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:
To submit your own testimony, please visit this link for more details.
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
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
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.
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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.”
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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.
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
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.
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.
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:
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:
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
Advocating for the orthopaedic surgeon, patients and musculoskeletal health in New York.
info@nyssos.org 1-518-439-0000 Address: PO Box 38004, Albany, NY 12203
