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Clinically Integrated Network Newsletter
January 3, 2023
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Join us on January 18 to Learn About the 2023 Clinical Integration Program | |
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Mount Sinai Health Partners will be hosting an informational webinar on the 2023 Clinical Integration (CI) Program for PCPs on Wednesday, January 18 from 8:00 – 9:00 AM.
At this meeting, we will share important updates and changes to the program. We strongly encourage you to attend. Please click here to register for this webinar.
MSHP will also be reviewing the 2023 CI Program and several other topics (see below) during the January 25 Town Hall. If you are unable to attend the Town Hall, we encourage you to join this webinar.
Attendance for this program will also meet a portion of the Program Engagement element within the 2023 CI program.
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Hosted by
Arshad Rahim, MD, MBA, FACP
Senior Vice President and Chief Medical Officer, Population Health, MSHP
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Q3 PCP Care Coordination Payments
Checks for Q3 PCP 2022 Care Coordination payments were issued in late December.
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The Retirement of Dr. Loredana Ladogana
Please join us in wishing Dr. Loredana Ladogana, Medical Director for Physician Engagement, all the best for her retirement. In this role she engaged, supported, and empowered CIN providers to help them meet quality and cost savings goals. She is a board-certified family physician and ran her own practice in Sunnyside, Queens, until 2006 before serving as Associate Chair and Chief of Ambulatory in the Department of Family Medicine at Bronx Lebanon Hospital overseeing the hospital’s inpatient and ambulatory centers. She then acted as Senior Medical Director/Interim Chief Medical Officer at a managed care plan where she developed clinical partnership infrastructure for physicians to promote data sharing, best practices, and strategies for delivering value-based care.
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Dr. Ladogana received her undergraduate degree from CUNY Hunter College and her medical degree from SUNY Downstate College of Medicine.
Dr. Ladogana will be greatly missed at MSHP where she always brings light and thoughtful feedback to every meeting and has been an instrumental contributor to a number of MSHP initiatives including our Town Hall Gatherings, our COVID-19 response, pediatrician engagement and education, and so much more.
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COVID-19 Treatment and Therapeutics Updates
The New York City Department of Health and Mental Hygiene released a new health advisory based on the latest CDC guidance for COVID-19 prevention and treatment. The guidelines for NYC-based providers include information about currently effective pharmacological treatments, including when to prescribe antivirals.
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Coming Soon: Annual Experience Surveys | | |
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Keep an eye on your inbox in January for our annual Provider Experience Survey and Office Manager Experience Survey. We value your feedback and suggestions and use them to inform our strategy and how to best serve you. | |
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Register Now for MSHP’s January Town Hall
Mount Sinai Health Partners will be hosting a virtual Town Hall Gathering on Wednesday, January 25 from 6:00 – 7:15 PM. During this Town Hall MSHP will discuss:
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- Review of 2023 Clinical Integration Program*
- Q1 Preferred Clinical Activities and 2023 data release schedule
- Contact Overview for 2023
Click here* to register for the Town Hall. We look forward to seeing you there!
*We will be hosting an additional virtual meeting dedicated to the review of the 2023 Clinical Integration Program on January 18, 2023 from 8:00 – 9:00 AM. Please click here to register for this webinar.
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Healthcare Rocks Benefit Concert Featuring Dr. Robert Fields | |
Healthcare Rocks, an evening of networking, live music, food, drink and holiday cheer, raised money for New York Common Pantry and V!brant Emotional Health. This show featured clinicians and healthcare leaders who moonlight as musicians, including our very own Robert Fields, MD, MHA, Executive Vice President and Chief Population Health Officer of the Mount Sinai Health System. | |
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2023 Top Tier Guides Now Available
Mount Sinai continues to offer Mount Sinai Health System and Mount Sinai South Nassau faculty, staff and their eligible dependents access to a Top Tier network in 2023 at a level of coverage that has the least out-of-pocket cost for quality healthcare service.
Mount Sinai Top Tier Network is administered by UMR, a division of UnitedHealthcare and Mount Sinai South Nassau’s Top Tier Network administered by Aetna. No action on your part is needed at this time.
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Please see below for guides that address rates, benefits, copays and deductibles, ID card images, claims submission, prior approval processes information and other relevant information:
For questions regarding MSHS member benefits, please contact UMR, a division of UnitedHealthcare at 877-233-1800. For questions regarding Mount Sinai South Nassau member benefits, please contact Aetna at 833-880-0375.
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Medicare provisions in Fiscal Year 2023 Omnibus Appropriations Bill
On December 23, 2022 Congress passed and the President signed into law the Fiscal Year 2023 Omnibus Appropriations Bill. The key Medicare provisions include the extension of Medicare telehealth flexibilities through the end of 2024 and a reduction of the scheduled cuts to the Medicare Physician Fee Schedule rates from 4.5% to 2% in 2023 and 3.25% in 2024.
The bill also includes a substantial increase in spending for behavioral health-specific programs, including workforce and graduate education and training, as well as $10 billion to address opioid abuse and other mental health treatment and research initiatives.
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New CIN Contracts: Cigna Medicare Advantage and EmblemHealth GHI Medicare Products
Effective January 1, 2023, Mount Sinai Health Partners has entered into Agreements with both Cigna Medicare Advantage (MA) and EmblemHealth GHI Medicare products for all providers in MSHP’s Clinically Integrated Network (CIN). As a member of MSHP’s Clinically Integrated Network, your practice is automatically enrolled in these fee-for-service arrangements. You do not need to sign an opt-in agreement to participate.
To learn more, review next steps, and view fee schedules, please refer to this communication we sent on December 12th.
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New Messenger Model Contracts: Welcome New Patients
On September 14, 2022, we informed you that MSHP has entered into Agreements with Empire BlueCross BlueShield and EmblemHealth to offer CIN providers participation with Empire HealthPlus Medicaid, EmblemHealth Enhanced Care Medicaid, and EmblemHealth Plan, Inc, fka Group Health Incorporated (GHI) Commercial products.
As a messenger model contract, providers were required to individually opt in to the contracts in order to participate. If you opted in, your participation with these plans is effective January 1, 2023. Please welcome these new patients to your practice and ensure your staff is aware of your participation with these plans.
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EmblemHealth November 2022 Newsletter
EmblemHealth shared their November 2022 newsletter with us which includes information on procedural changes for post-acute care effective December 1st.
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Cigna Mpox Policy Updates
Recently, the New York Department of Financial Services issued guidance regarding coverage for immunization against, testing for, and diagnosis of the monkeypox (“mpox”)* virus in response to the mpox outbreak. As a result, Cigna is making certain accommodations for insured health plans issued in the state of New York.
What this means for you
Effective August 31, 2022, Cigna began to waive copayments, coinsurance, and annual deductibles for testing at participating laboratories, visits to participating provider offices, urgent care settings or other outpatient settings, and hospital emergency departments (can be nonparticipating if the patient has an actual emergency).
Copayments, coinsurance, and annual deductibles are also waived for mpox immunization when provided out-of-network to individuals, subject to the recommendation by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention, as well as mpox immunization for grandfathered health plans and individuals who do not fall within the ACIP recommendations.
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Welcome New MSHP Providers!
We'd like to extend a warm welcome to all new provider members who recently joined our clinically integrated network.
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Primary Care
Muneeb Khan, MD
Family Medicine
Michelle Li, MD
New York, NY
Specialty Care
Carmen Castilla, MD
Dermatology
New York Dermatology Group
New York, NY
Jack Charney, MD
Anatomic & Clinical Pathology
North Shore Gastroenterology
Associates, PC
Great Neck, NY
Adebola Dele Michael, MD
Dermatology
Radiant Skin Dermatology and Laser, PLLC
New York, NY
Abiola Dele-Michael, MD
Cardiovascular Disease
Dele-Michael Cardiovascular Medicine
New York, NY
Corina Din-Lovinescu, DO
Otolaryngology
ENT and Allergy Associates
Shrewsbury, NJ
Jennifer Geiger, MD
Dermatology
Jennifer Geiger MD PLLC
New York, NY
Jaimie Glick, MD
Dermatology
New York Dermatology Group
New York, NY
Anita Krish, DPM
Podiatry
Starrett Podiatry, LLC
New York, NY
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Shari Marchbein, MD
Dermatology
Shari Marchbein MD PC
New York, NY
Brittany Robles, MD
Obstetrics & Gynecology
Chen & Morgan OB/GYN Westside, PLLC
New York, NY
David Turner, DO
Emergency Medicine
David A. Turner Medical PLLC
Cedarhurst, NY
Behavioral Health
Edith Gonzalez, LCSW
Licensed Clinical Social Worker
Gynecology & Integrative Women's Care, PC
New York, NY
Tayiba Mahmud, LCSW
Licensed Clinical Social Worker
Gynecology & Integrative Women's Care, PC
New York, NY
Advanced Care Practitioners
Milana Agadzhanyan, PA
Igor Rubinshteyn MD, PC
Brooklyn, NY
Tinley Chen, PA
Bobby Buka MD, PC
New York, NY
Tami Mcmanus, NP
Gynecology & Integrative Women's Care, PC
New York, NY
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If you have any questions about any of our announcements, please contact your Population Health Manager, email Mount Sinai Health Partners at mshp@mountsinai.org or call us at 877-234-6667.
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P: 877-234-6667
F: 646-537-1481
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