NYS changes requirements for physician profiles



May 12, 2015

Health Care Alert

Author(s): Peter J. Millock, Laurie T. Cohen, Philip Rosenberg, Michele A. Masucci

New York State’s physician profile requirements will change April 13, 2016. Physicians will have thirty (30) days, instead of one hundred twenty (120) days,  from the date they transmit an initial profile survey or update profile information to register for an account with the NYSDOH provider network (“HPN”). Failure to comply timely with profile reporting requirements is professional misconduct.

Instead of repealing New York State’s physician profile requirements as Governor Andrew M. Cuomo proposed in his 2015-2016 state budget proposal, the state legislature and Governor Cuomo amended current law to require physicians to report changes in their profile information more quickly. Effective April 13, 2016, physicians will have thirty (30) days—instead of one hundred twenty (120) days—from the date they transmit an initial profile survey or enter or update profile information to register for an account with the NYSDOH provider network (“HPN”), and to provide an e-mail address or notice of a changed e-mail address for DOH to use to communicate with the physician. The amendment also affirms the regulatory requirement that physicians must notify the New York State Department of Health (“DOH”) of any change in mandated profile information within thirty (30) days of the change.

The physician profile is an online, publicly available database providing information about NYS licensed physicians. The profile is required to include information about a physician’s medical education, licensure actions and limitations, certain medical malpractice actions and settlements and criminal convictions, as well as translation services available at the physician’s office. Physicians may provide additional optional information.

Failure to comply timely with these reporting requirements is professional misconduct. Recent State Board for Professional Medical Conduct (“SBPMC”) orders clearly show that these reporting requirements should not be ignored and that failure to comply in a timely manner with the requirements to create and update a physician profile is not considered to be merely a technical violation. Within the last seven months, at least two physicians who were charged with professional misconduct for failing to provide information needed to establish their profiles, were disciplined and fined by SBPMC.

The law also requires DOH to study and report to the governor and legislature by January 1, 2016, on the feasibility of incorporating health plan reporting requirements regarding network participation in the physician profile. DOH is to consider how to ensure the accuracy, currency and accessibility of the information without imposing extra burdens on physicians. This is a complex issue but if deemed feasible, health plan participation status may be a data element to be added to physician profiles.

The foregoing has been prepared for the general information of clients and friends of the firm. It is not meant to provide legal advice with respect to any specific matter and should not be acted upon without professional counsel. If you have any questions or require any further information regarding these or other related matters, please contact your regular Nixon Peabody LLP representative. This material may be considered advertising under certain rules of professional conduct.

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