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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