Due largely to the American Medical Association (AMA) and specialty society advocacy, the Health Resources and Services Administration (HRSA) has decided to reopen the reporting time for recipients of Period 1 Provider Relief Funds. In the AMA's March 31, letter to HRSA, the AMA and 31 national medical specialty societies noted small and rural practices appeared to be particularly impacted by the potential recoupment, and that physician practices were unaware of the deadline.

Those physicians who received more than $10,000 in provider relief funds and failed to submit their Period 1 report should act immediately. Between Monday, April 11 and Friday, April 22, 2022, at 11:59 pm ET, providers who have not submitted their Period 1 report may submit a late Reporting Period 1 report request. Physician practices should receive information about how to submit a request directly from HRSA via email. If a provider did not submit a Period 1 report and does not hear from HRSA, the provider may initiate communication by calling (866) 569-3522. During this reopening period, a provider must choose an extenuating circumstance(s) that prevented compliance with the original reporting deadline. While attesting to an extenuating circumstance is required, no supporting document or proof is required. If HRSA approves the extenuated circumstances form, the provider will receive a notification to proceed with completing the Reporting Period 1 report shortly thereafter. Providers will have 10 days from the notification receipt date to submit the late Period 1 report in the PRF Reporting Portal. The AMA will continue to advocate for greater flexibility and more information to ensure physician practices have an adequate opportunity to come into compliance.

The MSD 2022 Virtual Interim Council Meeting will be held on Thursday, April 21, 2022, beginning at 6:00 p.m. All Council members are highly encouraged to register early to ensure receipt of meeting materials to review prior to the meeting. As a Council member, please be sure you have renewed your membership! For more information and registration, visit the MSD website. Meeting materials will be sent out soon to those who are registered.

MSD member Kirill Alekseyev, MD, Medical Director at Post Acute Medical (PAM) Hospital in Dover, along with Mr. Dave Tiberi of Donate Delaware and MSD Executive Director Mark Thompson, are working together to deliver much-needed supplies to Ukraine. This is an opportunity for Delawareans to support the people of Ukraine. For a list of items needed, please visit the PAM Health Delaware Supplies for Ukraine Facebook page. Download flyer.

The Department of Health and Social Services (DHSS) has launched a new website called CostAware to help Delawareans understand how their health care dollars are spent by comparing the variation of average costs for different episodes of care and medical services based on actual medical claims in Delaware.

Hospital costs are compared for five common episodes of care at six hospital systems: cardiac procedures, C-section birth, emergency department visits, knee and hip replacement, and vaginal delivery. The costs across five accountable care organizations (ACOs) are also compared for seven common services: blood count, colonoscopy, doctor visits, hemoglobin A1c, head CT, lumbar spine MRI, and screening mammography. The rates are based on 2019 medical claims in the Delaware Health Care Claims Database and reflect the cost that consumers and their insurers actually paid for the care. In addition, quality measures are provided, including the readmission and utilization rates and patient satisfaction scores. In this initial version of CostAware, the Delaware hospital systems and accountable care organizations are not identified. DHSS Secretary Molly Magarik said she hopes to include that information in future versions of the website. 

Today, the Centers for Medicare & Medicaid Services (CMS) released a national policy for coverage of aducanumab (brand name Aduhelm™) and any future monoclonal antibodies directed against amyloid approved by the FDA with an indication for use in treating Alzheimer’s disease. As finalized in this two-part National Coverage Determination (NCD), Medicare will cover monoclonal antibodies that target amyloid (or plaque) for the treatment of Alzheimer’s disease that receive traditional approval from the Food and Drug Administration (FDA) under coverage with evidence development (CED). CMS, as a part of this decision, will provide enhanced access and coverage for people with Medicare participating in CMS-approved studies, such as a data collection through routine clinical practice or registries. Any new drugs in this class that receive FDA traditional approval may be available in additional care settings that people with Medicare can use, such as an outpatient department or an infusion center. Secondly, for drugs that FDA has not determined to have shown a clinical benefit (or that receive an accelerated FDA approval), Medicare will cover in the case of FDA or National Institutes of Health (NIH) approved trials. Under this NCD, CMS will support the FDA by covering the drug and any related services (including, in some cases, PET scans if required by trial protocol) for people with Medicare who are participating in these trials. This decision is specific to individuals who have a clinical diagnosis of mild cognitive impairment (MCI) due to Alzheimer’s Disease or mild dementia with a confirmed presence of plaque on the brain.

The American Medical Association (AMA) has provided a second toolkit to assist physicians with the payment process for certain out-of-network care under the No Surprises Act (NSA). The NSA prohibits surprise billing for emergency care and some non-emergency care at in-network facilities. The law and implementing regulations have established a process to determine payment for physicians and other providers that includes an Independent Dispute Resolution (IDR) process. As we are still awaiting additional federal guidance on the IDR process, as well as anticipating the opening of the federal online portal through which this process will occur later this month, this toolkit will be updated when new information is available. Additionally, the AMA has updated information here on the AMA-AHA lawsuit over a narrow, but critical, component of the interim final rule implementing the IDR process under the NSA.  

On Tuesday, President Biden issued a Presidential Memorandum directing the Secretary of Health and Human Services (HHS) to coordinate a new effort across the federal government to develop and issue the first-ever interagency national research action plan on Long COVID. the effort will advance progress in prevention, diagnosis, treatment, and provision of services, supports, and interventions for individuals experiencing Long COVID and associated conditions. The Memorandum also directs HHS to issue a report outlining services and supports across federal agencies to assist people experiencing Long COVID, individuals who are dealing with a COVID-related loss, and people who are experiencing mental health and substance use issues related to the pandemic. This report will specifically address the long-term effects of COVID-19 on high-risk communities and efforts to address disparities in access to services and supports. US Government Accountability Office estimates indicate that Long COVID likely affects between 7.7 million to 23 million Americans.

The Biden-Harris Administration announced on Monday that more than 59 million Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, now have access to Food and Drug Administration (FDA) approved, authorized, or cleared over-the-counter COVID-19 tests at no cost. The initiative continues until the COVID-19 public health emergency ends. People with Medicare can get up to eight tests per calendar month from participating pharmacies and health care providers for the duration of the COVID-19 public health emergency. This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost. National pharmacy chains are participating in this initiative, including: Albertsons Companies, Inc., Costco Pharmacy, CVS, Food Lion, Giant Food, The Giant Company, Hannaford Pharmacies, H-E-B Pharmacy, Hy-Vee Pharmacy, Kroger Family of Pharmacies, Rite Aid Corp., Shop & Stop, Walgreens and Walmart. A list of eligible pharmacies and other health care providers that have committed publicly to participate in this initiative can be found here. Because additional eligible pharmacies and health care providers may also participate, people with Medicare should check with their pharmacy or health care provider to find out whether they are participating.

On Wednesday this week, the Centers for Medicare & Medicaid Services (CMS) announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine and there is no applicable copayment, coinsurance or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including boosters, at no cost.

According to findings published in the New England Journal of Medicine, ivermectin does not reduce the risk of hospitalization from COVID-19. More than 1,300 patients were compared, with some given ivermectin and others given a placebo. There was no difference found between the groups.

On Tuesday, the Us Food and Drug Administration (FDA) announced the monoclonal antibody sotrovimab is no longer authorized to treat COVID-19 in any U.S. region due to increases in the proportion of COVID-19 cases caused by the Omicron BA.2 sub-variant. The Centers for Disease Control and Prevention (CDC) Nowcast data estimates that the proportion of COVID-19 cases caused by the Omicron BA.2 variant is above 50% in all Department of Health and Human Services (HHS) U.S. regions. Data included in the health care provider fact sheet shows the authorized dose of sotrovimab is unlikely to be effective against the BA.2 sub-variant. Other treatments continue to be effective against BA.2, including a newer monoclonal antibody, Bebtelovimab, and two antiviral pills, Paxlovid and molnupiravir.

There are several types of declarations and determinations related to emergencies, including public health emergencies, which serve different purposes. People asking this question are usually referencing the declaration by the U.S. Department of Health and Human Services (HHS) Secretary that a public health emergency exists under section 319 of the Public Health Service (PHS) Act. Separate declarations–sometimes referred to as “EUA declarations” (Emergency Use Authorization)—under section 564 of the Federal Food, Drug, and Cosmetic (FD&C) Act (also issued by the HHS Secretary) enable the issuance of EUAs. If the Secretary terminates an EUA declaration, then any EUAs issued based on that declaration will cease to be in effect, and FDA may no longer issue EUAs for products covered by that declaration. An EUA declaration is distinct from, and not dependent on, an HHS PHE declaration under section 319 of the PHS Act, and, therefore, an EUA may remain in effect beyond the duration of the section 319 PHE declaration if all other statutory conditions are met. Read more.

Health inequities historically affect underserved and marginalized communities. During National Minority Health Month, the Centers for Medicare and Medicaid Services (CMS) invites you to learn about preventive services, and find out how to advance health equity. Medicare covers preventive services, and your patients pay nothing if you accept assignment. Learn how to check eligibility (PDF) for preventive services. If you need help, contact your eligibility service provider.

In November 2020, the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) issued two final rules to modernize and clarify the Stark Law and the Anti-Kickback Statute (AKS). Recognizing the rapidly changing healthcare system, CMS and OIG finalized new rules and rule changes that are more consistent with emerging value-based healthcare delivery and payment models, and that may allow for better coordination of care. The significant changes affecting physician practices include fundamental changes in terminology; newly established exceptions/safe harbors for value-based arrangements; lowered regulatory hurdle with a new exception for limited remuneration to a physician; a safe harbor for patient engagement and support; a safe harbor for CMS-sponsored models; eased restrictions related to cybersecurity technology; changes to the group practice rules related to profit distribution; and more. Read more.

The U.S. Food and Drug Administration (FDA) updated the April 2020 Safety Communication to provide new information supporting the transition to fully disposable duodenoscopes and those with disposable components, as well as new information on completed postmarket surveillance studies (also known as 522 studies). The use of removable components to facilitate cleaning leads to decreased contamination compared with older duodenoscope models. 

The National Vital Statistics System has released new reporting guidance to provide physicians who medically certify information on death certificates with specific recommendations for documenting different types of deaths associated with pregnancy. The guidance serves to accurately and consistently characterize death associated with pregnancy on death certificates to help improve the quality of both mortality data and official maternal mortality statistics. Accurate completion of death certificates is vital to various public health efforts surrounding maternal mortality surveillance and prevention, as well as to the official reporting of maternal deaths in the US.

MSD wants to recognize physicians who demonstrated extraordinary commitment to their patients, communities, and profession during the COVID-19 pandemic. We seek to recognize both physician leaders whose work may be widely known, as well as physicians who labored in relative anonymity. To this, we are seeking nominations from our members of physicians whose personal sacrifice and performance beyond expectation during the pandemic would merit recognition. All physicians in Delaware, excluding trainees, are eligible. Nominations can be submitted online. Persons nominating will be asked to describe the reason the physician is being nominated. The deadline for submitting nominations is­­­ Thursday, May 19th. Awards will be presented this fall.

Governor John Carney this week announced the 2022 Compassionate Champion Awards nomination form is now available. The Compassionate Champion Awards recognize individuals, organizations, and educational institutions across the State of Delaware that provide trauma-informed services in a manner consistent with the Delaware Developmental Framework for Trauma-Informed Care. The award categories include:

The nomination period closes at 5:00 p.m. on April 29, 2022. Winners and a recognition event will be announced at a later date. Click here to access the nomination form.

Entries are now open for the 2022 Lt. Governor's Challenge Wellness Leadership Award, through which the state of Delaware honors individuals, organizations, and institutions who contribute to the advancement of health in the First State. The Lt. Governor's Challenge is an annual competition honoring those who have gone above and beyond to make Delaware a healthier place. Winners demonstrate that they have inspired others by making healthy choices the easiest ones for their communities, ultimately helping elevate the well-being, productivity, and prosperity of our state. The competition is sponsored by Lt. Gov. Bethany Hall-Long. The entry deadline is May 16. 

MSD is pleased to highlight a 2022 Premier Educational Program Partner. Coverys is a leading provider of medical professional liability insurance committed to helping reduce distractions so healthcare professionals and organizations can focus on what matters most—patients. You can count on Coverys for flexible coverage options, innovative insurance solutions, advanced data analytics, best-in-class education and risk mitigation resources, and unique support programs to assist healthcare providers who are experiencing a claim, adverse event, or burnout. With 40+ years of experience serving the medical community and underwriting companies with “A” (Excellent) ratings from A.M. Best, you can be confident in Coverys’ financial strength and stability. Please visit coverys.com for more information.

If you would like to become a PEP Partner, please contact Lynn Robinson, Director of Professional Education.

Bayhealth Hospital invites health care professionals to attend their Medical Grand Rounds. This regularly scheduled series takes place every fourth Tuesday from 12:00 p.m. to 1:00 p.m. at Bayhealth Medical Center in Dover. You can also join via zoom. Registration is required. Upcoming date for the next meeting is May 3, 2022. To join the Zoom by meeting number use Access Code 2435 528 4699 and Password Bayhealth.

As part of the League of Women voters of Delaware League Days 2022, the League is presenting a Zoom event on the need for climate emergency legislation in Delaware. This virtual event will take place on Tuesday, April 12th from 7-8:30 p.m. MSD member James M. Fletcher, DO, one of the presenters, will share insights on the particular need for climate mitigation in underserved neighborhoods. Download flyer. Register.

COVID-19 has put extraordinary stress on health care workers. Clinician well-being has never been more important. Join the American Medical Association (AMA) at 1:00 ET on April 19 to learn about insights from the 2022 national burnout benchmarking report. Highlights will include current trends in burnout, stress, and job satisfaction in addition to other key drivers of burnout that have emerged during the pandemic. The AMA will also share key strategies to address ongoing burnout and how health systems can reset as we emerge from the pandemic. https://bit.ly/STEPSW-041922

The AMA and the American College of Emergency Physicians will co-host an interactive session, “Clinical Case Study: Telehealth for Emergency Medicine,” on April 20 at 11:00 a.m. ET that will provide participants with an overview of innovative ways that telehealth is currently being used in emergency medicine. Register: https://zoom.us/meeting/register/tJEqce6upzIjEtOxhhHSxJ0_QHYz8tG4zvaA

Network with fellow MSD members and learn about what some of the MSD committees are doing for you and the community! Committees highlighted at this event will include: Editorial Board, Environmental Health Subcommittee, and Prison Health Care Subcommittee. Join us Monday, April 25th at 6:00 p.m. Zoom meeting details will be shared 24 hours in advance of the meeting with all registrants. To register, click here.

Night at the Blue Rocks at Frawley Stadium in Wilmington is an exclusive event for MSD early career physician members. The Wilmington Blue Rocks will take on the Bowling Green Hot Rods on Friday, May 6, with game time starting at 6:35 p.m. As a member of the MSD Young Physicians Section, enjoy a night of minor league baseball and fireworks show following the game. Tickets are free for you and one guest, with the option to purchase additional tickets. Physician members of the MSD Young Physicians Section are those who are age 45 or younger or have been in practice fewer than five years after completing training. The 2022 MSD membership renewal must be up-to-date to register. Ticket purchase deadline is Friday, April 22nd.

Join the Delaware Diabetes Coalition and Quality Insights at the 20th Annual Diabetes Wellness Expo on Tuesday, May 10th from 9:00 a.m. - 3:00 p.m. at the Delaware State Fair Grounds. This event is aimed at bringing together health care providers, businesses, diabetes-related organizations, and others to promote diabetes self-management and a healthier lifestyle for people with diabetes. Registration is open to all individuals who wish to attend, with special attention given to individuals and caregivers of people living with diabetes. Pre-register now.

In this virtual workshop sponsored by the Delaware Division of Public Health, practitioners, front-line workers, and health care leaders will explore multiple dimensions of culturally competent health care practices. Taking place on Thursday, May 12th from 1:30-4:30 p.m., participants will learn to apply culturally competent principles using case studies of common, point-of-care scenarios applicable to community health centers and the communities they serve. The speaker will teach participants how to apply an equity lens to health center policies, procedures, and practices governing patient interactions and encounters. Participants will understand the importance of using culturally competent approaches in delivering high-quality care and reducing health outcomes disparities. Learn more and register.

In the latest AMA STEPS Forward^TM podcast episode, Dr. Kevin Hopkins, Primary Care Medical Director at Cleveland Clinic and Senior Physician Advisor at the AMA, discusses the current state of telemedicine and why it’s important for practices and health systems to pivot from a “physician-does-it-all” mentality and embrace team-based care.

The Bayhealth Community Pharmacy, Kent Campus is now open 24 hours a day, 7 days a week. The front doors of the pharmacy will be open from 8 a.m. to 8 p.m. daily. They will operate as a “closed-door” pharmacy during all other hours, with prescriptions continuing to be filled during these times. These prescriptions will be available for pick up at the desk in the main lobby of Bayhealth Hospital, Kent Campus.

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 on the current pending member(s) listed above.