Thank you for visiting the website of the New York State Neurological Society (NYSNS)! You can use the top menu to discover who we are and how to join as well as find resources for neurologists and the most recent updates on our January 5, 2019 Annual Winter Meeting. Feel free to contact us if you have any questions or want more information!
NY Neurosociety Meeting
Member Perspective by Gil I. Wolfe, MD, FAAN, NYSNS President
The following is from the January 21, 2019, Capitol Hill Report, American Academy of Neurology (reprinted with permission)
The New York State Neurological Society (NYSNS) held its annual Winter Meeting on January 5, 2019, in New York City. Attendance at this year’s educational meeting grew significantly from prior years to more than 150 attendees, including some 20 exhibitors, and offered 6.5 hours of CME credit. Topics included therapy updates in multiple sclerosis, epilepsy, headache and stroke. There were also presentations on medical cannabis, telemedicine, and improving quality of life in Parkinson’s disease. The meeting included two workshops offering hands-on experience in headache procedures and vagal nerve stimulation in epilepsy.
Each year, the NYSNS Winter Meeting features the Neurostakes competition between New York-based neurology residency training programs, a trivia contest in the vein of the TV game show Jeopardy. Six teams of mostly senior neurology residents competed this year, with SUNY Stony Brook coming out on top. Mill Etienne, MD, MPH, FAAN, treasurer of the society, served as MC of the competition. Annual Meeting Committee members included Andrew D. Goodman, MD, FAAN, outgoing president of the society, in addition to Charles Esenwa, MD; Mill Etienne, MD, MPH, FAAN; Matthew S. Robbins, MD, FAAN; and Nilay R. Shah, MD. Cheryl Malone, executive director of NYSNS, played a key role in the meeting’s success.
The NYSNS has plans for smaller, regional meetings during the year, with the next Winter Meeting tentatively planned for October 2019. Check the NYSNeurology.com website for future information.
State neurological societies across the country not only fill an educational role for health care providers but are often involved with advocacy efforts at the state level. For instance, the NYSNS has an Advocacy Committee chaired by Allan Perel, MD, FAAN that monitors issues important to neurologists making their rounds in Albany. Supporting the work of state neurological societies is one of the roles of the Government Relations Committee of the AAN.
Thanks to Our Leadership
Gavel is Passed to Doctor Gil Wolfe at at the Annual Winter Meeting
Below new president Gil Wolfe, MD; past president John Ferro, MD; and outgoing president Andrew Goodman, MD. Doctor Wolfe helped us celebrate Doctors Ferro and Goodman at the Annual Winter Meeting on January 5, 2019.
The Annual Winter Meeting =
A Great Success
What a great meeting! We hope you were able to join us on January 5. The Board of Directors of NYSNS is already thinking about the next event, so stay tuned.
Our thanks to our speakers: Fiona Gupta, MD; Fred Lublin, MD; Matthew Robbins, MD; Robert Glover, MD; Mill Etienne, MD; Lazlo Mechtler, MD; Shazia Alam, DO; and Eric Anderson, MD, PhD. We heard the latest on Parkinson’s, MS, Headache Therapy, Epilepsy, Medical Cannabis, Stroke, and Telemedicine. The audience was engaged, and everyone enjoyed the program and networking.
It’s not an NYSNS Meeting without the Neurostakes Competition. This year the Competition was sponsored by Sunovion Pharmaceuticals. Our intrepid residents from programs at the University of Rochester, Mt. Sinai, SUNY Upstate, Stony Brook, Albany, and Northwell Health Hofstra all faced off against quizmaster Mill Etienne, MD. After a close competition, Stony Brook were this year’s champions. Congratulations to the Stony Brook Team: Cara Harth, MD; Kamil Stefanowski, MD; Alexander C. Ou, MD; and Kathryn Cooper, MD.
Thanks to all the teams pictured below.
Here’s the winning team from Stony Brook below.
Thanks to our exhibitors and CME providers below for helping to make it all possible.
Gold Sunovion Pharmaceuticals
Catamount Medical Education*
Biotel Heart Caridonet/Lifewatch
GE Health Care: DatScan
See you at the next meeting!
January 5, 2019 Annual Winter Meeting Agenda
Here’s the VERY Latest Program Details!
*Utilizing Advanced Science to Improve the Quality of Life in Patients with Parkinson’s Disease* with Fiona Gupta, MD, The Mt. Sinai Hospital, Assistant Professor of Neurology
The above portion of the agenda is a CME Category I Program provided by AcademicCME *This activity is supported by an educational grant from Acorda* AcademicCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AcademicCME designates this live material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
*Immune Dysfunction in Multiple Sclerosis: CMS Modern Considerations in Treatment and Management* with Fred D. Lublin, MD, Saunders Family Professor of Neurology, Director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai
The above portion of the agenda is provided by the Consortium of Multiple Sclerosis Centers (CMSC), International Organization of Multiple Sclerosis Nurses (IOMSN), and Catamount Medical Education and supported by educational grants from Biogen, EMD Serono, Genzyme, and Novartis Pharmaceuticals Corporation.
In support of improving patient care, this activity has been planned and implemented by the CMSC, IOMSN, and Catamount Medical Education. CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. For CE information, including statements of credit, please visit Catamount CME for Immune Dysfunction in MS.
Headache Therapy Update with Matthew S. Robbins, MD, Neurology Residency Program Director, Weill Cornell Medicine and New York Presbyterian Hospital
New Treatments in Epilepsy with Robert Glover, MD, Clinical Assistant Professor, Department of Neurology, University of Buffalo, Jacobs School of Medicine and Biomedical Sciences
Headache Procedure Workshop / VNS Demos with Doctor Robbins and Joshua M. Cohen, MD, MPH, Global Therapeutic Area Lead for Migraine & Headache, Teva Pharmaceuticals; and Doctor Glover and Mill Etienne, MD, MPH, FAAN, Director of the Epilepsy and EEG Laboratory at Good Samaritan Regional Medical Center, and Assistant Professor of Neurology at the New York Medical College.
An Overview and Update on Medical Cannabis with Laszlo L. Mechtler, MD, Medical Director, Dent Neuorlogic Institute, Professor of Neuorology and Neuro-Oncology, State University of New York at Buffalo
Stroke Update with Shazia Alam, DO, Director, Neurohospitalist & Stroke Services, NYU Winthrop Hospital
Telemedicine Update with Eric R. Anderson, MD, PhD, Director of Telemedicine, Corticare.
The above portion of the agenda is a CME Category I Program provided by MLMIC.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Medical Society of the State of New York (MSSNY) through the joint providership of MLMIC Insurance Company (MLMIC) and the New York State Neurological Society. MLMIC is accredited by MSSNY to provide continuing medical education for physician. MLMIC designates this live activity for a maximum of 4.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
MLMIC (NYSNS Endorsed) Earns A+ Rating According to AM Best
AM Best has assigned a Financial Strength Rating of A+ (Superior) and a Long-Term Issuer Credit Rating of “aa-” to MLMIC Insurance Company (MLMIC) (New York, NY). The outlook assigned to these Credit Ratings (ratings) is stable.
The ratings reflect MLMIC’s balance sheet strength, which AM Best categorizes as strongest, as well as its adequate operating performance, limited business profile and appropriate enterprise risk management. The ratings also benefit from the financial support provided by MLMIC’s direct parent company, National Indemnity Company, which is ultimately owned by Berkshire Hathaway Inc. [NYSE: BRK.A and BRK.B].
MLMIC’s risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR) is categorized as strongest and AM Best expects it to remain at a similar level in prospective years. The balance sheet strength assessment also considers the company’s track record of positive reserves development, as well as good financial flexibility provided by its publicly traded ultimate parent Berkshire Hathaway Inc.
MLMIC has historically generated an adequate level of operating results, supported by modest underwriting profits and moderate investment returns. Underwriting results have consistently benefited from reserve releases on prior accident years. Prospectively, AM Best does not expect any material change in the company’s profitability levels.
MLMIC’s insurance portfolio is concentrated in the medical malpractice line of business. The company underwrites risks only within New York state, which represents one of the nation’s most challenging market environments. However, management has been able to operate successfully through underwriting cycles while maintaining MLMIC’s leading market position within New York. In addition, risk management capabilities have proven appropriate for the risk profile of the company.
MLMIC is the only endorsed medical liability company of the New York State Neurological Society. To learn more go to https://www.mlmic.com/
CMS: New Quality Payment Program Resources Available and New Site Look
The Centers for Medicare & Medicaid Services (CMS) has recently revamped the look of the Quality Payment Program website and also posted new resources to help clinicians successfully participate in the first year of the Quality Payment Program.
CMS encourages clinicians to visit the website to review the following new resources:
- MIPS Quick Start Guide: Outlines the steps MIPS clinicians need to take between now and March 2018 to prepare for and participate in MIPS, including checking participation status, choosing to participate as an individual or as part of a group, deciding how to submit data, and selecting measures and activities.
- Medicare Shared Savings Program and Quality Payment Program Fact Sheet: Explains how the Shared Savings Program and the Quality Payment Program align reporting requirements for participating Accountable Care Organizations (ACOs) and MIPS clinicians, and how certain tracks in Shared Savings Program ACOs meet Advanced Alternative Payment Model (APM) criteria under the Quality Payment Program.
- MIPS APM Fact Sheet: Provides an overview of a specific type of APM, called a MIPS APM, and the special APM scoring standard used for those in MIPS APMs.
Federal Legislative Updates
Congress passed the FY2017 spending bill, which includes $34 billion for the NIH, an increase of 6.2% from FY2016. The BRAIN Initiative received $260 million, which was a request of the AAN’s Neurology on the Hill effort in February. The bill also provided substantial increases in funding for Alzheimer’s disease, telehealth, and opioid abuse.
On May 4, 2017, the House of Representatives narrowly passed the American Health Care Act (AHCA), a bill that repeals and replaces several provisions of the Affordable Care Act. Due to concerns about reduced access to health insurance coverage, the AAN and most other medical groups oppose the bill. The legislation will now advance to the Senate.
The Furthering Access to Stroke Telemedicine (FAST) Act (HR. 1148/ S. 431), now has 80 bipartisan cosponsors in the House and seven bipartisan cosponsors in the Senate. The bill has also been included in several key legislative packages. On May 15, 2017, AAN member neurologist and American Heart Association advocate Lee H. Schwamm, MD, testified in support of this legislation before the Senate Finance Committee.
State Legislative Updates
AAN Monthly Updates
Review the AAN’s 2016 accomplishments, financial results, and an outline of the 2017 strategic plan in the2016 Annual Report: We’ve Got Your Back.
The AAN and American Psychiatric Association released the dementia management quality measurement set update on May 1. The measures and publication are available online. Select dementia management measures are available in 2017 for use in CMS’ Merit-based Incentive Payment System (MIPS).
The Axon Registry® has been designated a Quality Clinical Data Registry (QCDR) for reporting year 2017 by CMS. This means the registry can report neurology specific quality measures under the MIPS program. Visit our website for information on how to join the Axon Registry and what it could do for your practice.
“Practice Guideline: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors” was published in Neurology during the Annual Meeting on April 24, 2017. It was codeveloped with the American Epilepsy Society and endorsed by the International Child Neurology Association.
“Practice Guideline: Reducing Brain Injury After Cardiopulmonary Resuscitation,” was published online ahead of print in Neurology on May 10, 2017. It was endorsed by the Neurocritical Care Society.
MSSNY Monthly Updates
With limited time left of current legislation session in Albany, we need to remain active in the legislative process. The end of session usually brings a lot of negotiations and deals on various bills and regularly includes surprises. While it’s hard for us to predict the unpredictable, there are ways to get involved and tip the odds in our favor. As we monitor bill introductions and meet with every legislator, our physicians must keep up on the most up-to-date information and important material to boost our efforts. Our grassroots action network click here is filled with informational materials and ways to contact your legislators. Please call, write and meet with your legislators before the end of session which is scheduled for June 21st.
All physicians are urged to continue to contact their legislators (click here) to oppose bills moving in the Legislature that could drastically increase the cost of medical liability insurance at a time when no increases can be tolerated. MSSNY has been working closely with hospital associations and specialty societies to demonstrate the health care community’s shared concerns regarding the serious adverse consequences to our healthcare system were any of such one-sided bills to be adopted. The timing of these bills could not be worse. We now have multiple malpractice insurance companies operating in New York State that appear to be in serious financial jeopardy which can ill-afford to absorb the substantial costs of a brand new cause of action. Moreover there is a great uncertainty in the NY healthcare delivery system as a result of legislation before Congress that could profoundly restructure Medicaid spending. Please urge you elected officials to oppose the following bills:
- Lengthening the Medical Liability Statute of Limitations (A.3339/S.4080) – would substantially lengthen the statute of limitations for medical malpractice actions and lead to enormous increases in the cost of liability insurance for physicians and hospitals. If enacted this bill could increase your liability premiums by 15%. This bill is on the Assembly floor and can be voted on at any time.
- Expansion of Wrongful Death Actions (A.1386/ S.411) – would greatly expand the categories of damages which a plaintiff may recover in a wrongful death action. Actuarial studies have predicted that this bill could increase liability premiums by over 50%. This bill is on the Assembly Codes Committee next week.
- Direct Actions Against a Third Party Defendant (A.1500 / S. 412) – would permit a plaintiff to bypass the defendant he or she sued to collect a judgment from a third party defendant who or which had been sued by the defendant for contribution or indemnification as a result of the underlying action.
- Prohibiting Ex-Parte Interviews of Plaintiff’s Treating Physician (S.243/A.1404) – would prohibit a physician’s defense counsel in a medical liability action from conducting an interview with the plaintiff’s treating physician. This bill would present significant issues for physicians in a medical liability action by limiting the opportunity to fully examine the plaintiff’s health condition to evaluate the merit of the plaintiff’s claim.
With just a few weeks left in the Legislative Session, physicians are urged to contact their legislators to ask them to support legislation strongly supported by MSSNY to address prior authorization hassles imposed by health insurance companies, increase coverage for patients, and to limit the ability of health insurers to narrow their networks. These bills include:
- S.3943 (Hannon)/A.2704 (Lavine) – would provide physicians and other health care practitioners with necessary due process protections where health insurers seek to terminate a physician from its network by failing to renew the physician’s contract. The bill has passed the Assembly and was recently reported to the Senate floor.
- S.3663 (Hannon)/A.4472 (Gottfried) – would permit independently practicing physicians to collectively negotiate patient care terms with market dominant health insurers under close state supervision. In addition to the ability to push back against exorbitant administrative hassles imposed by insurers, it would also help to protect physicians to have a stronger option to remain in independent practice. The bills have advanced to the Senate Finance Committee, and the Assembly Ways and Means Committee.
- S.5675 (Hannon)/A.7671 (Rosenthal) – would require health insurers to make out of network coverage options available through the New York Health Insurance Exchange. Currently, there are no out of network coverage options in the Exchange in downstate New York, despite Exchange officials strongly encouraging the offering of these options by insurers. The bills are in the Senate.