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December 2, 2021

A Perfect Storm of Medicare Cuts is Coming Looming Medicare Payment Crisis Could Lead to Devastating Consequences On January 1, 2022, the Centers for Medicare and Medicaid Services (CMS) will drastically reduce payments for certain health care providers. If Congress does not act to stop these cuts, it will further strain practices that are still struggling to keep their doors open during the ongoing pandemic.   Tell Congress to cancel Medicare cuts today!   Physician practices face the following stack of Medicare financial hits amounting to a 9.75 percent cut. These include: Expiration of the current reprieve from the repeatedly extended 2 percent sequester stemming from the Budget Control Act of 2011. Congress originally scheduled this policy to sunset in 2021 but it will now continue into 2030. Imposition of a 4 percent Statutory PAYGO sequester resulting from passage of the American Rescue Plan Act. Should lawmakers fail to act, it will mark the first time that Congress has failed to waive Statutory PAYGO. Expiration of the Congressionally enacted 3.75 percent temporary increase in the Medicare physician fee schedule (PFS) conversion factor to avoid payment cuts associated with budget neutrality adjustments tied to PFS policy changes. A statutory freeze in annual Medicare PFS updates under the Medicare Access and CHIP Reauthorization Act (MACRA) that is scheduled to last until 2026, when updates resume at a rate of 0.25% a year indefinitely, a figure well below the rate of medical or consumer price index inflation. These cuts, if allowed to go into effect, would lead to fewer primary care providers, limited access to specialists, a disruption in care, and additional barriers to life-saving treatment.    In the face of this looming threat, Congress had remained focused on a number of other issues until recently when Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) circulated a “Dear Colleague” letter highlighting the financial uncertainty within the Medicare payment system and the dangers facing the physician community if Congress fails to enact legislation to address these problems. Within a matter of weeks, 245 of their colleagues showed their support for fixing the problem by co-signing the letter.    Now is the time to build on that momentum and demand that Congress take action to address these devastating Medicare cuts before it's too late. Please take a moment and contact our Congressional Delegation to tell them to cancel the cuts!

State Agencies Warn of COVID Vaccine Text Message Scam DMV Does Not Request Personal Information Via Text Message The Delaware Department of Transportation and the Delaware Division of Motor Vehicles is advising the public of a scam alert. DelDOT has received inquiries about the validity of a text message requiring recipients to verify their COVID-19 vaccination status with a link to click. This is NOT a communication from the Division of Motor Vehicles and should be ignored and deleted. The Delaware Department of Motor Vehicles does not send vaccination status verification notices via text message, nor is personal information (driver license number, Social Security number, or payment information) requested via text. If you receive such a text message, report it to your local law enforcement.

Workers' Comp Rates to Decrease for Fifth Consecutive Year Double-Digit Drop Effective December 1 Insurance Commissioner Trinidad Navarro announced Monday that workers’ compensation insurance rates will decrease for the fifth year in a row, effective December 1, 2021. The voluntary market is seeing yet another double-digit decrease in voluntary market loss costs, with an average 20.02% reduction, and residual market rates will go down an average of 20.01%. Lower premiums do not change the amount of compensation an injured employee receives. The Delaware Compensation Rating Bureau (DCRB) agreed to the lower rates after discussion with the Department of Insurance and the State’s Ratepayer Advocate. The approval process included a review of the DCRB filing by actuaries for each party, and a public hearing. Actual savings vary by policy.  More than 1,100 employers are saving even more money on their workers’ compensation premiums by participating in the department’s Workplace Safety Program. Eligible businesses can earn up to a 19% discount on their insurance by successfully undergoing annual safety inspections and complying with associated recommendations. Organizations interested in participating can access questionnaires online and contact safety@delaware.gov to begin the process.

Community-Based Mental Health Services Fund Announced Support for Community-Level Mental Health Services Governor John Carney and Lieutenant Governor Bethany Hall-Long on Wednesday announced the creation of a Community-Based Mental Health Services Fund to support the delivery of mental health services in Delaware communities.    The program is funded by the American Rescue Plan Act (ARPA). The federal legislation was supported in Congress by Delaware’s congressional delegation - U.S. Senators Tom Carper and Chris Coons, and U.S. Representative Lisa Blunt Rochester - and signed into law by President Joe Biden on March 11.

Addressing Health Care Worker Shortage in Underserved Areas Administration to Invest $1.5 Billion Vice President Harris announced last week that the Biden administration is investing $1.5 billion from the coronavirus aid package to address the health care worker shortage in underserved communities. The funding will go to the National Health Service Corps, Nurse Corps, and Substance use Disorder Treatment and Recovery programs, all federal programs that offer scholarship and loan repayments for health care students and workers if they pledge to work in underserved and high-risk communities. The Health Resources and Services Administration (HRSA) will release two new Notices of Funding Opportunity to support training to expand the public health workforce. The funding opportunities are tentatively scheduled to post in February 2022. Along with funding through the American Rescue Plan, HRSA will also invest nearly $39 million to support organizations for developing scholarship programs that incentivize individuals to pursue careers in public health.

Supreme Court to Hear Arguments in 340B Case Determines Whether 340B Hospitals Retain Discounts on Part B Drugs According to the Commonwealth Fund, the Supreme Court will hear arguments next week in a case seeking to reverse cuts to the 340B Drug Program, which is designed to allow hospitals and clinics that treat low-income, medically underserved patients to purchase outpatient drugs at discounted prices. Plaintiffs are asking the high court to reverse a nearly 30% cut in 340B reimbursements the Centers for Medicare and Medicaid Services (CMS) initiated during the previous administration and continued under President Joe Biden. Some media outlets are indicating the outcome could have consequences for all providers, even those who don't access the discounted medicines. The Court's decision applies only to specific statutory language on reimbursement for a subset of outpatient drugs and will not have wider implications for Part B drug pricing.

CDC Now Recommends Booster Shot for Anyone 18+ CDC Strengthens Recommendations Amid Fears Over Omicron Variant The Centers for Disease Control and Prevention earlier this week announced it is now recommending that anyone 18 years of age and older receive the COVID-19 booster shot after completing the first course of vaccination. The Delaware Division of Public Health (DPH) is currently monitoring the science around a new variant, which the World Health Organization has named Omicron (B.1.1.529). This variant was first reported in South Africa and has since been detected in several other countries. As of today, no cases of this variant have been identified in Delaware or the United States. Variant strains of the COVID-19 virus are to be expected. While we still have more to learn about the Omicron variant, DPH advises Delawareans to continue doing what we know works: get vaccinated, wear a mask in indoor public settings, socially distance from others, and wash your hands regularly. Vaccines remain the critical tool to protect us against severe disease. Delawareans who are 5 years and older and have not received the vaccine should do so as soon as possible. DPH encourages those who have been vaccinated to complete the full vaccination series and receive a vaccine booster dose if eligible. Read the fact sheet on booster doses.

COVID-19 Vaccine Mandate for Health Care Workers Blocked Judges Block Biden's Vaccine Mandate The Associated Press indicated that a federal judge this week blocked the Biden administration from enforcing a coronavirus vaccine mandate on thousands of health care workers across ten states, the first legal challenge against the requirement. The mandate covers certain health care staff at providers that participate in Medicare and Medicaid and set a December 6 deadline for those workers to have received the first dose of the COVID-19 vaccine. The Judge cited that the Centers for Medicare & Medicaid Services (CMS) had no clear authority from Congress to enact the mandate for providers participating in the two government health care programs. In a ruling that followed, a US District Judge in Louisiana temporarily blocked CMS from enforcing its vaccine mandate for health care workers which applied nationwide, except in the ten states where CMS was already prevented from enforcing the rule. A workplace vaccine-or-testing mandate for businesses with at least 100 employees was temporarily blocked by a federal appeals court in early November.

CMS Primary Care First Model Seriously Ill Population Component Update On Tuesday, the Centers for Medicare & Medicaid Services (CMS) announced that, after careful consideration, it will not move forward with the Seriously Ill Population (SIP) Component of the Primary Care First (PCF) Model. The SIP component of Primary Care First was designed to have advanced primary care practices, including providers whose clinicians are enrolled in Medicare and who typically provide hospice or palliative care services, coordinate care for high need, seriously ill beneficiaries. After careful review, CMS has determined that the proposed SIP outreach method is unlikely to result in sufficient beneficiary uptake to allow for model evaluation.

NHSC Loan Repayment Program You Have More Time to Apply The deadline to submit an application for one of the National Health Service Corps (NHSC) Loan Repayment Programs is extended until Thursday, February 3 at 7:30 p.m. ET. Last year, every eligible applicant was able to be awarded thanks to additional funding through the Biden Administration's American Rescue Plan (ARP). Additional ARP-funded awards are planned for this year, so don't wait - apply today! Get specific details on eligibility and how to apply on the NHSC website.

Marketplace Open Enrollment Now Thru January 15, 2022 Quality Insights Offers Certified Navigators Providing Free Assistance Do you know anyone who does not have health insurance? There are currently 12 health insurance plans available in Delaware through the federal Marketplace. Four of Five consumers can obtain 2022 coverage for less than $10/month! Quality Insights certified “Navigators” are providing FREE assistance to consumers, walking through the application and plan selection process step-by-step. Open enrollment ends January 15, 2022, so please share this flyer now (in English and Spanish).

Spotlight on 2021 Annual Meeting Presenting Sponsor: Highmark

Top Vaccine Headlines Courts block two Biden administration COVID vaccine mandates COVID-19 vaccine effectiveness will likely drop against omicron variant, Moderna CEO says A new Covid vaccine wasn't needed for beta or delta. What about omicron? How HIV research paved the way for the Covid mRNA vaccines Delaware health experts say much needs to be learned about Omicron COVID-19 variant, but urge vaccinations Maryland-Based Vaccine Manufacturer Developing COVID-19 Vaccine That Targets Omicron Variant FDA advisory panel recommends emergency authorization of COVID-19 antiviral Omicron Variant Identified in US First U.S. omicron patient was fully vaccinated and has mild Covid symptoms, officials say New COVID-19 vaccine may protect against existing and future strains of coronavirus

MSD News Makers Dorothy M. Moore, MD Receives AAO 2020 Hall of Fame Award Delayed for a year because of the pandemic and a virtual meeting format, MSD member and Past President, Dorothy M. Moore, MD, was the recipient of the American Academy of Ophthalmology (AAO) Secretariat for State Affairs 2020 Hall of Fame Award, presented in person at the AAO 2021 Fall Council Meeting. The Delaware Academy of Ophthalmology nominated Dr. Moore for the award in recognition of her lifelong advocacy as a champion for patient safety and quality eye care. One recipient is selected annually for demonstrating a pattern of advocacy for quality patient eye care at the state and/or federal level(s) over a period of several years. Service must have been above and beyond the usual service commitment required by a sponsoring organization or expected by the type of service involved, have entailed personal sacrifices on the part of the ophthalmologist, and have been consonant with the principles of the Code of Ethics of the AAO. Congratulations on this well-deserved achievement, Dr. Moore!

Highlight On Events And Educational Offerings MSD and Food Bank of Delaware Join Together for Virtual Food Drive This holiday season, give the hope of a holiday meal. People in Delaware continue to struggle and food banks are in need of help to fill their shelves. With your donation or contribution, you can help provide three meals for every dollar given. From November 8 through December 17, reach out and make an impact in the Delaware community. Click to give.

New Equations for Estimating GFR without Race The National Kidney Foundation Serving Maryland and Delaware is pleased to invite you to attend the Renal Rounds Lecture Series for an evening of lively discussion on December 9th at 7 p.m. This virtual professional education event, "New Equations for Estimating GFR Without Race: Development & Task Force Recommendations," will feature Dr. Deidra Crews and Dr. Josef Coresh from Johns Hopkins on the work that has been done by the American Society of Nephrology and the National Kidney Foundation to remove race from the eGFR equations. This will be an excellent lecture to build knowledge on the issue of race correction and support the work that is being done in this regard at Delaware institutions. There is no charge for registration. An Approach to Patients Who Have Not Gotten the COVID-19 Vaccine This course module was developed by the "Made to Save" Campaign and will explore a patient-centered approach to COVID-19 vaccine counseling to increase trust, confidence, and vaccine uptake, based on the experience of a national grassroots COVID-19 vaccine education and outreach campaign focused on underserved communities of color. The Yale School of Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Congratulations to John Eric Hale, MD celebrating 30 years as an MSD member in December. Welcome New MSD Members Bryan T. Pepper, PA-C - Orthopaedic Associates of Southern Delaware MSD's Membership Department is pleased to announce the newest members of the Medical Society of Delaware. Welcome to the third oldest medical society in the country! If you know someone interested in joining MSD, please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions.

Pending Members Megan N. Hall, PA-C - Bayhealth Orthopaedics Geoffrey Gustavsen, MD - FM/Sports Med, UD Student Health Services Audrey O. Pessu-Uwah, MD - Internal Medicine, UD Student Health Services Andrew S. Reisman, MD - FM/Sports Med, UD Student Health Services 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.

"Rerum Cognoscere" 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.

80% Number of Americans who have heard some misinformation about COVID-19. Kaiser Family Foundation survey 87% Percent decrease in cervical cancer rates from HPV vaccine. The Lancet 42% Percent of health care organizations that do not have incident response plans to prepare for the highly likely event of a cyber incident. HealthIT Security

Upcoming Events December 7 - Diamond State Financial Group, Guide to Navigating Finances While in the Medical Field, 12:00 Noon, virtual event. December 9 - National Kidney Foundation Renal Rounds Lecture Series, New Equations for Estimating GFR Without Race: Development & Task Force Recommendations, 7:00 p.m., virtual. December 13 - 2021 Communicable Disease Summit "How 2020 Changed the World," 8:00 a.m.-3:00 p.m., virtual only. The Summit will begin broadcasting online at 7:55 am. January 21, 2022 - SAVE THE DATE! Delaware Section, American College of Obstetricians and Gynecologists Annual Maternal Health Awareness Day, 12:30-4:00 p.m., virtual. March 5, 2022 - 33rd Annual Update in Cardiology, 8:00 a.m.-2:00 p.m., virtual event.

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The information contained herein is solely informational, planned in accordance for a diverse membership audience. This communication reflects news and announcements that have been made available to MSD and is not intended to exclude other pertinent material. The content published is proposed to represent facts of interest and provide awareness to the members. MSD reserves the right to determine what information is relevant to its membership.

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