Schedule your Empire MA patients in December to close care gaps

CIN PCPs who care for Empire Medicare Advantage (MA) patients recently became eligible for a new incentive program for their efforts in driving Q4 2022 performance for MSHP’s Empire MA contract. MSHP’s Empire MA contract performance is based on ten performance measures. As part of this incentive program, each performance measure is assigned an award for provider reporting and Empire reconciliation of gap closure. To supplement this effort, MSHP mailed letters to patients describing what tests and screenings they need, asking them to schedule an appointment with their primary care physician.

Your Population Health Manager/Population Health Specialist should have provided you a link to your practices Care Gap Template if you are eligible for this program. The deadline for entering care gap closures in the OneDrive Care Gap Template is January 31, 2023 (for gaps closed by December 31, 2022). To learn more about this program and next steps, please contact your Population Health Manager or Population Health Specialist.

Reminder: Review Your VBC Performance Reports

Voluntary PCPs and pediatricians in our network received customized value-based care (VBC) performance reports in their One Drive accounts on October 21st. Please be sure to view these reports to see how you’re performing on quality, clinical documentation (PCPs only), and efficiency metrics for patients under VBC contracts. The patient opportunity report includes patient-level information on care gaps. Use this report to inform your patient outreach strategy.

Watch the recording of the November 1st MSHP Town Hall Gathering

The recording and slides from the most recent MSHP Town Hall Gathering are now available. During this Town Hall, Stephen Sisselman, DO, discussed how his practice effectively meets the CI 2022 metrics and shared successful workflows. Cigna representatives also provided an overview of our new Cigna Medicare Advantage contract. Below are materials we shared during the Town Hall.

2023 Cigna Medicare Advantage Materials

• Cigna Provider Manual 
• Cigna Provider Quick Reference Guide
• Website for Cigna MA Providers

Category II CPT codes for key CI Program metrics

• 2022 Primary Care Measures: CPT II Codes

Using the codes in the document above

• Allows for the submission of clinical data to the payers on a claim
• Reduces the need to "chase" results to provide to payers, thus improving efficiency and freeing up your administrative staff for outreach and performing improvement activities

Infectious Diseases Updates from Dr. Waleed Javaid

Dr. Waleed Javaid, Director of Infection Prevention and Control for the Mount Sinai Health System, shared some comments on the “tripledemic” of COVID-19, flu, and RSV we are currently facing. With reduced masking in public spaces, more community events, and fewer people vaccinated against influenza and COVID-19, we are likely in for the worst flu season this year since the pandemic started. In fact, we are already experiencing much higher rates of influenza infections at this point in the season compared to pre-pandemic years.

It is very important for all of us, our patients, and our staff to get a bivalent omicron booster as well as a flu shot (which can be done simultaneously). Dr. Judith Aberg, our Chief of Infectious Diseases, notes that early data from the Centers for Disease Control and Prevention suggests this year’s vaccine is a very good match for the variants of flu that are circulating. There is no vaccine for RSV, but hand hygiene and isolation if symptomatic can help control the spread. No one should come to work with respiratory symptoms even if a COVID-19 test is negative, as home tests can be unreliable and COVID-19 is not the only pathogen circulating.

Learn more

New Cigna CIN Medicare Advantage Contract

Effective January 1, 2023, Mount Sinai Health Partners IPA, LLC (MSHP) has entered into an agreement with Cigna Medicare Advantage for all providers in MSHP’s Clinically Integrated Network (CIN). New Cigna MA members may be contacting your practice for appointments, so please be sure that your practice staff are aware that you accept Cigna MA insurance.

Next Steps

• Review the Quick Reference Guide that includes links to view sample member cards and telephone numbers for key processes such as eligibility and benefits verification, claims processing, prior authorizations, pharmacy, and more
• Read the Participating Provider's Manual
• View the 2023 fee schedule for top E&M codes (login required)

Cigna Digital ID Cards

Some Cigna patients may come to your office with only a digital ID card, which looks the same as the physical ID card and contains the same benefit information. They may:

• Share their digital ID card image on a phone screen in the office
• Relay the information verbally over the phone to preregister for their appointment
• Upload the digital ID card image to your health portal
• Email the digital ID card image directly to your office from the myCigna app
• Print a copy of their digital ID card and share it with your office

Learn more

Bright HealthCare Exiting New York Market

You may already have been contacted by Bright HealthCare, but we wanted to make sure you are aware that Bright HealthCare will no longer offer any plans in the New York market in 2023.

Bright has notified all plan members so that they can select a new Medicare Advantage plan during Medicare’s open enrollment period, which runs through December 7.



Review the FAQs on the Bright website to familiarize yourself with important details, and don’t hesitate to email us or reach out to the Provider Engagement Team with any questions. 

EmblemHealth October 2022 Newsletter

EmblemHealth shared their October 2022 newsletter with us which includes information on procedural changes for post-acute care effective December 1st.

Complete by December 31, 2022: Mandatory Annual Medicare Training and Aetna D-SNP Training

All CIN providers

Per CMS compliance requirements, all CIN providers must complete an annual Medicare compliance First Tier, Downstream, and Related Entities (FDR) training by December 31, 2022. Review the guidebook and ensure you understand the material but no further action is required. 

All providers participating the Aetna Special Needs Plan

Per CMS compliance requirements, participating providers in Aetna's Special Needs Plans are required to complete an annual D-SNP Model of Care (MOC) training by December 31, 2022. You must review the slides and ensure you understand the material and complete the attestation.

If you have any questions about the training or requirement, please review the FAQ or email us. 

November is National Diabetes Month

This month we acknowledge more than 37 million Americans living with diabetes. As a major driver of health care spend and high rates of morbidity and mortality among our patients, Mount Sinai Health Partners has focused on improving provider education and standardizing care for diabetes patients across the health system.

Care Pathways

Review our ambulatory care pathway and quick reference guide for evidence-based guidelines on diagnosis, treatment, and management.

Diabetes Tips of the Month

Our tips of the month offer short clinical pearls on managing chronic conditions.

• December 2021: Considerations for the Diabetic Foot Exam
• June 2021: Screening for Heart Disease in Diabetes Patients
• May 2022: Monitoring for Diabetic Kidney Disease

Find a Specialist

Need to refer to a specialist? Visit our Find a Specialist page for directories of endocrinologists and other specialty providers in your geographic area, or use our provider search to create your own customized report.

Primary Care

Diana Ramirez-Baron, MD

Family Medicine

Gynecology & Integrative Women's Care, PC

New York, NY

Specialty Care

Christine Friedman, MD

Obstetrics & Gynecology

Goncharov Medical PC

New York, NY

Alyssa Hackett, MD

Otolaryngology

Otolaryngology

New York, NY

Evelyn Icasiano, MD

Ophthalmology

Physician Eyecare Of New York

New York, NY

Natalie Jensen, AUD

Audiology

ENT and Allergy Associates

West Nyack, NY

Ankit Kansal, MD

Otolaryngology

ENT and Allergy Associates

Astoria, NY

Machial Kreyner, PT

Physical Therapist

Igor Rubinshteyn MD, PC

Brooklyn, NY

Robert Latkany, MD

Ophthalmology

Physician Eyecare Of New York

New York, NY

Katharine Pelletier, MD

Obstetrics & Gynecology

Goncharov Medical PC

New York, NY

Kevin Sardy, AUD

Audiology

ENT and Allergy Associates

Bayside, NY

Isabella Schaefer, AUD

Audiology

ENT and Allergy Associates

New York, NY

John Shields, DPM

Podiatry

TD Podiatry P.C

New York, NY

Belinda Sun, AUD

Audiology

ENT and Allergy Associates

Brooklyn, NY

Neal Trulock, DO

Obstetrics & Gynecology

Michael Terrani MD PC

New York, NY

Aaron Westreich, MD

Allergy & Immunology

ENT and Allergy Associates

Howard Beach, NY

Behavioral Health

Felise Dezen, LCSW

Licensed Clinical Social Worker

Gynecology & Integrative Women's Care, PC

New York, NY

Maryann Foster, LCSW

Licensed Clinical Social Worker

Gynecology & Integrative Women's Care, PC

New York, NY

Rosemary Munoz, LCSW

Licensed Clinical Social Worker

Gynecology & Integrative Women's Care, PC

New York, NY

Kristal Ruiz, LCSW

Licensed Clinical Social Worker

Gynecology & Integrative Women's Care, PC

New York, NY

Advanced Care Practitioners

Floriana Massil, NP

Nurse Practitioner

Bobby Buka MD, PC

New York, NY