The 232nd Annual Meeting of the MSD Council was held on Tuesday, November 9th. The Council adopted a 2022 budget, elected officers and other positions, approved Bylaws changes, and supported four resolutions. Read the Report of the Proceedings.

To participate in the IAT, please go to: https://implicit.harvard.edu/iimplicit/takeatest.html. Review the consent and click "I wish to proceed" at the bottom of the text. The Committee requests completion of the "Race IAT." Once completed, you will receive your IAT result along with information about what it means. Results will be collected in SurveyMonkey. Please navigate to https://www.surveymonkey.com/r/IATRace to provide your result. It is appreciated if you are voluntarily willing to participate in the IAT, that you complete the IAT and reporting no later than Tuesday, November 30th. Thank you for taking the time to complete the IAT and help in understanding our membership to determine where there are areas for improvement to ensure we work towards our goals of diversity, equity, and inclusion in all that we do.

The Centers for Medicare & Medicaid Services (CMS) will require COVID-19 vaccines for all employees at Medicare and Medicaid-participating health care facilities by January 4. The rule went through an expedited process due to the public health emergency. It will take effect as soon as it is published in the Federal Register. The Biden Administration announced the mandate at the beginning of September as part of a broader action plan to combat the pandemic, with a more widespread vaccine mandate for large employers requiring rulemaking in the Labor Department's Occupational Safety and Health Administration (OSHA). CMS confirmed that physician offices are excluded from this rule (refer to slides). CMS held a COVID-19 Omnibus Vaccine Rule (IFC-6) presentation last Friday and has posted presentation slides and video recording of the call. To view slides, to view video, FAQ document.

OSHA has issued an emergency temporary standard (ETS) to minimize the risk of COVID-19 transmission in the workplace and will require all employees at businesses with 100 or more workers to be vaccinated or get tested weekly. The ETS generally applies to employers in all workplaces that are under OSHA's authority and jurisdiction. There are certain workplaces and employee conditions where this ETS does not apply. In short, nearly every employer with more than 100 employees (across all locations) must manage the vaccination status of employees. The ETS also requires employers to ensure compliance with weekly testing initiatives for unvaccinated employees who return to the workplace or come in contact with other employees or customers. While the implementation deadline is currently the subject of legal debate, many employers are, nevertheless, preparing to address new requirements under the ETS.

The US Surgeon General Dr. Vivek Murthy released a step-by-step toolkit this week to help people combat misinformation about the COVID-19 vaccines in their own close circles. During the summer, the Surgeon General issued an advisory that called misinformation an urgent public health threat. The new guide provides a road map for vaccinated people to talk to unvaccinated people who believe conspiracy theories that spread on the internet about the COVID-19 vaccines. The guide includes discussion questions and illustrations explaining why people share misinformation or what a hypothetical conversation around misinformation could look like. Dr. Murthy hopes the toolkit will be used by health professionals, faith leaders, teachers, and parents with children newly eligible for the vaccine.

Governor John Carney on Friday last week formally extended the Public Health Emergency order another 30 days to allow the State of Delaware and medical providers to continue COVID-19 vaccination and testing programs. Under Delaware law, Public Health Emergency declarations must be renewed every 30 days. 

On Wednesday, Governor Carney, the Delaware Department of Education, and the Delaware Department of Health and Social Services announced that the State of Delaware will extend the emergency mask requirement in public and private K-12 schools until February 8.

Ellume is recalling certain lots of its at-home COVID-19 antigen test due to a higher than acceptable false-positive rate. The US Food and Drug Administration (FDA) granted emergency use authorization for the test in December 2020, designating the test as the first over-the-counter COVID-19 test authorized by the FDA. This test requires the user to perform their own nasal swab and interpret test results through a smartphone app. If a patient received a positive result from one of the affected lots in the past 2 weeks, they should follow up with a healthcare provider for a molecular diagnostic test to confirm the result, the agency added. The FDA has identified this as a Class I recall, the most serious type of recall. Use of these tests may cause serious adverse health consequences or death.

As this year marks AMPAC’s 60th anniversary, the AMPAC Board's Report to the American Medical Association House of Delegates reflects on AMPAC's achievements as America’s oldest non-union political action committee and leading the way on many political activities like strategic contributions to federal candidates, in-kind contributions, and independent expenditures. At the same time, they recognize that many physicians may not fully understand or appreciate AMPAC’s core function, the scope of its work, and why AMPAC needs the support of all physicians. The AMPAC Board has developed a short, educational video that will answer basic questions to encourage you to join the chorus of medicine’s most powerful political voice: AMPAC. MSD is fortunate to have a direct connection with the AMPAC Board through member Janice Tildon-Burton, MD. Dr. Tildon-Burton was appointed to the AMPAC Board in December 2020.

The Centers for Medicare and Medicaid Services (CMS) will apply the Automatic Extreme and Uncontrollable Circumstances Exemption Policy (EUC) for the 2021 Merit-based Incentive Payment System (MIPS) performance year. This 2021 policy change recognizes the continued challenges physicians face with providing care during the public health emergency and reduces administrative burden. Therefore, if a physician participates in MIPS as an individual, they don't need to take any action to have the automatic EUC policy applied to them. Unfortunately, due to a systems issue, if a physician or small practice participates in the 2021 MIPS program by submitting Part B quality measures through claims and has submitted quality data codes on their 2021 Medicare claims, they will need to still file a 2021 MIPS Hardship EUC to avoid a 2023 payment adjustment and be exempt from the 2021 MIPS program. If a group has not submitted 2021 data, then the automatic EUC policy will apply to the individual physicians within the group. PY2021 EUC Exception Applications can be submitted by signing in to qpp.cms.gov and clicking Exception Applications on the left-hand navigation. Detailed information on the automatic EUC policy and CMS announcement.

The annual Physician Fee Schedule (PFS) final rule announces policy changes which sets the rates for Medicare payments made under the PFS and updates for the Quality Payment Program (QPP) for Calendar Year 2022 has been released/published. For further information:

The Centers for Disease Control and Prevention (CDC) expanded recalls and warnings to physicians about aromatherapy sprays that have been linked to fatal cases of a rare tropical disease. Physicians should be cognizant of symptoms of melioidosis, a difficult-to-diagnose infection caused by the bacteria Burkholderia pseudomallei, and should ask patients about whether they've used certain sprays. This follows last month's announcement by the CDC indicating it had traced the case of a fatal B. pseudomallei infection in Georgia to an aromatherapy spray sold by Walmart and tied three other cases to the spray.

Healio reports that the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) is recommending all US adults younger than 60 be vaccinated against Hepatitis B, because progress against the liver-damaging disease has stalled. The CDC’s director, Dr. Rochelle Walensky, must sign off on it before it becomes public policy, but it’s not clear when she will decide. Vaccinations for hepatitis B became standard for children in 1991, meaning most adults younger than 30 are already protected. Under existing policy, people 60 and older can receive the vaccine if they wish.

Last week, Governor John Carney released Delaware’s Climate Action Plan. The main goals of the Climate Action Plan are to reduce greenhouse gas emissions and to better prepare for the impacts of climate change by prioritizing clean energy and improved energy efficiency, providing support to state agencies in resilience efforts, and increasing research and monitoring. Delaware’s Climate Action Plan serves three primary purposes: To help meet current commitments; to set a course for the decades ahead; and to integrate actions for both minimizing greenhouse gas emissions and maximizing resilience to climate change impacts. The Climate Action Plan identifies five key action areas to minimize greenhouse gas emissions and seven action areas that state agencies can focus on to improve resilience to climate impacts we are witnessing today, including sea level rise, warmer temperatures, and more intense and frequent storms. Through Governor Carney’s commitment to the U.S. Climate Alliance, Delaware has adopted a goal of reducing the state’s greenhouse gas emissions by 26% to 28% by 2025 from 2005 levels.

Reuters has reported the World Health Organization (WHO) is warning of a possible shortage of one to two billion syringes needed to administer COVID-19 vaccinations in 2022, which could also impact routine immunizations and undermine needle safety. WHO experts warned that national health authorities should plan their needs well in advance to avoid hoarding and panic buying, as was seen early in the pandemic with the lack of personal protective equipment. About 6.8 billion COVID-19 vaccinations have been administered globally, double the number of routine vaccines, compared to total manufacturing capacity of about 6 billion immunization syringes a year.

The COVID-19 pandemic has created snags and disruptions in the global supply chain that ripple outward. According to a Kaufman Hall report, 99 percent of US hospitals and health care systems have reported challenges in procuring needed supplies, including shortages of key items and significant price increases. Shortages of raw materials and components hamper the production of both drugs and sophisticated medical devices while manufacturers struggle with COVID-19 infection rates among their workforce. The report also highlighted the pandemic's influence on clinical staff burnout, support staff retention, and adverse revenue cycle impact, among other areas.

This holiday season, give the hope of a holiday meal. People in Delaware continue to struggle and food banks are in need of help to fill their shelves. With your donation or contribution, you can help provide three meals for every dollar given. From November 8 through December 17, reach out and make an impact in the Delaware community. Click to give.

Diamond State Financial Group is presenting the "Guide to Navigating Finances While in the Medical Field" on three separate dates and times for your convenience: Wednesday, November 17 at 6 p.m.; Friday, November 19 at 7:30 a.m.; and Tuesday, December 7 at 12:00 Noon. The financial sessions will discuss organizing your finances, managing your debt, protection strategies for medical professionals, building wealth and investing, as well as explain what a financial professional can do for you. All sessions are being held virtually. Register for one of the three sessions offered.

The Delaware Academy of Family Physicians Annual Sports Medicine Symposium will be held virtually on the evening of November 18th starting at 6:00 p.m. This year’s symposium agenda will feature three dynamic speakers who will present a unique perspective on how COVID-19 has affected sports and our athletes at all levels of competition, provide an enjoyable fun Sports Medicine mystery presentation of “whodunit," and an easy to understand and retain approach to common joint injections in the Primary Care setting. All clinicians, attendings, NPs, PAs, residents, and students are welcome to attend this very informational CME event. (Residents and students are welcome to attend free of charge, but you must register). Sign up today by visiting the DAFP website or register at https://na.eventscloud.com/645403 .

The Medical Society of Delaware, the American College of Physicians Delaware Chapter, and the Delaware Academy of Family Physicians are pleased to present a Town Hall-style event with State Senator Sarah McBride, State Representative David Bentz, State Senator Spiros Mantzavinos, and Insurance Commissioner Trinidad Navarro on Wednesday, December 1st from 6:00-7:00 p.m. Bringing together the primary care physician community, join to share your thoughts and ask questions related to issues surrounding primary care reform legislation, addiction and mental health services, and interoperability. There is no charge to participate, however, registration is required.

Beebe Healthcare announced it will end its COVID-19 vaccine-or-test policy and require all its workers to receive the vaccine by Dec. 24. Beebe would require contractors and vendors to be vaccinated by Christmas as well. The health care system made the announcement within 24 hours after President Joe Biden made it clear that healthcare workers who work at facilities funded by Medicare or Medicaid must be vaccinated by Jan. 4. Unlike regulations set for private employers, health care workers have no testing option.

Beebe Healthcare will host two pediatric vaccination events on Nov. 13 in Millsboro and Nov. 20 in Lewes. The age range for these events is 5-11. Beebe will be using the Pfizer vaccine that received emergency use authorization for children ages 5-11, which is 1/3 of the adult dose. Subsequent second-dose events will be held 21 days after at the same location. 

MSD's Membership Department is pleased to announce the newest members of the Medical Society of Delaware. Welcome to the third oldest medical society in the country! If you know someone interested in joining MSD, please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions.

MSD members are afforded a seven-day review period from the date of this publication to comment regarding applicants for membership. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any comments.