Volume 119, No. 4: April 2023 Edition | |
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They Said It...
"AMWA’s goal is to support women in medicine at every stage of their career, by providing mentorship, sponsorship, advocacy, education, and mentoring. In addition, AMWA works with a broad coalition of strategic partners ranging from academic institutions, government agencies, industry, and media—with a goal of uniting women physician leaders across all sectors." We'll be covering AMWA in our upcoming edition of Philadelphia Medicine magazine. Learn more about their work at amwa-doc.org.
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If you are interested in writing an article for Philadelphia Medicine, please contact us at [email protected]. We are accepting articles for both the newsletter and magazine. | |
Things you should know... | |
Warm weather means ticks are back! | |
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Tick bite-related emergency department visits have increased recently. Physicians should have a heightened clinical suspicion for tickborne diseases in persons with clinically compatible symptoms. Notable rare tickborne diseases include B. miyamotoi and Powassan virus, which have been found in ticks in multiple Pennsylvania counties. Human cases have been reported.
For further information on Lyme Disease testing and the interpretation of test results, please see APHL Guidance and Interpretation of Lyme Disease and Serologic Test Results (PDF).
The Pennsylvania DOH has also released a Lyme and Other Tickborne Diseases webinar on TRAIN PA for physicians. Continuing educations credits (CME) are available upon completion of the webinar. If you do not already have a username and password, you must register for TRAIN PA and then register for the course.
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Repeat COVID infections increase the risk of Long COVID | |
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If your patient already had COVID, it’s especially important to remind them to get an updated vaccine to reduce their risk of Long COVID. Find free updated COVID vaccines at vaccines.gov. Also consider sharing this video explaining the detrimental effects of Long COVID on the body and why it's important to get an updated COVID vaccine.
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MIPS EUC hardship exception due to Covid-19 continues in 2023 | |
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CMS will continue to allow physicians and group practices to apply for an MIPS Extreme and Uncontrollable Circumstances hardship exception to avoid up to a -9% MIPS penalty in 2025 based on 2023 performance. This comes in response to advocacy from the AMA and organized medicine about the ongoing impacts of the COVID-19 public health emergency. This is a big relief for physicians and their patients, since according to CMS, an estimated one-third of MIPS eligible clinicians would have received a penalty due to the increasingly stringent requirements to participate in MIPS in 2023.
The exception will not be automatic, and interested physicians and groups must actively request reweighting of one or more MIPS performance categories due to the COVID-19 PHE. Requesting reweighting of all four MIPS performance categories will avoid an MIPS penalty in 2025.
CMS expects to release the hardship exception application before summer.
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Look out for lead poisoning | |
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Lead is a metal that's found in the environment and many consumer products. It can be toxic to people and animals. The Pennsylvania Childhood Blood Lead Act (2022 Act 150) was signed into law and took effect in January to provide for blood lead assessment and testing of certain children and pregnant women by healthcare providers, impose duties on the Department of Health (DOH), and require certain health insurance policies to cover blood lead tests. The Act establishes that health care providers shall consider possible lead exposure in an individual patient and/or pregnant woman by evaluating risk factors for lead exposures.
Blood lead testing for children should follow recommendations from the Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP). For blood lead testing of pregnant women, it is recommended to follow guidelines from the CDC and American College of Obstetricians and Gynecologists (ACOG). A blood lead test is the best way to determine if a child has been exposed to lead. Health Insurance policies or government programs provide covered individuals or recipients blood lead testing as identified in accordance with the recommendations from the CDC, AAP and ACOG.
For more information on childhood lead exposure, visit pa.gov or contact DOH at 1-877-PA-HEALTH.
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13th Annual Philadelphia Surgery Symposium held March 31 | |
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The PSS event is designed for medical students and was held on the Jefferson Campus. Those attending the collaborative event enjoyed poster presentations as well as a panel discussion with resident physicians. Guest speakers were: Olugbenga Okusanya, MD, FACS and Michael Kwiatt, MD, FACS, FASCRS. The evening concluded with award presentations.
Students from the following institutions participated: Sidney Kimmel Medical College at Thomas Jefferson University; Cooper Medical School of Rowan University; Drexel University College of Medicine; Lewis Katz School of Medicine of Temple University; Perelman School of Medicine of the University of Pennsylvania; Philadelphia College of Osteopathic Medicine; Rowan University School of Osteopathic Medicine.
Pictured are: Eileen Ryan from PCMS along with Tiffany Yu, class of 2023, from Sidney Kimmel Medical College, Thomas Jefferson University.
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Strengthening Medicare for Patients and Providers Act (H.R. 2474) | |
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Finally, legislation was introduced that will help to ensure that Medicare payments to physicians begin to keep up with inflation. The Strengthening Medicare for Patients and Providers Act (HR 2474) would base future annual updates to the Medicare Physician Fee Schedule on a measurement called the Medicare economic index (MEI).
Physicians and their practices have seen many years of flat payments. According to a recent Medicare Trustees’ Report, when adjusted for inflation, Medicare payments to physicians declined by 22 percent from 2001 to 2021. That has left physician practices unable to manage increases in practice expenses, staffing and supply shortages. HR 2474 is a start in the right direction.
Please urge your member of Congress to take a step now towards improving patient access to care and creating a stable Medicare payment system by cosponsoring H.R. 2474.
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PAMED Med School Membership Match Competition! | |
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From April 1 to April 30, PAMED is challenging all Medical Student members to help spread the word about PAMED's FREE medical student membership. The school with the most students recruited will get dinner on PAMED in May! Let’s Go Philly Med Schools!
Click Here for more information. (PDF)
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Consolidated Appropriations Act of 2023 | |
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There is a new training requirement for DEA registered practitioners: an 8 hour training on the treatment and management of patients with opioid or other substance abuse disorders. All DEA registered practitioners who are new or are renewing their registration must take the training. The deadline for satisfying the new training requirement is the date of a practitioner's next scheduled DEA registration submission on or after June 27, 2023.
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FDA abortion drug- what’s the next step? | |
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On Friday, April 14th, Justice Samuel A. Alito Jr. issued an order temporarily ensuring that a common abortion pill would remain widely available while the Supreme Court considered whether to grant the Biden administration’s emergency request to preserve the Food and Drug Administration’s approval of the drug.
The order was meant to maintain the status quo while the justices studied the briefs and lower court rulings, and it did not forecast how the court would ultimately rule. The justice department was seeking to remove restrictions on the drug, which had been imposed by a lower appeals court, pending their review of the Texas court ruling. While keeping the drug on the market, the appeals court had barred patients from receiving it by mail and shortened the window for mifepristone's approved use, from up to 10 weeks of pregnancy to seven. Experts say the legal fight could have far-reaching implications for both abortion access and drug regulation in the future.
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PDPH Advisory - Marburg Virus Disease outbreaks in Africa | |
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On April 6th, 2023, CDC issued a health advisory to inform clinicians of two separate Marburg Virus Disease (MVD) outbreaks occurring in Equatorial Guinea and Tanzania, respectively. Currently, the risk of MVD in the United States is low. Physicians should be prepared to identify suspect MVD cases and have a plan to isolate a patient until the patient can be transported to a facility with an Ebola or Special Pathogen Treatment Unit.
Like other viral hemorrhagic fevers, patients with MVD may present with fever and headache, muscle and joint pain, fatigue, loss of appetite, GI symptoms, unexplained bleeding, red eyes, skin rash, or hiccups. A travel history should be promptly obtained, and people having traveled to affected areas in Equatorial Guinea or Tanzania with compatible symptoms should be placed in a private room. Staff should conduct advance training on PPE usage for care of a patient with confirmed or suspected MVD or other viral hemorrhagic fevers including EVD. The Philadelphia Department of Public Health’s Division of Disease Control should be contacted for any suspect MVD case at 215-685-6741 during regular business hours or 215-686-4514 after hours (ask for DDC On-Call Staff).
The Pennsylvania Department of Health has compiled information from the CDC which can be found here.
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How to grow your practice digitally with PracticeBeat | |
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PCMS continues to partnership with PracticeBeat, a Carnegie Mellon University spin-off company specializing in growing your practices by finding new patients digitally. The solution has become an amazing acquisition tool for many of the Philadelphia practices. PracticeBeat studies your current site and provides amazing insight into your competitors. Some of the practices they worked with have typically seen significant increases in new patient requests, an increase in quality and volume of online patient reviews and a high ranking in competitive and local search results online.
To learn more or to set up a free consultation, please contact Mark at [email protected].
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Bank of America® Doctor Loan | |
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The Philadelphia County Medical Society has partnered with Bank of America to provide you with a new member benefit! Residents, fellows and licensed physicians may be qualified for a loan designed to meet your needs as a medical professional. The Bank of America Doctor Loan is designed to meet the needs of medical professionals who have student loans after years of education, have accepted a new position or residency/fellowship, and are now looking to purchase a home.
Click here for a list of benefits and conditions (PDF). For additional information, please contact Mark Austerberry at [email protected].
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CONTRACT CORNER BRIEFS
by Karen E. Davidson, Esquire
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ACADEMIC APPOINTMENT/CONTRACT SEASON IS UPON US. This is the time of year that academic employed physicians receive their contract/appointment renewal (usually 1-year) for the upcoming (July 1st through June 30th) fiscal year (FY). It is therefore a good time to think about whether a contract should be renegotiated.
Here’s a snapshot of what we are seeing on the ground based on the 4-pillar analysis discussed in previous Contract Corner Briefs. Since the 1st pillar is compensation, physicians should ascertain if their compensation is keeping pace with benchmark data. Such data can be helpful in determining appropriate compensation along with information physicians may have about their benchmark performance (e.g., wRVUs, etc.). Too often physicians feel at the mercy of the employers/academic medical centers, but we have seen movement on compensation under certain circumstances. One change to monitor is when the physician will be entitled to receive a productivity/incentive bonus; we are seeing policy changes requiring the physician to be employed on the date such bonus/incentive is paid, usually well after the FY end; whereas previously they only had to be employed at FY end.
The 2nd pillar pertains to term/termination provisions. These provisions often require close reading because some contracts have language which seems to permit termination on some notice period (e.g., 90-days), but in actuality require physicians to remain employed until the end of the appointment period. Failure to stay through appointment end can sometimes result in penalties along with bonus/incentive forfeiture.
The 3rd pillar pertains to professional liability insurance (PLI) coverage and an assessment about whether the employer’s PLI tail coverage obligation has changed. We anticipate significant increased Pennsylvania PLI costs that could result in a shift of the tail coverage cost burden to physicians under some circumstances.
The 4th pillar is whether there have been any changes to the non-compete. While we are awaiting the FTC non-compete ban final rule (see discussion in previous Contract Corner Briefs), academic institutions/hospitals/health systems have requested that they be excluded from the ban; it remains to be seen if the FTC will accommodate them. Until then, non-competes remain fully enforceable in Pennsylvania. So, if a physician expects to leave a position and has non-compete concerns, now is a good time to strategize about options for proposed changes (e.g., to ensure the physician could take calls and/or practice telemedicine from home if they live within the non-compete area). This is especially important if physicians find themselves working at new locations given the ever-expanding geography of academic employers. That is, the geographic area within which the physician is restricted could have expanded from what it might have been just a year ago.
All that said, it remains a best practice for employed physicians (academic and otherwise) to fully understand their contracts, monitor developments and develop negotiation strategies from a compensation, term/termination, PLI and non-competition standpoint.
The content of “Contract Corner Briefs” has been prepared by Karen E. Davidson, Esq. for informational purposes only and does not constitute legal advice. The information in this e-newsletter shall not be construed as an offer to represent you, nor is it intended to create, nor shall the receipt of such information constitute, an attorney-client relationship. We hope that you will find the information informative and useful, and we would be delighted to connect you with Karen Davidson.
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The 12th Annual Clinical Update in Gastroenterology
Date: Saturday, April 29
Time: 8:00 AM - 12:50 PM
Registration for the 12th Annual Clinical Update in Gastroenterology is now open. This year's topics include Pancreatic Cancer, End-Stage Liver Disease, Inflammatory Bowel Disease and Irritable Bowel Syndrome.
Learn More and Register Here
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Inflammatory Brain Disorders Conference 2023
Date: Thursday, May 18 to Friday, May 19
Time: 10:00 AM - 6:30 PM (ET) each day
The Neuroimmune Foundation is hosting an inflammatory brain disorders conference from May 18 to May 19 via webinar. The event focuses on both pediatric and adult patients. CME credit is available to all live attendees.
Register and Learn More Here
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Presidents Installation and Awards Night
Date: Saturday, June 3
Time: 6:00 PM
Place: The Philadelphia Country Club, 1601 Spring Mill Road, Gladwyne, PA 19035
Save the date! The Philadelphia County Medical Society will be celebrating the installation of our 162nd President John Vasudevan, MD as well as our annual awards night presentations, on June 3.
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PCMS at the Phillies
Date: Sunday, September 10
Time: 11:00 AM
The Philadelphia County Medical Society invites you to join us at Citizens Bank Park for the Phillies game and a tailgate party! Meet with colleagues and enjoy an afternoon of fun! Children, spouses and partners are welcome to attend.
Learn More and Sign Up Here
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