April 16, 2021
Medical Licensure Extended Until June 30, 2021
On March 31, 2021, as part of the response efforts to the Novel Coronavirus 2019 (COVID-19), FL State Surgeon General Dr. Scott A. Rivkees issued Emergency Order 21-001 extending the licensure renewal expiration date for any professional license issued by the Department or a Department board or council until June 30, 2021. https://www.flhealthsource.gov/pdf/DOH-EO-21-001.pdf
 
The license expiration date for Medical Doctors expiring January 31, 2021 is further extended to June 30, 2021.
Save the Date for Upcoming CMS Meetings/Events
CME Resources
Wolfson Pediatric CME Webinar - Pediatric Vascular Anomalies: Interdisciplinary Case Study Reviews - 1.75 CME Credit Opportunity
Join us for this unique case study CME webinar presented by several of our interventional radiology, otolaryngology, and hematology/oncology physicians. Cutting-edge clinical techniques, interdisciplinary collaboration, and treatment management plans used to achieve positive outcomes for patients suffering from complex vascular malformations will be discussed.

Tallahassee Orthopedic Clinic Foundation Sports CME Webinar - 2.0 CME Credit Opportunity
Please join us for this webinar series which aims to provide a greater understanding of the management of common sport & activity related orthopedic pathologies. The Sports Medicine webinar series will provide a complete overview of the management of sport & activity related ankle sprains, rotator cuff pathology, atraumatic spine injuries/chronic pain, and trunk/core muscle injuries for community providers.

PRIME Virtual Meeting - Impact of Earlier Treatment on Visual Outcomes in Retinal Diseases - 0.5 CME Credit Opportunity
Rapid progression to severe vision loss following the onset and diagnosis of retinal diseases underscores the need for timely initiation of treatment. Despite advances in anti-VEGF therapy, optimal patient visual outcomes are impacted by delays in treatment. Join this live discussion to examine critical considerations for prompt therapy initiation to support optimal visual outcomes.

Wolfson Pediatric CME Webinars - 5.5 CME Credit Opportunity
Wolfson Children’s Hospital is proud to provide Continuing Medical Education opportunities to our partners and referring providers by offering monthly virtual CME sessions at no cost. If you have missed any of our previously offered live webinars and still wish to obtain CME credit for them, we have provided 4 recorded webinars for a total of 5.5 CME credits possible. Please follow the instructions below in order to take advantage of this opportunity!
 
1.      Open the flyer and choose which education session you would like to watch.
2.      Click the link in the attachment for the desired education session.
3.      Watch the webinar.
4.      Follow the instructions included in the video description to complete the required survey and input the associated activity code.
*Please note, if you are licensed outside of the state of Florida, you must contact the CME office at [email protected] to request an official transcript of your participation.

Easy to use web portal makes it easy to find courses and track credits. Accredited activities for over 30 medical specialties; Over 100 active courses at any given time; Activity accreditations include ACCME, ANCC, AANP, ACPE, and more; Content is always current, and always free.
 
Free 1-hour online CME opportunity!
University of Florida's Department of Epidemiology
Raising awareness for Alzheimer's disease and increasing screening for cognitive impairment. This CME has a focus on primary care physicians but is applicable to all physicians who may encounter patients with cognitive impairments.
Johnson & Johnson Vaccine And Blood Clots: What You Need To Know
Federal health officials have called for a "pause" in the use of the Johnson & Johnson vaccine after reports that six women who got the vaccine developed blood clots afterward. Close to 7 million people have gotten this vaccine in the U.S. to date.

The Centers for Disease Control and Prevention says the blood clots are extremely rare but that it is reviewing the cases. The agency says it expects this pause to last for "a matter of days."


Source: Health News Florida
J&J COVID-19 Vaccine
American Medical Association President, Susan R. Bailey, MD, hosted a conversation with Peter Marks, MD, PhD, Director of the Center for Biologics Evaluation and Research at the Food and Drug Administration as part of the AMA's ongoing webinar series for physicians on COVID-19 vaccines. The most recent webinar focused on the Johnson & Johnson (Janssen) vaccine. 
 

Source: AMA/FDA
Inhaled Steroid for Early COVID-19 Passes Another Test
Inhaled budesonide (Pulmicort), commonly used in asthma, helped COVID-19 outpatients at extra risk for severe illness recover more quickly relative to standard care in the pragmatic PRINCIPLE trial, British researchers said.

In an updated analysis of interim data, through March 25, duration of illness was significantly shorter in the 751 patients assigned to budesonide -- by 2.6 days (95% CI 1.0-4.7) -- versus standard care, reported Christopher C. Butler, FMedSci, of the University of Oxford in England, and colleagues writing in a medRxiv preprint manuscript that had not been peer reviewed.


Source: MedPage Today
The Race for Antiviral Drugs to Beat COVID - And The Next Pandemic
The year 2003 was an ominous one for emerging infectious diseases. A pair of deadly influenza strains had leapt from birds to humans in Hong Kong and the Netherlands. And a new coronavirus was spreading around the world causing a mysterious illness that became known as severe acute respiratory syndrome, or SARS. Many experts feared they were watching the start of a global pandemic.
 
Fortunately, the worst-case scenario never materialized. But it was a close-enough call for Robert Webster, a leading authority on avian influenza, to start urging scientists and policymakers to prepare for the next outbreak. One of his top recommendations: develop and stockpile drugs that target a wide range of viral pathogens.


Source: Nature
CDC Studies 'Breakthrough' COVID Cases Among People Already Vaccinated
COVID-19 vaccines are highly effective but don't always provide perfect protection. Some vaccinated people later exposed to the virus still get sick. Why and how often that happens is under study.


Source: Health News Florida
Delta, American, United, and Other Major Airlines Signal Rejection of New CDC guidance Saying They Should Block Middle Seats
The Centers for Disease Control and Prevention just reignited the debate on whether airlines should be blocking middle seats just as airlines thought it was settled. 
 
A newly publicized study found that maskless flyers could spread COVID-19 at a higher rate when middle seats were not blocked, Insider's Hilary Brueck reported. Flyers on opposite ends of a three-seat row with the middle open reduced their risk of exposure by 57%, the study said.


Source: Business Insider
COVID Spawns ‘Completely New Category’ Of Organ Transplants
COVID-related transplants are surging as hospitals grapple with a growing subset of patients whose organs are “basically destroyed by the virus,” said Dr. Jonathan Orens at Johns Hopkins School of Medicine.


Source: Health News Florida
Florida Education Chief: Masks Should Be Voluntary In Schools
Florida Education Commissioner Richard Corcoran on Wednesday asked school superintendents to revise their school district’s mask policy, if they have one, to be voluntary instead of mandatory for the 2021-22 school year. In a memo to school superintendents, Corcoran bolded and underlined reasons that he says are why districts should make masks voluntary.
 

Source: Health News Florida
A Pandemic That Endures For COVID Long-Haulers
As public health officials race to vaccinate Americans amid the rapid spread of viral variants, physicians and scientists are turning their attention to a growing population of those who seem locked into COVID-19’s misery months after the acute phase has passed. These so-called “COVID long-haulers” or sufferers of “long COVID” are those who continue to feel symptoms long after the days or weeks that represent a typical course of the disease. These patients tend to be younger and, puzzlingly, in some cases suffered just mild initial conditions.


Source: The Harvard Gazette
Learn EM Newsletter by Dr. Sam Ashoo - April 8, 2021
It has been a couple of weeks since the last newsletter. Vaccine distribution in the U.S. continues to increase with approximately 112 million people having received at least one dose, and 66 million people fully immunized. Pockets of COVID-19 outbreaks are occurring in numerous states however Michigan is experiencing a significant outbreak with daily case numbers and hospitalizations nearing the pandemic peak in December. Most of these areas are also seeing a significant rise in B117 variant activity, which is thought to be the cause for the increasing cases. Unfortunately, this is a very concerning trend.


Source: Dr. Sam Ashoo
Read This If You Order/Refer Anything For Patients With Medicaid
"But I don't accept Medicaid" you may say. However, if you have a patient who has Medicaid or a Medicaid Advantage Plan that would normally cover the ordered item, the following will apply to you. Keep in mind that, if you prescribe a medication, order a test, home health, or DME and Medicaid might pay for the item (perhaps as secondary payer), if you are not enrolled, Medicaid will not pay for the item as of October 1st.
 
Medicaid has created a special enrollment path for providers who only need to have Medicaid recognize them as Referring, Ordering, Prescribing, or Attending (ROPA) Provider. 
 
For Assistance:
Florida Medicaid features a quick and easy, automated ROPA provider enrollment application on the Florida Medicaid Web Portal Enrollment Application Wizard page.
 
Please visit the ROPA Provider Enrollment page of the Web Portal for updated information, including the recently created Unenrolled ROPA Provider List, ROPA Providers Frequently Asked Questions and Quick Reference Guides on ROPA provider enrollment and claims billing.
 
Providers may call the Provider Services Contact Center at 1-800-289-7799, option 7, for billing assistance and option 4 for enrollment assistance.

Source: Acevedo Consulting
Cancer Vaccine Shows Durable Immune Effects
recent study showed that personalized cancer vaccines designed to fight melanoma, the deadliest form of skin cancer, maintain their effects on the immune system years after inoculation — another step in efforts to harness the immune system as an ally in the fight against cancers of all kinds.


Source: The Harvard Gazette
Pathophysiology of Type 2 Diabetes Mellitus
Type 2 diabetes can significantly impact quality of life by introducing a considerable number of potential long-term complications, as well as posing high treatment. Watch this Medical Economics Around the Practice series, for an in-depth discussion on: Pathophysiology, diagnostic process and economic burden of the disease; Overall landscape, patient counseling, and other considerations for insulin therapy; The role of insulin pumps in disease management, from patient selection criteria, education and benefits to a comparison of pums in use today.


Source: Medical Economics
How Chronic Stress Leads to Hair Loss
Harvard University researchers have identified the biological mechanism by which chronic stress impairs hair follicle stem cells, confirming long-standing observations that stress might lead to hair loss.


Source: The Harvard Gazette
Reported STDs Reach All-Time High for 6th Consecutive Year
New CDC data show that reported annual cases of STDs in the United States continued to climb in 2019, reaching an all-time high for the sixth consecutive year.



Source: Centers for Disease Control and Prevention (CDC)
How to Use Tax Diversification To Reduce Taxes Now AND in Retirement
Paying attention to your taxes now AND your taxes later will give you the tax diversification and freedom you’ll want during retirement. A tax diversified portfolio should be made up of tax-deferred, Roth, and taxable accounts.
 
Most doctors are aware of the importance of diversifying their portfolios among various “asset classes” such as stocks, bonds, and real estate (and within those asset classes as well) to spread their money across a large number of individual securities or properties. This move prevents the investor from making the classic mistake of putting too many eggs into one basket, which could lead to financial ruin in the event of a market downturn in a single security or asset class.
 
However, too few have applied these same principles to the taxation of our assets when it comes time to spend them.


Source: White Coat Investor
What to Know About Required Minimum Distributions (RMDs)
In 2020, the CARES Act was passed with a one-year Required Minimum Distribution (RMD) waiver for IRAs, qualified employer-sponsored retirement plans and governmental 457(b)s. Now that it's 2021, RMDs resume.


Source: Allen Mooney Barnes, Investment Advisors
ABIM Extends Maintenance of Certification Requirement Deadlines Through 2022
Board-certified physicians are getting another extension on the deadline to maintain their internal medicine credentials.

In light of the COVID-19 pandemic, the American Board of Internal Medicine (ABIM) once again extended the Maintenace of Certification (MOC) requirements through December 2022.


Source: Fierce Healthcare
Leon County Mask Mandate Still In Effect
The Leon County mask mandate added to the Leon County Amended Emergency Ordinance No. 20-15 is still in effect. The ordinance states that an individual in a business establishment in Leon County must wear a face covering while in that business establishment.
 
A business establishment means a location with a roof overhead under which any business is conducted, goods are made, stored or processed, or where services are rendered. The term “business establishment” also includes locations where non-profit, governmental, churches, and quasi-governmental entities facilitate public interactions and conduct business. Also, as part of the requirement, all businesses must post a notice visible to all customers that face coverings are required while indoors. An example sign can be found here.
 
Facial coverings are not required to be worn by the following persons:
 
  • Persons under the age of six years;
  • Persons who have trouble breathing due to a chronic pre-existing condition or individuals with a documented or demonstrable medical problem. It is the intent of this provision that those individuals who cannot tolerate a facial covering for a medical, sensory, or any other condition which makes it difficult for them to utilize a facial covering and function in public are not required to wear one;
  • Persons in their private rooms of a lodging establishment, such as a hotel, motel, or vacation rental—however, face coverings must be worn in all indoor commons areas of said establishment;
  • Persons exercising while observing at least six feet of distancing from another person;
  • Restaurant and bar patrons eating or drinking
  • Business owners, managers, and employees who are in an area of a business establishment that is not open to customers, patrons, or the public, provided that six feet of distance exist between persons.

The ordinance will remain in place until repealed. A copy of the ordinance and frequently asked questions are posted to the Leon County Emergency Information Portal at www.LeonCountyFL.gov/ei. For additional questions regarding the mask mandate ordinance, please call Leon County Administration at 850-606-5300.

For additional information on COVID-19, the Florida Department of Health has activated a 24/7 COVID-19 call center at (866) 779-6121. Leon County residents can also call the County Health Department at (850) 404-6300, Monday through Friday from 8 a.m. to 5 p.m. Also, the best resource for Florida-specific COVID-19 information remains the following FDOH website: www.FLHealth.gov/COVID-19.


Source: Office of Economic Vitality
Free Face Coverings Available at OEV
Face coverings are available at the Tallahassee-Leon County Office of Economic Vitality (315 S. Calhoun Street, Suite 110, Tallahassee, FL, 32301) Monday through Friday from 9 a.m. to 5 p.m. A business with one location is eligible for up to 100 face coverings. Local businesses with multiple locations are eligible for up to 200 face coverings. For FAQs regarding the distribution of masks to businesses, click here

Source: Office of Economic Vitality
Some Days Just Aren't As Bright As Others
No denying that the last 12+ months could have been a bit better and brighter. If your days don't seem as bright, we hope you take advantage of this program. The CMSF's Physician Wellness Program will pay for up to six completely confidential wellness coaching sessions with any of the counselors enrolled in our program (contact information below). Pick up the phone and call any of the resources noted below. Telehealth options available during COVID-19. 
 
Special thanks to MagMutual Foundation and others who are helping the CMSF fund this program.
 
Local Wellness Coaching Resources:
  • Paul Deitchman, Ph.D. - 850-878-3571
  • Tracey Morse, Ph.D. - 850-556-7944
  • Debra Weaver, Ph.D. - 850-942-5585
  • Stephen Wright, Ph.D. - 850-222-3045

C. Vincent Dix, Ph.D. has announced his retirement effective March 31, 2021. We appreciate the services Dr. Dix has provided to local physicians since the inception of the Capital Medical Society Foundation's Physician Wellness Program in 2017.

To view Physician Wellness resources, click here.
Coronavirus - Information, Updates, Resources
Updates and Resources

The State-Level COVID-19 profile for Florida. This data is collected from medical facilities in one of two system HHS protect or National Healthcare Safety Network  
 and the White House Coronavirus Task Force analyzes and distributes the report.
   
The New England Journal of Medicine - A collection of articles and other resources on the Coronavirus outbreak, including clinical reports, management guidelines, and commentary
 
Epidemiological and Clinical Resources For The COVID-19 Pandemic
 
CDC Healthcare Supply of Personal Protective Equipment
 
CDC Guidance for People at Higher Risk for COVID-19 Complications
 
CDC PPE Poster
 
CDC Guidance for Travelers from Countries with Widespread Sustained (ongoing) Transmission Arriving in the United States
 
CDC Communication Resources
 
NETEC coronavirus page includes PPE validation checklists and video resource, in addition to many others:
 
 
From the Florida Medical Association: Coronavirus Educational Resource Center

Vaccine Updates

 
See the latest state Department of Health data summarizing the number of people in Florida who have either received their first dose of the COVID-19 vaccine or completed the vaccine series (FMA) 
 
 (Florida Department of Health in Leon County)
 
(Florida Department of Health in Leon County) 
 
 
(Centers for Disease Control and Prevention)
 
 
COVID-19 Pandemic Planning FAQ (dated 11/19/2020) includes important information regarding procurement and handling of costs for vaccine administration. (FEMA) 
 
What Happens Once There is a COVID-19 Vaccine? Key Challenges to Vaccinating America (12/3/2020) - VIDEO or SLIDES (Kaiser Family Foundation) 

Reporting for Health Care Providers and Laboratories

 
 
 
 
Notable recent additions to CDC guidance include more detailed infection prevention and control recommendations for health care settings: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html.

Please continue to closely monitor the CDC novel coronavirus website for situation and guidance updates. https://www.cdc.gov/coronavirus/2019-nCoV/index.html.

If you have any patients who meet the person under investigation criteria, please contact the Florida Department of Health in Leon County Epidemiology Program at 850-404-6299.
 
Epidemiology and Disease Control Program
Florida Department of Health in Leon County
2965 Municipal Way,
Tallahassee, FL 32304
Office Number: (850) 404-6299 
Confidential Fax: (850) 921-9855
Public Service Announcement - "Don't Put It Off!"
Capital Medical Society Partners With Local Hospitals and Physicians to Encourage Patients to Seek Needed Healthcare Through Public Service Announcement, "Don't Put It Off!" 
 
Click here to view the PSA: "Don't Put It Off!" 
Cap Scan Series: "Portraits in COVID-19" - Please Share Your Experience
Capital Medical Society is accepting stories for its Cap Scan magazine from CMS and CMSA members as part of an occasional series called "Portraits in COVID-19," to capture the changes happening in healthcare and our personal lives due to COVID-19 as experienced by physicians and laypeople. These stories can be about your experiences treating COVID-positive patients, supporting patients and coping with families during "no visitation," entering the world of telehealth, concerns about PPE shortages, distancing from your own families, family celebrations by social distancing, newfound time with family, newbie ZOOM meeting experiences worthy of an SNL skit, staycations extraordinaire, or schooling from home. You get the idea. Please try to stay within 800 words, include a photo if it makes sense, and be mindful of HIPAA, if writing about a patient experience. Please send by email to Shannon Boyle at [email protected]. All submissions are reviewed by the Cap Scan editor prior to publication.
Not All Superheroes Wear Capes! We Salute Our PPE Donors and Volunteers!
COVID-19 Donations Needed
Rx for Miracles
Florida RX Card has created a new program and resource card to help Children's Miracle Network children and families in need. This card will work just as Florida Rx Card, helping people save on their prescription medications. 

The flyer explains the program and can be used to share/download the app.
Informed Webinar Series: Understanding the CMS Proposed Rule: Reducing Provider and Patient Burden by Improving Prior Authorization Processes
On December 11, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would improve the electronic exchange of healthcare data among payers, providers, and patients. If finalized, the CMS rule would streamline processes related to prior authorization with the goal of reducing the burden on providers and patients. Medicaid, CHIP (Children's Health Insurance Program), and QHP (Qualified Health Plan) payers would be required to build and implement FHIR-enabled APIs that could:
 
  • Allow providers to know, in advance, what documentation would be needed for each different payer. 
  • Streamline the documentation process. 
  • Enable providers to send prior authorization requests (and receive responses electronically) directly from the provider's EHR or other practice management system.
 
Start to HEAL - 8-Week Lecture Series
Do you have patients who could benefit from learning how to live a healthier lifestyle? Are you interested in how diet can aid in disease reversal? Dr. Andria Klioze, founder of HEAL (Healthy Eating. Active Life) has 20+ years of data and experience that will help your patients (and you!) become healthier from top to bottom. This is an 8-week virtual series.
 
 
Source: HEAL 
PAP Machine Donations Needed!
A PAP (Positive Airway Pressure) machine is an electronic respiratory ventilation device used to treat obstructive sleep apnea. Capital Medical Society Foundation, Inc.'s We Care Network program assists low-income, uninsured adults, whose income is at or below 150% of the Federal Poverty Level, with obtaining these potentially life-saving medical devices, when prescribed by a pulmonologist. Thanks to our partners at Desloge Home Oxygen and Medical Equipment, Inc., we are able to provide refurbished CPAP, AutoPAP, and BPAP machines for eligible We Care Network patients in Leon, Gadsden, Jefferson, and Wakulla Counties. We Care Network also accepts unused, unopened supplies for PAP machines, such as masks, nasal cannulas, and tubing. We Care Network coordinates over $8,000,000 in donated specialty medical and dental care annually.
 
Machine donations can be dropped off at Capital Medical Society Foundation's office at 1204 Miccosukee Road, Tallahassee, FL 32308. Donations to Capital Medical Society Foundation are tax-deductible within IRS guidelines Federal Tax I.D. #: 59-2104510. For additional information, please call 942-5215 or email [email protected].
You Can Support the CMS Foundation! Sign Up and Shop Today on AmazonSmile!
For eligible purchases at AmazonSmile, the AmazonSmile Foundation will donate 0.5% of the purchase price to the Capital Medical Society Foundation! 
 
Click here to access AmazonSmile and support the CMS Foundation today!
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