UMass FMCH Tuesday Talk - July 13, 2021/EDUCATION
Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to [email protected].
Table of Contents
Focus of the Week - Education
Announcements
Frankly Speaking Podcast
Faculty Presentations/Publications
Department Member Recognition
Clinical Services Spotlight
Wellness Resources
Working on Wellness

Focus of the Week - Education

DFMCH Vision 2030 Strategic Plan - Education Vision 
Thank you to those who were able to participate in our Grand Rounds Town Hall on the Department Strategic Planning. (If you were unable to attend live, please take the opportunity to review at https://umassmed.edu/fmch/faculty-resources/gr/2019-grand-rounds2/. The group designed this word cloud vision for the dimension of education. What do you have to add or emphasize? Feel free to add to the conversation by emailing comments to [email protected].
Scholarly Activity Opportunity
Please consider presenting your outstanding innovations at the Society of Teachers of Family Medicine Annual Spring Conference. Submission deadline September 13th, but no time like the present!
Academic Year 2022 (AY22)
Welcome to our new academic year. 
WELCOME - to all the new faces. We are so happy to have you join us.
Thank you to all the faculty and senior residents for the extra special effort this month welcoming our new residents and fellows to the department. 
Announcements

Affinity Groups Starting July 2021
The Worcester Family Medicine Residency SOAR Committee will be sponsoring affinity groups for those who identify as POC and LGBTQ+. These meetings are intended to create a safe space where those who have experienced structural oppression, marginalization, and micro-aggressions can share their experiences with others with a shared sense of identity. We envision these groups as a place for connection, mentorship, and support, creating belongingness and healing, and developing collective power. Students, Family Medicine residents, and Family Medicine faculty/attendings are welcome.  
  • LGBTQ+ Affinity Group
When: Thursday, July 29—7pm
Where: O’Connor’s Restaurant

  • POC Affinity Group
When: Tuesday, July 27—6pm
Where: Greenhill Park
Contact with Questions: [email protected]
Learning Opportunity
UMMS has two great survey software platforms that you have free access to: REDCap & Qualtrics. Our staff members Jess Baer and Diana Rinker will be giving one hour Getting Started workshops. Please register: https://umassmed.co1.qualtrics.com/jfe/form/SV_d6EHIwsWE2eXDHU for Qualtrics - July 20th from 2pm to 3pm (Jess Baer) and REDCap - July 22nd from 2pm to 3pm (Diana Rinker).

Worcester Public Schools provide meals Monday through Friday through the summer. Not practicing in Worcester? Take a minute to check with the school system in towns you serve to see how food access for kids is structured in your area. 

The WFMR is happy to announce a Fall Resident Retreat date
10/5/21 8am to 5pm at Camp Selah, Orange, MA. We appreciate faculty who will be doing additional service to allow the residents this important wellness and team building time. Also, residency faculty who are interested and able to be free are invited to join. Please mark your calendars and contact Hilda Alers for further details.

FHCW Wednesday Cultural Rounds
The residents at FHCW host the event each Wednesday from 5 – 5:30pm. We welcome a member of the community to talk about their culture and the ways it can impact their health and the care they receive. The sessions are informal and involve a robust Q&A. Through these weekly discussions, we hope to promote cultural humility and the continuous process of learning about perspectives outside of our own in order to improve the care we provide. We welcome anyone interested in joining us each week at the link below:

The FMCH Town Halls are once again being recorded for those unable to join the live meeting. A separate folder has been created on the FMCH website under Faculty Resources. No password is required to view these recordings. This URL will take you to the Faculty Resources portion of the FMCH website and it can be bookmarked for future reference. https://www.umassmed.edu/fmch/faculty-resources/gr/.

Upcoming Conferences and Calls for Abstracts
The research staff maintains a list of upcoming meetings and conferences that FMCH faculty members often attend. The list has information on deadlines for abstract submissions and links to conference websites. The list can be downloaded from the Department website:

Research Support
A reminder that the Department offers support for FMCH faculty research leading to scholarly publications and/or presentations. You can find more information, including a form for requesting support, on the FMCH website: Research Initiatives - UMass Medical School - Worcester.
Frankly Speaking Podcast

A weekly Podcast series covering newsworthy topics in primary care medicine.

Join us for this episode to discuss how for patients with community-acquired pneumonia (CAP), wide variation in the duration of treatment exists. Longer duration of treatment may result in treatment failure. See what new evidence shows may be the best antibiotics treatment duration in most patients with CAP. Guest: Alan Ehrlich, MD, FAAFP presents: Community-Acquired Pneumonia: How Long Do We Need to Treat? - Frankly Speaking Ep 232.
Clinical Services Spotlight:
COVID-19 UPDATES
Massachusetts
  • Massachusetts reported 0 new cases on July 10th.
  • Total confirmed cases 664,575; Hospitalization 87 with 25 in the ICU and 11 intubated; Confirmed deaths 17,646.
  • The state continues to give 10-15,000 vaccines per day across the state.
  • 7-day average percent positivity has increased slightly to 0.50%.
  • Worcester Stop-the-Spread percent positivity is 0.5%.
  • UMass in house positivity has increased slightly to 2.9% for symptomatic patients, and 0.1% for asymptomatic patients.

COVID-19 Variant
  • The Delta variant is highly contagious.
  • The Delta variant is the most common variant, and now accounts for about 20% of US cases.
  • The CDC and FDA state there is no indication for a booster vaccine currently.

Recent Guidance Regarding Telehealth Coverage and Reimbursement
  • All services that can appropriately be delivered by telehealth will be covered permanently. However, parity for reimbursement is scheduled to sunset at various times depending on the service beginning September 13, 2021.
  • Behavioral health services will continue to be reimbursed on par with in-person services. This includes audio-visual and audio only visits.
  • Primary care and chronic disease management will be reimbursed on parity for 2 years through the calendar year of 2022.
  • The requirement to reimburse all other services delivered via telehealth at parity will no longer be statutorily mandated starting 90 days after the close of the state of emergency, or September 13, 2021. 

Documentation of E/M services in the clinical learning environment
  • UMass Memorial billing at this point considers the primary care exception valid only for Medicaid and Medicare (they report that private insurers are denying claims where it is utilized.) Currently, we are awaiting definitive response on whether private payors will allow the primary care exception.
  • Medical records must demonstrate that the teaching physician performed the service or was present during the key or critical portion of the service when performed by a resident.
  • The presence of the teaching physician can be documented in the medical record by the physician, residents, and nurses. 
  • The combined entries into the medical record by the teaching physician and the resident constitute the documentation for the service and together must support the medical necessity of the service. 

Student Documentation
Any contribution and participation of students to the performance of a billable service (other than review of systems and/or past family/social history, which are not separately billable, but taken as part of an E/M service) must be performed in the physical presence of a teaching physician or physical presence of a resident in a service meeting the requirements. 
 
Appropriate Use of Modifiers
  • Modifier GC
  • This service has been performed in part by a resident under the direction of a teaching physician.
  • Submit this modifier with services that were performed by a resident in a teaching facility under the direction of a teaching physician. 
  •  Modifier GE
  • This service has been performed by a resident without the presence of a teaching physician under the primary care exception. 
  • This modifier is informational and may only be submitted with procedure codes:
HCPCS codes G0402, G0438 and G0439
CPT codes 99201 through 99203, and 99211 through 99213
CPT codes 93005 and 93041
  • Residents who may provide billable patient care without your physical presence have completed more than 6 months of an approved residency program.
  • You must not supervise more than four residents at any given time and must direct the care from such proximity as to constitute immediate availability.

For additional information, please see the Guidelines for Teaching Physicians, Residents, and Students found on the CMS website. Additional information regarding private payor reimbursement will be communicated after the information is available. 
Wellness Resources

The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or www.LiveandWorkWell.com, [company code UmassMemorial]. More information is available on the Caring for the Caregiver page.
Working on Wellness
Yoga Holiday 
No yoga on Wednesday July 14th. Weekly Wednesday morning yoga will return on July 21st. Please feel free to join, details below!  

Yoga Classes with Dr. Liz Erban
Please join department members for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.

Much appreciation to Dr. Erban for hosting these outstanding classes. Join Zoom Meeting
Zumba with Dr. Anna Zheng

May 2021 & summer months (until Sep 2021):
Please join department members Monday mornings at 6:00am, Thursday evenings at 5:45pm**(new time; outdoor location), some Saturday mornings at 9:15am**(only 1x/month; outdoor location) and get moving with Zumba. Please note schedule changes via webpage: http://annazheng.zumba.com/. ZOOM still possible for all classes.

Much appreciation to Dr. Anna Zheng for hosting these outstanding classes. Join Zoom meeting: https://kennedychc.zoom.us/j/5578995952?pwd=bzVnY0xXdFNTQkpQQ1hmZkw3Snh6Zz09.