The New York State Legislature completed passage of a $212 billion Budget package that produced several “victories” for organized medicine following months of extensive advocacy by MSSNY working together with county and specialty medical societies.
These issues include:
Excess Malpractice Insurance Program Extended
The final State Budget provides full funding for an additional year for the Excess Medical Malpractice Insurance program, which provides 17,000 physicians with a bonus $1 million/$3 million layer of liability insurance above the primary layer purchased by a physician. The State Budget restores the proposed $51 million cut in program funding and deleted an Executive Budget proposal strongly opposed by MSSNY to impose a 50% physician cost share requirement, which would have resulted in the imposition of thousands to tens of thousands of dollars of new costs on these 17,000 enrolled physicians.
Physician Due Process Protected
The final State Budget deleted several provisions proposed in the Executive Budget and opposed by MSSNY to substantially curtail physician due process rights when a complaint has been filed against them with the OPMC. The adverse provisions that were deleted included permitting the Commissioner to publicly disclose information regarding a complaint filed against a physician and creating a nebulous standard for imposing a summary suspension prior to the conclusion of disciplinary proceedings.
Pharmacy Scope Changes Rejected
The final State Budget deleted several provisions opposed by MSSNY that would have expanded the scope of pharmacists, including proposals to greatly expand the physician-pharmacy Collaborative Drug Therapy program, permitted pharmacist self-ordering of lab tests, and significantly expanded the number of the immunizations that can be performed by pharmacists.
Essential Plan Enhancements
The final Budget contains provisions supported by MSSNY to eliminate the premium requirements for the over 800,000 New Yorkers enrolled in the State’s Essential Plan, as well as providing bonus pool funding for physicians and other care providers participating with these plans.
Medicaid Cuts Defeated
The final Budget deleted a proposed 1% across the Board cut to Medicaid health care provider payments that had been opposed by MSSNY.
Protect Ability to Apply for E-Prescribing Waivers
The final State Budget deletes the Executive Budget proposal opposed by MSSNY to eliminate the ability for physicians and other prescribers to apply for a year-to-year waiver of e-prescribing requirements (availed by over 2,000 prescribers across the State of New York).
Protect Medicaid “Prescriber Prevails”
The final Budget deletes the Executive Budget proposal opposed by MSSNY to remove the statutory protection for the prescriber’s determination (not State Medicaid’s) to prevail for a medication prescribed to a patient covered by Medicaid fee for service.
No-Fault De-credentialing Rejected
The final Budget deletes the Executive Budget proposal MSSNY had raised concerns with to expand the power of the Superintendent of Financial Services to prohibit certain physicians from submitting claims for No-Fault services.
Addressing Cuts to MSSNY’s Committee for Physicians Health
The final Budget restored the proposed $198,000 cut to MSSNY’s Committee for Physicians Health.
The final State Budget includes an expansion of site locations where telehealth services can both provided and received. Importantly, it deletes a provision opposed by MSSNY advocacy that would have established an “interstate compact” of out of state health professionals to provide health care services to New York patients. Unfortunately, the final Budget also did not include “parity” for the payment of telehealth services, but MSSNY will continue to advocate in the remaining weeks of session to pass this legislation.
“Pass-Through” Entity Tax Option
The final State Budget includes a provision that will permit partnerships the option to pay taxes through the entity rather than on an individual basis, which would permit the individual to fully deduct State and Local Taxes (SALT) instead of being subject to the otherwise applicable federal $10,000 SALT deduction cap. Other high tax northeastern states, including Connecticut, Maryland and New Jersey recently passed similar laws.
Ensure Collaborative Practice by Nurse Practitioners with Physicians
The final Budget includes a provision to extend for an additional year - until June 30, 2022 - the existing law permitting certain nurse practitioners to practice without a written collaborative agreement with a physician provided they have proof of “collaborative arrangements” with physicians in the same specialty practiced by the NP. MSSNY has advocated for much stronger collaboration requirements for nurse practitioners in order to protect patients, however, with the sunset of the existing law coming up in two months, legislation (A.1535/S.3056) has also been introduced and strongly opposed by MSSNY that would repeal the requirements to even maintain proof of these collaborative arrangements.