November 2, 2018
Vol. 25, No. 20
DC Physician License Renewal Period Is Now Open. What You Need to Know.
Earlier this week, the DC Board of Medicine (DC Board) issued a newsletter about the requirements for DC licensure renewal, calling out that this year's process will for the first time be an online-only process which includes electronically uploading proof of continuing education. On November 1, the DC Board officially opened the 2018 DC physician license renewal period.

The deadline for the current license renewal period is December 31, 2018. There are several critical factors that licensees should note:

Paperless, Online-only Process. This year's renewals are completely online and paperless. This means applicants will have to go online and complete an electronic renewal, as well as electronically upload relevant documents (e.g., proof of CE). Licensees should have their NPI and DEA number (if applicable) for the process.


CME Requirements and Resources. CME requirements for DC physician (MD/DO) licensees are: "For physicians, licensees must complete a minimum of fifty (50) CE hours between 1/1/2017 and 12/31/2018. Furthermore, of those fifty (50) hours, three (3) must be in the subject of HIV/AIDs, two (2) in the subject of LGBTQ Cultural Competency, and a course in the subject of pharmacology. " The Medical Society has resources to assist members in complying with the CME requirements. Contact Pia Duryea (duryea@msdc.org, 202-355-9414) for information.

Webinar and One-on-one Member Assistance
MSDC will be hosting a webinar on November 16 at 2 PM to assist with the renewal process. Hear from DC Board staff 1) how to complete the online form and 2) tips and best practices to ease the process and common mistakes to avoid. More importantly, this is your chance to get answers directly from the Board of Medicine. For further details and webinar link, which are coming soon, contact hay@msdc.org. The webinar will be recorded for those who can't attend the live event.

As a member benefit, MSDC can assist members with questions or snafus related to 2018 DC physician license renewal. Call 202-466-1800 or email duryea@msdc.org for help.
DC Legislative Update
Today, the Committee on Health resumes public oversight hearings to examine Providence Hospital's proposed elimination of acute care services and the impact on the District's emergency health care system. Today's hearing is a continuation of the October 10 hearing which was recessed in order to hear from more people, especially the leadership of Ascension and Providence corporate leadership. In addition, the Mayor yesterday enacted legislation on an emergency basis that empowers the DC health planning agency to "approve or disapprove closure or termination of services of a health care facility." The act could effectively force the hospital to stay open, although the implications of such a move are unclear.

On October 26, the Committee on Health held a public hearing on the " East End Health Equity Act of 2018 " (B22-959), the " Breast Density Screening and Notification Act of 2018 ” (B22-960), the " Program of All-Inclusive for the Elderly Establishment Act of 2018 " (B22-924), and the “ Conversion Therapy for Consumers Under a Conservatorship or Guardianship Amendment Act of 2018 ” (B22-972) , followed by a regular meeting on November 1 for committee review and mark-up. The Medical Society submitted testimony on the breast density bill, supporting the intent but offering physician recommendations. The bills addressing East End health equity and breast density screening are of particular interest to MSDC members and remain under consideration by the Committee on Health.

The DC Council has dropped a bill, the " Health Insurance Marketplace Improvement Act of 2018" (B22-1001), to limit the sale of short-term, limited-duration insurance (STLDI) and ensure multiple employer welfare arrangements are covered by small employer market rules. The bill will receive a public hearing on November 7, 2018. See the Hearing Notice for information on how to participate.

In addition, the Bowser administration, DISB, and DC Health Exchange introduced a second bill also addressing the sale of short-term limited duration plans and multiple employer welfare arrangements. The fate of both bills is currently unknown, but MSDC is engaged in conversations on the best avenues to ensure DC patients receive appropriate health coverage.

The two bills are in response to recent Administration regulations revising STLDI plans from their historic scope (90 days, non-renewable) to 364 days, renewable up to 36 months at the discretion of the insurer. The Medical Society joined the American Medical Association, American College of Physicians and other national physician organizations in an amicus brief arguing that the STLDI rule will undermine consumer protections in the Affordable Care Act, leaving patients vulnerable to worse health outcomes or financial hardship. Learn more about this topic in a recent Kaiser Family Foundation Issue Brief .
MSDC eNewsline
Pia R. Duryea
202-355-9414 (direct)
202-466-1800 (main)
For previous editions, visit eNews Archives

MSDC Media
Follow us on social media!

2018-2019 Board of Directors
Susanne Bathgate, MD
Chair of the Board, At-large

Raymond Tu, MD, MS

J. Desiree Pineda, MD
President-elect, AMA Alternate Delegate

Barry L. Lewis, MD, MBA
Immediate Past President

Joseph E. Gutierrez, MD
Treasurer, AMA Delegation Chair

Peter E. Lavine, MD
AMA Delegate

Laurie Duncan, MBBS

E.W. Emanuel, MD

Alice Fuisz, MD
At-large, Secretary

Daniel I. Perlin, MD

Marc Rankin, MD

Robert Hay Jr., CAE
Executive Vice President
National News
AMA Applauds Delay in Implementation of E/M Coding Reforms
The Centers for Medicare & Medicaid Services (CMS) is delaying for two years implementation of evaluation and management (E/M) coding reforms that affect physician payment, in a move applauded by the American Medical Association. The final 2019 physician fee schedule and quality payment program rule also includes updates on interoperability, telehealth and drug costs. Fierce Healthcare reports that although CMS “moved ahead with parts of its plan to consolidate codes for Medicare patient visits, it made changes in response to the thousands of comments it received from doctors who worried that the plan would cut revenues for physicians who care for Medicare patients with complicated health conditions.”

CMS Attempts to Modernize Medicare Home Health
On October 31, CMS finalized significant changes to the Home Health Prospective Payment System (PPS) to strengthen and modernize Medicare. Specifically, CMS made changes to improve access to solutions via remote patient monitoring technology, updated payments for home health care with a new case-mix system, begin the new home infusion therapy benefit, and reduce burden. “This home health final rule focuses on patient needs and not on the volume of care,” said CMS Administrator Seema Verma. “This rule also innovates and modernizes home health care by allowing remote patient monitoring.”

The final rule implements the temporary transitional payments for home infusion therapy services for CYs 2019 and 2020 until the new permanent home infusion therapy services benefit begins on January 1, 2021, and establishes health and safety standards for qualified home infusion therapy suppliers of the new service benefit. The final rule also establishes the approval and oversight process for accrediting organizations of these suppliers as required by the 21st Century Cures Act. CMS is eliminating the requirement that the certifying physician estimate how much longer home health services are needed when recertifying the need for continued home health care. 

Read more in the CMS Fact Sheet .
P ractice Management
Editor's Note: This alert was first issued in April 2018. It has resurfaced again and the DEA urges registrants to remain vigilant.
Extortion Scam Targeting DEA Registrants
DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. The criminals have masked their telephone number on caller id by showing the DEA Registration Support 800 number. Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration.  

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “ Extortion Scam Online Reporting ” posted on the DEA Diversion Control Division's website .
6 Common Medical Office Manager Pain Points and How to Avoid Them
Provided by MSDC Corporate Partner GZ Realty
Keeping a medical practice running smoothly is one of the hardest challenges office managers face today. Having to juggle various administrative burdens while keeping your office fully staffed and maintained often takes a backseat to acquiring more patients.

Ensuring your patients’ satisfaction means tending to their worries and woes. The best way to do that is to have a staff that’s attentive, available, and extremely knowledgeable. Your staff must be willing and ready to meet with their patients one-on-one, give accurate and adequate information and offer each patient peace of mind.

How can you make that happen? Easy, follow these tips .
Bright Young Doctors
4 Keys for a Physician’s First Employment Contract
You aced medical school. You have survived residency and perhaps fellowship. Next comes another difficult test: deciphering your first physician employment contract. This professional benchmark is a young physician’s first opportunity to shape several aspects of the career path ahead, including compensation, work hours and benefits. Read more in the AMA Wire.
Thank you to our corporate supporters
MSDC 1817 Society
MSDC Member Opportunities
MSDC is pleased that many members have already responded to our newly launched interest groups and opportunities to connect with other physicians. If you haven't signed up yet, it's not too late. See detailed description of the opportunities or sign up here . Whether your interests lie in policy, strategic planning, networking or philanthropy, this is is your chance to advance the profession of medicine in the District .
Corporate Partners
Public Health
DCHealthLink Open Enrollment Started on November 1 
The Office of the Deputy Mayor for Health and Human Services opened the 2019 health insurance open enrollment season for District residents to enroll in high quality affordable health insurance on Thursday, November 1 at 9:00 am. Following the event, DC Health Link hit the road and took to the streets of the District with a Get Covered, Stay Covered “CARE-A-VAN."

DC Health Link, which has cut the District’s uninsured rate in half since opening for business in 2013, is redoubling its efforts to ensure that all residents have quality, affordable health coverage by targeting areas of DC with higher uninsured rates and focusing outreach toward Millennials, Latinos, and African-Americans. Individuals, small businesses and employers can sign up at DC HealthLink.
November is Lung Cancer Awareness Month 
Lung cancer accounts for about 27 percent of all cancer deaths and is by far the leading cause of cancer death among both men and women. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.

We proudly support awareness, outreach and education during Lung Cancer Awareness Month. Interested in spreading the LCAM word? Here are some ideas, provided by the DC Tobacco Free Coalition , for participating in a local or national campaign:

Great American Smokeout (Nov 15) : The American Cancer Society has hosted this annual event for over 40 years. Help someone take the first step to quitting during the Great American Smokeout event. Learn more and get involved at the American Cancer Society

American Lung Association : ALA's LUNG FORCE is uniting women and their loved ones across the country to stand together against lung cancer—the #1 cancer killer of women and men—by encouraging them to share their voice .
2018-2019 Influenza/pneumonia Season is Well Underway
An adult immunization campaign is underway between October 1, 2018 – January 31, 2019. Advertisement have been placed in 150 Metro Buses in Wards 7 and 8 to help raise awareness and improve immunization rates. These Wards have the lowest immunization rates in the District based on analysis of Medicare Part B Fee-For-Service administrative claims data.
End the Epidemic: Opioid-Related Resources and News
DC Prescription Drug Monitoring Program
AMA "End the Epidemic" Website
See the AMA's End the Epidemic website , with resources and recommendations from the AMA Opioid Task Force
November 10, 2018
9:00 AM - 12:30 PM, Breakfast at 8:30
The University Club of Washington, DC (1135 16th St NW, Washington, DC)
Long feared, avoided, and all but written off as outmoded once effective pharmacotherapy for serious mental disorders was available, electroconvulsive therapy (ECT) in recent years has re-emerged as the safe and effective “gold standard” treatment of severe mood disorders. In particular, advances in treatment administration have enhanced the benefit:risk ratio of ECT well beyond that of its original form in Italy 80 years ago. Over the past two decades ECT has been joined by a growing list of other noninvasive and surgical approaches to brain stimulation interventions, chiefly for medication-resistant depression. Read this flyer for more information or to register.
November 8, 2018
Royal Sonesta Harbor Court Hotel (550 Light St. Baltimore, MD)
Medical Society of DC members are invited to the Maryland Medical Cannabis Forum on November 8, 2018 in Baltimore MD. Top doctors, researchers, and regulators will provide reliable information on the state of medical cannabis research and practices, including:
■ The endocannabinoid system and its relation to treating diseases
■ Cancer case studies utilizing cannabis for symptom relief and pain management
■ Effect of cannabis on treating neurological disorders such as Alzheimer’s, Epilepsy and Autism.
■ Reduction in opioid dependency and other prescription medications
■ Proper dosing and understanding common side effects

RSVP & further details at www.medicalcannabisforum.org (443-714-3206)
Medical Real Estate Listings
Brought to you by MSDC Corporate Partner GZ Medical Realty. Contact Pete Papantoniou for your real estate needs.
Office Sublet Available
600-1,200 square foot sublet available in Class A office building on 19th Street in N.W., D.C. The space which is about to be built out will have a separate entrance, 2 large offices and 2 exam rooms (all with large windows), and a small reception area. Balance of the office space is occupied by an Internal Medicine practice. Option to share staff and EMR etc with our group. Space available approximately September 2018. Contact Dr. Alice Fuisz if interested. alicefuiszacp@gmail.com .

2440 M Street NW
2440 M Street NW
Washington, DC 20037
2440 M Street is a Class A 110,000 SF medical office building with a three-level parking garage in northwest Washington, DC. The building has abundant patient and physician parking. Please contact Peter Papantoniou at 301-961-1941 or see the online listing for more information. 

Part Time/Full Time Office Space Available
3 Washington Circle
Washington, DC 20037
Part time/full time office space available immediately at 3 Washington Circle. This includes a large consultation room, fully equipped examination room, lab drawing facility onsite, EKG machine, space for receptionist, space for medical records, shared use of copier, telephone system, wireless internet and waiting room. Ideal for general internist, medical subspecialist or surgeon. If interested, please call Mark Sklar, MD. 202-887-4769 or email mmsklar@gmail.com .
Boutique Townhouse Medical Office for Rent Across From GWU Hospital/ Medical School
900 New Hampshire Ave., NW
Washington, DC 20037
Boutique townhouse medical office for rent across from G.W.U. Hospital & School of Medicine. Very close to Foggy Bottom Metro. Three rooms, one on entry level with powered table/chair & overhead surgical light. Consultation room, reception/waiting room, & possibility of 2 additional rooms. Two-car driveway. Call/text Sheldon K. Gottlieb, MD, 301-509-3319, or email skgottliebmd@comcast.net .
Woodburn Medical Park
3229 Woodburn Road  
Merrifield, VA 22003
Woodburn Medical Park is located within walking distance of INOVA hospital directly off Capital Beltway. Common area was recently upgraded. Contact Peter Papantoniou at 301­-961­-1941 or see the online listing for more information.
Full Time/ Part Time Office Space Available
Well-designed and attractively decorated office of three general internists has additional consulting room/exam room suite available. Looking for another general internist to share space and overhead in fully staffed and equipped internal medicine office. Shared call coverage is possible. Contact Alan Stone, MD, 202-466-8118 or aws.md@verizon.net
Medical Society of the District of Columbia
1250 23rd Street NW, Ste 270
Washington, DC 20037