March 23, 2020

Dear Colleagues,

I trust that we are all in compliance with the AAO directive to remain open only for urgent / emergent care. This is an unimaginable public health crisis. We have an obligation to our patients not to spread this virus which may be transmitted asymptomatically.

We understand that this may result in severe financial distress for our practices and personal situations. To that end, we are providing updates for telemedicine and other information that may be helpful. There are many questions regarding the "Families First Act". We are asking that you contact your state and federal legislators and include the AMA letter.  We are sharing this information with all Maryland Ophthalmologists regardless of membership status and our WDMOS friends. We are also making our previous newsletters available on our website under the resources section. Marylandeyemds.org.   

We at MSEPS are in the same dire circumstances as you and greatly appreciate your understanding as work through this together. If you have information that you would like Sophie to share with everyone please email her at spumphrey@medchi.org.

We have included the latest updated information. Be sure to register for the physicians all call tonight at 5:00PM. instructions are below.

I request a point of personal privilege to share what inspires me and brings me some moments of calmness...

Aaron Copeland's Fanfare for the Common Man


Stay Safe & Healthy
Renee Bovelle, MD
MSEPS President
Update on the Recent Executive Order

The Executive Order released today

Office of Legal Council Interpretive Guidance of the recent Executive Order

Directive and Order Regarding Various Healthcare Matters
From Maryland Department of Health Secretary Robert Neall.

From MSEPS Lobbyists

Good afternoon: 

Today, Governor Hogan issued a new Executive Order on the closure of “non-essential” businesses as well as financial assistance being offered to businesses in Maryland. In addition, Secretary Neall has issued an order on non-urgent procedures and appointments. Please see below for additional information.

Physician’s Call
Secretary Neall, Maryland Department of Health, has issued an Order taking effect tomorrow at 5 pm. ALL physicians are urged to review the Order and participate on a Statewide Physician Call TODAY at 5 pm.   You need to register for the call at https://myemail.constantcontact.com/March-23-MedChi-COVID-19-Update.html?soid=1111086367809&aid=o_chwUD2DAY .  The Order is listed above.
 
Newly-Issued Executive Order
As you may have now heard, Governor Hogan announced today new measures to limit exposure to the COVID-19 through the additional closure of non-essential businesses. As of 5 pm today, all non-essential businesses will be closed in the State. Attached is the Interpretative Guidance as to what is considered “essential” and allowed to remain open. 

Business Financial Assistance
In addition, Governor Hogan outlined several new initiatives to provide financial support to businesses:
  • 500 or fewer employers: The Maryland Department of Labor is providing up to $50,000 from the COVID-19 Layoff Aversion Fund, which is designed to support businesses undergoing economic stresses due to the pandemic by preventing or minimizing the duration of unemployment resulting from layoffs. The award (up to $50,000 per applicant), will be a quick deployable benefit and customizable to the specific needs of your business to minimize the need for layoffs. Labor is accepting grant applications from small businesses for awards from now through 30 days after the State of Emergency ends (subject to funding availability). Additional information - https://www.dllr.state.md.us/employment/covidlafund.shtml
  • 50 or fewer employees:  The Maryland Department of Commerce is providing both loans and grants through three programs to eligible employers. Additional information - https://commerce.maryland.gov/fund/maryland-small-business-covid-19-emergency-relief-fund-programs
  1. Maryland Small Business COVID-19 Emergency Loan Fund - This $75 million loan fund (for for-profit businesses only) offers no interest or principal payments due for the first 12 months, then converts to a 36-month term loan of principal and interest payments, with an interest rate at 2% per annum.
  2. Maryland Small Business COVID-19 Emergency Relief Grant Fund - This $50 million grant program for businesses and non-profits offers grant amounts up to $10,000, not to exceed 3 months of demonstrated cash operating expenses for the first quarter of 2020.
  3. Maryland COVID-19 Emergency Relief Manufacturing Fund - This $5 million incentive program helps Maryland manufacturers to produce personal protective equipment that is urgently needed by hospitals and health-care workers across the country. More details are expected to be announced by Friday, March 27, 2020.

As more information becomes available, we will keep you informed. 


Danna L. Kauffman
Schwartz, Metz and Wise, P.A.
Update on Maryland Licensing
Governor Hogan has declared a State of Emergency and has issued an Executive Order extending the expiration dates of all driver’s and business licenses, identification cards, permits and registrations that expire or are eligible for renewal beginning Thursday, March 12, 2020. If you are currently holding one of these products, please know it will not expire until the 30 th  day after the state of emergency has been lifted

Dear MedChi Members and Maryland Physicians:

In an effort to ensure that all Maryland physicians have the information they need, MedChi's COVID-19 update emails are being shared as widely as possible beyond our membership. We are all in this together, and MedChi is here for all physicians in Maryland. We encourage you to share this email with your colleagues, let us know if there is more information you need, and reach out to us with any specific concerns.

Here are some of the latest resources and information:



  • CareFirst has developed a resource center for billing, telemedicine, and benefit updates.

  • Montgomery County Medical Society is holding an employment law webinar today at 12pm and again at 6pm. Registration is limited but the webinar will be recorded and made available online.



  • For questions regarding implementation of telemedicine, please contact Colleen George at cgeorge@medchi.org.


Please reach out to us if you have questions or if there are specific resources you are looking for. Thank you for all that you do as physicians and healers.

Gene Ransom
MedChi CEO
A letter from AMA President Dr. Patrice Harris:

I want you to know that the AMA is listening to you and channeling your collective voices into action.

On Wednesday, in a small virtual meeting with President Trump, Vice President Pence and other senior members of the administration, I told them, loud and clear, the single biggest thing on your minds: WE NEED MORE PPE AND TEST KITS.

We will continue to press the government to use every power they have, right now, to alleviate these dangerous shortages.

Second, I made it clear that physicians will need financial support. That’s why we combined forces with the American Hospital Association and the American Nursing Association to ask the administration for $100 billion to support front line health care personnel and providers.

The AMA is fighting every day on your behalf to remove the obstacles you face while confronting the COVID-19 pandemic. Last week, we fast-tracked new CPT codes for COVID-19 testing and worked with the administration to provide new guidelines for telemedicine.

In addition to representing physicians with a unified voice, we’re learning from and sharing first-hand accounts of physicians on the front lines. Listen to JAMA Editor Howard Bauchner, MD, interview Maurizio Cecconi, MD, in Italy and NIAID’s Anthony Fauci, MD ; read how The Permanente Medical Group developed new approaches to preserve PPE.

If you haven’t already, visit the AMA COVID-19 Resource Center and the JAMA Network COVID-19 Resource Center for evidence-based, actionable resources, including our new quick-start guide to telemedicine .

I’ll be keeping you updated on our progress in the weeks to come. In the meantime, please reach out to the AMA on Twitter ( @AmerMedicalAssn ) with your questions, and we’ll do our best to answer.
Thank you for everything you do,
Patrice A. Harris, MD, MA
President
American Medical Association
 
From the AMA:
The AMA and other organizations have sent three letters to Congressional leadership seeking support in physician efforts to fight the COVID-19 pandemic. See them Linked Below.
Dear Colleague:
We have had a number of calls about how to manage ROP screenings during the COVID-19 pandemic. Here are the recommendations from the OMIC ROP Task Force. As always, use your professional judgment to determine the best way to proceed with any particular patient or situation.
•   Consider ROP care as urgent and continue to provide it.
•   Follow the usual guidelines in the American Academy of Pediatrics Section on Ophthalmology Policy Statement 1 on who should be screened, timing and frequency of follow-up exams, and criteria for ending ROP screening.
•   Provide care in your office, with as little exposure as possible from other patients, for infants already
   discharged from the NICU.
•   Implement CDC recommendations and those of your local health department on social distancing and personal protective equipment.

Here is a link to the AAO’s ophthalmic-specific guidance on this:
You may access the ROP Safety Net at http://www.omic.com/rop-safety-net/. 
OMIC policyholders are encouraged to use our confidential Hotline. The fastest way to reach us is to contact our confidential Risk Management Hotline by mailing  riskmanagement@omic.com  or calling 800-562-6642, option 4.
Sincerely,
Robert S. Gold, MD
Chair of the OMIC ROP Task Force
  1 “Screening Examination of Premature Infants for Retinopathy of Prematurity.” Policy Statement issued by the American Academy of Pediatrics (AAP) Section on Ophthalmology, the American Association of Pediatric Ophthalmology and Strabismus (AAPOS), and the American Academy of Ophthalmology (AAO). Originally issued in 1997 and updated in 2001, 2005, and 2006; current version published in Pediatrics (Volume 131, Number 1, 2013, at http://pediatrics.aappublications.org/content/131/1/189.
Telehealth Resources
Backline from Dr. First is a Telehealth platform used by MedChi's CTO and can be used by any physician.

Online telehealth Course:  Learn how to implement telemedicine into your practice now. Today until March 31, 2020, MSEPS members will receive and $150 discount. Use the promo code MARYLAND to receive the discount.

Maryland Healthcare Commission
Broadening Telehealth During a Public Health Emergency


MedChi's offers telehealth billing and coding guidelines

MedChi Telehealth FAQs
Financial Resources
Resources to Help Your Small Business Survive the Coronavirus 

Maryland Small Business COVID-19 Emergency Relief Loan Fund

Maryland Small Business COVID-19 Emergency Relief Grant Fund
Additional COVID-19 Resources
Be sure to check these sites regularly for the most up to date information.

AAO
MedChi
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