21:30:00 GMT

OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health.

The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living.

All content is developed and peer reviewed by AAOS members. Written in simple language, OrthoInfo articles can help your patients be better informed and participate more fully in their care and recovery.

Access the site

Practice Management: The Who, What, When, Where, Why, and How of 2021 CPT E/M Coding

Babette Atkins — Sat, 13 Mar 2021 16:11:07 GMT

The year 2021 marks a historic change in the coding world for outpatient office visits, with the first major revision to the CPT evaluation and management (E/M) codes in more than 20 years taking effect. Learn more: https://www.aaos.org/aaosnow/2021/feb/managing/managing01/

Practice Management: New Challenges and Proven Strategies for Optimal Surgeon-patient Communication

Babette Atkins — Mon, 22 Feb 2021 15:55:00 GMT

NYSSOS is proud to share this article from Ariana Lott, MD a resident at NYU Langone! She partnered with Drs. Weiss, Baker and Kim to explore the need for formal training on communication with patients.

Patient-physician communication skills have always been important for orthopaedic surgeons in providing patient-centered care. Although communication is important, orthopaedic surgeons have little formal training on how to communicate with patients. Compared to the countless hours dedicated to surgical training, there is little direct observation of orthopaedic resident and fellow communication skills. This lack of training is demonstrated in the literature, as orthopaedic surgeons ranked last out of 28 specialties with respect to patient-reported communication skills.

Studies have demonstrated that with improved communication, there is higher patient satisfaction, increased compliance with proposed treatments, and overall improved outcomes. In an analysis in the outpatient setting, physician empathy was found to be the strongest driver of patient satisfaction. Communication skills are particularly important for surgeons because establishing trust with patients presenting for surgical evaluation is essential. For true shared decision making, it is imperative that surgeons are able to communicate clearly so patients understand their diagnosis and treatment options for their specific medical conditions. Improved communication and trust also correlate with decreased medical-legal liability.

> Read the entire article

NYSSOS Urges Action on Medical Liability Costs

Babette Atkins — Thu, 18 Feb 2021 15:53:52 GMT

This week the AAOS and the New York State Society of Orthopaedic Surgeons (NYSSOS) joined with other physician organizations in encouraging state legislative leaders to embrace a proposal for reducing medical liability costs. Specifically, the measure tucked into Governor Cuomo’s Executive Budget proposal would provide much-needed relief to medical professionals in the form of lower liability insurance premiums and litigation costs. The organizations pointed out that a significant impediment to an already challenged industry is a dysfunctional medical liability adjudication system that is increasing costs at a time when medical practices are already operating amidst heightened financial stress as a result of COVID-19. The stark reality is evident in New York, where physicians and hospitals endure the highest liability awards and costs. A recent report indicated that in 2019, New York had the greatest total medical liability payouts of any state and nearly 70% more than the state with the second greatest amount. AAOS believes that the structure of the current medical liability system limits the ability of physicians to provide the highest quality patient care and that systemic reform is necessary to improve the overall health care system. Read the full letter...

The Bone Beat: New Law Repeals Antitrust Exemption for Health Insurers

Babette Atkins — Tue, 16 Feb 2021 15:58:26 GMT

Recently enacted legislation has removed the McCarran-Ferguson Act, an antitrust exemption that has protected insurers since 1945. Insurers will now be required to follow the same free-market rules as the other industries. On an episode of AAOS’ advocacy podcast “The Bone Beat,” George Slover, senior policy counsel for Consumer Reports, discusses why this repeal took so long and how the new law will introduce more choice and opportunity into the marketplace. > Listen in

AAOS Now: Patient Safety in the Era of Telemedicine: Recognizing Red Flags

Babette Atkins — Tue, 09 Feb 2021 15:01:57 GMT

During these unprecedented times, a significant focus has been placed on implementation and integration of telemedicine within the traditional framework of in-person orthopaedic practice. Although the growth of telemedicine was expected previously, the COVID-19 pandemic has rapidly accelerated its widespread implementation. Recent publications have focused on pre-visit technical considerations, including obtaining requisite equipment and fostering pathways for viewing imaging studies. There remains a dearth of orthopaedic literature reporting on the prevalence of adverse events encountered in the setting of virtual visits. This lack of information presents a patient safety concern that must be addressed before telemedicine is considered a mainstay of everyday practice.

Defining such red flags is essential for a successful telemedicine program, given that a major disadvantage of telemedicine is the limited physical exam. Although surrogate examination maneuvers have been described for the upper extremity (pushing oneself up from a chair) and lower extremity (hopping in place on the involved leg) to conform to the video format, they may not be specific enough for particular diagnoses. Conditions that can potentially be missed because of a lack of in-person interaction include: > Read article

NYSSOS Advocates Against a Legislative Fiat for Patient Encounters

Babette Atkins — Mon, 08 Feb 2021 17:03:52 GMT

On Monday, February 8th, NYSSOS issued a memorandum in opposition to A273 (Gottfried) which Requires a practitioner to consider and prescribe non-opioid treatment alternatives for treatment of neuromusculoskeletal conditions.

NYSSOS stated the following:

The Society agrees that physicians should be looking at non-opioid alternatives to analgesia and work within the patient encounter to consider alternatives available before choosing an opioid prescription. However, legislating medical treatment or guidelines interferes with the doctor patient relationship. Advancing this type of legislation will negate the physician's expertise regarding treatment for neuromuscular problems. Mandating provisions like this will supersede the existing training and measures to reduce inappropriate prescribing of opioids. Going forward, physicians, public health officials, policymakers and health insurance companies must work together to take meaningful action and create an integrated approach to combat the opioid epidemic. Legislating a medical encounter will not achieve the shared goals of improving care to patients and supporting a sustainable, predictable and resilient public health system.

The opioid crisis is real, and steps are being taken within the profession to address it. Programs like ISTOP, although cumbersome as it was being set up, has helped prescribers to identify drug seeking patients and control prescribing. We do not agree with the principle to institute mandates of this nature which restrict a licensed physician from making decisions based upon their medical training and in their best judgement. This bill will limit the ability to appropriately treat patients in pain and can lead to additional liability. As such we are in opposition.

To see a copy of the full memo - please email bgrey@nyssos.org

Five Best Practices for the Social Media-inclined Orthopaedic Surgeon

Babette Atkins — Mon, 08 Feb 2021 15:58:29 GMT

Amid the COVID-19 pandemic, social media allows us to stay connected to loved ones. Beyond that, physicians have begun using social media platforms as tools in their practices—from offering medical information to the public to highlighting career achievements, social media has become personal marketing tools for the 21st-century doctor. With that in mind, this article provides five helpful tips for using social media as a part of your orthopaedic practice.

> Read the complete article

NY WCB - OnBoard: Limited Release Resources for Health Care Providers

Babette Atkins — Wed, 27 Jan 2021 16:17:54 GMT

The next chapter in the modernization of the New York State Workers’ Compensation Board, the OnBoard Project, is well underway. The Board, with its integration partner CapTech Consulting, is building a new claims system that will replace the multiple legacy, paper-based claims systems, such as CIS and eCase, with a single, web-based platform.

The new system will offer improved and expanded access to real-time claim data, new electronic self-service features for interacting with the Board, and a reduction in the amount of overall paper forms to improve system responsiveness to stakeholder needs.

To learn more please visit: http://www.wcb.ny.gov/onboard/

NYSSOS Legislative Update: Cuomo Delivers State of the State

Babette Atkins — Mon, 11 Jan 2021 15:51:45 GMT

Today the Governor began what will be a four-part series to his State of the State address. His rhetoric focused framing our current situation as war-like and calling on the Federal Government to provide financial relief.

Today’s overview included 7 areas that he wants to move forward simultaneously:

Defeat COVID
Vaccinate NY
Manage Budget Crisis
Invest in Future
Transition to Green Energy
Understand the Long-Term Effects of COVID
Address systemic injustices

Of particular interest to the medical community, he mentioned:

Managing hospitalizations
Looking at the public health system by
1. Creating the Medical Supplies Act – which would have NY manufacture medical supplies and sell them across the state
2. Increase in outlets for vaccine distribution
3. Creation of a public health corps (lead by Cornell/Northwell) to increase emergency response and vaccinations
4. Public training for NY health emergency volunteers (on-demand training - Cornell)
Expand Telehealth legislation: more details here
Legalize Adult Use Cannabis: more details here

What he didn’t mention in his overview but was released by his press office is a proposal to reform OPMC. According to the website: “The Governor will introduce legislation to update the Public Health Law to strengthen disciplinary actions for misconduct resulting in better misconduct enforcement and increased patient safety. In addition, the Governor will propose reforms to the investigation and hearing processes to ensure that the Office can act swiftly to hold physicians accountable, confirm investigations, and keep patients safe.” More details can be found here

He also spoke on mobile sports betting, increase in construction, affordable broad band, green energy, social injustice and housing.

A listing of the proposals can be found here: https://www.governor.ny.gov/keywords/2021-state-state

The NYS Legislature is scheduled for session today beginning at 2:30pm for the Assembly and 3:00pm for the Senate. They are scheduled to meet for a total of 60 session days, running through June 10. The legislature changed its rules to allow for virtual voting and meeting. A calendar of session days is found here.

The pandemic and increasing deficit will be the main issue for the Governor and Legislature so we will see how it influences policy, especially health care. Citing New York’s deficit, estimated at $15 billion in the current fiscal year and an additional $16 billion in the fiscal year beginning on April 1^st, the Governor is calling for legalized marijuana and sports betting to bring in revenue. We will see how the legislature responds. Progressive advocates, including those in support of the New York Health Act, are pushing for a package of measures designed to increase taxes on the wealthy, including increasing taxes on billionaires, a tax on inherited wealth, a capital gains tax and taxes for Wall Street and corporations.

OnBoard: Limited Release – New Resources and Webinar Opportunities

Babette Atkins — Tue, 22 Dec 2020 15:05:16 GMT

As you may already know, the New York State Workers’ Compensation Board is in the process of developing a new business information system, OnBoard, which will provide an intuitive, user-friendly system, increased accuracy and quality, and paperless transactions to our system participants. Since building a new, integrated system from the ground up takes time, we’re starting with some high-priority processes that will benefit from moving online in what we are referring to as OnBoard: Limited Release.

This email includes several OnBoard: Limited Release resources to help you continue to learn about the new system and prepare for a smooth transition when it becomes available.

Webinar Recordings and FAQs

Thanks to everyone who joined last month’s OnBoard: Limited Release introductory webinar series for health care providers, insurers and attorneys. Recordings and slide decks of these sessions can be found on the OnBoard: Limited Release resources page.

Based on the feedback and questions received during these sessions, we developed three new Frequently Asked Question (FAQ) documents that we hope you will find helpful:

Fact Sheets Now Available

We have also developed new fact sheets outlining what health care providers, insurers, insurer attorneys and claimant attorneys need to know about OnBoard: Limited Release, and what to do now to prepare:

Announcing Monthly Webinars – Starting in January

Starting in January, the Board will be hosting additional OnBoard: Limited Release webinars for insurers, health care providers and attorneys. These webinars will include a brief project review and update, a walkthrough of the most frequently asked questions we have received, and plenty of time to answer any new questions you have.

No registration is required. To join, please select the "Join Webinar" link for each session below. Add it to your calendar so you don't forget! These webinar links will also be available on the Board's upcoming webinars page.

OnBoard: Limited Release for Insurers
Tuesday, January 19, 2021
12:00 p.m. - 1:00 p.m.
Join webinar
Add to your calendar!

OnBoard: Limited Release for Health Care Providers
Wednesday, January 20, 2021
12:00 p.m. - 1:00 p.m.
Join webinar
Add to your calendar!

OnBoard: Limited Release for Attorneys
Thursday, January 21, 2021
12:00 p.m. - 1:00 p.m.
Join webinar
Add to your calendar!

Additional Resources

Visit the Board’s OnBoard webpage to learn more about the project – including the new resources mentioned above.
For more details about the new system, view the Intro to OnBoard video!
Subscribe to receive OnBoard-related news straight to your inbox.

For general questions about OnBoard, email OnBoard@wcb.ny.gov

Advocacy Call to Action: Maintain Access to Medically Necessary Surgeries

Babette Atkins — Tue, 01 Dec 2020 21:21:35 GMT

The NYS Society of Orthopaedic Surgeons (NYSSOS) strongly advises against the shutdown of medically necessary surgeries prior to the opportunity to review the criteria and provide surgical input and guidance.

Surgeons and providers should be the ultimate decision makers regarding the appropriate site of service for their patients keeping in mind quality, safety, and risks. With state guidance and coordination, hospitals and ambulatory surgical facilities should be given the data and guidance to allow the appropriate level of elective cases best indicated by their medical staff, administration and current needs of the community.

Email your elected officials today!

Important Information - Workers’ Compensation Board Prescription Drug Formulary

Babette Atkins — Fri, 20 Nov 2020 21:40:04 GMT

As you are aware, legislation was signed in 2017 that required the New York State Workers’ Compensation Board (Board) to establish a prescription drug formulary. After multiple public comment periods, the Board adopted the New York Workers’ Compensation Drug Formulary (Formulary) regulations in May 2019. These regulations required new prescriptions to comply with the Formulary by December 5, 2019, and refill prescriptions to comply by June 5, 2020. Due to the COVID-19 pandemic, the Board moved the date for refill compliance with the Formulary to January 1, 2021.

As with any formulary, providers must have a way to prescribe non-formulary agents to treat worker-specific issues. To accommodate that need, a prior authorization process, using the Board’s online Medical Portal, was implemented. To date, there have been nearly 40,000 requests by providers to use non-Formulary medications through the Medical Portal prior authorization process.

As the Board approaches the final step in Formulary implementation, refill compliance, it is taking some additional time to ensure that the Formulary and prior authorization process work for all stakeholders. Thus, the Board is temporarily suspending the January 1, 2021, date for refill compliance, and a new date (likely spring, 2021), will be announced soon. Between now and then, the Board will address feedback from providers and payers; make system and process improvements by aligning with the initial release of the Board’s new business information system, OnBoard; and continue outreach and education to key users.

In the meantime, if providers have any difficulty getting needed medications for injured workers, or if payers have questions, please reach out to the Board’s Medical Director’s Office at wcbformularyquestions@wcb.ny.gov.

About the Formulary Prior Authorization Process

A full description of the Formulary and the prior authorization process, including two sets of Q&As, are posted on the Board’s website http://www.wcb.ny.gov/content/main/hcpp/DrugFormulary/overview.jsp. You are encouraged to review the Q&As as a reminder of associated prior authorization requirements and parameters.

To reiterate key points associated with the prior authorization process:

Before prescribing a non-Formulary medication, a prior authorization request needs to be submitted and approved. Any and all requests for prior authorization must be submitted through the Board’s Medical Portal.
Providers are expected to provide a specific rationale for the need for a non-Formulary medication as part of the prior authorization request. Payers are expected to respond specifically to the provider’s rationale. A denial response, such as “the medication is not on the Formulary,” is not acceptable, as it is, in fact, the reason that the prior authorization request is being made.
It is currently the payer’s responsibility to communicate the final outcome of a prior authorization request to their pharmacy benefits manager (if one is utilized), so that there are no obstacles for the injured worker when they present at the pharmacy to get their medication.
Currently, a prescription refill for a non-Formulary medication does not require prior authorization. Any medication that the injured worker has been on in the past year is considered a refill. It should be noted that a change in dosage, either upward or downward, is considered a new prescription and would require prior authorization if it is a non-Formulary medication.
Formulary medications for established/accepted conditions do not require prior authorization. If a provider writes a prescription for a medication for a non-established/non-accepted body part/condition, the payer should notify the provider that the injured worker has not been accepted for that particular body part/condition.
Formulary Special Consideration #4 should be used when there are no adopted New York Medical Treatment Guidelines (MTGs) currently in effect. Formulary medications marked with this Special Consideration are considered Formulary in the absence of MTGs, “as clinically indicated for causally related injuries or conditions utilizing accepted standards of medical care.”
While not required at this time, if a provider submits a non-Formulary prior authorization request for a medication refill, or for a medication that is considered Formulary, the payer should review and respond to the request.

Training for New Medical Treatment Guidelines Available

Babette Atkins — Mon, 16 Nov 2020 16:10:51 GMT

Training is available for the new Medical Treatment Guidelines (MTGs) that are to go into effect on January 1, 2021.

Elbow Injuries
Foot and Ankle Injuries
Hip and Groin Injuries
Hand, Wrist and Forearm Injuries (including Carpal Tunnel Syndrome)
Occupational Interstitial Lung Disease
Occupational/Work-Related Asthma
Post-Traumatic Stress Disorder*
Major Depressive Disorder*

The Board has developed training for each of the MTGs so that stakeholders can familiarize themselves with the new guidelines. Each training will provide an overview of the General Guideline Principles, conditions associated with the body part or disease, and treatment recommendations.

The training presentations are available as pdfs at Training for Non-medical and Administrative Staff

* Post-Traumatic Stress Disorder and Major Depressive Disorder have been posted for a 60-day public comment period starting on October 21, 2020. Training for these MTGs will be adjusted if needed based on the feedback received during the public comment period.

More Information

For more information, please visit the Board's website or call (877) 632-4996. You can also email MTGTrainings@wcb.ny.gov.

AAOS Concerned About Unintended Consequences of Drastic CMS Proposal

Babette Atkins — Fri, 07 Aug 2020 18:39:45 GMT

AAOS President Joseph A. Bosco III, MD, FAAOS, issued a statement in response to the newly released Hospital Outpatient Prospective Payment System (OPPS) proposed rule, which would eliminate the inpatient-only list beginning with nearly 300 musculoskeletal-related services, adjust the criteria for procedures covered in the ambulatory setting, and remove certain restrictions on the expansion and development of physician-owned hospitals (POHs). “While we are cautiously optimistic about the Centers for Medicare & Medicaid Services' (CMS) attempt to offer these flexibilities by promoting site neutrality and lifting restrictions on high-value POHs, we are concerned about the potential for unintended consequences associated with eliminating the inpatient-only list,” Dr. Bosco said. He emphasized that setting of care is best determined by physicians through the lens of patient safety and peer-reviewed evidence and strongly encourages CMS to carefully reassess this aspect of the proposal.

Read Dr. Bosco’s statement…

The Bone Beat - Reducing Disparities in Health Care

Babette Atkins — Wed, 01 Jul 2020 16:39:45 GMT

Structural inequities and barriers to health care existed prior to COVID-19. But the pandemic has put a spotlight on the problem, which has also recently become the focus of advocacy efforts nationwide.

In this episode, Movement is Life Chair Mary O’Connor, MD, FAAOS, explains how public policy and individual surgeons together can strengthen community-based programs to ultimately help narrow the health equity gap.

Listen to the podcast

President's Message

Babette Atkins — Sat, 20 Jun 2020 14:05:20 GMT

Your state society is here for you and hopes people are healthy and safe and returning to closer to normal practice patterns. We would like to congratulate those residents finishing their training and welcome and look forward to the incoming residents embarking on their orthopaedic surgery careers.

New York State now has all counties open for elective surgery. Different counties are at different stages of phased reopening and these decisions have been somewhat arbitrary and inconsistent across the state without as much medical or physician input as there should have been.

Graduations and celebrations have been in parking lots or virtual and surgeries while resuming, are requiring changes in protocol, testing and PPE requiring more time, stress and energy which will continue for the foreseeable future. Telehealth visits while beneficial to patients in some cases is often requiring more time and is not the same as in an in-person visit for many problems.

Some of our patients are scared of COVID-19 exposure, others are tired of being cooped up, and others have a laissez-faire or blatant disregard of the virulence of this virus. It is our responsibility to educate and model good behavior.

The recent protests and responses from different organizations including the AAOS are important to encourage peaceful protests recognition and acknowledgment of racial disparities and biases. As orthopaedic surgeons, we strive to take care of patients regardless of race, color, sex or national origin. We, however, need to do a much better job of mentoring, actively encouraging and increasing diversity in our profession as well as understanding social determinants of health and how it impacts musculoskeletal care and treatments.

On behalf of NYSSOS, we would like to thank all of our brethren for those serving or who have served on the front lines of the COVID-19 pandemic, those physicians and residents taking care of known COVID-19 patients, and the different decision making processes needed in current reopening.

Your NYSSOS Board would like to thank all who wrote emails via our VoterVoice grassroots action center about the resumption of surgeries at ASCs being allowed in counties once hospitals could resume elective surgeries. Our 800 emails generated by our advocacy efforts followed by the campaign being taken up by MSSNY, the AAOS and others were all instrumental at adding ASCs to the reopening plans for counties.

As all counties have resumed surgeries and we are treating patients that have delayed care, let us continue to lead our groups, staff, ASCs and hospitals through the prioritization of surgery and different processes as we take care of current problems as well as scheduling and performing the postponed surgeries for our patients.

Estimates to perform the backlog of surgeries suggest 9-18 months to perform 90% of the postponed and rescheduled surgeries. Surgical resumption should be done in an efficacious manner leading and protecting our staff, ourselves, and our patients and requires significant physician input.

Your AAOS NY State Board of Councilor members and the NYSSOS Board were the only state Society this year submitting and getting approved Advisory Opinions to the AAOS that we will advocate on at both the Federal and the State level. These include telemedicine continuation s/p COVID-19 with payment equity equal to office visits or based on time spent, continued and enhanced medical liability protection for COVID-19 related claims regarding treatment and delays, ASC safety and efficacy education to legislators and regulatory bodies, and for the AAOS to support and advocate for bipartisan support of the Medicare Accelerated and Advanced Payments Improvement Act and/or advocate for legislation that includes Part B, extends the repayment period, includes decreased or no interest rates and discusses convergence of the program to grants.

Our NYSSOS Annual meeting is now virtual and scheduled for approximately 2 hour sessions November 5-7 consisting of 3 webinars with live and prerecorded symposiums, moderators, the ability to interact and asked questions, and allow resident/fellow presentations and discussions. This will be an exciting meeting format that should be engaging, informational and educative for participants. Please save the date and more information will be forthcoming.

Thank you for your membership, advocacy, collective expertise and responsiveness to the current pandemic. Please let us know of problems and ways we can be responsive and helpful in your districts.

- Jim Slough, MD, FAAOS
President

NYS DOH Issues Updated Guidance on Resumption of Non-Essential Elective Surgeries and Non-Urgent Procedures

Babette Atkins — Sun, 14 Jun 2020 22:30:00 GMT

Today, the New York State Department of Health issued updated guidance for Resumption of Non-Essential Elective Surgeries and Non-Urgent Procedures in Hospitals, Ambulatory Surgery Centers, Office Based Surgery Practices and Diagnostic and Treatment Centers.

Key updates include:

Hospitals

Hospitals in all counties may resume non-essential elective surgeries and non-urgent procedures in both inpatient and outpatient settings. Waivers are no longer required.

Hospitals should continue to monitor metrics, however, original thresholds of ICU total bed capacity, ICU bed capacity, and COVID hospitalization rate based on the HERDS survey data will no longer be used to qualify hospitals to resume and continue to perform non-essential elective surgeries and non-urgent procedures.

There is no longer a requirement to submit information about the types and numbers of surgeries and procedures to the Department on a monthly basis however, hospitals should have a mechanism to report this information to the Department if requested in the future.

Testing

The test period may now be extended from three days to five days prior to the surgery or procedure. Test results should be received and reviewed before conducting the surgery or procedure. The only exception would be a nonscheduled emergent procedure where testing prior to surgery may not be feasible. In this case, a thorough screening and history should be taken as well as appropriate precautions. A test should be performed as soon as possible, and if positive, may result in the need for health care worker exposure protocols to be followed. Providers do not have to perform the test; it is allowable to accept a third-party test provided it is a viral molecular assay as described above and is performed by a laboratory with any required permits and approvals.

Transfers / Hospital Capacity

The intention was clarified for for ambulatory facilities to maintain ongoing confirmation of local hospital capacity (bed census, ICU census, and ventilator availability). The intention of this guidance is for ASC, OBS, and DTC providers to monitor capacity at the hospitals to which they would normally be transferring to and/or recommend patients visit post procedure, if necessary. Providers should establish their own policies for frequency of monitoring and may monitor local hospital capacity by region at the following link: https://forward.ny.gov/early-warning-monitoring-dashboard.

PPE

There has been no change to the requirement for ASCs, OBSs and DTCs to have adequate PPE and medical and surgical supplies appropriate to the number and type of procedures to be performed. Adequate PPE means that an ambulatory provider has at least a seven-day supply of PPE on hand, and the provider’s supply chain can maintain that level to support outpatient surgeries and procedures without resorting to contingency or crisis capacity strategies. To prepare for a potential future surge, providers should be working towards having immediate access to a 90-day supply of PPE.

NYS Workers Compensation Issues FAQs on Benefits for Employees Who Get COVID-19

Babette Atkins — Sat, 06 Jun 2020 17:31:15 GMT

The Board has published a COVID-19 & Workers’ Compensation Q&A document to answer questions about workers’ compensation benefits to employees who get COVID-19 while on the job. This Q&A is available on the Board’s website

Employer Responsibility:

If a worker reports that they are sick due to a workplace exposure, you must contact your workers’ compensation insurance carrier immediately.

The insurance carrier then has 18 days to act on the claim and must begin paying benefits within this time frame if the claim is accepted.

AAOS Registry Program to Collect COVID-19 Data

Babette Atkins — Thu, 04 Jun 2020 17:26:26 GMT

Effective immediately, the AAOS Registry Program will begin collecting COVID-19 data through the capture of the ICD-10 code for COVID-19 confirmed diagnosis, U07.1. The new code is enabled across each of the AAOS registries, including: the American Joint Replacement Registry, the world’s largest national registry of hip and knee joint replacement data by annual procedural count; the Shoulder & Elbow Registry; the Musculoskeletal Tumor Registry, and the American Spine Registry, a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS.

WHY NOW?

The AAOS has taken swift action to understand COVID-19’s current and future impact on musculoskeletal care. With more than 1.97 million procedures across four registries, the AAOS Registry Program already collects clinical data to support orthopaedic surgeons, hospitals, health systems, and ambulatory surgery centers (ASCs) in providing the highest quality musculoskeletal care. Now more than ever, it is critical to collect data that will provide additional insights on the quality of care and outcomes of orthopaedic patients in the COVID-19 environment.

WHAT WILL THE DATA REVEAL?

By adding the ICD-10 code to the AAOS Registry Program, sites who contribute the data will have the ability to monitor the impact of COVID-19 on patients undergoing future joint replacement procedures. Tracking COVID-19 data will help analyze the impact of COVID-19 on outcomes, trends of surgery based on the pause in elective surgery, and the trends of patient-reported outcomes (PROMs) due to delayed procedures. It will also track the potential impact on CMS value-based payment models and coverage for patients recovering from COVID-19. On a broader scale, long-term data from the registries may allow for future insights into COVID-19 and its impact on clinical outcomes.

Key learnings from the AAOS Registry Program will be delivered to participants, the orthopaedic community, and the broader public throughout the coming years.

HOW ARE CURRENT AND NEW REGISTRY PARTICIPANTS IMPACTED?

Hospitals, health care systems, practice groups, and ASCs already participating in the registries will not need to join a new registry or engage in a new way to submit their data. Capturing this code will not change the site’s workflow since it was added as an accepted value for existing diagnosis or comorbidity code files. The ICD-10 code can be submitted as a pre-operative comorbidity or prior diagnosis present on admission and as a reason for readmission.

Participants who have questions about submitting the new code can reach out to AAOS Registry Support at RegistrySupport@aaos.org for assistance. To enroll in a Registry, contact an AAOS Registry Engagement Associate via email RegistryEngagement@aaos.org or phone 847-292-0530.

AAOS COVID-19 Presidential Update from Joseph A. Bosco III, MD, FAAOS

Babette Atkins — Tue, 02 Jun 2020 17:29:58 GMT

Our patients are finally getting the high-quality care they deserve as state and local governments continue to relax restrictions on surgical practices. Most importantly, this care is being provided in an environment that is safe for patients, staff, and society. All those involved in patient care—including the patients themselves—understand that certain aspects of our practices have changed. The need for social distancing requires that we see fewer patients and utilize telemedicine whenever possible. We are becoming accustomed to wearing masks during office hours and our patients welcome symptom screening before being seen. COVID-19 antigen testing is being required by many institutions prior to surgery and this has been well received by patients. Despite the inconvenience, they understand and appreciate the steps we are taking to protect them. In short, we are all getting used to the “new normal.”

> Read more

Guide to PPP Loan Forgiveness

Babette Atkins — Fri, 22 May 2020 21:14:29 GMT

Under the Paycheck Protection Program (PPP) created by the CARES Act, loans may be forgiven if borrowers use the proceeds to maintain their payrolls and pay other specified expenses.

The Treasury Department and Small Business Administration recently released the application form and instructions for loan forgiveness. The forgiveness forms, instructions, and worksheets can be downloaded here.

PPP borrowers must apply for loan forgiveness with the lender that processed the loan.

NYSDOH Guidance on Resumption of Elective Outpatient Surgeries and Non-Urgent Procedures

Babette Atkins — Tue, 19 May 2020 21:19:44 GMT

This Guidance is directed at Ambulatory Surgery Centers (ASC) Office Based Surgery practices (OBS), and Diagnostic and Treatment Centers (DTC) that are located in counties without a significant risk of COVID-19 surge and are deemed eligible to perform Deferred Procedures, (i.e., elective surgeries and non-urgent procedures).

These centers and practices are required to meet the same provisions required of hospitals in these eligible counties that are also resuming deferred procedures.

Any ASC, OBS, or DTC that fails to comply with this Guidance may be subject to civil penalties.

Guidelines for Restarting Elective Surgery Post COVID-19 - with Members as of 4.29.20.pdf

Healthcare Policy Update: Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800)

Babette Atkins — Fri, 15 May 2020 21:31:20 GMT

The House of Representatives passed the Health and Economic Recovery Omnibus Emergency Solutions Act (H.R. 6800), which includes over $3 trillion in funding for state and local governments, hospitals and physicians, payments to individuals, and other assistance.

> Access the AAOS Summary

Preventing Coronavirus Transmission in Ambulatory Surgery Centers

Babette Atkins — Tue, 05 May 2020 21:49:57 GMT

In this pre-recorded webinar, the Joint Commission provides an overview of COVID-19 routes of transmission and focuses on prevention strategies for freestanding surgical centers to consider prior to resuming elective procedures: Preventing Coronavirus Transmission in Ambulatory Surgery Centers

New AAOS Committee on Devices, Biologics, and Technology Springs to Life

Babette Atkins — Fri, 01 May 2020 17:27:09 GMT

As the world’s largest medical association of musculoskeletal specialists, AAOS announced in November 2019 a strategic investment in the field of biologics and future disruptive technologies. Over the next five years, AAOS will prioritize research and development for a biologics-focused competency addressing issues of unreliable information and patient receipt of substandard care from nonorthopaedists, as well as continuing to be the trustworthy source of information for patients, members, and external providers and payers. This reprioritization is an expansion of previous work of many members on previous committees who also worked in this space.

> Read more

Healthcare Policy Update: Centers for Medicare & Medicaid Services (CMS) issues another round of regulatory waivers and rule changes

Babette Atkins — Thu, 30 Apr 2020 21:32:35 GMT

The Centers for Medicare & Medicaid Services (CMS) issued another round of regulatory waivers and rule changes with the goal of increasing diagnostic testing and access to medical care during the COVID-19 pandemic.

The AAOS Office of Government Relations has developed an overview for members with high-level key points

Executive Orders issued by the Governor of New York State

Babette Atkins — Wed, 29 Apr 2020 14:49:12 GMT

(as taken from the MLMIC website)

Executive orders are a method for the state government to ensure all actions can be taken to respond effectively and efficiently to a state emergency without being impeded by state laws and regulations that ordinarily serve a purpose but during the emergency can often hinder the fastest and best response to an emergency. The executive order accomplishes this goal by suspending or modifying certain laws or regulations that are listed in the order.

No. 202.24 April 29, 2020	This Executive Order authorizes, through May 25, licensed pharmacies to administer the tests to detect COVID-19 or its antibodies in patients suspected of having COVID-19 or of having recovered from COVID-19. Read the full executive order
No. 202.18 April 21, 2020	This executive order suspends and modifies various public health law and education law provisions and regulations, until May 16, to maximize the pool of health care professionals available to assist the State in the response to COVID-19. Among those of particular note are the following: Allows several health care providers such as physicians, nurses, and physician assistants licensed in Canada to practice medicine in New York State. Permits retired respiratory therapists to practice along with numerous other retirees in various health care provider specialties not previously authorized by executive order. Read the full executive order
No. 202.16 April 14, 2020	This executive order suspends or modifies certain laws through May 12, 2020. Among this order’s provisions are the following with an impact on health care: Mandates that essential businesses (which includes physician offices) who remain open for business with one or more employees in the workplace must be provided, at no cost to such employees, face coverings that they must wear when in direct contact with customers or members of the public. This directive takes effect on Wednesday, April 15 at 8 pm. Permits individuals meeting the federal requirement for testing personnel appropriate to the assay or device authorized by FDA or NY Department of Health to perform testing for detection of SARS CoV-2, or its antibodies, in specimens collected from persons suspected of suffering a COVID-19 infection. Read the full executive order
No. 202.14 April 7, 2020	This executive order broadly continues the directives in previous executive orders issued since March 7 regarding the COVID-19 outbreak to May 7. Among the provisions that regard health care and malpractice liability are the following: Allows graduating medical students to immediately begin practicing medicine under the supervision of a licensed physician Continues the limited immunity from liability protections for physicians and certain other medical professionals in their rendering of medical services in support of the State’s response to the COVID-19 outbreak to May 7 Continues the tolling of the statute of limitations deadlines for filing civil lawsuits to May 7 Read the full executive order
No. 202.12 March 28, 2020	This Executive Order contains one health care matter directing hospitals and health care facilities to permit one person to be present who is a support person for a patient giving birth. Read the full executive order
No. 202.11 March 27, 2020	Continuing the State’s efforts to ensure sufficient numbers of healthcare professionals, nursing graduates (RN and LPN programs) may be employed for 180 days with supervision of a registered professional nurse and endorsement from the employing hospital or nursing home, and midwives licensed and in good standing from any state or Canada may practice in New York State without penalty. Also, physicians assisting the State’s response in a SUNY facility are provided with the defense and indemnification, as if a state employee. This Order also declares a modification of EO 202.10 on the dispensing of hydroxychloroquine or chloroquine by pharmacist and declares that COVID-19 guidance issued by DOH are immediately effective and supersede any prior conflicting guidance issued, including local health departments. Read the full executive order
No. 202.10 - Summary of Immunity Provisions March 25, 2020	This Executive Order ensures that New York State has adequate hospital bed capacity, supplies, and providers to treat patients affected with COVID-19, as well as patients afflicted with other maladies. To assist in this goal, the Governor has provided immunities to licensed healthcare individuals through April 22, 2020. Read the summary by Mia D. VanAuken, Esq., Fager Amsler Keller & Schoppmann, LLP
No. 202.10 - Executive Summary March 25, 2020	New York’s Governor declared a state of disaster emergency for the entire State of New York on March 7, 2020, which authorizes him to temporarily suspend or modify, to the extent necessary, any statute, local law, ordinance, order, rule, or regulation of any agency and authorizes him to issue directives to cope with the disaster. Read the full article by Mia D. VanAuken, Esq., Fager Amsler Keller & Schoppmann, LLP
No. 202.6 March 18, 2020	This executive order primarily mandates that most New York businesses reduce their in-office workforce by 50 percent. The order makes an exception for essential businesses providing essential services. The following is a list of essential health care operations: Research and laboratory services Hospitals Walk-in-care health facilities Veterinary and animal health services Elder care Medical wholesale and distribution Home health care workers or aides Doctor and dentist offices Nursing homes, or residential health care facilities or congregate care facilities Medical supplies and equipment providers Read the full executive order
No. 202.5 March 18, 2020	This executive order contains numerous suspensions and modifications of New York laws and regulations. Among those of particular note are the following: Allows physicians, physician assistants, and nurses licensed anywhere in the U.S. to practice medicine in New York State. Allows NY licensed but not registered physicians to practice medicine in New York State. Allows hospital staff who are privileged and credentialed to work in a hospital or health care facility in another state to practice in a hospital or health care facility in New York State. Read the full executive order
No. 202.4 March 16, 2020	This Executive Order directed local and state employees whose position is non-essential to either work from home or take leave. In addition, the Order mandated closure of all New York State schools until April 1. Read the full executive order
No. 202.3 March 16, 2020	This Executive Order limited gatherings in any one location to no more than 50 persons. The Order also required food service establishments to no longer serve food on premises but only via delivery or pick up and it closed all gyms, fitness centers and movie theaters in the state. Read the full executive order
No. 202.2 March 14, 2020	This Executive Order concerned suspension and modification of law governing elections in New York State. It also imposed certain requirements on school districts closing due to a local state of emergency. Read the full executive order
No. 202.1 March 12, 2020	This Executive Order suspends various laws and regulations in order to permit expansion of services and temporary facilities for health and human service providers. Also, the order suspended laws and regulations relating to child care to allow flexibility for providers while continuing to protect children’s health and safety. Read the full executive order
No. 202 March 7, 2020	This Executive Order suspended or modified a variety of New York Education Law and Public Health Law provisions in order to accomplish the following: Allow unlicensed persons to, upon training, collect swab specimens from persons suspected of having COVID-19. Authorized the New York State Department of Health to enact emergency rules and regulations to, among other things, permit hospitals to most effectively prepare for, and treat, the influx of persons seriously infected with COVID-19. Read the full executive order

HHS General Allocation Fund Portal is Open

Babette Atkins — Sun, 26 Apr 2020 20:08:49 GMT

The US Health and Human Services (HHS) has indicated that the application portal is open for physicians to avail themselves of a portion of the $20 billion allocation from the CARES Act Provider Relief Fund.

The AMA has advised that anyone who has a Billing TIN who lost revenue in March and/or can estimate lost revenue in April due to the COVID-19 crisis, should be filling out this portal.

The AMA has also put together this guide to help physicians pull together the information they need to submit to the portal. Here is additional information from HHS regarding the distribution.

New Applications for the SBA Paycheck Protection Program Can Be Submitted This Monday

Babette Atkins — Sat, 25 Apr 2020 20:41:12 GMT

This week, both chambers of Congress passed and President Trump signed into law The Paycheck Protection and Health Care Enhancement Act, which allocates an additional $321 billion for Paycheck Protection Program (PPP) loans and an additional $60 billion for the Economic Injury Disaster Loan program. New applications can be submitted starting on Monday, April 27, 2020 at 10:30am. Any borrower that applied for a PPP loan prior to the issuance of this guidance and repays the loan in full by May 7, 2020 will be deemed by SBA to have made the required certification in good faith

> Read our legal counsel's alert.

Set aside in the $321 billion of additional funds approved for the PPP is $60 billion for small- to medium-sized banks and other financial institutions. The legislation also includes an additional $75 billion for the Public Health and Social Services Emergency Fund.

Additional Resources:

SBA Paycheck Protection Program

April 24 -President Donald J. Trump signed a $484 billion COVID-19 relief package, the fourth passed by Congress, that provides $370 billion for small businesses and replenishes the Paycheck Protection Program. View AAOS Summary

April 22 - The Department of Health and Human Services awarded nearly $165 million to combat the COVID-19 pandemic in rural communities. Read the HHS press release, Check out AAOS Guidance

Healthcare Policy Update: 4th Relief Package Passed by Congress

Babette Atkins — Fri, 24 Apr 2020 21:34:34 GMT

President Donald J. Trump signed a $484 billion COVID-19 relief package, the fourth passed by Congress, that provides $370 billion for small businesses and replenishes the Paycheck Protection Program.

> Access an AAOS Summary

NYSSOS Urges the Governor to Include ASCs in Resumption Guidelines

Babette Atkins — Thu, 23 Apr 2020 20:52:03 GMT

NYSSOS penned a letter to the Governor, making him aware of issues concerning resumption of elective surgery and the necessity for ambulatory surgery centers to be included in the strategy.

NYSSOS stated that emergency and urgent surgeries have been proceeding at both hospitals and Ambulatory Surgery Centers (ASCs) but there are many patients with significant musculoskeletal problems that have received alternative conservative treatments that now require surgical intervention and appropriate time for recovery to get back into the workforce. These patients have been unable to work and awaiting surgery before the massive layoffs and COVID-19 restrictions.

NYSSOS advocated that ASCs need to be included with resumption of surgeries based off the community individual needs while collaborating with hospitals and health systems to coordinate care. Surgeons and providers should be the ultimate decision makers regarding the appropriate site of service for their patients keeping in mind quality, safety, and risks. With state guidance and coordination, hospitals and ambulatory surgical facilities should be given the data and guidance to allow the appropriate level of elective cases best indicated by their medical staff, administration and current needs of the community.

Resumption of elective surgeries in less affected counties has only referenced hospital settings. So far, there has been no direction about how this applies to other care settings such as ASCs in counties that are allowed to re-open or ASCs in general. We request additional clarification in order to assemble an adequate healthy workforce and sufficient resources to protect and care for these patients.

Read the detailed letter

Telemedicine Coding and Reimbursement

Babette Atkins — Wed, 22 Apr 2020 20:43:20 GMT

The AAOS Coding team has created a quick reference tool for telemedicine visits: AAOS Telemedicine Quick Guide

Practice Operations - CMS Releases New Toolkit

Babette Atkins — Wed, 22 Apr 2020 20:42:07 GMT

The Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting 2019 Novel Coronavirus (COVID-19) in their communities: COVID workforce virtual toolkit

NYS WCB Adopts New Telemedicine Regulations

Babette Atkins — Tue, 21 Apr 2020 20:59:55 GMT

The Chair has adopted on an emergency basis amendments to 12 NYCRR 325-1.8, 329-1.3, 329-4.2, 333.2, and 348.2 to expand the telemedicine options for social distancing purposes due to outbreak of COVID-19 and to supersede the previous emergency telemedicine adoption filed on March 16, 2020. A Notice of Emergency Adoption will be published in the May 6, 2020, edition of the State Register.

The text of the Emergency Adoption has been published to the Board's website. This emergency rulemaking is effective for 90 days upon filing April 20, 2020.

Elective Outpatient Treatments Resuming with Restrictions on April 28th

Babette Atkins — Tue, 21 Apr 2020 20:50:07 GMT

Governor Andrew M. Cuomo announced today that elective outpatient treatments can resume in counties and hospitals without significant risk of COVID-19 surge in the near term. Restrictions on elective surgery will remain in place in Bronx, Queens, Rockland, Nassau, Clinton, Yates, Westchester, Albany, Richmond, Schuyler, Kings, Suffolk, New York, Dutchess, Sullivan, Ulster, Erie, Orange and Rensselaer Counties as the state continues to monitor the rate of new COVID-19 infections in the region.

Hospitals will be able to resume performing elective outpatient treatments on April 28, 2020 if the hospital capacity is over 25 percent for the county and if there have been fewer than 10 new hospitalizations of COVID-19 patients in the county over the past 10 days. If a hospital is located in a county eligible to resume elective outpatient treatments, but that hospital has a capacity under 25 percent or has had more than 10 new hospitalizations in the past 10 days, that hospital is not eligible to resume elective surgeries.

If a county or hospital that has resumed elective surgery experiences a decrease in hospital capacity below the 25 percent threshold or an increase of 10 or more new hospitalizations of COVID-19 patients, elective surgeries must cease.

Further, patients must test negative for COVID-19 prior to any elective outpatient treatment. The State Department of Health will issue guidance on resuming elective surgeries.

AAOS Guidance

The Academy believes that decisions regarding when and how elective surgery should begin are best decided on a local basis. To help members prepare for these conversations, they have developed clinical considerations for navigating COVID-19 and are recommending the following universally applied guiding principles:

All decisions should be locally based as resource availability is locally determined. These resources include:

a. Hospital beds,
b. ICU beds,
c. Ventilators,
d. PPE, and
e. Healthcare workers.

Overall disease burden varies by location: Hot spots like New York City and New Orleans have high case rates.
Stage of pandemic varies by location. (Reproductive number*: greater, equal or less than one. Is the curve increasing, flattening or decreasing?)
Legal restrictions vary by location: We need to adhere to government mandates; however, these vary by state. (For example, New York State is in place until 4/30/2020, while Oklahoma is in place until 4/24/2020.)

* Reproductive Number: It is the average number of secondary infections produced by a typical case of an infection in a population where everyone is susceptible. If the number is >1, then the case numbers increase. If it is <1, they decrease.

Once the decision is made to resume elective surgery, other important issues that must be addressed include:

Velocity of return,
Location of return,
Prioritization of surgical cases, and
COVID-19 testing (for both patients and staff).

Again, decisions regarding these factors are best made on a local basis. For example, in areas of low disease burden, elective surgery may not need to be phased in and can start all at once. In other areas, where personnel and equipment have been repurposed, a more phased-in approach is necessary. The principles guiding velocity of return include:

Resource availability (repurposed staff and equipment)
Utilization of “COVID-19 free” hospitals or ASCs when possible
Ambulatory cases first (to avoid hospitalization and COVID-19 exposure)
Inpatient cases (ASA I and II)
Inpatient cases (ASA III and IV), once COVID exposure as inpatient is minimized and COVID-19 testing is perfected

There is much debate about the availability and utility of COVID-19 testing for patients and staff. Despite the debate, it is likely that perioperative patient testing and universal staff testing will be required.

CMS Recommendations

The new CMS recommendations for reopening facilities can be found here

White House

The Guidelines for Opening Up America Again can be found here

OrthoInfo Patient Information on COVID-19

Babette Atkins — Tue, 21 Apr 2020 20:44:13 GMT

OrthoInfo has published a COVID-19 Resource Center for patients. Find articles and Ortho-pinions on a range of topics relating to the coronavirus, including telemedicine, bone and joint health, and how orthopaedic surgeons continue to provide care during the pandemic. COVID-19: Information for Patients

NYS WCB Update: Insurance Carriers, Self-Insured Employers, and TPAs – Designated Email Contact

Babette Atkins — Wed, 08 Apr 2020 21:50:58 GMT

In response to staffing and other changes put in place related to the COVID-19 pandemic, the Workers’ Compensation Board is updating some processes to ensure timely continuity of programs within the workers’ compensation system.

Health care providers have been instructed to submit prior authorization requests for medical procedures to their insurance carrier’s designated email contact as posted on the Board’s website, rather than a fax number. Fax submissions may not be able to be reviewed in a timely manner because many insurer staff members are working remotely. Prior authorization requests for non-formulary medications should continue to be submitted through the medical portal.

All insurance carriers, self-insured employers, and third-party administrators should forward their fax number to their designated email contact to ensure that these non-formulary prior authorization requests are received and acted upon accordingly.

The Board will only issue Orders of the Chair (OOC) for emailed prior authorization requests listed below that are not responded to in a timely manner. An OOC will not be issued for a faxed prior authorization request.

These instructions pertain to the following forms:

Form Type	Carrier's Email Address
Attending Doctor’s Request for Optional Prior Approval and Carrier's/Employer's Response (Form MG-1)	Contacts for Optional Prior Approval
Attending Doctor's Request for Approval of Variance and Carrier's Response (Form MG-2)	Contacts for Variance Approval
Attending Doctor's Request for Authorization and Carrier's Response (Form C-4 AUTH)	Contacts for Pre-Authorization

The NY Workers’ Compensation Drug Formulary Prior Authorization process will continue to be used for prescriptions that require prior authorization.

We also ask that your Medical Treatment Guidelines administrator verify your designated email contact and update it if necessary.

Thank you for your cooperation. Please contact the Board at WCBMedicalDirectorsOffice@wcb.ny.gov if you have any questions.

CMS Applies MIPS Extreme and Uncontrollable Circumstances Policy to Qualifying Physicians

Babette Atkins — Tue, 07 Apr 2020 19:38:12 GMT

The Centers for Medicare & Medicaid Services (CMS) extended the 2019 Merit-based Incentive Payment System (MIPS) data submission deadline to April 30 at 8 pm E.S.T.

CMS also announced that the MIPS automatic extreme and uncontrollable circumstances policy will apply to eligible clinicians who are unable to submit their data by the April 30 deadline.

Qualifying clinicians will be identified automatically, without having to take any additional action, and will receive a neutral payment adjustment for the 2021 MIPS payment year.

CMS also reopened the MIPS extreme and uncontrollable circumstances application. Individual clinicians and groups that started but cannot complete their data submission, as well as virtual groups that are unable to start or complete their data submission, should apply. Applications submitted between April 3 and April 30 citing COVID-19 will override all previous data submissions.

Contact the Quality Payment Program at 866-288-8292, Monday through Friday, 8 a.m. to 8 p.m. E.S.T. or by email at QPP@cms.hhs.gov.

Download the Quality Payment Program COVID-19 Response Fact Sheet…

AAOS Guidelines on Elective Surgery During the COVID-19 Pandemic

Babette Atkins — Tue, 07 Apr 2020 19:25:13 GMT

AAOS released updated guidelines on elective surgery during the COVID-19 pandemic. These guidelines should be applied judiciously depending on your location, where your area/institution happens to be situated relative to the curve of the disease, and the availability or scarcity of your resources, including personal protective equipment, intensive care unit (ICU) beds, respirators, and personnel. It is AAOS’ position that every locality should be making their own decisions based on the availability of resources and personnel. In these situations, a panel that includes the head of the hospital (or the designee), chief of the ICU, chief of anesthesia, and chief of orthopaedic surgery should form a committee to review any prospective surgery. W

here feasible, input from the state department of health should be solicited.

Read the guidelines…

A Message About COVID-19 from Joseph A. Bosco III, MD, FAAOS, AAOS President

Babette Atkins — Tue, 07 Apr 2020 19:22:33 GMT

AAOS President Joseph A. Bosco III, MD, FAAOS, sent a letter to members detailing the online actions AAOS is taking to help manage and emerge from the COVID-19 pandemic as strong as possible.

AAOS temporarily pivoted off its Strategic Plan to devote nearly all of its resources to helping members mitigate the effects of COVID-19.

The three pillars of the AAOS COVID-19 Action Plan are: (1) communication, (2) advocacy, and (3) practice management.

Dr. Bosco said in closing, “I have faith that each of us will contribute in whatever way we can or have to. There is work and sacrifice to be made, and our profession has a rich history of selflessness in the face of adversity. I am certain that the upcoming weeks will be no exception.”

> Read the letter

Immunity Protections in the NYS Budget

Babette Atkins — Fri, 03 Apr 2020 19:27:49 GMT

On April 2, 2020, New York passed legislation, entitled "Emergency Disaster Treatment Protection Act," (the "Act") that provides comprehensive immunity from liability to health care professionals and health care facilities. Previously, New York's Governor issued Executive Orders that provided for limited liability for thirty day periods. The Act is retroactive to cover acts or omissions that occurred on or after March 7, 2020, the date of the COVID-19 emergency declaration in New York State , through the expiration date of that declaration.

The stated purpose of the Act, which took effect immediately, is to promote the public health, safety, and welfare of all citizens by broadly protecting the health care facilities and health care professionals in New York State from liability that may result during the public health emergency.

The most significant difference in the Act from the Executive Orders is that the health care facilities, along with volunteer organizations and an expanded class of individuals , are protected from liability. The Act also provides immunity protection from criminal liability in addition to civil liability. Finally, the Act clarifies that the exemption for willful or intentional misconduct does not include acts, omissions, or decisions that result from a resource or staffing shortage. This language will protect professionals and facilities against actions and decisions in rationing medical devices and services, among others.

Read the complete summary provided by MLMIC

NYSDOH Health Advisory: Options when Personal Protective Equipment (PPE)is in Short Supply or Not Available

Babette Atkins — Fri, 03 Apr 2020 14:42:46 GMT

Healthcare entities should continue to submit requests for PPE through their local Office of Emergency Management. New York State continues to fulfill requests for PPE, as available. However, NYSDOH has become aware of instances in which healthcare providers, facilities, or practices are using or considering alternative means to manage PPE shortages,such as:

Use of dubious means to attempt to disinfect N95 respirators or facemasks (e.g. putting them in the dishwasher).
Use of a ventilator circuit filter attached to a disposable anesthesia facemask and strapped to the face in place of an N95 respirator.
Use of homemade cloth masks.

If all efforts to obtain PPE through vendors and local Office of Emergency Management are exhausted or unsuccessful, healthcare providers should refer to the CDC guidance entitled “Strategies for Optimizing the Supply of PPE”

Conventional, then contingency, then crisis capacity strategies should be used in that order, as feasible.

Many of the options from the CDC guidance document are summarized in the advisory.

For general guidance on the use of PPE in healthcare settings, please refer to CDC guidance entitled “Healthcare Supply of Personal Protective Equipment”

> Read the complete advisory

Consumers and Small Businesses Experiencing Financial Hardship Due to COVID-19 May Defer Paying Health Insurance Premiums through June 1, 2020

Babette Atkins — Thu, 02 Apr 2020 21:00:00 GMT

The Governor announced that, through June 1, 2020, consumers and businesses experiencing financial hardship due to COVID-19 may defer paying premiums under individual and small group health insurance policies. DFS shall consider any liquidity or solvency concerns of the health plans. During this period, health plans will be required to continue to pay claims, not to report late payments to credit rating agencies, and to work with individuals to help them transition to new coverage, if appropriate. In addition, insurers are reminded that they cannot impose late payment fees. Governor Cuomo thanked Connecticut Governor Ned Lamont for his collaboration on this initiative.

Access the complete release
(Information found on page 2)

FBI Releases Guidance on Defending Against VTC Hijacking and Zoom-bombing

Babette Atkins — Thu, 02 Apr 2020 19:34:49 GMT

The Federal Bureau of Investigation (FBI) has released an article on defending against video-teleconferencing (VTC) hijacking (referred to as “Zoom-bombing” when attacks are to the Zoom VTC platform). Many organizations and individuals are increasingly dependent on VTC platforms, such as Zoom and Microsoft Teams, to stay connected during the Coronavirus Disease 2019 (COVID-19) pandemic. The FBI has released this guidance in response to an increase in reports of VTC hijacking.

The Cybersecurity and Infrastructure Security Agency encourages users and administrators to review the FBI article as well as the following steps to improve VTC cybersecurity:

Ensure meetings are private, either by requiring a password for entry or controlling guest access from a waiting room.
Consider security requirements when selecting vendors. For example, if end-to-end encryption is necessary, does the vendor offer it?
Ensure VTC software is up to date. See Understanding Patches and Software Updates.

CISA also recommends the following VTC cybersecurity resources:

FBI Internet Crime Complaint Center (IC3) Alert: Cyber Actors Take Advantage of COVID-19 Pandemic to Exploit Increased Use of Virtual Environments
Zoom blog on recent cybersecurity measures
Microsoft Teams security guide

NYSDOH Health Advisory: Update on Specimen Collection and Handling for Alternative Acceptable Specimen Collections

Babette Atkins — Wed, 01 Apr 2020 21:00:00 GMT

This advisory supersedes specimen collection and handling guidance from NYSDOH, released originally on March 25, 2020.

This update further extends previous recommendations that nasal and oropharyngeal swab specimen collection is an acceptable alternative, with recommendations for the collection of one (1) nasal swab AND one (1) saliva specimen through healthcare personnel (HCP) observed patient self-collection for specimens submitted to Wadsworth Center,if nasopharyngeal (NP) supplies are unavailable.

If you are using a laboratory other than the Wadsworth Center, follow the laboratory’s guidance for all specimen collection, handling, and transport processes, including whether nasal swab AND saliva specimen, or nasal swab AND OP swab specimen collection methods are acceptable alternatives to an NP swab.

For any suspected COVID-19 cases, ensure appropriate infection control precautions are in place and immediately notify the infection control lead at your facility and the local health department (LHD).
Review local testing options for those who do not require clinical outpatient/inpatient medical care

> Read the complete advisory

NYSDOH: Protocols for Essential Personnel to Return to Work Following COVID-19 Exposure or Infection

Babette Atkins — Tue, 31 Mar 2020 21:00:00 GMT

This advisory supersedes guidance from the New York State Department of Health issued on March 28, 2020, to clarify that this guidance applies to essential personnel who have been exposed to a confirmed OR suspected case of COVID-19.

Public and private sector organizations that provide essential services or functions where personnel are needed to perform critical functions, including infrastructure, public safety, and other essential operations, may allow personnel who were exposed to or are recovering from COVID-19 to work in the workplace setting,if needed to maintain essential operations.

Essential services or functions include but are not limited to public health personnel, utility and water operators, skilled manufacturers and supporting supply chains, transportation infrastructure, law enforcement, and emergency response personnel.

Essential personnel who have been exposed to a confirmed or suspected case of COVID-19 can return if the following conditions are met.

NYSDOH Health Advisory: Updated Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection

Babette Atkins — Tue, 31 Mar 2020 21:00:00 GMT

This advisory supersedes guidance from the New York State Department of Health to Hospitals, Nursing Homes (NHs) and Adult Care Facilities (ACFs) pertaining to the COVID-19 outbreak, released on March 16, 2020, and further clarifies the updated guidance issued on March 28, 2020.

Entities may allow healthcare personnel (HCP) who are confirmed with COVID-19 or have been exposed to a confirmed or suspected case of COVID-19, or who have traveled internationally in the past 14 days, whether healthcare providers or other facility staff, to work if all of the following conditions are met.

COVID-19 LEGISLATIVE PACKAGES: SMALL BUSINESS RELIEF

Babette Atkins — Tue, 31 Mar 2020 00:35:30 GMT

As the COVID-19 pandemic has heavily impacted the U.S. economy, Congress has sought to intervene through the passage several legislative packages striving to minimize the overall impact to workers, businesses and the economy. Through these packages, two small business support programs were created both of which are detailed below.

The first program was created through the passage of the first COVID relief package, the Coronavirus Preparedness and Response Supplemental Appropriations Act. That bill created a $1 billion fund to immediately assist small businesses hit hard by the current economic shutdown. Unlike traditional Small Business Administration (SBA) funding mechanisms, this program is being administered directly by the SBA and is live and accepting applications currently.

The second program was created when the U.S. Senate unanimously passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act of 2020. This historic $2 trillion economic stimulus package, including $349 million in federal funds appropriated specifically to support small business, outlines two loan programs intended to assist those impacted economically by this global pandemic.

Small Business Administration Loan Program Note: Small businesses may apply to both programs but cannot participate in or accept funds from both programs. It is up to businesses to determine which program best fits the needs business before enrolling.

Access the AAOS chart that defines eligibility, what the program does, loan forgiveness, and how to participate.

How the CARES Act Impacts Orthopaedists

The Coronavirus Aid, Relief, and Economic Security (CARES) Act is the third Covid-19 relief-related package that was considered by Congress and signed into law by President Trump.

See the provisions most relevant to orthopaedic surgeons and their patients.

AAOS Telemedicine Resources

Babette Atkins — Mon, 30 Mar 2020 00:38:01 GMT

For the latest information and guidelines regarding telemedicine via telephone and video conferencing, download the AAOS Telemedicine Resource Guide

Access a comprehensive list of commercial health plan payers and their coverage policies for telemedicine services > Learn More

Find comprehensive telemedicine coding information for COVID-19: AAOS Coding Guide for COVID-19

For the latest information and guidelines regarding telemedicine via telephone and video conferencing: AAOS Telemedicine Resource Guide

AMA Special Coding Advice During COVID-19 Public Health Emergency

Governor Announces Medical Malpractice Relief

Babette Atkins — Sat, 28 Mar 2020 00:37:00 GMT

On March 27, 2020 the Governor announced that for a 60 day period, consumers and small businesses experiencing financial hardship due to COVID-19 may defer paying premiums for property and casualty insurance, including auto, homeowners, renters, workers comp, medical malpractice, livery and taxi. No late fees will be assessed and no negative data will be reported to credit bureaus during this time, and late payments will be payable over a one-year period. More details are forthcoming.

Additionally, you may call your malpractice carrier to ask about their additional accommodations for relief, such a reduction to part-time status.

CMS Announces Relief for Medicare Quality Reporting Program Participants, Issues CHIP FAQs

Babette Atkins — Sun, 22 Mar 2020 21:01:52 GMT

The Centers for Medicare & Medicaid Services (CMS) announced relief for clinicians, providers, and facilities participating in the Medicare quality reporting programs.

Among other programs, clinicians and providers will be granted exceptions from reporting requirements and extensions pertaining to measure reporting and data submission for the Merit-based Incentive Payment System (MIPS). The deadline for submitting 2019 MIPS data has been extended to April 30.

Those clinicians who fail to submit their MIPS data by that date will receive an extreme and uncontrollable circumstances exemption (i.e., they will receive a neutral adjustment).

> Learn more

State Agencies Send Out Reminder that New York Law Covers Telemedicine

Babette Atkins — Thu, 19 Mar 2020 17:46:36 GMT

Both the New York State Department of Financial Services (DFS) and Department of Health (DOH) have sent out notifications relating to the Covid-19 outbreak reminding health insurers, physicians and hospitals that New York law requires coverage for telemedicine in the same manner as if care had been provided in an office setting. For more information about how to start and choosing a vendor visit the AAOS Practice Management/Telemedicine center

To read the NYS Department of Financial Services circular letter, click here
For NYS Medicaid guidance click here

NYS Workers Compensation has issued amendments to allow telemedicine in some circumstances for social distancing purposes due to the outbreak of COVID-19. The text can be found here
Moreover, Congress passed a law last week that reduces current restrictions on Medicare coverage for telemedicine. A fact sheet can be found here.

Summary of Medicare Telemedicine Services

Source: https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

President's Message As physicians we need to continue to be prudent, compassionate, lead by example, and be guided by science

Babette Atkins — Thu, 19 Mar 2020 15:45:46 GMT

We have all been receiving multiple notifications and updates on the COVID-19 pandemic. There are more confirmed cases, school systems are closed and concerns regarding infrastructure, ICU beds, emergency room and hospital personnel exposure, and recent more restrictive bans on gathering sizes and nursing home visitation. The CDC recommends rescheduling non-urgent outpatient visits as necessary.

Current efforts to mitigate the spread of the virus include social distancing and quarantine restrictions as necessary depending on exposure, risk, symptoms, and testing. Testing still lags behind and hopefully continues to improve. As physicians we need to continue to be prudent, compassionate, lead by example, and be guided by science. We collectively need to practice improved health hygiene going forward and limit the spread not only of this virus, but other innumerable transmissible diseases in our society.

Our Executive Director Babette Grey is continuing to actively monitor the MSSNY website, New York State Department of Health, CDC, and other resources daily. She and the board are a resource and are here to help as needed. > Access the resource page

Protecting our patients, staff and visitors continues to be of the utmost importance. My private single specialty orthopaedic practice, physical therapy, imaging and ASC process more than 1000 patients per day. Instituting social distancing earlier has been shown to save lives. Many of our patient population falls into a vulnerable category and much of the work we do is elective. We currently are seeing urgent patients and keeping our open access clinic for fractures open to help offload the emergency rooms with screening of patients and discouraging non--urgent office visits. That being said, we are still having patients in the elderly group trying to walk in to get a cortisone shot in the knee and other nonessential visits as today I have seen patients with arthritic knees and pain since July and an elbow problem since July despite discouraging those visits. This is one of the problems unless people completely shut down.

On behalf of the NYSSOS Board, our thoughts and prayers are with you and your families, patients, staff, facilities and your communities. We are continuing to work for the orthopaedic surgeons of the state of New York and nationally to be able to continue to improve the ability to take care of musculoskeletal problems for our patients. Please reach out to us if we can be of assistance or a resource.

James Slough, MD FAAOS
President

Coronavirus (Covid-19) Resources for Physicians

Babette Atkins — Thu, 12 Mar 2020 18:01:28 GMT

Physicians should utilize the New York State Department of Health website that has up-to-date information on COVID-19 and includes information on known cases of COVID-19, cleaning and disinfection guidance, help for childcare providers and schools, and guidelines for individuals who have recently traveled internationally.
https://health.ny.gov/diseases/communicable/coronavirus/providers.htm

Reporting
COVID-19 is a reportable disease. If novel Coronavirus is suspected, immediately notify the local health department (LHD) where the patient resides.

Health care providers should review: CDC's Interim Guidance for Healthcare Professionals Evaluating Persons Under Investigation (PUI)

Free Communication Resources
CDC offers free resources including video, fact sheets, and posters. https://www.cdc.gov/coronavirus/2019-ncov/communication/index.html

Additional Resources
CDC Website for Healthcare Professionals
https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html

OrthoInfo Helps Doctors Educate Patients

Babette Atkins — Tue, 03 Mar 2020 14:20:39 GMT

OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health.

The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living. All content is developed and peer reviewed by AAOS members.

Written in simple language, OrthoInfo articles can help your patients be better informed and participate more fully in their care and recovery.

Visit the site

Comprehensive Care for Joint Replacement Model Three Year Extension and Changes to Episode Definition and Pricing (CMS 5529 P )

Babette Atkins — Mon, 24 Feb 2020 16:56:53 GMT

The Centers for Medicare & Medicaid Services (CMS) proposed a three-year extension and changes pertaining to episode definition and pricing to its Comprehensive Care for Joint Replacement (CJR) model.

The proposed changes would incorporate outpatient hip and knee replacements into the episode of care definition, as well as change the reconciliation process, the beneficiary notice requirements, gainsharing caps, and the appeals process.

The CJR model three-year extension would provide time to assess the changes in practice. > Learn More

Practice Management: Five Coding Tips for Dealing with Third-party Billing Entities

Babette Atkins — Fri, 21 Feb 2020 16:53:18 GMT

Editor’s note: AAOS partners with KarenZupko & Associates, Inc. (KZA) on the organization’s coding education, and KZA often provides content for AAOS Now. For more information, visit www.aaos.org/membership/coding-and-reimbursement.

Whether due to the complexities of hiring billing staff or a result of hospital employment and practice acquisition, many orthopaedic practices are moving their billing operations to a third-party entity or centralized billing office.

This process is part of what institutions call revenue cycle management.

If you find yourself in this situation, these best practices will help improve coding accuracy:

Keep Current Procedural Terminology (CPT) and International Classification of Diseases, 10th Edition coding as physician-primary tasks.
Insist that the third party follows AAOS coding guidelines.
Verify that the third-party billing staff includes coding experts, not just billing staff.
Ask for reports that illustrate the third party’s coding knowledge and performance.
Require ongoing orthopaedic coding education.

> Learn more

Congratulations to Carl Herndon, MD - New York AAOS Resident Advocacy Fellow

Babette Atkins — Thu, 20 Feb 2020 14:53:51 GMT

The AAOS Office of Government Relations (OGR) is proud to introduce its 2020 Resident Advocacy Fellows: Carl L. Herndon, MD, and Kacy Peek, MD.

Launched in early 2018, the one-year fellowship is designed to encourage orthopaedic residents to participate in the national health policy arena and ultimately become lifelong advocates of the profession. Eligible post-graduate year (PGY)-3 and -4 residents who are selected for the fellowship have the opportunity to gain a greater understanding of health policy legislative and regulatory processes; contribute to the development of new policies and programs, as well as strategic planning; work on various projects with senior AAOS staff; and develop a strong foundation for leadership in the healthcare environment.

During their tenure as Resident Advocacy Fellows, participants will attend the National Orthopaedic Leadership Conference, partake in Capitol Hill visits and advocacy training, spend a week at the AAOS OGR office, develop a presentation on health policy issues covered during the program, and actively engage in resident advocacy.

Carl L. Herndon, MD

Dr. Herndon is a PGY-4 orthopaedic surgery resident at the Columbia University Medical Center in New York. Originally from the Chicago area, he graduated from Northwestern University and completed medical school at the University of Florida College of Medicine prior to residency. From an early age, he has had multiple opportunities to travel on medical missions abroad with his mother, an obstetrician-gynecologist, and cultivate a heart of service. After graduating from Northwestern University and before enrolling in medical school, Dr. Herndon worked on the medical operations team of a large, federally qualified, inner-city health center, where he was first exposed to advocacy and how health policy can affect the daily lives of both patients and healthcare professionals. In medical school, he served as president of his class and was a member of both the local chapter of the American Medical Association and the Florida Medical Association. He was elected to the Alpha Omega Alpha Honor Medical Society and won several other awards for service. During residency, he has been an active member of the New York State Society of Orthopaedic Surgeons and also serves on both the AAOS Council on Education and the Resident Assembly Health Policy Committee. After residency, he plans to pursue a fellowship in total joint arthroplasty and continue to advocate for both surgeons and patients.

Study Assesses Effect of ACA Medicaid Expansion on Orthopaedic Surgery Access in New York

Babette Atkins — Thu, 20 Feb 2020 14:40:39 GMT

A study published in the Feb. 15 issue of the Journal of the AAOS evaluated how Affordable Care Act (ACA)-associated Medicaid expansion impacted the utilization of elective orthopaedic surgery in New York state. The abstract is below. Full article can be found here.

Background:

As part of the Patient Protection and Affordable Care Act, states were given the option of expanding Medicaid coverage to include adults younger than age 65 years with income at or below 138% of the federal poverty level. Although this expansion was intended to provide health care coverage to an estimated 20 million Americans, several studies have shown increased coverage does not equate to increased access to care by specialty providers.

Methods:

We queried the New York Statewide Planning and Research Cooperative System database and identified all patients who underwent the 10 most common elective orthopaedic surgeries from January 1, 2012, through March 31, 2016. Medicaid monthly enrollment for the 4-year study period was obtained from NY Department of Health Medicaid Managed Care Enrollment Reports.

Results:

Our query identified 700,159 patients who underwent the investigated orthopaedic surgeries. Of these, 60,786 were Medicaid recipients. During the 4-year study period, Medicaid enrollment and the number of procedures reimbursed by Medicaid increased significantly (P < 0.001 for both).

Conclusions:

Affordable Care Act–supported Medicaid expansion was associated with an increase in Medicaid enrollment and a concomitant increase in the utilization of orthopaedic surgery by Medicaid beneficiaries in New York State.

House Committee Releases New Surprise Medical Billing Legislation

Babette Atkins — Tue, 11 Feb 2020 15:12:52 GMT

Late last week, the House Ways & Means Committee issued bipartisan legislation tackling surprise medical billing. The proposal, which is scheduled for markup on Feb. 12, would eliminate balance billing for emergent procedures. Conflicts would be resolved with an independent mediation process.

AAOS is reviewing the proposal and continues to advocate for a fair, accessible Independent Dispute Resolution process for resolving payment disputes.

Contact your congressional representative to voice your concerns.

Tips for improving your revenue cycle in 2020

Babette Atkins — Tue, 11 Feb 2020 15:10:08 GMT

Each year, KarenZupko & Associates, Inc., (KZA) sends a precourse survey to those who have registered for the KZA/AAOS coding and reimbursement workshops. The results provide insights on a variety of coding, documentation, and revenue-cycle processes and trends. In 2019, KZA received 178 completed surveys.

This article summarizes three revenue cycle data points from the 2019 survey results and provides commentary and guidance from two revenue-cycle experts.

Collect at the time of service for office visits and surgery. Most practices could boost their revenue by $25,000 to $75,000 per surgeon by doing this.
Adequately document failed conservative treatment in the office note to support that advanced imaging or surgery is indicated. The amount of administrative time spent piecing together information that may or may not exist in the patient’s records is astronomical. A concise summary of the failed conservative treatments, with dates and specifics, significantly reduces the amount of time it takes for preauthorization to be approved.
Be proactive with denials. Most denials we see in practices are preventable. Review denial patterns and develop a plan to address them proactively.

—Cheyenne Brinson, CPA (inactive), MBA, of KarenZupko & Associates, Inc. (KZA)

Fully preregister patients at the time of scheduling, which includes capturing their full insurance information and verifying eligibility. This essential step lays the groundwork for tips 2 and 3.
Collect from patients at the time of service.
Collect presurgical deposits.

Tips 2 and 3 are the two most impactful things a practice can do to increase patient collections and decrease patient accounts receivable.

—Amy Anderson, MBA, of KZA

AAOS Practice Management Resources

Babette Atkins — Mon, 10 Feb 2020 15:11:28 GMT

The Academy’s numerous free practice management resources provide knowledge, education, clinical tools, and professional support that help you meet the challenges of your chosen specialty and build mastery throughout your career.

Access white papers, the Practice Management Advice Center, webinar recordings, and learn about topics such as Medicare Access and CHIP Reauthorization Act delivery reform and the Quality Payment Program.

> Practice Management Center

WCB New Drug Formulary FAQs

Babette Atkins — Fri, 07 Feb 2020 17:23:27 GMT

To support the successful implementation of the New York Workers’ Compensation Formulary (NY WC Formulary), the Board continues to educate medical providers and payers about the Formulary and prior authorization process. This includes providing timely responses to frequently asked questions and requests for clarification. This week, the Board published a new round of frequently asked questions (FAQs). Please visit the Board’s Drug Formulary Overview webpage for the latest FAQs as well as:

An overview of the NY WC Formulary and the prior authorization process
The latest version of the NY WC Formulary
A Quick Guide to the NY WC Formulary
NY WC Formulary Dashboard Guides for Providers and Payers/TPAs

More Information

For more information, visit the Drug Formulary Overview Page
General NY WC Formulary questions: WCBFormularyQuestions@wcb.ny.gov
Technical support questions: WCBCustomerSupport@wcb.ny.gov
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The Joint Commission Updates Total Hip and Knee Replacement Certification Requirements

Babette Atkins — Thu, 06 Feb 2020 00:39:59 GMT

The Joint Commission released its updated total hip and knee replacements requirements for hospitals and ambulatory surgical centers that are part of the Advanced Total Hip and Total Knee Replacement Certification program.

Among the new requirements, which take effect on July 1, participating groups are required to follow AAOS clinical practice guidelines.

>Learn more

AAOS Warns Against Broadening Scope of Practice

Babette Atkins — Tue, 28 Jan 2020 23:00:00 GMT

On January 17, AAOS submitted feedback to the Centers for Medicare and Medicaid Services (CMS) on its proposal to ease scope of practice restrictions.

The agency had requested input and recommendations on carrying out the President’s recent executive order to eliminate certain supervision and licensure requirements that “limit healthcare professionals from practicing at the top of their professional license.”

In its comments, AAOS stressed the importance of keeping the title "physician" reserved only for those health care professionals who have completed rigorous training and passed the United States Medical Licensing Exam. AAOS also reiterated support for non-physician providers who work as valued members of physician-led care teams. In addition to offering its own comments, AAOS signed onto the American Medical Association’s feedback letter which cited the impact these changes would have on the overall cost and quality of care. Read AAOS’ full comments to CMS…

On the state level, NYSSOS focuses advocacy efforts on ensuring that all patients have access to high quality, comprehensive musculoskeletal care by providers who have met and completed uniform standards for education, licensure, training and certification. > Advocacy Program

Practice Management: NYS Laws Affecting Employers in 2020

Babette Atkins — Wed, 08 Jan 2020 16:51:16 GMT

As of December 31, 2019, the minimum wage increases across New York State, and more employees will be eligible to receive overtime pay because the salary threshold for exempt employees also increases. Be sure to update your state and federal labor law posters!
Effective January 1, employees taking Paid Family Leave will receive 60% of their average weekly wage and the employees’ contribution increases to 0.270% of gross wages each pay period, up to a max of $196.72 for the year. More information and resources for employers can be found here.
On January 6, a statewide ban on salary history inquiries takes effect. The new law prohibits all employers - both public and private - from asking prospective or current employees about their salary history and compensation.
By January 7, employee handbooks must include a notice of employees' rights and remedies under a 2019 law that prohibits employment discrimination based on an employee or dependent’s reproductive health decision-making. For more information about the new laws related to workplace discrimination, harassment, and protected classes, click here.

For Residents: Sounds from the Training Room

Babette Atkins — Mon, 06 Jan 2020 14:57:11 GMT

The American Academy of Orthopaedic Surgeons (AAOS), along with JAAOS (aka the “Yellow Journal”), the AAOS Resident Assembly and OrthoMentor have come together to create this forum in order to further the mentorship and education of orthopaedic surgeons during various stages in their career. Authors from the contributing organizations will offer insights into residency transitions, medical school success, attending involvement and more.

Learn More: https://soundsfromthetrainingroom.com/

For Residents: AAOS Orthopaedic Board Preparation and Review Course

Babette Atkins — Fri, 03 Jan 2020 14:53:03 GMT

April 14 - 18, 2020
Holiday Inn Chicago-Mart Plaza
Chicago, Illinois

> Learn More and Register

Faculty draw on material based on common test questions to guide you through the vast amount of content for each specialty area. This focused approach includes dedicated time for high-yield review sessions to re-cap the most important testable facts and concepts.

This blended learning program is the premier course with exclusive pre- and post-event resources with online access to study resources to build your conﬁdence at your own pace. Start preparing early - access to the pre-course content on an exclusive registrant portal will be available in January 2020.

Governor Vetoes Bills to Increase Oversight on PBMs and Prohibit Mid-Year Formulary Changes

Babette Atkins — Thu, 02 Jan 2020 16:09:06 GMT

Changes to Drug Formularies Mid-Year

S.2849, vetoed on December 23rd, would have created a list of safeguards designed to protect patients with private, commercial health insurance plans seeking to remove drugs from their pharmacy benefit formularies, in the middle of a contract year. New York’s current law puts thousands of patients at risk of losing access to therapies for such chronic and life-threatening diseases as epilepsy, rheumatoid arthritis, multiple sclerosis, among many others. It also usurps decisions by physicians as to what the most effective therapy is to treat a patient’s condition. NYSSOS was in support of the passage of the bill.

The Governor vetoed the bill because of concerns that “Insurers would have to anticipate and set rates for hypothetical future drug price increases, causing higher premiums for everyone, while pharmaceutical companies would be able to raise their prices with impunity”.

Pharmacy Benefit Managers

On December 26, the Governor vetoed, S.6531, which would have increased the oversight, transparency and accountability of Pharmacy Benefit Managers (PBMS). According to a recent article published by MSSNY, the Governor vetoed the bill because of concerns that provisions could be pre-empted by ERISA, and invite scrutiny from the FTC and DOJ and “sweep in plans that are not true PBMs, but rather health benefit funds only.”

WCB Drug Formulary Resources Now Available

Babette Atkins — Fri, 27 Dec 2019 17:05:16 GMT

The NYS Workers’ Compensation Board has a number of resources to help medical providers understand and utilize the NY Workers’ Compensation Drug Formulary.

• Overview Video: Providers are encouraged to watch the Board’s video for medical providers, which includes a detailed overview, examples, and screenshots of the new drug formulary and the associated processes.

• Drug Formulary Web Page: Providers can also visit the Drug Formulary Overview page for information about the NY WC Formulary, a PDF of current and previous versions, details on the prior authorization process, frequently asked questions, and quick links to additional resources.

• New! January 13th Live Webinar Q&A Session: The Board is hosting a follow-up Q&A webinar so you can get answers to any remaining questions you may have. To make the most of this time, please be sure to watch the video and review the website information ahead of this session.

January 13, 2019
2:00 p.m. - 3:00 p.m.
Register Here

If you would like to send your questions in advance of the session, or if you have an urgent question, please write to wcbmedicaldirectorsoffice@wcb.ny.gov.

Participating in the National Resident Advocacy Fellowship - Dr. Conti's Experience

Babette Atkins — Sun, 01 Dec 2019 15:11:29 GMT

My Glimpse into the World of Advocacy

Matthew Conti, MD

I didn’t know there is an underground subway connecting the House of Representatives and Senate buildings to the U.S. Capitol until I was running through the halls with Representative Virginia Foxx (R-N.C.). We jumped into the “members only” elevator, sprinted to the subway, and arrived just in time for a vote on the House floor. I also didn’t know there is an orthopaedic surgeon who is also a senator until I met John Barrasso, MD, FAAOS (R-Wyo.). I also didn’t know the difference between the terms “regulatory” and “legislative” until I did the AAOS Resident Advocacy Fellowship.

NYSSOS congratulates Dr. Conti on his advocacy efforts and for getting involved at the State level. We look forward to his participation on the State level as well!

> Read the full story

Over the past year, I have spent time meeting with and learning from the AAOS Office of Government Relations (OGR), located in Washington, D.C. Truthfully, before I applied for the fellowship, I didn’t even know that the office existed. Based on a recent poll undertaken during my AAOS Instagram stories takeover, about 70 percent of respondents said they did not know that AAOS has an office in Washington, D.C.

I have learned that effecting change in government requires persistence and patience. Ironically, one of the reasons I went into orthopaedics was that the care we provide has more immediate results. If a bone is broken, it needs to be urgently fixed. But if the government is broken, then we form a committee to debate the merits of fixing it, vote on a resolution, and then have a debate on the House floor.

Change does happen though—very slowly. We are fortunate as a profession to have dedicated, passionate people in Washington, D.C., fighting battles daily on behalf of orthopaedic surgeons—battles most of us do not even know about. While you’re preparing for your first total knee arthroplasty of the day, the AAOS advocacy team is fighting to make sure that case isn’t delayed because you couldn’t get timely prior authorization from the insurance company.

I’ve learned a tremendous amount over the past year. Prior to the AAOS Resident Advocacy Fellowship, I didn’t know that the voice of an orthopaedic surgeon in Congress is powerful, or how important it is to donate to the Orthopaedic Political Action Committee.

Matthew Conti, MD, is an AAOS 2019 Resident Advocacy Fellow and is completing postgraduate year-4 at the Hospital for Special Surgery

Read his full story: https://www5.aaos.org/aaosnow/2019/dec/advocacy/advocacy01/

What you Need to Know - New Codes for Drug-delivery Implant Devices and More

Babette Atkins — Sun, 01 Dec 2019 14:45:10 GMT

Joanne Willer, Manager of coding and reimbursement resources in the AAOS Office of Government Relations, recently wrote an article for the AAOS Now summarizing the relevant changes to the musculoskeletal section for 2020.

To view her full article follow this link.

Below is a overview of her article. For a full summary of the additions, deletions, and revisions, refer to Appendix B of the CPT Manual.

Six new add-on codes describing insertion and removal of drug-delivery implant devices specific to musculoskeletal treatments have been added to the CPT code set for 2020.

The new codes were created to differentiate between the existing codes (which are in the integumentary section of CPT 11981–11983) and orthopaedic procedures for the treatment of soft tissue-, bone-, and joint-related infections. The new codes are for insertion, removal, and removal with reinsertion of nonbiodegradable drug-delivery implants.

Multiple specialties have been using the existing codes, which lack specificity, and that was the catalyst for change.

CPT code 20926, Tissue grafts, other (e.g., paratenon, fat, dermis), has been deleted for 2020.

That code was identified as potentially misvalued by the AMA Relative Value Scale Update Committee Relativity Assessment Workgroup (RAW). RAW determined that the code was being used for significantly different procedures, such as small soft-tissue grafts, correction of minor contour deformities, and placement into a defect for reconstructive purposes.

In the absence of code 20926, five new codes have been created to report those services.

Additionally, several changes were made to codes within the Extracranial Nerves, Peripheral Nerves, and Autonomic Nervous System section of the CPT Manual, including revised code descriptors to the 64400–64450 series of codes; instructional parenthetical notes; and deletion of codes 64402, 64410, and 64413.

Are you ready? NYS Workers' Compensation Prescription Formulary Effective 12/5

Babette Atkins — Fri, 22 Nov 2019 22:12:41 GMT

The New York Workers’ Compensation Board Drug Formulary (NY WC Formulary) becomes effective on December 5, 2019 for all new prescriptions.

All new prescriptions for injured workers in New York State must be listed within the NY WC Formulary unless an alternative medication has been approved through the NYS Workers’ Compensation Board’s new prior authorization process.

The new electronic prior authorization process will soon be available through the Board’s Medical Portal; please watch for the notification.

Please visit the Board’s Drug Formulary Overview webpage for:

An overview of the NY WC Formulary and the prior authorization process
The latest version of the NY WC Formulary (effective 11/5/19)
A video overview for Medical Providers
A Quick Guide to the NY WC Formulary
An NY WC Formulary Dashboard Guide for Medical Providers

Information and resources related to requesting prior authorization through the Board’s Medical Portal, can be found on the Board’s Medical Portal Overview webpage.

For more information or assistance: http://www.wcb.ny.gov/content/main/hcpp/DrugFormulary/overview.jsp

NYS Workers' Compensation Board Hosts Drug Formulary Webinars for Medical Providers

Babette Atkins — Thu, 17 Oct 2019 13:30:32 GMT

The NYS WC Board is hosting webinars to provide training on the Drug Formulary and prescription prior authorization process. Visit the Board's website to register: http://www.wcb.ny.gov/webinars/

October 22, 8:30 a.m. - 9:30 a.m.
October 24, 4:30 p.m. - 5:30 p.m.
October 29, 8:30 a.m. - 9:30 a.m.
________________________________________
More Information
For more information, visit wcb.ny.gov/content/ebiz/drugformulary/

General Formulary questions: WCBFormularyQuestions@wcb.ny.gov

Technical support questions: WCBCustomerSupport@wcb.ny.gov

New Look and Process for CMS Local Coverage Determination (LCDs)

Babette Atkins — Wed, 31 Jul 2019 17:59:27 GMT

Changes to National Government Services Local Coverage Determination Process

In accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), CMS is updating the “Medicare Program Integrity Manual” with detailed changes to the LCD process.

All coding information, will be removed from the LCDs and placed in a related billing and coding article, including national coverage provisions, and associated information (documentation requirements, utilization guidelines).
The article name will begin with “Billing and Coding,” followed by the title of the associated LCD.
Bill types, revenue codes, CPT/HCPCS codes, ICD-10 codes, as well as any coding guidance or mention of codes in the LCD will now be found in the associated billing and coding article.
Several LCDs will be revised for 8/1/2019 publication. The remaining LCDs will be revised in the coming months, with all completed by 1/1/2020.
Billing and coding articles will be listed on the Medical Policy Center page alongside the related LCD.

Related Content

More details on this update are available in MLN Matters® Article MM10901.
For a complete listing of all LCDs, visit the Medical Policy Center

AAOS Members - Order FREE Posters and Postcards for Your Practice

Babette Atkins — Mon, 29 Jul 2019 17:30:07 GMT

Order FREE Posters and Postcards for Your Practice
Download FREE PSA materials now or order the quantity you need. Communications tools and office resources include:

public service announcements: multimedia and multiple sizes for your needs
media outreach templates;
customizable community presentations; and
communications toolkits for special national Academy initiatives.

MLMIC Releases Albany Report - Legislative developments impacting the New York medical professional liability marketplace

Babette Atkins — Tue, 23 Jul 2019 17:44:54 GMT

MLMIC’s The Albany Report offers policyholders a concise, insiders’ view of pending legislative, regulatory, and political developments that have an impact on the New York State medical malpractice insurance marketplace.

Open or download the latest issue of The Albany Report: https://www.mlmic.com/why-mlmic/services-resources/albany-report

2019 Legislative Session Has Concluded

Babette Atkins — Mon, 24 Jun 2019 18:15:35 GMT

The State Legislature has concluded its 2019 Legislative Session. This was certainly one of the most memorable in recent years given the range of issues addressed following the democratic power-shifting election.

Be advised that we may be calling you to action during the summer to help secure vetoes from the Governor addressing the proliferation of e-scooters, e-bikes and unbalanced medical liability reforms.

NYSSOS wishes to thank our members who took the time to make phone calls, write letters and personally meet with legislators on this year's advocacy program. Every interaction matters and we will continue to address the orthopaedic community's concerns in the coming year. We are very proud of this year’s interactive advocacy day with the most attendees we’ve had in the past few years as well as those who participated in the federal visits.

We encourage you to reach out to your legislators and continue to build a relationship off session. You can always thank them for their efforts.

You may also contribute to the ORTHOPAC which supports candidates who understand the current and long-term challenges that orthopaedists face when practicing in New York.

At-A-Glance Orthopaedic Specific Issues
•   Defeat of inappropriate scope expansions by podiatrists, chiropractors and physical therapists
•   Defeat of efforts to impose a single payer system in NY
•   Defeat of several mandates related to opioid prescribing that would have imposed even more requirements on physicians prior to prescribing opioids
•   Defeat of numerous trial lawyer backed bills that would have: exponentially expanded awardable damages in wrongful death lawsuit; prohibited a defendant physician’s defense counsel from interviewing a medical malpractice plaintiff’s treating physician; and permitted the admissibility of certain “hearsay” statements of employees in civil actions. It should be noted that the Legislature did pass a couple of smaller measures opposed many groups that will affect certain cases involving multiple defendants and where an adverse judgment has been reached
•   Advancement of efforts to license athletic trainers
•   Passage of legislation to reduce insurer prior authorization (PA) requirements when a PA for a related procedure has already been received

Highlights on the behalf of the House of Medicine
•   Enactment of legislation which ensures that medical contraindications are the only acceptable exception to vaccine requirements;
•   Legislation that curtails health insurers making mid-year changes to their prescription formularies; or increasing patient cost sharing;
•   Defeat of legislation which would have legalized adult use marijuana, as well as proposals that would have significantly expanded the medical marijuana program. Instead legislation was enacted that provides further “decriminalization” of small amounts of marijuana
•   Defeat of the authorization of retail health clinics

Call for Abstracts - Orthopaedic Resident Poster Competition

Babette Atkins — Mon, 24 Jun 2019 15:52:02 GMT

Orthopaedic residents are invited to submit an abstract for a chance to present it at 2019 NYSSOS Symposium and Annual Meeting.

The meeting will take place on September 21-22, 2019 at the Gideon Putnam Resort and Spa in Saratoga Springs, New York.

Orthopaedic residents can submit abstracts in the following categories:

•   Research
•   Clinical
•   Quality, Advocacy and Public Policy

The deadline to submit your abstract is Friday, August 9, 2019.

> See complete details

Opioid Prescribing in NYS Down by 37.5% Over Five Year Period

Babette Atkins — Wed, 12 Jun 2019 17:07:29 GMT

Opioid prescribing by New York State physicians has decreased 37.5% percent between 2013-2018 and opioid prescriptions also decreased by 11.2% from 2017 to 2018 according to data recently released by the IQVIA, Danbury, CT, a data collection firm within the healthcare industry. The data is available here.

Additionally, the American Medical Association (AMA) has released its 2019 Opioid Progress Report—the third year that the AMA has reported on actions that physicians have taken to help end the nation’s opioid epidemic. The report shows significant decreases in opioid prescribing as well as increases in PDMP use and naloxone prescriptions. In addition to the national data, the AMA also released state-level data for opioid prescribing and PDMP use. New York State physicians and other users of the prescription monitoring program logged 23,931,571 inquiries in 2018, a 42% increase since 2014.

AAOS efforts
In November 2015, the AAOS released an information statement titled "Opioid Use, Misuse, and Abuse in Orthopaedic Practice." The document says, in part, "The AAOS believes that a comprehensive opioid program is necessary to decrease opioid use, misuse, and abuse in the United States. New, effective education programs for physicians, caregivers, and patients; improvements in physician monitoring of opioid prescription use; increased research funding for effective alternative pain management and coping strategies; and support for more effective opioid abuse treatment programs are needed."

During the 2017 Annual Meeting, the AAOS introduced a multimedia public service campaign to highlight the potential dangers of opioids. The campaign includes display and radio ads, urging doctors and patients to exercise caution in prescribing and taking opioids (Fig. 2). For more information, visit http://orthoInfo.org/PrescriptionSafety

Additionally, the AAOS has developed a Pain Relief Toolkit that can be accessed here: https://aaos.org/painrelieftoolkit/

NYSSOS President to Deliver Testimony on Single Payer

Babette Atkins — Fri, 24 May 2019 20:13:18 GMT

On Tuesday, May 28, 2019 the New York State legislature will hear public testimony on a proposal to create single payer system in the state.

The New York Health Act, A.5248/S.3577, would replace traditional health insurance coverage and public health coverage programs with single-payer health coverage, including long-term care, for all New Yorkers. The program would be publicly funded, including existing federal support for Medicaid and Medicare. New Yorkers would not be required to pay premiums, deductibles, co-pays, or out-of network charges.

This hearing is the first of a series of hearings that will provide an opportunity for comments and suggestions from stakeholders around the state on the New York Health Act.

NYSSOS President, James Slough, MD will testify on behalf of the Society. The Society plans to cite concerns regarding the impact on access to care should this proposal advance.

NYSSOS believes that expanding health care coverage and access should be implemented through a public-private partnership, and we strongly oppose proposals that create a federal health care authority or move health care
further in the direction of a single-payer health care system in New York State.

NYSSOS acknowledges the Sponsor’s efforts to add provisions that remove the requirement for prior authorizations for health care services. Additionally, we acknowledge the provisions to allow for health care providers to collectively negotiate with New York Health including payment rates and methodologies.

NYSSOS believes patients should receive access to health care coverage – including specialty care - without financial barriers or undue burdens placed on the patient or physician. The responsibility of financing appropriate
health care services must be a shared public-private cooperative effort that advances a patient-centered model for choosing affordable health care options

NYSSOS believes that as policymakers consider health care reforms they should:

Make certain that patients are empowered to control and decide how their own health care dollars are spent
Ensure unencumbered access to specialty care
Make health care coverage more affordable
Improve the value of care
Extend both coverage and access for the uninsured and under-insured
Avoid establishing new unsustainable programs
Support initiatives to examine the impact of proposals before implementation

To submit your own testimony, please visit this link for more details.

CBO Report Outlines Issues Associated with Single-payer Healthcare System

Babette Atkins — Tue, 07 May 2019 14:09:54 GMT

A new report from the Congressional Budget Office (CBO) detailed components and considerations that would be involved in implementing a single-payer healthcare system in the United States. Potential problems with a single-payer system include provider capacity issues and lack of health benefit and insurer choice, while benefits may include stronger purchasing power and reduced administrative costs.

Read the CBO Report

Contact Your Elected Representatives

Babette Atkins — Mon, 06 May 2019 19:05:35 GMT

NYSSOS continues to promote and represent viewpoints of the orthopaedic community before Federal and State legislative, regulatory and executive agencies through a variety of mechanisms.

We encourage you to take advantage of the online software that quickly enables you to send a message to your legislator as well as help engage your patients in voicing concerns and recommendations to their own elected representatives.

Educate yourself on the current issues and contact your elected representatives

Nominate a Colleague for the AAOS Diversity, Humanitarian, or Tipton Leadership Awards

Babette Atkins — Tue, 19 Mar 2019 22:00:00 GMT

AAOS is now accepting nominations for the 2020 Diversity and Humanitarian Awards and the William W. Tipton Jr, MD, Orthopaedic Leadership Award. These awards are presented at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. The last day to submit nominations for the Humanitarian Award is May 17; the last day to submit nominations for the Diversity and Tipton Awards is June 14.

> Learn more

First woman to assume top AAOS leadership role presents vision for an evolving Academy

Babette Atkins — Sat, 16 Mar 2019 16:08:11 GMT

History took center stage yesterday, as Kristy L. Weber, MD, stepped onto the Your Academy2019 podium and took office as the Academy’s 87th president. Dr. Weber is the first woman to serve in the top leadership role for AAOS.

In her speech, Dr. Weber, professor and chief of orthopaedic oncology in the Department of Orthopaedic Surgery at the Perelman School of Medicine at the University of Pennsylvania, acknowledged the progress that her 2019–2020 presidency of the premier orthopaedic organization represents, while recognizing that much work remains to be done before the profession and its culture are deemed truly inclusive of women and other underrepresented groups.

“I stand here today as a proud woman in a profession that is 94 percent male,” she said. “I really loved several different subspecialties in medical school but decided on orthopaedics after I was told that women couldn’t get in to the field. I have never regretted that decision for a minute.”

> Read more

Incoming VP Joseph A. Bosco III, MD, Speaks of an Empowering Academy

Babette Atkins — Sat, 16 Mar 2019 16:00:00 GMT

By: Terry Stanton

Incoming First Vice-President Joseph A. Bosco III, MD, emphasized the central role the Academy plays in enabling and empowering orthopaedic surgeons to provide high-quality, high-value care to patients during his address at yesterday’s Your Academy 2019 event.

In education, while surgeon learners have ever-increasing numbers of options from multiple sources, the Academy “remains the go-to resource for musculoskeletal learning and knowledge,” Dr. Bosco said. “This requires that AAOS serve many masters, from residents to the most experienced surgeons and from [general orthopaedic surgeons] to the most subspecialized among us.”

Orthopaedic surgery is in a “transformative time” that “presents an opportunity to maintain our preeminence in musculoskeletal care,” said Joseph A. Bosco III, MD, during yesterday’s Your Academy 2019.

Meeting the educational needs of so disparate a universe of physicians “is a daunting task,” he continued. “But through the leadership of Paul Tornetta III, MD, and a superb and dedicated staff, our educational offerings are evolving rapidly to meet these challenges. Whether it is individualized educational tracks here at our Annual Meeting, our new and improved Orthopaedic Video Theater (now a member benefit), or our new state-of-the-art Orthopaedic Learning Center, we provide educational offerings that serve every type of learner and subspecialist.”

The Academy’s Council on Advocacy, “led by Wilford K. Gibson, MD, and his dedicated team, work tirelessly to ensure that healthcare policy and government regulation serves to enhance our ability to provide high-quality, high-value care for our patients. Whether it is our industry-leading Orthopaedic Political Action Committee or our incessant lobbying on the Hill, the Academy is constantly working with policy leaders to ensure that our profession and patients’ needs are met.”

In the matter of quality, Dr. Bosco said, “By any means of measurement, we have always provided high-value, high-quality, life-altering care for our patients.” A central role of the Council on Research and Quality “is to demonstrate the quality of care we provide to our patients,” Dr. Bosco said. “It is not to tell us how to care for our patients. Through evidence-based data, it provides each of us the ability to make informed decisions on what is the best care for our patients.

“The transformative times [in which] we practice presents an opportunity to maintain our preeminence in musculoskeletal care,” Dr. Bosco said “As first vice-president, I will work tirelessly and closely with Incoming President Kristy L. Weber, MD, and our Incoming Second Vice-President Daniel K. Guy, MD, to serve you and our profession.”

As the Academy moves forward, he said, “There will be victories and perhaps [some setbacks], but rest assured that together, we will continue the transformative trajectory of our organization.”

Terry Stanton is the senior science writer for AAOS Now. He can be reached at tstanton@aaos.org.

Michael L. Parks, MD, receives American Academy of Orthopaedic Surgeons’ Diversity Award

Babette Atkins — Fri, 15 Mar 2019 16:00:00 GMT

LAS VEGAS (March 14, 2019)—In recognition of his dedication to advancing diversity in orthopaedics, the American Academy of Orthopaedic Surgeons (AAOS) today presented its 2019 Diversity Award to Michael L. Parks, MD, clinical director of Orthopedic Surgery at Hospital for Special Surgery (HSS) in New York City, during the organization’s 2019 Annual Meeting.

The Diversity Award recognizes members of the Academy who have distinguished themselves through their outstanding commitment to making orthopaedics more representative of, and accessible to, diverse patient populations.

“I am honored to be recognized by the AAOS,” Dr. Parks said. “In order to provide care for an ever-increasing diverse population, we must understand their needs. The diversity of our faces helps with this understanding and ultimately our ability to provide excellent care for the patients we serve.”

“Dr. Michael Parks has been involved in diversity-related conversations and ideas since the moment I met him,” said Ramon L. Jimenez, MD, Dr. Parks’ former mentor-turned-colleague. “He has always promoted diversity in a quiet and effective manner. He works tirelessly to point out and decrease disparities in musculoskeletal care.”

Dr. Jimenez, who also happens to be a past recipient of the AAOS Diversity Award, said Dr. Parks draws students in and offers advice and encouragement. “He knows how to look back, give back, and bring folks along,” said Dr. Jimenez.

Dr. Parks specializes in total joint replacement at Hospital for Special Surgery, where he serves as vice chair for Quality. He also serves on the hospital’s Board of Trustees and is an associate professor of orthopedic surgery at Weill Cornell School of Medicine.

Dr. Parks has led a number of research projects at HSS, with a particular interest in socioeconomic and racial disparities in access to arthritis care and total joint replacement surgery. He has published numerous journal articles related to joint replacement outcomes and racial differences.

In 2018, Dr. Parks was named president of the Orthopaedic Research and Education Foundation. He is a former president of the New York State Society of Orthopaedic Surgeons and has served on the Board of Directors of the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons.

Colleagues describe Dr. Parks as an exemplary leader who is actively involved in many organizations and teams working to break barriers across racial, ethnic and gender disparities for both patients and future physicians.

Valerae O. Lewis, MD, chair of the Department of Orthopaedic Oncology at MD Anderson Cancer Center, explained, “Dr. Parks is a skilled, thoughtful and caring colleague and surgeon. We need more orthopaedic surgeons like [him], a physician who works to conquer disparities within orthopaedics and within our health care system.”

Dr. Lewis notes Dr. Parks’ work earlier in his career as the chief of orthopaedics at North General Hospital in Harlem, where many black and Latino patients were at risk of not receiving needed treatment. Dr. Parks led the alliance efforts between North General and Mt. Sinai Hospital to improve patients’ access to care.

He currently serves on the steering committee of the Movement is Life Caucus, which seeks to understand and address disparities in musculoskeletal health care. Dr. Parks is also actively involved with Nth Dimensions, a nonprofit organization that works to increase representation of women and minorities in orthopaedic surgery.

Dr. Parks was born in Columbia, South Carolina. He graduated from Duke University with a Bachelor of Arts in Chemistry and went on to earn his medical degree from the Medical University of South Carolina in Charleston, where he received the President’s Clinical Science Award. After completing an internship in general and thoracic surgery, followed by an orthopedic residency at Duke University Medical Center, he continued his training at Hospital for Special Surgery with a fellowship on the Hip and Knee Service.

Photos of the award ceremony are available upon request.

# # #

About the AAOS

With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal health care issues and it leads the health care discussion on advancing quality.

For more information, contact:
Kayee Ip 847-384-4035 312-543-3211 ip@aaos.org
Kelly King Johnson 847-384-4033 217-377-9745 king@aaos.org

AAOS Board of Directors Approves Two Updated Clinical Practice Guidelines

Babette Atkins — Wed, 13 Mar 2019 16:00:00 GMT

On Monday, March 11, 2019, the AAOS Board of Directors approved the complete updates of both the Management of Rotator Cuff Injuries and the Management of Periprosthetic Joint Infections Clinical Practice Guidelines (CPGs).

Both CPGs were originally published in 2010, during a time when the available evidence for orthopaedic surgery was limited and the field of evidence-based medicine was still maturing at a rapid pace.

Learn more about the Management of Rotator Cuff Injuries CPG
Learn more about the Management of Periprosthetic Joint Infections CPG

Workers Compensation Issues Clarification of Drug Testing Rules

Babette Atkins — Mon, 11 Mar 2019 16:16:15 GMT

The new Medical Fee Schedule (Pathology and Laboratory section, Ground Rule 12), updating the reimbursement for services to injured workers, takes effect April 1, 2019. The NYS Workers Compensation recently issued guidance on clarifying that the Non-Acute Pain Medical Treatment Guidelines recommendations govern urine drug testing.

An excerpt of the Non-Acute Pain Medical Treatment Guideline criteria is provided as a reference.

The new Medical Fee Schedule incorporates standards from the Board’s 2014 Non-Acute Pain Medical Treatment Guidelines and offers guidance as to the frequency of urine drug testing based on the level of risk for each patient. The updated rules do not contain the same level of detail, medical analysis and instructions as are contained in the Board’s Non-Acute Pain Medical Treatment Guidelines. Every medical provider should always use any applicable Medical Treatment Guideline when providing treatment and care to a workers’ compensation patient.

The Medical Fee Schedule states in every section that the Medical Treatment Guidelines set forth the standard of care and will prevail when there is a conflict between the two documents.

In Ground Rule 12, the Medical Fee Schedule identifies low/moderate/high risk test results and behavior and provides guidance as to how frequently urine drug testing may be performed in a medical provider’s office. The chart in the Ground Rule indicates that testing should be performed at different frequencies depending on a patient’s level of risk. The NAP-MTG on page 54 includes a similar chart. The chart in the NAP MTG sets forth that urine drug testing should be performed at least the annual allowable indicated for the applicable level of risk. The NAP MTG provide more detail and set forth the medical standards required for managing patients being treated for non-acute pain management.

As set forth on page 54 of the Non-Acute Pain Medical Treatment Guidelines, Risk Category (Score) and Random UDT Frequency:

•   Low Risk patients should be tested at least once per year
•   Moderate Risk patients should be tested at least twice per year
•   High Risk patients should be tested at least 3-4 times per year
•   Any patient demonstrating aberrant behavior should be tested at the time of visit

For more information, please review the Non-Acute Pain Medical Treatment Guidelines, First Edition, September 15, 2014.

NYSDOH Advisory - Written Treatment Plans for Opioid Prescribing

Babette Atkins — Mon, 18 Feb 2019 21:55:51 GMT

On February 13, 2019, the New York State Department of Health provided the following advisory to physicians:

Effective April 1, 2018, a written treatment plan in the patient’s medical record is required if a practitioner prescribes opioids for pain that has lasted for more than three months or past the time of normal tissue healing.

There are exceptions for patients being treated for:

Cancer that is not in remission
Hospice or other end-of-life care and
Palliative care.

The treatment plan must follow generally accepted national professional or governmental guidelines, and shall include (but is not limited to) the documentation and discussion of the following clinical criteria within the medical record:

Goals for pain management and functional improvement based on diagnosis, and a discussion on how opioid therapy would be tapered to lower dosages or tapered and discontinued if benefits do not outweigh risks;
A review with the patient of the risks of and alternatives to opioid treatment; and
An evaluation of risk factors for opioid-related harms.

Such documentation and discussion of the above clinical criteria shall be done, at a minimum, on an annual basis.

For an example of a generally accepted national governmental guideline for prescribing opioids for chronic pain from the Centers for Disease Control and Prevention (CDC), visit https://www.cdc.gov/media/modules/dpk/2016/dpk-pod/rr6501e1er-ebook.pdf.

Additionally, AAOS has developed a Pain Relief Toolkit that can be accessed online: https://aaos.org/Quality/PainReliefToolkit/?ssopc=1

MIPS: Check Your Preliminary 2019 Eligibility

Babette Atkins — Thu, 14 Feb 2019 20:06:16 GMT

Check the Quality Payment Program Participation Status Tool to view your eligibility status for the 2019 performance period under the Merit-based Incentive Payment System (MIPS).

Enter your National Provider Identifier to find out if you need to participate in MIPS during the 2019 performance year.

For More Information:

About MIPS Participation webpage
2019 MIPS Quick Start Guide
QPP Year 3 Final Rule Overview Fact Sheet - Opens
2019 MIPS Eligibility and Participation Fact Sheet
Contact the Quality Payment Program at QPP@cms.hhs.gov or 866-288-8292 (TTY: 877-715-6222)

NYSSOS Calls on Members to Submit Resolutions

Babette Atkins — Tue, 05 Feb 2019 17:35:59 GMT

Let the House of Medicine hear your voice! Every member of the New York State Society of Orthopaedic Surgeons has the opportunity to provide input regarding the development of policies and positions impacting orthopaedic surgeons and we encourage you to get involved!

Working with NYSSOS Board of Directors, NYSSOS members have advocated for Resolutions that have covered a variety of issues including:

Fair Health Transparency
Use of High Molecular Weight Hyaluronic Acid to treat Knee Osteoarthritis
Pathology Specimens
WC Preferred Provider Organizations
Repeal of the New York State Medicare/Medicaid 20% Payment Charge
Truth in Advertisements or Marketing Materials to the Public

What is a Resolution?

Resolutions set forth background information and propose a course of action to change policy, laws and regulations at the state and federal levels.

Resolutions are constructed with background information ("Whereas" clause/s) and conclude with a specific proposal oh how to change the issue at hand ("Resolved" clause/s).

When Crafting a Resolution Keep in Mind the Following:

What do I want to change?
Is there existing policy, statute or regulation?
Who can effect the desired change?
Are there potential allies?
What are the financial consequences?

We will help you craft and refine your idea and then submit it for consideration at this year’s MSSNY House of Delegates Meeting. Please email Babette Grey, Executive Director at bgrey@nyssos.org

How OrthoInfo Helps Doctors Educate Patients

Babette Atkins — Tue, 11 Dec 2018 14:45:36 GMT

OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health.

The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living.

All content is developed and peer reviewed by AAOS members.

OrthoInfo articles can help patients be better informed and participate more fully in their care and recovery.

Visit the site today

Advocating for Student Loan Repayment Reform

Babette Atkins — Mon, 10 Dec 2018 22:30:00 GMT

At the Federal Level

The AAOS Office of Government Relations, along with 15 other medical specialties, has given its support to legislation that would help relieve interns and residents of student loan debt. The bill (H.R. 5734), introduced by Rep. Brian Babin, DDS (R-Texas), would allow medical or dental interns or residents to defer their loans, interest-free. > Read More

At the State Level

In 2008, New York enacted an initiative called the Doctors Across New York Program to help train and place physicians in underserved communities in a variety of settings and specialties to care for New York´s diverse population. The program offers two tracks: the Doctors Across New York Physician Practice Support and Physician Loan Repayment programs. Due to statutory For a 3-year service obligation, there is a maximum amount of $120,000 provided for loan forgiveness. Learn more bout the program

New Online Tool Displays Cost Differences for Certain Surgical Procedures

Babette Atkins — Tue, 04 Dec 2018 14:18:18 GMT

The Centers for Medicare & Medicaid Services (CMS) launched a new online tool that allows patients to compare costs for certain procedures that are performed in hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs).

The Procedure Price Lookup tool displays national averages for the amount Medicare pays and the national average copayment amount a beneficiary with no Medicare supplemental insurance would pay the provider.

For example, the average total cost of a total disk arthroplasty with diskectomy is $11,213 at an ASC versus $15,371 at a HOPD; the average total cost of an anterior cervical diskectomy is $7,337 at an ASC versus $10,123 at a HOPD.

University of Rochester Medical Center Achieves 100% Orthopaedic Physician Membership!

Babette Atkins — Thu, 29 Nov 2018 16:36:49 GMT

The New York State Society of Orthopaedic Surgeons would like to recognize Paul Rubery, MD, Chairman for the Department of Orthopaedics at the University of Rochester Medical Center, and his commitment to supporting the Society's efforts. The department also supported each of its residents with membership to the Society!

The New York State Society of Orthopaedic Surgeons (NYSSOS) is the premier organization representing the orthopaedic community in New York in all practice settings. Your support will enable us to advance our mission and continue to grow!

Thank you!

University of Buffalo Achieves 100% Orthopaedic Physician Membership!

Babette Atkins — Thu, 29 Nov 2018 16:30:36 GMT

The New York State Society of Orthopaedic Surgeons would like to recognize Leslie Bisson, MD, Chairman for the Department of Orthopaedics at the University of Buffalo, and his commitment to supporting the Society's efforts.

Thank you!

Webinar on 11/15/18: CMS Final Rule Overview

Babette Atkins — Thu, 15 Nov 2018 15:51:21 GMT

Thursday November 15, 2018 | 12:00 PM – 1:30 PM EDT

The Centers for Medicare & Medicaid Services (CMS) is hosting a webinar on Thursday, November 15, 2018 at 12:00 PM ET to provide information about the final rule for Year 3 (2019) of the Quality Payment Program.

During the webinar, CMS subject matter experts will:

Provide an overview of the Quality Payment Program, Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)
Discuss Year 3 MIPS and Advanced APM policy changes
Highlight key differences between Year 2 and Year 3 requirements
Review ways to connect to the no-cost technical assistance and identify additional resources where attendees can learn more.

The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers.

CMS will open the phone line for the Q&A portion.

If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com

AAOS Issues Statement on Potentially Misvalued Codes in 2019 Medicare Physician Fee Schedule

Babette Atkins — Tue, 13 Nov 2018 18:12:47 GMT

American Association of Orthopaedic Surgeons (AAOS) President David A. Halsey, MD issued the following statement in response to the Centers for Medicare and Medicaid Services (CMS) identifying potentially misvalued current procedural terminology (CPT) codes in the newly released 2019 Medicare Physician Fee Schedule Final Rule:

“The AAOS strongly disagrees with the assumption that the seven high-volume CPT codes, including 27130 (total hip arthroplasty) and 27447 (total knee arthroplasty), are potentially misvalued. Since they were last revalued by the RVS Update Committee (RUC) and CMS in 2013, there hasn’t been any evidence to suggest a change in physician work or practice expense.

“The nature of the reevaluation request is also problematic, which was made by a large for-profit managed care health insurance company. CMS did not identify the source, nor did it make the full communication publicly available in the proposed rule. We are troubled by this lack of transparency and failure to disclose a potential conflict of interest.

“Given these concerns, we do not believe that any further action is warranted and would advise against a review by the RUC and CMS. These procedures save the United States economy a combined $28 billion in lifetime societal savings, and any change to their relative value units (RVUs) could impair patient access to high quality orthopaedic care.”

For more information please visit:

http://newsroom.aaos.org/media-resources/Press-releases/misvalued-codes.htm

Be Advised: Extortion Scam Targeting DEA Registrants

Babette Atkins — Thu, 01 Nov 2018 14:14:09 GMT

DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. The criminals have masked their telephone number on caller id by showing the DEA Registration Support 800 number. Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant's DEA registration.

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through "Extortion Scam Online Reporting" posted on the DEA Diversion Control Division's website, www.DEADiversion.usdoj.gov.

Extortion Scam Online Reporting

For more information contact:
Locate DEA Field Office for your area - https://apps.deadiversion.usdoj.gov/contactDea/spring/fullSearch
Registration Service Center - 1-800-882-9539
Email - DEA.Registration.Help@usdoj.gov

President's Message: Helping You Improve Musculoskeletal Care

Babette Atkins — Wed, 31 Oct 2018 14:01:31 GMT

With November upon us, we are in an election season which will determine the ease or hardship we have fighting and advocating to take care of our patients, manage a practice, and maintain the physician-patient relationship.

Reduced regulations, easier or no pre-authorizations for indicated testing, appropriate reimbursements, malpractice/tort reform, antitrust relief, and more common sense Worker’s Compensation rules and regulations are some of the many things your NYSSOS Board is advocating for. We are involved with regulations and advocacy to help orthopaedic surgeons improve musculoskeletal care at the state and national level.

We had a successful and informative annual meeting at the University of Rochester in September. A special thanks to Sam Flemister MD for doing such a great job as program coordinator. Next year’s meeting will be in September in Albany and I would like to extend an invitation to all to attend for great educational talks along with advocacy and practice management updates.

We would like to thank and recognize outgoing NYSSOS President John Olsewski MD for his tireless work and advocacy on all of our behalves the past two years. He improved our fiscal stability, improved the Worker’s Compensation board relationship, started our MLMIC reduced nerve injury in total joint initiative which we will be rolling out next year, and has been fighting for eliminating silent PPO reductions below the New York State Worker’s Compensation rate which is currently increasing.

I encourage all Orthopaedic surgeons to make sure to join your New York State Society of Orthopaedic Surgeons (NYSSOS) and ask those who are already members to renew your membership.

We are stronger together and we represent all orthopaedic surgeons in the state whether private practice, academic or employed physicians, or physicians in training.

Please make a special point to encourage your partners or colleagues to join and also contribute to the OrthoPAC which is our advocacy arm. Society membership dues do not go to OrthoPAC and we have been growing the size, importance, and relevancy of our state PAC which goes to state issues and is separate from the AAOS PAC.

Please reach out to your District Representatives, your Board of Councilors, the NYSSOS Board, Babette Grey (our excellent Executive Director), or me with issues or concerns that come up so that we can be a resource and of assistance.

James Slough, MD
NYSSOS President
2018-2020

NY Workers' Compensation Board Launches Virtual Meetings

Babette Atkins — Mon, 29 Oct 2018 13:49:46 GMT

The NYS Workers' Compensation Board has launched a first-in-the-nation initiative that allows injured workers and other participants to attend workers' compensation hearings right from their homes or offices. The Board's virtual hearings provide a way to move the claim process forward without the need to travel many miles for a hearing that may last only minutes, which is especially beneficial depending on the extent of their injuries.

To participate in a virtual hearing, the party of interest needs only a smart phone, tablet or computer with a microphone and video camera, as well as a high-speed internet connection. All participants can see and hear each other on their respective screens. Additionally, workers’ compensation law judges can share claim documents with all involved parties. The system includes security.

The Board is also developing a mobile app, for future release, that parties may download and use to attend hearings.

Virtual hearings are entirely optional, and parties may now choose them over attending a hearing at a Board office. They can always choose to attend in-person if they prefer.

More information on virtual hearings, including instructional videos and other training materials, is at www.wcb.ny.gov/virtual-hearings.

Risk Management CME Course Now Available - Premium Discounts May Apply

Babette Atkins — Thu, 25 Oct 2018 22:26:36 GMT

NYSSOS is pleased to announce that MLMIC has designed an orthopaedic specific Risk Management CME program.

This course is available to NYSSOS members who are also MLMIC policyholders.

This program can meet the criteria to be eligible for CME+ applicable premium credit (5-12%).

For more details click here

Do You Want NY to Legalize Recreational Marijuana?

Babette Atkins — Tue, 25 Sep 2018 18:31:18 GMT

Governor Cuomo has called for a series of “listening sessions” across New York State to receive public comment regarding a proposal to legalize and regulate the recreational use of marijuana in New York State.

There are public health concerns with this proposal including but not limited to the following.

Intoxication
Carcinogenic effects
Respiratory illnesses
Altered mental status
Depression
Anxiety
Addiction

In the era of narcotic dependence and associated catastrophic outcome, the State of New York is seeking to legalize this substance. It is important to have a consistent and scientifically sound public health policy concerning this issue.

We encourage all physicians to participate in these listening sessions and provide your expertise and feedback.

Newburgh – Monday, October 1, 2018 – Register
Binghamton – Tuesday, October 2, 2018 – Register
Buffalo – Wednesday, October 3, 2018 – Register
Rochester – Thursday, October 4, 2018 – Register
Syracuse – Tuesday, October 9, 2018 – Register
Utica – Wednesday, October 10, 2018 – Register
Watertown – Thursday, October 11, 2018 –Register
Ronkonkoma – Tuesday, October 16, 2018 – Register
New Rochelle – Wednesday, October 17, 2018 – Register

Reducing Nerve Injuries in Joint Replacement Surgery - New NYSSOS/MLMIC Patient Safety Initiative

Babette Atkins — Tue, 18 Sep 2018 15:33:37 GMT

NYSSOS is excited to announce a new partnership with the MLMIC, New York’s largest medical malpractice liability insurance company for physicians, hospitals, and dentists.

Under the new partnership, NYSSOS and MLMIC seek to improve patient safety and quality of care while remediating the adverse medical malpractice environment in New York.

As part of its first endeavor, NYSSOS and MLMIC will execute programs dedicated to individual patient safety initiatives, such as the reduction in occurrence of nerve injuries after joint replacement surgery.

The official launch of the patient safety educational program will take place in early 2019. Details will be shared on the NYSSOS website at http://www.nyssos.org/and mlmic.com.

Having been founded by an orthopaedic surgeon by the name of Arthur J. Mannix, Jr., back in 1975, MLMIC shares a special connection with the specialty and has long been an advocate for the profession.

Learn more about this ground-breaking initiative at the upcoming NYSSOS annual meeting and symposium, scheduled for Saturday, September 22, 2018 at the University of Rochester School of Medicine and Dentistry in Rochester, New York. MLMIC representatives will be there to share details on the project. Click here to register for the meeting.

Early Bird Registration Ends Today!

Babette Atkins — Tue, 28 Aug 2018 14:34:34 GMT

Early Bird Rates End Today! Register Today and Save Your Seat

Meeting Features
This year's meeting features 20 different presentations geared to help you avoid complications and improve outcomes in common orthopaedic conditions. See complete schedule of events

Additionally, experts in the field will provide guidance on alternative payment models, medical aspects of the medical record and management of the injured worker.

Resident Education
New this year, Michael Rauh, MD, Clinical Assistant Professor from the University of Buffalo will prepare residents for practice after residency. Residents and medical students can attend for free!

2018 Legislator of the Year Award
We are proud to announce Senator Rich Funke and Assemblyman Michael Cusick as the honorees for the 2018 NYSSOS Legislator of the Year award. This award is bestowed to them for their commitment to preserving access to sports medicine physicians who provide high-quality, continuous care to team members and coaching staff.

Saying Thank You
This is your opportunity to thank NYSSOS President John M. Olsewski, MD, for his exceptional stewardship and guidance this past two years as we continue to enhance orthopaedic care throughout the state. Under his direction, the Society earned the title of 2017 AAOS State Society of the Year, has increased its services, strategic relationships, membership and financial stability

ACCREDITATION
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Rochester School of Medicine and Dentistry and the New York State Society of Orthopaedic Surgeons. The University of Rochester School of Medicine and Dentistry is accredited by the ACCME to provide continuing medical education for physicians.

CERTIFICATION
The University of Rochester School of Medicine and Dentistry designates this live activity for a maximum of 6.75 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Schedule Loss of Use Informational Webinar - Recording and Slide Deck Now Available

Babette Atkins — Mon, 06 Aug 2018 18:43:19 GMT

Recently, the New York State Workers Compensation Board provided training on the 2018 Impairment Guidelines' approach to assessing Schedule Loss of Use (SLU) permanent impairment. The new 2018 SLU Guidelines took effect January 1, 2018.

A recorded version of the webinar training, as well as a copy of the slide deck, are now available on the Impairment Guidelines page on the Board's website.

More information

For more information on the Schedule Loss of Use Guidelines, please visit the Impairment Guidelines page on the Board's website and the Workers’ Compensation Guidelines for Determining Impairment.

Questions? Contact 2018Guidelines@wcb.ny.gov.

Webinar Opportunity - The Physician's Role in Paid Family Leave

Babette Atkins — Mon, 30 Jul 2018 15:25:32 GMT

As a physician, you play a critical role in certifying medical documentation in a timely manner and raising awareness of Paid Family Leave among your patients and their families.

Physicians can determine if a patient with a serious health condition is in need of family care and help them receive the support they need. Additionally you can provide the required certification or documentation to patients and family members who request Paid Family Leave for either bonding with a new child or caring for a family member with a serious health condition.

This presentation will:

Provide an overview of New York's Paid Family Leave
Provide an overview of the health care providers' role in the process
Point you to helpful resources.

There are two opportunities to attend. There will be time at the end for questions and answers as well.

Tuesday, July 31, 4:00 p.m. - 5:00 p.m. Register here
Tuesday, August 7, 4:00 p.m. - 5:00 p.m. Register here

When you click 'Register here', you will be taken to a general information page. You must click 'Register' on the bottom of that page to sign up.

More Information

Complete details regarding Paid Family Leave are available at ny.gov/PaidFamilyLeave, including Employee and Employer request forms

Additionally, downloadable guides:

You can also call the Paid Family Leave Helpline at (844) 337-6303, Monday through Friday, 8:30 a.m. - 4:30 p.m. for more information or assistance

8/23/18 - Public Hearing on MLMIC’s Plan of Conversion and Acquisition by Berkshire Hathaway

Babette Atkins — Thu, 21 Jun 2018 15:30:00 GMT

A public hearing has been scheduled by the New York State Superintendent of Financial Services (the “Superintendent”), pursuant to Section 7307 of the New York Insurance Law, to consider the Plan of Conversion (the “Plan”) adopted by the Board of Directors of Medical Liability Mutual Insurance Company, a New York mutual insurance company (“MLMIC”).

The public hearing will be held at the offices of the New York State Department of Financial Services, One State Street, New York, NY, 10004 (6th floor in the main hearing room), beginning at 10 a.m. Eastern Daylight Time on August 23, 2018.

To view a digital copy of the entire notice of public hearing, click here.

To view a digital copy of the Plan of Conversion, click here.

For additional information about the transaction, visit our Frequently Asked Questions or call 1-888-998-7871.

We are Headed to Rochester in 3 Months and You're Invited to Join us!

Babette Atkins — Thu, 21 Jun 2018 14:57:24 GMT

The New York State Society of Orthopaedic Surgeons and the University of Rochester Medical Center are pleased to invite you to the:

NYSSOS 2018 ANNUAL MEETING AND SYMPOSIUM
“Pearls and Pitfalls in Diagnosis and Management”
Saturday, September 22, 2018

With over 20 presentations on topics ranging from the mutli-traumatized patient, to complex rotator cuff, this one day event is focused on providing you with the most current information in the field and opportunities to engage with the faculty for question & answer sessions.

N ew features for this meeting include: Guidance of APMs, Use of Self-Reported Outcomes, Managing the Injured Worker, Safe and Effective Opioid Prescribing

In addition, we are hosting a Resident luncheon on Navigating Entry into Practice

Take advantage of this one day event! Register today!

New Systematic Literature Review on the Management of Surgical Site Infections

Babette Atkins — Tue, 19 Jun 2018 13:42:05 GMT

AAOS developed a systematic literature review to provide the most up-to-date recommendations for the management of surgical site infections following orthopaedic surgery.

The systematic review includes recommendations regarding diagnostic criteria and associated risk factors, as well as antibiotic protocols and rifampin use.

This review is intended for use by orthopaedic surgeons, infectious disease specialists, and other providers who manage orthopaedic surgical site infections.

The review was developed by a 12-member multidisciplinary work group with representatives from seven societies. Systematic reviews are developed using the same methods as AAOS Clinical Practice Guidelines but focus on smaller topics that may have less available literature.

>Access the recommendations

Review Your Website for “ADA” Compliance

Babette Atkins — Mon, 18 Jun 2018 15:28:27 GMT

Legal Technology Alert: ADA Website Accessibility Lawsuits are on the Rise

It is important for all health care providers to ensure that their websites are fully accessible to persons with visual impairments or other similar disabilities.

The best practice for health care providers to follow is to have IT professionals conduct a comprehensive website audit, guided by counsel to preserve confidentiality.

In order to avoid litigation, practices should review their websites for compliance with the Americans with Disabilities Act (“ADA”).

Click here to learn more about reviewing your exposure.

Our Relationship Partners

Garfunkel Wild PC is general counsel to the Society. Our Garfunkel Wild's relationship partners are:

Barry Cepelewicz, M.D., Esq. (bcepelewicz@garfunkelwild.com)
Andrew E. Blustein, Esq. (ablustein@garfunkelwild.com)
James E. Dering, Esq. (jdering@garfunkelwild.com)

You can reach them by phone at: (516) 393-2230

NYS Workers Compensation Proposes Increase to Fee Schedule

Babette Atkins — Thu, 07 Jun 2018 16:19:32 GMT

On June 6, 2018, the New York State Workers Compensation Board released a proposal o to provide an “overall” 5% increase in the Workers Compensation medical fee schedule effective October 1, 2018.

To review how such increase is proposed to be implemented: http://www.wcb.ny.gov/content/main/hcpp/FeeSchedules.jsp

Comments are due to the WCB by August 5, 2018. NYSSOS Board and Worker's Compensation Task Force are reviewing the entire proposal and is seeking your feedback. Please send your comments to Babette Grey, Executive Director and cite how this proposal will impact your practice (positively or negatively).

Additionally, the proposed regulation cites the cost of ordering a hard copy of the fee schedule will be $100, and an electronic copy will cost $400. WC t testimony fee for physicians will also increase from $400 to $450.

NYSSOS has advocated for the past three years to include PAs in its eligibility of providers. However, we have expressed concern that the proposal would enable a nurse practitioner to assess an injured worker’s level of disability and determine causation of a patient’s injury without the involvement of a physician. S.8812A and A.8387-C in the Assembly and Senate seeks to expand the list of eligible providers to include acupuncturists, chiropractors, nurse practitioners, physical therapists, physician’s assistants, podiatrists, psychologists and social workers.

WC Announces Schedule Loss of Use Informational Webinars

Babette Atkins — Fri, 04 May 2018 15:48:49 GMT

As part of the 2017 executive budget, Workers’ Compensation law §15(3)(x) required the Workers' Compensation Board to implement new Permanency Impairment Guidelines for Schedule Loss of Use (SLU) evaluations. The new 2018 SLU Guidelines took effect January 1, 2018.

The Board's Medical Director and Senior Policy Advisor, Elain Sobol Berger, MD, JD will provide training in the 2018 Guidelines' approach to assessing SLU permanent impairment. Case studies will demonstrate how to apply the SLU principles and objective criteria in making an SLU determination.

There will be four webinars, so you can register for the time that works best for you. Each webinar will last approximately one hour and will include time for questions and answers. Space is limited, so please register early. When you click ‘register here’, you will be taken to a general information page. You must click ‘Register’ on the bottom of that page to sign up.

Wednesday, May 16, 8:30 a.m. - 9:45 a.m. Register here
Wednesday, May 16, 4:00 p.m. - 5:15 p.m. Register here
Wednesday, May 23, 8:30 a.m. - 9:45 a.m. Register here
Wednesday, May 23, 4:00 p.m. - 5:15 p.m. Register here

More information

For more information on the Schedule Loss of Use Guidelines, please see Subject No. 046-1011. The enabling regulation is set forth at 12 NYCRR 325-1.6, and is also available at the Board's website.

Workers' Compensation Board Announces Proposals to Reduce Administrative Burdens and Increase Fee Schedule

Babette Atkins — Tue, 24 Apr 2018 20:03:35 GMT

Last week, the New York State Workers' Compensation Board released a bulletin announcing efforts to increase provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care

The proposals are centered around an increase to provider fees and adoption of the universal CMS-1500 form to reduce administrative burden. Additional measures include the launch of a portal and increasing the recognition of provider types in the system.

NYSSOS has issued a statement to the NYS Workers Compensation Board as they explore these proposals.

(excerpts)

We applaud the New York Workers’ Compensation Board for undertaking a multipronged approach to increase access to quality medical care for injured workers.

We are optimistic the Board will use this opportunity to reflect and support the importance of the orthopaedic specialty and its role in advancing the appropriate care of an injured worker.

We acknowledge the importance of a care team in providing services to the injured worker, however we caution the Board that delays in direct, appropriate care can result in high percentages of patients not returning to work, essentially increasing costs to the overall system.

We stand ready to share our goal in returning the injured worker to maximal function, with the least residual impairment, and resume work safely in the shortest term possible.

We remain vigilant as to the potential impact the proposals may have on access to care. We are committed to promoting and representing viewpoints of the orthopaedic community and it patients throughout this process.

National Prescription Drug Take Back Day Scheduled for April 28th

Babette Atkins — Tue, 03 Apr 2018 17:53:43 GMT

April 28, 2018 - 10AM to 2PM

The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.

Locate a Collection Site Near You

Database will be active on April 1, 2018. Search by zip code or city/state to find a collection site near you.

Partnership Toolbox

Download posters, handouts and other materials to promote National Prescription Drug Take Back Day.

Drug Disposal Information

MIPS Data Submission Deadline Extended from March 31 to April 3rd

Babette Atkins — Thu, 29 Mar 2018 15:38:03 GMT

The data submission deadline for the Merit-based Incentive Payment System (MIPS) is March 31.

Resources to help you meet the deadline:

For More Information:

Quality Payment Program website
Resource Library webpage
Contact the Quality Payment Program Service Center at QPP@cms.hhs.gov or
866-288-8292 (TTY: 877-715-6222)

ON A SEPARATE BUT VERY IMPORTANT NOTE, ANY PAPER CLAIMS THAT CONTAIN HANDWRITTING IN OTHER THAN THE SIGNATURE FIELD WILL BE RETURNED AFTER April 30, 2018 and will need to be resubmitted in a TYPED format!

Oppose the Governors Budget Proposal to Lower NY's Safe Anesthesia Standards

Babette Atkins — Fri, 16 Feb 2018 18:17:45 GMT

Governor Cuomo's budget proposal includes a provision that would remove the physician supervision requirement for Certified Registered Nurse Anesthetists (CRNAs) and replace it with a poorly defined collaborative agreement.

This proposal would lower the standard of care for the administration of anesthesia and put New York's patients at increased risk.

Additionally, the proposal will grant up to 1,240 nurse anesthetists full prescribing authority upon obtaining a vaguely described "certificate," at a time when New York State is combating prescription drug and opioid abuse. This will exacerbate the crisis.

Email your state Assembly member and Senator to tell them to remove PART H in the budget bill S.7507/A.9507.

Use This Table to See Which APM is Categorized as MIPS or Advanced

Babette Atkins — Mon, 05 Feb 2018 19:07:13 GMT

Today, the Centers for Medicare and Medicaid Services (CMS) published a table displaying the Alternative Payment Models (APMs) that CMS operates.

In the table CMS identifies which of those APMs CMS has determined to be MIPS APMs or Advanced APMs.

See the table here: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Comprehensive-List-of-APMs.pdf

AAOS Issues FAQs on Coverage for 2018 Total Knee Arthroplasty

Babette Atkins — Wed, 31 Jan 2018 01:10:31 GMT

Until recently, total knee arthroplasty (TKA) was included on the Medicare inpatient-only (IPO) list.

The removal of TKA from the IPO has raised multiple questions.

Because of the significant amount of confusion surrounding this issue, AAOS is providing this list of frequently asked questions as an easily accessible resource.

Access resource: TKA IPO FAQs(2).pdf

AJRR Announces New Educational Blog

Babette Atkins — Mon, 08 Jan 2018 17:20:02 GMT

The American Joint Replacement Registry (AJRR)—an initiative of AAOS—is now offering a free educational blog to help improve orthopaedic care through the collection, analysis, and reporting of hip and knee arthroplasty data.

The blog will be updated each Wednesday and will cover a variety of topics, including:

Best practices
News alerts
Research findings on quality initiatives
Other relevant issues in the orthopaedic field

I'd like to read the Blog

New Workers Compensation Provider Registration Due by January 15th

Babette Atkins — Thu, 04 Jan 2018 15:17:24 GMT

Authorized providers are required to register with the Workers’ Compensation Board (Board) and update their office address(es) and contact information by January 15, 2018. This registration process will be an ongoing initiative every two to three years.

Health providers who have not registered by January 15, 2018 will

Be removed from the public directory of authorized providers, and
Become ineligible for the Board’s disputed bill process.

How to Register

The Board will use the existing New York State Health Commerce System (HCS) for the registration process and future updates to your registration information.

Log in at https://commerce.health.state.ny.us
Select My Content > All Applications from the Main Menu.
Select P from Browse by list, and then add Person-based Electronic Response Data System (PERDS) to your application list by selecting + under the column add/remove.
On the top of the page, select Home.
On the home page, select Refresh My Applications List. If PERDS does not appear in My Applications List call (800)-781-2362, option 6.
Select PERDS on the My Applications list to open it. DO NOT click the information icon (i).
Select the Data Entry tab located on the top left of page.
In the Activity field, select WCB Registration from the drop-down list.
The following default values will be shown:

Activity: WCB Registration

Form: WCB Registration for Health Care Provider

Data Entity Type: WCB Provider

Data Entity Name: Please Select Name

10. Select the Search WCB Provider button.

Search Entity (Validation of Information)

When you select the Search WCB Provider button, you are brought to the Search Entity page. On this page, please do the following:

The field Entity Id must be left blank for your initial registration.
Select the Profession from the drop-down list.
Complete the License Number, Birth Month and Birth Day fields.
Select the Search button.
If your information is correct, an Entity Id is displayed below the blue Search Entity line. Keep this number for your records. It is not stored in the registration form.
If the name that appears on the page is the same as it is on your license, click the Select button to proceed. If it is incorrect, select the Name Field Help icon for further assistance.

Complete the Registration Form

Complete your registration, be sure to click the Save All, Review & Submit and Submit to DOH buttons. This will ensure you are found on the public directory of authorized providers and remain eligible for the Board’s disputed medical bill process.

If you are registering multiple providers on their behalf, do not close the PERDS application after you register the first provider. For each subsequent provider:

Select the Home tab located at the top left of the page (next to the Data Entry tab).
Follow steps 7-10 in the How to Access the Registration Form section.
Follow steps 1-5 described above in the Search Entity (Validation of Information) section.

Questions?

For instructions that include screen shots of the registration process, please email wcbcustomersupport@wcb.ny.gov with the subject “Provider Registration Instructions”.

If you have general questions regarding health care provider registration, please contact the NYS Workers’ Compensation Board Medical Director's Office at (800)-781-2362, option 6.

CMS clarifies texting policy: Medical orders are not HIPAA compliant; most other texts are permitted

Babette Atkins — Wed, 03 Jan 2018 16:17:36 GMT

As seen in the January 3, 2018 edition of AAOS Headline News

The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a clarification to its policy on texting by healthcare providers.

A recent report from the Health Care Compliance Association suggested that CMS was requiring healthcare providers to halt all texting.

In response, the agency says that it "recognizes that the use of texting as a means of communication with other members of the healthcare team has become an essential and valuable means of communication among the team members. However, the agency states that the "practice of texting orders from a provider to a member of the care team is not in compliance with the Conditions of Participation (CoPs) or Conditions for Coverage (CfCs)," and goes on to note that, in order to be compliant with the CoPs or CfCs, "all providers must utilize and maintain systems/platforms that are secure, encrypted, and minimize the risks to patient privacy and confidentiality as per HIPAA [Health Insurance Portability and Accountability Act] regulations and the CoPs or CfCs.

It is expected that providers/organizations will implement procedures/processes that routinely assess the security and integrity of the texting systems/platforms that are being utilized, in order to avoid negative outcomes that could compromise the care of patients."

> Read the complete CMS Statement

Questions? Please email Marie.Vasbinder1@cms.hhs.gov

Seeking Public Comment: NYS Workers Compensation Board Announces Draft Regs for NYS Pharmacy Formulary

Babette Atkins — Fri, 29 Dec 2017 15:43:10 GMT

On December 28, 2017, The New York State Workers' Compensation Board (Board) announced the establishment and release of a proposed Pharmacy Formulary.

Governor Cuomo signed into law in April 2017 legislation that required the Board to establish a comprehensive prescription drug formulary by December 31, 2017.

Publication in the State Register on December 27, 2017 commences a 60-day comment period (which expires on February 26, 2018). The draft formulary and the associated regulations necessary for implementation are available on the Board's website.

The current draft proposes a July 1, 2018 effective date. However, the drug formulary and regulations will not become effective until the regulations are adopted and a final implementation date has been determined.

What is NYSSOS Doing?

The NYSSOS Board of Directors is reviewing the proposal at its January meeting. Anyone interested in sharing your feedback with the NYSSOS Board to be considered for incorporation with the Society's response, is asked to submit comments to: bgrey@nyssos.org

If you'd like, you can directly submit you comments on or before February 26, 2018. This includes requests to add/delete pharmaceuticals to the preferred list of the prescription drug formulary.

The Board will evaluate all comments received, and will consider necessary revisions as the process advances.

Now Available: 2018 Permanent Impairment Guidelines for Schedule Loss of Use Evaluations

Babette Atkins — Thu, 28 Dec 2017 15:51:00 GMT

As Posted by the New York State Workers' Compensation Board on December 28, 2017: http://www.wcb.ny.gov/content/main/SubjectNos/sn046_1011.jsp

Workers' Compensation law §15(3)(x), enacted as part of the 2017 executive budget, called upon the Board to implement new Permanency Impairment Guidelines for Scheduled Loss of Use (SLU) evaluations, with an effective date of January 1, 2018.

The Board announced the SLU Guidelines have been adopted, and are available on the Board's website. The enabling regulation is set forth at 12 NYCRR 325-1.6, and is also available at the Board's website.

NYSSOS believes and advocates that properly designed and efficiently run workers compensation programs can provide high-quality health care to injured workers and minimize their disabilities. NYSSOS is extremely appreciative for the unique opportunity to provide substantial contributions during the process.

However, NYSSOS is deeply disappointed in the substantial changes and deviations in methodology from the original proposal that NYSSOS submitted for consideration.

We invite you to share with us any issues or concerns that arise from using the new guidelines. They will be reported back to the NYS WCB.

The 2018 SLU Guidelines will replace chapters in the existing 2012 Medical Impairment Guidelines with respect to SLU, and will take effect January 1, 2018. The 2012 Guidelines remain unchanged for determining non-schedule permanent impairments.

For SLU claims that have at least one examination conducted before January 1, 2018, the Board will consider the issue of SLU to have been joined under the auspices of the Guidelines in effect at the time, and as such the Board will determine the claimant's degree of permanent disability using the 2012 Guidelines. Where the first medical evaluation of SLU occurs on or after January 1, 2018, the question of SLU will be evaluated under the 2018 SLU Guidelines.

Unsustainable Physician Reimbursement Rates

Babette Atkins — Fri, 27 Oct 2017 14:39:34 GMT

By: John Cherf, MD, MPH, MBA, and Alex Paul

The United States has the highest per capita healthcare spending in the world. U.S. healthcare costs have outpaced inflation for several years. Over the past 20 years, the federal government has attempted to control costs—specifically Medicare costs.

Cost reduction strategies often focus on specific segments of the healthcare market. These segments include hospitals, outpatient facilities, labs, drugs, physicians, rehabilitation, durable medical equipment, etc. Medicare has unique fee schedules for the various segments of the healthcare economy. The annual changes to these various fee schedules have not been uniform.

The most striking finding among various provider fee schedule changes was the Medicare Physician Fee Schedule (MPFS), which controls how physicians are paid by Medicare...> Read More

Orthopaedic Surgeons Clarify Differences Between Themselves and Podiatrists

Babette Atkins — Fri, 27 Oct 2017 14:37:52 GMT

Representatives of the American Orthopaedic Foot & Ankle Society (AOFAS) and AAOS were successful in changing legislation that would have labeled all podiatrists at the Department of Veterans Affairs (VA) as "physicians." It also would have raised salaries for podiatrists to make them equal to medical doctors (MD) and doctors of osteopathy (DO) as well as allow them unrestricted access to clinical leadership positions.

Due to their direct intervention, the result was legislation that reinforced the necessity of clinical leadership belonging to MDs and DOs as well as the "physician" title.

That success did not come overnight, however...> Read More

Risk Management Tips for Today's Medical Practice: Volume II

Babette Atkins — Wed, 25 Oct 2017 14:42:33 GMT

In the complex and busy world of healthcare delivery, physician practices may overlook basic office procedures that promote patient safety and reduce exposure to liability.

This handbook identifies potential risks and provides recommendations to mitigate them.

Each tip is designed to address a common issue in the office practice and provide practical guidance on how to employ best practices.

These easy-to-implement recommendations are a guide for physicians, other healthcare providers, and staff. The implementation of these recommendations may assist in preventing adverse outcomes, improving patient care, and minimizing liability exposure in the office practice.

Access the Guide

Tip #11: Using Chaperones During Physical Examinations
Tip #12: Promoting Communication Between Referring and Consulting Physicians
Tip #13: Handling Patients' Complaints Properly
Tip #14: Managing Drug Seeking Patients
Tip #15: Communicating and Following-Up Critical Test Results
Tip #16: Promoting Adherence to a Medication Regimen
Tip #17: Communicating with Low Health Literacy Patients
Tip #18: Discontinuing the Physician-Patient Relationship Properly
Tip #19: Treating Patients with Whom You Have a Close Relationship
Tip #20: Reducing the Risk of the Copy and Paste Function in Electronic Health Records

Submit Your Comments by October 23 - NYS Workers' Compensation Board Proposes New Permanency Impairment Guidelines

Babette Atkins — Sat, 21 Oct 2017 12:21:08 GMT

In this year's 2017 - 2018 Executive Budget, Governor Andrew M. Cuomo signed into law several significant pieces of workers’ compensation reform which includes new Permanency Impairment Guidelines (“Guidelines”) to be adopted by January 1, 2018.

On Tuesday, September 26, 2017, the New York State Assembly Labor Committee held a hearing to examine the proposal and listen to concerns expressed by stakeholders including, NYS Society of Orthopaedic Surgeons, organized labor, groups representing injured workers and trial attorneys.

Watch the re-broadcast of the NYS Assembly Labor Committee hearing.

Access a copy of the Workers Compensation Proposed Guidelines

We encourage you to read and comment on the NYS WCB proposed guidelines during the public comment period.

Comment Period
The public comment period is 45 days and will be open until October 23, 2017. Comments can be submitted using the following link: https://www.surveymonkey.com/r/ImpairGuideComments

For additional information
For more information regarding these proposed regulations, contact Heather M. MacMaster, Deputy General Counsel, Workers' Compensation Board 328 State Street, Schenectady, New York 12305-2318, telephone: (518) 486-9564 e-mail: regulations@wcb.ny.gov.

Risk Management - Use of Medical Assistants in Your Office

Babette Atkins — Mon, 16 Oct 2017 15:07:52 GMT

MLMIC has released its Fall 2017 issue of MLMIC’s Dateline® newsletter. Published twice a year (spring and fall), Dateline® focuses on risk management issues and improving patient safety, as well as keeping MLMIC policyholders apprised of changes in underwriting procedures, legal matters, legislative affairs, and many other matters of interest to physicians and healthcare facilities

In the Fall issue:

Use of Unlicensed Medical Assistants in the Physician’s Office

A significant number of physicians inappropriately use medical assistants or other unlicensed staff to assist in treating their patients in clinical settings and private offices and are unaware of the dangers of doing so.

Social Media: Responding to Unflattering Online Reviews

Used for social networking, professional networking, media sharing, blogging, and research and information gathering, the number of patients and healthcare professionals using social media has exploded in recent years.

Risk Management Tip #22

The Proper Use of Patient Portals.

New York and the End of Cost-Sharing for Essential Health Plans

Babette Atkins — Mon, 16 Oct 2017 14:52:34 GMT

President Trump's administration announced last week that it will immediately end subsidies that insurance companies and New York State receive to help pay for health care for lower- and middle-income people buying insurance on their own.

New York was one of two states (the other was Minnesota) to implement an optional benefit under the ACA known as the Essential Plan within the NY Health Exchange.

The Essential Plan offers health insurance with maximum premiums of $20 a month to New Yorkers who earn more than the limit allowed by Medicaid, up to 200 percent of the federal poverty level, or $27,720 for a single person. About 665,000 New Yorkers are enrolled in the Essential Plan.

For New Yorkers on the Essential Plan, the cost-sharing reductions go directly to the state to cover costs. This year the payments for the Essential Plan totaled about $925 million. Those payments will end if there were no more cost-sharing reductions.

For a full Q and A on the issue, see recent TimesUnion news article by Claire Hughes highlighting the impact.

Solo Practitioners - See if You Qualify to Become a Virtual Group

Babette Atkins — Thu, 12 Oct 2017 18:03:20 GMT

As proposed in the 2018 Quality Payment Program proposed rule, solo practitioners and groups can choose to participate in the Merit-based Incentive Payment System (MIPS) as a virtual group for the 2018 performance period.

To form a virtual group for 2018, solo practitioners and groups would need to engage in an election process.

For the 2018 MIPS performance period, the election period for virtual groups to make an election is from October 11, 2017 to December 1, 2017.

What is a Virtual Group?

CMS has proposed a virtual group to be a combination of two or more Taxpayer Identification Numbers (TINs) made up of:

A solo practitioner who’s eligible to participate in MIPS and bills under a TIN with no other National Provider Identifiers (NPIs) billing under the TIN, OR
A group with 10 or fewer eligible clinicians (at least 1 must be eligible for MIPS) that joins with at least 1 other solo practitioner or group for a performance period of a year.

How Do I Form a Virtual Group?

To form a virtual group, CMS has proposed a two-stage virtual group election process:

Stage 1 (optional): Solo practitioners and groups with 10 or fewer eligible clinicians may contact their designated Technical Assistance representative or the Quality Payment Program Service Center to determine if they are eligible to join or form a virtual group.
Stage 2: For groups that choose not to participate in Stage 1 of the election process, CMS will determine if they are eligible in Stage 2. During Stage 2, the virtual group must name an official representative who will submit their election to CMS via email to MIPS_VirtualGroups@cms.hhs.gov by December 1, 2017.

The election would include:

1. A written formal agreement between each of the virtual group members; and

2. Information about the TIN and NPI associated with the virtual group representative’s contact information.

For more information about joining or forming virtual groups, see theVirtual Groups Toolkit.

Need Help with the Election Process?

Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222). You can also contact your local support organization for support.

New MIPS Fact Sheets and Eligibility Resources Posted to CMS Website

Babette Atkins — Thu, 12 Oct 2017 15:00:24 GMT

The Centers for Medicare & Medicaid Services (CMS) has recently posted the following new Merit-based Incentive Payment System (MIPS) resources on the CMS website:

MIPS Quality Performance Category Claims Data Submission Fact Sheet: Provides an overview of how to submit data through your claims for the Quality performance category, and offers data collection and submission tips for you and your billing staff.
MIPS Eligible Measure Applicability (EMA) Resources: Includes an overview fact sheet and supporting documents that provide details about EMA analysis and how it affects your Quality performance calculation and score.

NYSSOS Recognized as AAOS State Society of the Year

Babette Atkins — Tue, 12 Sep 2017 18:54:26 GMT

The New York State Society of Orthopaedic Surgeons (NYSSOS) received the 2017 State Orthopaedic Society of the Year Award during the National Orthopaedic Leadership Conference (NOLC) in Washington, D.C. Gregory G. Gallant, MD, chair of the Board of Councilors State Orthopaedic Societies Committee presented the award to John M. Olsewski, MD, NYSSOS president.

Babette Grey, executive director of the NYSSOS, was honored as the 2017 Executive Director of the Year. Ms. Grey was recognized for her many accomplishments on behalf of the society, including lobbying for the adoption of a state educational program to train, examine, and license orthopaedic technologists and her efforts to curb a significant cut in workers' compensation reimbursement fees for orthopaedic care.

Dr. Gallant (left) and AAOS President William J. Maloney, MD (right) present Dr. Olsewski with the 2017 State Orthopaedic Society of the Year Award.

Dr. Gallant (left) and AAOS President Dr. Maloney (right) present Babette Grey with the 2017 Executive Director of the Year Award.

2017 Annual New York State Orthopaedic Symposium Jointly Provided by Hospital for Special Surgery

Babette Atkins — Tue, 12 Sep 2017 18:45:58 GMT

What's New in Orthopaedics
Saturday, September 23, 2017
On-site at HSS or Live Streaming

Hospital for Special Surgery
Richard L. Menschel Education Center
535 East 70th Street, 2nd Floor
New York, NY 10021
> REGISTER

Please join us at the 2017 New York State Society of Orthopaedic Surgeons Annual Symposium and Meeting on Saturday, September 23, 2017 at Hospital for Special Surgery in New York City.

If you prefer to mail in your registration, you may download the brochure here.

This year’s theme is “What’s New in Orthopaedic Surgery.” Through a joint providership with Hospital for Special Surgery, the Symposium will deliver brief, high yield presentations in all disciplines of orthopaedics followed by discussions with the audience.

Hospital for Special Surgery designates this live activity for a maximum of 7.0 AMA PRA Category 1 Credits™.

In addition, participants who elect to purchase and pass the OKU 12 test will receive up to 20 SAE credits.

New for 2017: For those unable to join us in person, we are pleased to offer an affordable live streaming option! > Register

Looking for information and resources for the Quality Payment Program, MIPS or APMs?

Babette Atkins — Sat, 09 Sep 2017 18:50:28 GMT

Don't put yourself at risk of a 4% penalty under MIPS. To check if you need to submit data to MIPS, enter your 10-digit National Provider Identifier (NPI) number.

If you're exempt from MIPS with the first review, you won't need to do anything else for MIPS this year. If you are included in MIPS, you may be exempt with the second review of eligibility determinations at the end of 2017. Learn more about MIPS eligibility.

To fully participate in MIPS you must report on 90-days of performance in three MIPS categories: Quality (formerly known as PQRS), Advancing Care Information (previously Meaningful Use), and Improvement Activities (new!).

Want to maximize your incentive eligibility? To earn the highest MIPS score you must take action before October 2 to plan and attest for a full 90-days of performance for MIPS Improvement Activities.

Check out the MACRA & Delivery Reform Information Center by visiting: www.aaos.org/MACRA-DelieveryReform/

2017 Orthopaedic Preferred Set of Specialty Measures (OPS List)

Babette Atkins — Fri, 08 Sep 2017 18:51:42 GMT

The Performance Measures Unit has finalized the 2017 Orthopaedic Preferred Set of Specialty Measures (OPS) that orthopaedic surgeons can use to comply with the Quality component of the MIPS reporting requirements.

Research Roadmap

Babette Atkins — Tue, 01 Aug 2017 18:52:18 GMT

Members of the AAOS Evidence-Based Medicine have created a set of tools to facilitate and encourage the conduct of high-quality research with the goal of establishing a stronger and more comprehensive evidence base for clinical practice guideline (CPG) recommendation and performance measure (PM) development. Drawing on methodology and resources utilized in guideline development, the Research Roadmap seeks to give researchers insight to improve or self-assess their work, regardless of level of

experience.

The Roadmap is available for free on the AAOS website (www.aaos.org/ResearchRoadmap) and includes resources related to: IRB approval, grant funding, study planning, study calculations, manuscript preparation, quality appraisal, and journal submission criteria.