COVID-19 News, Reports, and Reflections
April 20, 2020

News:

PPE Supplies Available through HCMA Partnership
The HCMA has partnered with several other medical associations throughout the state in order to offer PPE supply ordering for members only . Our collaborative has been working diligently vetting suppliers to ensure we’re using a trusted source in order to get the best pricing and availability for members. Given the strained supply chains, in order to secure PPE supplies, we must order supplies in bulk quantities.
 
Orders will be processed once the supplier’s minimum threshold requirement has been met. Once products have been ordered from our supplier, members will be notified of their anticipated delivery date and sent an invoice to pay for their items individually. The individual invoice will include the following approximate fees: Sales Tax (7%), Merchant Fee (3.5%), Shipping ($8.99 per box), Handling Fee ($0.48 per box), Warehouse fee ($7.50).  Note: The warehouse fee covers the cost of the professional warehouse and distribution staff necessary to manage this program.

HCMA depends on the pre-order commitments made by members to satisfy the minimum requirements set by our suppliers. Cancellation of an order after the group order has been placed could jeopardize the availability and time it takes to access the supply chain for our Association.   While we remain at the mercy of the availability and fluctuations in the supply distribution chain, we are confident we can secure these needed supplies to help you continue your mission to serve your patients.

Click here to place your order: https://form.jotform.com/201065626058149

Please note… Contact Fraser Cobbe, Physicians Society of Central Florida, directly at 844-234-7800 or fcobbe@cobbemanagement.com with any questions.   

Opening Up America - guidelines
Today, the Centers for Medicare & Medicaid Services issues new recommendations specifically targeted to communities that are in Phase 1 of the Guidelines for President Trump’s Opening Up America Again with low incidence or relatively low and stable incidence of COVID-19 cases. The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and medical procedures. The new CMS guidelines recommend a gradual transition and encourage health care providers to coordinate with local and state public health officials, and to review the availability of personal protective equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care.


The Guidelines for Opening Up America Again can be found here: https://www.whitehouse.gov/openingamerica/#criteria

Florida Surgeon General extends Emergency Order 20-002 to May 8
On March 16, Florida Surgeon General Scott Rivkees, MD, issued Emergency Order 20-002 , which among other things, allows physicians to renew controlled substance prescriptions and medical marijuana certifications for existing patients via telemedicine without having to conduct an in-person physician examination. This order was set to expire on April 15, but was extended by the Surgeon General until May 8, 2020 . 

Responding to a spike in cyber threats that exploit telework technologies during the COVID-19 pandemic, the American Medical Association (AMA) and the American Hospital Association (AHA) have teamed to provide physicians and hospitals with guidance on protecting a remote work environment from cyber criminals.
Orlando Medical News , April 17, 2020

A Safe Harbor for Members
The newly launched HCMA Foundation Physician Wellness Program provides a safe harbor for members to address life difficulties, especially during this time of uncertainty and challenges due to the ongoing threat of COVID-19, in a confidential and professional environment. The Program features completely confidential and complimentary access to professional psychological services for all members. Visit the LifeBridge HCMA Foundation Physician Wellness Program webpage to learn about the Program and to utilize this exclusive benefit.
Reports:

CARES Act
Since last Friday when HHS announced it would begin disbursing the first $30 million of the emergency fund created under the Coronavirus Aid, Relief, and Economic Security (CARES) Act to physicians and other providers via direct payment, the AMA has received several questions about how to verify eligibility for payment and who to contact when a physician believes they are eligible but did not receive a payment. HHS partnered with UnitedHealth Group (UHG) to deliver the stimulus payments, and physicians should contact UHG’s Provider Relations at 866-569-3522 about eligibility, whether a payment has been issued, and where it was sent. Note, if a physician or practice did not already set up direct deposit through CMS or UHG’s Optum Pay, they will receive a check at a later date. Practices that would like to set up direct deposit now can call the UHG Provider Relations number.
 
In addition, HHS has opened the  CARES Act Provider Relief Fund Payment Attestation Portal . Physicians who have been allocated a payment from the initial $30 billion general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment. The terms and conditions are listed here . 

Clarification on Stark Law Waivers
The Secretary of Health and Human Services issued blanket waivers of the Stark Law on March 30th in order to facilitate COVID-19 related medical services. The waivers apply only to financial relationships and referrals related to COVID-19. The circumstances and conditions under which the waivers apply are strictly and narrowly described. Moreover, the waivers have no impact in the presence of fraud or abuse. With respect to physicians wanting to provide designated health services (e.g. clinical lab services) related to COVID-19 detection and treatment, for instance:
 
  • the federal requirement that the DHS be provided in the same building as the physician office is waived; and
  • the financial relationship limitations between the physician (or family member) and the DHS provider is waived.
 
The waiver also contains specific examples of waived interactions between providers and hospitals, including:
 
  • a hospital paying a physician above previously contracted rates for treating COVID-19 patients; and
  • a hospital renting space in a physician office related to COVID-19 patients below FMV or free of charge. 
  • Despite the federal waivers, physicians have to take care to make sure whatever they do in response to COVID-19 (a) isn't likely to be construed as constituting "fraud or abuse," and (b) is consistent with existing state law (since Florida has not yet lifted any laws applicable to physicians, such as the Florida Patient Self-Referral Act of 1992, which has many features similar to the Stark Law.)


NIH sa ys researchers have confirmed there are ways to decontaminate N95 masks so they can be reused
The New York Times reports the NIH announced that “researchers have confirmed that there are several effective methods for decontaminating the N95 masks worn by health professionals so that they can be used more than once.” The NIH publicized the research , which was posted on medRxiv. 
AMA Morning Rounds , April 17, 2020

Doctors and hospitals ask for advance Medicare payment to stay in business
To help stay afloat, thousands of doctors, hospitals and other healthcare providers are reaching out for a lifeline made available in the series of federal relief measures to counteract the pandemic’s effects. More from Health News Florida
 
Physician restrictions during pandemic being felt across the country
As federal officials are encouraging the loosening of physician restrictions, state governments are subsequently restricting the same caregivers from providing potentially life-saving medical and surgical care. In many instances, state governments have threatened physicians and surgeons with loss of licensure, fines and even jail time. More from The Hill

Telemedicine — How it is working for private practice physicians
Three private practice physicians who had successfully integrated telemedicine into their practice before COVID-19 hit the U.S. with full force told the AMA they have found it useful, practical and convenient—though they do have one caveat: Telehealth and driving do not mix. More from the AMA
 
Coronavirus is new doctors’ first assignment
Medical residents spend years training to turn calamities into victories, but the scale of the COVID-19 crisis has been daunting. More from National Geographic

Funeral professionals ask physicians to sign death certificates as soon as possible
Anticipating a significant increase in the number of deaths this month because of COVID-19, the Florida Cemetery, Cremation & Funeral Association (FCCFA) is asking physicians to sign death certificates “as soon as practically possible.” In a letter to Florida’s medical community , FCCFA President Jon Thomas wrote, “Our system, like the medical system, is likely to be stretched to capacity. …This will help us serve families in the most expeditious manner possible.”
Reflections:

HCMA Members COVID-19 Video Support Group
Join Daniel Baughn, PhD and other HCMA members for a free, confidential, video support group for physicians facing additional stress related to the COVID-19 health and economic crisis.
  • Groups will be held every Tuesday evening from 8:00PM-9:00PM over video using Google Meet beginning 4/28/20.
  • You can start, pause, or stop your attendance at any time, as well as attend as few or as many sessions as you choose.
  • If you are interested in attending please contact Daniel Baughn, PhD at daniel@danielbaughn.com or 813-546-0571 to complete a one-time phone call to verify your contact information, review the expectation of confidentiality among group members, and sign an electronic informed consent document.
  • Group attendees will receive a new video link each week.

COVID Providers Relief Program
USF medical students have been worried about the extra work and stress the pandemic places on healthcare providers. A group of students have started a program called COVID Providers Relief where they are volunteering to assist providers with a variety of services, including childcare, pet care, errands, home care, and meal prep. A Provider Services Request Form has been created for providers to fill out and submit. (It requires a photo of an institutional ID.)

Feel free to also forward this message to other physicians, nurses, PAs, residents, med techs, etc. The medical students need help to get the word out! If you have any questions, the program email is usf.cpr2020@gmail.com .

5 Video Lessons Show You How to Survive the Five Layers of the COVID-19 Crisis, Hold Your Center and Find Solid Ground on the Far Side.
The Happy MD , April 19, 2020

THANK YOU HEALTHCARE WORKERS!
Full Circle PR, HCMA's Benefit Provider for marketing and public relations, has created a Go-Fund-Me campaign to show appreciation to our physicians and all local health care workers. You can help "Paint Tampa Bay" with yard signs showing community support for our healthcare workers! The proceeds will go to locally owned restaurants to provide meals to the healthcare workers in the Tampa Bay area. Click here for more information and to donate.
Visit www.hcma.net for more information. 

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