In late April, Congress approved an additional $310 billion dollars for the Paycheck Protection forgivable loan Program (PPP) to assist small businesses, including physician practices. To date, the program has approved assistance to nearly 250,000 New York businesses in two different rounds of application periods.

The Congressional package also provided $75 billion more for the CARES Act Health Provider Relief Pool, to assist hospitals and physicians. This is in addition to $30 billion dedicated to physicians and hospitals, in early April, based on 2019 Medicare payments, and $20 billion was just made available to physicians and hospitals based on 2018 total patient revenue.

As with its first survey, MSSNY wants to gather data to determine how much New York physicians are benefiting from these new resources, to better guide our advocacy for further stimulus bills.

Please help us evaluate this by taking a few minutes to fill out and submit the following Survey Monkey questionnaire.

Please take the survey here

The purpose of this weekly publication is to provide healthcare providers in New York State with a consolidated update of guidance released by the New York State Department of Health (NYSDOH) related to the COVID-19 pandemic response.

This will show only current guidance for any given topic and will be updated to reflect new guidance.

As a reminder, all advisories and informational messages (including webinar invitations) are distributed through the Integrated Health Alerting Network System (IHANS), an application housed on the Health Commerce System (HCS). If you are not receiving IHANS notifications, please work with your site’s HCS coordinator.

Additional COVID-19 resources may be found on the NYSDOH webpage under Information for Healthcare Providers. Recordings of COVID-19 Weekly Healthcare Provider Updates are also available on the NYSDOH webpage.

Access the publication here

In this pre-recorded webinar, the Joint Commission provides an overview of COVID-19 routes of transmission and focuses on prevention strategies for freestanding surgical centers to consider prior to resuming elective procedures: Preventing Coronavirus Transmission in Ambulatory Surgery Centers 

The New York State Department of Health has issued the following interpretative guidance:

The March 23 and April 4 directives to suspend all non-essential elective surgeries and non-urgent procedures did not preclude general hospitals, ASCs, OBSs and D&TCs from performing certain surgeries and procedures related to the diagnosis of cancer (e.g., lumpectomies, biopsies), the treatment of intractable pain, or other diagnostic or treatment services for highly symptomatic patients.

The Department considers such surgeries or procedures to be "Tier 3a" as defined by CDC rules for urgent and emergency surgeries and procedures (see Attachment A).

Therefore, such surgeries or procedures should not be postponed or otherwise delayed, and should be scheduled and performed in accordance with the medical judgment of the treating physician. This interpretative guidance is applicable to all general hospitals, ASCs, OBS practices, and D&TCs in 811 counties of the State.

Read the full directive here

This Executive Order permits certain hospitals in certain New York State counties to begin performing non-essential, i.e., elective, surgeries. The criteria consists of the following:

• Eligible counties where non-essential surgeries can be performed must have total available inpatient and ICU capacity of over 30% with a total change in number of hospitalized COVID-19 positive patients during the period of April 17 – April 27 of less than ten.
• For each hospital within an eligible county, the hospital must meet the numerical criteria set forth above.
• General hospitals not meeting the criteria may seek a waiver from the New York State Department of Health (“DOH”) by submitting a plan.
• DOH shall issue guidance for non-essential surgeries that will require all pre-operative patients to test negative for COVID-19.

Here is a list of eligible counties: Allegany, Broome, Cattaraugus, Chautauqua, Chenango, Delaware, Dutchess, Essex, Franklin, Fulton, Genesee, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Putnam, Saratoga, Schoharie, Schuyler, St. Lawrence, Steuben, Sullivan, Tompkins, Ulster, Wayne, Wyoming and Yates.

Read the full order here

The NY Chapter commits itself to the health and well-being of NY surgeons and the health care community.

During this time we will share messages of support from your Chapter leadership & provide you w/ resources.

Share your messages!

We are Here for You #NYChapterACSUnites

The US Health and Human Services (HHS) has indicated that the application portal is open for physicians to avail themselves of a portion of the $20 billion allocation from the CARES Act Provider Relief Fund.  

The AMA has advised that  anyone who has a Billing TIN (including a pediatric or obstetric practice) who lost revenue in March and/or can estimate lost revenue in April due to the COVID-19 crisis, should be filling out this portal.   

The AMA has also put together this guide to help physicians pull together the information they need to submit to the portal. Here is additional information from HHS regarding the distribution.

Governor Cuomo announced elective outpatient treatments can resume on April 28 in counties and hospitals without significant risk of a COVID-19 surge. However, the state has not yet issued guidance.

To ensure these services can be resumed safely, the American College of Surgeons and other associations created a roadmap to guide readiness, prioritization and scheduling.

Mark Reiner, MD FACS, Chair of the Manhattan Council of the NY Chapter ACS will present this roadmap in a Safely Resuming Elective Procedures webinar on Monday, April 27, at 3 p.m.

This webinar will be co-hosted by HANYS and the New York Chapter of ACS. Please register online.

The NY Chapter commits itself to the health and well-being of NY surgeons and the health care community. During this time we will share messages of support from your Chapter leadership and provide you with resources.

You are encouraged to share your messages of support using the following hashtag on Twitter and social media #NYChapterACSUnites

"We recognize the tremendous strain that the New York City healthcare system is facing in managing the COVID-19 pandemic. We are grateful for your leadership in working to both optimize care for patients and protect healthcare workers. The American College of Surgeons has worked with NYC hospitals to develop a robust trauma system to care for critically injured patients. This system is part of an emergency care system that responds to other time sensitive medical emergencies such as acute cardiac events and strokes. We have heard from the trauma directors in many of the Level 1 trauma centers that the system is overwhelmed by COVID patients and is at risk of being unable to provide care for these common emergencies. To that end, we have developed the attached statement on the importance of maintaining the emergency care system and have offered recommendations to meet this goal. We stand ready to assist you."

> Access the letter

> Read the ACS Statement on the Importance of Maintaining the Emergency Care System