Registration Deadline is Friday, April 14th

The MSD 2023 Interim Council Meeting will be held on Thursday, April 20, 2023 at the Smyrna Opera House, with cocktails/hors d'oeuvres at 6:00 p.m. and the meeting beginning promptly at 6:30 p.m. All MSD members are invited to attend. Click to register. REGISTRATION DEADLINE IS CLOSE OF BUSINESS ON FRIDAY, APRIL 14TH.

Resolutions that have been submitted for the Council's consideration are:

• Increasing Representation on the Medical Society of Delaware’s Delegation to the American Medical Association
• MSD Position on the Legalization of Cannabis
• Dialysis Coverage for Undocumented Immigrants with End-Stage Renal Disease

Observed Each Year on April 16

Aimed to inspire, educate and empower patients, caregivers, and physicians about the importance of advance care planning, National Healthcare Decisions Day is a series of independent events held around the country on April 16. It was founded in 2008 by Nathan Kottkamp, a Virginia-based health care lawyer, to provide clear, concise, and consistent information on health care decision-making to both the public and physicians/facilities, through the widespread availability and dissemination of simple, free, and uniform tools to guide the process. Click for tools and resources.

Discussion of Alzheimer's Disease, Other Dementias Mandatory Education

On Monday, April 10th, the Medical Society of Delaware convened a discussion with Senator Spiros Mantzavinos, primary sponsor of Senate Bill 283 that was signed into law on September 8, 2022. Despite opposition from MSD, this law adds a requirement that practitioners licensed by the Board of Medical Licensure and Discipline and the Board of Nursing who treat adults complete one hour of continuing education in each reporting period on the topic of the diagnosis, treatment, and care of patients with Alzheimer's disease or other dementias. The event included speakers from the AMA, MSD, and numerous specialty societies. The focus of conversation was on the unintended consequences of this new law, as well as options for a path forward on modifications to this law and other state mandated educational requirements. MSD will continue to meet with Sen. Mantzavinos and other legislators to achieve a more suitable outcome. Special thanks to Dr. Ted Saad and Nephrology Associates for hosting the meeting and Dr. Selvam Mascarenhas for serving as moderator for the event. For more information, please contact Mark Thompson, MSD Executive Director, at Mark.Thompson@medsocdel.org or Lincoln Willis at Lincoln.Willis@thewillisgroup.com.

Dueling Rulings Create Uncertainty About Legal Status of Mifepristone

Last Friday, U.S. District Judge Matthew Kacsmaryk of Texas ruled to suspend the Food and Drug Administration’s (FDA's) approval of mifepristone nationwide by the end of this week. Mifepristone is the first drug in a two-drug protocol approved for early pregnancy termination and is also used for miscarriage management. The judge based his decision, in his opinion, that the FDA failed to adequately consider risks associated with the drug, disregarding well-established scientific facts showing mifepristone as a safe and effective drug. Immediately following Judge Kacsmaryk's ruling, Washington state District Judge Thomas Rice issued a separate opinion barring the FDA from taking any action that would limit access to mifepristone. The U.S. Department of Justice filed an emergency motion seeking a stay on the Texas Court ruling, while an appeal is sought. A U.S. Court of Appeals for the 5th Circuit on Wednesday overturned part of Judge Kacsmaryk's decision, ruling that mifepristone can remain available for the time being, but imposed temporary restrictions on access. The pill can no longer be mailed to patients, requires a prescription, and is approved up to seven weeks into pregnancy, rather than 10. This decision will stand until the full case is heard. The Justice Department will appeal the Texas ruling to the Supreme Court. The risk of upholding the Texas ruling would allow filing a lawsuit compelling the FDA to revoke approval of any drug someone may dislike. Vaccines, antibiotics, antidepressants, painkillers, etc. are all vulnerable under Judge Kacsmaryk's decision.

March Ruling Strikes Down ACA Provisions Requiring Free Preventive Care

After a federal judge in Texas last month overturned the Affordable Care Act provisions that required health insurers to provide some free preventive care services (such as cancer screenings and HIV drugs), the U.S. Department of Justice is seeking a court order to stay the ruling while the case goes through an appeals process. The Texas Judge's ruling means patients would have to pay for some preventive services that are now free, potentially putting these services out of reach for many. Read more.

Xylazine Approved by FDA for Veterinary Use in 1972

Also known as "tranq" or "zombie heroin," xylazine is a non-opioid tranquilizer approved by the U.S. Food and Drug Administration (FDA) for veterinary use, but not human use. It is being used by drug dealers as a low-cost cutting agent in drugs like fentanyl as a way to extend a user's high. Xylazine depresses breathing, lengthens overdoses, and causes skin wounds. Both chambers of Congress introduced legislation that would list xylazine as a Schedule III controlled substance. Read more.

Provides Additional Guidance for Safe Use

The US Food and Drug Administration (FDA) is requiring several updates to the prescribing information for both immediate-release (IR) and extended release/long acting (ER/LA) opioid pain medicines. Read more.

Recommendations Include Whole-Person Approach, Expanded Non-Opioid Options

The Delaware Drug Overdose Fatality Review Commission (DOFRC) has released its second annual report to Governor John Carney and the General Assembly. The report examines a sample of 108 cases from fatal overdoses that occurred in 2020, and includes data collected from death certificates, medical records, legal records, and treatment history. Read the full report.

Causing Itchy Eyes in Kids

Medscape is reporting that a new COVID-19 variant, Arcturus (formally Omicron subvariant XBB.1.16) is being watched closely by the World Health Organization (WHO) after being detected in late January. Arcturus hasn't yet made the Centers for Disease Control and Prevention's (CDC's) watchlist, and pediatricians are seeing children with itchy or sticky eyes, similar to conjunctivitis or pinkeye. Read more.

Notifications of Enforcement Discretion Expire at 11:59 p.m. on May 11th

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that the Notifications of Enforcement Discretion issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act during the COVID-19 public health emergency will expire at 11:59 pm on May 11, 2023, due to the expiration of the COVID-19 public health emergency. OCR is continuing to support the use of telehealth after the public health emergency by providing a transition period for health care professionals to make any changes to their operations that are needed to provide telehealth in a private and secure manner in compliance with the HIPAA Rules. Read more.

Office for Civil Rights Seeks to Strengthen HIPAA Privacy Rule

The U.S. Department of Health & Human Services (HHS), through its Office for Civil Rights, issued a Notice of Proposed Rulemaking to strengthen Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule protections by prohibiting the use or disclosure of protected health information (PHI) to investigate or prosecute patients, physicians, and others involved in the provision of legal reproductive health care, including abortion care. While the Department is undertaking this rulemaking, the current Privacy Rule remains in effect. Read more.

Rewards Hospitals Delivering High-Quality Care to Underserved Populations

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for inpatient and long-term care hospitals to advance health equity and support underserved communities. As required by statute, the fiscal year (FY) 2024 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) rule updates Medicare payments and policies for hospitals. The rule would also adopt hospital quality measures to foster safety, equity, and reduce preventable harm in the hospital setting. CMS is proposing to recognize homelessness as an indicator of increased resource utilization in the acute inpatient hospital setting, which may result in higher payment for certain hospital stays. CMS is also proposing that rural emergency hospitals could be designated as graduate medical education training sites. Read more.

Medicaid Members Should Verify Contact Information with DHSS

The Delaware Department of Health and Social Services (DHSS) has resumed the standard eligibility renewal process for Medicaid and CHIP recipients as of April 1, 2023, as required by federal law. Between April 2023 and April 2024, DHSS is reviewing every member’s eligibility and, where approved by state or federal rules, using available data sources to automatically renew members. Physicians and other health care professionals who provide services to members should remind their Medicaid patients to complete their Medicaid renewals this year and encourage them to start exploring other coverage options if they believe they will no longer qualify for their current coverage. The federal government has authorized a Special Enrollment Period for the Health Insurance Marketplace for individuals who lose their coverage through Medicaid and CHIP between March 31, 2023 and July 31, 2024. Read more.

Accelerating Transition to a Clean-Transportation Future

On Wednesday, the U.S. Environmental Protection Agency (EPA) announced new proposed federal vehicle emissions standards that will accelerate the ongoing transition to a clean vehicles future and tackle the climate crisis. The proposed standards would improve air quality for communities across the nation, especially communities that have borne the burden of polluted air. The proposed automobile pollution limits would require up to two-thirds of new vehicles sold in the U.S. to be electric by 2032, almost a tenfold increase over current electric vehicle sales. The proposed regulation would set tailpipe emissions limits for the 2027 through 2032 model years and call for more new electric vehicle sales than the auto industry agreed to less than two years ago. Read more.

FDA Issues Safety Communication

The U.S. Food and Drug Administration (FDA) issued a safety communication recommending consumers, health care professionals, and facilities to not use certain surgical N95 respirators by O&M Halyard, and to use caution with certain surgical masks and pediatric face masks by O&M Halyard. Read more.

SimplyProtein Peanut Butter Chocolate Crispy Bars Distributed by Costco

Wellness Natural USA Inc. of Wilmington, DE is expanding their voluntary recall of its SimplyProtein® Peanut Butter Chocolate Crispy Bar, which is sold in a 15-count variety pack that contains two other flavors, because it may contain undeclared cashews. The initial recall which included a single lot has been expanded to include all lots within expiration. The recalled products were only distributed in Costco stores nationwide in the United States. Any product with the Best Before date between 11 APR 2023 and 14 MAR 2024 is included in this expanded recall. Read more.

Some Devices Assigned Incorrect or Duplicate Serial Numbers

Philips Respironics is recalling certain reworked Philips DreamStation CPAP and BiPAP machines because some devices were assigned incorrect or duplicate serial numbers during initial programming. This duplication can cause therapy to be delivered using the wrong prescription or factory default settings. Additionally, it may fail to deliver any therapy at all. The FDA has identified this as a Class I recall, the most serious type of recall. Read more.

Expansion Allows More Collaborative Space for Home Care Teams

Delaware Hospice announced that it has moved its Kent County office to 555 E. Loockerman Street, Suite 200, Dover, DE 19901. Read more.

Beebe Healthcare

On Wednesday, April 12, all Beebe Healthcare campuses and Beebe Medical Group offices became mask optional for patients, visitors, and team members with a few exceptions based on infection prevention safety. Read more.

TidalHealth Peninsula Regional / TidalHealth Nanticoke

TidalHealth will be offering free skin cancer screenings in May in Berlin, Salisbury and Seaford. These free screenings are being provided as part of Skin Cancer Awareness Month in May. Read more.

Going, going, gone! Only a small number of tickets are available to watch the Wilmington Blue Rocks take on the Aberdeen Iron Birds on Tuesday April 25, 2023. Game time is 6:35 p.m. at Frawley Stadium in Wilmington. This is a MSD member only event. Tickets are free for MSD members and will be provided via email prior to the event date. All MSD members must be current & membership dues for 2023 paid. Register

Register for the Delaware Chapter, American Academy of Pediatrics Justice, Equity, Diversity, and Inclusion CME Webinar, "Health Literacy and Pediatric Anesthesiology." This webinar will take place on Thursday, April 27th at 5:30 p.m.

To kick off Hepatitis Awareness Month, the Hepatitis B Foundation and HepB United are hosting a webinar on Monday, May 1 at 3:00 pm ET titled "Universal Adult Hepatitis B Recommendations are Here - Best Practices for Implementing Universal Screening and Vaccination". Panelists will share best practices for implementing the updated hepatitis B adult screening and vaccination recommendations within their communities, challenges they have faced, and resources that are available to leverage the recommendations. This event is being sponsored in part using funds from the Centers for Disease Control and Prevention. 

Bruce S. Sachais, MD - Sr. VP & CMO, Blood Bank of Delmarva

Vincent E. Schaller, MD - Family Medicine, Mid-Atlantic Concussion Alliance

Please join MSD in welcoming the newest members of the Medical Society of Delaware. As the third oldest medical society in the country, MSD has an amazing history. Thank you for taking part in our continued success!

On January 30, 2023, the Biden-Harris Administration announced its intent to end the national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic on May 11, 2023. The Centers for Medicare & Medicaid Services (CMS) has resources available to help you prepare for the end of the PHE, some of which have been updated based on recent action by Congress. The following materials reflect recent changes and are currently available on the CMS Emergencies Page:

• Provider-specific fact sheets for information about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers
• CMS 1135 Waiver / Flexibility Request and Inquiry Form: https://cmsqualitysupport.servicenowservices.com/cms_1135
• Acute Hospital At Home: https://qualitynet.cms.gov/acute-hospital-care-at-home
• Loss of Medicaid or CHIP coverage
• FAQs on COVID-19 (released March 29, 2023)

Updates will continue to be provided as we approach the end of the PHE. You are encouraged to regularly visit the CMS Emergencies Page for the most up to date information.

• (Delaware) General Questions: call 211 or email DPHCall@delaware.gov or Vaccine@delaware.gov for vaccine-specific questions.
• Latest information on Delaware's response (testing, treatment, vaccination): de.gov/coronavirus (Updated 2/2023)
• CDC COVID-19 Testing Locator Website (no-cost COVID-19 Testing. launched 1/2023)
• Delaware "My Healthy Community" COVID-19 Dashboard (updated weekly on Wednesdays)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• COVID-19 Community Transmission (based on cases per 100,000 people and positivity rate, both measured over the last 7 days)
• DPH Public Health Alerts: de.gov/publichealthalerts
• Federal website for information on navigating COVID: COVID.gov
• CDC COVID-19 Quarantine and Isolation Calculator
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker Weekly Review.
• FDA At-Home OTC COVID-19 Diagnostic Tests provides a list of all FDA-authorized at-home over-the-counter (OTC) COVID-19 diagnostic tests
• Subscribe to the COVID-19 Update podcast - on Apple Podcasts or Simplecast.  

The Latin phrase Rerum Cognoscere translates to learn, examine, or become aware of facts or things. In this section, we highlight measurable items of interest in health care from MSD, Delaware, the US, and the world.