Volume 113, No. 8Top
August 2017 Edition

They Said It...

"It was more than the physical pain. I was masking the emotional pain, too." Kris McFadden, recovering drug addict, sober for 11 years, current president and CEO of Pa. Adult and Teen Challenge, one of the nation's largest drug and rehab programs. McFadden got hooked on prescription painkillers while being treated for a football injury.

In the News... 

AMA Offers Help with Medicare's New Merit-Based Incentive Payment System A1

The AMA continues to hear from physicians who say they feel unprepared to participate in Medicare's Merit-Based Incentive Payment System. Many physicians, especially those who never participated in Medicare reporting programs, need basic information on how to avoid a payment penalty in 2019 through minimal reporting in 2017.

The AMA has the tools that can help. It has a short video entitled One Patient, One Measure, No Penalty: How to Avoid Medicare Payment Penalty with Basic Reporting. You can find it at: ama-assn.org/qpp-reporting.

Physicians can also find at this website, a sample CMS-1500 claim form, links to quality measures on the CMS website, a link to the CMS MIPS eligibility and other materials.

AMA Releases New MIPS Action Plan A2

The plan is designed to help physicians think strategically about how to successfully implement MIPS in 2017, and avoid penalties.

You can find the plan by going to: https://apps.ama-assn.org/pme/#/actionplan.

No Shots, No School A3

A very different set of rules now exists in Pennsylvania for how much time parents have to get their school-aged children immunized. A new law that goes into effect this school year, requires children to be vaccinated within five days of the opening day of school. Before this year, students had an eight-month grace period to get their shots.

The deadline may be extended, if a doctor provides a medical plan explaining when the vaccines will be given. Parents may also opt out of the immunizations for religious, medical or philosophical reasons.

For more information, Philadelphia residents can visit phila.gov/health. Those living outside the city can visit dontwaitvaccinate.pa.gov.

When a Friend Refuses to Cancel a Party that Only He Wants A4

Over the continued objections of the Pa. Medical Society (PAMED), Independence Blue Cross (IBC) has implemented its new payment policy for physicians using Modifier 25. Effective August 1, when an E&M service is provided on the same day as a procedure with a 0-day or 10-day global period, IBC is cutting the E&M reimbursement by half. It will also reduce the reimbursement for the E&M when it's provided on the same day as a preventive service.

PAMED has opposed the policy change and has requested a meeting with IBC and the state insurance commissioner over the issue. PAMED strongly disagrees that the change will have only a minimal impact on physician practices.

Pa. Drug-Related Overdose Deaths in 2016 Tops 4,600 A5

The number of drug-related deaths in Pa. continues to grow at an alarming rate. Drug-related overdose deaths have soared 37% in just one year. About 13 people a day died from a drug-related overdose. Philadelphia, with by far the largest population among the 67 counties, had the most deaths - 907, followed by 648 deaths in Allegheny County, where Pittsburgh is located.

Fentanyl and fentanyl-related substances were the most frequently identified substance found in the victims, followed by heroin.

Deaths in rural counties rose 42%, compared to a 34% rise in urban counties. Philadelphia dropped in rank from first to fifth in the rate of overdose deaths among the state's 67 counties, despite a 26% increase in the number of overdose deaths in the city.

78% of Pa. counties had overdose death rates higher than the national average.

77% of overdose victims were White, 12% Black, 4% Hispanic.

The report was compiled by the University of Pittsburgh School of Pharmacy and the DEA Phila. Division.

New Guidelines to Prevent Fentanyl Exposure Among First Responders A6

The American College of Medical Toxicologists recently released a new position paper on the subject.

The paper states that dermal toxicity is very low for powdered fentanyl products, and that standard universal precautions, and in some cases an N95 mask for respiratory protection are sufficient protection. The NIOSH has recently updated their guidance on this topic. You can find it by going to: https://www.cdc.gov/niosh/topics/fentanyl/risk.html.

You can find the American College of Medical Toxicologists position paper by clicking here.

How to Sign Up for Medical Marijuana Program A7

The Pa. Dept. of Health now has an online registration process for physicians who want to take part in the Medical Marijuana Program. The registry is at: https://padohmmp.custhelp.com/app/login.

And the Dept. of Health has approved the first two providers who will offer the four-hour training course required for physicians who want to be participate in the Medical Marijuana Program: The Answer Inc, and Extra Step Assurance LLC.

Collapse of Pa. Long-Term Care Insurer Leaves Other Health Insurers with Huge Bill A8

The insolvency of Penn Treaty American Corp. of Allentown, Pa., has put health insurers across the country on the hook for hundreds of millions of dollars.

When insurance companies fail, surviving companies are legally required to help pay off the company's claims, and protect policyholders through what are called state guarantee associations. Analysts say the Penn Treaty liquidation poses a potential shock to the health marketplace. It has long-term claims liabilities of $4 billion, but only about $700 million in assets.

Aetna, the industry's third largest insurer, for example, expects to pay $232 million. Penn Treaty's insurance units have about 73,000 policyholders nationwide. The company's collapse is one more unwelcome charge tacked onto the growing U.S. health tab.

Temple University a Clinical Hub for NIH Emergency Medical Clinical Trials Network A9

Temple University has been selected as one of only 11 clinical hubs for a new National Institutes of Health (NIH) emergency medicine clinical trials network. The network will support clinical trials aimed at improving patient outcomes for neurologic, heart, lung, blood and traumatic emergencies.

The trials will cover all areas of emergency research from the most critical, such as heart attack and traumatic brain injury, to chronic conditions such as asthma and migraine headache, that frequently lead people to the ER.

A Phila. First at Einstein Medical Center -- a"GPS" for the Operating Room A10

Einstein Medical Center Phila. is the first hospital in the city to use the Airo Mobile Intraoperative CT in the operating room.

Einstein officials say the high-tech equipment is a GPS-like navigation system for the human body during surgery. The Airo allows surgeons to see in real time how surgery is going, and make adjustments before surgery is completed.

Mark Kotapka, MD, chairman of the Division of Neurosurgery for Einstein Healthcare Network, has used the equipment during spinal fusions, and while removing tumors from the pituitary gland and brain. Dr. Kotapka said he used the Airo on a patient who "had a tiny tumor removed from her cerebellum. The Airo assisted me in easily locating the tiny mass and ensuring the tumor had successfully been removed."

The device offers surgeons information that can prevent a patient from having to undergo a second surgery.

Pa. Coalition for Civil Justice Reform: This Suit is not a Good Fit A11

The Pa. Coalition for Civil Justice Reform is urging state lawmakers not to try to turn the opioid crisis into a lawsuit cash cow.

The coalition says that unlike the successful tobacco suits of the 1990s, opioid lawsuits would go up against drug company products that are regulated by the Food and Drug Administration. The agency's approval of these products would be evidence in court of their safety and effectiveness.

A House resolution - HR 363 - and an expected Senate resolution, would explore the possibility of a lawsuit. Attorney General Josh Shapiro has announced that he is also looking into such a suit.

You Can Help Fulfill a Dream A12

The Society of Ibero Latino American Medical Professionals (SILAMP) is looking for volunteers to mentor Latino-American college students interested in a health care career, or students already enrolled in a health care program, or early career professionals.

SILAMP is seeking ways of encouraging these individuals, including helping them to gain access to research and other professional opportunities. For more information contact Natalia Ortiz, MD, FAPA, FAPM, president of SILAMP, at Natalia.Ortiz@tuhs.temple.edu.

PAMED Wants Your Opinion A13

The Pa. Medical Society wants to know what you think of the Pa. Supreme Court ruling on informed consent. The high court recently ruled that a physician may not delegate to others the physician's obligation to provide sufficient information to obtain informed consent. The court concluded that the duty to obtain a patient's informed consent is a non-delegable duty that must be carried out by the physician conducting the surgery or treatment.

PAMED is conducting a survey to determine what impact the ruling will have on you. You can take part in the survey until August 14, by clicking here.

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17 - How to Succeed With 2017 MACRA

Date: Thursday, August 17
Time: Noon - 1:30 PM
Place:The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

To all Philadelphia Practice Managers and Physicians: Join us for a practical review of MACRA/MIPS in 2017. Learn how to create a plan that will avoid penalties and optimize your incentive and potential bonus.

6 - Doctors on Call

Date: Wednesday, September 6
Time: 4:30 PM - 6:30 PM
Place: KYW- TV 3, 1555 Hamilton Street, Philadelphia, PA 19130

Doctors on Call is a live TV program where viewers in the Philadelphia area can call a toll-free number and ask questions of member physicians on any medical topic. Member volunteers discuss with patients their concerns and answer questions in general terms. (We do not offer diagnoses or specific medical advice.) 12-16 volunteers are needed.

7 - Reimagining Health in Cities: From Local to Global

Date: September 7 - 8
Place: Drexel University, Dornsife School of Public Health, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104

The symposium will bring together researchers, practitioners and policy makers focused on health in cities across the United States and worldwide, to energize work on urban places and health, generate novel ideas for research, and stimulate debate on policy implications.

13 - House of Delegates

Date and Time: Friday, October 13, 8:00 AM - Sunday, October 15, 2:00 PM
Place: Hershey Lodge in Hershey, Pa.

Join your colleagues for a lively, informative weekend of continuing education, leadership development, advocacy, and networking at the Pennsylvania Medical Society's (PAMED's) House of Delegates Meeting and Annual Education Conference.

19 - EMR Physician Listening Session

Date: Thursday, October 19
Time: 6:30 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

CMS recently announced a new initiative to increase physician engagement. The initial goal will be to engage with physicians to learn about burdens placed upon physicians through regulatory and CMS program requirements. We are looking for 25 physicians to participate so that CMS can learn about the burdens placed upon you regarding EMR and documentation requirements and the barrier to achieving success because of those requirements.

Philadelphia County Medical Society | stat@philamedsoc.org
215-563-5343 | http://philamedsoc.org