Weekly Roundup: In Case You Missed It

March 31, 2023

Napa County Health Alert on Xylazine

Xylazine, a veterinary tranquilizer with no approved human use, is showing up in the nation’s street drug supply, where it is also known as “tranq” and “tranq dope.” It is increasingly present in overdose deaths, compounding the overdose crisis. There is no evidence to suggest that xylazine is currently prevalent in California’s drug supply, however experts note that xylazine may be mirroring the path of fentanyl in the illicit drug market with a westward expansion. A sedative and not an opioid, xylazine is not known to be reversed by naloxone. However, since xylazine is typically combined with opioids like fentanyl and sometimes heroin, administering naloxone is still recommended for reversing an overdose. When patients do not respond to naloxone, providers should consider the possibility of xylazine exposure. Read the full health alert here

Proposed Bill Undermines Physician Expertise, Creates Barriers for Patients

AB 1751, sponsored by the California Chiropractic Association, is being represented as an attempt to reduce opioid prescription rates. This bill would require physicians to share information on non-pharmacological options, offer referrals, and confirm with the patient's signature that this was done, creating unnecessary administrative burden and undermining the judgment and expertise of physicians. This bill also establishes referral requirements without proposed coverage expansions – Medi-Cal is not required to cover all non-pharmacological treatments. Send a message to your State Assemblymember to vote no on AB 1751. 

Prior Authorization for Certain Gastroenterology Services

UnitedHealthcare (UHC) recently announced it will begin requiring prior authorization (PA) for certain gastroenterology endoscopy services for commercial plan members effective June 1, 2023. The following procedures are included in the new PA requirements: esophagogastroduodenoscopies, capsule endoscopies, diagnostic colonoscopies, surveillance colonoscopies. Screening colonoscopy procedures are not included in this new PA requirement. 

Bill Introduced to Protect CA Physicians Mailing Abortion Medication

Doctors in California who mail abortion pills to people in other states would be protected from prosecution under a new bill, SB 345, announced Friday in the state Legislature. The bill would not let CA extradite doctors who are facing charges in another state for providing abortion medication. It would also shield doctors from having to pay fines and it would let CA doctors sue anyone who tries to stop them from providing abortions. Read more 

Violence Against Physicians in the Workplace

Some physicians have reported a growing likelihood of experiencing physical and verbal abuse in their practices, especially in emergency medicine departments. In response, the San Francisco Marin Medical Society is hosting a webinar on April 12th, from 12-1pm. Staff from the San Francisco District Attorney's Victim Services Division will address services available to physicians who have experienced violence in their practice, and best practices for documenting and reporting incidents of violence. Register here.

FDA Approves OTC Narcan

The FDA on Wednesday approved Narcan, an opioid overdose reversal drug, to be sold without a prescription. The approval marks the first time any form of naloxone will be available without a prescription. Emergent BioSolutions, which makes the drug, estimates that it would begin commercializing OTC Narcan by late summer.

Physicians Seeking PSLF Must Have Direct Gov Loan by May 1

Physicians should be aware that to be eligible for the PSLF program and to have past time worked counted towards the program requirements, they must have a direct government loan or consolidate their loans into a direct loan by May 1. Physicians must convert any non-qualifying loans into direct loans, although some non-qualifying loans cannot be converted into direct loans. While it is not mandatory that physicians consolidate their loans, they cannot obtain loan forgiveness without a direct government loan. This is particularly important for physicians with older loans from the FFEL program. 


Working with Different Generations 

Tuesday, April 4 | 12:15 to 1:15 pm 


Bridging the generational gap in the workplace doesn’t have to be difficult. Presented by one of CMA’s practice management experts, this presentation will dive into how to understand the differences in generations and work together to manage the gaps to ensure a positive and efficient work environment. Topics covered include understanding generation names and timeframes, understanding assumptions, how to work as a team, workplace characteristics by generation, and workplace values and best practices. 


Register here

Treatment Considerations in the Age of Fentanyl

Wednesday, April 5 | 9:00 to 10:30 am 

Hosted by the Addiction Policy Forum 


Healthcare systems, treatment providers, and justice systems are grappling with the physiological consequences of chronic fentanyl use and how its use may impact treatment. Presenters will discuss practical clinical practice-based guidance on treating opioid use disorder in the age of fentanyl, the use of medications for opioid use disorder (MOUD) in the treatment of individuals using fentanyl, and other considerations and challenges. 


Register here

Leadership Reading and Discussion Group 

Wednesday, April 5 | 6:00 to 7:30 pm 


Join Dr. Hilary Worthen and fellow physicians for a rich discussion on creating psychological safety in the workplace. Reading the book of the month is not required to join the discussion, however you can access the book to read on your downtime or download the free audiobook (with the 3-month Audible trial) here.  


RSVP here

Federation Health Equity Exchange 

Thursday, April 6 | 12:00 pm 

Hosted by the American Medical Association 


The April call will feature a CME series that examines morbidity and mortality through a health equity lens and how these sessions foster a space conducive to building a community of professionals focused on achieving health equity. They will also examine the findings from the AMA's Health Equity in Organized Medicine survey. This recently conducted AMA survey assessed actions organizations are taking or are considering to advance health equity, gather success stories, and identify barriers and resources needed to take action. 


Register here.

Leading the Charge: Embedding Health Equity into the Forefront of Value Based Care 

Thursday, April 6 | 12:15 to 1:15 pm 


Despite the successes demonstrated by accountable care organizations (ACOs) over the last decade, health disparities remain a critical and ever-growing challenge. ACOs have the potential to advance health equity, but without intentionality and guardrails in place, they are also in a position to worsen existing health disparities. For ACOs to truly succeed in improving patient health outcomes for all, it's imperative that health equity is kept at the forefront of value-based care efforts. 


Click here to register.

NSMS Movie Night featuring The Super Mario Bros. Movie

Friday, April 7

Century Napa Valley & XD

Bring the family along for a private screening of The Super Mario Bros. Movie. Arrive before showtime to play a Super Mario Bros. quiz and win prizes! This event is free for members +3 guests. Tickets will be reserved on a first-come first-served basis. A waiting list will be generated once all tickets are claimed.

Reserve your spot.

CMA Data Exchange Explainer Series #2: Data Exchange Policy and Legal Environment 

Thursday, April 13, from 12:15 to 1:15 pm 


Over the next three years, California’s Data Exchange Framework will require all physician practices to exchange data with other practices, health plans, hospitals and others. To help physicians prepare for this change, CMA has partnered with the California Health and Human Services Agency to develop the “CMA Data Exchange Explainer Series.” This webinar is the second in a series that will walk practices through the various considerations in implementing robust data exchange. Learn more – and view other webinars in the series – at cmadocs.org/DxF.   

End of the X-Waiver: A New Frontier in Addiction Treatment 

Wednesday, April 19 | 10:00 to 11:00 am 

Hosted by the National Overdose Prevention Network 


The recent elimination of the X-Waiver, a burdensome requirement for clinicians to prescribe addiction treatment, is now gone ... what’s next? Dr. Roneet Lev, an emergency and addiction physician who served as the first Chief Medical Officer of the White House Office of National Drug Control Policy joins us for a conversation breaking down the new legislative move, what it means for providers, and steps you can take to get more clinicians to prescribe addiction treatment in your community. 


Register here.

Introduction to Value-Based Care for Physicians 

Thursday, April 20 | 12:15 to 1:15 pm 


CMA’s PSO is proud to partner with Integrated Healthcare Association to provide this webinar and other resources to help physician practices, community health centers and other stakeholders improve encounter data quality.  


Click here to register. 

The 2023 NSMS Awards Gala & Casino Night

Friday, May 19 | 6:00 to 9:00 pm

Eagle Vines Golf Club, American Canyon

Join over a hundred physicians, health care leaders and special guests for an evening of entertainment as we celebrate the following individuals:

  • Haroon Mojaddidi, M.D. - Physician of the Year (Solano)
  • Colleen Townsend, M.D. - Physician of the Year (Napa)
  • Karen Relucio, M.D. - Professor Emeritus
  • Eugene Eisenberg, M.D. - Lifetime Achievement

Stay after the awards ceremony to try your hand at blackjack, poker, craps and more. Gamble with complimentary chips, then turn them into raffle tickets for a shot at great prizes. Past raffle prizes have included hot air balloon rides, SF Giants and Golden State Warriors memorabilia, wine train dinners, golf rounds, and more. This event is free for NSMS members +1 guest.

Register here.

Health IT: Powering Value-Based Care 

Monday, May 22 | 9:00 am to 4:00 pm 

Sacramento, CA | Free for CMA members 


Save the date for CMA’s first annual healt IT conference. The conference will bring together thought leaders from across California and the nation to explore the intersection of technology and payment reform. CMA expects a diverse set of attendees that will include physicians, medical groups and IPAs, health plans, health information organizations (HIOs) and others who will take the learnings from this conference to change how care is delivered in this state. 


Register here

NSMS's On-Demand Library

To access all on-demand programs, go to https://www.pathlms.com/medical-society/courses 



Please contact NSMS at grogers@napasolanodocs.org or (707) 255-3622with any questions or concerns you have.