September 30, 2022

HHS Initiative Will Replace Bebtelovimab for Free

HHS announced a new effort to help uninsured and underinsured Americans access the COVID-19 monoclonal antibody treatment bebtelovimab even after the product became available on the commercial market last month. HHS is making 60,000 doses of the product available to support the bebtelovimab product replacement initiative. Through this new initiative, which is effective immediately, health care providers who use a commercially procured dose of bebtelovimab to treat an uninsured or underinsured patient may be eligible to have the dose replaced for free by HHS. At the current rate of use, the additional doses purchased for this initiative are expected to be available through September 2023.

Rules on Information Blocking Expanding October 6

In April 2021, the Office of the National Coordinator for Health Information Technology’s (ONC) rules on information blocking went into effect. However, starting October 6, information blocking requirements shift to the entire set of EHI. Physicians will be responsible for the access, exchange, or use of the full EHI requirement. Physicians should: 1) make sure your practice has implemented a process to evaluate and comply with the information blocking requirements, and 2) contact your EHR vendor to find out how they are preparing to assist you and your practice in meeting the October 6 EHI deadline. This document from AMA provides an overview of the information blocking regulations, EHI definition, and recommendations for physicians to prepare for the upcoming deadline.

Medicare Part B Premiums to Decrease for First Time in Over a Decade



The Centers for Medicare & Medicaid Services (CMS) announced that Medicare Part B premiums would be lowered by three percent, or $5.20, going from $170.10 a month to $164.90. The program’s annual deductible will also fall by $7, from $233 to $226. The last time Medicare Part B premiums fell was in 2012 when they went from $115.40 to $99.90 a month, a decrease of 13.4 percent. In 2022, Medicare Part B premiums rose by 14.5 percent, one of the largest annual increases ever seen in the program’s history. A major factor in this increase was the inclusion of Aduhelm, the first Alzheimer’s medication approved by the Food and Drug Administration in 20 years.

Make Your Voice Heard on Health Equity and Access to Care



The Centers for Medicare and Medicaid Services (CMS) has released a Request for Information seeking public input by November 4 on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 public health emergency. What the RFI aims to do is gather feedback and perspectives on the challenges of achieving equity, which CMS said would inform its efforts to encourage innovation, reduce burden and create efficiencies in the U.S. healthcare system. Click here to access the public comment form.

Join the Conversation: Innovating for Women’s Health



As the AMA celebrates Women in Medicine Month, the Physician Innovation Network will be highlighting innovations that promote access and overall well-being for patients who identify as women. Physicians, care team members, and other innovation leaders will be asking women’s health companies about the healthcare problems they are solving, the solutions they’ve designed, the barriers they’ve experienced in bringing their solutions to market, and the processes they’ve been using to gather user feedback. Join the virtual discussion going on from September 26 to October 4. 

Cigna Will Not Move Forward with Modifier 25 Policy



Earlier this year, Cigna had announced a policy to require the submission of medical records with all Evaluation and Management (E/M) claims with CPT 99212-99215 and modifier 25 when a minor procedure was billed as a precondition of payment. CMA sent a letter to Cigna outlining its concerns, urging the payor to rescind the policy that effectively penalized physicians for providing efficient, unscheduled care to Cigna enrollees. As a result of CMA advocacy, Cigna announced in July it was reevaluating the policy and delaying implementation. Cigna also agreed to meet with CMA and AMA to discuss further. Since the meeting, Cigna has advised CMA and AMA that it does not plan to move forward with implementation of this policy at this time.

UHC Fee Schedule Updates: Effective October 15 OR December 15

In August, UnitedHealthcare (UHC) announced it would begin migrating some physicians to an updated commercial fee schedule beginning in October 2022. Half of the 3,000 providers previously notified may actually not be part of the first phase of the fee schedule update. Providers in receipt of the new mailing/notice will have their fee schedule effective date delayed until December 15. Providers who did not receive a corrected mailing will continue to have an effective date of October 15, for their fee schedule change. Physicians do not need to sign or return the contract amendment to UHC for the fee schedule changes to take effect. If you would like additional information regarding this change, object to the amendment, wish to terminate their entire agreement with UHC, or want to confirm whether their practice is affected should contact their Network Account Manager directly or email UHC at [email protected]. Read more here.

Newsom Signs 13 Abortion Protection and Reproductive Health Bills

Click here and scroll to the end of the article to see the full list. Here are some of the bills that aim to protect physicians and their patients:

• AB 1242: Bans arresting anyone “aiding or performing a lawful abortion in California” and bars law enforcement from sharing information or aiding out-of-state investigations into legal abortions. 
• SB 523: Requires health care plans to cover some over-the-counter birth control and vasectomies without cost-sharing, regardless of gender or insurance coverage status. 
• SB 1375: Enables nurse practitioners who meet training requirements to perform first trimester abortions without a physician’s supervision. 
• AB 657: Speeds up the licensing process for health care providers who want to perform abortions. While there are providers clustered in the state’s largest metro areas, 40% of California counties have no clinics providing abortions. 
• AB 2626: Prohibits suspending or revoking the certificate of a provider for performing an abortion that complied with state regulations. 
• AB 2134: Creates the California Reproductive Health Equity Program to provide grants to health care practitioners who provide abortion and contraception services at little or no cost to low-income residents. 

Bivalent Vaccine for Children Ages 5-11, Expected Soon



Pfizer has submitted a request for the FDA to authorize a 10-microgram booster dose of its bivalent COVID-19 vaccine booster for emergency use in children aged 5-11. Pfizer also announced a clinical study to evaluate the safety and effectiveness of different dosing regimens for the bivalent vaccine in children aged 6 months through 11. According to the AMA, approval for use of the bivalent vaccine in children 5-11 is expected around mid-October.

Climate and Health Advocacy Bootcamp

Running every Thursday until October 27 | 12:00 to 1:30 pm 

Hosted by the Medical Society Consortium on Climate and Health 

Health professionals are the most trusted voices in society and our collective voices are needed to prepare communities to effectively respond to the climate crisis. Through this 5-week bootcamp, you will grow your network by joining colleagues around the country to learn strategies to effectively channel your voice and action as a health professional to address the “greatest health threat” of the 21st Century. 

Register here.

AB 35: Truth and Impact 

Thursday, October 6 | 12:00 to 1:00 pm 

FREE | Hosted by the Cooperative of American Physicians (CAP) 

A likely surge in medical malpractice claims frequency and severity are expected to occur when Assembly Bill (AB 35) goes into effect on January 1, 2023. Learn more about how this legislation impacts your medical professional liability and what you can do to protect your practice. This webinar will help physicians identify the most impactful changes to MICRA contained in AB 35 that increase physicians’ liabilities for claims of medical negligence, understand the increases in noneconomic damage caps and attorney’s fees, formulate specific steps to ensure patient safety, and prepare for the medical professional liability landscape in 2023 and beyond. 

Register here. Even if you can’t attend, you can register and receive the recording after the event. 

Unconscious Bias in Healthcare: Policy, Practice, and the State of the Science Symposium 

Friday, October 14 | 9:00 am to 5:00 pm 

FREE | Presented by Sutter Health’s Institute for Advancing Health Equity 

Join health equity experts, researchers and change agents for a day of focused discussion and problem-solving around how to effectively mitigate unconscious bias in healthcare settings. The insights and strategies explored during this one-day event will inform evidence-based recommendations and a framework to guide the development and implementation of effective, measurable unconscious bias mitigation strategies. This event is co-sponsored by CMA, Physicians for a Health California, and the California Primary Care Association. 

Register here. 

AMA Digital Health Research: 2022 Findings 

Wednesday, October 19 | 8:00 to 9:00 am 

First launched in 2016, the AMA conducts a study of physicians’ motivations and requirements for the adoption of digital health solutions. To maintain a pulse on trends, the AMA regularly refreshes this study every three years and most recently fielded the survey in Q1 of 2022. The findings report of this study will be released in mid-September. Join this session for an executive summary and walkthrough of this year's key insights along with a longitudinal analysis of key changes in physician motivations and requirements for the adoption of digital clinical tools compared to prior years. 

Register here. 

Understanding the Climate Health Crisis and How California Physicians Can Make an Impact 

Friday, October 21 | 2:00 to 4:00 pm 

Hybrid: Virtual and In-person at L.A. Live 

This free event will be an engaging two-part panel discussion that will explore the health impacts of climate change in California and the opportunities for California's physicians to advance policy-level climate solutions with enormous public health co-benefits. Sponsored by Climate Health Now and the California Foundation on the Environment and the Economy (CFEE) in coordination with CMA. 

Register here.

Harm Reduction and Treatment Strategies for People Who Use Fentanyl

Wednesday, October 26 | 10:00 to 11:00 am 

Hosted by the National Overdose Prevention Network 

Many people use fentanyl, whether by choice or by accident. With overdose-related deaths continuing to rise, how do we keep people safe? This first session in our webinar series on fentanyl will focus on harm reduction strategies and treatment options for people who use fentanyl. We will hear from a harm reduction expert and a clinician on key strategies and opportunities to center people who use drugs and save lives. 

Register here.

CMS Medicare Updates 2023 

Tuesday, November 8 | 12:15 to 1:15 pm 

FREE | Hosted by CMA 

Centers for Medicare and Medicaid Services (CMS) Regional Chief Medical Officer Ashby Wolfe, M.D., will provide an update on CMS policy for the 2023 calendar year. Information presented will be relevant to practicing clinicians, including an overview of the updates to the 2023 Physician Fee Schedule. 

Register here. 

Bay Area Physician Wellness Collaborative 

Tuesday, November 15 | 6:00 to 8:00 pm 

FREE | CME Available | Online 

Join a roundtable of your colleagues – leaders from medical groups, hospital medical staffs, residency programs and other physician organizations – to learn and share how to apply the organizational culture and practice changes that can reduce physician burnout and drive professional fulfillment. Learn more here. 

The next meeting of the collaborative will focus on creating a center or committee for physician wellbeing within your organization. Learn about self-care support systems, peer support resources, mental health referrals and consultation services, life-needs support mechanisms, and other comprehensive wellbeing resources. This collaborative is by invitation only; please click here to indicate your interest in joining the collaborative.