NYSAFP Advocacy Commission Agenda
August 2, 2008, Albany NY
I. Meeting called to order by Chair, Philip Kaplan, MD at 10am
Present: Philip Kaplan, MD, Norman Loomis, MD, Leon Zoghlin, MD, Heidi Zinkand, MD, Paul Slazburg
MD, Charles Francis, MD, Tim Donavan MD, Courtney McHale, MS IV, Peter Liepmann MD, Christine M.
Doucet MD, Mark Krotowski MD, Amoge Okonkwo MD, Dr. Marc Price DO, Dr. Jun David, MD and
NYSAFP President and Bob Reid, Weingarten, Reid & McNally (WRM)
II. Process of reaching commission decisions. The Commission has and will continue work to achieve
consensus on issues. Absent consensus the Commission may choose to take no position on a
controversial initiative from the legislature.
III. Approval of Minutes from March 2008
IV: Albany update- Bob Reid provided the Commission an Albany Update.
V: Actions passed since last meeting:
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OPMC bill (A11136a/ S8298a)
Expedited Partner Therapy (A8730c/S6210a)
No Fault legislation (A10000/S8294a)
Pharmacists as Immunizers (A2140d/S8673)
Child Psychiatry Access Demo Project (S7033a/A10297a)
Temporary insurance coverage for recent college graduates (S8357/A11485)
Excellus action re: carecorps deal with AG, supported by mssny but favoring oncologists over
fps, and requirement for prior approval for certain narcotics (fentanyl patches, oxycontin and
duragesic)
VI: Vaccine registry update---Below New Business
VII: Leon Zoghlin’s editorial regarding nurse practitioner independent practice was distributed, and Leon
was congratulated on the effort.
VIII: Congress of Delegates Resolutions forwarded to this commission- resolutions attached
Resolution ’08-4 “Refuse Federal Funding for Abstinence-Only-Until-Marriage Programs”
---Commission recommends letter to Governor Paterson supporting prior Governor’s policy to
refuse federal funding. Commission recommends continued support of Health Teens Act.
Resolution ’08-6 “Tobacco Prevention and Cessation—Public Playgrounds”
--Commission recommends support of legislation with appropriate definition of what is a
playground.
Resolution ’08-7 “Flu Vaccine”
--Commission recommends letter to Senate and Assembly conveying the intent of the resolution
advocating for a pilot program for flu vaccines for primary care providers. The Commission Chair is
currently working with the NYS Department of Health on such a pilot.
Resolution ’08-09 “Workers Compensation and Diagnostic Testing
--The Commission discussed the resolution which essentially calls for an “any willing provider”
standard for diagnostic tests under the Workers Compensation system. Members of the
commission were divided on whether to support or oppose the resolution and believe
modifications should be considered by the Board relative to specific actions currently under
consideration by the Workers Compensation Board.
Resolution ’08-18 “AAFP Endorsement of Single Payer Health Insurance”
--The Commission recommended that the Academy continue to support this issue on a state level and
send the resolution to the AAFP. Discussion was spirited regarding the linking of tort
reform and collective bargaining to the single payer initiative. A large majority of the
commission members favored not linking these issues, as such linkage would impede
progress on single payer.
IX: Legislation- See charts below, please review bills via the legislative bill search website
http://public.leginfo.state.ny.us/menuf.cgi in advance of the meeting to be familiar with the details for
discussion.
New business:
The consent agreement between the AG and Excellus in Rochester was reviewed. This
agreement provides oncologists access to imaging studies without prior approval, while primary
care physicians were not allowed this privilege. The commission recommends communication
of our concerns to the office of the attorney general, and to MSSNY, seeking redress of this
injustice to family physicians, with a copy to Excellus.
LEGISLATION
Consent Calendar to be forwarded to board before cluster, having commission approval by email or by
obvious prior policy.
BILL
COMPANION
BILL
SUMMARY
STATUS
POSITION
A10357,
Christensen
S7195,
DeFrancisco
Enacts the health care consumer and
provider protection and equity allowing
for physician collective bargaining
Senate and
Assembly
Insurance
Support
A11461,
Gottfried
S8722, Hannon
Provides for HIV testing to be offered on
a routine basis and allow for it as part of
general medical consent; Allows for
testing in cases of occupational exposure
Senate and
Assembly
Rules
Support
S7748,
Hannon
S4997, Hannon
and S157,
Golden
Establishes a neurologically impaired
infant fund
Senate
Health
Support
(not same as)
A10829,
Gottfried
S8005, Young
Allows certified nurse practitioners to
practice without collaboration of a
licensed physician and provides coverage
for services performed by a nurse
practitioner
Senate and
Assembly
Higher
Education
Oppose
S8104,
Hannon
No same as
Establishes mandatory safe injection
practices; Requires infection control
training every 2 years
Senate Rules
Oppose
This consent calendar was approved as submitted to the board.
Legislation for discussion to determine Academy position (Support, Oppose, No Position).
BILL
COMPANION
BILL
SUMMARY
STATUS
POSITION
A11187,
Gottfried
S8556, Rules
Prohibits certain gifts and payments to
prescribers and requires disclosure of
other gifts and payments
Assembly
Codes,
Senate Rules
Oppose
A11464,
Peoples
S8179a,
Hannon
Mandates reporting of lead screenings to
the state immunization registry
Passed
Assembly,
Senate
Health
Oppose
S8087,
Hannon
No same as
Authorizes the establishment of the
physicians performance measurement
reporting program
Senate
Health
Oppose
S7516a,
Saland
A11237a, Perry
Prohibits incentive arrangements for
inducing a health care provider to change
Senate and
Assembly
Support
prescriptions
Insurance
A11680a,
Morelle
S8354b,
Seward
Standardizes the calculation of
minimum loss ratio for purposes of the
alternative premium rate adjustment
process known colloquially as "file
and use; Provides that no managed
care health insurance policy that
provides coverage for hospital,
medical or surgical care shall provide
that services of a participating hospital
will be covered as out-of-network
services solely on the basis that the
admitting physician or treating
physician is not a participating
provider
Assembly
Rules, Senate
Codes
Support
A8142,
Canestrari
S4173, Skelos
Regulates the use of certain laser, intense
pulsed light, radiofrequency and medical
microwave devices
Assembly
and Senate
Higher
Education
Oppose
A6811B,
Gottfried
S7749A,
Hannon
Directs health care providers to provide
pain-relieving medications to the extent
authorized by accepted professional
guidelines
Passed
Assembly,
Senate Rules
Support
XI.
New Business
Medical Home
The issue of a medical home, in which a primary care physician is paid at the time of the visit, as a
way to establish a more cost effective and efficient model of health care delivery was introduced by
Dr. Liepmann, who will develop an action plan. Dr. Loomis stated that MSSNY recently sent a letter
to the NYS DOI discussing this issue. The Commission recommends to the Board that a task force be
formed to address this issue chaired by Dr. Liepmann, including interested members who may not
be members of Advocacy.
NYS DOH MEDICAID Primary Care Guidelines
The Commission discussed the recently proposed Medicaid Primary Care Guidelines. The
commission supports the comments made by the ad hoc group that has negotiated with AAP, ACP
and MSSNY in responding to the DOH proposal.
Vaccine Registry
Dr. Kaplan reviewed his discussion with NYSDOH staff regarding the vaccine registry. We have
advocated for an automated reporting system derived from billing data, accommodations for
physicians who outsource electronic billing, accommodations for physicians who lack high speed
internet access, and a relationship with the regulators which is collaborative instead of punitive.
Lot number and maiden name reporting continues to be problematic. The HIPAA implications of
sending nonconsented adult data which is then blocked at DOH were reviewed. DOH has agreed to
alter the specifications to cure this breech. NYSAFP (WRM) wrote S.7169 sponsored by Senator
Hannon to delay the reporting requirements, which assisted our negotiations with DOH.
The commission supports the elements of these negotiations.