On February 11th, the second iteration of the Governor’s Medicaid Redesign Team (MRT) met. The Team is charged with recommending $2.5 billion in Medicaid savings as part of an effort to enact a State Budget by April 1. 

The meeting reviewed the successes of the previous MRT, a statement of the general charge and activities for the MRT 2, and identifying the highest cost drivers in the Medicaid program that will be under the microscope for revisions.

Public input will be solicited online as well as through 3 upcoming public forums/evening webinars. The next one will take place on Tuesday February 18^th from noon – 3pm, at the Monroe County Community College, High Falls Auditorium, 321 State St., Rochester, NY

To submit your ideas for Medicaid cost-saving suggestions visit their form online.

There are 3 meetings of the MRT 2 scheduled including one on March 2 in NYC and a third meeting to be announced for mid-March.  There will also be a Long Term Care advisory group established. 

Cost Drivers

In looking at the services for 6.2 million Medicaid enrollees, among the highest cost drivers identified included:

• LTC and Consumer Directed Personal Care Program (800% growth from 2016 to 2021)
• Prescription Drugs (36% growth from 2011 to 2019, exceeding 25% medical CPI)
• Transportation (up 131% from 2011 to 2019)
• Case management including Health homes
• Program Integrity (reducing fraud and abuse, and ensuring cost-efficient delivery of care for Medicaid recipients)
• Distressed Hospitals (160% increase)

It was also noted that, among the 770,000 “dual eligibles” in New York, only 3% are enrolled in managed care programs.

The only area where physician care under Medicaid appeared to be directly implicated was the stated 344% increase in the Patient Centered Medical Home program from 2011 to 2019, which pays physicians a PMPM bonus to help manage the care of certain Medicaid patients.  However, DOH also noted that patients enrolled in PCMH also had significantly lower health costs overall than non-PCMH enrollees.  

 

The Call for Abstracts and Videos for Clinical Congress 2020, October 4–8 in Chicago is now open.

The Owen H. Wangensteen Scientific Forum offers researchers the opportunity to present the results of their original, basic science, clinical, education, health sciences, and translational research.

The Video-Based Education Sessions aim to educate surgeons and members of surgical teams in order to improve the care of the surgical patient as well as safeguard the standards of care in an optimal practice environment.

The History of Surgery Poster Session offers surgical history enthusiasts the opportunity to present on subjects of interest related to the history of the field of surgery and its subspecialties.

Start submitting abstracts and videos today.

The last day to submit abstracts and videos is Monday, March 2 at 11:59 pm (CST).

The Commission on Cancer (CoC) and the National Accreditation Program for Breast Centers (NAPBC) are actively seeking medical professionals to join their accreditation site visit teams. Physicians with an interest in learning more about cancer patient care delivery across the country, as well as have a desire to positively impact the quality of that care, are strongly encouraged to apply.

Accreditation by the CoC and NAPBC quality programs of the American College of Surgeons demonstrates a cancer program’s commitment to providing high-quality, multidisciplinary, patient-centered cancer care. Site Visit Reviewers perform a vital service in the accreditation process through site visits to and evaluation of cancer programs.

More information is available in the CoC and NAPBC surveyor applications.

The American College of Surgeons (ACS) Division of Advocacy and Health Policy (DAHP) reported numerous legislative successes last year, including the introduction or reintroduction of more than 16 ACS-supported bills.

These accomplishments are attributable in large part to surgeon-advocate engagement via SurgeonsVoice. Thousands of participants contacted members of Congress about key health policy priorities, resulting in nearly 6,000 grassroots actions. To date, activity surrounding surprise or unanticipated medical billing had the highest participation rate of any issue campaign, with more than 1,100 Fellows, residents, and young surgeons working to effect change.

Surgeons’ voices and expertise continue to play a critical role in helping to educate and inform policymakers. As Congress continues to consider important health care legislation that will affect surgical patient care, all ACS members are encouraged to engage in advocacy.

To learn more and participate, visit the SurgeonsVoice web page.

The American College of Surgeons (ACS) signed a letter to the House Committees on Ways and Means and Education and Labor as they consider policy solutions to the issue of surprise medical bills. The letter highlights the medical community’s commitment to working with Congress to develop an equitable legislative solution to protect patients from surprise medical bills, while also facilitating a process to quickly, efficiently, and fairly resolve physician and health plan billing disputes. The ACS remains actively engaged as Congress looks toward addressing surprise medical billing before the end of May.

For more information, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.

The American College of Surgeons (ACS) responded to a recently published Washington Post opinion piece describing a patient's experience with surprise medical billing, in which the patient had an upsetting interaction with the surgeon regarding treatment costs.

As the patient was being prepared for an emergency appendectomy, she was told that she would be responsible for the surgeon's full fee because the provider was out of the patient's insurance network.

The ACS letter to the editor, written by Executive Director David B. Hoyt, MD, FACS, was published January 17.

Governor Andrew M. Cuomo today announced the 36th proposal of his 2020 State of the State Agenda - strengthening the oversight of physicians and other medical professionals to protect patients.

The Governor is proposing a comprehensive set of reforms to provide the Department of Health's Office of Professional Medical Conduct with tools to investigate, discipline and monitor physicians, physician assistants and specialist assistants licensed in New York, providing greater transparency in physician discipline and reducing the length of misconduct investigations.

According to the release, areas he will address include:

• Making Investigations and Non-Disciplinary Actions Public
• Eliminating Lifetime Licensure
• Reform Public Health Law's Burdensome Provisions
• Consumers Have Up-To-Date and Accessible Information about New York State Licensed Physicians

"The first responsibility of any medical professional is do no harm, and when someone violates that oath they must be held appropriately accountable," Governor Cuomo said. "These sweeping proposals will help ensure patients have access to critical information they need to make informed decisions about their healthcare and give state health regulators more tools to investigate and penalize providers for dangerous, unethical or illegal behavior."

> Read the full press release

The deadline for the Resident Travel Awards for the Leadership & Advocacy Summit has been extended from January 10^th to Friday, January 17.

The American College of Surgeons (ACS) is pleased to again offer a limited number of scholarships to Resident Members of the American College of Surgeons who are interested in attending the upcoming Leadership & Advocacy Summit, March 28–31, 2020, at the Renaissance Downtown Hotel in Washington, DC. The ninth annual Summit is a dual meeting that offers volunteer leaders and advocates specialized educational sessions focused on effective surgeon leadership, interactive advocacy training, and coordinated visits to Congressional offices

 The award will cover up to $500 in housing and transportation costs.

Full details about the awards and how to apply can be found at the following link:.

The deadline to apply is now Friday, January 17, 2020.

Today marks the start of the 2020 legislative session and right outside the NY Chapter ACS offices, there are about 300 people participating in an anti-vaccination demonstration growing in size. 

The NYS Senate and Assembly is set to convene at noon today.

Governor Andrew M. Cuomo will hold the 2020 State of the State Address  in the Empire State Plaza Convention Center in Albany at 1:30 PM today. 

"Last year we laid out the most aggressive agenda in modern political history and we got it done," Governor Cuomo said. "This year we'll build on that record of accomplishment and continue restoring confidence in government as a force for good. We're going to set the bar even higher, making progress happen for the people of this great state and sending a signal to a weary country to follow New York as we lead the way upwards."

Here is a list of his proposals that he has pre-released that will impact healthcare. What we didn't see in his original list is the legalization of marijuana, but do anticipate him introducing something.

• Banning Fentanyl Analogs to Further Combat the Opioid Epidemic
• Lowering Prescription Drug Prices for All New Yorkers Through Comprehensive Three-Part Plan
• Increasing Transparency in Healthcare Costs
• Legislation Banning Flavored Nicotine Vaping Products and Vaping Ads Aimed at Youth
• Legalizing Gestational Surrogacy

 STATE BUDGET

New York’s budget gap for the coming year stands at $6.1 billion. It’s the largest state budget gap since the Great Recession, mostly attributed to $4 billion in Medicaid overspending. 

New York’s Medicaid program covers over 6 million residents and is projected to reach $74.5 billion in 2019, in total costs split between the federal government, state and local governments.

In 2019, the Cuomo administration delayed  payments into April, thereby transferring the issue into the 2020 state budget.

Gov. Andrew Cuomo’s administration has cited a trio of issues facing Medicaid spending including: An increase in the minimum wage, a phase out of federal funding and an aging population that has seen more people enroll in long-term care.

On December 31, 209 - the NYS Department of Health released a proposal in the NYS Register to cut Medicaid payments by 1%. It’s expected to save $124 million in "gross Medicaid expenditures" in the final quarter of the current fiscal year, and $496 million in each subsequent year, according to the notice.

The across-the-board rate cut would impact providers such as hospitals, nursing homes, doctors and others who provide care through the state’s Medicaid program, which serves roughly 6 million New Yorkers, most of whom are children, seniors or individuals with disabilities.

The Medical State Society of New York and several organizations including the New York Chapter ACS have signed onto a joint letter calling on the Governor to reconsider across the board payment reduction, other Medicaid reductions and protect this critical program to our State’s most vulnerable residents, the workers who care for them and the providers who bear the responsibility. 

ASSEMBLY LEADERSHIP CHANGES

Assemblyman Brian Kolb has officially resigned as minority leader, following a drunk driving arrest on New Year’s Eve just days after writing an op-ed against drinking and driving. Not only that He was apparently twice the legal limit when he crashed and tried to blame his wife for the crash.

The new Assembly minority leader is William Barclay -  a nine-term legislator, who was named deputy minority leader in 2012 and served in that role in 2018.  Barclay currently serves as the top Republican on the Ways and Means Committee, which is responsible for all business that pertains to the state budget.  He lives halfway between Syracuse and Watertown.

 NY CHAPTER ACS UPCOMING ADVOCACY EVENTS

• The New York Chapter will participate in a press conference on 1/13/2020 to help launch the Statewide Campaign to Ban Flavored Tobacco. 
• Mark your calendars for New York Chapter ACS PAC Reception is May 4th and Annual Advocacy Day: Tuesday, May 5, 2020!

The 2020 ACS/Pfizer Surgical Volunteerism and Humanitarian Awards nominations process is open through February 15, 2020.

There are five award categories for which an individual can be nominated: humanitarian, domestic volunteerism, international volunteerism, military volunteerism, and resident volunteerism.

The awardees will be announced in September and recognized at the ACS Clinical Congress 2020 in Chicago, IL.

These awards recognize ACS Fellows and members whose altruism, vision, leadership, and dedication provide models to emulate and whose contributions have made a lasting difference.

To learn more about the nomination process visit www.facs.org/ogb/award-winners/nominations.