Memos of Support 2013


American Academy of Pediatrics, District II, New York State
Supporting Positions on Pending Legislation in New York State

Memo of Support for A.2316/S.270
Universal Newborn Testing for Congenital Heart Disease
May 31, 2013

Contact: Elie Ward, Director of Policy & Advocacy

The NYS Academy of Pediatrics enthusiastically supports the requirement that all birthing hospitals perform Pulse Oximetry testing on all newborns to detect Congenital Heart Defects.  It is the accepted form of standard practice for quality pediatrics and neonatal care.  It should be universally required across New York State.

Pulse oximetry screening involves taping a small sensor to a newborn’s foot while the sensor beams red light through the foot to measure how much oxygen is in the blood. Pulse oximetry screening is effective at detecting congenital heart defects that may otherwise go undetected by current screening methods.

Pulse oximetry screenings are non-invasive, painless, and take approximately one minute to perform. According to the United States Secretary of Health and Human Services’ Advisory Committee on Heritable Disorders in Newborns and Children, congenital heart disease affects approximately seven to nine of every 1,000 live births in the United States and Europe; the federal Centers for Disease Control and Prevention states that CHD is the leading cause of infant death due to birth defects, and that about 4,600 babies born every year have CHD’s.

The Academy of Pediatrics supports universal pulse oximetry testing as an evidenced based approach to early identification and treatment of congenital heart defects in infants.

Current methods used to detect CHDs include prenatal ultrasound screening and repeated clinical examinations; however, prenatal ultrasound screenings, alone, identify less than half of all CHD cases. Many newborn lives could be saved by requiring birthing facilities to incorporate pulse oximetry screening as a method for early detection of CHDs in conjunction with current CHD screening methods.

The NYS AAP, District II, supports passage of A.2316/S.270 this session.  The lives of infants born across New York State this year are in the balance.

Go to top

Memo of Support for A.07248
Fair Payment for Vaccine Costs and Administration Fees
May 31, 2013

Contact: Elie Ward, Director of Policy & Advocacy

The New York State Academy of Pediatrics, District II, representing more than 4,100 pediatricians across the state enthusiastically supports A.07248, which requires health insurance companies to pay physicians who immunize children for both the actual costs of vaccine purchase and to pay a fair administration fee.

At this time, many pediatricians across New York are subsidizing large health insurance companies, which are refusing to pay them for the costs of vaccines purchased at the CDC posted retail price.  The pediatrician is buying the vaccine in good faith to immunize covered children and the insurer is refusing to fully compensate the doctor.  This leads to private physicians subsidizing large insurers.  Practices cannot be expected to carry the financial burden that rightly belongs to the insurer.

In addition, there has been a complete breakdown in health insurance companies fairly compensating physicians for the administration of vaccines.  This legislation requires insurers to pay physicians a fair administration fee.  Again, this fee is set by the federal government for Medicare based on a formula that takes many measures into consideration.  The legislation simply requires that insurers pay the Medicare set administration rate for childhood immunizations as they do for immunizations for those over 65. If anything, the work involved in immunizing small children is much greater than that involved in immunizing adults.  With children there are lots of questions from parents, there are requirements to report to the City or State Registry, and there is often a frightened child who needs comforting.

We support this legislation because it will help support what is truly New York State’s public health infrastructure for childhood immunization – the pediatrician’s office.

Go to top

Memo of Support for A.5692/S.3690
Physician Negotiation with Insurers for Fair Contracts
May 31, 2013

Contact: Elie Ward, Director of Policy & Advocacy

The American Academy of Pediatrics, representing more than 4,100 pediatricians across the state supports A.02474/S.3186 providing legal support for physicians to negotiate with insurers for fair service and reimbursement contracts.

Due to the current imbalance of negotiating power in favor of the managed care plans, physicians are offered take-it-or-leave-it contracts by health plans that can significantly hamper their ability to provide quality patient care. These contracts often permit burdensome processes and unjustifiably long wait times for obtaining pre-authorization to provide needed patient care; impose limitations on whom a physician or other health care provider may refer a patient for necessary care; permit demands for refunds of payments long after the time that such payments were originally made; permit health plans to make major changes to key elements of a contract without physician consent; and cede to physicians and other health care providers the legal consequences for patients harmed by health plan utilization review decisions.

Right now, the playing field in health care contract negotiations strongly favors large managed care plans and disempowers physicians to represent the needs of their patients.

By allowing independent contractor physicians and health care providers to conduct some collective negotiations while being closely monitored by the state, this bill would give physicians greater ability to advocate for patients in contract negotiations. This bill would also create a system under which the state could closely monitor those negotiations, and any negotiations involving fee-related matters would only be permitted when an individual managed care plan controls a substantial share of the managed care market. This legislation would not authorize strikes or boycotts of health benefit plans by physicians.

We fully support A.0274/S.3186 because we believe it will not only help improve health care, it will also create an equitable partnership between health care service providers and large managed care insurers across the state.  This legislation will have the ultimate effect of improving patient care and keeping more highly skilled physicians in New York State.

Go to top


Memo of Support for A.7667/S.3137A
Health Insurance Coverage for Maternal Depression Screening
June 3, 2013


Contact: Elie Ward, Director of Policy & Advocacy

The proposed legislation creates health insurance coverage for Maternal Depression screening in both the prenatal and postpartum periods of pregnancy/childbirth, as well as during pediatric visits during an infant’s first year.   The legislation will also create a referral network, so Mom’s identified as in need of further evaluation and treatment can access the appropriate treatment to address their Maternal Depression symptoms.

Maternal Depression is broadly defined as a wide range of emotional and psychological reactions a mother may experience during pregnancy and/or after childbirth.   These reactions may include, but are not limited to, feelings of despair, prolonged sadness, extreme guilt, thoughts of suicide, lack of energy, difficulty concentrating, fatigue, extreme changes in appetite, and thoughts of suicide and/or of harming the baby.  In some cases these reactions, which can occur without warning, happen before, during, and immediately after childbirth, and continue into the infant’s first year of life.  Untreated Maternal Depression can have significant negative impacts on both the mother and the baby.

Each year, approximately ten to fifteen percent of mothers and twenty- two percent of multi-ethnic inner city mothers develop Maternal Depression; 50-80 percent of new mothers will get “baby blues”; and 0.1-0.2 percent of new mothers develop postpartum psychosis.

Often, the symptoms of Maternal Depression are not immediately identified because they closely resemble those generally associated with pregnancy.  As a result, Maternal Depression is sometimes left untreated, and ultimately may result in detrimental impact to the entire family, especially the newborn and other children in the family.  Children of mothers with untreated Maternal Depression are at higher risk for serious developmental, behavioral, and emotional problems.  Unfortunately, the immediate family is often unaware of or unsure of how to offer support.  And most often, the mother experiencing depression does not disclose her condition due to feelings of shame and confusion.  As a result, severity of the condition can and often does worsen.

Early screening and identification of Maternal Depression has an 80 to 90 percent success rate and offers long-term health care costs savings.   It also helps support healthy child development and addresses issues of early childhood mental health challenges.

Most new mothers visit the pediatrician for their infant’s check- ups and health/sick visits more often than they would visit any other health professional for one year after the birth of their child.  Therefore, it makes sense to create a systematic and legal way for pediatricians to screen and refer new mothers who may be struggling with postpartum depression.   This legislation will create that opportunity and support its implementation.

Maternal Depression is often undetected and untreated by maternal and child health professionals due to both lack of training in identifying the condition and lack of support both professionally and financially.  Physicians are also concerned about the availability of treatment options and coverage for women identified with Maternal Depression.  This legislation addresses both issues.

Maternal Depression is a secret epidemic that impacts mothers and their babies across the state, across economic and social boundaries and across racial, ethnic and cultural differences.  Maternal depression knows no boundaries.  It requires a universal screening to identify Moms who need help.  It requires a high quality accessible network of treatment options to deliver that help.  And it requires public support so that moms and their new babies can truly have a healthy start.

It is our hope that we can work together to shine a bright light on the secret epidemic of Maternal Depression and help the thousands of mothers and babies at risk of mild, moderate or serious mental illness that can disrupt mother/child bonding and healthy child emotional development.

Go to top