MEDICAL SOCIETY OF THE STATE OF NEW YORK Resolution

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					                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                          Resolution 2010-90

     Introduced by:        Medical Society of the County of Westchester, Inc.

     Subject:              Health Care Costs Task Force

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Health care costs are an increasing focus of Government health care regulation; and
 2
 3   Whereas, Reducing health care costs has bipartisan support; only the proposed methods of doing
 4   so are controversial; and
 5
 6   Whereas, Physicians conceive and enact all health care plans for patients; and
 7
 8   Whereas, Only physicians truly appreciate the costs associated with “defensive medicine”; and
 9
10   Whereas, Physicians are in the best position to think of ways to reduce health care costs and
11   eliminate wasteful spending; there be it
12
13   RESOLVED, That the Medical Society of the State of New York establish a task force to
14   explore methods to reduce health care costs in New York State and report back to the House of
15   Delegates in 2011.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                            Resolution 2010-91

     Introduced by:         Medical Society of the County of Westchester, Inc.
                            American Academy of Pediatrics, District II (missing from original resolution)

     Subject:               Child Health Plus Program

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, The New York State Department of Health established the Child Health Plus (CHP)
 2   program for children under the age of 19 who are not eligible for Children’s Medicaid and meet
 3   certain family income criteria; and
 4
 5   Whereas, HR 3590, the “Patient Protection and Affordable Care Act,” adopted by the US
 6   Senate in December 2009, includes a provision that would eliminate federal funding of the New
 7   York State CHP program under Medicaid; and
 8
 9   Whereas, Many children currently receiving medical services and treatment from physicians in
10   the CHP would be reassigned to the general Medicaid program, which already suffers from a
11   terrible physician participation problem due to pitifully low reimbursement rates; and
12
13   Whereas, Many children would lose their coverage or force New York state to incur
14   overwhelming costs to keep them covered; and
15
16   Whereas, Many New York children currently enrolled in and receiving medical care through the
17   CHP program would likely lose their access to a primary care physician; and
18
19   Whereas, While the New York State CHP program has less than adequate physician payment
20   rates, its rates are significantly better than those of the general Medicaid program and it currently
21   attracts a fair number of pediatricians, family physicians and specialists to take care of eligible
22   children; therefore, be it
23
24   RESOLVED, That the Medical Society of the State of New York (MSSNY) urge New York
25   State’s US Senators Schumer and Gillibrand, through any and all means deemed appropriate, to
26   strongly support the continued funding of the Child Health Plus program in New York State at
27   not less than current levels; and be it further
28
29   RESOLVED, That MSSNY communicate this position to the American Medical Association.
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                           Resolution 2010-92

     Introduced by:        Medical Society of the County of Westchester, Inc.
                           American Academy of Pediatrics, District II (missing from original resolution)

     Subject:              Medicaid Funding

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, On December 24, 2009, the US Senate passed HR 3590, the “Patient Protection and
 2   Affordable Care Act,” which, among other things, will result in an overall decrease in federal
 3   matching dollars to the New York State Medicaid program; and
 4
 5   Whereas, This decrease in Medicaid funding will exacerbate an already growing budget deficit in
 6   New York State; and
 7
 8   Whereas, Many hospitals and other providers in the state that depend heavily upon Medicaid
 9   reimbursement to provide medical services will either have to scale back or eliminate certain
10   services; and
11
12   Whereas, Patients who currently depend upon these services will lose access to medical care; and
13
14   Whereas, New York Senators’ Charles Schumer and Kirsten Gillibrand voted in favor of HR
15   3590; therefore be it
16
17   RESOLVED, That the Medical Society of the State of New York (MSSNY) urge Senators
18   Schumer and Gillibrand, through any and all means deemed appropriate, to only support Federal
19   health reform legislation which enhances and improves health care coverage for all New Yorkers
20   and to withdraw their support for any current or future legislation in the US Senate that will
21   result in any decrease in Medicaid funding to New York State; and be it further
22
23   RESOLVED, That MSSNY communicate this position to the American Medical Association.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                           Resolution 2010-93

     Introduced by:         Douglas M. DeLong, MD, As an Individual

     Subject:               Integrated/Accountable Care Organizations

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Currently the majority of physicians practice in solo or small group practices; and
 2
 3   Whereas, There is great interest in controlling health care costs through greater integration of
 4   physician services; and
 5
 6   WHEREAS, The long term utilization of current fee for service reimbursement appears
 7   unsustainable; therefore be it
 8
 9   RESOLVED, That the Medical Society of the State of New York (MSSNY) create a Task Force
10   to explore the barriers facing physicians who are attempting to form integrated/accountable care
11   organizations, and be it further
12
13   RESOLVED, That MSSNY in collaboration with the American Medical Association (AMA)
14   develop a plan to assist physicians as they move to integrated/accountable care organizations.
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                         Resolution 2010-94

     Introduced by:        New York Chapter, American College of Physicians

     Subject:              Methodology for Efficiency/Quality Indicator Data
                           Collection and Analysis

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)
     _____________________________________________________________________________________

 1   Whereas, “Quality” and “efficiency” evaluations are increasingly being used by organizations,
 2   including third-party payors; and
 3
 4   Whereas, Patient noncompliance may adversely affect a physician’s rating on such “quality” and
 5   “efficiency” evaluations; and
 6
 7   Whereas, At times although a physician-patient relationship is terminated, evaluators refuse to
 8   eliminate such patients from measurement calculations; and
 9
10   Whereas, It is patently unfair to penalize a physician for patient noncompliance with medical
11   advice that is clearly documented in the medical record; therefore be it
12
13   RESOLVED, That the Medical Society of the State of New York (MSSNY) seek legislation
14   and/or regulation that permits patient data to be excluded from calculations utilized to develop
15   physician profiles where medical advice and patient noncompliance are clearly documented, and
16   such noncompliance has an adverse effect on a physician’s “quality,” “efficiency” and/or other
17   similar rating; and be it further
18
19   RESOLVED, That MSSNY seek legislation and/or regulation that limits physician profiling data
20   to the time period that the doctor-patient relationship existed; and be it further
21
22   RESOLVED, That MSSNY introduce a similar resolution to the American Medical Association
23   House of Delegates.
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                         Resolution 2010-95

     Introduced by:        The Suffolk County Medical Society

     Subject:              Charge for Copies of Medical Records

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, New York State Public Health Law (PHL), Section 18, adopted in 1991 states the
 2   reasonable charge for paper copies of medical records shall not exceed seventy-five cents per
 3   page; and
 4
 5   Whereas, The law was amended to raise the fee to $1.00 in 2002, but was repealed before it took
 6   place; and
 7
 8   Whereas, Since implementation of PHL Sec. 18, the Medical Society of the State of New York
 9   (MSSNY) has adopted numerous policy positions seeking to increase the $.75 per page
10   limitation (180.988; 180.992; 180.999), however, this charge still remains intact; and
11
12   Whereas, Physicians’ overhead expenses continue to rise while reimbursement from insurance
13   companies has been drastically reduced; therefore be it
14
15   RESOLVED, That the Medical Society of the State of New York seek immediate change to the
16   New York State Public Health Law, Section 18, to allow physicians to charge a reasonable fee
17   which more accurately reflects the time and resources involved in locating, copying, and mailing
18   copies of patients’ medical records.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                      Resolution 2010-96 (CORRECTED VERSION)

     Introduced by:         The Suffolk County Medical Society

     Subject:               Truth In Advertising

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, In today’s economic environment, many physicians are looking at ways to supplement
 2   their incomes by becoming proficient in various ancillary procedures frequently unrelated to
 3   their practice specialty (i.e., doing laser hair removal); and
 4
 5   Whereas, Frequently, many physicians will advertise this new venture in local newspapers,
 6   physician’s office practice setting, and through other modes of communication; and
 7
 8   Whereas, The American Board of Medical Specialties (ABMS) is the largest physician specialty
 9   certification organization in the U.S. consisting of 24 of the 26 approved medical specialty
10   boards and which certifies specialists in about 145 specialties and subspecialties; and
11
12   Whereas, An advertisement may state that the physician is “board certified,” but not necessarily
13   identify the actual ABMS designated board certification; thereby implying that the physician is
14   board certified to perform these particular “ancillary” procedures; and
15
16   Whereas, None of these “ancillary” services/procedures have ABMS board certification
17   designation; and
18
19   Whereas, Patients can be misled to think that the physician is board certified to perform these
20   ancillary procedures; therefore be it
21
22   RESOLVED, That the Medical Society of the State of New York seek legislation/regulation
23   which would require that any advertisement for the performance of specific ancillary
24   services/procedures, which may be unrelated to a physician’s true board certification (i.e., laser
25   hair removal) clearly identify the physician’s actual ABMS board designation (or another
26   country’s equivalent), so as not to mislead patients regarding the physician’s actual credentials.
                           MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                            Resolution 2010-97

     Introduced by:         The Suffolk County Medical Society

     Subject:               Uniformity in Appearance of Generic Drugs

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, If a generic drug is written on a script and DAW (Dispense as Written) is not indicated, a
 2   pharmacist is not required to identify the brand name drug; and
 3
 4   Whereas, When a physician prescribes a brand name drug and authorizes the pharmacist to substitute
 5   a generic equivalent there is a potential for confusion between the brand name prescribed and the
 6   name of the generic substitution; and
 7
 8   Whereas, Additional confusion can exist for patients, especially those on chronic therapy, when a
 9   pharmacist refills a generic prescription with a product from a different generic manufacturer; and
10
11   Whereas, Not only do generic manufacturers use different names for the same brand, but the size,
12   shape and color of the generic drug can also differ considerable (ex: metoprolol tablets, 100 mg from
13   Mylan are round in shape and light blue in color, whereas the generic from Geneva are oblong in
14   shape and medium blue in color, and
15
16   Whereas, American Medical Association (AMA) Policy H-115.974 recommends a mechanism to
17   prevent or minimize the potential for confusion among patients when generic substitution occurs (see
18   attached); and
19
20   Whereas, Resolution 90-7 provides that “The Medical Society of the State of New York seek
21   changes in laws and/or regulations to require that when a generic substitution is made by a
22   pharmacist, the prescribed drug name be included on the label in addition to the generic drug name
23   and that the pharmacist notify the patient that the medication is generic;” and
24
25   Whereas, MSSNY Policy 70.981 stipulates “The Medical Society of the State of New York seek
26   legislation to provide that where there is generic substitution because the physician has not
27   designated ‘DAW,’ the pharmacist filling the prescription include on the label the words ‘Substituted
28   for’ (brand name);” therefore be it
29
30   RESOLVED, That the Medical Society of the State of New York (MSSNY) reaffirm Policy 70.981
31   which stipulates that “The Medical Society of the State of New York seek legislation to provide that
32   where there is generic substitution because the physician has not designated ‘DAW,’ the pharmacist
33   filling the prescription include on the label the words ‘Substituted for’ (brand name);” and be it
34   further
35
36   RESOLVED, That MSSNY advocate for legislation/regulation which would encompass the concepts
37   embodied in American Medical Association Policy H-115-974 specifically relating to the
38   identification of generic drug substitution by different manufacturers.
Attachment

The following statements, recommended by the Council on Scientific Affairs were, adopted by the
AMA House of Delegates as AMA policy at the 1999 AMA Interim Meeting.
              1. Policy H-115.974 is amended to read as follows: The AMA recommends
    (a) That when a physician desires to prescribe a brand name drug product, he or she do so by
        designating the brand name drug product and the phrase "Do Not Substitute" (or comparable
        phrase or designation, as required by state law or regulation) on the prescription; and when a
        physician desires to prescribe a generic drug product, he or she do so by designating the
        USAN-assigned generic name of the drug on the prescription.
    (b) That, except where the prescribing physician has indicated otherwise, the pharmacist include
        the following information on the label affixed to the container in which a prescription drug is
        dispensed: In the absence of product substitution,
        i) the brand or generic name of the drug dispensed;
        ii) the strength, if more than one strength of drug is marketed;
        iii) the quantity dispensed; and
        iv) the name of the manufacturer or distributor. When generic substitution occurs:
             i) the generic name (or, when applicable, the brand name of the generic substitute
                 ["branded" generic name]) of the drug dispensed;
             ii) the strength, if more than one strength of drug is marketed;
             iii) the quantity dispensed; iv) the manufacturer or distributor; and
             iv) either the phrase "generic for [brand name prescribed]" or the phrase "substituted for
                  [brand name prescribed]."
    (c) When a prescription for a generic drug product is refilled (e.g., for a patient with a chronic
        disease), changing the manufacturer or distributor should be discouraged to avoid confusion
        for the patient; when this is not possible, the dispensing pharmacist should satisfy the
        following conditions:
         i) orally explain to the patient that the generic drug product being dispensed is from a
             different manufacturer or distributor and, if possible (e.g., for solid oral dosage forms),
             visually show the product being dispensed to the patient;
        ii) replace the name of the prior generic drug manufacturer or distributor on the label
            affixed to the prescription drug container with the name of the new generic drug
            manufacturer or distributor and, show this to the patient;
        iii) affix to the primary label an auxiliary (sticker) label that states, "This medication
              contains the same active ingredient you have been getting. Color, size, or shape may
              appear different;" and
            iv) place a notation on the prescription record that contains the name of the new generic
            drug manufacturer or distributor and the date the product was dispensed.
The AMA will send this report, as expeditiously as possible, to the National Association of Boards of
Pharmacy.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                          Resolution 2010-98

     Introduced by:         The Suffolk County Medical Society

     Subject:               Direct-To-Consumer Advertising

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, According to a study by the Government Accountability Office, from 1997 through
 2   2006, the amount of money spent by pharmaceutical companies on direct-to-consumer (DTC)
 3   advertising grew almost 300% from $1.1 billion to well over $4.2 billion; and
 4
 5   Whereas, PricewaterhouseCoopers Health Research Institute and Life Sciences Industry Group
 6   concluded that only 10% of consumers, physicians, and researchers thought DTC ads provided
 7   complete and useful information; and
 8
 9   Whereas, Research also found that 94% of consumers, physicians and other interested parties
10   agreed that drug companies spend too much money on drug promotion; and
11
12   Whereas, Drug ads currently do not have to be reviewed before they are aired. The only
13   requirement is that after a first airing or appearance in a magazine, a copy must be submitted to
14   the Food and Drug Administration (FDA). However, it can be up to a year before the FDA
15   reviews it; and
16
17   Whereas, Although many ads can inspire dialogue between a patient and physician, very often
18   they take valuable time away from an already shortened office visit; and
19
20   Whereas, A recent study took a look at drug ads and found that while many did provide some
21   basic factual information, typically in the form of detailing symptoms, overall they provided
22   limited insight into the causes of a disease or who may be at risk; and
23
24   Whereas, Although the pharmaceutical industry has developed a broad set of guidelines for DTC
25   ads, they are purely voluntary and are not specific as to what the ads should include; and
26
27   Whereas, Physicians would have a more positive view of DTC advertising if they spent more
28   time talking about how patients must take greater responsibility for their own health; and
29
30   Whereas, American Medical Association Opinion 5.015 stipulates that the medical profession
31   needs to take an active role in ensuring that proper advertising guidelines are enforced and that
32   the care patients receive is not compromised as a result of direct-to-consumer advertising; and
33
34   Whereas, Opinion 5.015 further stipulates that since the FDA has a critical role in determining
35   the future direction of DTC advertising of prescription drugs, physicians must work to ensure
36   that the FDA remains committed to advertising standards that protect patients’ health and safety;
37   therefore be it
     Resolution 2010-98…Continued


38   RESOLVED, That, in keeping with the sentiments articulated in American Medical Association
39   (AMA) Opinion 5.015 which directs physicians to take an active role in ensuring proper
40   advertising guidelines that do not interfere with appropriate patient care, the Medical Society of
41   the State of New York (MSSNY) reaffirm Policy 227.997 which directs MSSNY to urge the
42   Food and Drug Administration (FDA) to require prior approval of all direct-to-consumer (DTC)
43   advertisements and that such advertisements include disease-specific information rather than
44   product specific information; and be it further
45
46   RESOLVED, That MSSNY urge the AMA to immediately explore enforcement and
47   implementation of the following (DTC) recommendations as adopted by the AMA Board of
48   Trustees at the 2006 Annual Meeting:
49
50         DTC ads should be indication-specific and enhance consumer education.
51         The ads should convey a clear, accurate and responsible health education message by
52          providing objective information about benefits and risks.
53         A statement such as “Your physician may recommend other appropriate treatments”
54          should be included.
55         Warnings, precautions and potential adverse reactions should be presented in a way that
56          will be understood by a majority of consumers.
57         The ad should include information about alternative non-drug treatments, such as diet and
58          lifestyle changes, when appropriate.
59         If factors portray health care professionals in ads, disclaimers should be prominently
60          displayed.
61         The FDA should review and pre-approve all DTC advertisements before they are run.
62         Congress should provide sufficient funding to the FDA to ensure effective regulation.
63         Ads for newly approved drugs or implantable devices should not be run until physicians
64          have been appropriately educated about the item. The length of a moratorium could vary.
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                          Resolution 2010-99

     Introduced by:        Medical Society of the County of Westchester, Inc.

     Subject:              Orthopedic Implant Extraction

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Orthopedic surgeons and other surgical specialists commonly use various implants to
 2   repair fractures and to correct abnormalities; and
 3
 4   Whereas, These implants (screws, plates, rods, etc.) are produced by various manufacturers; and
 5
 6   Whereas, These manufacturers commonly use different insertion and extraction devices for their
 7   implants; and
 8
 9   Whereas, It often occurs that an implant inserted in one institution may have to be removed or
10   adjusted at another institution, which may not have access to the appropriate extraction device;
11   therefore, be it
12
13   RESOLVED, That the New York State Delegation to the AMA introduce a resolution asking the
14   AMA to petition the Food and Drug Administration, or other appropriate agency, to require all
15   implant manufacturers to develop implant insertion and extraction devices which can be used
16   interchangeably in any surgical implant procedure.
                             MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                               Resolution 2010-100

     Introduced by:           Cayuga County Medical Society, Inc.

     Subject:                 Physicians to Control the Universal Health Network

     Referred to:             Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Physicians are the main source of knowledge, technical ability, and compassion for providing
 2   health care; and
 3
 4   Whereas, The government, health insurers and other health care organizations have failed to provide
 5   meaningful, efficient and effective health information systems; and
 6
 7   Whereas, Health information system vendors and government supported agencies have failed to
 8   overcome their proprietary and political constraints to provide practical and transparent health
 9   information systems; and
10
11   Whereas, Only a health information system directed, controlled and operated by physicians will best meet
12   the needs of the patients, the medical community, the public, the states and the nation; and
13
14   Whereas; The present political conflict between providing the best health care possible and providing for
15   the best use of our resources is only resolvable with a universal health information network to focus
16   market and public forces with validity and transparency; therefore be it
17
18   RESOLVED, That the Medical Society of the State of New York ask NY State for the responsibility,
19   authority and start up funding to develop a fully functional State universal health information network
20   that is open to all payers and providers; and that provides real time records, adjudication of all claims
21   prior to the time of service, payments for services rendered; and private and secure health and financial
22   analysis to patients, physicians, administrators, and the public; and be it further
23
24   RESOLVED, That the American Medical Association ask the Government of the United States of
25   America for the responsibility, authority and start up funding to develop a national fully functional
26   universal health information network as described above for the State of New York.
27
28   MSSNY House of Delegates 2007 Resolutions 103-107
29
30
31                        FINAL ACTION ON RESOLUTIONS 2007-103 THRU 107
32
33   103     Health Care Reform Based Upon Evidence Not Ideology
34           Introduced by Suffolk County Medical Society, Inc.
35           ADOPTED
36
37           RESOLVED, That, in recognition that the current health care delivery system model has
38           proven ineffective at the goals of cost containment, improved access, and improved
39           outcomes, the Medical Society of the State of New York actively engage in pursuit of a new
40           health care delivery system model that is primarily based upon evidence which supports
41           these stated objectives, and not reforms based just upon political or economic ideology.
     Resolution 2010-100…Continued


42   104       United States Health Care and Gratuitous Privatization
43             Introduced by Suffolk County Medical Society, Inc.
44             REFERRED TO COUNCIL
45
46             RESOLVED, That the Medical Society of the State of New York oppose health care policies
47             that tend to support the use of insurance products to achieve health care goals, in the
48             absence of evidence to support that insurance products are the most effective means of
49             achieving national health care goals of quality improvements, cost effectiveness, and
50             interoperability.
51
52             Council Action 3/3/08: NOT ADOPTED
53
54   105       Universal Health Care
55             Introduced by Westchester County Medical Society, Inc.
56             ADOPTED
57
58             RESOLVED, That the Medical Society of the State of New York oppose funding universal
59             health insurance through decreased reimbursement, or any tax on physicians.
60
61   106       The Role of Physicians in Health Care Reform in New York State
62             Introduced by Ninth District Branch
63             ADOPTED
64
65             RESOLVED, That the officers of the Medical Society of the State of New York seek
66             practicing member physician involvement in health care policy and reform in the state,
67             offering its own policies formulated by the Task Force on Health Care Reform, by
68             vigorously petitioning, lobbying and conferencing with the Governor’s office and the
69             Department of Health to be included as a key partner in any state-mandated health care
70             reform program.
71
72   107       Opposition to Any Proposed Increase in the Physician Biennial Registration Fee
73             Introduced by Suffolk County Medical Society, Inc.
74             SUBSTITUTE RESOLUTION ADOPTED
75
76             RESOLVED, That the Medical Society of the State of New York oppose any future increase
77             to the biennial physician registration fee.
78
79   American Medical Association Council on Medical Services 2006 Report
80   http://www.ama-assn.org/ama1/pub/upload/mm/38/a-06cms.pdf
81
82   MSSNY Policies
83   265.939    Electronic Billing: MSSNY supports the development of a universally acceptable
84              electronic claims methodology. (HOD 01-253; Reaffirmed HOD 03-268 and 278)
85
86   265.994         Determination of Where Medically Necessary Services Are to be Provided to Patients
87                   Enrolled in Managed Care Entities: MSSNY has adopted the position that in the event
88                   that a patient enrolled in a managed care program is referred to the emergency room of a
89                   local hospital following direct or verbal contact with a participating physician, this visit be
90                   covered and reimbursable whether categorized as emergent or not. (HOD 94-262)
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                         Resolution 2010-101

     Introduced by:        Bronx County Medical Society, Inc.

     Subject:              E-Prescription for Durable Medical Equipment and Diabetic Supplies

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Physician offices are increasingly adopting Electronic Health Record with ability to
 2   send E-Prescriptions
 3
 4   Whereas, E-Prescriptions are computer generated prescriptions created by the physician and sent
 5   directly to the pharmacy
 6
 7   Whereas, The number of prescribers routing prescriptions electronically grew from 74,000 at the
 8   end of 2008 to 156,000 by the end of 2009 – representing about 25 percent of all office-based
 9   prescribers*
10
11   Whereas, Although many pharmacies are enrolled, E-Prescription is yet to be adopted by all
12   pharmacies and mail order pharmacy
13
14   Whereas, E-Prescription offers many advantages including accurate, understandable and error
15   free prescription patient convenience as well as lowering cost of prescribing
16
17   Whereas, Medicare Improvements for Patients and Providers Act of 2008 (Section 132) and New
18   York State Medicaid offers incentive payment for E-Prescription to physicians; therefore, be it
19
20   RESOLVED, That the Medical Society of the State of New York encourage all physicians to
21   adopt E-Prescription and make the information about E-Prescription including incentive payment
22   from Medicare and Medicaid available to all physicians; and be it further
23
24   RESOLVED, That the Medical Society of the State of New York urge all pharmacies including
25   mail order pharmacies to accept E-Prescription from physicians.
26
27
28   *2009/10 National progress report on E-Prescribing by Surescripts.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                          Resolution 2010-102

     Introduced by:         Bronx County Medical Society, Inc.

     Subject:               Universal Automated Message Systems for Pharmacies

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Physician offices are obligated to call pharmacies for call-in prescriptions for patients;
 2   and
 3
 4   Whereas, Most large pharmacies have automated response system directing the caller to enter
 5   extension numbers to talk to the general store or pharmacy; and
 6
 7   Whereas, Patients use different pharmacies due to preference or due to contractual obligation
 8   between the insurance companies and pharmacies; and
 9
10   Whereas, Each pharmacy has a individual message system with different combination of
11   extensions which the physician must to listen and enter before being able to reach the
12   pharmacist; and
13
14   Whereas, Different messages at different pharmacies force a physician to listen to the whole
15   message before they can know which extension to enter in leading to lengthy delays before
16   reaching the pharmacist; therefore be it
17
18   RESOLVED, That the Medical Society of the State of New York (MSSNY) urge all pharmacies
19   to adopt a universal message system with a standard extension which will replace the current
20   pharmacy specific message system to reach the pharmacist; and be it further
21
22   RESOLVED, That MSSNY make the information about the universal message system available
23   to all physicians so as to avoid lengthy delays in calling in patients’ prescription.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                            Resolution 2010-103

     Introduced by:         The Suffolk County Medical Society

     Subject:               List of Patients Medications Provided by Pharmacist

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Elderly patients frequently take multiple medications for different diseases/ailments;
 2   and
 3
 4   Whereas, It is easy for elderly patients to forget the names and dosage of multiple medications,
 5   as well as the reasons why the medications have been prescribed; and
 6
 7   Whereas, The problem can be exacerbated when a patient encounters an emergency, is admitted
 8   to a hospital, or is prescribed a new medication by a physician who may not be aware of the
 9   patient medication history; and
10
11   Whereas, The eventual implementation of electronic medical records will make it easy for
12   physicians/hospitals to obtain accurate and up-to-date information on a patient’s medication
13   history; and
14
15   Whereas, There needs to be a mechanism whereby patients can keep track of the various
16   medications they are taking; therefore be it
17
18   RESOLVED, That the Medical Society of the State of New York seek legislation/regulation
19   which would require all pharmacists licensed in the State of New York to provide individuals
20   with a complete listing of all their medications each time a prescription is filled; and be it further
21
22   RESOLVED, That the above referenced list include the name of the drug (brand and generic, if
23   appropriate) dosage, diagnoses for which the drug was prescribed, and any other identifying
24   information which will assist the individual in recognizing and understanding the medications
25   they are taking.
                              MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                                 Resolution 2010-104

     Introduced by:           The Suffolk County Medical Society

     Subject:                 Establishment of Guidelines to Assess the Accuracy & Reliability
                              of Health-Related Information Found on Internet Web Sites

     Referred to:             Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Everyday, more and more people are relying on the Internet to obtain medical information; and
 2
 3   Whereas, There are literally thousands of web sites devoted exclusively to medically-related information
 4   which people are consistently relying upon to “self diagnose” a disease or symptom; and
 5
 6   Whereas, Most people are not aware of a mechanism to substantiate the authenticity of the information on
 7   these sites; and
 8
 9   Whereas, Undocumented/unproven medical information has the potential of causing serious harm to
10   individuals; and
11
12   Whereas, Of particular concern is the uncertain quality of medical advice provided on many sites, as well
13   as the lack of scientific-based evidence behind claims made by commercially available treatment options;
14   and
15
16   Whereas, There is no common legal framework for the provision of health information on the Internet;
17   and
18
19   Whereas, “Health On The Net Foundation” (HON) which was launched in 1996, verifies the accuracy and
20   reliability of information on health-related web sites, etc.; and
21
22   Whereas, Health sites approved by the HON Foundation have a red and blue “seal of approval” which
23   tells users that they adhere to a particular code of conduct, and that the information on that particular site
24   can be considered reliable; and
25
26   Whereas, The general public needs to be educated as to the accuracy of health-related information
27   currently available on the Internet; therefore be it
28
29   RESOLVED, That the Medical Society of the State of New York (MSSNY) urge the appropriate state
30   agencies to develop and promote guidelines to assist consumers in assessing the accuracy and reliability
31   of health-related information found on medical Internet web sites; and be it further
32
33   RESOLVED, That, if appropriate and after necessary due diligence, MSSNY recommend that the above-
34   referenced guidelines include information about the “Health On The Net Foundation” which verifies that
35   the information on a particular site is reliable and that the site and provided information has adhered to a
36   standardized code of certification; and be it further
37
38   RESOLVED, That Google, Yahoo, and other key Internet search engines, be encouraged to link only to
39   Internet web sites (providing health-related information) that have adhered to standardized codes of
40   certification which have verified the accuracy and reliability of the listed information.
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                          Resolution 2010-105

     Introduced by:        The New York County Medical Society

     Subject:              The CMS Electronic Medical Records Initiative Should
                           Not Be Used To Detect Alleged Fraud by Physicians

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, To finance healthcare reform initiatives, the Federal government plans to use program
 2   monies that have been saved via the vigorous identification and prosecution of fraud, waste, and
 3   abuse, and the Centers for Medicare and Medicaid Services (CMS) plans to sharpen its fraud,
 4   waste, and abuse detection activities accordingly; and
 5
 6   Whereas, CMS has long focused on rates of errors as a way of finding generally negative trends
 7   in Medicare claims payments (often using these rates as a “launch point” for physician audits and
 8   reviews), but now is particularly scrutinizing these rates as possible indicators of fraud, waste
 9   and abuse (in fact, CMS was directed in 2009 to revise and improve its calculation of error rates
10   in order to help spotlight fraud, waste and abuse); and
11
12   Whereas, That strategy by CMS is of great concern and may be erroneous, since improper
13   payments often do not signal actual fraud by physicians—rather, improper payments may just
14   signal unintentional coding and billing errors (indeed, CMS itself acknowledges that rates of
15   improper payments are not necessarily an indicator of fraud in Medicare or any other federal
16   health care program); and
17
18   Whereas, One stream of data that CMS is particularly studying for this purpose is the data
19   obtained via the new electronic health record reporting initiative; and
20
21   Whereas, That strategy by CMS is also of great concern, since up to now the electronic health
22   record reporting initiative and its accompanying physician incentives have been portrayed in a
23   positive light, as ways of streamlining and improving medical care, but now, these initiatives
24   may turn out to be a way of trapping physicians; therefore be it
25
26   RESOLVED, That the Medical Society of the State of New York (MSSNY) communicate to the
27   American Medical Association (AMA) its concerns about the plan recently announced by the
28   Centers for Medicare and Medicaid Services (CMS), in which CMS is to use data from the
29   electronic medical record incentive program in the pursuit of fraud, waste and abuse; and be it
30   further
31
32   RESOLVED, That MSSNY urge the AMA to seek active involvement in the drafting of all
33   program directives for CMS’s electronic medical record initiative, including all directives about
34   potential data capture and subsequent audit processes.
                         MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                           Resolution 2010-106

     Introduced by:         The New York County Medical Society

     Subject:               The PQRI Reporting Standard Should Be Amended

     Referred to:           Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, The Centers for Medicare and Medicaid Services (CMS) has launched two “sister”
 2   incentive payment programs, the Physician Quality Reporting Initiative (PQRI) Program and the
 3   E-Prescribing Program; and
 4
 5   Whereas, Each of these programs has its own unique reporting standard, which the physician
 6   must meet in order for CMS to properly calculate any incentive payments due to the physician;
 7   and
 8
 9   Whereas, For the E-Prescribing Program, the standard used to be relatively rigorous, but has now
10   been relaxed (in 2009 the physician had to include a special e-prescribing code on at least 50%
11   of a certain category of claims, but for 2010 the physician only has to include the code on 25 of
12   those claims, representing 25 occurrences); and
13
14   Whereas, For the PQRI Program, on the other hand, Medicare has not relaxed its standard (the
15   2010 standard is identical to the 2009 standard – the physician must still report at least three of
16   the PQRI Quality Measure Codes, and must still apply those codes to at least 80% of his/her
17   patients); therefore be it
18
19   RESOLVED, That the Medical Society of the State of New York (MSSNY) petition the Centers
20   for Medicare and Medicaid Services (CMS) to reassess the reporting standard of the Physician
21   Quality Reporting Initiative (PQRI) in view of the fact that this standard is difficult to meet,
22   requiring the physician to report at least three Quality Measure Codes and apply those codes to
23   80% of his/her patients; and be it further
24
25   RESOLVED, That MSSNY work with CMS to establish a clinically appropriate but less
26   demanding standard for the PQRI Program, e.g., an occurrence-based standard similar to the
27   standard used by the 2010 E-Prescribing Program (in which the physician is only required to
28   submit the special e-prescribing code on 25 claims, representing 25 occurrences).
                        MEDICAL SOCIETY OF THE STATE OF NEW YORK

                                                         Resolution 2010-107

     Introduced by:        Nassau County Medical Society

     Subject:              Delay of the Physician Quality Reporting Initiative (PQRI) Program

     Referred to:          Reference Committee on Governmental Affairs and Legal Matters (B)


 1   Whereas, Medicare will soon impose mandatory physician participation in the Physician Quality
 2   Reporting Initiative (PQRI) program; and
 3
 4   Whereas, The PQRI program has proven to be very cumbersome and difficult for physician
 5   participation; and
 6
 7   Whereas, Only 50% of physicians attempting to comply with the PQRI system were able to do
 8   so; therefore be it
 9
10   RESOLVED, That the Medical Society of the State of New York ask the American Medical
11   Association to work toward delaying Medicare’s mandatory physician participation in the
12   Physician Quality Reporting Initiative (PQRI) system until the system has been refined to the
13   point where it is more efficient and physician friendly.

				
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