Congresswoman Lisa Blunt Rochester to Run for Senator Carper's Seat

U.S. Senator Tom Carper announced in May that he would not be seeking re-election in 2024 and would be retiring from the U.S. Senate when his term ends in early 2025. Congresswoman Lisa Blunt Rochester announced her campaign on Wednesday for the Delaware Senate seat being vacated by Senator Carper. If elected, it would make her the first black Delawarean and first woman to represent Delaware in the U.S. Senate, as well as the third black woman in U.S. history to win election to the Senate. Congresswoman Blunt Rochester interned in Carper's congressional office, later serving in his gubernatorial cabinet as labor secretary. She worked as personnel director for the late Governor Ruth Ann Minner and was CEO of the Metropolitan Wilmington Urban League. Her campaign slogan is "Bright Hope," which is the name of the church where her grandmother worshiped. (Watch the 3 minute video of the Bright Hope Campaign.) Photo credit to https://bluntrochester.house.gov/biography.

Delaware One of 35 States to Extend Coverage

The Delaware Department of Health and Social Services’ (DHSS) Division of Medicaid and Medical Assistance (DMMA) announced that it has extended Medicaid postpartum health care coverage from 60 days to 12 months after the end of a pregnancy. This expansion is made possible through a State Plan Amendment approved by the Centers for Medicare and Medicaid Services (CMS) in May. The expansion is retroactively effective as of July 2022. Delaware is one of 35 states to extend Medicaid and Children’s Health Insurance Program (CHIP) coverage to 12 months following the end of pregnancy. Previously, Medicaid enrollees who were pregnant received coverage through the end of the month in which their 60-day postpartum period ends. A provision in the American Rescue Plan Act in 2021 gave states the option to extend Medicaid postpartum coverage to 12 months. This provision was made permanent by the Consolidated Appropriations Act, which was signed into law by President Biden in December 2022. Medicaid recipients will now be eligible to receive 12 months of ongoing postpartum health care coverage beginning on the date their pregnancy ends, regardless of the reason, through the last day of the month 12-months after the last date of the pregnancy. These individuals will remain eligible for ongoing postpartum health care coverage even if certain changes occur that may affect eligibility — such as a change in income or household/family unit.

Long-Acting Penicillin for Children

Pfizer sent a letter to physicians indicating a limited supply and impending stock out situation for select Bicillin® L-A (penicillin G benzathine injectable suspension) and Bicillin® C-R (penicillin G benzathine and penicillin G procaine injectable suspension) Prefilled Syringes. The supply interruption is the result of a complex combination of factors including significant increases in demand, due to an increase in syphilis infection rates, as well as competitive shortages. In order to meet this increased demand, Pfizer has prioritized manufacturing capacity to Bicillin® L-A (penicillin G benzathine injectable suspension) 1.2 million Units/2 mL and 2.4 million Units/4 mL (600,000 units/mL) Prefilled Syringes. At this time all Bicillin ® C-R (penicillin G benzathine and penicillin G procaine injectable suspension) are estimated to deplete in Q3 2023 and Bicillin® L-A (penicillin G benzathine injectable suspension) Pediatric (600,000 units/mL) Prefilled Syringes are estimated to deplete by end of Q2 2023.

CDC Issues Health Advisory

As the summer travel season begins, the Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network (HAN) Health Advisory to remind clinicians and public health officials to provide guidance for measles prevention to international travelers and to be on alert for cases of measles. Guidance is also provided for people planning international travel. Measles (rubeola) is extremely contagious; one person infected by measles can infect 9 out of 10 of their unvaccinated close contacts. As of June 8, 2023, CDC has been notified of 16 confirmed U.S. cases of measles across 11 jurisdictions, with 14 (88%) linked to international travel. Based on current estimates, twice as many Americans are planning to travel internationally in 2023 compared with 2022. Many countries and popular travel destinations, such as London, England, have experienced measles outbreaks in recent years. The United States has seen an increase in measles cases during the first 5 months of 2023, with 16 reported cases compared with 3 in 2022 during the same period. Most of these cases were among children who had not received measles-mumps-rubella (MMR) vaccine. To prevent measles infection and spread from importation, all U.S. residents should be up to date on their MMR vaccinations, especially prior to international travel regardless of the destination.

Join the Fight to Fix Medicare Now

Congress and the administration are still not focused on fixing the root of the problem—the payment system itself. But it’s time for that to change. Reforming Medicare means putting the patient back in the center of health care. It is vital that Congress supports systemic reforms to the Medicare payment system. Bipartisan legislation, H.R. 2474 the Strengthening Medicare Patients and Providers Act, advances the need to provide financial stability for physician practices in order to preserve access to care for Medicare beneficiaries. Get all the information and resources you need to make your voice heard in the halls of Congress at the AMA’s new Fix Medicare Now website. Contact the Delaware Congressional leaders and urge them to support this meaningful policy initiative. H.R. 2474 is a step in the right direction in the fight to fix Medicare now. Click the purple button below to take action and ensure Congress works to address the critical issues physicians and their patients face due to the flawed Medicare physician payment system.

Recommendations on Lowering Telehealth Payments to Pre-Pandemic Facility Rates

The Medicare Payment Advisory Commission (MedPAC) released its 2023 report to Congress that included numerous recommendations such as the price of Medicare Part B drugs, standardizing benefits under Medicare Advantage plans, behavioral health services in the Medicare program, aligning fee for service rates across ambulatory settings, reforming Medicare's wage index system, and more. Also included in the report, mandated by the Consolidated Appropriations Act, 2022, was the usage of telehealth services during the public health emergency and the association between expanded telehealth coverage and health care quality, access, and costs.

Review Your Preliminary Scores Now!

The Centers for Medicare & Medicaid Services (CMS) and the Quality Payment Program (QPP) have released the preliminary preview of 2022 feedback for the MIPS and QPP performance scores. This early access allows you to assess your performance and ensure that your scores are in line with what was reported earlier this year. Review each category carefully - Quality, Promoting Interoperability, Improvement Activities, and Cost. Take this opportunity to examine your preliminary scores thoroughly, ensuring they accurately reflect your practice's performance. Contact QPP if you find inconsistencies with your overall score. The CMS Learning Network Center has a video tutorial to further assist in understanding your scoring previews.

Pfizer, Moderna, Novavax Ramping Up Production for Fall Rollout

The U.S. Food and Drug Administration's (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) met last week regarding the formula for COVID-19 vaccines for the 2023-2024 fall and winter seasons. The FDA has since advised manufacturers seeking to update their COVID-19 vaccines that they should develop vaccines with a monovalent XBB.1.5 composition, moving away from the existing formula that protected against the Omicron variant and an early form of the virus, and to aim at the most dominant variant of the coronavirus this summer. Pfizer, Moderna, and Novavax began development on versions of their vaccines targeting XBB.1.5 months before the FDA's decision. Early data from the companies indicate their vaccines produce strong immune responses against all XBB variants.

New Recommendation Statement from the USPSTF

Anxiety disorders are commonly occurring mental health conditions. They are often unrecognized in primary care settings and substantial delays in treatment initiation occur. The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for anxiety disorders in asymptomatic adults (adults 19 years or older, including pregnant and postpartum persons and in older adults defined as those 65 years or older). Based on this review, the USPSTF recommends that asymptomatic adults ages 19 through 64, including those who are pregnant and postpartum, should be screened for anxiety disorders using questionnaires and other screening tools. There was insufficient evidence on screening for anxiety disorders in older adults. Physicians are not required to follow the USPSTF's recommendations. The recommendation statement from the USPSTF was published June 20 in JAMA.

Compared to Adults, Children with T2D Have Limited Treatment Options

The U.S. Food and Drug Administration (FDA) approved Jardiance (empagliflozin) and Synjardy (empagliflozin and metformin hydrochloride) as additions to diet and exercise to improve blood sugar control in children 10 years and older with type 2 diabetes. These approvals provide a new class of medicines taken by mouth to treat pediatric type 2 diabetes. Metformin, the only other oral therapy available for the treatment of children with type 2 diabetes, was first approved for pediatric use in 2000.

Cyberattack Made on U.S. Cancer Center

The Department of Health and Human Services (HHS) is alerting the health care industry about a ransomware variant and threat group called TimisoaraHackerTeam (THT) that has resurfaced after a June ransomware attack on a cancer center, significantly reducing treatment capability, shut down digital services, and threatened to expose patient identifiers and personal health information. When its ransomware is deployed, their rarely used and very effective technique of encrypting data in a target environment has paralyzed the health and public health sector. THT has previously attacked health care organizations around the world. Rather than use custom built tools to encrypt the files like many ransomware groups, THT abuses legitimate tools, such as Microsoft Bitlocker and Jetico's BestCrypt, making them unique among threat actors.

For Certain Oncology Drugs Used with Tests to Identify Patients for Certain Cancer Treatments

The U.S. Food and Drug Administration announced a new voluntary pilot program for certain oncology drug products used with certain corresponding in vitro diagnostic tests to help clinicians select appropriate cancer treatments for patients. Under current FDA policy, an in vitro companion diagnostic test is one that provides information essential for the safe and effective use of a corresponding treatment. In oncology, for example, specific tests may be used to identify patients, such as those with a particular genetic mutation, who may or may not benefit from certain cancer treatments. In certain limited circumstances, the FDA may decide to approve a life-saving treatment that requires use of an in vitro companion diagnostic even if a corresponding in vitro companion diagnostic has not yet received marketing authorization, which then is used for patient treatment decisions. The agency has become increasingly concerned that some tests made by laboratories and not authorized by the FDA may not provide accurate and reliable test results or perform as well as FDA authorized tests and may negatively impact treatment decisions. This pilot program is one step that may be helpful in reducing the risk of using laboratory developed tests (LDTs) for oncology drug treatment decisions while the FDA continues to work on a broader approach for LDTs, including moving forward with rulemaking. 

MSD Academic Channel Call for Submissions

We are living through a time of unprecedented innovation and advancement in the realm of artificial intelligence (AI) and robotics, and health care is undergoing revolutionary changes, bringing about new methodologies, challenges, and opportunities. In light of this evolution, the MSD Academic Channel is calling for submissions of articles focusing on the impact of AI, robotics, or both of these technological advancements in health care. How are either or both of these technologies reshaping diagnostics, treatments, patient care, or the medical profession at large? What are the ethical implications, challenges, or limitations faced? How might we anticipate the role of these technologies in future health care scenarios? MSD invites physicians, medical practitioners, researchers, engineers, and others working in this fascinating intersection of technology and health to share their insights, experiences, and findings by submitting original research, review articles, technical reports, and case reports.

Example topics could include but are not limited to:

• The Use of AI in Diagnosing Diseases: Present and Future
• Robotics in Bariatric Surgery: Benefits, Limitations, and Challenges
• How AI and Robotics are Improving Patient Care and Experience
• AI in Medical Imaging: Opportunities and Concerns
• Ethical Implications of AI and Robotics in Health Care

To be included in this collection, please add the keyword "AI & Robotics in Healthcare" to your submission. All submissions will be featured on the Cureus.com email campaign and newsroom page. Published articles will be featured on the MSD Academic Channel and the MSD Digital Digest communication to the membership. The deadline for submissions is August 18th, 2023. Please review the Author Guidelines prior to submitting any work. Your submission should be uploaded through the MSD Academic Channel and not directly through Cureus.com.

Delaware's First Rabies Case in 2023

The Delaware Division of Public Health (DPH) announced its first reported rabies case of 2023. DPH received a report last week of a human and their pet dog who had been exposed to a potentially rabid groundhog in a residential neighborhood located near Bringhurst Woods Park on Washington St., off Carr Road. The groundhog was tested for rabies and the results came back positive on Friday, June 16. Both the individual and their pet dog have been advised to receive prophylaxis for rabies following the exposure.  

Educational Opportunity to Present Interest Story

The MSD Physician Emeritus Section is planning its 2024 educational luncheon series and is interested in next year’s presentations being personal stories from our members. Everyone has a story to tell, and we would love to hear from you! Are you interested in being a presenter at one of next year’s luncheons? Please contact Michelle.Seymour@medsocdel.org or Katie.Hamilton@medsocdel.org so we can place you on the schedule. We are looking for someone to present at our April luncheon in Rehoboth Beach (1776 Steakhouse); and June and October (University and Whist Club, Wilmington) - specific dates will be announced.

Confidential, Voluntary Questionnaire Developed to Capture Information

WE INCHED UP SLIGHTLY SINCE LAST MONTH IN THE NUMBER OF RESPONSES RECEIVED! The MSD Committee on DEI is working to support a diverse physician workforce and inclusive organizational culture. Prior to 2021, MSD did not collect racial, ethnic, and gender identification information of our members. As a starting point toward understanding and improving our membership diversity, your help is greatly appreciated in submitting this information. A brief, four-question questionnaire has been developed and will take less than a minute to complete. Your information will not be made public, but will be used in aggregate to assess the diversity of our membership, how that correlates with the diversity of our leadership, and to understanding the diversity of the physician workforce in Delaware. Access the questionnaire.  

Controlled Substance Registration, MATE Act Training Requirements

The Controlled Substance Registration (CSR) biennial renewal deadline is June 30, 2023. All

active CSR renewals must be completed through the DELPROS system

(https://delpros.delaware.gov/OH_CommunitiesLogin). As a condition of CSR renewal, registrants will be asked to attest to completion of two hours of continuing education in the areas of controlled substance prescribing practices, treatment of chronic pain, or other topics related to the prescribing of controlled substances.

As MSD has reported, the US Drug Enforcement Administration (DEA) informed DEA-registered practitioners of the training that will meet the requirements of the Medication Access and Training Expansion (MATE) Act that was passed as part of the Consolidated Appropriations Act of 2023. The Act requires new or renewing DEA registrants, as of June 27, 2023, to have completed a total of at least eight hours of accredited continuing education on the treatment and management of patients with opioid or other substance use disorders before renewing their registration. The letter also states that physicians will be able to simply check a box on their DEA registration application or renewal form indicating that they have satisfied this training requirement. The DEA letter includes information on prior trainings on the treatment and management of patients with opioid or other substance use disorders that can count towards a practitioner meeting this requirement. Please refer to the DEA letter for specifics about qualifying education in meeting the requirements. The AMA also has worked to identify the educational resources that will satisfy the MATE Act. Please visit the AMA EdHub™ for courses that satisfy the MATE Act.  

Education, Resources, and Research

The American Medical Association is sharing events and resources through AMA Professional Satisfaction and Practice Sustainability. Find education on physician health and well-being, behavioral health care, and social determinants of health. There are also resources for MOC Part IV activities. Along with all of that, the AMA is sharing new research published in the American Journal of Preventative Medicine and the NEJM Catalyst. Take a look!

Free, Money-Saving Membership Benefit for You!

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, 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 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 $1,000s 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!

ChristianaCare

For the fifth consecutive year, ChristianaCare has earned a spot in Newsweek’s exclusive list of the World’s Best Hospitals – United States, recognized for consistently being at the forefront in care, research and innovation. Headquartered in Wilmington, Del., ChristianaCare ranked 81st in the United States in the annual list that ranks 2,300 hospitals in 28 countries.

For a fourth year in a row, Modern Healthcare has recognized ChristianaCare President and CEO Janice E. Nevin, M.D., MPH, as one of the nation’s 50 Most Influential Clinical Executives.

Tyasia K. Guadalupe, DO - Internal Medicine Residency, Bayhealth

Dhara P. Popat, MD - Internal Medicine Residency, Bayhealth

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

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 At Home: https://qualitynet.cms.gov/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 COVID-19 Quarantine and Isolation Calculator
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker Weekly Review.
• 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)

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.