February 8, 2019
Vol. 26, No. 3
It’s Déjà Vu All Over Again as the Council Looks Back to Look Forward
The Council calendar is full these next few weeks as the oversight and budget process picks up steam. February is full of hearings for every District government agency, including the Committee on Health’s oversight of DC Health (February 8) and the Department of Behavioral Health (February 12). MSDC will be submitting testimony during the budget hearings to outline public health priorities and areas of collaboration with the various agencies. MSDC member and MedStar Washington Hospital Center (WHC) President Dr. Gregory Argyros is pictured testifying on behalf of WHC before the Committee on Health. Those who are interested in testifying for the oversight hearings or budget hearings can contact MSDC at 202-466-1800 or hay@msdc.org to learn how and how MSDC can help. Check the MSDC calendar for a list of upcoming hearings and legislative meetings.

MSDC also took a stand on substance abuse disorder and the District government’s response to the epidemic ravaging the city. In a statement submitted for a nine-hour hearing on January 28, MSDC urged the Council, as well as the Bowser administration and private sector interests, to come together and eliminate prior authorization and step therapy for medication-assisted-treatment (MAT) requests. While this is not the first time that MSDC has spoken out on this issue, the testimony noted MSDC is seeking a consensus agreement on the issue with all involved parties before pushing for a legislative solution. MSDC will be heavily engaged in prior authorization policy this spring, so keep an eye on this space for more information. Those who want to get involved can email hay@msdc.org or call 202-466-1800.
Welcome New Members!
MSDC welcomes the following physicians and medical student who recently joined the Medical Society:

Supriya Goyal, MD (Ophthalmology)
Lavdena Orr, MD (Pediatrics)
Naeha Haridasa (Medical Student)
Attention Controlled Substance Prescribers:
PDMP Registration Required by March 31, 2019
In response to the District's growing opioid epidemic, physician requirements related to the Prescription Drug Monitoring Program (PDMP) have changed. The Opioid Abuse Treatment Act , signed into law last month but still under Congressional Review, now mandates PDMP registration by prescribers by March 31, 2019. The requirement applies to "any prescriber who is currently licensed before March 31, 2019, in the District to prescribe a controlled substance or other covered substance in the course of his or her professional practice." It should be noted that the law requires registration, not use. Physicians may register with the PDMP here . DC Health will formally announce the change and further details after the bill completes Congressional Review.
National Policy
Senators Tackle High Drug Price s; Role of PBMs Debated
Reuters reports that on Tuesday, a bipartisan group of senators “re-introduced a bill...aimed at helping generic drug companies bring out a cheaper version of pharmaceuticals.” Manufacturers “of branded drugs have long been accused of refusing to provide samples of drugs on a government list of restricted medicines." The lack of samples makes it difficult for generic competitors to prove their medicines are as safe and effective as the more expensive versions.   As rising drug prices face growing scrutiny, pharmaceutical companies have pointed to the role of pharmacy benefit managers in increasing costs, reports the Wall Street Journal .

MSDC Urges Congress to Curb Surprise Medical Billing, An Issue With Rare Bipartisan Appeal
MSDC joined more than 100 state medical and specialty societies to send a letter to the Ways and Means Committee calling for greater insurer accountability, transparency and limits on patient responsibility. Kaiser Health News reports that President Donald Trump has "recently waded into a widespread health care problem for which almost everyone — even those with insurance — is at risk: surprise medical billing. The sudden presidential interest has lawmakers on both sides of the aisle expressing optimism about attacking a problem that has affected 57% of American adults."

Empathy: A Critical Ally in Battling Physician Burnout  
With almost half of doctors nationally experiencing burnout, one medical group turned to empathy training for doctors and other staff members. Find out what they learned about empathy’s capacity to reduce burnout in  the AMA Wire .
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
President, AMA Alternate Delegate

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, MS

E.W. Emanuel, MD

Alice Fuisz, MD
At-large, Secretary

Daniel I. Perlin, MD

Marc Rankin, MD

Carla C. Sandy, MD

Robert Hay Jr., CAE
Executive Vice President
Practice Management
Prior Authorization Updates
One in Four Doctors Says Prior Authorization Has Led to a Serious Adverse Event
Physicians in an AMA survey report that prior authorization delays access to care and that the burden associated with the process has gotten worse. That’s a major finding of an AMA survey of 1,000 practicing physicians who were asked what impact prior authorization has on their ability to help their patients. Read more from the AMA.
Are You Frustrated By Prior Authorization?
Is prior authorization a burden on you or your patients? Do you want an innovative solution to prior authorization challenges? MSDC leadership is working to develop new solutions and is seeking a select group of volunteers to share their experience, time and insights. Contact Robert Hay, Jr. at hay@msdc.org .
UnitedHealthcare Prior Authorization Notice
UnitedHealthcare will be retiring fax numbers previously used for prior authorization. See the fax numbers and details in the UnitedHealthcare bulletin .
Attention Practice Managers!
Would you like to connect with others?MSDC is forming a Practice Management Group for managers to socialize with their colleagues, share practice tips and resources. If interested, please contact Pia Duryea ( duryea@msdc.org )
MSDC Community
Early Career Physicians Survey
MSDC is planning events for early career physicians in 2019 and sent a brief survey to early career physicians. If you are an early career physician and did not reply to the survey, please do so here .
MSDC Women in Medicine Celebrate National Women Physicians Day with Distillery Tour and Tasting
In celebration of National Women Physicians Day on February 3, MSDC Women in Medicine attended a distillery tour and tasting at Republic Restoratives , a woman-owned distillery located in Ivy City, Washington DC. Thank you to all who attended, and for those who weren't able to attend, contact Pia Duryea (duryea@msdc.org) to ensure you are on the email list for future events!
Community Connections
MSDC continues to connect with medical societies, practices and medical staff in all eight wards. Last week, MSDC attended the George Washington University Hospital medical staff quarterly meeting.

Follow MSDC on Twitter or Instagram as we work to make the District the best place to practice medicine. If your practice or group would like to meet with MSDC, please contact Robert Hay Jr.
MSDC Chair Susanne Bathgate, MD, and MSDC President, Raymond Tu, MD, at George Washington University Hospital
Coming Soon . In the next edition of eNewsline, MSDC will introduce a new semi-regular feature spotlighting MSDC viewpoints. The first one will start with MSDC Executive Vice President Robert Hay Jr. MSDC invites members to share their viewpoints and submit entries to Pia Duryea, duryea@msdc.org.
Upcoming Board Meeting
MSDC's next board meeting will be Monday, February 25 at 6:30 PM at MSDC headquarters (1250 23rd Street, NW). MSDC members in good standing who are interested in attending may contact Robert Hay Jr for an invitation.
Thank You To Our Corporate Supporters
MSDC 1817 Society
Public Health
US Surgeon General's Message on Current Measles Outbreak
Measles is a highly-contagious respiratory disease caused by a virus. It spreads through the air through coughing and sneezing. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, and is followed by a rash that spreads all over the body.

Measles is so contagious that if one person has it, 9 out of 10 people around that person will also become infected if they’re not yet vaccinated. You can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left. And what is even more worrisome is that an infected person can spread measles to others even before the infected person develops symptoms—from four days before they develop the measles rash through four days afterwards.

The good news is that measles can be prevented with the MMR (measles, mumps, and rubella) vaccine. The MMR vaccine has an excellent safety record and is highly effective. It is one of the most effective vaccines we have in our country. For more information, please visit CDC.gov

Do you have enough vaccine?
Not surprisingly, the majority of people who got measles were unvaccinated. MSDC Corporate Partner Atlantic Health Partners offers MSDC members the most favorable pricing for the MMR (measles, mumps, rubella) vaccine, and can assist your practice in strengthening your immunization efforts for all required and recommended vaccines. For more information, contact Atlantic Health Partners at 800-741-2044 or info@atlantichealthpartners.com

Corporate Partners
National Black HIV/AIDS Awareness Day
Earlier this week, President Donald Trump announced efforts aimed at ending AIDS transmission by 2030 . Yesterday was National Black HIV/AIDS Awareness Day , a day to acknowledge progress in reducing HIV infections and their consequences in African American communities and renew our commitment to the remaining work. There has been some success. New HIV diagnoses declined among African American women (25%) and heterosexual men (26%) from 2010 to 2016, but they were stable among African American gay and bisexual men. African Americans continue to be disproportionately affected by HIV, accounting for 13% of the U.S. population but 43% of the 38,739 diagnoses in the U.S. and 6 dependent areas in 2017. 

Providers play an important role in reducing stigma and increasing the number of African Americans accessing HIV testing, prevention, and treatment services will require all of us working together. Providers can ensure all patients are tested for HIV and offer supportive care that improves health outcomes for patients with HIV and helps them maintain viral suppression. People with HIV who take antiretroviral therapy (ART) as prescribed and achieve and maintain viral suppression can stay healthy and have effectively no risk of transmitting HIV to their HIV-negative sex partners. CDC’s NBHAAD site contains additional educational resources you can use to raise awareness about and combat stigma.
End the Epidemic: Opioid-related Resources and News
This Valentine's Day, Comply With New Part D Opioid Prescribing Rules
CMS implemented new opioid policies for Medicare drug plans effective January 1. According to the AMA , there are three key elements of the new policies for 2019:
1) Opioid-naïve patients will be limited to an initial seven-day supply. If a physician believes that the patient will need more initially, they can proactively request a coverage determination attesting to the medical need for a longer supply. The seven-day limit will only apply to the first prescription.
2) When pharmacies receive a prescription that leads to the patient's cumulative daily morphine milligram equivalent (MME) dose reaching 90 MME or more, the pharmacist will receive an alert and may consult with the prescribing physician to confirm that the dose is medically necessary. This is not an MME limit. Similar to the system in previous years, the main idea is for physicians to be made aware that their patients have already been dispensed other opioid analgesics and that the cumulative dose has reached 90 MME or more.
3) Medicare Part D plans may also implement drug management programs this year for patients determined to be at risk of opioid overutilization. These programs build upon the previous opioid policies by focusing on patients who obtain opioids from multiple pharmacies and prescribers. After completing several steps to coordinate the patients' care with the prescribing physicians, Part D plans may restrict some of these patients to particular pharmacies or prescribers, or limit their ability to fill prescriptions for certain opioid analgesics or benzodiazepines. Patients in long-term care facilities, those receiving hospice, palliative or end-of-life care, and those being treated for cancer-related pain are exempt from the drug management program.

These policies are discussed in an MLN Matters article and will also be described in the Medicare Learning Network call described below.
New Part D Opioid Overutilization Policies Call Thursday, February 14 1:30-3 PM ET
During this call, CMS experts discuss the new policies and answer questions.   Prior to the call, participants should review the following materials:
• Training materials, including slide decks and tip sheets for prescribers , pharmacists , and patients  
Reducing Opioid Misuse webpage for more information on the CMS strategy
Register online . Target audience is physicians, physician assistants, nurses, nurse practitioners, other prescribers, case managers, and other interested stakeholders.
Webinar Next Week on Countering the U.S. Opioid Epidemic  
Join the National Academy of Medicine for a webinar on February 13 from 3:00-4:00 PM CT (4:00-5:00 PM ET) to hear about the work of the Action Collaborative on countering the U.S. opioid epidemic. The session will provide an overview of the Action Collaborative’s mission, followed by reports from the leaders of the four working groups and end with Q&A. Register now
CDC Opioids Training Modules
Help stop the growing  number of drug overdose deaths  in the United States. Take the final three modules in a training series from the Centers for Disease Control and Prevention (CDC):  Applying CDC’s Guideline for Prescribing Opioids . Each module includes clinical scenarios, knowledge feedback prompts, and a resource library to help enhance learning:
View additional modules on the  Interactive Training Series  webpage. The modules offer free continuing education.
DC Prescription Drug Monitoring Program
Enroll and participate in the District of Columbia Prescription Drug Monitoring Program at https://dchealth.dc.gov/service/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
Healthcare Technology
Feds’ EHR Problem-tracking Program Must Do These 3 Things  
The AMA has been tenacious in its advocacy toward improving electronic health record usability, an area in which physicians have told the organization that its support is greatly needed.  Read more from the AMA
Data Show Telemedicine Services are Becoming More Commonplace, But People Aren’t Using Them
The Associated Press reorts that 80% “of mid-size and large U.S. companies offered telemedicine services to their workers last year, up from 18 percent in 2014,” but “only 8 percent of eligible employees used telemedicine at least once in 2017.” 
Saturday, February 23, 2019
8:00 AM - Noon
Lisner Hall (2023 G Street NW, Room 201, Washington, DC)
G2Z Law Group, PLLC and GW Law are pleased to invite you to the 4th Annual Healthcare Law & Compliance Boot CampTM of the greater Washington metropolitan area. Healthcare providers face a myriad of legal and regulatory issues on a daily basis. Awareness of and compliance with healthcare laws and regulations not only enhance patient quality of care but also promote healthy and efficient healthcare practices. At the 4th Annual Healthcare Law & Compliance Boot CampTM learners will analyze and debate challenging issues routinely is seen by healthcare professionals. The event is complementary for providers and GWU students. RSVP to Rghafoorian@g2zlaw.com by February 19, 2019. Read the flyer for more information on the program, speakers, and CME accreditation. 
Loss Prevention Seminars
April 9, 2019 (DC)
April 25, 2019 (MD)
May 9, 2019 (DC)
July 25, 2019 (MD)
September 19, 2019 (DC)
6:00 - 8:00 PM
DC: American College of Cardiology (2400 N Street, NW, Washington, DC)
MD: Bethesda Marriott (5151 Pooks Hill Road, Bethesda, MD)
This year, ProAssurance, MSDC's 1817 Society Member and partner for medical professional liability insurance, will offer a sports-themed loss prevention seminars titled, Out-of-Bounds: Previous Claims Under Further Review Participation in this seminar will better enable participants to:
·    Explain the relationship between physician-patient boundaries and professional liability risks
·     Identify a previous encounter where expectations were not met
·     Recognize the need to apply an internal or external boundary in a patient scenario

Whether you are competing for a championship sports title or practicing medicine, there are consequences for crossing the line. In this course, physicians and other healthcare professionals will hear the professional liability considerations associated with personally and professionally stepping out of bounds. The information and examples will help you stay in the game. Register online at proassurance.com/OutofBounds
Abdominal Wall Reconstruction 2019
June 6-8, 2019
Grand Hyatt Washington (1001 H Street NW, Washington, DC)
MedStar Georgetown University Hospital is pleased to announce Abdominal Wall Reconstruction (AWR) Conference taking place on June 6 to 8, 2019. This comprehensive conference will offer evidence-based discussion on all aspects of AWR through lectures and case presentations to address the growing rate of hernia repairs and updates in technology and procedures. We will also cover the high overall complication rate as well as the association of ventral hernia repair as the cause of the second highest postoperative readmission rate. The agenda is constructed to provide an in-depth understanding of the complexity of AWR. 

To register please visit AWRConference.com
Medical Real Estate Listings
Office Sublet Available
600 square foot sublet available on 19th Street NW between Farragut North and Dupont Circle Metro. Brand new build out with separate suite number, entrance, waiting area. One office and one exam room with large window. One smaller office without windows. Sublet space is connected to an established private internal medicine practice. Price negotiable . 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 Resources and Announcements
Healthcare Job Opening/Service Opportunities
DC Health Seeks Senior Deputy Director, Health Emergency Preparedness and Response Administration (HEPRA)
 DC Health invites qualified applicants to visit DCHR careers site to complete your application.
Directions :
1. Select the  link to access the careers site
2. Sign In to access your account, or if you are not an existing user, select the New User link to create one. 
3. Review the job description and select the Apply button to begin your application.

General Job Information : Bring your professional career to Washington, D.C., the most dynamic and diverse city in the country. With its proximity to major museums, world class parks, entertainment and restaurants, increasing job opportunities and the seat of the federal government, the District of Columbia continues to be ranked in the top 10 of thriving city indicators where you can live, work and play. Contribute to and work for a nationally accredited Health Department. The District of Columbia Department of Health (DOH) earned national accreditation by the Public Health Accreditation Board (PHAB) and is an early adopter in attaining the designation. Come see where your skills are appreciated and rewarded by applying for the following public health opportunity. 

Job Summary : This position is located in the District of Columbia’s DC Health, Health Emergency Preparedness and Response Administration. The Senior Deputy Director directs activities of the DC Health relating to protecting the District population from acts of bio-terrorism and other public emergencies through effective planning and timely operational response. The Senior Deputy Director for HEPRA oversees DC Health’s efforts to prepare for and protect against, respond to, and recover from all acts of bio-terrorism and other public health emergencies, including but not limited to; Prevention/Deterrence/Protection, Emergency Assessment/Diagnosis, Emergency Management Response, Incident/Hazard Mitigation, Public Protection, Investigations, Recovery and Remediation.
 The DC Medical Reserve Corp (MRC) is actively recruiting for medical and public health professionals. The MRC is a network of local medical volunteers who are willing to donate their time during emergencies and other times of community need like parades or inaugurations. All volunteers receive comprehensive instruction in areas of emergency response. Learn more here .
Medical Society of the District of Columbia
1250 23rd Street NW, Ste 270
Washington, DC 20037