April 9, 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.
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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.
-         Tuesday, April 20th, 6-7:30pm EST
-         1.75 CME credits available
-         No cost to attend
-         Register here: PediatricAnomalies.Eventbrite.com

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 Kimberly.Branham-Nelson@bmcjax.com 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 Shortage Cuts Florida Supply Next Week, Down Nearly 270k Doses
Florida’s weekly allotment of vaccines for COVID-19 from the federal government will take a big hit from this week’s record numbers after a major reduction in the one-dose Johnson & Johnson supply, but the state will still be getting more than 500,000 initial doses from either Moderna and Pfizer.

After getting more than 300,000 doses of the J&J vaccine this week, Florida is only in line to receive 37,000 the week of April 12, according to data released by the U.S. Department of Health and Human Services on Wednesday.

Source: Orlando Sentinel
DeSantis Bans COVID-19 'Passports' Under Executive Order
Gov. Ron DeSantis on Friday issued an executive order barring government agencies from issuing COVID-19 “passports” and preventing Florida businesses from requiring customers to show documentation that they have been vaccinated or have recovered from COVID-19 before gaining entrance.
The order directs state agencies --- such as the Department of Business and Professional Regulation and the Agency for Health Care Administration, which regulate bars and restaurants and nursing homes and hospitals, respectively --- to “work to ensure businesses comply with this order.”

Source: Health News Florida
Moderna's COVID Vax Produces Antibody Responses 6 Months Later
Antibodies persisted 6 months after the second dose of Moderna's COVID-19 vaccine in younger and middle-age adults, but were diminished in older adults when using more sensitive assays, according to data from an ongoing phase I trial.

Antibody activity was high across groups at day 209, but assessment with a "live virus" neutralization test found geometric mean titers declined more over time in participants ages 56 and older compared with adults ages 18-55, reported Mehul Suthar, PhD, of Emory University School of Medicine in Decatur, Georgia, and colleagues in a correspondence piece in the New England Journal of Medicine.

Source: MedPage Today
Patients Allergic to COVID Vax Got Dose 2 With Graded Dosing
A graded dosing protocol allowed two patients with hypersensitivity reactions to the first dose of Moderna's COVID-19 vaccine to receive their second doses safely, researchers said.

The patients -- one with an immediate hypersensitivity reaction managed on site and one needing emergency department transport -- got divided second doses, reported S. Shahzad Mustafa, MD, of Rochester Regional Health in Rochester, New York, and colleagues.

Three to four weeks after receiving the second dose, both patients had IgG antibodies against the spike protein of COVID-19, "suggesting vaccination was efficacious despite the graded dosing protocol," they wrote in Annals of Internal Medicine. One had no reaction to the second dose while the other experience some non-serious allergic symptoms.

Source: MedPage Today
Guillain-Barre After COVID-19 Vaccine: Case Report
A case report revealed details about a person who developed Guillain-Barré syndrome (GBS) 10 days after receiving a COVID-19 vaccine in a clinical trial in Boston.

The patient, a 60-year-old woman with a history of migraines, received the Johnson & Johnson one-dose vaccine and recovered from GBS after intravenous immunoglobulin (IVIG) treatment, reported Anthony Amato, MD, of Harvard Medical School in Boston, and co-authors, in Neurology.

Source: MedPage Today
COVID on the Brain: Neuropsych Diagnoses Common Within 6 Months of Infection
One-third of COVID-19 survivors received a neurologic or psychiatric diagnosis within 6 months of being infected with SARS-CoV-2, an analysis of 236,000 electronic health records showed.

Incidence of any diagnosis of a neurologic or psychiatric disorder was 33.62% (95% CI 33.17%-34.07%), according to Paul Harrison, FRCPsych, of University of Oxford in England, and co-authors.

About one in eight (12.84%, 95% CI 12.36%-13.33%) had never received a neuropsychiatric diagnosis prior to SARS-CoV-2 infection, the researchers reported in The Lancet Psychiatry.

Source: MedPage Today
Prevalence of SARS-CoV-2 Infection in Children Without Symptoms of Coronavirus Disease 2019
During the coronavirus disease 2019 (COVID-19) pandemic, determination of prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children without symptoms of COVID-19 is critical to guide infection control policy. While estimates have been reported in children undergoing emergency surgery1 and oncologic care,2 these small studies have limited generalizability to large populations of children without symptoms. When children's hospitals resumed elective medical and surgical care in April and May 2020, many implemented routine SARS-CoV-2 testing for children presenting for care not associated with suspicion of COVID-19. Here, we report the prevalence of positive SARS-CoV-2 test results in children without symptoms at 28 children's hospitals across the US.

Source: JAMA
Assessment of Protection Against Reinfection with SARS-CoV-2 Among 4 Million PCR-Tested Individuals in Denmark in 2020: a Population-Level Observational Study
SARS-CoV-2, the cause of the COVID-19 epidemic, has resulted in over 117 million cases and over 2·6 million deaths worldwide as of March 7, 2021, as estimated by WHO. The presence or absence of protective immunity after infection with, or vaccination against, SARS-CoV-2 will affect transmission of the virus and severity of illness.1 The absence of pre-existing immunity to SARS-CoV-2 is thought to be responsible for the rapid spread of the virus globally and for the continuing pandemic. Therefore, greater understanding of the degree of protection against reinfection with SARS-CoV-2 is essential to refine appropriate intervention strategies.

Source: The Lancet
Dunking on COVID: NBA Installs Clear Health Pass Tech as Arenas Refill
After bursting its own bubble for the 2021 season, the NBA has come up with a new protocol to protect players, fans and employees from the spread of COVID-19.
The league and Clear have formed a new dream team, with the latter’s health pass technology now available for use by all NBA venues across the U.S., about one-third of which are already using the company's digital tools to screen fans or employees for compliance with COVID safety guidelines.

Source: FierceBiotech
Leaders on the Line
Elder Care held Leaders on the Line this past month to support senior vaccination efforts for those requiring transportation or in-home administration. 23 community leaders across Tallahassee were given a list of seniors to call and ask if they needed the COVID-19 vaccine. Participants were able to help us identify those needing transportation and in-home administration. Thank you to Senator Ausley, Mayor Dailey, and everyone involved in Leaders on the Line! 
Governor Appoints Michael Wasylik, M.D. to Board of Medicine
FMA member Michael Wasylik, MD, a Board-certified orthopedic surgeon based in Tampa, has been appointed to the Florida Board of Medicine. An FMA member since 1975, Dr. Wasylik has served on the FMA’s Council on Medical Economics and Practice Innovation (formerly the Council on Medical Services and Health Care Delivery Innovation) for many years and is a past Council Chair. He is also a member of the Hillsborough County Medical Association, the AMA, the Florida Orthopaedic Society, and the American Academy of Orthopedic Surgeons. Congratulations to Dr. Wasylik!
Information Blocking Rules
Last year the Office of the National Coordinator for Health Information Technology (ONC) released a rule implementing provisions of the 21st Century Cures Act requiring physicians to comply with new regulations on the access, exchange and use of patients' electronic health information (EHI). Information blocking is defined as practices that are likely to interfere with, prevent, or materially discourage the access, exchange or use of EHI. Physicians, hospitals, electronic health record (EHR) vendors, health information exchanges (HIE) and health information networks (HIN) are all subject to ONC's rule and are collectively referred to as "Actors." Actors whose actions are likely to interfere with the access, exchange, or use of EHI could be considered information blockers and subject to penalties or disincentives. EHR vendors and HIE/HINs can receive up to $1 million in civil monetary penalties per violation. 
Actors are required to comply with ONC's information blocking regulations starting April 5, 2021. The AMA has created a two-part educational resource to help physicians and their medical practices understand the requirements and develop an information blocking compliance program.
Part One: Outlines what information blocking is, key terms to know, examples of information blocking practices and a summary of exceptions for when physicians may restrict the access, exchange or use of EHI.
Part Two: Will help physicians start down the path of compliance, including questions to consider, considerations for maintaining a compliance program and next steps.
ROTH IRAs for Physicians: 13 Questions and Answers
Higher earners like physicians may feel locked out of some tax-free withdrawal options as their high income disqualifies them from opening Roth IRA accounts. They may be unaware of some tools that could be at their disposal to get those same benefits, such as the backdoor Roth IRA and Roth IRA conversions.

Source: Medical Economics
Despite Tax Breaks, Nonprofit Hospitals Spend Less on Charity Care Than For-Profits
Though nonprofit hospitals receive tax breaks for providing charity care, a new analysis shows that they may not be doing their share.

In 2018, nonprofit hospitals spent $2.3 of every $100 in total expenses incurred on charity care, which was less than government or for-profit hospitals, according to a study published in Health Affairs.

Source: MedCity News
Continuing Certification a Cash Cow for Emergency Medicine Board
The American Board of Emergency Medicine (ABEM) spent more than a half a million dollars on its two board of directors meetings in fiscal year 2018-2019.
For its winter meeting, the organization flew about 30 board members and ABEM staff -- some accompanied by family members -- to Maui and lodged them for about a week at the luxury Fairmont Kea Lani resort.
The total cost was $317,419, according to ABEM budget documents provided to MedPage Today.

Source: MedPage Today
Trends in the Dental Industry: Dental Technology in the Next Decade
With the prevailing situation created by the Covid-19 pandemic – and the resultant dental industry market recession – there is one thing on every dentist’s mind: “What does the future hold for us?” While we can’t control the future, we can be sure of one thing — 10 years down the road, we can expect remarkable changes in the dental industry that will completely revolutionize dental healthcare facilities worldwide.

Source: MedCity News
Black Patients Are More Likely Than White Patients to Be in Hospitals with Worse Patient Safety Conditions
Black and white patients receive different standards of care in the United States. This was true when the Institute of Medicine published Unequal Treatment in 2003, identifying differences in care by patient race and laying out policy proposals and guidelines aimed at narrowing these differences (Institute of Medicine 2003), and this remains true today. In the 2019 Agency for Healthcare Research and Quality (AHRQ) disparities report, an annual assessment on disparities in medical care quality and access, Black patients received significantly worse quality of care relative to white patients in 82 out of 202 (or 40 percent of) quality measures (Agency for Healthcare Research and Quality 2020).

Source: Urban Institute
Reproductive Life Span of U.S. Women Increasing
The reproductive life span of women in the United States has increased over the past 6 decades, as menarche has been starting earlier and menopause coming later, according to an observational study.

In 7,773 women followed from 1959 to 2018, the mean age at menopause increased by 1.5 years, from 48.4 to 49.9, and the mean age at menarche declined by 0.8 years, from 13.5 to 12.7 (P<0.001 for both trends), reported Duke Appiah, PhD, of Texas Tech University Health Sciences Center in Lubbock, and colleagues.

Source: MedPage Today
These Med Board Execs Make Triple a Practicing Doc's Salary
Top executives at medical boards frequently make more money than the average practicing physicians they regulate -- and sometimes it's a lot more.

MedPage Today looked at tax documents for ABMS and its 24 member boards to find executive compensation and compared those figures with data from the American Medical Group Association's latest physician salary survey.

The analysis found that for the 19 boards with complete data on both executive and physician pay, 12 of those executives made more than the median specialist salary.

Source: MedPage Today
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
Doctor of the Day Program for the 2021 Regular Legislative Session
To: All Physicians and Interested Parties,
We appreciate your past participation in the Doctor of the Day Program. In anticipation of the 2021 Regular Legislative Session, preparations for this program are underway.
The Florida Legislature has implemented COVID-19 protocols, please review the DOCTOR OF THE DAY PROGRAM_COVID memo for details. Please also see the Doctor of the Day Information Packet and the Application Form.
Please contact a member of the Florida Senate or the Florida House of Representatives for sponsorship prior to submitting your Doctor of the Day Application Form.
Thank you and we look forward to your participate in the 2021 Doctor of the Day Program. Please contact me regarding any questions or concerns.
Mavis Knight
Office of Legislative Services
111 West Madison Street, Room 874
Tallahassee, Florida 32399-1400
(850) 717-0301
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 sboyle@capmed.org. 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 dbixler@capmed.org.
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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