Volume 114, No. 1Top
January 2018 Edition

They Said It...

"When the Harvey Weinstein thing came up, I said, 'yeah that's about right.'" A Philadelphia female physician commenting on her sexual harassment experiences while working in the medical profession. Her comments are part of an article on sexual harassment in our profession and in our area, in the latest issue of the magazine edition of Philadelphia Medicine. Click here to view it electronically. The magazine will also soon be in your mailbox.

In the News... 

Gov. Wolf Declares Heroin and Opioid Epidemic a Statewide Disaster Emergency A1

Gov. Wolf has issued a first-of-its kind public health emergency declaration regarding the heroin and opioid epidemic in the state. The emergency declaration outlines 13 initiatives that include: establishing an emergency command center at the Pa. Emergency Management Agency; expanding access to the prescription drug monitoring program; ensure that there is an uninterrupted 24/7 helpline. So far, more than 18,000 callers have used the helpline to find out how to get treatment.

"While we have made progress in combatting the heroin and opioid abuse crisis and drastically expanded Pennsylvania's response, we are still losing far too many Pennsylvanians," Governor Wolf said. "I am taking this step to protect Pennsylvanians from this looming public health crisis, and I am using every tool at my disposal to get those suffering from substance use disorders into treatment."

You can get the complete list of initiatives and other information by going to https://www.governor.pa.gov.

Aetna Starts New Opioids Policy A2

The policy limits the quantity of opioids prescribed for acute pain and post-surgery to a seven-day supply. It also waives co-pays for the opioid-reversal drug Narcan for its fully-insured commercial members. Aetna joins others, including three pharmacy benefit managers - CVS Caremark, Express Scripts and Optum RX - who have also made similar changes to conform to new CDC guidelines on the issue.

Aetna has also announced five-year goals to fight the epidemic. You can find them by going to https://news.aetna.com/2017/06/aetna-sets-five-year-goals-fight-opioid-epidemic/.

Ten Takeaways for the MACRA/QPP Final Rule... A3

1 - The low-volume threshold has been expanded.

2 - CMS has indicated how the four MIPS performance categories will be weighted.

3 - There will no longer be an option to participate and avoid a penalty by submitting at least one measure for one patient.

4 - The performance threshold has been increased from three to 15 points as a minimum number of points required to avoid a five percent penalty in 2020 for performance in 2018.

5 - Clinicians and practices can earn a 10 percent bonus for using only 2015 CEHRT.

6 - A virtual group participation option is new for PY 2018, which consists of a combination of two or more taxpayer identification numbers (TINs).

7 - More flexibilities for practices of 15 or fewer clinicians.

8 - Up to five points can be awarded on MIPS final scores for the treatment of complex patients.

9 - CMS is taking steps to increase APM participation.

10 - CMS says it has created the final rule to provide clarity and additional details on many aspects of the program.

You can find all the details on the CMS final rule by going to https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-24067.pdf.

Starting on January 15, Novitas Will Deny Claims that Use NOC Codes Incorrectly A4

Novitas Solutions will reject Medicare Part B claims that use Not Otherwise Classified (NOC) Healthcare Common Procedure Coding System (HCPCS) codes incorrectly.

Claims for services received on or after Jan. 15, 2018, will be denied if they contain a description in the narrative field describing a procedure or service in cases where a valid HCPCS/CPT code exists, Novitas says.

Claims for all drugs and biologicals should be reported using the HCPCS/CPT code which most accurately describes the drug and/or biological. The reported units of service for the code should be consistent with the quantity of a drug/biological.

NOC codes can be used only if an HCPS Level II code or Current Procedural Terminology (CPT) code that describes the service is not available.

For more details on the policy, access Novitas' website at www.novitas-solutions.com, access the webpage for Jurisdiction L, and enter "Appropriate Use of Not Otherwise Classified Codes" in the search field.

CMS to Hold Quality Payment Program Webinars in Our Region A5

The Philadelphia Regional Office of CMS has announced two upcoming webinars for the Quality Payment Program (QPP).

MIPS Reporting for the 2017 Performance Year:
Tuesday, January 23, 2018 at 1:00 PM EST

Click Here to register and for more information.

Year 2 of the Quality Payment Program (Rescheduled)
Tuesday, February 6, 2018 at 1:00 PM EST

Click Here to register and for more information.

If you are interested in either of these calls, please register by visiting the above links.

Pa.'s Medical Marijuana Program on Track for 2018 Implementation A6

Pa. Dept. of Health (DOH) Acting Secretary Rachel Levine, MD, announced that implementation will begin in the early part of this year. In her letter, Dr. Levine included information on the steps physicians can take to register if they wish to participate in the program. So far, 10,135 patients and 550 physicians have registered.

PCMS will host a Medical Marijuana 101 informational meeting on Thursday, February 15 at the PCMS building. Details follow in our "Dating Service" section of the newsletter.

Sharp Increase in Influenza A(H3N2) in Pa. A7

The more serious strain of the flu, Influenza A(H3N2), has become the predominant circulating subtype this winter, infecting 90 percent of those tested so far. Flu seasons where A(H3N2) predominates are typically associated with more hospitalizations and deaths in persons 65 years old and older and young children. The effectiveness of the vaccine also tends to be lower when A(H3N2) is the dominant strain.

The Pa. Dept. of Health (PADOH) recommends that hospitalized, severely ill and high-risk patients be treated with anti-viral medications; that influenza testing take place for patients with symptoms; that all flu-related hospitalizations and deaths be reported individually to PA-NEDSS.

By January 6, Philadelphia had documented 190 Influenza A cases.

PADOH posts current influenza surveillance data weekly at: http://www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/I-L/Pages/20172018-Influenza-Season.aspx#.WlfgiainGUk.

Phila. Dept. of Public Health Issues Changes Concerning Zika Testing A8

PDPH now recommends that health care providers discontinue Zika virus testing for pregnant women who recently had a Zika exposure through travel or sexual contact but are asymptomic and well-appearing newborns whose mothers were exposed to Zika during pregnancy and tested negative or were not tested for Zika.

CDC recommended these changes last July, due to the decline in the outbreak in the Americas, and the increased potential for a false positive.

Those who should continue to be tested, are:

- Pregnant and non-pregnant women with Zika-specific symptoms within two weeks of a Zika exposure;

- Exposed, pregnant women who have a fetal loss or prenatal ultrasound findings consistent with congenital Zika virus syndrome;

- Newborns with possible maternal exposure and clinical findings consistent with congenital Zika syndrome;

- All newborns whose mothers have laboratory evidence of possible Zika virus infection during pregnancy.

Further information on specimen collection and appropriate Zika virus test selection is available at: https://hip.phila.gov.

PAMED Calls on Congress and the President to Allow DACA Program to Continue A9

Theodore Christopher, MD, president of the Pennsylvania Medical Society, has released a statement urging the president and Congress to resolve the DACA situation by allowing those who are part of the DACA program to renew their work permits.

Without a positive resolution, Dr. Christopher says the country will lose about 100 promising medical students.

"At a time when the demand on health care is growing," Dr. Christopher stated, "now is not the time to send these up-and-coming physicians away. And the same can be said about those studying to become nurses, physician assistants, and other health care professionals.... Congress should work to keep this talented group of individuals here where they are needed."

Dating ServiceDatingService

30 - The Child Abuse Reporting Training Program

Date: Tuesday, January 30, 2018
Time: 6:00 PM - 8:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

Under the amended Child Protective Services Law (CPSL), all physicians must complete approved training on child abuse recognition and reporting, as a condition of licensure. The Philadelphia County Medical Society will host a "Live" state approved CME program that meets this requirement for the 2018 licensing cycle. This program is FREE for all physician members.

13 - Tax Cuts and Jobs Act: How The New Tax Code Will Affect You and Your Practice

Date: Tuesday, February 13, 2018
Time: 6:30 pm - 8:00 pm
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

PCMS will host an informational program to help the members gain insight on the Tax Cuts and Jobs Act, a sweeping $1.5 trillion tax-cut package that fundamentally changes the individual and business tax landscape, and its impact on physicians.

15 - Introduction to Medical Marijuana in Pennsylvania

Date: Thursday, February 15, 2018
Time: 6:30 PM - 8:00 PM
Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130

The Pennsylvania Department of Health is in the process of implementing the state's Medical Marijuana Program, signed into law on April 17, 2016. When fully implemented in early Spring of 2018, the Medical Marijuana Program will provide access to medical marijuana for patients with a serious medical condition.

The PCMS intro to medical marijuana program is informational only and seeks to provide physicians, resident/ fellows and medical students with additional information and resources to better understand the program.

Click Here to Register

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