MedPAC Acknowledges Pay Gap for Physician Practices

The Medicare Payment Advisory Commission (MedPAC) acknowledged during a recent meeting what it called the growing gap between the costs of practicing medicine and what Medicare pays. According to American Medical Association (AMA) President Jack Resneck Jr., M.D., “the organization’s research shows that, adjusted for inflation in practice costs, Medicare physician pay declined 22% from 2001 to 2021, or by 1.2% per year, on average,” and “this widening gap has created instability for physician practices and threatens Medicare patient access to care.” The AMA and individual state medical associations, including the Medical Society of Delaware, sent a letter to House and Senate leaders in support of expeditious legislative action to stop the impending 4.5% Medicare Physician Fee Schedule (MPFS) payment cut stemming from statutory requirements for budget neutrality. The Centers for Medicare and Medicaid Services released the Calendar Year 2023 MPFS Final Rule in November 2022, which included the new, lower conversion factor (CF). The 4.5% reduction stems from the combination of the expiring 3% increase to the CF that Congress enacted via the Protecting Medicare and American Farmers from Sequester Cuts Act and a new 1.5% budget neutrality reduction related to payment changes for evaluation and management services in the non-office setting.  As a result, absent Congressional intervention, all physicians will experience a 4.5% across the board reduction in Medicare payments.  

Let's Stop "Ground Hog Day"

Fighting to avert deep Medicare payment cuts feels a bit like “Groundhog Day,” with the same series of events unfolding again and again. For many physicians, a sustainable payment system seems like an ongoing, unfulfilled wish. If Congress fails to act by the end of the year, physician Medicare payments are planned to be cut by 4.5% in 2023. Please take a moment and contact your Senators and Representatives to tell them to cancel the cuts to protect physician practices and preserve patient access to care.

Use these materials and contact your members of Congress to let them know the Medicare physician payment system needs reform to become a more sustainable, value-based system that better meets the needs of patients and physicians.

• The need for Medicare payment reform (PDF)
• Congress must stop Medicare payment cuts triggered by budget neutrality (PDF)
• The Medicare physician payment system needs annual inflation updates (PDF)
• Medicare alternative payment models (PDF)
• The principles: Characteristics of a rational Medicare physician payment system (PDF)

The evidence is clear: The Medicare payment system is on an unsustainable path threatening patient access to physicians. Read more.

File a MIPS Exception Application If You Need Relief

The deadline to submit a 2022 MIPS Extreme and Uncontrollable Circumstances (EUC) Exception application is Jan. 3, 2023. Practices that need the relief will may miss the opportunity to file a MIPS exception application, especially since the EUC deadline coincides with the upcoming holidays, continued COVID PHE, and the severe staffing shortages. The American Medical Association has reached out to the Centers for Medicare & Medicaid Services (CMS) requesting CMS once again automatically apply the automatic EUC for 2022 MIPS reporting. Alternatively, at a minimum requesting CMS extend the 2022 MIPS EUC deadline until the end of the 2022 data submission period, which is March 2023. Information will be shared should the policy change to provide additional relief from MIPS. 

In the interim, physicians that are interested in requesting a 2022 MIPS EUC and avoiding a 2024 payment adjustment may do so by going to the CMS MIPS EUC Exception application page until 8 p.m. ET on January 3, 2023. If you believe you’ve been affected by an extreme and uncontrollable circumstance (such as the public health emergency triggered by the COVID-19 pandemic), you can apply whether reporting traditional MIPS or the APM Performance Pathway (APP). Learn more about the COVID-19 flexibilities. 

Help Donate to Those Hungry Through December 17

MSD is raising money to help the Food Bank of Delaware address the increase in need for hungry Delawareans. With every $1 raised, the Food Bank of Delaware can provide three meals. Let's help our fellow citizens in their time of need. Access the virtual donation site to make your donation. It is quick, easy, and convenient. Donations will be accepted through December 17th. Thank you for making a difference!

Reaccredited for Four Years as a Provider of Continuing Medical Education

MSD is proud to announce that it achieved reaccreditation by the Accreditation Council for Continuing Medical Education (ACCME) for four years as a provider of continuing medical education (CME) for physicians. Accreditation in the ACCME system seeks to assure the medical community and the public that MSD delivers education that is relevant to clinicians’ needs, evidence-based, evaluated for its effectiveness, and independent of commercial influence. MSD provides evidence-based science, quality initiatives, clinical best practices, and the latest medical guidelines to our physicians and other health care professionals. That means better outcomes for patients in our community.

Follows FDA Amended EUA for the Bivalent Moderna, Pfizer COVID Vaccines

Last Thursday, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) of the updated (bivalent) Moderna and Pfizer-BioNTech COVID-19 vaccines to include use in children down to 6 months of age. Following this FDA action, on Friday last week, the Centers for Disease Control and Prevention (CDC) expanded the use of updated (bivalent) COVID-19 vaccines for children ages 6 months through 5 years.

• Children ages 6 months through 5 years who previously completed a Moderna primary series are eligible to receive a Moderna bivalent booster 2 months after their final primary series dose.
• Children ages 6 months through 4 years who are currently completing a Pfizer primary series will receive a Pfizer bivalent vaccine as their third primary dose.

The vast majority of children in this age group have not received any doses of a COVID-19 vaccine. CDC is working to increase parent and physician confidence in COVID-19 vaccines and improve uptake among the 95% of children who are not vaccinated or who have not completed the COVID-19 vaccine primary series.

Rick Hong, MD, Interim Director, Outlines Use of Bivalent Boosters

On December 9, the Food and Drug Administration (FDA) granted Emergency Use Authorization to Moderna for the bivalent booster for ages 6 months – 5 years, and Pfizer for use as the third dose in the primary series for 6 months – 4 years of age, but not for use as a bivalent booster. Those ages 5 and up were previously authorized for a Pfizer bivalent booster, and ages 6 and up were previously authorized for a Moderna bivalent booster. Read the separate communication sent to MSD members today about the specifics for administration of the bivalent booster for these age groups.

New CPT Codes for Moderna, Pfizer Bivalent Vaccines for Youngest Patients

The Current Procedural Terminology (CPT^®) Editorial Panel (the Panel) recently approved new vaccine product codes and new vaccine administration codes for the administration of two bivalent vaccine products to address severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 [COVID-19]): a booster dose of the Moderna bivalent vaccine for patients aged 6 months through 5 years; and a third dose of the Pfizer vaccine for patients aged 6 months through 4 years.

The vaccine and administration codes for both bivalent products are effective as of Dec. 8, 2022, as that is the date that the Food and Drug Administration (FDA) issued the emergency use authorization (EUA) for both vaccines.

The November issue of CPT^® Assistant Special Edition provides guidance on the appropriate use of the new Moderna bivalent booster vaccine product code (91316) and its associated vaccine administration code (0164A) for patients aged 6 months through 5 years.

The December issue of CPT^® Assistant Special Edition provides guidance on the appropriate use of the new Pfizer bivalent booster vaccine product code (91317) and its associated vaccine administration code (0173A) for patients aged 6 months through 4 years. Learn More.

Public Health Emergency Declarations Must Be Renewed Every 30 Days

Governor Carney last Friday formally extended the Public Health Emergency order another 30 days to allow the State of Delaware and health care professionals to continue COVID-19 vaccination and testing programs.

“Let’s keep doing the things we know that work,” said Governor Carney. “Stay home if you’re sick. Get vaccinated and boosted when you’re eligible. And get your flu shot if you haven’t yet.” 

Residential Households in the US Can Order One Set of Four Individual Tests

Residential households in the U.S. can once again order free at-home tests through the US Postal Service. There is a limit of one order per residential address. One order includes four individual rapid antigen COVID-19 tests (COVID.gov/tests has more details about at-home tests, including extended shelf life and updated expiration dates). Before you throw out "expired" tests, check to see if your COVID-19 tests' expiration dates have been extended. Orders will ship free starting the week of December 19, 2022.

Collaboration to Help Testing and Treatment Awareness for Patients

Roche announced it has entered into a U.S. focused collaboration with Pfizer to drive awareness and educate on the importance of timely COVID-19 testing, available treatment options, symptoms and the high-risk factors that can increase the chance of progressing to severe illness. The Pilot COVID-19 At-Home Test, distributed in the U.S. by Roche Diagnostics and manufactured by SD Biosensor, Inc., will now include a QR code that directs individuals to covid19knowmore.com where they can learn more about COVID-19, including CDC guidance on testing and treatment options. It is authorized for the detection of COVID-19 with or without symptoms for individuals ages 14 years and older, and by an adult for children ages 2 to 13 years old. It has been distributed to tens of millions of Americans through the US government's efforts to expand access to testing earlier this year. The Pilot COVID-19 At-Home Test is available for over-the-counter purchase through select retail channels in the US.

Interim Guidance in the Setting of Reduced Availability of Oseltamivir

The Centers for Disease Control and Prevention (CDC) estimates that in the 2022-2023 season to date, there have been at least 13 million illnesses, 120,000 hospitalizations, and 7,300 deaths from influenza (Weekly U.S. Influenza Surveillance Report | CDC). While the Food and Drug Administration (FDA) has not indicated shortages of oseltamivir (generic or Tamiflu) in any of its forms (capsules, oral suspension), CDC has received numerous anecdotal reports of availability issues for generic oseltamivir in some locations. This may continue to occur in some communities as influenza activity continues. The Health Alert Network (HAN) Health Advisory provides clinicians and public health officials with guidance for prioritizing oseltamivir for treatment and information on other influenza antivirals that are recommended for treating influenza in areas where oseltamivir is temporarily unavailable. Learn more. 

For Those Working with Adult Patients or in the Field of Gerontology

The Board of Medical Licensure and Discipline and the Board of Nursing are responsible for establishing continuing education requirements for medical professionals licensed by these Boards. Senate Bill 283 requires practitioners who treat adults to take continuing education on the diagnosis, treatment, and care of patients with Alzheimer’s or other dementias. MSD opposed this legislation on all fronts (read the MSD/DNA Joint letter of opposition). The legislation passed both chambers and was signed by the Governor on September 8, 2022, changing the law governing continuing education requirements for medical professionals.

According to the Delaware Board of Medical Licensure and Discipline, the following requirement must be completed during each biennial medical license renewal period beginning with the 2025 renewal cycle. Senate Bill 283 requires all medical professionals who work with adult patients or in the field of gerontology in a health care setting to complete at least one (1) hour of continuing education on the topic of diagnosis, treatment, and care of patients with Alzheimer's disease or other dementias. During license renewal in 2023, you will be required to acknowledge your understanding that, you will have to complete this mandatory CE requirement starting in renewal cycle 2025, if you work with adult patients or in the field of gerontology in a health care setting.

MSD will be working closely with the Delaware Board of Medical Licensure & Discipline to obtain further clarification on how this will effect specific practices and specialties prior to the 2025 renewal cycle. Please continue to watch your communications from MSD.

Get Ready for 2023: Physician Medical Licensure Renewal Year

Delaware law requires that, in order for medical professionals to renew their license, they must attest that they have completed training on:

• how to recognize child sexual and physical abuse, exploitation and domestic violence
• your reporting obligations under the Medical Practice Act and Regulatory Provisions Concerning Public Health

The 2023 Mandatory Reporting Training for Medical Professionals will be available on January 1, 2023, and features videos from professionals within the child welfare field that walk participants through how to detect and respond to child abuse and neglect.

Licensed physicians must take the 2023 Mandatory Reporting training even if they recently completed mandatory reporting training. This training must be completed before every medical license renewal. Physicians are required to attest to completing the training on their renewal application. Failure to do so will delay the renewal of the medical license.  

This training is provided by the Office of the Child Advocate. To complete the training on or after January 1, 2023, go to https://stateofdelaware.csod.com/default.aspx?c=courts-oca to create an account. If you already have an account, just click the “login in” icon and sign in User ID and Password. Once training is completed, medical professionals can then reapply for licensure through the Division of Professional Regulation's website at https://delpros.delaware.gov/OH_HomePage.

Medicare Recipients Benefit with Capped Pricing

With the passage of the Inflation Reduction Act (IRA) in August, people with Medicare will begin to save money in 2023 with the new $35 cap for covered insulin products starting on January 1st for Part D insulin products and on July 1st for insulin products covered under Part B. The Centers for Medicare & Medicaid Services (CMS) has issued a set of Frequently Asked Questions for the Medicare insulin benefit that is included with the IRA to help understand the benefit and answer patient questions.

Will Discuss Results and Initiate Phase 3 Study in Melanoma in 2023

Moderna, Inc., a biotechnology company pioneering messenger RNA (mRNA) therapeutics and vaccines, and Merck announced that the trial of mRNA-4157/V940, an investigational personalized mRNA cancer vaccine, in combination with KEYTRUDA^®, Merck's anti-PD-1 therapy, demonstrated a statistically significant and clinically meaningful improvement in the primary endpoint of recurrence-free survival (RFS) versus KEYTRUDA alone for the adjuvant treatment of patients with stage III/IV melanoma following complete resection. Adjuvant treatment with mRNA-4157/V940 in combination with KEYTRUDA reduced the risk of recurrence or death by 44% compared with KEYTRUDA alone. Personalized cancer vaccines are designed to prime the immune system so that a patient can generate a tailored antitumor response specific to their tumor mutation signature. mRNA-4157/V940 is designed to stimulate an immune response by generating specific T cell responses based on the unique mutational signature of a patient's tumor. KEYTRUDA is an immunotherapy that works by increasing the ability of the body's immune system to help detect and fight tumor cells. Based on early clinical studies, combining mRNA-4157/V940 with KEYTRUDA may potentially provide an additive benefit and enhance T cell-mediated destruction of tumor cells.

"Royal" Ransomware Has Increased in Appearance

The Department of Health and Human Services (HHS) is warning the health care sector that it is under threat of cyberattacks from a human-operated ransomware called Royal. Royal was first observed in 2022 and has increased in appearance. It has demanded ransoms up to millions of dollars. Due to the historical nature of ransomware victimizing the healthcare community, Royal should be considered a threat to the health care and public health care sector. Royal appears to be a private group without any affiliates while maintaining financial motivation as their goal. The group does claim to steal data for double-extortion attacks, where they will also exfiltrate sensitive data. Multiple actors have been spreading Royal ransomware. Malware has been delivered with human-operated attacks and by using new techniques, evasion tactics, and post-compromise payloads. Malicious links embedded in malvertising, phishing emails, fake forums, and blog comments have been observed. In addition, Microsoft researchers have identified changes in delivery method to start using malvertising in Google ads, utilizing an organization’s contact forum that can bypass email protections, and placing malicious installer files on legitimate looking software sites and repositories. If you have any additional questions, you are encouraged to contact the Health Sector Cyber Security Coordination Center at HC3@hhs.gov.

Housing Considered to be a Key Social Determinant of Health

Not all households can keep up with timely maintenance and repairs. Financial means is often a determining factor in the ability to do so. This creates conditions where, when needed repairs and maintenance are not made, physical and structural problems in the home accumulate to the point where the home is considered substandard, in that it poses a risk to the health, safety or physical well-being of occupants, neighbors, or visitors. Substandard housing, insofar as it leads to and exacerbates health problems, can incur health costs in addition to home repair costs, impair employment and increase risk for mortgage default, foreclosure and abandonment. Deteriorating housing systematically impacts health, on a population level, on a scale to where housing is considered to be a key social determinant of health.

A report by the Tri-County Habitat for Humanity Organizations in Delaware presents an assessment of the need for assistance with housing repairs for low income homeowners in Delaware. Identifying and fixing a variety of repairs can help people of lower incomes, as well as senior citizens, stay in their homes and avoid having to find other, more costly housing or going to the rental market. It's more effective to provide repair services and keep somebody in their home than necessarily to build a new house. Habitat for Humanity is still building new homes, but they want to try to find all the different partners who link up with health and energy efficiency and resiliency to provide these repairs. Habitat for Humanity leaders hope to utilize these findings to demonstrate the need for more funding for these and other home repair programs. The study also examined various socio-economic factors that create housing affordability challenges and made a series of recommendations.

CPT E/M Guidelines: Implications for Patient Social Risk Data & Health Equity

A new module called “CPT Evaluation and Management (E/M) Guidelines: Implications for Patient Social Risk Data and Health Equity” is now available on the AMA Ed Hub^TM.  In this module, American Medical Association (AMA)-created content reviews how clinicians can report time or complexity of medical decision making (MDM) associated with social factors using the E/M coding guidelines, and discusses opportunities to document data that reflects the social determinants influencing patient health. The module presents ways that clinicians and care teams can use this data to adjust and improve quality of care, and support both population health management and community-level approaches to address health equity. Continuing Medical Education (CME) credit is available for those who complete the module.

Reimagines Nylon Capital Shopping Center to Include a Medical Facility

Governor John Carney on Tuesday joined local officials, business leaders, and community members to announce a transformative economic development project in the City of Seaford. A combination of private and public investment will fund the redevelopment of the Nylon Capital Shopping Center into a multi-purpose community facility that includes on-site health care services, an education hub, early learning center, co-working space, and a job skills center. This project is the result of a state, city, and nonprofit partnership to redevelop a shopping center in a city that was hit hard by COVID-19.

The new facility will have the following features:

• Public Wi-Fi availability
• A higher education hub focusing on workforce development trainings and courses
• A medical facility
• An early learning center
• A co-working space for start-up companies

Photo obtained from Governor Carney's Flickr page on the press conference held.

1 in 3 Employees Are Unhappy With Their Health Plan

The reality is most workers are satisfied with their employer-sponsored health insurance. That’s good for both recruitment and retention. But if a third of employees aren’t happy, that could be trouble. And, of course, even great plans often come with high costs to the employer and plenty of frustration for plan administrators.

If you’re not entirely sure you’re getting everything you and your employees need, you need to speak with the experts at My Benefit Advisor sooner rather than later.

Cureus is Now Part of Springer Nature

Are you looking to publish your original article, case or technical report? MSD has established a designated online "Academic Channel" for MSD within the Cureus Journal of Medical Science. As an author interested in publishing your work, this online, open access process will make it simpler and put you in control.

Cureus is now part of Springer Nature, a German-British academic publishing company considered to be a leader in global research, educational, and professional publishing, and one of the "Big Five" in academic publishing along with Elsevier, Wiley, Taylor & Francis, and SAGE. Springer Nature had published 16% of all Open Access primary research, which is 29% more than any other publisher. This recognition from one of the largest and most respected academic publishers in the world will further strengthen efforts to be the fastest, most affordable Open Access medical journal in the world, with the broadest reach of any journal, as well. The result is a larger audience, more citations, and more recognition for authors.

We invite you to review the Medical Society of Delaware Academic Channel and consider submitting your work for publication. Click to register for your free account and join the community to get started publishing!

Get Free CME, CNE

The Delaware Division of Public Health (DPH) and Quality Insights have partnered to offer a series of e-learning courses to practices, health care systems, and federally qualified health systems in Delaware. Nine courses are offered on demand and are at no cost. For additional information on each course and instructions on accessing them, visit the Quality Insights website or watch this video. Feel free to print the flyer and post it for your staff.

The following courses are currently offered.

• Colorectal Cancer Screening 
• Diabetes: Awareness to Action
• Health Literacy
• Healthy Heart Ambassador Blood Pressure Self-Monitoring
• Screening for Life
• Medication Therapy Management
• Motivational Interviewing
• Tobacco Cessation
• National Diabetes Prevention Program (National DPP) Coverage Toolkit Overview

With the exception of the National DPP course, continuing nursing education and continuing medical education credits are offered.

January 23, 2023 - Hybrid Event

This year's annual event will educate providers, community members and legislators regarding how to enhance awareness and de-stigmatize the prominent need for and role of appropriate mental health care in the lives of patients and health care professionals. We plan for a virtual presentation from our regional District; a community roundtable with legislators and community members; and a legislative forum. The event will be a hybrid format, with in-person attendance at Eden Hill Medical Center in Dover. Watch for more information, including registration details.

MSD's My Green Doctor Explains How Your Patients Can Avoid Them

Per- and PolyFluoroAlkyl Substances (known as PFAS chemicals) seem to be everywhere these days: at the top of Mount Everest, in umbilical cord blood, in breast milk, and in the news. In 2022, the U.S. Environmental Protection Agency announced new health advisories for PFAS in drinking water. MSD’s My Green Doctor explains PFAS and how your patients can avoid them. https://mygreendoctor.org/pfas-toxic-chemicals-to-understand-avoid/

My Green Doctor is a free money-saving membership benefit from the Medical Society of Delaware. Members use My Green Doctor’s “Meeting-by-Meeting Guide” to learn how to adopt environmental sustainability, save resources, and help create healthier communities. The program adds just five minutes to each regular office staff meeting or weekly office “huddle”, making small changes at each meeting that really add up over time. 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 save $60 instantly and get full free access to My Green Doctor forever. Ask your practice manager to register today and to put My Green Doctor on your next agenda. You can do this!

Beebe Healthcare

The Jean & Joan Golf Tournament committee recently presented the Beebe Medical Foundation with a donation of $27,791 for Beebe Healthcare’s Cancer Patient Special Needs Fund from the proceeds of the 23rd Annual Jean & Joan Tournament. The annual tournament featured pickleball and golf tournaments . The Fund was founded in 1999 in memory of local cancer victims Jean James and Joan Martin, and the charity tournament has been played at Kings Creek Country Club every year.

Charles S. Riegel, MD

It is with sadness we share that MSD member Charles S. Riegel, MD passed away on August 5, 2022, at the age of 90. He graduated from Hahnemann Medical School (now Drexel University College of Medicine) in 1958. He served as captain in the U.S. Army Medical Corps from 1961-1962, earning a commendation medal of meritorious service. While completing residency training in Internal Medicine, Dr. Riegel was chosen as chief resident at Wilmington Hospital from 1963-1964. He spent multiple summers providing medical services at Native American Reservations, served on the Medical Committee of the Delaware Board of Pensions (1998-2014), and was instrumental in opening the Henrietta Johnson Medical Center in Wilmington. He received the Governor's Outstanding Volunteer Award in Health for his years treating patients at Claymont Family Services. Dr. Riegel also served as ship's physician on a Quark ice breaker ship carrying a team of scientists to Antarctica. Read obituary.

Congratulations to the following physicians as we

celebrate their MSD membership milestone

anniversaries during the month of January.

Vineet Puri, MD - Sleep Medicine, Primary Care of Delaware, LLC

MSD's Membership Department is pleased to announce the newest members of the Medical Society of Delaware. If you know someone interested in joining MSD, please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions. You could be eligible for a referral discount!

Gregory K. Wanner, DO - Emergency Medicine, Doctors for Emergency Srvcs.

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.

• DPH Flu Dashboard
• DPH Delaware Weekly Influenza Surveillance Reports by week.
• CDC https://www.cdc.gov/flu/weekly/index.htm
• WHO https://www.who.int/teams/global-influenza-programme/surveillance-and-monitoring/influenzaupdates/current-influenza-update

• 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)
• Fact Sheet: Data Points on Bivalent COVID-19 Vaccination (November 16, 2022)
• DPH Public Health Alerts: de.gov/publichealthalerts
• DPH COVID-19 Booster Information: de.gov/boosters
• Federal website for information on navigating COVID: COVID.gov
• CDC COVID-19 Quarantine and Isolation Calculator
• COVID-19 Treatment Options
• Medical Provider Guidance for Administering Therapeutics
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker Weekly Review.
• For testing flyers (available in English, Spanish, Haitian Creole): https://covidmaterialsde.com/resources/community-organizer
• For all testing site referral locations, visit: de.gov/gettested
• For vaccination site referral locations, visit: de.gov/getmyvaccine
• Pfizer-BioNTech COVID-19 Vaccine Presentation Wall Chart (updated November 15, 2022)
• Pfizer/Moderna pediatric vaccine information: de.gov/youthvaccine
• 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
• Know the COVID-19 Community Level where you live
• DPH COVID-19 Vaccine Fact Check Page to help separate fact from fiction.
• Subscribe to the COVID-19 Update podcast - on Apple Podcasts or Simplecast.  

• DPH Public Health Alerts: de.gov/publichealthalerts
• DPH Hotline - (866) 408-1899 (Monday -Friday, 8:30 a.m. to 4:30 p.m.) or DPHCall@delaware.gov
• Reporting suspected monkeypox rash in Delaware: Contact DPH Office of Infectious Disease Epidemiology (OIDE), at 302-744-4990 (business hours) or 1-888-295-5156 (after hours).
• Delaware health care facilities that require specimen collection kits can order through OEMS@delaware.gov using a SHOC Request form.
• DPH website: de.gov/monkeypox
• DPH Social Channels: Facebook (@DEPublicHealth), Instagram (@depublichealth), DHSS Twitter (@Delaware_DHSS)
• FDA Monkeypox Response Website
• CDC Monkeypox Website
• CDC Case Definitions for 2022 Monkeypox Response
• CDC Considerations for Monkeypox Vaccination for the recommended use of vaccine in the U.S.
• CDC Monkeypox Treatment Information for Healthcare Professionals
• Specimen collection: Follow Lab Advisory: CDC Updates Specimen Collection Guidelines for Monkeypox Virus