City Council's Proposed Pharmaceutical Rep Ordinance Heading for a Final Reading on Thursday...	Thursday is Naloxone Giveaway Day
CMS Posts new Guidelines for Medicare Part D Opioid Overutilization Policies	Hepatitis A Outbreak in Pa.
Two Words for new Pa. Patient Test Result Information Act - It's Complicated	Calendar of Events

It's a Bad Prescription for Physicians

The Philadelphia County Medical Society (PCMS) is lobbying hard against this proposed city ordinance, which is scheduled for a second and final reading on Thursday, December 13. If approved by the committee, the ordinance would be cleared to go to the full Council for a vote.

The ordinance's goal is to help address the opioid crisis by limiting the access or influence of drug salespersons on a doctor. Under the ordinance, manufacturers would have to register sales reps who work in the city, submit any product marketing materials to the city for review, and require sales reps to pay an individual registration fee.

PCMS believes the ordinance is an insult to doctors, because it presumes that they lack the judgment and moral and ethical values to make the best decisions for their patients in the matter of drugs. Pharmaceutical manufacturers are already one of the most heavily regulated industries in the country, falling under the investigative eye of the FDA.

PCMS also believes that the ordinance would hurt the city's economy, by placing unnecessary restrictions on professional workers and limit access to essential medications patients need.

Visit our website for more information.

The Philadelphia Dept. of Public Health (PDPH) is taking part in the state-sponsored "Naloxone Giveaway Day" - Thursday, December 13.

From 11:00 am to 5:30 pm, four of the city's libraries will give away a Naloxone kit to each person who requests it. No personal information will be requested. Officials will also be on hand to show how to administer the injections.

Here is the list of libraries:

• South Philadelphia Library, 1700 South Broad Street. (Available on the second floor in Health Center 2 Until 2:00 pm.)
• Lucien E. Blackwell Library, 125 South 52nd Street
• McPherson Square Library, 601 East Indiana Avenue
• Holmesburg Library, 7801 Frankford Avenue

For more information, click here.

The Centers for Medicare & Medicaid Services (CMS) has issued new guidelines for physicians treating Medicare patients with opioids. They are an expansion of the June 2018 roadmap CMS published which are designed to:

• Prevent new cases of opioid use disorder
• Treat patients who have already become dependent on or addicted to opioids
• Make better use of data from across the country to target prevention and treatment methods.

The new policies will go into effect on January 1, 2019. The policies involve further partnership with providers and prescription drug plans. CMS believes that providers are in the best position to identify and manage potential opioid overutilization in the Medicare Part D population.

Medicare prescription drug plans can assist providers by alerting them about unusual utilization patterns in prescription plans. The new policies include better safety alerts when opioid prescriptions are dispensed at the pharmacy, and drug management programs to better coordinate care when chronic high-risk opioid use is present.

Starting in January 2019, Medicare Part D plans will employ the following safety alerts at the pharmacy:

• 7-day supply limit for opioid naïve patients
• Opioid care coordination alert

Click here to download the complete CMS document on the new Medicare Part D overutilization policies.

PDPH has released a health advisory regarding the declaration of a statewide outbreak of Hepatitis A Virus (HAV) in Pennsylvania.

Physicians should routinely offer HAV vaccination to high risk patients who are homeless, use drugs or are men who have sex with men (MSM). Physicians should promptly report patients with confirmed or suspected acute HAV infections to PDPH at 215-6850-6740.

This year there has been an 80% increase in reported HAV cases in Pennsylvania among persons with and without specific risk factors. Allegheny County, where Pittsburgh is located, experienced a sudden case increase last month. Philadelphia HAV transmissions have been elevated since July of last year. The majority of cases (21/38, 55%) have occurred among men having sex with men.

To prevent further HAV increases in the city, area providers should increase efforts to vaccinate at-risk individuals, including:

• Patients 12 months and older who are currently homeless or who have had periods of homelessness.
• Patients who use injection or non-injection drugs.
• Patients who identify as MSM or who have a sex partner identify as MSM.

PDPH says you should consider HAV for any patient, particularly if high risk, who has fever, fatigue and signs of liver damage, dark urine, clay colored or pale stools, jaundice, abdominal pain, nausea and vomiting.

Test serum from suspected, symptomatic cases for HAV lgM and perform liver function tests.

Promptly report acute HAV cases to PDPH by calling 215-685-6740.

Educate HAV cases on measures to prevent transmission, such as handwashing and safe sex practices.

Visit the PDPH Health Information Portal for more information.

Click here for updated guidance from CDC.

The act is set to take effect on December 23 loaded with a lot of unanswered questions. The law requires organizations performing diagnostic imaging service to directly notify the patient or the patient's designee if a significant abnormality exists.

The Pa. Medical Society (PAMED) is fielding members' questions about the law, while realizing that the language in the law leaves a lot of room for interpretation.

PAMED and the Hospital Healthsytem Association of Pa. has sent a letter to Sec. of Health Rachel Levine, calling on the Pa. Dept. of Health (DOH) to clarify the law's requirements. PAMED is encouraging DOH to do two things:

• Allow stakeholders to submit questions to DOH so DOH can create FAQ pages or other documents that would answer those questions.
• And delay issuing sanctions for a year, to help physicians and other stakeholders become better prepared to meet the law's requirements.

PAMED will share any updates from DOH.

Visit the Pennsylvania Medical Society website for more information.

December

13 - Naloxone Giveaway Day Date: Thursday, December 13 Time: 11:00 AM - 5:30 PM Place: South Philadelphia Library, 1700 South Broad Street (Available until 2:00 PM) Lucien E. Blackwell Library, 125 South 52nd Street McPherson Square Library, 601 East Indiana Avenue Holmesburg Library, 7801 Frankford Avenue The Pennsylvania Department of Health and the City of Philadelphia Department of Public Health are partnering with the Free Library of Philadelphia to provide free naloxone kits (limited to one per person) and training in an effort to stop overdoses in PA. Click Here to Learn More

February

13 - Philadelphia Public Health Grand Rounds Date: Wednesday, February 13 Time: 5:30 PM Place: 19 S. 22 Street, Philadelphia This Public Health Grand Rounds will explore barriers to accessing primary care in the Philadelphia area and examine solutions to improve access to care among underserved populations. Click Here to Register

26 - SBIRT and MAT Implementation Program Date: Tuesday, February 26 Time: 6:00 PM Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130 Save the date! The Philadelphia County Medical Society is holding an educational program on SBIRT(Screening, Brief Intervention, and Referral to Treatment), which is a comprehensive approach to the delivery of early intervention and treatment services that can be used with patients who are using substances, and MAT(Medication-Assisted Treatment), which is the use of medications in combination with counseling and behavioral therapies for the treatment of substance use disorders.