From: Scott Tenner [Scott.Tenner@downstate.edu]

Sent: Monday, July 14, 2008 10:50 PM

To: DrTenner@BrooklynGI.com

Subject: Update on Office Based Endoscopy From Albany

To members of the NYSGE:

In one year, all offices performing endoscopy must become accredited! 

Will we be compensated for this mandate?  Probably No.

I am writing this letter to update you on a meeting held in Albany today with the Department of Health.  Today, over a dozen lawyers, including our Council Scott Einiger, Esq. and Donald Moy, Esq. (Medical Society State of New York) met with the Department of Health to clarify the issue of whether an office that becomes accreditated can bill (and receive) a facility payment.  Interestingly, other than DOH staff, and multiple lawyers, I was the only physician present at this important meeting affecting all fields of medicine that perform office based surgery.

Despite intense discussion over two hours, no definite decision was made.  However, it appears that the Department of Heath no longer interprets the law in such a way that would allow a facility formed by a physician, even if accreditated, from billing a facility fee. 

There are complex issues that largely involve interpretation of the law, both corporate law and Article 28 law.  Although there appeared to be "emotional support" for the concept of a gastroenterologist receiving fair payment for a office based "facility", the current Department of Health attorneys appear to have concern about the practice model for office based endoscopy "facility billing".   The discussion appears to be evolving and no firm decision was made today.

However, when I specifically approached Thomas Conway, Esq, Lead Council for the NYS DOH: "As of today, can our members bill a facility payment?".  His response was: "I will not give render an opinion today" . . . He suggested that I "submit the model for review".  Specifically, Mr. Conway wants us to describe our corporate accreditated facility model and allow the DOH to render a final decision. 

Based on the discussion during the meeting, I believe that the DOH will not allow offices to establish a separate corporate entity, with a separate tax identification number, to bill a "facility payment".

Over the next several months, a final decision from the DOH will likely occur.  During this time, The NYSGE will be working closely with our legal team and the DOH to find a solution that will allow the fair payment of offices that become accreditated and provide a "facility" for patient care.

- Scott

Scott Tenner, M.D., M.P.H.

President, New York Society for Gastrointestinal Endoscopy

Governor, American College of Gastroenterology
Director, Medical Education and Research
Division of Gastroenterology
Maimonides Medical Center
Associate Professor of Medicine,
State University of New York - Health Sciences Center
2211 Emmons Ave
Brooklyn, NY 11235
718-368-2960
718-368-2249 Fax
DrTenner@BrooklynGI.com