They Said It...
"The work has a fascinating balance of translating cutting-edge research we have with our neuroscience and clinical partners with the artistry of the experience itself. It's a symbiotic relationship. Something coming up a lot right now for healthcare workers is a struggle with purpose and tapping into it as a north star when they're facing competing issues on a daily basis that prevent them from doing what ultimately fulfills them. We know their day is full of withdrawals for their brain-body budget, so we design for a deposit." Mirelle Phillips, founder and CEO of design and technology firm Studio Elsewhere, discussing the firm's Recharge Rooms. You can learn more in our Spring 2022 edition of Philadelphia Medicine magazine.
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Things you should know... |
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Ukrainian Refugees will be arriving to the Philadelphia Region |
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The Greater Philadelphia region expects up to 10,000 individuals who have fled Ukraine to arrive in the region over the coming months. Ukrainian refugees need both immediate and ongoing health care. Immediate needs (within 30 days of arrival) include IGRA tuberculosis testing and vaccinations (polio and COVID-19). Ongoing needs include primary care and preventive screenings. Ukrainians with humanitarian parole are eligible for Medicaid. For more information visit ORR’s website.
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HHS rolls out Pedi-vac Toolkit |
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The Pediatricians and Family Physicians Toolkit is a resource is for pediatricians, family physicians, parents, and community activists who want to help increase confidence in and uptake of COVID-19 vaccines in the communities they serve. Developed in partnership with the American Academy of Pediatrics, it contains a variety of materials to help build vaccine confidence with parents and guardians of patients, including a letter template and text messages for physicians to keep parents and guardians informed about COVID-19 and vaccines, FAQs about consent for minors, and tips for talking with vaccine-hesitant people. The materials are regularly updated, so please check back for new materials.
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Attention all Novitasphere Office Approvers |
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The CMS Identity Management (IDM) System requires annual role certifications for all Novitasphere roles. As a result, all Novitasphere roles established before July 2021 will need to be certified no later than July 15, 2022. Any roles not certified by July 15 will be removed. Failure to meet this deadline will result in the end users not being able to access Novitasphere. For details go to: https://www.novitas-solutions.com. |
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Is it safe to still go in the water? |
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PADOH issued an alert of harmful algal bloom exposures (HAB) in recreational waterbodies in Pennsylvania. Exposure to HABs can cause sickness in animals and humans. The public should follow waterbody advisories or closures, and stay out of water that is discolored, smells bad, or that has the presence of visible foam, algal mats, or a paint-like appearance. Physicians should assess for potential HAB exposures when caring for patients exhibiting compatible symptoms following recreational water activities. Review the Association of State and Territorial Health Officials’ (ASTHO) Clinician Toolbox for Cyanobacterial Blooms and Associated Illnesses and report potential cyanotoxin exposures or illnesses to [email protected].
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No Surprises Act: Fact sheets for patients |
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Sharing information with patients can help protect them from surprise billing. As of January 1, 2022, they have new billing protections when they get:
- Emergency care
- Non-emergency care from out-of-network providers at in-network facilities
- Air ambulance services from out-of-network providers
Check out these No Surprises fact sheets:
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Serving as a delegate to the PAMED House of Delegates helps us develop meaningful policy that benefits all Pennsylvania physicians and patients. The 2022 House of Delegates will be held Oct. 21-23. If you are a PCMS member and are interested to serve on the delegation, please contact us at [email protected]. |
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Proposed Physician Payment Schedule Rule |
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AMA working to establish a rational Medicare Physician Payment System
The Centers for Medicare & Medicaid Services (CMS) has released the proposed rule for the 2023 Medicare physician payment schedule. The AMA wants to make you aware of three key issues:
- The 2023 Medicare conversion factor would be reduced by about 4.5%, largely due to the expiration of a 3% increase to the conversion factor at the end of calendar year 2022 as required by law. The AMA will continue to strongly advocate that Congress avert this significant cut and extend the 3% increase for 2023.
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CMS would adopt changes to several evaluation and management (E/M) code families which are estimated to require an additional reduction of about 1.5% to the 2023 Medicare conversion factor. In addition, the final performance year that physicians are eligible to earn the 5% Advanced Alternative Payment Model (APM) incentive payment and $500 million Merit-based Incentive Payment System (MIPS) exceptional performance bonus is 2022, which will affect payment adjustments made in 2024. Therefore, the proposed rule does not contain any estimates of MIPS participants exceeding the exceptional performance threshold in 2023 or Advanced APM participants earning 5% incentive payments. These cuts contribute to long-term financial instability in the Medicare physician payment system and threaten patient access to Medicare-participating physicians. The AMA and various partners in organized medicine have developed a set of principles to guide advocacy efforts on Medicare physician payment reform as part of the AMA’s Recovery Plan for America’s Physicians.
- Services that were going to be covered via telehealth only through the end of the COVID PHE would now be covered for an additional five months after the PHE ends, including the CPT codes for telephone visits.
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2023 Physician Fee Schedule - Important Links |
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Below you’ll find links to the CY 2023 Medicare Physician Fee Schedule Proposed Rule, Quality Payment Program proposed changes, a fact sheet on the proposed Medicare Shared Savings Program changes and a CMS blog on the proposed behavioral health changes.
Please note the comment period as you review since this can lead to changes.
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Telehealth: Outpatient Psychiatric Oversight Act |
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During the COVID-19 pandemic, many behavioral health providers moved to an entirely virtual model. Telehealth makes mental health services more accessible as it helps patients avoid stigma and get treatment from the privacy of home. Different mental health problems, typically anxiety, depression, and substance-related disorder, etc. can be treated with telemedicine efficiently and effectively.
House Bill 2419 amends the Outpatient Psychiatric Oversight Act to allow outpatient psychiatric clinics to satisfy required psychiatric time through telebehavioral health technology with Department of Human Services approval. The bill amends the act to remove the statutory requirement that 50 percent of required psychiatric time be provided by an on-site psychiatrist. Required time may be provided either in-person or using telebehavioral health technology as specified in department regulations or waivers. This act shall take effect immediately. House Bill 2419 was unanimously approved by the state Senate and now heads to the governor’s desk for his consideration.
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PDPH Update on Clinical Presentation and Epidemiology of Monkeypox in Philadelphia |
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Monkeypox cases are increasing as of July 7th, 2022, with 700 confirmed and probable Monkeypox cases in the United States including 12 cases in Philadelphia. Most cases in Philadelphia have been diagnosed within the past 2 weeks. According to the CDC, the median age is 36 years and the vast majority of the cases have been diagnosed in men who have sex with men. Case trends in Philadelphia mirror national findings.
Clinical presentation in the current outbreak has been atypical and often there is no prodrome. All patients have been found to have a skin rash on physical examination, however the rash is often not scattered and is instead limited to one body site. Lesions are typically firm, deep seated and often umbilicated. Rather than rash, the presenting complaint in some individuals has been anorectal pain or tenesmus.
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CONTRACT CORNER BRIEFS
by Karen E. Davidson, Esquire
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FOUNDATIONAL UNDERSTANDING
Physician employment contracts essentially stand on four principal pillars:
- Compensation/Business terms (e.g., base and productivity compensation, practice locations, scheduling, call obligations)
- Term/Termination (e.g., how long is the contract in effect and how can it be terminated whether with or without cause)
- Professional Liability Coverage (basically who pays for coverage including tail coverage - also known as extended reporting endorsement)
- Restrictive Covenants (e.g., non-competition, non-solicitation and confidentiality provisions).
A best practice in reviewing these contracts is to deep dive into each pillar, understand its implications, and then understand how the provisions may affect each other. We will examine each pillar in forthcoming Contract Corner Briefs.
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Child Abuse Prevention Training Program
Date: TBA
We're planning to hold another Child Abuse Prevention Training Program for the 2022 licensing cycle. All physicians renewing their license are required to submit documentation to verify the completion of at least two hours of approved continuing education in child abuse recognition. Stay tuned for more information!
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