March 8, 2019
Vol. 26, No. 5
District Advocacy: Summer on the Mind
Despite winter chills in the air, MSDC has summer on the mind in its advocacy efforts. This week, the Society sent a letter to Chairman Grosso of the Committee on Education urging him to hold a hearing on B23-84, the School Sunscreen Safety Amendment Act of 2019 . The bill would remove the requirement for students to need a doctor’s note to bring sunscreen to school as well as permit schools to carry a modest amount of available sunscreen. MSDC and the American Medical Association (AMA) strongly believe in sun safety; the Centers for Disease Control and Prevention (CDC) has found that only 11% of students reported regular or near regular use of sunscreen during prolonged periods of regular sun exposure.

Speaking of the AMA, MSDC and a number of other medical societies signed a letter urging the Center for Medicare & Medicaid Services (CMS) to include language about prior authorization in its 2020 Call Letter to Medicare Advantage plans. The letter requests that the guidance advise plans to carefully consider delays related to prior auth and its impact on beneficiaries. Also this week, the AMA joined Planned Parenthood and the Oregon Medical Association in a lawsuit to block the Trump Administration’s rule that would limit the advice physicians could give to their Title X patients. The rule directs physicians and other providers to give pregnant patients full information about only some of their reproductive health care options while withholding information about others.

Closer to home, the District may soon consider legislation to strengthen the ability to vaccinate patients. Councilmember Mary Cheh introduced legislation on Tuesday that would permit minors to request vaccinations without prior consent of their guardians or parents. CM Cheh introduced the language in response to the misinformation on vaccines and to allow mature minors to receive vaccines. MSDC is considering the implications but will share updates on its website, social media, and eNews.
Mayor Muriel Bowser this week announced several key appointments to her Administration, including Wayne Turnage as the new Deputy Mayor for Health and Human Services. With this appointment, Mr. Turnage will continue concurrent roles as Deputy Mayor for Health and Human Services and Director of the Department of Health Care Finance.

Join Mayor Muriel Bowser for the 2019 State of the District Address on Monday, March 18 at 5:30 PM. The address will highlight key topics for District residents and take place at University of DC Theater of the Arts (Connecticut Ave and Windom Place NW). Learn more and RSVP here
DC Health Releases First Health Equity Report
The first Health Equity Report: District of Columbia 2018 is now available on DC Health’s website. This comprehensive report focuses on the social and structural determinants of health in the District. Read a summary report or attend one of eight Health Equity Community Conversations being hosted by t he Office of Health Equity, in collaboration with The Mayor’s Commission on Health Equity. The conversations will take place ov er the next several weeks, with the first sessions slated for March 11, 12, and 14 (See flyer ).
National Healthcare News
FDA Commissioner Scott Gottlieb, MD, to Step Down The  Washington Post  reported that FDA Commissioner Scott Gottlieb, MD, submitted his resignation on Tuesday, March 5, "effective in about a month” in order to spend more time with his family. During his tenure, Commissioner Gottlieb has taken a strong stand on cigarette and tobacco regulation. HHS stated “no information was available on who might be named to assume his responsibilities on an acting or permanent basis.”  
CMS Issues Hospital Compare Data; Check Your Ranking
This week, the Centers for Medicare & Medicaid Services (CMS) released hospital performance data on the  Hospital Compare website and on  data.medicare.gov . Hospitals can check how they compare to one another . The site is intended to provide comparative information on healthcare, but MSDC strongly feels star ratings do not adequately represent the high quality of care delivered by District physicians and their care teams. Working with the AMA and our local partners, MSDC is spread the news of the excellent work physicians do day in and day out in the District. Hospital Compare is undergoing revisions to improve its role in informed healthcare decision-making.  CMS has posted potential changes which are open to public comment.
MSDC eNewsline
Pia R. Duryea
202-355-9414 (direct)
202-466-1800 (main)
For previous editions, visit eNews Archives

MSDC Media
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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

Kirstiaan Nevin, MD

Marc Rankin, MD

Carla C. Sandy, MD

Robert Hay Jr., CAE
Executive Vice President
MSDC Community
Join MSDC and DC ACP on May 4 for a Bright Young Docs Social
MSDC and the DC Chapter of American College of Physicians are partnering to hold a joint social for early career physicians. The social will be at 1:30 PM on Saturday afternoon, May 4 at Circa (Foggy Bottom). See the MSDC Events page for further details.
MSDC's Annual Meeting Date Set for October 25, 2019 - Save the Date!
MSDC will be holding its 2019 annual meeting on Friday, October 25, 2019, from 6:00 to 9:30 PM. The meeting will take place at the AAMC Learning Center, located at 655 K Street NW. The event will feature ample time to catch up with physician colleagues from across metropolitan Washington DC.
Practice Management
CMS: Important Info on the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Program
As of January 1, 2019, there is a temporary gap in the entire DMEPOS Competitive Bidding Program that CMS expects will last until December 31, 2020. During the temporary gap, any Medicare enrolled DMEPOS supplier may furnish DMEPOS items and services to people with Medicare. In most cases, CMS says, people with Medicare won’t need to switch suppliers on or after January 1, 2019. Suppliers must continue to furnish specific items that include capped rental items and oxygen/oxygen equipment through the remainder of the specific month or rental period. For additional information, see the Temporary Gap Period fact sheet.
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 so, contact Pia Duryea.
How Does E&M Coding Change In the CY2019 PFS? Find Out Via Podcast.
Hear about Evaluation and Management Coding on CMS' new podcast, which discusses the Calendar Year 2019 Physician Fee Schedule including significant changes to how doctors and other clinicians document office and outpatient visits billed to Medicare.
MSDC Welcomes it's Newest Corporate Partner, CRISP DC
CRISP DC is a regional Health Information Exchange (HIE) serving the District of Columbia. We are a non-profit organization advised by a wide range of stakeholders who are responsible for health care throughout the region. Participating in a health information exchange offers a system-wide view of the care your patients receive across the District.

Our main goal is to is to deliver the right health information to the right place at the right time —providing safer, timelier, efficient, effective, equitable, and more patient-centered care. We are committed to ensuring that District providers are securely sharing data to facilitate better patient care, reduce costs, and improve overall health outcomes.

For more information on CRISP DC log onto dc.crisphealth.org
Thank You To Our Corporate Supporters
MSDC 1817 Society
Public Health
DC Health Notice: Reporting, Control and Containment of Candida Auris  
The following is adapted from a DC Health notice
The purpose of this notice is to increase awareness and provide recommendations on the identification, reporting, management, and control of C. auris to help prevent any further spread in DC.  

Candida auris (C. auris) is an emerging fungus of increasing public health concern. C. auris has caused severe and even fatal illness in hospitalized patients in multiple countries. It was first identified in the United States (U.S.) in 2013, and as of December 31, 2018, there have been 520 confirmed clinical cases and 31 probable cases.1 DC Health was first notified of a C. auris case in a DC healthcare facility in 2018. Patients can remain colonized for extended lengths of time, and C. auris can persist on surfaces in healthcare environments, thus facilitating the spread between patients. Clinical cases of C. auris will become nationally notifiable in 2019.

Recommendations for Healthcare Facilities (as of December 21, 2018)  Screen patients for colonization with C. auris upon admission if they have a history of overnight hospitalization outside the United States in the last 12 months, especially 1) if hospitalized in a country with C. auris transmission or 2) have a carbapenamase-producing organism.
 Expand the list of disinfectants used in the facility that have been found to be effective against C. auris. Additional information can be found here.
Celebrate the Health Benefits of Nutrition This Month!
March is National Nutrition Month ®. Choosing nutritious foods and getting enough physical activity can make a real difference in someone’s health. Talk to your patients about making informed choices to help prevent or reduce nutrition-related health conditions, including diabetes, chronic kidney disease, and obesity. Encourage your patients to take advantage of appropriate  Medicare-covered preventive services : Medical Nutrition Therapy, Diabetes Screening, Diabetes Self-Management Training, Intensive Behavioral Therapy for Obesity, Intensive Behavioral Therapy for Cardiovascular Disease, Annual Wellness Visit.
Corporate Partners
End the Epidemic: Opioid-related Resources and News
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
Comment on Guidelines for Mobile Health Apps
In 2016 the American Medical Association (AMA) and a number of other health-related organizations partnered to establish Xcertia, with the goal of developing guidelines for safe and effective digital health apps that will facilitate virtual care, including remote patient monitoring for chronic diseases. This is an emerging set of technologies, which is largely unregulated. Many solutions are not evidence-based and have not demonstrated that they are safe and effective tools for use as part of a patient’s treatment plan. Xcertia has released a complete set of guidelines covering the privacy, security, operability, usability and clinical content of mHealth solutions , and the guidelines are available for public comment until May 15, 2019 at: https://www.xcertia.org/the-guidelines/ . Xcertia will rely on these public comments to create a final version of the guidelines. For questions, comments or if you wish to join this effort, please contact Michael L Hodgkins, MD, VP & CMIO, AMA at michael.hodgkins@ama-assn.org .
Saturday, April 6, 2019
9:00 AM–4:30 PM | Breakfast at 8:30 AM
The University Club of Washington, DC (1135 16th Street, NW, Washington, DC)
This all-day Presidential Symposium will explain and illustrate how the increasing streams of information available to the clinician in the computer age is expanding and enriching the modern practice of Psychiatry. The morning session will focus on the use of “big data” derived from the growing body of electronic health record, pharmacy, and population demographic data to understand service use and treatment response across psychiatric diagnoses. Newer models of clinical practice reviewed in the afternoon session will include discussions of collaborative and integrative care, telepsychiatry, and the rapid rise of smartphone and Web-based apps as adjuncts in diagnosis and symptom tracking. Register by March 18 to get the early bird rate. Learn more or register here .
ProAssurance Loss Prevention Seminars
April 9, 2019 (DC)
April 25, 2019 (MD)
May 9, 2019 (DC)
July 25, 2019 (MD)
September 19, 2019 (DC)
Registration opens at 5:30 PM, Seminar runs 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
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
Brought to you by MSDC Corporate Partner GZ Medical Realty. Contact Pete Papantoniou for your real estate needs.  
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 .

University Medical Building
2141 K Street NW
Washington, DC 20037
University Medical Building is conveniently located in the heart of DC with easy access to Metro stations. 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 has recently been 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
Get Over $66,000 Towards Loan Repayment
DC’s Health Professional Loan Repayment Program (HPLRP) provides loan repayment (up to $66,809.92) to eligible providers practicing in underserved areas of the District for at least two years. Eligible participants include licensed and certified physicians, dentists, dental hygienists, advanced practice nurses, registered nurses, clinical psychologists, clinical social workers, and licensed professional counselors practicing at HPLRP-certified Service Obligation Sites (SOS). A certified SOS must be either a nonprofit or a public entity that provides primary care, mental health and/or dental services to District residents regardless of their ability to pay and is located in a federally-designated Health Professional Shortage or Medically Underserved Area within the District that corresponds to the services the entity provides.  Applicants must be already employed or have a signed employment contract with a certified SOS at the time of application. Read more about the HPLRP or get a list of approved site on DC Health's website .
 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