Today, Delaware Attorney General Kathy Jennings announced a historic $26 billion settlement with the nation's three major pharmaceutical distributors and one of its largest opioid manufacturers, bringing desperately needed relief to those struggling with opioid addiction. The agreement resolves investigations and litigation over the role that Johnson & Johnson, Cardinal Health, McKesson, and AmerisourceBergen played in creating and accelerating the opioid crisis. Delaware stands to receive more than $100 million from the settlement over the course of 17 years, with $20 million coming in the first year.

The AMA has provided a summary of the recent Interim Final Rule implementing certain provisions of the "No Surprises Act." The Interim Final Rule becomes effective on September 13, 2021. However, comments are requested on several aspects of the rule, which the AMA plans to provide by the September 7 comment period deadline. This is the first of several regulations on the "No Surprises Act," which will go into effect on January 1, 2022. Additional regulations will be forthcoming regarding the Independent Dispute Resolution process, price comparison tools, and certain transparency requirements. Other rules, including insurance care requirements, continuity of care, provider network directions, and prohibition on gag clauses, may not be published until next year.

An effort has been initiated to persuade Congress to prevent a nearly four percent cut to Medicare payments from going into effect in 2022. The Centers for Medicare & Medicaid Services (CMS) released the 2022 Physician Fee Schedule that proposes to cut the Medicare conversion factor used to calculate Medicare reimbursements. Congress averted a 3.75 percent cut from going into effect for 2021 to help physicians struggling financially due to COVID-19, but that moratorium ends after this year. The Surgical Care Coalition, an advocacy group of 13 surgical associations, indicates that updates to the conversion factor have not kept up with inflation, resulting in a conversion factor of about 50 percent of what it would have been if it had been indexed to general inflation as it had been prior to 1998. The Physician Fee Schedule payments must be budget neutral, meaning any pay raises for one specialty must come with cuts to another.

The Centers for Medicare and Medicaid Services (CMS), the Department of Labor, and the Department of Treasury issued guidance requiring almost all health insurers to cover the HIV prevention pill known as PrEP (pre-exposure prophylaxis) with no cost sharing, including associated clinic visits and lab work, for generic or brand name medications.

The Centers for Medicare & Medicaid Services (CMS) announced proposed rulemaking, which includes proposals related to the Radiation Oncology (RO) Model. The RO Model tests whether prospective, site neutral, modality agnostic, episode-based payments to physician group practices and hospital outpatient departments for radiotherapy (RT) episodes of care reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries. The RO Model has a new proposed start date of January 1, 2022 and would run for five performance years, ending December 31, 2026. CMS is seeking comment on the proposals.

In collaboration with United Way of Delaware and ChristianaCare, Delaware 211 is now part of Unite Delaware, offering a more robust suite of community-based social service providers statewide. Through Unite Delaware, once a care provider identifies a person's social service needs, a secure electronic referral is sent to the most appropriate social service provider in the Unite Delaware network. Partners involved in that person's care will be informed about whether an individual received the services and the results. With the addition of Delaware 211, if an individual's needs cannot be met through an existing Unite Delaware partner, a Delaware 211 resource specialist connects the person to an appropriate service provider. In addition to referrals for services such as food, clothing, shelter, and more, Delaware 211 can connect those in need to Help Me Grow Delaware (linking new parents to childcare solutions) and $tand By Me® (free financial coaching services). Read more.

With the Governor proclaiming a Public Health Emergency effective July 12, 2021, the Delaware Emergency Management Agency (DEMA) and the Delaware Division of Public Health (DPH) on behalf of the Department of Health and Social Services (DHSS) have issued a replacement order authorizing certain individuals to provide health care services. This order replaces Joint Practice Order #8 and was formalized on July 14. The Order remains in effect until further notice but not later than such time as the Governor's Declaration of the Public Health Emergency is lifted. Read the Joint Order.

Since COVID-19 vaccinations have become widely available, some who have been vaccinated have lost or misplaced their immunization cards. The Delaware Division of Public Health (DPH) is informing that it does not replace lost immunization cards. However, if contacted by the individual, DPH will provide them with their full immunization record from DelVAX. Medical providers and office staff should accept copies of the person's full immunization record, if it includes a record of COVID-19 vaccination, as official verification of receipt of the COVID-19 vaccination. If you have questions, please contact DPH at covidvaccine@delaware.gov.

The Delaware Division of Public Health (DPH) has announced a partnership with the Department of Education (DOE) and Quidel Corporation to provide comprehensive COVID-19 testing, processing, and reporting in Delaware schools, utilizing rapid antigen tests for on-the-spot results. DPH, DOE and Quidel have already launched the initiative at five pilot schools for summer school students and staff. Quidel can expand the program to all 350 of the State's K-12 public, private, and charter schools in the fall. Parental permission is required for students to participate. Read more.

The American Academy of Pediatrics (AAP) released updated guidelines for schools reopening in the fall. The nation's leading association of pediatricians recommended in-person learning to fully resume and universal masking to make school safe for all students, teachers, and staff. The COVID-19 guidance recommends that everyone over the age of 2 wear masks, even if they have been vaccinated against the virus. This is a more cautious approach than current recommendations from the Centers for Disease Control and Prevention (CDC).

The American Hospital Association (AHA) Board of Trustees adopted a policy statement on the vaccination of health care workers. The statement supports hospitals and health systems that adopt mandatory COVID-19 vaccination policies, with local factors and circumstances shaping whether and how these policies are implemented. The AHA represents nearly 5,000 hospitals and health systems across the country.

The Health Resources and Services Administration (HRSA) announced the availability of American Rescue Plan funding opportunities to help reduce burnout and promote mental health among the health workforce. Three funding opportunities are now accept applications, which are due August 30th. These investments, which take into particular consideration the needs of rural and medically underserved communities, help health care organizations establish a culture of wellness among the health and public safety workforce and will support training efforts that build resiliency for those at the beginning of their health careers. Read more.

The Employee Retention Tax Credit (ERTC) can mean a tax credit for your business. If your business has 10-50 full-time employees, the Delaware Small Business Development Center (SBDC) is providing 25 businesses a customized tax credit filing service. Complete a short pre-screening questionnaire to determine eligibility. Cover & Rossiter, CPAs explains the details of the ERTC Support Program to help understand federal eligibility guidelines and how the tax credit can work for your business. Deadline is Friday, July 30th at 10:00 a.m.

The American Stroke Association, a division of the American Heart Association, published a new scientific statement online in the journal, Stroke, outlining the role of primary care providers in post-stroke care. It recommends PCPs see patients soon after hospital discharge for a stroke, within one to three weeks to reduce the risk for recurrence. The current average time for the first medical visit after hospital discharge is 27 days.

Microsoft is partnering with Teladoc Health to integrate telehealth into the Microsoft Teams app for hospitals and health systems. During the COVID-19 pandemic, many hospitals and health systems adopted Microsoft Teams to connect clinicians and patients on video. Clinicians already have the ability to securely access clinical data included within their electronic health record system using Teladoc Health's Solo platform and will be able to do so without having to leave the Teams app. Read more.

Each year 30,000 to 40,000 Lyme Disease cases are reported to the CDC by state health departments, but the figure is lower than what is actually diagnosed and treated. Experts say that increased awareness of tick-borne illnesses, as well as better public health surveillance and environmental factors play a role. There are concerns about the potential chronic health issues as more people encounter ticks and develop tick-borne disease, as well as with delayed diagnosis and treatment. Until there is a vaccine, prevention and awareness are key. Read more.

Please join the American Medical Association, YMCA of Delaware, Quality Insights, and MedNet/Medical Society of Delaware in an interactive and engaging webinar, "Preventing Diabetes Type 2 In A Post Pandemic World: Leveraging National DPP." Interesting in learning more about how the Diabetes Prevention Program (DPP) can help your patients, decrease costs, and reduce the number of diabetics in your practice? Or, would you like to enhance your workflow to refer more eligible patients? Bring your lunch, your staff, and your questions to this virtual event being held on July 29 beginning at 12:00 p.m. To register.

The Oregon Health Forum will present Institutionalized Racism in Medicine, a no-charge virtual event on July 29 from 1:00-2:00 p.m. ET. Health care professionals work in an environment which, despite good intentions, produces racial disparities in outcomes. Authors of the Oregon Medical Association statement on racism in medicine and the president of the American Medical Association will discuss this challenge for physicians. Read more and register.

The Medical Society of Delaware, Mom's House of Wilmington, and Vision to Learn co-hosted a health fair for the Wilmington community at Father Tucker Field on Saturday, July 17. Over 20 community partners joined in providing health resources and fun giveaways that included vision exams for kids, dental screenings, COVID-19 vaccinations, Zumba demonstrations, blood pressure checks, and so much more. A special thank you to Dealmed for sponsoring healthy snacks and Food Lion for providing bottled water for our vendors and attendees. Pictured are MSD staff Michelle Seymour and Katie Hamilton and Matthew Burday, DO.

Bayhealth, ChristianaCare, and Highmark Blue Cross Blue Shield Delaware are joining together with the intention to offer Medicare Advantage products expected to be available for enrollment this fall for coverage beginning January 1, 2022. The plan is pending regulatory approval.

The Saint Francis Advanced Wound Care Center has received the Center of Distinction award from Healogics, the nation's largest provider of advanced wound care services, for the third consecutive year. To receive the award, a wound care center must have achieved outstanding clinical outcomes for 12 consecutive months, including patient satisfaction higher than 92 percent and a minimum wound healing rate of at least 92 percent within 28 median days to heal.

This week's spotlight is on Christian Kasianko, MD, Emergency Medicine Resident at ChristianaCare. Read more.

If you would like to be featured in the Spotlight section, please contact Michelle Seymour, Membership Manager.

MSD members are afforded a seven-day review period from the date of this publication to comment regarding an applicant applying for membership. Please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions or concerns.