| 2020_wsma_house_of_delegates_meeting_goes_virtual | 2020 WSMA House of Delegates Meeting Goes Virtual | memo | Shared_Content/News/Membership_Memo/20200528/2020_wsma_house_of_delegates_meeting_goes_virtual | <div class="col-md-12">
<h5>May 28, 2020</h5>
<h2>2020 WSMA House of Delegates Meeting Goes Virtual</h2>
<p>Out of an abundance of caution for the health and well-being of all concerned, the WSMA is transitioning the 2020 Annual Meeting of the House of Delegate, previously scheduled for Sept. 26-27 in Spokane at the Historic Davenport Hotel, to a virtual one-day meeting. The meeting will now take place on Saturday, Sept. 26, and will be condensed to focus solely on the business of the House of Delegates.</p>
<p>In the weeks preceding the meeting, the WSMA will open our <a href="[@]WSMA/Membership/Discussion_Forums/Virtual_Reference_Committees/WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx?hkey=d674a5ae-4fb5-48d6-b969-16aab9b63647">online reference committee forums</a> in order to give all members an opportunity to provide feedback on resolutions. In addition, we will hold virtual reference committee meetings so that members will have an opportunity to provide verbal testimony. On Sept. 26, the House will act on the reports of the reference committees, vote on the slate of candidates for the board of trustees, and conduct other business of the House. Your WSMA staff is currently working on the new schedule and will share more information soon.</p>
</div> | 5/28/2020 2:56:45 PM | 5/28/2020 11:25:10 AM | 5/28/2020 12:00:00 AM |
| bree_collaborative_adopts_long_term_opioid_therapy_report_and_recommendations | Bree Collaborative Adopts Long-Term Opioid Therapy Report and Recommendations | memo | Shared_Content/News/Membership_Memo/20200528/bree_collaborative_adopts_long_term_opioid_therapy_report_and_recommendations | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/opioid_hydrocodone_bottle-645x425px.jpg" class="pull-right" alt="Hydrocodone bottle" />
</div>
<h5>May 28, 2020</h5>
<h2>Bree Collaborative Adopts Long-Term Opioid Therapy Report and Recommendations</h2>
<p>The Dr. Robert Bree Collaborative adopted Long-Term Opioid Therapy Report and Recommendations. The recommendations are a supplemental update to prior guidelines and are intended for providers managing adult patients (&gt;18 years old) with chronic pain who are receiving long-term opioid therapy. The WSMA was actively engaged in the work group that created the recommendations. The full recommendations can be found on their website <a href="http://www.breecollaborative.org/wp-content/uploads/Bree-Long-Term-Opioid-Use-Recommendations-FINAL-20-05.pdf" target="_blank">here</a>.</p>
</div> | 5/28/2020 2:56:45 PM | 5/28/2020 11:25:17 AM | 5/28/2020 12:00:00 AM |
| covid_19_financial_relief_updates | COVID-19 Financial Relief Updates | memo | Shared_Content/News/Membership_Memo/20200528/covid_19_financial_relief_updates | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/COVID-19-financial-relief-645x425px.jpg" class="pull-right" alt="COVID-19 Financial Relief logo" />
</div>
<h5>May 28, 2020</h5>
<h2>COVID-19 Financial Relief Updates</h2>
<p>Protect yourself from unemployment claim fraud; deadline for additional provider relief funds approaches; new PPP loan forgiveness application; WSMA urges delay on EPCS mandate; and more.</p>
<h3>Scam alert: Protect yourself from unemployment fraud</h3>
<p>The WSMA has heard from multiple physicians and staff who have been targeted for unemployment fraud, i.e., having their SSN and other information used to file fraudulent unemployment claims. To prevent yourself from being targeted or to find out if you've been a target for fraud, follow these steps</p>
<ul>
<li>Set up a <a href="https://secure.esd.wa.gov/home/">Secure Access Washington account (SAW)</a>.</li>
<li>Sign into your account and begin the process to file for unemployment (you won't actually complete this process)</li>
<li>At the "verify my identity" step, you will be able to see if anyone has accessed your account or filed a claim on your behalf.</li>
<li>Enter your email to verify your account.</li>
</ul>
<p>The head of the Employment Security Department in Washington confirmed this method will successfully secure your SSN and your information with the unemployment office and prevent unemployment claims being fraudulent filed on your behalf. If you've been the target of a phony unemployment claim, this <a href="https://www.seattletimes.com/seattle-news/what-to-do-if-your-name-is-used-by-unemployment-fraudsters-taking-advantage-of-coronavirus-crisis/">Seattle Times article</a> outlines helpful steps to you can take to protect your financial identity and credit history.</p>
<h3>June 3 deadline to act for additional Provider Relief Fund payments</h3>
<p>The U.S. Department of Health &amp; Human Services announced that physicians and health care providers have until June 3 to submit revenue information to be considered for an additional payment from the $50 billion general distribution of the CARES Act Provider Relief Fund. HHS automatically disbursed payments from the first portion ($30 billion) starting on April 10, however most group practices will need to submit a request to receive additional funds from the second portion ($20 billion). <a href="https://www.hhs.gov/about/news/2020/05/20/providers-must-act-june-3-2020-receive-additional-relief-fund-general-distribution-payment.html">Learn more in the HHS announcement</a>.</p>
<h3>SBA releases PPP loan forgiveness application</h3>
<p>The Small Business Administration released an <a href="https://home.treasury.gov/system/files/136/3245-0407-SBA-Form-3508-PPP-Forgiveness-Application.pdf?utm_campaign=government-affairs&amp;utm_medium=email&amp;utm_source=5.21.20%20Washington%20Connection&amp;elqEmailId=10211">application</a> for Paycheck Protection Program (PPP) borrowers to submit to their lenders when seeking loan forgiveness. The application includes:</p>
<ul>
<li>Instructions on how to perform calculations for loan forgiveness.</li>
<li>A list of documents borrowers must submit with the PPP loan forgiveness application.</li>
<li>Confirmation that eligible nonpayroll costs still cannot exceed 25% of the total forgiveness amount.</li>
<li>A newly created "Alternative Payroll Covered Period" for borrowers with biweekly (or more frequent) pay periods, which would allow the eight-week Covered Period to begin on the first day of the first pay period following PPP loan disbursement.</li>
<li>Clarification that borrowers are generally eligible for forgiveness for payroll/nonpayroll costs paid and payroll costs incurred during the eight-week Covered Period (or Alternative Payroll Covered Period); and</li>
<li>Additional FTE reduction exceptions.</li>
</ul>
<h3>WSMA seeks delay of EPCS mandate</h3>
<p>As reported in a <a href="[@]Shared_Content/News/Membership_Memo/20200514/covid_19_practice_management_updates">previous Membership Memo</a>, at the urging of the WSMA, the state has delayed the EHR-PMP integration requirement from Senate Bill 5380, with the deadline now pushed out to Sept. 30, 2021. In a letter thanking Secretary Wiesman for the needed delay, the WSMA requested a similar extension for the mandate, also from SB 5380, requiring electronic prescribing of controlled substances scheduled to start Jan. 1, 2021. We will keep members apprised of his response. For practices facing barriers to these mandates, SB 5380 does allow for an economic/technical hardship or exceptional circumstance exemption. The WSMA has been working with DOH staff as they draft and finalize the details of the waiver processes. If you have questions on either mandate, email the WSMA's policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 5/28/2020 2:56:45 PM | 5/28/2020 11:25:07 AM | 5/28/2020 12:00:00 AM |
| covid_19_telehealth_updates | COVID-19 Telehealth Updates | memo | Shared_Content/News/Membership_Memo/20200528/covid_19_telehealth_updates | <div class="col-md-12">
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</div>
<h5>May 28, 2020</h5>
<h2>COVID-19 Telehealth Updates</h2>
<p>A look at (and links to) current telemedicine payment parity policies, including a new extension from the Office of the Insurance Commissioner; new CMS telephone-only payments for behavioral health services; a new WSMA webinar; and more.</p>
<h3>Payment parity roundup</h3>
<p>During the pandemic, telemedicine has emerged as a vital resource for patients to safely access care and for physicians and practices to bring in needed revenue. To support the ongoing utilization of telemedicine, the WSMA continues to prioritize telemedicine payment parity in its advocacy at the state and federal levels.</p>
<p>The following health plans and payers have passed temporary policies to pay at parity for telemedicine, including services delivered through telephone only:</p>
<ul>
<li><a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-20-02_3.pdf?utm_content=&amp;utm_medium=email&amp;utm_name=&amp;utm_source=govdelivery&amp;utm_term=">OIC fully insured plans</a> (the OIC has <a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-20-02-extension.pdf?utm_content=&amp;utm_medium=email&amp;utm_name=&amp;utm_source=govdelivery&amp;utm_term=">extended its emergency order</a> to health insurers expanding telehealth and other coverages until June 21)</li>
<li><a href="https://www.hca.wa.gov/assets/billers-and-providers/Clinical-policy-and-billing-for-COVID-19-FAQ.pdf" target="_blank">HCA Medicaid plans</a></li>
<li><a href="https://www.hca.wa.gov/information-about-novel-coronavirus-covid-19">HCA UMP (PEBB/SEBB) plans</a></li>
<li><a href="https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf" target="_blank">CMS Medicare</a></li>
</ul>
<p>Plans not required to pay at parity - </p>
<ul>
<li>Certain self-insured/ERISA plans that cannot be regulated by the state. The WSMA is supporting legislation introduced by Rep. Kim Schrier (D-08) that would ensure telemedicine payment parity for ERISA plans. <a href="https://takeaction.wsma.org/tell-congress-to-prioritize-patients-and-physicians/">Write your congressional representative and urge their support for H.R. 6644</a>.</li>
</ul>
<h3>CMS broadens telephone-only list of services paid for by Medicare</h3>
<p>CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone and now they are broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. CMS is crosswalking CPT codes 99212, 99213, and 99214 to 99441, 99442, and 99443. This will increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.</p>
<h3>New WSMA telehealth webinar, more resources</h3>
<p>Be sure to join us on Friday, June 19, from noon - 1 p.m., for a free webinar, <a href="[@]WSMA/Education/Upcoming_Webinars/WSMA/Education/Upcoming_Webinars/Upcoming_Webinars.aspx?hkey=b760d6bd-1833-412d-b681-babf251792a8">Telehealth: The Rapid Evolution to Full-Scale Implementation</a>, and learn how to implement a lasting telehealth program in your clinic. And be sure to visit our <a href="[@]WSMA/Resources/COVID-19_Response/WSMA/Resources/COVID-19/COVID-19_Response.aspx?hkey=958ce791-54b8-4eba-892f-54924db26b60">COVID-19 resource pages</a> for a wealth of practice guidance on telehealth, including step-by-step guidance on setting up telemedicine at your practice, information on reimbursement policies, what you need to know about HIPAA compliance during the public health emergency, federal changes on prescribing controlled substances via telemedicine, and much more.</p>
</div> | 5/28/2020 2:56:45 PM | 5/28/2020 11:25:00 AM | 5/28/2020 12:00:00 AM |
| doh_considers_granting_psychologists_prescriptive_authority | DOH Considers Granting Psychologists Prescriptive Authority | memo | Shared_Content/News/Membership_Memo/20200528/doh_considers_granting_psychologists_prescriptive_authority | <div class="col-md-12">
<h5>May 28, 2020</h5>
<h2>DOH Considers Granting Psychologists Prescriptive Authority</h2>
<p>WSMA members should take note of a proposal underway to grant psychologists prescriptive authority. Prompted by a proposed bill (House Bill 2967) from the 2020 legislative session, the Legislature has requested the Washington State Department of Health consider a "sunrise review" application from the Washington State Psychological Association (sunrise reviews are the process by which the DOH considers proposals to amend practices of regulated health professions in the state). DOH is now reviewing the proposal and is soliciting feedback from stakeholders. At the end of the review process, DOH will issue a final report with recommendations to the Legislature. While these recommendations are technically advisory, they often serve as the basis for future legislation. <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2020-Sunrise-PsyScope.pdf" target="_blank">Click here to read the proposal from the WSPA</a>. Comments on the proposal are due by June 17 at midnight and should be emailed to <a href="mailto:sunrise@doh.wa.gov">sunrise@doh.wa.gov</a>. Pursuant to policy adopted at the 2019 House of Delegates, the WSMA opposes non-physician practitioner scope expansion efforts that do not stipulate commensurate education and training to what a physician receives. Once we have compiled our draft comments in opposition to the proposal, we will share it with members. If you have questions on this issue, email Alex Wehinger, WSMA's associate director of legislative and policy affairs, at <a href="mailto:alex@wsma.org">alex@wsma.org</a>.</p>
</div> | 5/28/2020 2:56:47 PM | 5/28/2020 11:25:21 AM | 5/28/2020 12:00:00 AM |
| new_webinars_on_telehealth_implementation_and_communicating_effectively_in_times_of_stress | New Webinars on Telehealth Implementation and Communicating Effectively in Times of Stress | memo | Shared_Content/News/Membership_Memo/20200528/new_webinars_on_telehealth_implementation_and_communicating_effectively_in_times_of_stress | <div class="col-md-12">
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</div>
<h5>May 28, 2020</h5>
<h2>New Webinars on Telehealth Implementation and Communicating Effectively in Times of Stress</h2>
<p>The WSMA's Continuing Professional Development webinar series offers two live sessions this summer for physicians and physician assistants. Register for these free CME events today. On Friday, June 19, from noon - 1 p.m., join us for <a href="https://zoom.us/webinar/register/7115894832246/WN_Zr7Wv5YsRBe1hKTs-2XkSw">Telehealth: The Rapid Evolution to Full-Scale Implementation</a> and learn how to implement a lasting telehealth program in your clinic. Speakers will review the unique clinical aspects of delivering digital health care, as well as vetting and selecting a vendor, contracting, designing workflow, preparing the team and patients, coding and billing, and managing liability and risk. On Friday, July 17, from noon - 1 p.m., join us for <a href="https://zoom.us/webinar/register/7115894777167/WN_GXL-x0GRQNuizxAObVdtIg">Communicating Effectively During Times of Stress</a> and learn to develop a more effective communication process. Speakers will detail the advantages and disadvantages of different communication modes and give examples of how communication style, mode, and content might be adjusted to account for the needs of the message recipient. These activities have been approved for <em>AMA PRA Category 1 Credit</em> TM. The WSMA introduced its Continuing Professional Development webinar series as part of our commitment to supporting physicians and physician assistants on their lifelong learning journey. Find recent archived webinars on our <a href="[@]WSMA/Education/Webinars_OnDemand/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx?hkey=53a67f34-e7a8-4b79-9463-6f51e1418ff5">On Demand Webinars webpage</a>, under our new Education section on wsma.org.</p>
</div> | 5/28/2020 3:01:57 PM | 5/28/2020 11:25:03 AM | 5/28/2020 12:00:00 AM |
| register_for_wsmas_fall_leadership_courses | Register for WSMA's Fall Leadership Courses | memo | Shared_Content/News/Membership_Memo/20200528/register_for_wsmas_fall_leadership_courses | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/PLC-Zoom-Picture-april-2020-645x425px.png" class="pull-right" alt="PLC Zoom Course" />
</div>
<h5>May 28, 2020</h5>
<h2>Register for WSMA's Fall Leadership Courses</h2>
<p>Register today to enroll in our core leadership trainings scheduled for this fall: The popular WSMA Physician Leadership Course, for physicians and PAs, and the WSMA Dyad Leadership Course, for physicians/PAs and their administrative partners. Don't miss these opportunities to develop core leadership competencies not taught in medical school.</p>
<h3>Physician Leadership Course</h3>
<p>The WSMA Physician Leadership Course is a 40+ hour course for physicians and physician assistants who want to develop their health care leadership skills. Live virtual sessions will be held on Sept. 18-19 and Dec. 11, with eight weeks in between of self-guided online learning. The deadline to register is Aug. 18. <a href="[@]WSMA/Education/Physician_Leadership/Physician_Leadership_Course/WSMA/Physician_Leadership/Physician_Leadership_Course/Physician_Leadership_Course.aspx?hkey=30a53472-d3c0-4d7d-bd0c-cf09b4bea7f5">Register online</a>.</p>
<h3>Dyad Leadership Course</h3>
<p>Taking your leadership journey deeper, the WSMA Dyad Leadership Course is a 24+ hour educational workshop for physicians and their administrative dyad partners that helps improve team function and achieve greater operational success within their clinical system. Live virtual sessions will be held on Oct. 16-17 and Nov. 13, with four weeks in between of self-guided online learning. The deadline to register is Sept. 16. Completion of the WSMA Physician Leadership Course is a pre-requisite for enrollment. <a href="[@]WSMA/Education/Physician_Leadership/Dyad_Leadership_Course/WSMA/Physician_Leadership/Dyad_Leadership_Course/Dyad_Leadership_Course.aspx?hkey=f6387317-48e4-44f1-b623-4b00fcba57ab">Register online</a>.</p>
<p>These activities have been approved for <em>AMA PRA Category 1 Creditâ„¢</em>.</p>
</div> | 5/28/2020 2:56:47 PM | 5/28/2020 11:25:13 AM | 5/28/2020 12:00:00 AM |
| wsma_focus_remains_on_physician_practices_as_health_care_restarts | WSMA Focus Remains on Physician Practices as Health Care 'Restarts' | memo | Shared_Content/News/Membership_Memo/20200528/wsma_focus_remains_on_physician_practices_as_health_care_restarts | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/Exam-Room-645x425px.jpg" class="pull-right" alt="Exam room" />
</div>
<h5>May 28, 2020</h5>
<h2>WSMA Focus Remains on Physician Practices as Health Care 'Restarts'</h2>
<p>WSMA CEO Jennifer Hanscom sat down with AMA Senior News Writer Sara Berg to <a href="https://www.ama-assn.org/practice-management/sustainability/hit-first-us-covid-19-washington-doctors-eye-safe-reopening">discuss the WSMA's recent work on behalf of physicians and practices</a> in response to COVID-19, including working with the state to build a framework for reopening health care and efforts to help physician practices survive the economic fallout from the pandemic. As Jennifer notes, "We are trying to educate policy makers in our state right now to do all that we can to support physician practices economically so that should the surge come back in the fall, we do have physician practices that are ready to treat those patients." Read on to get up to speed on WSMA's work on behalf of physicians and to get the latest on the state's emergency response.</p>
<h3>WSMA practice guidance for resuming elective procedures</h3>
<p>Gov. Inslee's <a href="[@]Shared_Content/News/Latest_News/2020/May/governor_issues_new_proclamation_on_non_urgent_procedures">latest proclamation related to health care services</a> in Washington state permits all health care facilities, practices, and practitioners acting in good faith, and that meet certain criteria, to resume providing elective procedures and other non-urgent care. The proclamation, effective May 17, is intended to remain in effect through the end of the state of emergency, and details criteria required for resuming non-urgent procedures before there is a vaccine, effective treatment, or herd immunity to COVID-19. Those criteria include monitoring resources (ventilators, beds, PPE, etc.), conserving PPE, and on-site fever screening and symptom screening for all patients, visitors, and staff, and more.</p>
<p>In case you missed it: The WSMA has collaborated with the Washington State Medical Group Management Association to offer new guidance on the proclamation for medical practices. <a href="javascript://[Uploaded files/Resources/COVID19/2020.05.29-Proclamation_Guidance_for_Medical_Practices.pdf]">Download this new resource</a>. If you have questions on this new WSMA resource or what the proclamation means for you and your practice, contact the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
<h3>WSMA asks Legislature to support key priorities in advance of next session</h3>
<p>The Washington State Legislature has established a bipartisan Special Committee on Economic Recovery that is tasked with making recommendations on COVID-19 recovery legislation in advance of the 2021 legislative session (or before then if lawmakers are called back into session this year). In anticipation of the committee's first meeting in June, the WSMA submitted a letter to all state legislators detailing key policy priorities for physician practices that would help ensure they can keep their doors open and continue to treat patients.</p>
<p>Our members have identified four key priorities for the state legislature to support:</p>
<ul>
<li>Full resumption of medically necessary medical physician services.</li>
<li>Continuation of telemedicine payment parity.</li>
<li>Establishment of an enhanced Medicaid payment program.</li>
<li>Tax relief.</li>
</ul>
<p>For details on each of these policy priorities, <a href="javascript://[Uploaded files/Resources/COVID19/5.14.20_WSMA_letter_to_the_Legislature.pdf]">download the letter</a>, delivered May 14, 2020. In our continued advocacy on behalf of physicians and practices, our core message remains the same: Just as policymakers relied upon the physician community in the state's response to the pandemic, both to treat patients and to follow state care restrictions to help flatten the curve, the physician community is now looking to policymakers to help ensure they can keep their doors open and continue to treat patients.</p>
<p>While not yet official, it remains likely that a special legislative session will be needed between now and Jan. 2021 to provide additional financial resources and address needed changes to policy issues in response to COVID-19.</p>
<h3>Take action: Tell Congress to prioritize patients and physicians</h3>
<p>Congressional action is needed on three issues that are critically important for ensuring patient access to care and physician practice viability during the COVID-19 pandemic: 1). Requiring ERISA plans to pay at parity for telemedicine services; 2.) Enacting liability protections for health care workers as part of the next stimulus package; and 3.) Prioritizing direct support to physician practices in the next stimulus package. Elected officials in the U.S. Senate and House of Representatives need to hear from their physician and PA constituents on these issues. <a href="https://takeaction.wsma.org/tell-congress-to-prioritize-patients-and-physicians/">Learn more about these issues and send a message to your congressional representatives today</a>.</p>
<h3>Legislature extends emergency proclamations</h3>
<p>The <a href="https://www.governor.wa.gov/office-governor/official-actions/proclamations">emergency proclamations</a> issued by Gov. Jay Inslee in response to the COVID-19 pandemic expire after 30 days unless an extension is granted by the state Legislature. The following proclamations have been granted temporary extensions, and the WSMA continues to advocate for these policies to be extended beyond their current expiration dates as the physician community and the state respond to the COVID-19 pandemic.</p>
<p>Extension approved until May 31:</p>
<ul>
<li><a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-29%20Coronovirus%20OIC%20%28tmp%29.pdf?utm_medium=email&amp;utm_source=govdelivery">Proclamation 20-29</a>, concerning telemedicine payment parity.</li>
<li><a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-32%20-%20COVID-19%20DOH%20Healthcare%20Worker%20Licensing%20%28tmp%29.pdf" target="_blank">Proclamation 20-32</a>, concerning health care worker licensing requirements.</li>
<li><a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-27%20-%20COVID-19%20Notary%20%28tmp%29.pdf" target="_blank">Proclamation 20-27</a>, concerning electronic notary.</li>
</ul>
<p>Extension approved until July 8:</p>
<ul>
<li><a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-36%20-%20COVID-19%20-%20DOH%20Health%20Care%20Facilities-Hand%20Sanitizer%20%28tmp%29.pdf" target="_blank">Proclamation 20-36</a>, concerning the Certificate of Need program.</li>
</ul>
</div> | 5/29/2020 9:06:01 AM | 5/28/2020 11:24:56 AM | 5/28/2020 12:00:00 AM |
| covid_19_practice_management_updates | COVID-19 Practice Management Updates | memo | Shared_Content/News/Membership_Memo/20200514/covid_19_practice_management_updates | <div class="col-md-12">
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<h5>May 14, 2020</h5>
<h2>COVID-19 Practice Management Updates</h2>
<p>Updates on financial relief measures, COVID-19 billing and reimbursement issues, and more.</p>
<h3>Provider Relief Fund deadline extension &amp; new FAQ</h3>
<p>The U.S. Department of Health and Human Services has extended the Provider Relief Fund attestation deadline. Physicians now have 45 days from the date of receipt or payment to attest and accept the terms and conditions or return the funds. If a recipient does not complete the attestation within 45 days of receipt of the funds and does not contact HHS about remittance, HHS deems the recipient as having accepted the <a href="https://www.hhs.gov/sites/default/files/terms-and-conditions-provider-relief-30-b.pdf" target="_blank">terms and conditions</a>. In its <a href="https://www.hhs.gov/about/news/2020/05/07/hhs-extends-deadline-attestation-acceptance-terms-and-conditions-provider-relief-fund-payments-45-days.html">May 7 announcement of the extension</a>, HHS indicates that the lack of response is considered an attestation.</p>
<p>HHS provides additional guidance about the use of the funds through its <a href="https://www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf" target="_blank">Provider Relief Fund FAQ document</a>, issued May 6, 2020.</p>
<h3>Provider billing and payment questions and answers related to COVID-19</h3>
<p>Do you have questions related to COVID-19 billing and coding, such as telemedicine, testing codes, and other requirements? The Washington Healthcare Forum COVID-19 Work Group is compiling and updating <a href="https://www.onehealthport.com/covid-19">frequently asked questions and answers</a> from physician practices as they apply to specific commercial and Medicaid managed care plans. The resource also includes links to the COVID-19 webpage for most major carriers.</p>
<p>If you have a COVID-19 billing or payment question not addressed in the Q&amp;A, please send to the WSMA policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. We will coordinate with the Washington Healthcare Forum Work Group to track down the answer you need.</p>
<h3>The COVID-19 Uninsured Program portal now open</h3>
<p>Physicians and providers who have conducted COVID-19 testing or provided treatment for uninsured individuals with COVID-19 on or after Feb. 4, 2020 can begin the process to file claims for reimbursement for testing and treating the uninsured. Learn more about the program <a href="https://www.hrsa.gov/CovidUninsuredClaim">here</a>; use the <a href="https://coviduninsuredclaim.linkhealth.com/">dedicated web portal</a> to file claims.</p>
<h3>PMP-EHR integration mandate delayed until September 2021</h3>
<p>Senate Bill 5380, a measure aimed at addressing the opioid epidemic, was signed into law during the 2019 legislative session. Among other provisions, the bill requires electronic health record (EHR) integration with the prescription monitoring program (PMP) for practices with 10 or more prescribers beginning on Jan. 1, 2021. Last week, in response to protracted WSMA advocacy on the issue, the Department of Health Secretary John Wiesman announced he'd be delaying the EHR-PMP integration requirement due to the COVID-19 public health emergency and its impact on the financial viability of physician practices. Practices will now be required to complete integration by Sept. 30, 2021.</p>
<p>For practices with 10 or more prescribers facing additional hurdles to integration, SB 5380 does allow for an economic/technical hardship or exceptional circumstance exemption to the mandate. The WSMA has been working with DOH staff as they draft and finalize the details of the waiver process. We will continue to advocate for flexibility for physicians and their practices moving forward. Should you have questions on the EHR-PMP integration requirement, please don't hesitate to contact <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
<h3>ABIM postpones Maintenance of Certification requirements</h3>
<p>Recognizing the demands being placed on board certified physicians, the American Board of Internal Medicine is postponing all Maintenance of Certification requirements due in 2020. Any physician who is currently certified and has an MOC requirement due in 2020 will now have until the end of 2021 to complete it. Physicians currently in their grace year will also have until 2021. All fall 2020 MOC assessments will be offered as planned for those who wish to take them. More information can be found on the ABIM's Coronavirus Updates page.</p>
</div> | 5/14/2020 2:20:36 PM | 5/7/2020 12:43:15 PM | 5/14/2020 12:00:00 AM |
| drop_in_child_vaccinations_prompts_call_for_patient_outreach | Drop in Child Vaccinations Prompts Call for Patient Outreach | memo | Shared_Content/News/Membership_Memo/20200514/drop_in_child_vaccinations_prompts_call_for_patient_outreach | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/cdc-immunization-645x425px.jpg" class="pull-right" alt="Child being immunized" />
</div>
<h5>May 14, 2020</h5>
<h2>Drop in Child Vaccinations Prompts Call for Patient Outreach</h2>
<p>Child immunizations are dropping during the COVID-19 pandemic, both in <a href="https://coronavirus.wa.gov/news/drop-vaccination-leaves-children-vulnerable-other-diseases">Washington</a> and <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e2.htm?s_cid=mm6919e2_w">nationally</a>, leaving both children and communities vulnerable to outbreaks of vaccine-preventable diseases.The Washington State Department of Health and the Washington Chapter of the American Academy of Pediatrics are encouraging physicians and providers to ask their patients who have missed well-child appointments and vaccinations to make an appointment right away. If needed, physicians can prioritize care and vaccination of infants and young children (0 to 24 months of age), followed by children age four to six years. Download <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/PleaseContinueVaccinatingPatients.pdf" target="_blank">DOH's provider guidance</a> on the issue. WCAAP offers helpful family-facing materials in multiple languages <a href="https://wcaap.org/physicians/coronavirus-covid-19-resources/back-to-clinic-campaign/">on its website</a>. Additional immunization resources for both patients and physician can be found on WithinReach's <a href="https://immunitycommunitywa.org/covid-19-and-immunizations/">Immunity Community website</a>.</p>
</div> | 5/19/2020 12:11:02 PM | 5/7/2020 12:43:19 PM | 5/14/2020 12:00:00 AM |
| new_webinar_opioids_and_telehealth_in_a_pandemic | New Webinar: Opioids and Telehealth in a Pandemic | memo | Shared_Content/News/Membership_Memo/20200514/new_webinar_opioids_and_telehealth_in_a_pandemic | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/April/opioid_hydrocodone_bottle-645x425px.jpg" class="pull-right" alt="Hydrocodone bottle" />
</div>
<h5>May 14, 2020</h5>
<h2>New Webinar: Opioids and Telehealth in a Pandemic</h2>
<p>Tune in today (Friday) from 1-2 p.m. for Opioids and Telehealth in a Pandemic, a virtual session for physicians and advanced practitioners caring for chronic pain patients via telemedicine during the pandemic. We will delve into: strategies to provide remote care for patients that you usually need to see in person, how to bill for telemedicine, regulatory changes to opioid prescribing and telemedicine policies, and the key features of the Better Prescribing, Better Treatment acute opioid reports. Speakers include Laura-Mae Baldwin, MD; Michael Parchman, MD, MPH; Jessica Schlicher, MD, MBA; Nathan Schlicher, MD, JD, MBA, FACEP; and WSMA Director of Policy Jeb Shepard. This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢</em>. Register <a href="https://zoom.us/webinar/register/WN_txil7JdzRUibIRv_k4VEjw">online</a> and join us! For those unable to tune in, the session will be archived and offered on the WSMA website.</p>
<h3>Other upcoming webinars</h3>
<h4>Planning Tools to Meet the Unique Challenges of COVID-19</h4>
<p>Part of Honoring Choices Pacific Northwest's series of free webinars on communication skills and tools in response to the COVID-19 pandemic. Featuring Stephanie Anderson, DNP, RN, executive director, Respecting Choices®.</p>
<p>Friday, May 22, noon-1 p.m.</p>
<p>Register <a href="https://register.gotowebinar.com/register/89394000289644302?source=HCPNW+Website">online</a>.</p>
</div> | 5/14/2020 2:20:41 PM | 5/7/2020 12:43:12 PM | 5/14/2020 12:00:00 AM |
| sustaining_physicians_and_pas_during_covid_19 | Sustaining Physicians and PAs During COVID-19 | memo | Shared_Content/News/Membership_Memo/20200514/sustaining_physicians_and_pas_during_covid_19 | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/Tree-Lake-645x425px.jpg" class="pull-right" alt="Tree in a lake" />
</div>
<h5>May 14, 2020</h5>
<h2>Sustaining Physicians and PAs During COVID-19</h2>
<p>It's critical that physicians and physician assistants are able to access the support they need and practice self-care while they strive to meet their calling to provide medical care to patients. Several organizations have reached out to the WSMA to offer support services to our state's clinical workforce. The WSMA shares these resource links as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by the WSMA. However, if you choose to utilize resources from these organizations, we would appreciate you sharing your experiences with us.</p>
<ul>
<li><a href="https://www.wacovid19therapists.com/home?from=@">The Washington COVID-19 Mental Health Network</a> is a growing body of licensed therapists who are providing short term, no-fee therapy to front-line health care workers and first responders. Therapy will be by video or phone.</li>
<li><a href="https://www.psychologytoday.com/us/therapists/washington?sid=5e73e0fcbaa71">Find a licensed therapist near you</a>. Many therapists provide online and phone sessions. You can either private pay or bill your insurance.</li>
<li>Access your employer's employee assistance or physician assistance program. Services are 100% confidential and provided by skilled mental health professionals. Online and phone sessions are available through most EAPs. Important: The WSMA is advocating for steps EAPs and PAPs can take to reduce clinician reluctance to use the programs. <a href="[@]WSMA/Resources/COVID-19_Response/Care_for_the_Caregiver_During_COVID-19_Outbreak/WSMA/Resources/COVID-19/Care_for_the_Caregiver_During_COVID-19_Outbreak/care_for_the_caregiver_during_covid_19_outbreak.aspx?hkey=997ed483-e3fa-466e-bd81-a66e0fc1575b#eap">Learn more</a>.</li>
<li><a href="https://www.physiciansupportline.com/">The Physician Support Line</a> is staffed by psychiatrists to provide "free and confidential support to physician colleagues on the COVID-19 front line."</li>
<li><a href="http://traumarecoverywa.org/">The EMDR Trauma Recovery Network of Western WA</a> is providing no-fee, short-term EMDR-informed therapy to front-line health care and EMS workers.</li>
<li><a href="https://www.talkspace.com/blog/coronavirus-talkspace-donation-healthcare-workers/">Talkspace</a>, an online therapy platform, is donating free therapy to front-line health care workers.</li>
<li>Review the Center for the Study of Traumatic Stress' <a href="https://www.cstsonline.org/assets/media/documents/CSTS_FS_Sustaining_Well_Being_Healthcare_Personnel_during.pdf.pdf" target="_blank">Sustaining the Well-Being of Healthcare Personnel during Coronavirus</a>.</li>
</ul>
</div> | 5/14/2020 2:20:41 PM | 5/7/2020 12:43:23 PM | 5/14/2020 12:00:00 AM |
| updates_on_telehealth_parity_practices_in_financial_crisis | Updates on Telehealth Parity, Practices in Financial Crisis | memo | Shared_Content/News/Membership_Memo/20200514/updates_on_telehealth_parity_practices_in_financial_crisis | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/telemed_smartphone_steth-645x425px.jpg" class="pull-right" alt="Stethoscope and smartphone" />
</div>
<h5>May 14, 2020</h5>
<h2>Updates on Telehealth Parity, Practices in Financial Crisis</h2>
<p>Payment parity news, including action needed by lawmakers in Olympia on state parity measures, ERISA legislation introduced in Congress, and a breakthrough on Medicare telephone visits. Also, the WSMA announces new data showing physician practices experiencing worsening financial fallout from COVID-19.</p>
<h3>Further action needed to extend telemedicine payment parity in Washington</h3>
<p>In response to the outbreak, Gov. Jay Inslee issued a proclamation that immediately - and temporarily - implemented Senate Bill 5385, requiring that physicians be paid for telemedicine services at the same rate as if those services had been provided in person. On May 4, the governor extended the order through May 31, but further action is needed to keep telemedicine payment parity in place until the operative provisions of SB 5385 take effect (as per the original bill) on Jan. 1, 2021. If you haven't yet done so, <a href="https://takeaction.wsma.org/tell-lawmakers-to-put-patients-and-physicians-over-politics/">send a message to your state lawmakers</a> and urge their support for telehealth/phone consultation at payment parity with in-person visits through the end of the year, so that there is no gap in the law being in effect.</p>
<p>At the federal level, the WSMA is supporting a new proposal from Rep. Kim Schrier (D-WA) that addresses another pain point frequently mentioned by physicians - reimbursement from self-insured ERISA plans for telemedicine services. HR 6644 would require ERISA plans to pay at parity with face-to-face services for care delivered via telemedicine. <a href="https://www.congress.gov/bill/116th-congress/house-bill/6644">Learn more about HR 6644</a>.</p>
<h3>CMS broadens telehealth access and provides payment parity for telephone services</h3>
<p>In our advocacy, the WSMA has also urged parity for another remote care delivery model: phone visits. Like telemedicine, telephone consults have become a vital strategy used by physicians to deliver patient care during the outbreak. In good news for physicians, the Centers for Medicare &amp; Medicaid Services has recognized the need to better support audio-only telephone services by increasing payments for telephone visits to match payments for office and outpatient visits. CMS has increased payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020. CMS has cross-walked payment rates for CPT codes 99212, 99213, and 99214 to 99441, 99442, and 99443. CMS is also finalizing on an interim basis and for the duration of the COVID-19 public health emergency the following work RVUs: 0.48 for CPT code 99441; 0.97 for CPT code 99442; and 1.50 for CPT code 99443. You can read the rule <a href="https://www.cms.gov/files/document/covid-medicare-and-medicaid-ifc2.pdf" target="_blank">here</a> and the press release <a href="https://www.cms.gov/newsroom/press-releases/trump-administration-issues-second-round-sweeping-changes-support-us-healthcare-system-during-covid">here</a>.</p>
<p>CMS has also waived the interactive audio-video requirement for certain telehealth evaluation and management services, so now physicians can bill for these services when provided by audio-only telephone, provided all other applicable requirements are met. CMS has updated the list of eligible codes on the <a href="https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes">Medicare telehealth services list</a> and clearly marked which codes are eligible for audio-only. You can read the rule <a href="https://www.cms.gov/files/document/covid-medicare-and-medicaid-ifc2.pdf" target="_blank">here</a> and the press release <a href="https://www.cms.gov/newsroom/press-releases/trump-administration-issues-second-round-sweeping-changes-support-us-healthcare-system-during-covid">here</a>.</p>
<h3>Survey data show physician practices in financial crisis</h3>
<p>Results from the WSMA's latest economic impact survey of physician clinics in Washington state illustrate the severe economic hardship many doctors' offices are facing as they struggle to remain available to patients in the community.</p>
<p>Survey data, compiled in early May from 136 physician practices, represent a snapshot of what is happening in practices across the state and should serve as a wake-up call to both patients and policymakers as the state begins reintroducing health care services.</p>
<p>On the financial impact on practices, survey respondents indicate, since March 1:</p>
<ul>
<li>On average, patient volume has decreased 62%.</li>
<li>47% of practices have lost revenue up to $150,000. 32% have lost between $150,000 and $500,000. 13% have lost more than $1 million.</li>
<li>73% of practices report only having 1-6 weeks "days cash on hand," defined as the number of days a practice could pay its operating expenses with cash available. Ideally, practices should have 18 weeks' worth.</li>
</ul>
<p>When asked what they expect if the status quo remains for the next 30 days, 30% of practices said they expect to lose an additional $100,000 to $250,000, 21% expect to lose between $250,000 and $1 million, and 11% expect to lose more than $1 million in revenue.</p>
<p>As the survey indicates, practices are making decisions in response to financial constraints now. On the immediate impact on communities, survey respondents indicate, since March 1:</p>
<ul>
<li>67% are changing office hours</li>
<li>55% are laying off or furloughing staff</li>
<li>41% have stopped taking a paycheck</li>
<li>21% have reduced physician salaries</li>
<li>Nearly 20% have closed temporarily</li>
</ul>
<p>39% of survey respondents were solo practitioners. 40% were in practices of 2-10 physicians and 10% were in practices of 11-20 physicians. Less than 9% of respondents represented practices of 21-100 physicians, and less than 2% of respondents were from practices with over 100 physicians.</p>
<p>As WSMA President William Hirota, MD, noted in <a href="[@]Shared_Content/News/Press_Release/2020/washingtons_physician_practices_in_financial_crisis_new_wsma_survey">a press release announcing the survey results</a>, "The WSMA is raising a clarion call on policymakers to act. Policymakers looked to the physician community to treat patients during the pandemic, and we did just that. The physician community is now looking to policymakers to help ensure that we can keep our doors open so we can continue that care."</p>
</div> | 5/14/2020 2:20:44 PM | 5/7/2020 12:43:09 PM | 5/14/2020 12:00:00 AM |
| wsma_urges_more_education_on_serological_testing | WSMA Urges More Education on Serological Testing | memo | Shared_Content/News/Membership_Memo/20200514/wsma_urges_more_education_on_serological_testing | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/Blood-Vials-national-cancer-institute-645x425px.jpg" class="pull-right" alt="Blood vials" />
</div>
<h5>May 14, 2020</h5>
<h2>WSMA Urges More Education on Serological Testing</h2>
<p>
While serological testing shows promise in helping determine disease prevalence in a community, until more is known about the performance of these tests the WSMA urges our members to make their patients aware that more research needs to be done on antibody testing and its interpretation in the individual patient. The WSMA has concerns over the performance of many of these tests currently coming to market. Additionally, serological testing for SARS-CoV-2 antibodies currently has a number of limitations, including the possibility of false positive results due to cross-reactivity with other coronaviruses, as well as potential errors in interpretation of a positive result in areas of low disease prevalence. As with all things related to COVID-19, the dynamic around serological testing is fluid and we will continue to monitor the issue closely. For now, the WSMA believes these tests should be limited to use in epidemiological/population-level study or by physicians and laboratorians trained in the interpretation of serological tests.
</p>
</div> | 5/14/2020 2:20:22 PM | 5/7/2020 12:43:00 PM | 5/14/2020 12:00:00 AM |
| health_advisory_pediatric_multi_system_inflammatory_syndrome_potentially_associated_with_covid_19_in | Health Advisory: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19 i | memo | Shared_Content/News/Membership_Memo/20200514/health_advisory_pediatric_multi_system_inflammatory_syndrome_potentially_associated_with_covid_19_in | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response graphic" />
</div>
<h5>May 12, 2020</h5>
<h2>Health Advisory: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19 in Children</h2>
<p>The Washington State Department of Health issued the following health advisory today, May 12, 2020. The advisory asks physicians and other health care providers to report cases of "Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19."</p>
<h3>Actions</h3>
<ul>
<li>Be aware that the novel coronavirus (COVID-19) has been recently reported as possibly linked with a pediatric multi-system inflammatory syndrome disease – "Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19."</li>
<li>Consider "Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19" in children who present with persistent fever, inflammation (e.g., neutrophilia, elevated C-reactive protein and lymphopenia) and evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder). See below for additional information.</li>
<li>Immediately reportcases of pediatric multi-system inflammatory syndrome potentially associated with COVID-19 in patients who are under 21 years of age to <a href="https://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions">your local health jurisdiction</a>.</li>
<li>Perform a PCR and serological testto detect the presence of SARS-COV-2, the virus that causes COVID-19, or corresponding antibodies in the patient.</li>
<li>Use COVID-19 PPE and infection control precautions while patients are under evaluation for and if diagnosed with COVID-19.</li>
</ul>
<h3>Background</h3>
<ul>
<li>In the United Kingdom and Europe, a possible link has been reported between COVID-19 and a serious inflammatory disease recently termed "Pediatric Multi-System Inflammatory Syndrome Temporally Associated with COVID-19."</li>
<li>As of May 11, 2020, one suspected pediatric clinical case compatible with multi-system inflammatory syndrome associated with COVID-19 has been reported in children in Washington state. As of May 5, 2020, 64 cases have been reported in children in New York state.</li>
<li>This syndrome has features which overlap with Kawasaki Disease and Toxic Shock Syndrome. Inflammatory markers may be elevated, and fever and abdominal symptoms may be prominent. Rash also may be present. Myocarditis and other cardiovascular changes may be seen. Additionally, some patients have developed cardiogenic or vasogenic shock and required intensive care. This inflammatory syndrome may occur days to weeks after acute COVID-19 illness.</li>
<li>The syndrome may include:</li>
<ul>
<li>A child presenting with persistent fever, inflammation (e.g., neutrophilia, elevated C-reactive protein, ferritin, and lymphopenia) and evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder). This may include children meeting full or partial criteria for Kawasaki disease.</li>
<li>Exclusion of any other microbial cause, including bacterial sepsis, staphylococcal or streptococcal shock syndromes, and infections associated with myocarditis such as enterovirus. Clinicians should not delay seeking expert advice while waiting for results of these investigations.</li>
</ul>
<li>Early recognition by pediatricians and prompt referral to an in-patient specialist, including to critical care is essential.</li>
<li>This syndrome should be considered by pediatricians and specialists, particularly when other microbial etiologies have not been identified.</li>
<li>Pediatricians and specialists should elicit any recent history of illness with COVID-19 or close contact with individuals who are known to have COVID-19 in children presenting with symptoms that are compatible with pediatric multi-system inflammatory syndrome potentially associated with COVID-19.</li>
<li>The majority of patients who have presented with this syndrome have tested positive for SARS-CoV- 2 or corresponding antibodies. Some tested positive on diagnostic, molecular testing for SARS-CoV-2, others were positive on serological testing for corresponding antibodies.</li>
</ul>
<h4>RESOURCES</h4>
<ul>
<li><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31094-1/fulltext">Lancet correspondence (May 6, 2020)</a></li>
<li><a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html">Centers for Disease Control and Prevention (CDC) COVID-19 Website</a></li>
<li><a href="https://www.rcpch.ac.uk/sites/default/files/2020-05/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf" target="_blank">Royal College of Paediatrics and Child Health Guidance: Paediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19</a></li>
</ul>
</div> | 5/14/2020 2:20:40 PM | 5/7/2020 12:43:03 PM | 5/12/2020 12:00:00 AM |
| governor_issues_new_guidance_on_non_urgent_procedures | Governor Issues New Guidance on 'Non-Urgent' Procedures | memo | Shared_Content/News/Membership_Memo/20200508/governor_issues_new_guidance_on_non_urgent_procedures | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/May/Surgery_room2_645x425.jpg" class="pull-right" alt="Surgery room" />
</div>
<h5>April 30, 2020</h5>
<h2>
Governor Issues New Guidance on "Non-Urgent" Procedures
</h2>
<p>
At the urging of the WSMA and others in the health care community, Gov. Jay Inslee issued an interpretive statement providing clarification on his <a href="https://www.governor.wa.gov/sites/default/files/20-24%20COVID-19%20non-urgent%20medical%20procedures%20%28tmp%29.pdf" target="_blank">proclamation</a> issued March 19 that imposed restrictions on "non-urgent" medical procedures.
</p>
<h3>What's in the interpretive statement</h3>
<p>
The interpretive statement clarifies the proclamation's definition of "harm" and the intent of physicians using their medical judgment when determining whether a medically necessary procedure or surgery should be postponed. The new interpretive statement also outlines prerequisites for performing procedures and surgeries, such as maintaining appropriate PPE supplies and following the Department of Health guidance on the use of PPE. Download the <a href="https://www.informz.net/WSMA/data/images/Attachments/Non-Emergent_Procedure_Interpretive_Statement_4.29.20.pdf" target="_blank">interpretive<strong> </strong>statement</a> released, April 29, 2020.
</p>
<p>
<strong>As violating the March 19 proclamation could subject physicians to criminal penalties,the WSMA strongly urges you to review both the proclamation and interpretive statement.</strong>
</p>
<p>
As a reminder, the March proclamation does not apply to outpatient clinics. As stated in today's interpretive statement, "The proclamation permits outpatient clinic visits, both in hospital-based clinics and other outpatient clinic settings. While not addressed in the proclamation, the department encourages clinicians to weigh the benefits and risks of such visits to patients given the active presence of COVID-19 in our communities. It also encourages clinicians to use telehealth visits where possible."
</p>
<h3>WSMA thanks governor, emphasizes liability concerns</h3>
<p>
The WSMA thanked the governor for releasing the clarifications of the original proclamation, which many physicians and hospitals found vague in intent. With criminal penalties attached to the original order, clinicians were cautious about proceeding with some medical procedures, largely focusing on those that would result in death or disability if postponed for three months.
</p>
<p>
"Since the imposition of the order, we've heard numerous stories from physicians who describe situations where their patients with chronic health conditions are at home, in pain, and unable to schedule necessary procedures while their conditions worsen," said WSMA President William K. Hirota in a&nbsp;<a href="https://www.informz.net/WSMA/data/images/Attachments/Medical_Procedures_Proclamation_clarity_news_release-WORD_042820-FINAL-w-logo.pdf" target="_blank">statement</a>. "Patients need assurances that they can, and should, access necessary health care, and physicians need assurance their clinical decisions won't lead to criminal penalties." The WSMA is also seeking civil liability protections for physicians and other practitioners responding to the COVID-19 pandemic. <a href="http://wsma.informz.net/z/cjUucD9taT05MzAyMDMzJnA9MSZ1PTEwNzgxMDgzNjAmbGk9NzY0MDk3MTE/index.html">Learn more</a>.
</p>
<h3>New checklist to help you adjust practice workflow</h3>
<p>
To help your practice adjust its workflow and help comply with the governor's proclamation restricting non-urgent procedures, the WSMA offers a new checklist. Use the checklist manually or to build prompts into your electronic health record (e.g. Epic dot phrase). Download the checklist as a <a href="https://www.informz.net/WSMA/data/images/Attachments/Nonurgent_proc_dotphrase_04292020_WSMA.docx" target="_blank">Word document</a> or a <a href="https://www.informz.net/WSMA/data/images/Attachments/Nonurgent_proc_dotphrase_04292020_WSMA.pdf" target="_blank">PDF</a>. Please note that the checklist does not constitute legal advice.*
</p>
<p>
By taking these precautions, physicians can make a difference in helping to preserve the limited PPE supply available to front-line health care personnel providing emergency and critical care in response to the pandemic, while keeping themselves, their patients, and their communities safe.
</p>
<p>
<em>*This checklist is provided for general informational purposes only. It is not intended to provide or be relied upon for legal advice, and may not be comprehensive or ensure compliance with the requirements. Accordingly, before using this checklist, the WSMA strongly urges all physicians seeking to provide care during the pandemic to read the <a href="https://www.governor.wa.gov/sites/default/files/20-24%20COVID-19%20non-urgent%20medical%20procedures%20%28tmp%29.pdf" target="_blank">proclamation</a> and <a href="[@]doc_library/news/non_emergent_procedure_interpretive_statement_42920.pdf" target="_blank">interpretive statement</a> to understand requirements in detail.</em>
</p>
</div> | 5/1/2020 6:22:02 PM | 4/30/2020 9:00:13 AM | 4/30/2020 12:00:00 AM |
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<h5>April 29, 2020</h5>
<h2>PMP-EHR Integration Mandate Delayed Until September 2021</h2>
<p>
<a href="https://app.leg.wa.gov/billsummary?BillNumber=5380&amp;Year=2019&amp;Initiative=false">Senate Bill 5380</a>, a measure aimed at addressing the opioid epidemic, was signed into law during the 2019 legislative session. Among other provisions, the bill requires electronic health record integration with the state's prescription monitoring program for practices with 10 or more prescribers beginning on Jan. 1, 2021. Last week, in response to protracted WSMA advocacy on the issue, Secretary of Health John Wiesman announced he'd be delaying the EHR-PMP integration requirement due to the COVID-19 public health emergency and its impact on the financial viability of physician practices. Practices will now be required to complete integration by September 30, 2021.
</p>
<p>
For practices with 10 or more prescribers facing additional hurdles to integration, SB 5380 does allow for an economic/technical hardship or exceptional circumstance exemption to the mandate. The WSMA has been working with DOH staff as they draft and finalize the details of the waiver process. We will continue to advocate for flexibility for physicians and their practices moving forward. Should you have questions on the EHR-PMP integration requirement, please don't hesitate to contact the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.
</p>
</div> | 4/29/2020 2:50:57 PM | 4/29/2020 2:47:37 PM | 4/29/2020 12:00:00 AM |
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<h5>April 29, 2020</h5>
<h2>Take Action Today: Tell Lawmakers to Put Patients and Physicians Over Politics</h2>
<p>
So much about health care has changed in the past few weeks, from the way patients access care to your practices' business model and everything in between. But the one thing that has remained the same is that you're there for your patients every day, providing care and prioritizing their health above your own. You deserve to know that lawmakers in Olympia are working to support the physician community just as you're working to support your patients.
</p>
<p>
Currently pending in Olympia are three policies that are desperately needed to help ensure patient access to care in Washington. Lawmakers need to hear from you today in support of:
</p>
<ul>
<li><strong>Providing clarity on Gov. Jay Inslee's nonurgent procedure delay order</strong>, so that physicians know the circumstances under which they can provide needed care.</li>
<li><strong>Enacting liability protections for front-line health care practitioners</strong>, giving certainty to physicians that they won't be punished for treating patients during the pandemic.</li>
<li><strong>Continuing to reimburse telemedicine at parity with in-person visits</strong>, to support the transition to remote care.</li>
</ul>
<p>
These three policies are in jeopardy—not because of their merits, but because of politics.
</p>
<p>
We know there are powerful interest groups in Olympia. And we understand that people are frustrated with the constraints of the "stay home, stay healthy" order. But we can't let politics take priority over science and over patients being able access the care that they need.
</p>
<p>
Our state's physician community has been steadfast in prioritizing public health over politics and over their own business interests. We supported social distancing restrictions to keep people healthy. We advocated for delaying nonurgent medical procedures to preserve personal protective equipment. And we continue to show up to work every day to treat the patients who need care.
</p>
<p>
<strong>It's time that Olympia shows physicians the same support we've shown our patients. </strong>
</p>
<p>
Our state lawmakers must take action on these issues now. Learn more and send a message to the governor's office and your state legislators today.
</p>
<a href="https://takeaction.wsma.org/tell-lawmakers-to-put-patients-and-physicians-over-politics/" class="TextButton">Take Action</a>
</div> | 4/29/2020 3:28:54 PM | 4/22/2020 3:48:43 PM | 4/29/2020 12:00:00 AM |
| updates_on_new_ppp_funding_additional_hhs_provider_relief_funds_and_more | Updates on New PPP Funding, Additional HHS Provider Relief Funds, and More | memo | Shared_Content/News/Membership_Memo/20200424/updates_on_new_ppp_funding_additional_hhs_provider_relief_funds_and_more | <div class="col-md-12">
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<h5>April 24, 2020</h5>
<h2>Updates on New PPP Funding, Additional HHS Provider Relief Funds, and More</h2>
<p>
Here's the latest on federal movement on a new stimulus package, new direct deposit funds starting this week, and several updates on financial assistance measures underway.
</p>
<h3>Congress passes The Paycheck Protection Program and Health Care Enhancement Act</h3>
<p>
The U.S. Senate and House of Representatives passed a new stimulus package, which aims to replenish the funds for the small business loan program. The Trump administration has promised a quick signature once on the president's desk.
</p>
<p>
Highlights of the Act include:
</p>
<ul>
<li>$321 billion in new funding for the Paycheck Protection Program.</li>
<li>$75 billion for reimbursement to hospitals and health care providers to support the need for COVID-19-related expenses and lost revenue. This funding is in addition to the $100 billion provided in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.</li>
<li>$25 billion for necessary expenses to research, develop, validate, manufacture, purchase, administer, and expand capacity for COVID-19 tests. Specific funding is provided for:</li>
<ul>
<li>$11 billion for states, localities, territories, and tribes to develop, purchase, administer, process, and analyze COVID-19 tests, scale-up laboratory capacity, trace contacts, and support employer testing. Funds are also made available to employers for testing.</li>
<ul>
<li>$2 billion provided to States consistent with the Public Health Emergency Preparedness grant formula, ensuring every state receives funding.</li>
<li>$4.25 billion provided to areas based on relative number of COVID-19 cases.</li>
<li>$750 million provided to tribes, tribal organizations, and urban Indian health organizations in coordination with Indian Health Service.</li>
</ul>
</ul>
</ul>
<p>The AMA provides a <a href="javascript://[Uploaded files/News and Publications/Newsletters/2020/Paycheck Protection Program and Health Care Enhancement Act Summary (4-23-20).pdf]">detailed summary of the legislation</a>.</p>
<p>
ICYMI: The WSMA offers an archived webinar, featuring attorneys from K&amp;L Gates, which provides guidance on how to tap into federal financial assistance programs. Visit the WSMA website to <a href="[@]WSMA/Resources/COVID-19_Response/Financial_Viability_During_COVID-19/WSMA/Resources/COVID-19/Financial_Viability_During_COVID-19/financial_viability_during_covid_19.aspx?hkey=59bdde18-196d-479e-bfab-10b7ddd7b227">view the webinar</a>.
</p>
<h3>New HHS provider relief funds released this week</h3>
<p>
The U.S. Department of Health &amp; Human Services announced more funds from the $100 billion CARES Act Provider Relief Fund will be released starting this week. In good news for physicians, this new dispersion takes into consideration practices that were disadvantaged by the previous payment methodology. Here's what you need to know—and note that some practices that do not see many Medicare patients will need to be proactive. From the HHS press release:
</p>
<ul>
<li><em>HHS has indicated funds will be going out quickly to help providers with a relatively small share of their revenue coming from Medicare fee-for-service, such as children's hospitals.</em> </li>
<li><em>Those funds are beginning to be delivered this week. HHS will begin distribution of the remaining $20 billion of the general distribution to these providers to augment their allocation so that the whole $50 billion general distribution is allocated proportional to providers' share of 2018 net patient revenue.</em> </li>
<li><em>On April 24, a portion of providers will automatically be sent an advance payment based off the revenue data they submit in CMS cost reports. Providers without adequate cost report data on file will need to submit their revenue information to the <a href="https://www.hhs.gov/provider-relief/index.html">CARES Act Provider Relief Fund Payment Attestation Portal</a> opening this week for additional general distribution funds.</em> </li>
<li><em>Providers who receive their money automatically will still need to submit their revenue information so that it can be verified.</em> </li>
<li><em>Payments will go out weekly, on a rolling basis, as information is validated, with the first wave being delivered at the end of this week (April 24, 2020).</em></li>
</ul>
<p>Read the <a href="https://www.hhs.gov/about/news/2020/04/22/hhs-announces-additional-allocations-of-cares-act-provider-relief-fund.html">HHS announcement for details</a>.</p>
<p>
A reminder: Physicians who have been allocated a payment from the Provider Relief Fund general distribution must sign an attestation confirming receipt of the funds and agree to the terms and conditions within 30 days of payment. The terms and conditions are <a href="https://www.hhs.gov/sites/default/files/relief-fund-payment-terms-and-conditions.pdf" target="_blank">listed here</a>. Access the attestation portal <a href="https://covid19.linkhealth.com/#/step/1">here</a>.
</p>
<p>
Physicians should note that, as a condition of receiving the HHS funds, balance billing is prohibited. From the press release:
</p>
<p>
<em>President Trump is committed to ending surprise bills for patients. As part of this commitment, as a condition to receiving these funds, providers must agree not to seek collection of out-of-pocket payments from a presumptive or actual COVID-19 patient that are greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.</em>
</p>
<h3>Medicare 2% payment increase to take effect on May 1</h3>
<p>
The CARES Act temporarily suspends the -2% sequestration payment adjustment on Medicare fee-for-service payment. This means that physicians will see a 2% payment increase on Medicare claims effective May 1, 2020. The increase is effective for claims with dates of service from May 1, 2020, through December 31, 2020.
</p>
<p>
Since the passage of Sequestration Transparency Act of 2012, Medicare payments have been subject to a 2% sequestration reduction. These cuts are the result of a congressional deal to address the debt ceiling crisis.
</p>
</div> | 4/24/2020 3:44:05 PM | 4/22/2020 3:48:30 PM | 4/24/2020 12:00:00 AM |
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<h5>April 24, 2020</h5>
<h2>WSMA Works with State to Outline Resumption of Service</h2>
<p>
With Washington state having "flattened the curve" and no longer projecting an overwhelmed health care system, the WSMA is working with state and health care leaders to develop guidance on resuming services.
</p>
<h3>Confusion persists on governor's proclamation on elective surgeries and procedures</h3>
<p>Due to ongoing confusion about what can and can't be done in the hospital and ambulatory surgical communities with regards to "elective" surgeries or "nonurgent procedures," the WSMA, the Washington State Hospital Association, the Washington Ambulatory Surgery Center Association, and others requested an interpretive statement from Gov. Jay Inslee and the state Department of Health on the order, specifically looking for more clarity on the definition of harm.
</p>
<p>
As we await action on the statement, we want to emphasize the <a href="https://www.governor.wa.gov/sites/default/files/20-24 COVID-19 non-urgent medical procedures %28tmp%29.pdf?utm_medium=email&amp;utm_source=govdelivery">governor's proclamation</a> applies to hospitals, ambulatory surgery facilities, dental, orthodontic, and endodontic offices in Washington—not outpatient clinics. The proclamation allows performance of all services considered to be "emergent" or "urgent" for which delay would result in worsening a life-threatening or debilitating prognosis. Specific language in the proclamation reads: "Hospitals and ambulatory surgical facilities may perform any surgery that if delayed or canceled would result in the patient's condition worsening." Clinicians should use clinical judgment to determine the best course of care for their patients.
</p>
<h3>More physicians and facilities report patients delaying care </h3>
<p>
More physicians are reporting a troubling trend of patients who are avoiding seeking needed care, possibly due to various factors: a reluctance to go into perceived "dangerous" health care settings, confusion about state prohibitions on elective and nonurgent procedures, or statewide stay-at-home orders.
</p>
<p>
Since the WSMA first reported on the issue in <a href="[@]Shared_Content/News/Weekly_Rounds/2020/weekly_rounds_april_17_2020_advocacy_and_answers_in_the_time_of_covid_19">last week's Weekly Rounds</a>, which included a look at concerns from within the <a href="https://www.knkx.org/post/washington-state-doctors-puzzled-drop-heart-attack-stroke-patients-amid-covid-19">UW Medicine system</a>, we've gathered the following local data points:
</p>
<ul>
<li>Bellevue Overlake Medical Center's stroke program notes reductions from March through April in code stroke activations (51%), Alteplase administration (62%), and mechanical thrombectomy (38%) compared with the same time last year.</li>
<li>The Washington State Department of Health reports that visits to emergency departments in Washington are down nearly 40% compared to last year.</li>
<li>A <a href="https://www.propublica.org/article/theres-been-a-spike-in-people-dying-at-home-in-several-cities-that-suggests-coronavirus-deaths-are-higher-than-reported">ProPublica article</a> noted that data in Seattle indicates that EMT and paramedic calls dropped by more than 25% in the first 10 days of April compared with the same time frame last year.</li>
</ul>
<p>
The "Stay Home, Stay Healthy" mandate does not apply when a patient is sick or needs care. In those instances, "you may need to leave home in order to stay healthy," as WSMA President Bill Hirota, MD, says in a <a href="https://vimeo.com/410792380">new public service announcement</a> released this week. That PSA, plus a second PSA urging patients to seek care for stroke symptoms, are available on the WSMA's <a href="[@]WSMA/Resources/COVID-19_Response/COVID-19_Patient_Education/WSMA/Resources/COVID-19/COVID-19_Patient_Education/covid_19_patient_education.aspx?hkey=1883b646-8a34-48dc-926d-c9711850a7cd#psa">website</a> and social channels.
</p>
</div> | 4/24/2020 12:54:45 PM | 4/22/2020 3:48:41 PM | 4/24/2020 12:00:00 AM |