In New York, 1 in 38 babies are born with a congenital anomaly. On average, children with congenital anomalies can expect anywhere from three to five surgical procedures throughout their childhood to restore a more normal appearance and function.

Although insurance carriers may provide coverage for the initial procedures, they may resist coverage of the later stage procedures, claiming they are cosmetic and not medically necessary. Denial or delay of these procedures – which by definition are reconstructive – could lead to long-term physical, functional, and psychological injuries.

Join us in the campaign to Give Kids a Chance and modify existing laws to ensure there is insurance coverage for congenital anomalies. Learn more > www.1in38.org

PRESIDENT'S MESSAGE As many of you know, in 2017, the NYS Department of Health (NYSDOH) implemented an adverse event monitoring program for office-based surgery (OBS) facilities. As part of an initial pilot program that began in 2017, OBS practices were asked to voluntarily file reports with the NYSDOH. Approximately 18% of all OBS practices in NY State voluntarily filed reports with NYSDOH in 2017 and 2018. In late 2018, NYSDOH issued a proposed regulation that would have mandated specific annual reporting by all OBS practices. Our Society reviewed the proposed changes to 10 NYCRR 1000 and found that such regulatory changes would require burdensome and costly monitoring/tracking by OBS practices. The proposed regulations could have made office-based surgery economically untenable for small OBS facilities like those run by many plastic surgeons. We filed rational objections during NYSDOH’s public comment period and also brought to the attention of NYSDOH many of the mechanisms, already in place, that facilitate patient safety in the accredited OBS facilities in which board-certified plastic surgeons operate. I am pleased to share with you that, following the public comment period in which the NYSSPS vigorously opposed the proposed regulatory changes, NYSDOH announced that OBS practices will not be mandated to report under the OBS monitoring program for 2019. Furthermore, the NYSDOH indicated that alternative data sources for procedural monitoring—that would hopefully be less burdensome—will be sought.  We will continue to monitor any proposed changes to the OBS reporting regulations, and work to keep OBS in NYS both safe and economically viable for plastic surgeons and their patients. Thank you for your membership to the NYSSPS as is vital to our advocacy efforts - this is but one example!   Best, David T. Greenspun, MD, MSc, FACS NYSSPS President

NYSSPS is proud to announce that it is working to advance efforts in the state to address insurance coverage for congenital anomalies. With support from ASPS, the Society will educate the public and policymakers on the importance to expedite care for those impacted with by congenital anomalies and seek legislative and regulatory changes to the existing law. More information on how you can become involved will be released in the coming weeks. 

The 1in38 Campaign will focus it efforts on the following: 

Educate

One in 38 New York babies are born with a congenital anomaly.

Nationally, of the 120,000 children born annually with congenital anomalies, approximately 40,000 require reconstructive surgery. 

Although surgeons are able to correct many of these problems, some insurance companies deny or excessively delay access to care by labeling the procedures not medically necessary–“cosmetic,” or “non-functional” in nature.

Although carriers may provide coverage for initial procedures, they may resist coverage of the later stage procedures by claiming they are cosmetic and/or not medically necessary. 

Regulate

Proactively address delays and denials of coverage for procedures and therapies.

Legislate

Require all health insurance policies to cover medically necessary procedures and therapies.

The NYS Society of Plastic Surgeons issued its opposition today to the NYS Senate Health Committee to advance legislation that would remove the rights of hospitals and insurance carriers to include standards for credentialing and privileging practices. 

NYSSPS and ASPS are committed to ensuring  patients have the best care possible, and  believe that, across the practice of medicine, such a commitment requires physicians to: (1) stay abreast of the latest clinical research and standards of care; (2) demonstrate their mastery of the latest knowledge through objective and reliable assessment methods; and (3) integrate this knowledge into their practice. 

NYSSPS believes the commitment to lifelong learning and clinical practice improvement that board certification and maintenance of certification (MOC) represent are appropriate criteria for hospitals and insurers undergoing credentialing. 

It does not necessarily think MOC should be a mandated requirement in every state and facility, however, it does believe that S5280/A5140 undercuts the rights of hospitals and insurance carriers to determine what standards are required for participation. 

The government should not dictate standards to experts on credentialing and privileging committees, as these determinations are made through highly-specialized evaluations. 

This bill takes decisions that should be in the hands of doctors and places them in the hands of policymakers. Board certification is unquestionably an appropriate criterion to consider in licensure and for credentialing a physician to a hospital staff or an insurance network, and legislative efforts to undermine its relevance are unwise.

> For the complete memorandum, please contact the NYSSPS office. 

The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, and the exclusively endorsed carrier for the NYSSPS and ASPS^®, has announced a $10 million dividend. Since 1976, The Doctors Company has paid more than $425 million in dividends.

The 2019 dividend, approved by The Doctors Company Board of Governors, will provide a credit of 7 percent to eligible members in ASPS.

Eligible members will receive this year’s dividend on their annual premium for policy renewals on or after July 1, 2019.

For more information, please contact:

Brian Dalton
Assistant Vice President, Business Development
The Doctors Company, Northeast Region
105 Maxess Road, Suite 124, Melville, NY 11747
Mailing Address: PO Box 1471, East Lansing, MI 48826
Direct: (631) 248-2701, Toll Free: (800) 748-0465, extension 2701
Brian.Dalton@thedoctors.com

On February 13, 2019, the New York State Department of Health provided the following advisory to physicians: A written treatment plan in the patient’s medical record is required if a physician prescribes opioids for pain that has lasted for more than three months or past the time of normal tissue healing.

There are exceptions for patients being treated for:

• Cancer that is not in remission
• Hospice or other end-of-life care and
• Palliative care.

The treatment plan must follow generally accepted national professional or governmental guidelines, and shall include (but is not limited to) the documentation and discussion of the following clinical criteria within the medical record:

• Goals for pain management and functional improvement based on diagnosis, and a discussion on how opioid therapy would be tapered to lower dosages or tapered and discontinued if benefits do not outweigh risks;
• A review with the patient of the risks of and alternatives to opioid treatment; and
• An evaluation of risk factors for opioid-related harms.
  
  

Such documentation and discussion of the above clinical criteria shall be done, at a minimum, on an annual basis.

For an example of a generally accepted national governmental guideline for prescribing opioids for chronic pain from the Centers for Disease Control and Prevention (CDC), visit https://www.cdc.gov/media/modules/dpk/2016/dpk-pod/rr6501e1er-ebook.pdf.

NYSSPS ANNUAL ADVOCACY DAY 
Tuesday, May 21, 2019

Albany, NY 

On Tuesday, May 21st, 2019 you are invited to advocate for your patients and the profession during the annual New York State Society of Plastic Surgeons Annual Advocacy Day. 

The day will begin with a legislative briefing of the issues and “asks” as well as a discussion on how to maintain and advance relationships with lawmakers.

 Appointments are scheduled to begin at 10:00am and end at 4:00pm. 

Why Advocate?

• Advocacy ensures issues affecting plastic surgeons and patients are recognized
• If you don’t have a seat at the table, you’re on the menu 
• Regardless of your politics, the consequences of state policy affect your daily practice and cannot be ignored

Registration is open and available

ASPS Advocacy Summit

June 17-19, 2019
Washington Court Hotel
525 New Jersey Ave NW
Washington, DC 20001

Brought to you by the ASPS Legislative Advocacy Committee and the PlastyPAC Board of Governors

• Meet with your U.S. Senators and Representative
  
• Participate in workshops to learn more about the state, federal and regulatory issues facing the specialty
  
• Shape the Society's advocacy agenda by determining ASPS's federal and state policy priorities
  
• Learn first-hand from congressional staff, administration liaisons and political analysts about the future of healthcare
  
• Network with leaders from ASPS and local, state and regional plastic surgery societies
  

As a board-certified plastic surgeon and an ASPS member, you have the experience, knowledge and ideas to inform Congress before they craft and vote on public policy matters affecting the practice of medicine and the care your patients receive.

Speak with one voice in Washington, D.C. at the 2019 ASPS Advocacy Summit!

Register Today!

On November 15, 2018, the New York State Society of Plastic Surgeons (NYSSPS), sent a letter to Marcus Friedrich, MD, Chief Medical Officer at the NYS Department of Health, citing concerns regarding the vagueness of the recently released regulations seeking to mandate procedure reports for office-based surgical practices. 

As written, the Society noted that the proposed regulation does not meet the standards of rule making and lacks specificity in how, when and what the NYS DOH will require of practices, making the opportunity for plastic surgeons to provide meaningful comment as to the impact this will have on their practices null and void.

NYSSPS appreciates the opportunity to continue to work with the New York State Department of Health in furthering quality improvement while protecting patients.  However, as written, does not support efforts by the DOH to grant itself broad discretion to define what information OBS practices must report, as well as the form, format and timing of such reports. 

The Society urged DOH to re-publish a proposed regulation that provides the public with a meaningful opportunity to clearly understand the expectations of the department.

NYSSPS Comment Letter
Proposed Regulations 

Thursday November 15, 2018 | 12:00 PM – 1:30 PM EDT
Register Here: https://engage.vevent.com/index.jsp?eid=3536&seid=1288  

The Centers for Medicare & Medicaid Services (CMS) is hosting a webinar on Thursday, November 15, 2018 at 12:00 PM ET to provide information about the final rule for Year 3 (2019) of the Quality Payment Program.

During the webinar, CMS subject matter experts will:

• Provide an overview of the Quality Payment Program, Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)
• Discuss Year 3 MIPS and Advanced APM policy changes
• Highlight key differences between Year 2 and Year 3 requirements
• Review ways to connect to the no-cost technical assistance and identify additional resources where attendees can learn more.

The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. CMS will open the phone line for the Q&A portion. If you cannot hear audio through your computer speakers, please contact CMSQualityTeam@ketchum.com

DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel.  The criminals have masked their telephone number on caller id by showing the DEA Registration Support 800 number.  Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant's DEA registration.   If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through "Extortion Scam Online Reporting" posted on the DEA Diversion Control Division's website, www.DEADiversion.usdoj.gov. Extortion Scam Online Reporting  For more information contact: Locate DEA Field Office for your area - https://apps.deadiversion.usdoj.gov/contactDea/spring/fullSearch Registration Service Center - 1-800-882-9539 Email - DEA.Registration.Help@usdoj.gov