MSD Experiencing Email Issues

MSD has been experiencing challenges with receiving, and in some cases, sending emails with those outside of the organization. This problem was first recognized last week. MSD apologies for any inconveniences this has caused. At the time of this publication, MSD continues to work with its IT solutions provider to resolve the issue. If you have sent an email to an MSD staff member and have not received a response, please consider calling MSD to reach your intended contact. Please refer to the MSD staff directory.

Concerns That Tracking Technologies, Such as Google Analytics and Meta Pixel, Are in Violation of HIPAA

The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) and the Federal Trade Commission (FTC) are cautioning hospitals and telehealth providers about the privacy and security risks related to the use of online tracking technologies that may be integrated into their websites or mobile apps that may be impermissibly disclosing consumers’ sensitive personal health data to third parties. Tracking technologies are used to collect and analyze information about how users interact with websites or mobile apps. Generally, tracking technologies developed by third parties send information directly to the third parties who developed such technologies and may continue to track users and gather information about them even after they navigate away from the original website to other websites. 

AMA Continues Review of Proposed Rule Summary

On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2024 Medicare Physician Payment Schedule (MFS) proposed rule including key proposals that impact Medicare physician payment and the Quality Payment Program (QPP). Key proposals include a predicted 3.36 percent reduction in the 2024 Medicare conversion factor, implementation of the Evaluation and Management (E/M) add-on code with a modified utilization assumption, a delay in implementing updated Medicare Economic Index (MEI) weights, an increased performance threshold in the Merit-based Incentive Payment System (MIPS), and a delay in mandatory eCQM adoption for MSSP participants. The AMA has provided the following information as it continues to analyze the proposed rule.

 1. A detailed summary of the MFS discusses these crucial provisions in depth as well as many other provisions in the proposal and will provide further understanding of the potential impacts of these changes.

 2. A specialty impact analysis developed by the American Medical Association (AMA) illustrates the combined effect of the budget neutrality proposals in the rule and the reduction to the conversion factor under current law.

 3. A comprehensive QPP data analysis based on the 2021 performance period, includes information about MIPS scores by specialty and state.

AMA staff continues to analyze the rule and develop comments during the 60-day comment period to address potential impacts and advocate for improvements, sharing a draft comment letter with the Federation in advance of this submission deadline. Comments are due by Sept. 11, 2023.

National Study to Document Changes in Physician Practice Expense

The American Medical Association (AMA) is undertaking a new national study, supported by 173 healthcare organizations, including MSD, to collect representative data on physician practice expenses. The aim of the Physician Practice Information (PPI) Survey is to better understand the costs faced by today’s physician practices to support physician payment advocacy. The study will serve as an opportunity to communicate accurate financial information to policymakers, including members of Congress and the Centers for Medicare & Medicaid Services (CMS). The AMA has contracted with Mathematica, an independent research company with extensive experience in survey methods as well as health care delivery and finance reform, to conduct the study. (The subject line for the PPI Survey invitation email will read, “American Medical Association requests your input on physician practice expense and patient care hours." Invitations and reminders about the PPI Survey, sent financial experts in the practice, will come from PPISurvey@mathematica-mpr.com.)

The Medicare physician payment schedule relies on 2006 cost information to develop practice expense relative values, the Medicare Economic Index, and resulting physician payments. As the U.S. economy and health care system have undergone substantial changes since that time, including inflation and the wide-spread adoption of electronic health records and other information technology systems, practice expense payments no longer accurately reflect the relative resources that are typically required to provide physician services.

In addition to the information collected in this survey, the study will also rely on financial experts in the physician's practice to complete an online financial information survey. The number of direct patient care hours is a critical component of the Medicare payment methodology. Therefore, thousands of individual physicians will receive a short patient care hours survey from either their practice directly or from Mathematica. The input from physician practices and individual physicians that are randomly selected to participate in this study is critical for its success. Participation will ensure that practice expenses and patient care hours are accurately reflected. (The subject line for the Physician Hours Survey invitation email will read, “Please help to update accurate physician payments." Invitations and reminders about the Physician Hours Survey, distributed to physicians, will come from PhysicianHoursSurvey@mathematica-mpr.com or from the practice directly.)

If you are selected, MSD highly encourages your participation in this most important survey and provide assistance to you and practice. Read more details.

USPSTF Draft Recommendation Statement

The U.S. Preventive Services Task Force (USPSTF) concluded that there is insufficient evidence to make a recommendation on primary care screening for speech and language problems in children five years and younger who show no signs of a disorder. USPSTF determined there was a lack of evidence as to whether the screenings improved outcomes, similar to the recommendations made in 2015. However, according to USPSTF, children showing signs or whose parents raise concerns about language development or speech should be evaluated and receive treatment if needed. The USPSTF draft recommendation statement and review are available for public comment until August 21. Links available to Draft Evidence Review, Draft Recommendation Statement, and Comment on Recommendation Statement on the USPSTF's website.

Announcement of Rules to Increase Coverage of Mental Health Treatments

On Tuesday this week, the Biden Administration announced new rules that would press insurance companies to increase their coverage of mental health treatments. The new regulations, which still need to go through a public comment period, would expand access to mental health care by requiring health insurance plans to identify gaps in the mental health care they provide. For example, they’d need to measure how many mental health care professionals are in their networks, how much they are paying these professionals, how difficult it is for someone to join their network, and how often physicians have to obtain prior authorization before they can treat a patient. The new plan would require health plans to collect this data, which many health plans don't collect currently. The Mental Health Parity and Addiction Equity Act that went into effect almost 15 years ago requires that insurers provide the same level of coverage for both mental and physical health care — though the administration and advocates argue insurers’ policies restrict patient access.

Third Democrat to Announce Plans for Lisa Blunt Rochester's Seat

Eugene Young, current Director of the Delaware State Housing Authority, announced his intentions to run for Delaware's U.S. Congressional seat. He previously served as President and CEO of the Metropolitan Wilmington Urban League. He is the third Democrat to announce plans to run for the seat, along with State Senator Sarah McBride and State Treasurer Colleen Davis. Lisa Blunt Rochester currently occupies the seat and has indicated she is vying for Tom Carper's U.S. Senate seat with his announcement of retirement. Photo credit - State of Delaware.

Capping a Years-Long Legislative Effort by Signing Senate Bill 55

On Wednesday this week, Lieutenant Governor Bethany Hall-Long joined lawmakers and advocates as Governor John Carney signed Senate Bill 55, legislation to create a new advisory body for Delawareans living with rare diseases. Sponsored by Senator Nicole Poore and Representative Krista Griffith and championed by Lieutenant Governor Hall-Long, Senate Bill 55 would establish a Rare Disease Advisory Council (RDAC) in Delaware to help identify and address barriers to treatment and care, fostering robust dialogue around research, resources, and best practices. MSD intends to submit the name of MSD member Bhavin R. Dave, MD for consideration of appointment to the Rare Disease Advisory Council.

To Comply with 21st Century Cures Act

Managed Care Organization-Only Providers (MCOPs) contracted with the Delaware Division of Medicaid and Medical Assistance (DMMA) Managed Care Organizations (MCOs) must comply with the 21st Century Cures Act, by registering with the Delaware Medical Assistance Program (DMAP). All providers are required to verify and enroll their correct Medicaid ID number and address in order to continue to receive Medicaid reimbursement for services. Failure to comply will result in the termination of their Medicaid contracts. A large number of clinicians have not registered and could be in jeopardy of having their Medicaid contract terminated. The state of Delaware continues to conduct outreach and mitigation efforts to discourage termination of contracts to ensure that Delaware maintains an optimum network to provide needed services to members. Note… Clinicians who are currently engaged (actively working) with the DMAP screening and enrollment process are not at risk of suspended payment(s) and/or termination from Delaware MCO network participation. DMMA has scheduled a lunch-time Q&A on August 10th at 12:00pm. If you have questions about this request and are available to join the Q&A event, please register. For assistance with enrollment or questions, please email the Provider Enrollment Team at delawarePRET@gainwelltechnologies.com. NOTE: This content information as given by DMMA includes the use of the word "provider" and has not been altered by MSD.

There is a Responsibility to Ensure Recommendation to Eligible Patients

Unfortunately, lung cancer is still a leading cause of cancer death in Delaware, and only 9% of those at high risk have gotten screened. Lung cancer screenings only became a standard of care within the past 10 years. So, unless symptoms are present, we may neglect to discuss this important topic with patients. Additionally, the screening guidelines continue to evolve, and eligibility guidelines are complex. As health care professionals, it’s our responsibility to ensure we are recommending lung cancer screenings to eligible patients before it’s too late. The Delaware Division of Public Health (DPH) seeks opportunities to ensure Delawareans are getting lung cancer screenings. With your help, we can fight back against lung cancer and make sure patients stay up to date on screenings.

Delawareans eligible for a lung cancer screening include:

• Individuals ages 50-80 years old
• Current smokers or those who quit within the last 15 years
• Those who smoke or smoked a pack a day for 20 or more years, or two packs a day for 10 or more years

DPH has made resources available to assist in having these important conversations with patients. Please consider reviewing the communication toolkit DPH has created to assist in discussing this topic with patients. For additional resources and guidelines to eligibility for lung cancer screenings, please visit HealthyDelaware.org/Lung.

Funding Focused on Communities Hardest Hit During the Pandemic

Governor Carney, U.S. Senators Carper and Coons, and Representative Blunt Rochester announced Monday nearly $6 million in American Rescue Plan Act (ARPA) capital projects funding (CPF) to nonprofit organizations that provide much needed housing services. This funding is in addition to the $65 million in capital projects announced this past March for community center projects and $40 million distributed to libraries throughout all three counties to benefit those hardest hit by the COVID-19 pandemic. The State of Delaware has now received approval for the full $112 million in CPF funds that were allocated to Delaware through the ARPA CPF program. 

Nancy Fan, MD

MSD member and Past President Nancy Fan, MD was highlighted recently in an American Medical Association (AMA) article about how she is giving voice to the unique interests of employed physicians. Not only is Dr. Fan busy with her roles as Chair of the Delaware Health Care Commission, Co-chair of the Primary Care Reform Collaborative, and a practicing physician with Saint Francis Healthcare, she serves at the national level in the AMA Organized Medical Staff Section and as Chair of the Employed Physician Caucus. Thank you, Dr. Fan, for your never-ending energy in standing up for physician interests. Photo credit to the American Medical Association.

Nicolas J. Petrelli, MD

MSD member and 2019 Tilton Award recipient Nicholas J. Petrelli, MD, Bank of American Endowed Medical Director of ChristianaCare's Helen F. Graham Cancer Center & Research Institute, has received the Lifetime Achievement Award from Tulane University School of Medicine in New Orleans, LA. Dr. Petrelli is a 1973 graduate of the school. The award recognizes an alumnus of the school who has made significant contributions to the field of medicine and has offered outstanding leadership in the community. Under Dr. Petrelli's leadership at ChristianaCare since 2001, the Helen F. Graham Cancer Center & Research Institute has become a national model for multidisciplinary cancer care and a top enroller in U.S. clinical research trials. The Graham Cancer Center is a National Cancer Institute Community Oncology Research Program and one of only five hybrid academic community cancer centers in the nation.

Confidential, Voluntary Questionnaire Developed to Capture Information

WE ARE MOVING THE NEEDLE! FROM 12% OF THE MEMBERSHIP PROVIDING INFORMATION AS OF LAST MONTH TO 14% NOW! The MSD Committee on Diversity, Equity, and Inclusion is working to support a diverse physician workforce and inclusive organizational culture. Prior to 2021, MSD did not collect racial, ethnic, and gender information about 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 remain confidential, however, it 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.

Has Your Contact Info or Practice Changed? Please be Sure to Inform Us!

MSD staff works hard to ensure we have the most up-to date information for our members, but we need your help! If you are retiring, moving, need to report any changes of address, email updates, changes of practice, or any other changes, please use the Membership Information Update Form and return to MSD or directly contact Michelle Seymour, Manager of Membership and Community Outreach at Michelle.Seymour@MedSocDel.org or (302)224-4905. You can also log in to the MSD website to access your membership profile information to make most basic updates yourself, such as address, email, practice and other changes, as well as renewing your membership online.

Submit Your Idea as a Resolution and Make a Difference

Turn your idea into a resolution. MSD is accepting resolutions for health care-related issues to be considered by the Council at the MSD Annual Meeting scheduled for Saturday, November 18th. Resolutions must be submitted in writing by Sunday, October 15th (absolute deadline). This is an excellent opportunity to share your concerns with your peers and make a difference. Not sure where to start? MSD has created a Resolution Writing Guide to help! Please contact Mary LaJudice, Senior Director of Corporate Services, with any questions or to submit your resolution (Mary.LaJudice@medsocdel.org or 302/593-8589).

Beebe Healthcare

ChristianaCare

Saint Francis Healthcare

John V. Fenice, MD - Family Medicine, Heritage Medical Associates

Akshatha S. Kamath, MD - Pediatric Anesthesiology, Bay Anesthesia Assoc.

Markian Y. Pazuniak, MD - Psychiatry, ChristianaCare Behavioral Health

Robert Ferro Valdes, MD - Hem/Onc, Medical Oncology Hematology Consult

Please join MSD in welcoming the newest members of the Medical Society of Delaware. As the third oldest medical society in the country, MSD has an amazing history. Thank you for taking part in our continued success!

Ariella A. Alexander, DO - IM/Peds Residency, ChristianaCare

Layla Annous, MD - IM/Peds Residency, ChristianaCare

Jeffrey Liu, MD - Emergency Medicine Residency, ChristianaCare

Cassidy A. O'Sullivan, MD - OBGYN Residency, ChristianaCare

Savanah A. Richter, MD - OBGYN Residency, ChristianaCare

Hussien Said, MD - Emergency Medicine Residency, ChristianaCare

Nakia M. Wighton, MD - OBGYN Residency, ChristianaCare

Grace J. Thole, DO - Family Medicine Residency, ChristianaCare

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 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 Isolation and Precautions for People with COVID-19
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker
• 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.