Saturday, November 18 - Christiana Hilton, Newark

Registration is open for the 234th MSD Annual Meeting to be held on Saturday, November 18th. This year's meeting will be held at the Christiana Hilton in Newark. All MSD members are encouraged to attend. Thank you to our Council members for their service to MSD and their constituents. Your fork is the most powerful tool to heal your body. Learn about the influence of nutrition on patients' wellbeing and how food can help manage chronic diseases and improve overall health during the planned education sessions. Register for the presentation (and cooking demo!) and discover the power of nutrition. It is vital for physicians to be able to educate their patients about nutrition to achieve optimal health.

Things to know:

• Registration deadline is Friday, November 10th!
• The Inaugural Gala is on hold for this year. View the Annual Meeting agenda.
• There will be two education sessions on the topic of "Food as Medicine." The Medical Society of Delaware designates this live activity for a maximum of 2 AMA PRA Category 1 Credit™. 
• Those members who graduated medical school fifty years ago (1973) will be recognized in a ceremony following the first education session.
• Delaware Medical Political Action Committee (DELPAC) members can enjoy gourmet coffee and conversation with Delaware lawmakers. Join DELPAC if you are not already a member.
• Resolutions are a vehicle to submit your issues to the Council. Resolutions must be submitted via email to Mary LaJudice no later than October 27th. The MSD Resolution Writing Guideline should be utilized to ensure proper creation and format of the resolution.
• For anyone who wishes to stay overnight at the Christiana Hilton, when making reservations, use code MEDSD to obtain the discounted room rate of $149/night. Reservation cut off is Friday, October 27th.

Thank you to our featured sponsors:

For Prescribing of Controlled Medications

On October 6, 2023, the Drug Enforcement Administration (DEA) released a second temporary rule extending the COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications. This second extension gives practitioners and patients certainty of the DEA requirements for telemedicine prescribing through the end of 2024. Without this Second Temporary Rule, COVID-19 telemedicine flexibilities would expire on November 11, 2023. This Second Temporary Rule – entitled “Second Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” continues the temporary extension of the “full set” of DEA’s COVID-19 waivers for prescribing controlled substances via telemedicine. Those waivers, which have been in place since March 2020, are now extended through December 31, 2024. Click for additional information.

Physicians Facing MIPS Penalties in 2024 for First Time Since Program Started

On Aug. 10, CMS made available 2022 MIPS performance feedback, which determines whether physicians will receive a positive, neutral or negative payment adjustment on Medicare services furnished in 2024. The American Medical Association (AMA) has heard alarming reports of physicians facing MIPS penalties in 2024 for the first time since the program started. The AMA strongly encourage you to view this information as soon as possible for two reasons:

1. If there are any errors, you should consider submitting an appeal, also called a targeted review. For more information about how to request a targeted review, please refer to the 2022 Targeted Review User Guide (PDF). The deadline to submit a targeted review is 8 pm ET Oct. 9, 2023.
2. You can help the AMA advocate against Medicare physician payment cuts in 2024 by sharing this information. If you feel comfortable, you can share de-identified score and corresponding payment adjustment information. This will inform their understanding of the impact of MIPS on physician payment in 2024 and can help them in their conversations with the administration and Congress about ensuring physician payment supports high-quality care to Medicare patients. Please share your information by emailing the AMA Advocacy staff at ama.advocacy@ama-assn.org.

Physicians can view their 2022 MIPS Performance Feedback information on the Quality Payment Program (QPP) website using their HCQIS Access Role and Profile (HARP) credentials. The CMS Payment Adjustment User Guide (PDF) walks through the process of accessing and downloading performance feedback. 

AMA Webinar: November 3rd. Register Now!

Payment cuts and temporary fixes have become predictable in Medicare physician payment over the past decade—leaving physician practices and patient access to care at serious risk. The American Medical Association (AMA) is working to change that by urging lawmakers to work with the physician community to permanently reform the system. Congress needs to establish a permanent, annual inflationary Medicare physician payment update that keeps up with the cost of practicing medicine and encourages practice innovation. 

Register now for the AMA Advocacy Insights webinar, “What’s next with Medicare payment reform,” on Friday, November 3 at 2 p.m. ET to hear about: 

1. Where Medicare payment reform stands now. 
2. How the AMA, alongside state and national medical specialty societies, is pushing for permanent payment reform. 
3. How you can get involved in these advocacy efforts.

Help the AMA Help YOU to Update Medicare Physician Payment!

The American Medical Association (AMA) Physician Practice Information (PPI) Survey is underway, and all selected physicians are urgently needed to actively engage in this effort. The intent of the survey, which has been endorsed by over 170 medical societies and other health care associations (see full list here), is to collect updated and accurate data on practice costs which are a key element of physician payment. These data have not been updated since last collected over 15 years ago and it is critically important to update these data to ensure accurate payment. See here for more information about this survey.

Mathematica, a well-regarded consulting firm, is helping the AMA run this survey. Your practice may receive an email (from ppisurvey@mathematica-mpr.com) and an USPS priority mail packet from Mathematica that contained a link to the survey as well as supporting information. We urge you to speak with your practice management colleagues to determine if they have received these communications and ask them to complete this important survey. In the coming weeks or months, your practice, or Mathematica, may ask you to complete a brief survey on the number of weekly hours spent on direct patient care. We urge you to complete this two-minute survey. Help the AMA to help YOU to update Medicare physician payment!

MSD Subsidiary That Directs Technology, Vision/Mission, and Needs

Do you have an interest in all things technology? Do you have an interest in Artificial Intelligence and want to help direct how it is utilized in health care? Serving on the Health Hub Board of Directors may be the place for you! The Health Hub Board was instrumental in identifying telehealth vendors to use by medical practices, which was done prior to the pandemic, allowing MSD to provide information to its members who were seeking telehealth technology during the pandemic and beyond. Those vendors were already vetted and ready to go when there was an immediate need! As Artificial Intelligence (AI) continues to emerge and be part of every aspect of our lives, including health care, appropriate guardrails need to be in place and education provided for an understanding of AI's power and benefits. Digital technology is here and many issues need to be considered for its use: health equity, cybersecurity, etc. Health Hub, LLC is a for profit subsidiary of the Medical Society of Delaware and helps to direct and manage MSD's technology, vision/mission and needs as appropriate. Health Hub, LLC is for the benefit of members. Meetings are usually held virtually on a quarterly frequency. If you have an interest, please contact Mary.LaJudice@medsocdel.org or (302) 593-8589. Elections to the Health Hub Board of Directors will take place next month. Don't wait and miss your opportunity!

To Support the Development of Safe, Effective Digital Health Technologies

The U.S. Food and Drug Administration (FDA) announced the creation of a new Digital Health Advisory Committee to help the agency explore the complex, scientific and technical issues related to digital health technologies (DHTs), such as artificial intelligence/machine learning (AI/ML), augmented reality, virtual reality, digital therapeutics, wearables, remote patient monitoring and software. The Digital Health Advisory Committee will advise the FDA on issues related to DHTs, providing relevant expertise and perspective to help improve the agency’s understanding of the benefits, risks, and clinical outcomes associated with use of DHTs. The committee should be fully operational in 2024. To support the development of safe and effective digital health technologies while also encouraging innovation, the FDA will solicit views from the committee, which will consist of individuals with technical and scientific expertise from diverse disciplines and backgrounds. This will help ensure digital health medical devices are designed and targeted to meet the needs of diverse populations. Digital health is a rapidly evolving, cross-cutting space that spans a wide range of technologies. In addition to the technologies mentioned above, it also includes issues such as decentralized trials, patient-generated health data and cybersecurity.

Breast Cancer Awareness Month Proclamation Signing

On Tuesday of this week, Governor Carney joined House Speaker Valerie Longhurst, the Delaware Breast Cancer Coalition, members of the General Assembly, and advocates to recognize October as Breast Cancer Awareness Month.

DPH Encourages Public to Get Vaccinated

The Delaware Division of Public Health (DPH) has marked the start of 2023-2024 influenza (flu) season. As a possible signal of what we might expect, the U.S. often looks at what Australia and New Zealand experienced in the Southern Hemisphere during their flu season in our summer. This year, the countries had a particularly active flu season. As the spread of RSV and COVID-19 variants continue, and the possibility that an active flu season is ahead, the DPH is recommending Delaware residents, 6 months of age or older, especially those under age of five, older adults, pregnant women, individuals with chronic underlying medical conditions, and those who live or work with infants under six months of age or in congregant settings, get their flu vaccines as soon as possible. Updated 2023-2024 COVID-19 vaccines from Pfizer-BioNTech and Moderna were recently rolled out in response to the emergence of new variants of the COVID-19 virus. DPH wants to let the public know that both the flu and COVID-19 booster shots can be safely administered together. The RSV vaccine is available for people 60 years of age and older, and it can be combined with flu and COVID-19 vaccines. However, the CDC recommends discussing RSV vaccination with your primary care provider to determine if it is appropriate for you and your medical situation. As with COVID-19, DPH will make flu data available on its My Healthy Community data portal on October 10. Pharmacies (including those within grocery stores) as well as participating medical offices, Federally Qualified Health Centers (for their patients) and Division of Public Health clinics are all offering flu vaccines. DPH provides flu vaccines at locations where DPH mobile units also provide health care.  

Portal is Now Open Through December 31st

Created under the Healthy Delaware Families Act, the Paid Family and Medical Leave Insurance Program offers eligible Delaware workers up to 12 weeks of paid leave to address a serious health condition, to care for a family member with a serious health condition, to bond with and care for a new child, or to address the impact of a family member’s military deployment. Most businesses with 10 or more employees are required to participate. The program will be funded by less than 1% of an employee’s weekly salary. Employers can require employees to contribute up to half the cost.

The Delaware Department of Labor’s Division of Paid Leave (DPL) has opened its portal (de.gov/paidleave), giving Delaware employers a way to apply for exemption from immediately joining the state’s plan. If an employer offers a private plan that is comparable to the state’s plan, their existing plan is “grandfathered in.” If a private plan is deemed comparable, it can be grandfathered in for the program’s first five years. Smaller employers (10 to 24 employees) will also be able to notify the Labor Department if they wish to reduce their employees’ maximum parental leave duration (PLD) — from the standard 12 weeks to as low as six weeks — for the first five years of the program. The online Grandfathering/PLD Portal will close on Dec. 31, 2023. Delaware paid leave goes into full effect as of January 1, 2026.

New Rates Effective December 1st

Delaware Insurance Commissioner Trinidad Navarro announced that workers’ compensation insurance rates will decrease for the seventh year in a row, effective December 1, 2023. The voluntary market is expected to decrease 7.24%, while the residual market will see a reduction of 11.18%. Workers’ compensation insurance provides coverage when an employee is hurt on the job and can provide medical coverage as well as payments for lost wages if a person is unable to work due to their injury. Lower premiums don’t change the amount of compensation an injured employee receives. This year’s decrease in worker’s compensation insurance rates continues the reversal of voluntary and residual market trends. With the residual market expected to see a greater rate decrease, it shows that companies who previously could only obtain coverage in this ‘last resort’ market, due to cost, high risk, or claims history, can now obtain traditional voluntary market coverage. This is the second year of this trend, which indicates substantial improvement in coverage affordability and employee safety.

Update: Following a review of the Delaware Compensation Rating Bureau (DCRB) filing by independent actuaries and a public hearing with DCRB and the State’s Ratepayer Advocate, the final Workers’ Comp rates have been approved. Actual savings will vary by policy. Commissioner Navarro is proud to announce that additional decreases have been negotiated from the initial filing:

• Residual Market: Average decrease of 13.85%
• Voluntary Market: Average decrease of 10.03%

Read more about the Workplace Safety Program, where employers can save more on their premiums by participating.

Reprinted from Reuters Health Rounds (10/10/2023)

An increasingly popular form of medical imaging that is less accurate in nonwhite patients can be modified to deliver clear images no matter the skin tone, researchers say. Photoacoustic imaging, a hybrid technique that combines ultrasound with light waves, is increasingly being used to assess blood vessels and look for tumors. But as with fingertip pulse oximeters that pass light waves through skin to measure oxygen levels in blood, photoacoustic imaging is vulnerable to racial bias. The technique has higher error rates in nonwhite patients because the melanin in their skin absorbs more of the light being emitted by the devices. "When you're imaging through skin with light, it's kind of like the elephant in the room that there are important biases and challenges for people with darker skin compared to those with lighter skin tones," co-senior author Muyinatu Bell of Johns Hopkins University said in a statement. As reported in the medical journal Photoacoustics, Bell's team has now created an algorithm that allows them to “sharpen” the photoacoustic information from images of darker skin, in the way a camera filter sharpens a blurry picture, to show internal biological structures more accurately. "We're aiming to mitigate, and ideally eliminate, bias in imaging technologies,” Bell said. "Our work demonstrates that equitable imaging technology is possible."

Greatest Toll on Black Youth

An analysis of mortality data led by National Institute on Minority Health and Health Disparities (NIMHD) researchers assessed the differences in the overall burden of firearm-related deaths amongst youth in the United States. The data show rates increased across all youth racial and ethnic groups from 2019 to 2020. Black youth accounted for 47% of the more than 4,000 deaths in 2020. For the first time, firearm-related deaths exceeded motor vehicle collisions as the leading cause of death for children and adolescents in the United States. According to the researchers, the increase in firearm-related mortality between 2019 and 2020 may be related to the COVID-19 pandemic and social unrest. They also noted the need for effective public health firearm reduction interventions like the Cure Violence Model.

NIMHD’s Division of Intramural Research and NIH’s Distinguished Scholars Program supported the study.

Nation's Highest Court Must Reverse a Lower Court Decision

Noting that the U.S. Supreme Court has said in prior rulings that Second Amendment rights are not unlimited, physicians are telling the nation’s highest court that domestic violence abusers who have restraining orders against them are most certainly among citizens who do not have a constitutional right to bear arms. The AMA and several other medical associations explained why the nation’s highest court must reverse a lower-court decision and uphold a federal law that prohibits those with domestic violence restraining orders from possessing a firearm. Read more.

Comprehensive Guide for States

The Centers for Medicare & Medicaid Services (CMS) released a Medicaid Transportation Coverage Guide, a compilation of Medicaid transportation policy providing a one-stop transportation resource for states on federal requirements and state flexibilities. The guide highlights existing policies and includes new policies to address scenarios for extended wait times, long-distance trips to health care facilities, and scenarios where non-Medicaid-eligible parents, family members, or other caregivers may require transportation to participate in a Medicaid-eligible child’s care. CMS is committed to equity and ensuring that individuals who rely on Medicaid, including those living in rural areas, can access the care they need to stay healthy.

To Expand, Improve Coverage, Care & Outcomes

As part of CMS’ efforts to expand access and coverage for individuals with sickle cell disease (SCD), CMS released its action plan in conjunction with Sickle Cell Disease Month. Sickle Cell Disease – an inherited blood disorder, affects approximately 100,000 individuals in the United States, the majority of whom are Black/African American, and/or Hispanic. The plan addresses the challenges specific to CMS programs and is designed to improve health outcomes and reduce health disparities for individuals with SCD. Additional information is included in this blog authored by CMS Administrator, Chiquita Brooks-LaSure and CMS Office of Minority Health Acting Director, Dr. Aditi Mallick.

Public Comment on Potential Improvements to Requirements in Medicaid, CHIP to Address Mental Health Coverage Roadblocks

CMS is working to help ensure that insurance coverage for mental health conditions, including substance use disorders, is no more restrictive than coverage for any other medical condition. The agency recently posted information and questions for public comment on potential improvements that could be made to Mental Health Parity and Addiction Equity (MHPAEA) requirements in Medicaid and the Children's Health Insurance Program (CHIP) to address mental health coverage roadblocks. This request for comment will gather information to address concerns regarding compliance with MHPAEA requirements in Medicaid and CHIP. Comments must be submitted to the following email address by November 3rd, 2023, to receive full consideration: MedicaidandCHIP-Parity@cms.hhs.gov.

Seeks Stronger Oversight of Laboratory Developed Tests

On Oct. 3, the Food and Drug Administration (FDA) released a highly anticipated proposed rule seeking stronger oversight of laboratory developed tests (LDTs). The American Medical Association (AMA) will continue to review the proposed rule and work closely with pathology members of the Federation of Medicine to advocate for appropriate regulation that both ensures safety and performance of LDTs while maintaining access to diagnostic testing and the ability for pathologists to continue test design and development. Read more.

May Lead to Autism

The Washington Post (10/5, Johnson) reports, using a host of high-tech tools to simulate brain development in a lab dish, investigators have discovered several dozen genes that interfere with crucial steps in the process and may lead to autism, according to findings published online in the journal Nature. The study tested 425 genes that have been linked to neurodevelopmental disorders to determine which ones interfere with the generation and migration of interneurons, identifying genes linked to autism.

Education Session Presented on Physician Burnout

The MSD Physician Emeritus Section enjoyed their final educational luncheon of the year at the University Whist Club in Wilmington this past Tuesday. Dr. Julia MacRae, a board certified plastic surgeon who has been in private practice in Newark for almost 20 years and works with the Center for WorkLife Wellbeing at ChristianaCare, presented, "Physician Burnout: Why now? What now?" the presentation focused on examining causes of burnout in today's world and what some health care systems are doing about it. The MSD Physician Emeritus Section is looking forward to its 2024 educational luncheons, which will resume in April. Luncheons will be held again at the University and Whist Club, Wilmington and also at 1776 Steakhouse in Rehoboth plus we are adding a Dover location next year; information will be sent out after the New Year.  If you have questions, please contact Michelle Seymour or Katie Hamilton.

Relaxing Evening at Constitution Yards with Peers

The Young Physician Sections of the Medical Society of Delaware and the Delaware Chapter of the American College of Physicians had a great time at their Autumn Social at Constitution Yards on October 5th. Several of the physician members spent a relaxing evening sharing each other’s company while enjoying complimentary food, drinks, and games including corn-hole and axe throwing. The weather couldn't have been nicer for an October evening. Thank you to Diamond State Financial Group for sponsoring the event. The Young Physician Sections look forward to hosting another event in the summer and encourages all members to attend!

If you would like to get involved or have ideas for the Young Physicians Section to explore, please contact YPS Chair Anthony Tramontozzi, DO - anthony.tramontozzi@christianacare.org

Deadline Extended to November 16th

The Physicians Foundation recently launched the new Physicians Foundation’s Leadership Award Program to honor the next generation of physician leaders. Award winners will receive a $10,000 scholarship to elevate their efforts to address drivers of health (DOH) or to advance innovative solutions to make their communities or practices a healthier place for patients and physicians. New or early-career physicians are encouraged to apply by November 16th. 

Make Your Work Stand Out at a Conference

Poster presentations are a great way for medical students and residents to showcase their hard work on a project. Learning how to do a poster presentation means finding the best way to present the information so that your work can stand out from the crowd. The American Medical Association (AMA) offers some great tips. For medical students looking to gain insight on the research process and the work their peers are doing, the 2023 AMA Research Challenge virtual poster symposium and semifinals takes place Oct. 18–20. The event offers the opportunity to explore research in a variety of topics and specialties, provide advice and feedback, and score posters to help decide the five finalists who will compete for a $10,000 grand prize. Plus, you can access high-caliber educational sessions focused on trending research topics and get your questions answered live by the experts. Register now.

Health Information for International Travel

For over 50 years, (Centers for Disease Control and Prevention) CDC Yellow Book: Health Information for International Travel has provided expert guidance on how to remain healthy and safe during international travel. Comprehensively revised, CDC Yellow Book 2024 includes both new and updated content. It compiles the US government's most current international travel health information, including pretravel vaccine recommendations; destination-specific health advice; and easy-to-reference maps, tables, charts, and checklists. As international travel resumes and rebounds to pre-pandemic levels, CDC Yellow Book 2024 remains a trusted resource for clinicians helping prepare their patients for travel outside the United States.

Cost Saving Measures Without Compromising Benefit Value

In a constantly evolving economic landscape, employers continue to seek effective strategies to optimize their operations, including the various aspects of employee benefits. Since ensuring the well-being and satisfaction of their workforce is central to their concerns, they seek cost-saving measures that can be implemented without compromising the overall value of benefits. As employers approach 2023 year-end benefit planning, there are a series of steps that can be taken to fine tune their employee benefit offerings in order to achieve financial savings. By utilizing any of the methods discussed, business owners can successfully counter the pressures of today’s evolving business and economic forces to stay within their budgetary restraints while crafting an effective and robust benefit portfolio, all while maintaining a positive work environment. Read more.

The Medical Society of Delaware Insurance Services offers its members access to My Benefit Advisor as a solution for employee benefits, including voluntary offerings. For more information about My Benefit Advisor, visit our website at www.mybenefitadvisor.com or contact Sharon Ruth at (302) 397-0173.

SRA - Security Risk Analysis

All the information you need in order to redeem all Promoting Interoperability (PI) points. And to earn those points, you MUST ensure you have completed your SRA. What is SRA?

Security Risk Analysis - evaluates and mitigates any risks to patients’ privacy. Why is SRA Important? It acts as a prerequisite in the PI category, meaning without a proper SRA, you could lose all PI points. Disregard for this measure is a primary reason practices fail audits. Chirpy Bird offers detailed SRA services that make this process easy. Their experts will dissect all required policies, provide thorough reports, and review your results in simple, understandable terms. Read their full guide to your SRA success and rest easy knowing they’ve got your back.

Streamline Messages from SNFs

Many physicians find their electronic health record (EHR) inbox flooded with messages from skilled nursing facilities (SNFs). Ask the SNF staff to batch their communications so you receive only one or two contacts a day. Other strategies include developing standing orders with the facility, explaining what messages your triage nurses can answer and encouraging the facility to make non-emergency calls during office hours.

LEARN MORE:

• Toolkit: EHR Inbox Management
• Playbook: Taming the EHR
• Podcasts:
• A System-Level Approach to EHR Inbox Reduction
• Electronic Health Record Optimization

AMA STEPS Forward^® offers a collection of engaging and interactive educational content designed to help put the joy back into medicine.

Register With My Green Doctor

If your home or business has an unshaded roof, now is the time to install solar panels and claim a $7,500 credit on your 2023 tax filings. The 2022 U.S. Inflation Reduction Act is an opportunity for Society members that should not be missed! The electricity you save is expected to pay for the panels in eight years and then you’ll have free power for another twenty. This month, MSD’s My Green Doctor explains in a three-minute blog everything you need to know to get started.

My Green Doctor is a free money-saving membership benefit from the Medical Society of Delaware. Members use the “Meeting-by-Meeting Guide” to learn how to adopt environmental sustainability, save resources, address the health threats of climate change, and help create healthier communities. The program requires adding only five minutes to each regular office staff meeting or weekly office “huddle”, making small changes at each meeting that over time really add up. Everyone in your practice can register as Partner Society members at www.MyGreenDoctor.org or at www.MyGreenDoctor.es (si, en espanol). Use the discount code MGDMSD to get full free access to My Green Doctor, save $60 instantly, and save $1000s in the first year. Ask your practice manager to register today and to put My Green Doctor on your next agenda. You can do this!

Beebe Healthcare

TidalHealth Nanticoke

Yehuda (Yudi) Kerbel, MD

MSD spotlights members throughout the state, highlighting medical students, residents, and practicing colleagues, whether they are new to membership or have been a member over the years.

This week's spotlight is on Yehuda (Yudi) Kerbel, MD, Orthopaedic Surgeon with First State Orthopaedics. Read more.

If you would like to be featured in a future Member Spotlight, please contact Michelle Seymour, Manager of Membership.

De'Jah Jennings - Medical Student, Sidney Kimmel Medical College (2027)

Kelly Ann Mackessy, DO - Breast Surgical Oncology Fellow, ChristianaCare

Jennifer Ranton, MD - Family Medicine, St Francis Family Practice, Tiny Steps

Cameron K. Yau, MD - Orthopaedic Associates of Southern Delaware, PA

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!

Steven Calamita, MD - Southern Delaware Imaging Associates

Joseph Cardinale, MD - Orthopaedic Associates of Southern Delaware, PA

Rachel Chang, MD - Brandywine Pediatrics, PA

Neilay Dedhia, DO - Internal Medicine, Middletown Family Care Associates

Shannon FitzPatrick, MD-Orthopaedic Associates of Southern Delaware, PA  

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 or if you know of someone interested in joining MSD. You could be eligible for a membership referral dues discount!

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.

CDC Director Rochelle P. Walensky, M.D., M.P.H. adopted the 2023-2024 Advisory Committee on Immunization Practices’ (ACIP) recommendations on annual influenza (flu) vaccination for everyone 6 months and older in the United States on June 27, 2023. There were small changes to the annual recommendations around flu vaccination, including an acknowledgement of the updated flu vaccine composition for the 2023-2024 flu season and a change in the recommendations for vaccination of people with egg allergies. Dr. Walensky’s adoption of the ACIP recommendations makes them official CDC policy, which have been published in the Morbidity and Mortality Weekly Recommendation Report August 23, 2023. Health care professionals should begin vaccinating patients according to CDC’s recommended timing, which remains the same as last season. Read the CDC Vaccine Recommendations for the 2023-2024 flu season.

Flu Vaccination Guidance for Children

Flu can be a serious threat to children. During a COCA call on August 31, 2023, presenters discussed flu prevention and treatment recommendations from the American Academy of Pediatrics and CDC. If you’ve missed it, this recording is a great update on vaccination, coadministration of flu vaccines, coverage, and health disparities.

The FDA has outlined the following brief guidelines for the updated COVID-19 vaccines to simplify the questions regarding whom should receive the vaccine and when: 

• Individuals 5 years of age and older regardless of previous vaccination are eligible to receive a single dose of an updated mRNA COVID-19 vaccine at least 2 months since the last dose of any COVID-19 vaccine.  
• Individuals 6 months through 4 years of age who have previously been vaccinated against COVID-19 are eligible to receive one or two doses of an updated mRNA COVID-19 vaccine (timing and number of doses to administer depends on the previous COVID-19 vaccine received).  
• Unvaccinated individuals 6 months through 4 years of age are eligible to receive three doses of the updated authorized Pfizer-BioNTech COVID-19 Vaccine or two doses of the updated authorized Moderna COVID-19 Vaccine. 
• On October 3, 2023, the FDA amended the emergency use authorization (EUA) of the Novavax COVID-19 Vaccine, Adjuvanted for use in individuals 12 years of age and older to include the 2023-2024 formula. Individuals 12 years of age and older previously vaccinated with a COVID-19 vaccine (and who have not already been vaccinated with a recently updated mRNA COVID-19 vaccine) are eligible to receive one dose and unvaccinated individuals receive two doses. As part of this action, the Novavax COVID-19 Vaccine, Adjuvanted (Original monovalent) is no longer authorized for use in the United States.

Vaccination will be available free for everyone through one of three methods.

• Most Private and government insurance plans - cost fully covered by insurance (receive through pharmacies, health care professionals)
• Uninsured, underinsured - cost covered through FQHCs; public health clinics; pharmacies; health care professionals via Delaware Immunization Program; and Walgreens, CVS, and pharmacies affiliated with ETrue North pharmacy network through Bridge Access Program.
• Children participating in CDC's Vaccines for Children Program - free from where they receive routine vaccinations.

 A full listing of vaccine locations is posted on www.vaccines.gov.

The national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic ended on May 11, 2023. The Centers for Medicare & Medicaid Services (CMS) has resources available, some of which have been updated based on recent action by Congress.

• Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency (Updated 5/12/2023).
• Provider-specific fact sheets for information about COVID-19 Public Health Emergency (PHE) waivers and flexibilities: https://www.cms.gov/coronavirus-waivers
• Acute Hospital Care At Home
• Loss of Medicaid or CHIP coverage
• FAQs on CMS Waivers, Flexibilities, end of COVID-19 PHE (May 4, 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.

• Find COVID-19 Vaccines: https://www.vaccines.gov/
• No Cost COVID-19 Testing Locator can help people find current community and pharmacy partners participating in the Increasing Community Access to Testing (ICATT) program.
• 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
• Federal website for information on navigating COVID: COVID.gov
• CDC Isolation and Precautions for People with COVID-19
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker
• CDC will report regional-level test positivity data from the National Respiratory and Enteric Virus Surveillance System (NREVSS)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• 2nd bivalent COVID-19 Vaccine Booster: Who Should Receive It?
• (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)