visitors since last modified.
Here is what you will find below:
Future Medicare Cuts? (2008)
NYS Malpractice Insurance Rate Increase (2007)
Medical Malpractice Insurance Crisis (2006)
2006 Medicare Reimbursement Cuts? (2005)
Malpractice Insurance Rate Increase (2005
Vioxx Withdrawn by Merck (2004)
Medicare Bill Passes (2003)
Call for Tort Reform in New York State (2003)
More Medicare Cuts? (2003)
Crisis in Health Care (2000)
is the text of a Letter to the Editor from County Medical Society President
Thomas A. Bersani, M.D. which appeared in today's Post Standard. The paper
gave the letter this headline: "Let's ensure health care for aging baby
Thursday, April 17 lead editorial, “Timely Medicine: Changes needed now to
ensure health care for aging boomers,” correctly pointed out some major
problems and challenges facing our country.
changes are made, the increasing number of Americans who are Medicare
beneficiaries will not have access to the medical care they expect and
immediate task in Washington re: Medicare is to head off a proposed 10 per
cent cut in reimbursement to physicians for care they render to patients with
Medicare coverage . In the next several years, physicians have been told to
expect a total reduction of 40 per cent in Medicare reimbursement.
At a time
that we need more physicians to care for seniors, such drastic reductions will
limit access to care for Medicare recipients.
join us in urging our elected officials in the U.S.
Senate and House of Representatives to “ensure health care for aging
boomers.” Call the Syracuse
offices of Senators Charles
Clinton, and Congressman
County Medical Society is also deeply concerned about recruitment and
retention of physicians in this area. Because of our concern, in February we
established the Onondaga
County Medical Society Medical
Student Scholarship Fund. This fund initially will provide a $5,000
scholarship each year at Upstate Medical University for a graduate of an
Onondaga County high school who will enter Upstate’s medical school this
fall. We believe that someone who went to high school and medical school in
this county will be more likely to stay here for the duration of his or her
County Medical Societ
NYS Society of Orthopaedic Surgeons
July 2, 2007
NYS Insurance Department Announces Medical Malpractice Insurance Rates
will Increase 14% and Announces Creation of a Medical Malpractice Reform
NYS Superintendent of Insurance announced today that medical malpractice
insurance rates have been approved for a 14% increase and also announced that
Governor Spitzer has created a new Task Force to Confront Medical Liability
Dinallo stated “After years of failing to confront the fundamental problems
that have led to this current environment, we have inherited the worst of both
worlds – physicians who cannot afford to practice medicine, and insurers whose
financial condition is rapidly eroding. The cause is high medical liability
costs, and this administration is going to address it. I
understand many health professionals already feel rates are too high, which is
why we are asking these and other stakeholders to join us in developing a
lasting, practical solution. But the fact remains, this rate increase is less
than what carriers sought and is what our experts believe is necessary to stave
off an industry-wide crisis unless the underlying problem of high medical
malpractice costs is addressed.”
full copy of the Press Release is on our website at
you for your review.
Society of Orthopaedic Surgeons
From the Onondaga County Medical Society,
Medical Malpractice Insurance Crisis
The news on medical malpractice
insurance in New York State continues to get worse and there is truly an
impending crisis. That message came through loud and clear yesterday
(Thursday, June 1) in a monthly teleconference with William R. (Rick)
Abrams, executive vice president of the Medical Society of the State of New
Medical Liability Mutual Insurance
Company has asked the State Superintendent of Insurance Howard Mills for
approval to increase its rates nearly 27 per cent for the premium year
beginning July 1. If that request is not approved, MLMIC is seeking to
increase rates by 33 per cent over a three-year period. In recent years,
MLMIC has seen its surplus drop dramatically from $1.25 billion to a
dangerously low figure of $200 million.
The MLMIC rate filings also include a
6 per cent surcharge on the third layer of medical malpractice coverage,
often referred to as the second excess layer. The 6 per cent surcharge would
apply to entity or professional coverage paid for by a group practice.
Two major factors contributing to the
decline in MLMIC’s surplus are jury verdicts and awards and a policy of
the State Insurance Department to keep rates artificially low when actuarial
data dictates that much higher rates, unfortunately, would be appropriate.
The State Medical Society is finalizing an action plan designed to convince
Governor George Pataki and the State Legislature to address this issue in
the next three weeks.
There had been expectations earlier
this year that the Governor would embrace a program advanced by a number of
hospital organizations, MSSNY and specialty societies which would provide
meaningful tort reform and premium relief.
We all hope that it doesn’t take a
crisis in the state threatening access to care before the Senate, the
Assembly and the Governor act responsibly. The State Legislature returns to
Albany on Monday, June 5 after a week’s recess.
In the coming days and weeks, we will be calling upon
members, family and staff to contact state legislators on this vital issue.
From the Onondaga County Medical Society and the American
ARTHUR P. VERCILLO, MD
STATUS OF MEDICARE CUTS
STILL UP IN THE AIR
Despite bipartisan agreement by the U.S. Senate and the House of
Representatives earlier this week to enact a freeze on Medicare
reimbursement for 2006 at the 2005 levels, this issue is still unresolved.
Each house of Congress has passed a different omnibus budget reconciliation
bill during the week, which included $7.3 billion needed to fund the freeze
on rates as opposed to the proposed 4.4 percent cut for 2006. Before a
budget reconciliation bill can go to the President for his action, the same
bill must pass both houses, who are now in recess for the holidays.
Following is a statement by the American Medical Association President J.
Edward Hill on this issue. The County Medical Society office has been in
constant communication over the past several days with Duane M. Cady, M.D.,
a former County Medical Society and MSSNY president, who currently serves as
chair of the AMA’s Board of Trustees.
More information will be shared with you when there are other
AMA: Congress fails to stop Medicare
physician payment cut
Payment cut will harm seniors' access to care
Statement attributable to:
J. Edward Hill, M.D.
Congress has failed to fulfill its responsibilities to Medicare patients
and their physicians. On Jan. 1, the 2006 Medicare physician payment cut
begins, and the AMA is deeply concerned that this will harm seniors' access
to physician care. There is bipartisan agreement in both the U.S. House and
Senate that this cut must be stopped to preserve seniors' access to care,
and both the House and Senate have passed legislation to stop the cut.
Procedural issues in the Senate and House prevented final action on this
critical access to care issue for Medicare patients.
A national AMA survey found that 38 percent of physicians will be forced
to limit the number of new Medicare patients they accept into their practice
when the cut begins Jan. 1. The 2006 Medicare physician payment cut of 4.4
percent is the first of six years of planned cuts totaling 26 percent.
During this same time, practice costs will increase at least 15 percent.
Physicians cannot continue on the current path of being paid less than
the cost of providing care without serious consequences for patients. For
those physicians who will continue to treat Medicare patients, 61 percent of
physicians told the AMA they plan to defer purchase of new medical equipment
and 54 percent plan to defer purchase of information technology. When these
types of decisions are made in order to keep medical practices open, the
overall ability to improve health care delivery in the digital age suffers.
It is our hope that Congress will immediately take up this issue when
they return to Washington in the new year to halt the payment cuts and
retroactively adjust payments. The AMA will continue to strenuously advocate
for a fair physician payment formula based on practice costs, as well as
continue to advocate for sound quality improvement initiatives. Physicians
are the foundation of Medicare, and Congress needs to act promptly to
preserve seniors’ access to care.
PREMIUMS FOR 2005 – 2006 ANNOUNCED
The New York State Insurance Department announced on Thursday,
June 30 that it has approved a 7% medical liability premium increase for the
policy year 2005 – 2006, which began on Friday, July 1.
Medical Liability Mutual Insurance Company had requested a 30%
premium increase because of an alarming decrease in its reserves from $1.2
billion to $400 million in recent years and a 29% increase in severity (dollar
amount of awards and settlements) over the past four years.
When more details are available, we will share them with you.
(From Onondaga County Medical Society, June 5, 2005.)
American Academy of Orthopaedic Surgeons
FDA issues public health
Merck withdraws Vioxx from world markets
Merck & Co., Inc. today announced a
voluntary withdrawal of Vioxx from U.S. and international markets due to safety
concerns. Vioxx is a prescription COX-2 selective, non-steroidal
anti-inflammatory drug (NSAID) approved by the Food and Drug Administration
(FDA) in May 1999 for the relief of the signs and symptoms of osteoarthritis,
for the management of acute pain in adults, and for the treatment of menstrual
symptoms. It is also approved for the relief of the signs and symptoms of
rheumatoid arthritis in adults and children.
On Sept. 27, 2004, Merck & Co., Inc.
informed the FDA that the Data Safety Monitoring Board for an ongoing long-term
study of Vioxx in patients at risk for developing recurrent colon polyps had
recommended that the study be stopped early for safety reasons.
The study showed an increased risk of
cardiovascular events (including heart attack and stroke) in patients on Vioxx
compared to placebo, particularly those who had been taking the drug for longer
than 18 months. Based on this new safety information, Merck and FDA
officials met and Merck announced its voluntary withdrawal of Vioxx from the
Although the risk that an individual patient taking Vioxx will suffer a heart
attack or stroke related to the drug is very small, the FDA is advising that
patients currently taking Vioxx contact their physician for guidance regarding
discontinuation and alternative therapies.
and other healthcare professionals should direct any questions to:
1-888-368-4699 or at
the FDA’s Drug
Information Office at 301-827-4573 or 1-888-463-6332
information can be found on FDA’s website at:
American Academy of Orthopaedic
6300 N. River Road
Rosemont, IL 60018
Medicare Bill Passes
From 11/03 OCMS E-mail:
November 25, 2003
PASSAGE OF HISTORIC MEDICARE BILL
Statement Attributable to: Donald J. Palmisano, M.D., J.D. AMA President
"Today’s Senate passage of the Medicare bill is a historic victory for
Medicare patients and their physicians. This Thanksgiving, Congress and the
Bush Administration have given America’s seniors a Medicare bill for which
they can be truly thankful.
"There are so many positive provisions in this bill. All Medicare patients
will be eligible for a long overdue prescription drug benefit, and the
neediest patients will receive the most assistance. All Medicare patients will
receive a greater choice of health plans. Health savings accounts, which
empower patients to have greater control over their health care decisions,
will become a more attractive option for all Americans.
"This truly significant legislation also enhances access to care for
seniors by halting Medicare cuts to physicians and other health professionals
for the next two years. Instead of cuts, the Medicare bill provides at least a
1.5 percent increase in payments in 2004 and 2005. For next year, this
represents a 6 percent difference in Medicare payments at a time when
physician practice costs are on the rise.
"Patients also will benefit from a comprehensive package to strengthen
health care in rural and underserved areas. This bill will reduce payment
disparities in parts of the country where physician services are in great need
and short supply. It also provides regulatory relief, so physicians can spend
more time with patients and less on paperwork.
"The AMA applauds Congress for giving America’s seniors and disabled
greater access to prescription drugs and medical care and increased choice
under Medicare. We look forward to President Bush’s signature on this historic
bill and to a stronger Medicare program for our nation’s seniors."
Stand Up For Tort Reform!
From 5/03 MSSNY Newsletter:
POLL SHOWS SIGNIFICANT MAJORITY OF
NEW YORKERS SUPPORT TORT REFORM
The New Yorkers for Civil Justice Reform, the 1200 member broad based
coalition dedicated to seeking the enactment of tort reform, held a press
conference to release a survey indicating the overwhelming support of New
Yorkers for reasonable civil justice reforms. MSSNY Director of Governmental
Affairs Gerard Conway participated in this press conference. The press
conference was held in conjunction with an Albany Lobby Day held this week to
demonstrate the extensive grass roots support for the enactment of reasonable
tort reforms, including S.2944 (Volker), the Civil Justice Reform Act.
Of particular note in the survey was
that 62% of those persons polled supported a cap at some level on the
non-economic damage portion of awards in medical liability cases. Moreover,
over 80% of those surveyed agreed that "a medical malpractice insurance crisis
is increasing the cost of healthcare, decreasing patient access to doctors and
hospitals, and affecting the overall quality of care provided to patients.
“ Also, almost 80% agreed that there are too many lawsuits today.
Demonstrating how broad-based support for these reforms are, the poll
respondents were divided almost equally between men and women across the
State, and there were a similar number of poll respondents from every
congressional, senatorial and assembly district in New York State.
MSSNY PREPS FOR TORT REFORM PUSH WITH MAY 20TH "STAND UP"
Physicians, medical office staffs and supporters are rallying for a major tort
reform push with "Stand Up" rallies slated for more than 20 locations across the
state on Tuesday, May 20. It is expected that more than 5,000 physicians will
participate statewide. "This is the critical push," according to MSSNY President
Jeffrey Ribner, MD. "At a time when physicians are being squeezed from all
angles, it has become abundantly clear that neither patients nor physicians can
any longer be subject to the outrageous costs associated with our runaway
Speaking in a recent editorial for an upstate newspaper, Dr. Ribner pointed out
that physicians face greater liability exposure in New York than in any other
state and that New York premiums are the highest in America. He also debunked
the notion offered by trial lawyers that removing a few physicians from practice
would solve the liability problem. "In
the past five years MLMIC data indicates that fully 60% of their covered
obstetricians, orthopedists and general surgeons, as well as 70% of their
neurosurgeons have been sued," Dr. Ribner said. "These are amongst the
most highly trained physicians in the profession, and they are delivering care
to patients who frequently have life-threatening conditions. Are all of these
physicians incompetent? I doubt it. They are victims of the trial bar "jackpot"
system that doesn't acknowledge the difference between negligence and
unavoidable adverse outcomes."
Dr. Ribner called for all physicians across the state to join with their county
organizations at the "Stand Up" rallies scheduled for May 20.
CONGRESS: MEDICAL LIABILITY REFORM WOULD SAVE GOVERNMENT $19.5 BILLION -
DECREASE UNINSURED BY 3.9 MILLION
The Joint Economic Committee of the United States Congress has released an
exhaustive report on the societal cost of the out-of-control medical liability
situation in the U.S. The report finds that between 1994 and 2001 the typical
malpractice award skyrocketed 176% to $1 million. This has resulted in steep
increases in insurance premiums, which in turn has led to higher costs for
health care services and reduced access to medical services. The report
makes the case that the current liability system neither fairly compensates the
victims of negligence, nor does it effectively deter negligent behavior. It
concludes that the current system has a particularly adverse effect on women,
low-income individuals and rural residents. Significant savings and public
benefits would be created if comprehensive liability reform were enacted, the
authors point out. They include:
Reducing unnecessary tests and
procedures motivated out of fear of litigation
Halting the exodus of doctors
from high-litigation states (such as New York) and specialties
Improving access to care,
particularly for women, low-income patients and rural residents
Encouraging systematic reform
to reduce medical errors
Generating gross indirect
savings to the health care system ranging from $99 Billion to $178 Billion per
Producing annual savings in
direct costs to the federal government of $12.1 Billion to $19.5 Billion per
Increasing the number of
Americans with health insurance by up to 3.9 million people
This report adds yet another set
of compelling facts to the overwhelming case for comprehensive liability reform.
The Joint Economic Committee study, "Liability for Medical Malpractice: Issues
and Evidence" can be viewed online at
More Medicare Cuts?
From 5/03 MSSNY Newsletter:
URGENT CALL TO ACTION: CMS PROJECTS 4.2% CUT IN 2004 MEDICARE PHYSICIAN
PAYMENTS; CONTACT YOUR REPRESENTATIVES AND SENATORS NOW!
Earlier this year, President Bush signed into legislation that replaced a 4.4%
cut for 2003 with a modest increase of 1.6%. The Centers for Medicare and
Medicaid Services (CMS) told Congress the legislation enacted last February
would produce positive updates for the next few years. Recently, CMS issued a
letter stating, " While we previously estimated positive updates for 2004 and
later years, we now estimate updates will be negative for 2004-2007" with a 4.2%
cut in 2004. Therefore MSSNY and the AMA strongly believe that the current
Medicare MD payment formula must be replaced. Physicians are the only
"providers" subject to the Sustainable Growth Rate (SGR). The SGR cuts payments
if growth in Medicare patients' use of services exceeds the Growth in Domestic
Product (GDP) of the entire American economy. The SGR is centralized government
planning at its worst. The medical needs of patients do not decline during
economic downturns. CMS should not penalize physicians for volume increases when
the government promotes greater use of physician services through new coverage
decisions, quality improvement activities and a host of other administrative
decisions that are good for patients but aren't reflected in the SGR. From
1991-2003, payment rates for physician services fell 14% behind practice cost
inflation as measured by the conservative estimates of CMS. MedPAC, an advisory
group established by Congress, has recommended that the SGR formula be replaced
with a more equitable process for updating Medicare physician payments (similar
to the Medicare hospital update process). For 2004, MedPAC has recommended that
payments be increased by 2.5% instead of the -4.2% cut.
Multiple studies have shown that
physician acceptance of new Medicare patients is declining and that this trend
will accelerate if payments are again cut. Contact Your Representative
and Senators Today! Urge your Representatives and Senators to
implement the MedPAC recommendations to replace the SGR with a more equitable
update process for Medicare physician payment and to increase 2004 payments by
2.5%. Please use the AMA Grassroots Hotline at (800) 833-6354 or point your
Health Care in Crisis
I sent this letter in response to the following request from the Medical
Society of the State of New York, feel free to send your views to me at email@example.com,
or click on the link immediately below:
||News of New York Survey
||12/6/2000 10:13:02 AM Eastern Standard Time
To: firstname.lastname@example.org (mssny-members)
NEWS OF NEW YORK PHYSICIANS SURVEY
For the January 2001 issue of the News of New York (circ.27,000), MSSNY is
asking New York physicians to answer the following questions:
· What do you propose the new administration address immediately regarding
health policy, HMOs, prescription plans?
· Given the current practice environment, how do you expect your practice
to change in the next five years?
3229 East Genesee St.; Syracuse, NY 13214
Critical issues need attention to inhibit or better yet, reverse the
downward spiral of deteriorating health care in NY and USA. We are in
Morale problems abound. Doctors
and nurses speak of career changes, strikes, constant staff shortages, mandatory
overtime (I am getting my MBA from Syracuse University, and may look for other
work when finished).
Insurance companies continue to cut
reimbursements, while increasing co-pays, restricting access to specialists,
tests, and procedures, AND PREMIUMS ARE GOING UP!! Where is the money
going??? The hassle factor increases. Office staff spend more
and more time away from patient care on the phone ON HOLD seeking authorization
for tests, referrals, etc., increasing the costs of office care. Why do
the insurance companies have a controlling choke hold on patient care?
Medicare cuts have pushed hospitals
toward financial ruin. Programs are cut (Crouse Health has closed a
diabetes program, an outpatient PT facility, and an urgent care center,
orthopedic patient education, to name a few), beds are closed. ER services are
limited as ER's are closed due to staffing cuts. Our hospitals are
crumbling, and they show it- dirty, dusty, paint peeling, ceiling tiles falling
out. The money does not exist for capital improvements and investments.
We need to decide, as a society, if quality care is worth more money.
There is a worsening nursing shortage.
Why anyone would want to be a nurse today is beyond me: more
paperwork, less patient care, less money, staff shortages, more overtime,
liability risk, less respect from patients/hospital management, etc.
Medical liability reform remains an
urgent need. We, as physicians, are caught in a vice between less
involved, cheaper, quicker, more streamlined care and the constant threat of
legal action. Defensive care remains costly, but necessary. The
lawyers advertise increasingly re: the ubiquitous nature of malpractice, and the
public responds. We need tort reform!
Who will finance medical research and
medical training? Managed care shows little concern for even essential
medical services, like physical therapy, prompt access and evaluation by
specialists, and testing. I am concerned that the distraction of "bottom line medicine" will divert attention and dollars from our
future investments in health care: the development of medical techniques,
procedures, drugs, research in disease etiology, prevention, management, and
cure, and the training of future physicians and ancillary health care staff.
I am worried about the future of our industry.
All of this with an aging population.
The volume and costs of medical care increase as the age of the patient
rises. What will we have to offer our aging baby boomers in ten to twenty
It is very difficult to
imagine how things can improve in the next five years. I have
a tough time visualizing the "light at the end of the tunnel". Managed
care was touted as the solution to spiraling rises in the cost of care. It
has only added to our woes. It has not controlled costs. Insurance
premiums continue to rise, while patient access and choice have become
increasingly limited, and patient financial responsibility has also
paradoxically escalated (see rising co-pays).
There has, in my opinion, been a general
trend of interference with patient care. As clinicians, we can rarely
make a move without asking for permission from the payors, and this wastes the
valuable time of office staff, distracting from clinical patient care. The
insurors have made a mockery of "customer service", hindering the
authorization process with complicated phone menus, and unnecessarily long
holding times and phone transfers, as well as insulting interviews with insuror
staff substantiating straightforward tests and procedures.
We must, as a society, decide whether,
and how much, health care is desirable and valuable. We must, as
individuals, take responsibility for our own care, and hold the payors as
accountable as our providers for their decisions. Denial and delay of
care based on financial reasons impact one's health. For example,
arbitrarily limiting physical therapy treatments for a "frozen
shoulder" to twelve visits for the proper management of a condition that
may take 6-12 months to resolve can no longer be tolerated by those who pay
larger premiums and get less in return.
We must seek a better way to participate
in decisions about our care, and realize that these decisions cost money. Medical
savings accounts may help merge the consumer function with the payor function.
I wonder if I can still derive
satisfaction from my profession in 5-10 years.
The interaction with my patients still makes it all worthwhile at
present, but this is increasingly devalued by the amount of time that is spent
in non-clinical tasks mandated by the managed care environment.
I can only hope that reform will occur
that will free our profession from the drudgery of this managed care quagmire.
This will take a revolt from the grass roots level. I do not think
that the general public has yet to realize what it has lost, and what it is
continuing to lose regarding health care. Quality is suffering. Morale
is suffering. Access is suffering. Choice is suffering. It
cannot be expected that continued cuts will not adversely affect quality care.
Will I be practicing medicine
(orthopedics) in five years? I hope so, but I am not certain, and I am
only 42, in merely my eleventh year of medical practice. My daughter is a
straight A, high honor student at Fayetteville-Manlius high school. I have
been unable to recommend to her a career in medicine. I have advised her
to consider Vet school instead! I will finish my MBA, and try to encourage
change, by educating my patients, and all those who will listen.
Daniel C. Wnorowski, MD
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