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analyzing_the_2020_primary_election_so_farAnalyzing the 2020 Primary Election So FarLatest_NewsShared_Content/News/Latest_News/2020/August/analyzing_the_2020_primary_election_so_far<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/King-Co-Ballot-645x425px.png" class="pull-right" alt="King County ballot" /> </div> <h5>August 7, 2020</h5> <h2> Analyzing the 2020 Primary Election So Far</h2> <p> By WSMA Government Affairs & Policy staff </p> <h5> <em>Members only; sign-in required.</em> </h5> <p> WSMA's team in Olympia provides the following update for members on the results (so far!) from the state's primary election on Aug. 4: </p> <p> The 2020 election cycle hasn't been as advertised to date, with the pandemic justifiably diverting our attention from politics, but things did start to pick up heading into Tuesday's primary election with campaign ads dominating airwaves and mailboxes. The main event of Trump vs. Biden will have to wait until November, but there is plenty to analyze from this week's results. </p> <p> A quick disclaimer before we dive in: Washington's vote-by-mail system has many virtues, but speed is not one of them. When the polls closed on Tuesday, the state had upwards of 500,000 ballots on hand yet to be counted, with many more to be received in the coming days. As a result, this reporting is based on very preliminary returns, and results will shift in the coming days, or even weeks, before some races are decided. </p> <p> At the congressional level, all nine of the state's incumbents look to be safe, including Rep. Kim Schrier (D-Issaquah), the Issaquah pediatrician who is running for reelection for the first time. Rep. Schrier solidly bested a crowded field and will advance to the general with a well-funded campaign, including contributions from the AMA's political action committee and several other physician organizations. </p> <p> The action is in the 10th Congressional District, centered on Olympia, where 19 candidates are seeking to replace Rep. Denny Heck (D-Olympia). Most prominently, the race features three Democrats who have held elected office, with former Tacoma mayor Marilyn Strickland posting a solid lead over current state House Rep. Beth Doglio (D-Olympia) and former Rep. Kristine Reeves. Our state's "top-two" primary means that Strickland will advance to the general election, likely against Rep. Doglio. </p> <p> The governor's race—weighted down with nearly 40 candidates—is at the top of the ticket for statewide campaigns. Gov. Jay Inslee cruised to victory in the primary and figures to do the same in the general against Loren Culp, a conservative Republican from Ferry County. In other statewide races of interest to WSMA members and WAMPAC, WSMA's political action committee, Attorney General Bob Ferguson and Insurance Commissioner Mike Kreidler will similarly be heavy favorites in the general. And in the lieutenant governor race, Denny Heck will face off against fellow Democrat Marko Liias in November. </p> <p> Early results in state legislative races are something of a Rorschach test, as evidenced by competing messaging that Republicans and Democrats rushed to push out in the wake of returns being posted Tuesday night. Two incumbent Republicans are trailing Democratic challengers on the Senate side, with the inverse being true in the House. Democrats may have been disappointed with preliminary performance in a few swing districts, but they are also likely holding out hope for better results in the general (more on that later). Here are a few of the state legislative races WAMPAC is keeping a close eye on: </p> <ul> <li>In Pierce County's 28th District, Sen. Steve O'Ban (R-University Place) is just a handful of votes behind Democratic challenger T'wina Nobles. O'Ban is a moderate and the lead Republican on the Senate Health & Long Term Care Committee.</li> <li>In an intraparty Democratic contest in the Issaquah-area 5th District, Sen. Mark Mullet narrowly trails challenger Ingrid Anderson, a nurse at Overlake's psychiatric department and the more progressive of the two candidates.</li> <li>Republicans look poised to potentially pick up two seats in southwest Washington's 19th legislative district, and another in Whatcom County's 42nd. Meanwhile, Democrats may return the favor in a Senate race in the 10th legislative district, which is comprised of Island County and parts of Skagit and Snohomish counties.</li> </ul> <p> It would be tempting to look at the mixed results and call it a wash, but if Democrats were to pick up two seats in the state Senate and replace a moderate Democrat with a more progressive one in a third seat, it would have a major impact in the tenor of the Legislature, as the Senate has often been a tempering force in recent years. </p> <p> Legislative Democrats making the case for why they'll perform even better in the November general election will point to a historically unpopular Trump being at the top of the ticket (a recent statewide poll has him underwater by a margin of 62-28), and the fact that higher turnout in the general likely favors Democrats. Republicans would likely cite those economic indicators that remain strong as serving as a tailwind, along with residents of the state potentially wanting a check on Democratic control via a few more Republicans in the Legislature. </p> <p> With everything that has happened this year already, the best bet is that our world will likely turn a few more times between now and the general election on Nov. 3. Another smart bet is using the remaining weeks of the campaign season to get in touch with candidates running in your district now and begin <a href="https://wsma.org/WSMA/Advocacy/Become_a_Grassroots_Advocate/Get_to_Know_Your_Legislators/Get_to_Know_Your_Legislators.aspx">building a relationship before they take office next year</a>. A full rundown of election results can be found here, and if you'd like help getting connected, or would like assistance with anything related to campaigns, contact WSMA Government Affairs Director Sean Graham at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> </div>8/7/2020 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_august_7_2020_the_good_and_the_bad_of_proposed_new_cms_ruleWeekly Rounds: August 7, 2020 - The Good and the Bad of Proposed New CMS RuleLatest_NewsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_august_7_2020_the_good_and_the_bad_of_proposed_new_cms_rule<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>August 7, 2020</h5> <h2>The Good and the Bad of Proposed New CMS Rule</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> No matter how unusual things have been over the last several months, one thing we can count on every summer is the release of proposed updates to Medicare's physician fee schedule. This year, the Centers for Medicare & Medicaid Services published its proposed rule, comprised of more than <a href="https://www.federalregister.gov/documents/2020/08/17/2020-17127/medicare-program-cy-2021-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other">1,300 pages of fee and policy proposals for 2021</a>, on the evening of Aug. 3 - the latest the agency has released the document in over a decade. </p> <p> The uncertainty and associated anxiousness created by the late release has given way to concerns around several controversial proposals. Most notably, CMS is overhauling the evaluation and management (E/M) office visit, documentation, and payment system, which will require an 11% budget neutrality reduction in the conversion factor, pitting the house of medicine against itself. </p> <p> While supportive of CMS's proposal to implement reforms and substantial payment increases for office visits, the WSMA is concerned by the <a href="https://www.cmadocs.org/Portals/CMA/files/public/CY%202021%20PFS%20Estimated%20Impact%20on%20Total%20Allowed%20Charges%20by%20Specialty.pdf" target="_blank">associated cuts to the non-primary care specialties</a> that will have a negative impact on many physician practices. </p> <p> Due to the community response to COVID-19, Washington's physician practices of all specialty types have <a href="[@]Shared_Content/News/Press_Release/2020/washingtons_physician_practices_in_financial_crisis_new_wsma_survey">experienced severe financial difficulty</a>. Instead of compounding these challenges, the WSMA supports the growing <a href="https://www.mgma.com/getattachment/764a1f8b-32b3-4975-85b9-54fa4703a644/E-M-Sign-on-letter-to-HHS-Budget-Neutrality.pdf.aspx">chorus</a> of medical associations and societies calling on the U.S. Department of Health and Human Services to use its authority under the public health emergency declaration to preserve patient access to care and mitigate financial distress due to the pandemic by implementing the office visit increases as planned while waiving budget neutrality requirements for the new Medicare office visit payment policy. </p> <p> Other notable proposed policies include: </p> <ul> <li>Annual updates to the MIPS quality program, including gradually implementing MIPS in 2021 and postponing the MIPS Value Pathways participation option until 2022.</li> <li>Permanently keeping several codes that were temporarily added to the Medicare telehealth list during COVID-19, including the prolonged office or outpatient E/M visit code and certain home visit services. These policies were included, in part, because of WSMA advocacy with CMS officials.</li> <li>Implementing the Appropriate Use Criteria program, which will require, starting Jan. 1, 2021, physicians to consult AUC using clinical decision support tools prior to ordering advance imaging services for Medicare beneficiaries.</li> </ul> <p> You can find a copy of the proposed rule <a href="https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17127.pdf" target="_blank">here</a>, RVU files and other downloads <a href="https://www.cms.gov/medicaremedicare-fee-service-paymentphysicianfeeschedpfs-federal-regulation-notices/cms-1734-p">here</a>, and a CMS fact sheet overviewing the rule <a href="http://wsma.informz.net/z/cjUucD9taT05NTA1NTY2JnA9MSZ1PTEwNzgxMDgzNjEmbGk9Nzk0MzcwOTE/index.html">here</a>. CMS is taking comments on its proposals until 5 p.m. on Oct. 5. We encourage you to review the rule and submit your comments at its <a href="https://beta.regulations.gov/document/CMS-2020-0088-0001">regulations.gov webpage</a>. </p> <p> The Medicare physician fee schedule, in a normal year, is finalized in early November. The WSMA will keep members apprised of developments. If you have any questions, email WSMA's policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> </div>8/7/2020 12:00:00 AM1/1/0001 12:00:00 AM
hhs_extends_deadlines_for_provider_relief_funds_telemedicine_parity_extended_financial_relief_newsHHS Extends Deadlines For Provider Relief Funds; Telemedicine Parity Extended; Financial Relief NewsLatest_NewsShared_Content/News/Latest_News/2020/August/hhs_extends_deadlines_for_provider_relief_funds_telemedicine_parity_extended_financial_relief_news<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>August 3, 2020</h5> <h2>HHS Extends Deadlines For Provider Relief Funds; Telemedicine Parity Extended; More Financial Relief News</h2> <p> An update on financial relief measures for physicians and practices experiencing lost revenues or increased expenses due to COVID-19. </p> <h3>HHS extends deadline, reopens window for Provider Relief Fund</h3> <p>The Department of Health and Human Services has <a href="https://www.hhs.gov/about/news/2020/07/31/hhs-extends-application-deadline-for-medicaid-providers-and-plans-to-reopen-portal-to-certain-medicare-providers.html">made several important announcements</a> regarding the Provider Relief Fund, the $175 billion pool of federal monies included in the CARES Act intended to help physicians and health care organizations responding to the COVID-19 pandemic. </p> <p> The initial $50 billion distribution from the Provider Relief Fund was based on a provider's Medicare revenues. Not all providers who treat Medicare patients were able to successfully receive funds, however, so HHS is reopening the window to apply starting the week of Aug. 10. Providers will have until <strong>Aug. 28</strong> to complete an application for a payment for up to 2% of their annual Medicare patient revenues. </p> <p> A subsequent $15 billion distribution was made available from the Provider Relief Fund for providers who treat Medicaid patients and who did not qualify for the Medicare distribution. The deadline to apply for those funds is being extended to <strong>Aug. 28</strong>, and HHS is developing a simplified application to streamline the process. Resources on the Medicaid distribution can be found <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html?language=en">here</a>. </p> <p> Finally, also beginning the week of Aug. 10, HHS will allow providers whose practice changed ownership in the last ear to apply for funds if their initial allocation from the Medicare distribution was made to the prior owner of a practice. And for those practices that have not been eligible for any distributions from the Provider Relief Fund to date (i.e. those that do not provide services to Medicare and Medicaid enrollees) HHS is working to formulate a distribution methodology, with further details forthcoming. </p> <p> The WSMA wants to help ensure that all of our members receive the Provider Relief Fund monies they are eligible for. More information and resources on the Provider Relief Fund can be found on the <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html?language=en">HHS website</a>. If you have questions about prior or pending allocations, contact WSMA's policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <h3>Reimbursement available from CMS for counseling patients to self-isolate at time of COVID-19 testing</h3> <p>The Centers of Medicare & Medicaid Services announced that payment is now available to physicians and health care providers to counsel patients, at the time of COVID-19 testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms. CMS will use existing evaluation and management payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor's offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites. </p> <p> Further information and resources are available in the <a href="https://www.cms.gov/files/document/counseling-checklist.pdf" target="_blank">counseling checklist PDF here</a>. </p> <h3>Telemedicine proclamation, other priority proclamations extended to Sept. 1</h3> <p>Washington's Democrat and Republican leaders in the House and Senate have again approved extending Gov. Jay Inslee's telemedicine payment parity <a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-29 Coronovirus OIC %28tmp%29.pdf?utm_medium=email&utm_source=govdelivery">proclamation 20-29</a>, now through Sept. 1. Proclamation 20-29 implements <a href="https://app.leg.wa.gov/billsummary?BillNumber=5385&Initiative=false&Year=2019">Senate Bill 5385</a>, requiring payment parity for state-regulated plans, ahead of its Jan. 1, 2021 effective date. While we are glad to see the proclamation extended again, the WSMA continues to advocate for the policy to be extended through the end of the year when SB 5385 takes effect. If you'd like to assist in our efforts, please consider writing your local legislators and sharing how critical telemedicine is to providing care during the COVID-19 pandemic, as well as requesting that proclamation be extended through Dec. 31, 2020. <a href="https://takeaction.wsma.org/urge-your-state-lawmakers-to-support-telemedicine-payment-parity-policies/">Click here to send a message to your state lawmakers</a>. </p> </div>8/3/2020 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_july_31_2020_wsma_zooms_into_its_virtual_futureWeekly Rounds: July 31, 2020 - WSMA Zooms Into Its Virtual FutureLatest_NewsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_31_2020_wsma_zooms_into_its_virtual_future<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>July 31, 2020</h5> <h2>WSMA Zooms Into Its Virtual Future</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> One of my favorite things about the WSMA being a member-driven organization is when we come together in person, whether in small meetings or large, to connect, to share, and to get to know one another. But now that COVID-19 has derailed such gatherings for the foreseeable future, I'm grateful for the technology that enables us to come together - even if virtually - to build and sustain community, even as our need to distance continues. </p> <p> Just like most other organizations, your WSMA team is hard at work transitioning two upcoming events from in-person to virtual. And the silver lining to making that change? Even more of you will be able to participate! So read on and be sure to mark your calendars. </p> <h3>Join our Virtual Road Trip</h3> <p> Last year we launched our first road shows, hitting the road to Spokane, Vancouver, and Bellingham so we could meet with our members face to face. This year, on Aug. 27 from 6 - 8 p.m., we'll make that a virtual trip, without the pesky limitations of geography! </p> <p> Members are welcome to join us as we offer an update on WSMA's advocacy and policy work, with an emphasis on our work during the COVID-19 outbreak. We'll want to hear from you too, so we'll "Zoom" into virtual breakout rooms where you'll have an opportunity to share your thoughts with staff and members of the executive committee about how we can amplify our work in representing the profession or improving patient care. </p> <p> Lest you think this Zoom meeting will be just one more regular ol' meeting or webinar…think again! We'll make it fun, interactive, and there will be prizes. Beyond that, the first 25 folks to register will be the lucky recipients of a dandy "Road Trip Snack Box," shipped to their home just in time for the Virtual Road Trip. Our Zoom space will be limited, so sign up quickly once registration goes live. If the Aug. 27 event becomes over-subscribed, stay tuned as we'll add another date to the schedule if needed. </p> <p> <a href="[@]WSMA/Events/Virtual_Road_Trip/WSMA/Events/Virtual_Road_Trip/WSMA_Virtual_Road_Trip.aspx">Click here</a> for the event webpage. Stay tuned - registration will be announced shortly. </p> <h3>WSMA Annual Meeting goes virtual</h3> <p> The WSMA House of Delegates was formed back in 1889. Ever since, we've taken pride that this structure allows policies to spring from our members - staying true to our member-driven roots. Despite COVID-19, your WSMA leadership decided that this year's annual HOD meeting will carry on - albeit virtually. </p> <p> Several deadlines are fast approaching. The deadline for submitting resolutions is Aug. 10. If you have new policy you'd like to propose, consider submitting a resolution through your local county medical society or specialty society. More details about how to structure a resolution can be found <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx">here</a>. </p> <p> When the time comes to vote on resolutions during the meeting, remember that only delegates can vote. If you want to serve as a delegate, let us know, and we will put you in touch with your county medical society or state specialty society (see our <a href="[@]WSMA/About_Us/Policies/WSMA/About/Policies/Policies.aspx">bylaws on who is eligible to vote</a>). If you feel frustrated that you don't have a formal vote except through these societies, consider getting engaged and <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx">advance a change to the process</a>. </p> <p> If you are curious to know more about our work, be sure to visit our website at <a href="[@]">wsma.org</a>. There you can also access our <a href="[@]WSMA/About_Us/Who_We_Are/WSMA/About/Who_We_Are/Who_We_Are.aspx#strat">current strategic plan</a>, find an <a href="[@]WSMA/About_Us/Leadership/House_of_Delegates/WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx">update on last year's official actions from the House of Delegates</a>, or review <a href="[@]WSMA/About_Us/Policies/Whats_Our_Policy/WSMA/About/Policies/Whats_Our_Policy/Policy_Index.aspx">current WSMA policy</a>. </p> <p> Another way to inform us about issues of concern to you is to engage with us via our members-only <a href="[@]WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx">virtual reference committees</a> and general discussion forum in advance of the WSMA Annual Meeting on Sept. 26-27. It's easy to post your ideas or comment on the ideas of others. </p> <p> All of this to say…as a member-driven organization, your views and opinions matter, regardless of specialty, geography, and/or whether you are working within a large integrated group or small private practice. You matter. </p> <p> Let us hear from you, and I hope I'll see you online at our Road Trip in August or at the virtual <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">WSMA House of Delegates</a> in September. </p> <p> If you can't make either event but would like me to speak to your medical staff or group, write me at <a href="mailto:jen@wsma.org">jen@wsma.org</a>. I'm happy to provide an update on our work, live or virtually. </p> </div>7/31/2020 12:00:00 AM1/1/0001 12:00:00 AM
ama_partners_with_project_n95_to_offer_ppeAMA Partners with Project N95 to Offer PPELatest_NewsShared_Content/News/Membership_Memo/20200723/ama_partners_with_project_n95_to_offer_ppe<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/July/Project-N95-Logo-645x425px.png" class="pull-right" alt="Project N95 logo" /> </div> <h5>July 23, 2020</h5> <h2>AMA Partners with Project N95 to Offer PPE </h2> <p>The American Medical Association has partnered with Project N95, a not-for-profit national COVID-19 clearinghouse, to make personal protective equipment available exclusively to its members.</p> <h3> How it works</h3> <p>Starting this week, AMA members will receive a series of three emails over a nine-day period that describe the program. Members are required to sign in using their AMA credentials and <a href="https://www.ama-assn.org/delivering-care/public-health/order-ppe-your-practice-ama">complete a registration form</a> to express an interest in ordering PPE shown below.</p> <ul> <li>Makrite 9500 N95 surgical respirator; size S.</li> <li>Makrite 9500 N95 surgical respirator; size M/L.</li> <li>Disposable Isolation gown.</li> </ul> <p>All AMA member orders will be aggregated and shipped no later than Aug. 26, via UPS ground. Gowns may start shipping as early as Aug. 17. Members will receive email and text order status and shipping confirmation notices.</p> <p><a href="https://www.projectn95.org/">Project N95</a> has written policies on order cancellations, refunds, and handling of damaged goods. See <a href="javascript://[Uploaded files/News and Publications/Newsletters/2020/Project N95 FAQs Final.pdf]">this FAQ</a> for those and other details about the program and order process.</p> <h3> Deadlines and purchasing guidelines</h3> <p>This pilot program has specific deadlines for registration, orders, and shipping, which are summarized below.</p> <ul> <li>Registration: Last date to submit registration form is July 30, 2 p.m. PDT.</li> <li>Orders: Last date to submit an order is Aug. 1, 2 p.m. PDT.</li> <li>Cancel order: Last date to cancel order is Aug. 2 - open timeframe.</li> <li>Shipping: Orders shipped by date is Aug. 26 - open timeframe.</li> </ul> <p>For this program, AMA and Project N95 established the purchasing business guidelines shown below in order to support as many members as are interested in participating.</p> <h4> Minimum purchase</h4> <ul> <li>1 box of surgical N95 respirator (20 masks) or 1 bag of isolation gowns (15 gowns)</li> </ul> <h4> Maximum purchase</h4> <ul> <li>Surgical N95 respirator, size S & standard (M/L): 50 boxes (20 masks/box) - 1000 masks</li> <li>Isolation gowns: 66 bags (15 gowns/bags) - 990 gowns</li> </ul> <p> Questions about this collaboration should be directed to Kristen Tinney at <a href="mailto:kristen.tinney@ama-assn.org"> kristen.tinney@ama-assn.org </a>. </p> </div>7/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
washington_in_an_explosive_situation_as_covid_19_spreadsWashington in an 'Explosive Situation' as COVID-19 SpreadsLatest_NewsShared_Content/News/Membership_Memo/20200723/washington_in_an_explosive_situation_as_covid_19_spreads<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>July 23, 2020</h5> <h2>Washington in an 'Explosive Situation' as COVID-19 Spreads</h2> <p> </p> <p>Gov. Jay Inslee has announced a pause on Washington's reopening plans in response to <a href="https://covid.idmod.org/data/WA_Situation_Report_9_COVID-19_transmission_across_Washington_State.pdf">transmission and hospitalization data</a> that show accelerated COVID-19 spread across most of the state, with state officials describing Washington as facing an "<a href="https://covid.idmod.org/data/WA_Situation_Report_9_COVID-19_transmission_across_Washington_State.pdf">explosive situation</a>." As noted by Secretary of Health John Wiesman, "In these trends, we are seeing the impact of our collective decisions. We are jeopardizing the gains we made as a state with the Stay Home, Stay Healthy order and the actions each one of us takes now will determine what happens next." As the state looks to redouble its efforts to slow the spread of the virus, please take this moment to make sure you and your practice or organization are up to date on the resources and opportunities the WSMA offers to assist the physician community.</p> <h3>COVID-19 Virtual Grand Rounds webinar series</h3> <p>With this new <a href="https://zoom.us/webinar/register/7315946699598/WN_CYxJznM4R_6jqfRROGdf5A">multi-part series</a>, the WSMA brings you the state's public health leaders - Vice Adm. Raquel Bono, MD; Kathy Lofy, MD; and Charissa Fotinos, MD - as well as guest speakers for free sessions that will offer the latest information on COVID-19. Upcoming lunchtime sessions are: </p> <ul> <li> Aug. 5 - "Outpatient Testing of Patients for COVID-19: Who, How, and When to Test and What to Do with the Results" </li> <li> Aug. 19 - "Inpatient Management of COVID-19 Patients" </li> <li> Sept. 4 - "Managing the Fall Surge" </li> </ul> <h3> Using in-state labs for COVID-19 testing</h3> <p>ICYMI: State Health Officer Kathy Lofy, MD, is urging physicians, clinics, and hospitals to use in-state labs for molecular COVID-19 testing to help shorten the turnaround time for test results, which is critical for informing the state's contact tracing efforts. <a href="[@]Shared_Content/News/Latest_News/2020/July/DOH_Provider_Alert__In-State_COVID-19_Testing">Click here to download a list of laboratories willing to provide testing</a>. Dr. Lofy further advises that physicians and clinics identify multiple laboratory testing options so that specimens can be redirected if necessary to ensure rapid results.</p> <h3> More COVID-19 testing needed</h3> <p>The state is still far from meeting its target goal for testing, a <a href="https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard">key metric in the state's response to COVID-19</a>. Public health officials continue to urge physicians and the health care community to test more. See our <a href="[@]Shared_Content/News/Membership_Memo/20200709/state_to_physicians_more_covid_19_testing">update from the previous Membership Memo for more information and resources</a>.</p> <p>The WSMA is helping state officials identify barriers faced by physicians and practices seeking to provide or ramp up testing. We recently surveyed our members on testing and PPE supply to help inform the state's response; the results are being reviewed and will be shared with state officials and with members shortly.</p> <h3> PPE for your practice</h3> <p>The WSMA has partnered with the Washington State Hospital Association to supply procedural masks to medical groups and physician practices throughout the state at bulk pricing. Submit your order by 9 a.m. each Monday to be included in that week's distribution. <a href="[@]WSMA/Resources/COVID-19_Response/PPE/WSMA/Resources/COVID-19/PPE/PPE.aspx?hkey=0532ab8c-a5d4-4bb0-9772-98861013d856">Learn more and place an order</a>.</p> <p>Also, the AMA is now offering PPE, including N95 masks and disposable isolation gowns, to AMA members. <a href="https://www.ama-assn.org/delivering-care/public-health/order-ppe-your-practice-ama">Learn more</a>.</p> <h3> Coronavirus data collection moved out of CDC</h3> <p>WSMA CEO Jennifer Hanscom <a href="[@]Shared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_20_2020_even_covid_19_cant_keep_the_wsma_from_its_mission">provides some perspective</a> on the news that hospital data on COVID-19 will be redirected from the Centers for Disease Control and Prevention to TeleTracking Technologies, a private company.</p> <h3> More professional resources</h3> <p>Find more <a href="[@]WSMA/Resources/COVID-19_Response/COVID-19_Clinical_Guidance_and_Testing/WSMA/Resources/COVID-19/COVID-19_Clinical_Guidance_and_Testing/covid_19_clinical_guidance_and_testing.aspx?hkey=5236cdd9-90b5-46fe-9cbd-d9bf9ad4831e">COVID-19 professional resources</a> by visiting the WSMA's <a href="[@]WSMA/Resources/COVID-19_Response/WSMA/Resources/COVID-19/COVID-19_Response.aspx?hkey=958ce791-54b8-4eba-892f-54924db26b60">dedicated COVID-19 webpages</a>, where you'll also find guidance on <a href="[@]WSMA/Resources/COVID-19_Response/Telehealth/WSMA/Resources/COVID-19/COVID_19_Telehealth/covid_19_telehealth.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae">telehealth</a>, <a href="[@]WSMA/Resources/COVID-19_Response/Reimbursement/WSMA/Resources/COVID-19/COVID_19_Reimbursement/covid_19_reimbursement.aspx?hkey=bb096bfc-12a0-4237-beb7-f8c9d8758123">reimbursement</a>, <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">patient education materials</a>, <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">financial relief</a>, and much more.</p> </div>7/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_july_20_2020_even_covid_19_cant_keep_the_wsma_from_its_missionWeekly Rounds: July 20, 2020 - Even COVID-19 Can't Keep the WSMA From Its MissionLatest_NewsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_20_2020_even_covid_19_cant_keep_the_wsma_from_its_mission<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>July 18, 2020</h5> <h2>Even COVID-19 Can't Keep the WSMA From Its Mission</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> The onset and disruption of COVID-19 has shaken us all, to be sure. But even in the midst of it, I'm grateful that the WSMA's vision, mission, and strategy remain relevant and appropriate for the times. The pillars of our strategic plan focus on advocacy through strong, thoughtful policy; physician-directed quality improvement; physician education and development; and organizational stewardship. </p> <p> This framework continues to serve us well as we raise up the interests of physicians at the highest levels of influence and unite our members to make a difference. We know a robust and healthy professional and practice environment is necessary to ensure that patients and communities have access to high-quality care when they need it. We achieve this by advancing strong physician leadership and advocacy to shape the future of medicine and advance quality care for all Washingtonians. Working together, we are building a vibrant medical profession and a healthy population. </p> <p> That effort doesn't stop or change even during a pandemic. Still, we press on. Here are five highlights of some of the ways we are doing just that. </p> <h3>Seeking clarity as hospital COVID-19 data redirected from CDC to HHS</h3> <p> Several physicians have inquired about the <a href="https://www.seattletimes.com/seattle-news/health/coronavirus-data-is-funneled-away-from-cdc-sparking-worries/">news that hospital data on COVID-19 will be redirected</a> from the Centers for Disease Control and Prevention to the Department of Health and Human Services. </p> <p> Our understanding based on informal discussions with American Medical Association staff is that since April, hospitals have been reporting COVID-19 data to two federal databases: CDC and TeleTracking. The principle purpose of reporting is to allocate federal resources among the hospitals; however, concerns have been raised regarding the burden of the dual reporting. Additionally, the Coronavirus Task Force has needed to periodically change the reporting requirements to coincide with developments. It seems the CDC data collection has been more robust than TeleTracking, but not capable of adapting as quickly to changing requirements. Consequently, the administration decided to require hospitals to report only toTeleTracking. The CDC will remain on the Coronavirus Task Force Data Group. </p> <p> Currently, the CDC helps states analyze and understand the data. While the CDC will continue to have access to the data, it is unclear how that will be operationalized, so the implications of the change in data collection are not clear to us at this time. </p> <p> The AMA continues to stress to officials that data collection is vital to combatting COVID-19. The data needs to be accurate and transparent so it can be actionable and inform the health care community's response. It will closely monitor the situation and weigh in as issues arise. </p> <h3>Speaking up about barriers to COVID-19 testing</h3> <p> State officials recently expanded criteria for who should be tested for COVID-19 to include the mildly symptomatic and their close contacts (for the full criteria, download the <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Interim-2019NovelCoronavirusQuicksheetProviders.pdf" target="_blank">DOH testing guidance for health care providers</a>, updated June 28). Along with expanding testing criteria, Gov. Jay Inslee delivered a message directly to physicians and medical providers: If a patient comes to you with symptoms, get them tested. As the guidance states, symptomatic patients should be tested within 24 hours or referred to another testing site and provided guidance on the need to isolate (for ill persons) and self-quarantine (for exposed contacts). </p> <p> In our role as advocates for the physician community, the WSMA is helping state officials identify barriers faced by physicians and practices seeking to provide or ramp up testing. We need to hear from you: What is your experience with testing, and are you facing any barriers to increasing testing in your office or practice? <a href="https://www.surveymonkey.com/r/XR6QQ5J">Take this brief WSMA survey on testing and PPE supply</a> and let us know. </p> <h3>Supporting candidates that support physicians and their patients</h3> <p> The primary election is just around the corner on Aug. 4, with the general election to follow on Nov. 4. WSMA leaders and staff have been meeting virtually with candidates and providing financial support for those whose priorities align with ours. </p> <p> As you consider how to cast your vote, you can see how your state legislators voted on WSMA's priority issues last session by checking out the "WAMPAC Report Card" in the <a href="https://wsma.informz.net/WSMA/data/images/Attachments/wsma_2020_legislativereport_printers_final.pdf" target="_blank">2020 WSMA Legislative Report</a>. And if you're disappointed with how your legislator voted, remember that one of the best ways to send a message is by <a href="[@]WSMA/Advocacy/WAMPAC/Give_to_WAMPAC.aspx">supporting WAMPAC</a> and helping physicians speak with a loud, unified voice on campaigns. </p> <h3>Equipping the front lines with information they need to know</h3> <p> Given that COVID-19 will impact the medical community for the foreseeable future, WSMA is launching a Virtual Grand Rounds webinar series to provide you the latest on local developments. The series will focus on the evolution of the disease, management of COVID-19 patients, and our state's response to the pandemic - with an emphasis on what front-line physicians need to know. </p> <p> We will be joined by state public health leaders - Vice Adm. Raquel Bono, MD; Kathy Lofy, MD; and Charissa Fotinos, MD - on July 22, Aug. 5, Aug. 19 and Sept. 4 for sessions that will offer the latest information on COVID-19. This series is free to all WSMA members. The format will include 45 minutes of content and 30 minutes for a Q&A discussion with the speakers. This activity has been approved for <em>AMA PRA Category 1 Creditâ„¢</em>. <a href="[@]WSMA/Education/Upcoming_Webinars/WSMA/education/Upcoming_Webinars/Upcoming_Webinars.aspx">Click here to learn more and to register</a>. </p> <h3>Influencing policy, shaping the future</h3> <p>The <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">2020 Annual Meeting of the WSMA House of Delegates</a> will be held virtually on Sept. 26 and 27 via Zoom. If you are interested in proposing policy or serving as a delegate at the meeting, be sure to take note of the following guidance and key dates. Resolutions, one of the key policy drivers for the association, are considered for adoption by the House of Delegates at its annual meeting each fall. Resolutions must be sponsored by a WSMA delegate, alternate delegate, or member of the board of trustees. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to develop your resolution idea and help find a sponsor. <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx">Learn more about resolutions on the WSMA website</a> and be sure to mark your calendar for the following dates:</p> <ul> <li>Aug. 10 - Deadline to submit your resolution for publication in the WSMA Delegate Handbook, the compilation of resolutions and other business to be considered by the House of Delegates.</li> <li>Aug. 21 - Delegate Handbook will be available on the <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx">WSMA website</a>.</li> <li>Aug. 27 - Final deadline to submit your resolution. Resolutions received after this date must have consent of two-thirds of the House to be considered.</li> </ul> </div>7/18/2020 12:00:00 AM1/1/0001 12:00:00 AM
DOH_Provider_Alert__In-State_COVID-19_TestingDOH Provider Alert: In-State COVID-19 TestingLatest_NewsShared_Content/News/Latest_News/2020/July/DOH_Provider_Alert__In-State_COVID-19_Testing<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 logo" /> </div> <h5>July 10, 2020</h5> <h2>DOH Provider Alert: In-State COVID-19 Testing </h2> <p>Washington State Health Officer Kathy Lofy, MD, shared the following urgent provider alert on Friday, July 10:</p> <p>Dear Provider,</p> <p> We recently became aware of significant delays in obtaining COVID-19 test results from some of the large commercial labs. This is very concerning because obtaining test results quickly is critical for informing our contact tracing efforts and containing the spread of the virus. </p> <p> Below is a list of Washington-based labs that have confirmed their willingness to provide molecular COVID-19 testing to hospitals and clinics. In most cases, our in-state laboratories can process specimens and return results more rapidly than out-of-state labs. <strong>We strongly encourage you to use our in-state labs for COVID-19 testing so that we can shorten the turn-around time for test results.</strong> Furthermore, it would be useful for providers to identify multiple laboratory testing options so that COVID-19 specimens can be redirected to other labs in the state when necessary to ensure rapid results for patients. </p> <p> Please feel free to reach out to these labs to discuss: <a href="javascript://[Uploaded files/Resources/COVID19/Labs_in-state_covid-19_July2020.pdf]">Download the list of in-state laboratories and their contact information</a>. </p> <p> Kathy Lofy, MD<br /> State Health Officer<br /> Office of the Secretary<br /> Washington State Department of Health<br /> <a href="mailto:kathy.lofy@doh.wa.gov">kathy.lofy@doh.wa.gov</a> </p> <p> For more resources and information, visit WSMA's <a href="https://wsma.org/WSMA/Resources/COVID-19_Response/WSMA/Resources/COVID-19/COVID-19_Response.aspx?hkey=958ce791-54b8-4eba-892f-54924db26b60">COVID-19 Resources</a>. </p> </div>7/10/2020 6:49:59 PM1/1/0001 12:00:00 AM
2020_wsma_annual_meeting_how_to_propose_policy_serve_as_delegate2020 WSMA Annual Meeting: How to Propose Policy, Serve as DelegateLatest_NewsShared_Content/News/Membership_Memo/20200625/2020_wsma_annual_meeting_how_to_propose_policy_serve_as_delegate<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/MembershipMemo/2020/July/2020-Annual-Meeting-Graphic.jpg" class="pull-right" /> </div> <h5>July 9, 2020</h5> <h2>2020 WSMA Annual Meeting: How to Propose Policy, Serve as Delegate</h2> <p>The 2020 Annual Meeting of the WSMA House of Delegates will be held virtually on Sept. 26 and 27 via Zoom. If you are interested in proposing policy or serving as a delegate at the meeting, be sure to take note of the following guidance and key dates.</p> <h3>Deadlines for submitting resolutions</h3> <p>Resolutions, one of the key policy drivers for the association, are considered for adoption by the House of Delegates at its annual meeting each fall. Resolutions must be sponsored by a WSMA delegate, alternate delegate, or member of the board of trustees. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to develop your resolution idea and help find a sponsor. <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136">Learn more about resolutions on the WSMA website</a> and be sure to mark your calendar for the following dates:</p> <p><strong>Aug. 10</strong> – Deadline to submit your resolution for publication in the WSMA Delegate Handbook, the compilation of resolutions and other business to be considered by the House of Delegates.</p> <p><strong>Aug. 21</strong> – Delegate Handbook will be available on the <a href="https://wsma-my.sharepoint.com/personal/katiehoward_wsma_org/Documents/Membership%20Memos/June%202020/wsma.org">WSMA website</a>.</p> <p><strong>Aug. 27</strong> – Final deadline to submit your resolution. Resolutions received after this date must have consent of two-thirds of the House to be considered.</p> <h3>How to serve as a delegate</h3> <p>The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county society or specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2020 WSMA Annual Meeting, please contact your local county society or state specialty society.</p> <h3>How the 2020 WSMA Annual Meeting will work</h3> <p>The 2020 Annual Meeting will take place virtually over two days: virtual reference committee hearings held on Saturday, Sept. 26, followed by a virtual House of Delegates meeting on Sunday, Sept. 27. In the weeks preceding the meeting, we 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">virtual reference committee forums</a> on the WSMA website to give WSMA members an opportunity to review and provide feedback on the resolutions that will be considered by the House. Then, on Sept. 26, we will hold "live" virtual reference committee meetings via Zoom, an opportunity for members to provide verbal testimony to reference committee members. Then, on Sept. 27 via Zoom, 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.</p> <p>Members planning to participate in the meeting should note that, while there are no educational sessions associated with this year's meeting, the WSMA offers many educational opportunities available <a href="[@]WSMA/Education/Webinars_OnDemand/WSMA/Resources/Practice_Management/OnDemand/Webinars_OnDemand.aspx?hkey=53a67f34-e7a8-4b79-9463-6f51e1418ff5">on demand</a> on our website.</p> <p>Registration information for the meeting will be available shortly.</p> </div>7/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
covid_19_financial_relief_molina_primary_care_support_medicaid_funding_concerns_mips_opt_out_moreCOVID-19 Financial Relief: Molina Primary Care Support; Medicaid Funding Concerns; MIPS Opt-out; MorLatest_NewsShared_Content/News/Membership_Memo/20200709/covid_19_financial_relief_molina_primary_care_support_medicaid_funding_concerns_mips_opt_out_more<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>July 9, 2020</h5> <h2>COVID-19 Financial Relief: Molina Primary Care Support; Medicaid Funding Concerns; MIPS Opt-out; More</h2> <p>An update on financial relief measures for physicians and practices experiencing lost revenues or increased expenses due to COVID-19.</p> <h3>Molina announces $10 million for primary care support</h3> <p>One of the issues that the WSMA has prioritized during the pandemic is securing financial support for physician practices, virtually all of which have seen declining patient volumes and revenue in recent months. One of the tracks of discussion has been with our state's Health Care Authority and the managed care organizations that contract with the Medicaid program. We were pleased to see <a href="https://www.businesswire.com/news/home/20200630005886/en/Molina-Healthcare-Washington-Commits-Additional-15-Million">Molina announce</a> that they will be providing $10 million to primary care providers they contract with, in addition to $5 million for substance use disorder providers.</p> <p>According to Molina, the payments will be delivered automatically to all contracted primary care providers who are not on total capitation payments - providers do not need to do anything to trigger these payments. Molina has stressed that the disbursement is not an advance or a loan to primary care providers, but are "supplemental, direct payments for primary care services that are delivered." It will be paid to Molina's primary care providers as a one-time payment (supplemental care coordination fee) during the month of July.</p> <p>The WSMA applauds Molina for making this investment in the primary care system, as it's imperative to take steps to support the financial viability of practices so that the many new enrollees of the Medicaid system will have adequate access to care. We encourage the state's other MCOs to take similar action in making significant, supplemental, directed payments (not just loans or advances) to providers across the state.</p> <h3>HHS will renew public health emergency</h3> <p>Last week, the U.S. Department of Health and Human Services indicated it will extend the COVID-19 public health emergency that is set to expire July 25. The extension would prolong the emergency designation by 90 days. As noted by WSMA CEO Jennifer Hanscom in Weekly Rounds, this is <a href="[@]Shared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_3_2020___six_things_to_know_while_planning_your_virtual_july_4th_celebration">welcome news for physicians</a>. Several payment policies and regulatory adjustments are attached to the public health emergency, including the <a href="https://www.modernhealthcare.com/politics-policy/covid-19-economic-stimulus-deal-passes-senate-billions-hospital-funding">Medicare inpatient 20% add-on payment for COVID-19 patients</a>, increased federal <a href="https://www.modernhealthcare.com/politics-policy/trump-signs-second-major-covid-19-relief-package">Medicaid matching rates</a>, requirements that insurers cover COVID-19 testing without cost-sharing, and <a href="https://www.modernhealthcare.com/politics-policy/cms-use-glide-path-when-removing-covid-19-waivers">waivers of telehealth restrictions</a>.</p> <h3>$15 billion is being distributed to Medicaid providers by HHS. Has your practice received its share?</h3> <p>The federal CARES Act appropriated $175 billion to physicians, providers, and health care facilities through a variety of mechanisms. The most recent distribution that was <a href="https://www.hhs.gov/about/news/2020/06/09/hhs-announces-enhanced-provider-portal-relief-fund-payments-for-safety-net-hospitals-medicaid-chip-providers.html">announced by the Department of Health and Human Services</a> is $15 billion dedicated for eligible physicians and providers who participate in Medicaid and the Children's Health Insurance Program.</p> <p>To be eligible for this funding, clinicians must have billed their state's Medicaid/CHIP programs or Medicaid managed care plans between Jan. 1, 2018 and Dec. 31, 2019. Additionally, they must not have received payments from the earlier $50 billion Provider Relief Fund general distribution based on Medicare utilization.</p> <p>Washington state's Medicaid agency, the Health Care Authority, has raised concerns with HHS about the Medicaid distribution, asserting the funds allotted are insufficient and that it's administratively burdensome for practices to tap into. Perhaps most concerningly, practices were not aware that accepting the Medicare general distribution would preclude them from receiving Medicaid funds, where the latter may have been financially advantageous for a practice. Further, there is no mechanism for a practice to return the Medicare funds to create eligibility for the Medicaid distribution.</p> <p>If you believe you're eligible for a payment under the Medicaid distribution, HHS provides an <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html">Enhanced Provider Relief Fund Payment Portal</a> that allows you to report your annual patient revenue, as well as information such as the number of Medicaid patients you serve, which will be used as factors in determining your payment. Distributions to eligible providers will equal to at least 2% of reported gross revenues from patient care.</p> <p>If you have concerns pertaining to the Medicaid distribution or anything related to the Provider Relief Fund under the CARES Act, the WSMA wants to know. Share your perspective with us by emailing <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p> <p>Find more information on financial relief measures for physicians and practices in our <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">COVID-19 Resources webpages</a>.</p> <h3>Manual opt-out option for the MIPS program</h3> <p>The Centers for Medicare & Medicaid Services <a href="https://qpp-cm-prod-content.s3.amazonaws.com/uploads/966/QPP%20COVID-19%20Response%20Fact%20Sheet.pdf" target="_blank">announced that physicians will have the option to opt out completely or partially from the 2020 MIPS program</a> by completing a hardship exemption application and indicating it is due to the COVID-19 Public Health Emergency. Individual clinicians and group practices have until Dec. 31, 2020 to complete the <a href="https://qpp.cms.gov/login">hardship application</a>.</p> <p>CMS plans on providing physicians with a couple of options on the hardship exemption application. For example, a practice may submit a hardship application and indicate that they do not want to be scored on Cost and Quality and have their score calculated only based on Promoting Interoperability and Improvement Activities. Alternatively, practices may submit a hardship application and opt out of all four performance categories and be held harmless from a 2022 payment adjustment. Submitting any MIPS data to CMS will override the hardship exception application and physicians will be scored on their submission.</p> <p>The <a href="https://qpp.cms.gov/">Quality Payment Program website</a> is in the process of being updated with the 2020 policy and should reflect the announcement along with additional educational materials in a couple weeks. The information currently posted on the website is regarding the 2019 MIPS COVID-19 policy. CMS has also indicated that additional information on MIPS COVID-19 policy will be included in upcoming rulemaking.</p> <h3>Updated Provider Relief Fund FAQs</h3> <p>The Department of Health and Human Services has issued updated Provider Relief Fund <a href="https://www.hhs.gov/sites/default/files/provider-relief-fund-general-distribution-faqs.pdf" target="_blank">FAQs</a>. Of note, the new FAQs clarify whether there is a set period of time in which providers must use the funds to cover eligible expenses or lost revenues attributable to COVID-19. Consistent with previous guidance, HHS indicated that it expects providers to "only use Provider Relief Fund payments for as long as they have eligible expenses or lost revenue," adding that, "if, at the conclusion of the pandemic, providers have leftover Provider Relief Fund money that they cannot expend on permissible expenses or losses, then they will return this money to HHS." HHS will provide future instructions.</p> </div>7/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
seattle_city_council_approves_new_payroll_taxSeattle City Council Approves New Payroll TaxLatest_NewsShared_Content/News/Membership_Memo/20200709/seattle_city_council_approves_new_payroll_tax<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/July/Seattle-Skyline-645x425px.jpg" class="pull-right" alt="Seattle skyline" /> </div> <h5>July 9, 2020</h5> <h2>Seattle City Council Approves New Payroll Tax</h2> <p><em>Update: The tax percentages below have been corrected. An earlier version contained a transcription error.</em></p> <p>On Monday, the Seattle City Council approved the creation of a new payroll tax, to be imposed beginning in 2021 on businesses with a total payroll of more than $7 million whose employees earn $150,000 or more. Revenue from the tax is dedicated primarily to housing programs. The tax applies in tiers as follows:</p> <ul> <li>For businesses with Seattle payrolls of $7 million to $99.9 million: <ul> <li>No tax on salaries under $150,000</li> <li>0.7% tax on salaries of $150,000-$399,999</li> <li>1.7% tax on salaries over $400,000</li> </ul> </li> <li>For businesses with Seattle payroll between $100 million and $999.9 million: <ul> <li>No tax on salaries under $150,000</li> <li>0.7% tax on salaries of $150,000-$399,999</li> <li>1.9% tax on salaries over $400,000</li> </ul> </li> <li>For businesses with Seattle payrolls of $1 billion or more: <ul> <li>No tax on salaries under $150,000</li> <li>1.4% tax on salaries of $150,000 to $399,999</li> <li>2.4% tax on salaries over $400,000</li> </ul> </li> </ul> <p>The number of physician organizations that will be subject to the tax is not known. The WSMA, the King County Medical Society, and other physician organizations oppose the tax on the grounds that it will negatively impact patient access to care, increase the cost of health care, and jeopardize the viability of physician organizations already reeling due to the pandemic.</p> <p>Several amendments were made to the bill before its passage, including one exempting salaries up to $400,000 for certain nonprofit health care organizations that deliver at least 50% of their services to the uninsured and enrollees of Medicaid and TRICARE. Another provision requires the city to reassess application of the tax if the Washington State Legislature enacts a payroll tax, as was proposed during the 2020 legislative session.</p> <p>The tax passed the council by a <a href="https://www.seattletimes.com/seattle-news/politics/seattle-city-council-passes-new-jumpstart-tax-on-high-salaries-paid-by-big-businesses/">vote of 7-2</a>, and Seattle Mayor Jenny Durkan has not yet indicated whether she will sign the legislation or veto it. Six members of the council would need to vote in support of the legislation to override a veto. There is also a possibility the legislation will be forced to a referendum vote, as business organizations sought to do in 2018 with the short-lived "head tax" that was approved and then subsequently repealed.</p> </div>7/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
state_to_physicians_more_covid_19_testingState to Physicians: More COVID-19 TestingLatest_NewsShared_Content/News/Membership_Memo/20200709/state_to_physicians_more_covid_19_testing<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/July/COVID-19-Testing-Office-645x425px.jpg" class="pull-right" alt="Covid-19 testing office" /> </div> <h5>July 9, 2020</h5> <h2>State to Physicians: More COVID-19 Testing</h2> <p><em>Updated July 24, 2020</em></p> <p>Washington state, like many states around the country, is seeing an increasing number of COVID-19 infections. State officials continue to urge physicians and medical providers to increase testing to help the state identify those infected with the virus. Testing and contact tracing, together with a statewide mask mandate, are foundational components of the state's effort to combat the outbreak.</p> <p>State officials expanded criteria for who should be tested for COVID-19 to include the mildly symptomatic and their close contacts (for the full criteria, download the <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Interim-2019NovelCoronavirusQuicksheetProviders.pdf" target="_blank">DOH testing guidance for health care providers, updated June 28, 2020</a>). Along with expanding testing criteria, Gov. Jay Inslee delivered a message directly to physicians and medical providers: If a patient comes to you with symptoms, get them tested. As the guidance states, symptomatic patients should be tested within 24 hours or referred to another testing site and provided guidance on the need to isolate (for ill persons) and self-quarantine (for exposed contacts).</p> <h3>How can physicians and providers help?</h3> <ul> <li>Test all persons with any symptom that could be consistent with COVID-19.</li> <li>Test all close contacts (< 6 ft. of distance for > 15 minutes).</li> <li>Use self-collected nasal swabs if the person is able to.</li> <li>Complete all required information on requisition to include: <ul> <li>Complete contact information.</li> <li>Race/ethnicity.</li> </ul> </li> <li>Provide public health centered counseling around: <ul> <li>What and how to isolate and quarantine.</li> <li>Assess support needs.</li> <li>How important it is to do this.</li> <li>If they are positive that they will be contacted by public health and why it is important that they provide contact information.</li> </ul> </li> </ul> <h3>Using in-state labs for COVID-19 testing </h3> <p>The DOH is now strongly encouraging clinicians to use our in-state labs for COVID-19 testing so that we can shorten the turn-around time for test results. The following is a list of Washington-based labs that have confirmed their willingness to provide molecular COVID-19 testing to hospitals and clinics. Please feel free to reach out to these labs to discuss: <a href="javascript://[Uploaded files/Resources/COVID19/Labs_in-state_covid-19_July2020.pdf]">Download the list of in-state laboratories and their contact information</a>.</p> <h3>WSMA survey on testing and PPE</h3> <p>The state is still far from meeting its target goal for testing, a <a href="https://coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard">key metric in the state's response to COVID-19</a>, with daily testing needing to more than double to meet the state's goal of 50 tests for each new case of novel coronavirus infection. The WSMA is helping state officials identify barriers faced by physicians and practices seeking to provide or ramp up testing. We recently surveyed our members on testing and PPE supply to help inform the state's response; the results are being reviewed and will be shared with state officials and with members shortly. </p> <h3>Testing and PPE resources</h3> <p>The following professional and patient resources are available to help physicians and practices with COVID-19 testing.</p> <p><strong>For physicians and providers</strong></p> <ul> <li><a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Interim-2019NovelCoronavirusQuicksheetProviders.pdf" target="_blank">COVID-19 Testing Information for Healthcare Providers</a> (June 28, 2020)</li> <li><a href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/identify-assess-flowchart.html" rel="external">COVID-19 Testing Information for Healthcare Providers (CDC)</a></li> <li><a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Self-SwabNasalCollectionInstructions.pdf">Self-Swab Nasal Collection Instructions</a></li> <li><a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Self-SwabMid-turbinateCollectionInstructions.pdf">Self-Swab Mid-Turbinate Collection Instructions</a></li> <li><a href="https://www.youtube.com/watch?v=WKtHoVMI69w&feature=youtu.be" rel="external">Nasopharyngeal (NP) Specimen Collection Instructions</a></li> </ul> <p><strong>For your patients</strong></p> <ul> <li><a href="javascript://[Uploaded files/Resources/COVID19/Testing_guidance_for_DOH_page_6-27-20.pdf]">COVID-19 Testing Resources for Patients</a> (updated June 30, 2020) - This patient handout details testing resources available to patients, including information on cost and testing sites.</li> <li><a href="https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/HealthcareProviders">Health Care Provider Resources and Recommendations page</a> - Find materials for your patients on this page to help educate them on public health best practices if symptomatic or exposed.</li> <li><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#test">How Can I Get Tested for COVID-19?</a> This new section, part of WSMA's COVID-19 Patient Education webpage, provides guidance for patients looking for testing sites near them. </li> </ul> <p><strong>Reimbursement for testing</strong></p> <ul> <li><a href="[@]WSMA/Resources/COVID-19_Response/Reimbursement/WSMA/Resources/COVID-19/COVID_19_Reimbursement/covid_19_reimbursement.aspx?hkey=bb096bfc-12a0-4237-beb7-f8c9d8758123">COVID-19 Reimbursement</a> - This WSMA webpage featured detailed guidance on reimbursement related to COVID-19 and the novel coronavirus.</li> </ul> <p><strong>Testing supplies</strong></p> <ul> <li>If you are having challenges obtaining specimen collection supplies, contact your <a href="https://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions">Local Health Jurisdiction</a>.</li> </ul> <p><strong>Personal protective equipment (PPE)</strong></p> <ul> <li>Contact your local emergency management agency to request and receive these items.</li> <li><a href="[@]WSMA/Resources/COVID-19_Response/PPE/WSMA/Resources/COVID-19/PPE/PPE.aspx?hkey=0532ab8c-a5d4-4bb0-9772-98861013d856">FDA-approved disposable ASTM Level 1 simple procedural masks</a> - The WSMA has partnered with WSHA to make these masks available to medical groups and physician practices at bulk pricing, while stocks are available.</li> <li>The AMA is now offering PPE, including N95 masks and disposable isolation gowns, to AMA members. <a href="https://www.ama-assn.org/delivering-care/public-health/order-ppe-your-practice-ama">Learn more</a>.</li> </ul> <p>Also, this week the WSMA released two new public service announcements featuring WSMA President Bill Hirota, MD, on "<a href="https://vimeo.com/435813422">What your doctor wants you to know: Why wear a mask?</a>" and "<a href="https://vimeo.com/436165430">What your doctor wants you to know: How to wear a mask safely</a> ." You can find the PSAs on WSMA's social media channels. Find all our PSAs and other COVID-19 resources on our website at <a href="http://www.wsma.org/covid19">wsma.org/covid19</a> (the PSAs are under Patient Education).</p> </div>7/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
urge_your_elected_officials_to_support_stronger_telemedicine_policyUrge Your Elected Officials to Support Stronger Telemedicine PolicyLatest_NewsShared_Content/News/Membership_Memo/20200709/urge_your_elected_officials_to_support_stronger_telemedicine_policy<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/July/Telemedicine-Patient-Tablet-645x425px.jpg" class="pull-right" alt="Telemedicine patient" /> </div> <h5>July 9, 2020</h5> <h2>Urge Your Elected Officials to Support Stronger Telemedicine Policy</h2> <p>Take a moment to write to your state legislators and Congress and urge support for stronger, lasting telehealth policy.</p> <h3>Urge your state legislators: Support telemedicine parity</h3> <p>Democrat and Republican leaders in the House and Senate have approved extending <a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-29%20Coronovirus%20OIC%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery">Proclamation 20-29</a> - concerning telemedicine payment parity - through Aug. 1. However, the WSMA continues to press lawmakers to extend to the end of the year to allow the provisions of <a href="https://app.leg.wa.gov/billsummary?BillNumber=5385&Initiative=false&Year=2019">Senate Bill 5385</a>, which permanently enforce parity, to take effect. Please take a moment to write your local legislators on this issue. <a href="https://takeaction.wsma.org/urge-your-state-lawmakers-to-support-telemedicine-payment-parity-policies/">Learn more and send a message</a>.</p> <h3>Tell Congress: Support telehealth during COVID-19 and beyond</h3> <p>While we must remain vigilant in our battle with COVID-19, it is important to recognize that expanded use of telehealth technology should have a place in our health care system permanently. As Congress considers new "phase-four" COVID-19 relief legislation, it should ensure that telehealth services are covered and remain available after the COVID-19 public health emergency.</p> <p>Specifically, Congress should permanently lift the geographic and site restrictions on telehealth technologies so all Medicare beneficiaries have access to telehealth services, including from home, regardless of where they live. <a href="https://www.votervoice.net/BroadcastLinks/A9Ov4FnumqlV2v-6jA-9HA">Please contact your senators and representative today</a> and tell them that any new COVID-19 relief legislation should include the telehealth provisions outlined above.</p> <p>The WSMA continues to advocate for telehealth flexibilities, including with the Centers for Medicare & Medicaid Services. WSMA CEO Jennifer Hanscom runs down the regulatory flexibilities the WSMA is calling for in her <a href="[@]Shared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_3_2020___six_things_to_know_while_planning_your_virtual_july_4th_celebration">July 3 edition of Weekly Rounds</a>.</p> </div>7/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_july_3_2020___six_things_to_know_while_planning_your_virtual_july_4th_celebrationWeekly Rounds: July 3, 2020 - Six Things to Know While Planning Your Virtual July 4th CelebrationLatest_NewsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_july_3_2020___six_things_to_know_while_planning_your_virtual_july_4th_celebration<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>July 3, 2020</h5> <h2>Six Things to Know While Planning Your Virtual July 4th Celebration</h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> It's hard to believe it's already time for July 4th celebrations - such as they will be, without the usual fireworks displays and crowded gatherings. As I plan how best to celebrate the Fourth with my immediate household, I do feel increasingly better equipped to cope and adapt as needed. My growing collection of face masks is at least one indication that our new reality is becoming more familiar! </p> <p> It's also been heartening to see some of our WSMA team back in the office, with staff alternating days and schedules. Things are far from the way they used to be, but seeing team members occasionally around the office is certainly encouraging. </p> <p> We all press on, and there is plenty of news to share with you this week. Here are several things you need to know about. </p> <h3>HHS will renew public health emergency</h3> <p> On Monday, U.S. Department of Health and Human Services spokesperson Michael Caputo tweeted the news that the agency intends to extend the COVID-19 public health emergency that is set to expire July 25. The extension would prolong the emergency designation by 90 days. This is welcome news for physicians because several payment policies and regulatory adjustments are attached to the public health emergency. </p> <p> Some <a href="https://www.modernhealthcare.com/law-regulation/how-ending-covid-19-public-health-emergency-will-impact-healthcare-industry">notable policies</a> attached to the public health emergency are the <a href="https://www.modernhealthcare.com/politics-policy/covid-19-economic-stimulus-deal-passes-senate-billions-hospital-funding">Medicare inpatient 20% add-on payment for COVID-19 patients</a>, increased federal <a href="https://www.modernhealthcare.com/politics-policy/trump-signs-second-major-covid-19-relief-package">Medicaid matching rates</a>, requirements that insurers cover COVID-19 testing without cost-sharing, and <a href="https://www.modernhealthcare.com/politics-policy/cms-use-glide-path-when-removing-covid-19-waivers">waivers of telehealth restrictions</a>. </p> <p> Even if HHS maintains the public health emergency, some changes the Trump administration has made to help health care practitioners also depend on a separate <a href="https://www.modernhealthcare.com/politics-policy/trump-declares-covid-19-emergency-asks-hospitals-activate-emergency-plans">Stafford Act national emergency declaration</a> staying active (the emergency declaration is effective until March 13, 2021, or until the president issues a proclamation terminating the declaration, whichever comes first). These changes include <a href="https://www.modernhealthcare.com/medicaid/cms-grants-new-york-5-other-states-medicaid-waivers-respond-coronavirus">CMS Medicaid waivers</a> that allow bypassing some prior authorization requirements, temporarily enrolling out-of-state providers, delivering care in alternative settings, and pausing fair hearing requests and appeal times. </p> <h3>Governor to announce extension of telemedicine parity proclamation to Aug. 1</h3> <p> Earlier this week, we received word that the Legislature has approved extending Gov. Jay Inslee's proclamation requiring payment parity for telemedicine services through Aug. 1. No formal announcement has been made yet, but we will let you know once the governor's office officially confirms. </p> <p> Payment at parity is critical for patients and physicians. The WSMA will continue to advocate that this important policy be extended through the end of the year when the provisions of parity legislation Senate Bill 5385 take effect. </p> <h3>$15 billion being distributed to Medicaid providers by HHS: Has your practice received its share?</h3> <p> The federal CARES Act appropriated $175 billion to health care providers and facilities through a variety of mechanisms. The most recent distribution that was <a href="https://www.hhs.gov/about/news/2020/06/09/hhs-announces-enhanced-provider-portal-relief-fund-payments-for-safety-net-hospitals-medicaid-chip-providers.html">announced by HHS</a> is $15 billion dedicated for eligible physicians and providers who participate in Medicaid and the Children's Health Insurance Program. To be eligible for this funding, clinicians must have billed their state's Medicaid/CHIP programs or Medicaid managed care plans between Jan. 1, 2018 and Dec. 31, 2019. Additionally, they must not have received payments from the earlier $50 billion Provider Relief Fund general distribution based on Medicare utilization. </p> <p> Our state's Medicaid agency has raised concerns with HHS about the Medicaid distribution, asserting the funds allotted are insufficient and that it's administratively burdensome for practices to tap into. Perhaps most concerningly, practices were not aware that accepting the Medicare general distribution would preclude them from receiving Medicaid funds where the latter may have been financially advantageous for a practice. Further, there is no mechanism for a practice to return the Medicare funds to create eligibility for the Medicaid distribution. </p> <p> If you believe you're eligible for a payment under the Medicaid distribution, HHS provides an <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html">Enhanced Provider Relief Fund Payment Portal</a> that allows you to report your annual patient revenue, as well as information such as the number of Medicaid patients you serve, which will be used as factors in determining your payment. Distributions to eligible physicians will equal to at least 2% of reported gross revenues from patient care. </p> <p> If you have concerns pertaining to the Medicaid distribution or anything related to the Provider Relief Fund under the CARES Act, the WSMA wants to know. Share your perspective by emailing our policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <h3>WSMA advocates for flexibility as state grapples with COVID-19</h3> <p> The WSMA continues to advocate on several fronts related to COVID-19, including with the Centers for Medicare & Medicaid Services. In recent correspondence, we shared with CMS the need to make permanent, or continue for a reasonable duration of time after the public health emergency is declared over, the following regulatory flexibilities: </p> <ol> <li> Continue telehealth flexibilities so that the Medicare population, which is particularly vulnerable to COVID-19, may access appropriate remote care. Audio-only coverage is particularly important for those who may not feel comfortable with or are unable to navigate audio/visual platforms or cannot afford or do not live in an area that has access to the broadband required to use the platforms. <ol style="list-style-type: lower-alpha; margin-left: 40px;"> <li> Continue coverage for audio-only telephone evaluation and management when necessary. </li> <li> Continue coverage of video and telephone E/M for patients who could make an office visit. </li> <li> Continue coverage of telehealth treatment services to patients at home. </li> <li> Maintain payment parity between audio-only E/M claims and their in-person equivalents, as well as between all telehealth and in-person visits. </li> <li> Establish clear telehealth billing guidance. Maintain the increased payment rates for these codes to equal Medicare's established in-person codes (99212-99214) to ensure that patients without advanced video-sharing capabilities can access care. </li> <li> Change the definition of "originating site" to allow for patients to receive telehealth services in any location/permanently extend the policy to lift geographical and originating-site restrictions. This will allow patients who cannot or should not make office visits and for whom such services are safer or more feasible. </li> <li> Continue coverage for remote patient monitoring services. </li> <li> Permanently remove frequency limitations on telehealth utilization. </li> <li> Continue the reduction or waive cost-sharing requirements for telehealth service. </li> <li> Continue to allow direct supervision to be performed via audio-video real-time communications when necessary, especially in rural and underserved areas. </li> </ol> </li> <li> Allow multimedia communication equipment, such as smartphones, to provide telehealth, and release practical examples of the technologies and devices that Medicare beneficiaries are permitted to use so that the public can have a better understanding of what is allowed. </li> <li> Cover inpatient hospital services in patients' homes to accommodate socially distanced services for this high-risk population. </li> <li> Continue to cover emergency department, critical care, and other telehealth services to patients at sites outside their homes, and do so without frequency limits, especially in rural and underserved areas, to facilitate access to this high-risk population. </li> <li> CMS should not reinstate the once-per-lifetime limit for Medicare Diabetes Prevention Program services and should allow these services to continue to be provided virtually, including allowing the first core session to be provided virtually. </li> <li> Continue to permit durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items except for powered medical devices (PMDs) to be provided via a verbal order. </li> <li> Continue to permit physician assistants to order home health services. </li> <li> We urge CMS to further reduce burden by enabling the use of telemedicine and remote patient monitoring services to satisfy the face-to-face requirement in certifying eligibility for Medicare home health services. </li> </ol> <p> If we are missing anything, please contact our policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <h3>Tell your patients to mask up</h3> <p> The mandatory use of face masks is now in effect statewide. The order applies to anyone who is: </p> <ul> <li>Inside of, or in line to, enter any indoor public space.</li> <li>Seeking health care services.</li> <li>Waiting for or riding public transportation.</li> <li>Outdoors and unable to keep six feet away from others not in their household.</li> </ul> <p> There are exceptions to this order for children under the age of five and people with a medical condition, mental health condition, or disability that prevents them from wearing a face covering. In no case should children under two years of age wear a face covering due to the risk of suffocation. </p> <p> Washington state purchased 3.6 million cloth face masks to provide two masks to every person in Washington below 200% of the federal poverty level (which means, for example, a family of four earning $52,400 or less). They have already sent 2.8 million masks to local emergency management programs that are working with various community organizations and service providers to deliver to people who need them. </p> <p> If you have patients in need, masks are available through your <a href="https://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions">local public health department</a> and other community organizations. </p> <p> If you need masks for your medical practice, the WSMA is partnering with the Washington State Hospital Association, and its subsidiary Washington Hospital Services, to supply FDA-approved disposable ASTM Level 1 simple procedural masks to medical groups and physician practices throughout the state at bulk pricing. Orders will be filled on a first-come, first-served basis. Submit your order by 9 a.m. each Monday to be included in that week's distribution. <a href="[@]WSMA/Resources/COVID-19_Response/PPE/WSMA/Resources/COVID-19/PPE/PPE.aspx">Learn more and place your order</a>. </p> <h3>Gaining a better understanding of cultural diversity</h3> <p> In our <a href="[@]Shared_Content/News/Press_Release/2020/wsma_statement_on_the_death_of_george_floyd">statement on the death of George Floyd</a>, the WSMA noted that physicians and health care professionals wield power, privilege, and responsibility for dismantling structural racism in medicine, and we have an obligation and opportunity to contribute to health equity through legislative action and advocacy. The disparate health outcomes of Black Americans in the United States are an extension of a historical context where Black lives and the lives of people of color have been devalued. </p> <p> We are shaken by these racist and unjust events, and we join the many voices calling out the connectedness between these issues and health equity. As a health care community, we know well that racism is detrimental to public health and must be addressed. </p> <p> We are renewing our efforts to contribute to health equity and are examining what steps we can take to make a difference. As always, we seek to reflect the voices of our members, and we'd like to hear from you about this - write me at <a href="mailto:jen@wsma.org">jen@wsma.org</a>. We will continue to keep members apprised about opportunities to learn, reflect, and improve the house of medicine. </p> <p> In the meantime, here are some opportunities we encourage you to take advantage of: </p> <ul> <li> View AMA's recent virtual meeting: "<a href="https://www.ama-assn.org/delivering-care/health-equity/time-tackle-hard-questions-root-causes-health-inequities">Time to tackle hard questions on root causes of health inequities</a>." </li> <li> Access the online CME multicultural care and cultural diversity courses offered by Physicians Insurance via their <a href="https://www.phyins.com/education/all-courses">online education portal</a>.<br /> Titles include: </li> <ul> <li>Building a Multicultural Care Environment (1.25 credits)</li> <li>Individual and Organizational Approaches to Multicultural Care (1.25 credits)</li> <li>Culture Responsiveness in Clinical Practice (1.50 credits)</li> <li>Culture Competence (.50)</li> </ul> <li>Add your voice to the "<a href="http://thenocturnists.com/blackvoices">Black Voices in Health Care</a>," a new audio documentary series created by <a href="http://thenocturnists.com/whoweare">The Nocturnists</a>, an independent medical storytelling community. They've issued an "open call" for voices, recognizing that more needs to be done to create equity and erase racism in our society.</li> </ul> <p> With all that's happening in our world these days, I'm actually grateful for what I anticipate will be a quiet Fourth of July. I want to reflect about what more I can do as an individual - and what we can do as an organization - to bring health and healing to a world that sorely needs it. </p> </div>7/3/2020 12:00:00 AM1/1/0001 12:00:00 AM
quality_improvement_put_to_the_testQuality Improvement Put to the TestLatest_NewsShared_Content/News/Latest_News/2020/July/quality_improvement_put_to_the_test<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="WSMA Reports: July/August 2020 issue cover" src="/images/Newsletters/Reports/2020/COVER-WSMA_JulyAug-2020-645x425px.jpg" class="pull-right" /></div> <h5>July 2, 2020</h5> <h2>Quality Improvement Put to the Test</h2> <p> By Rita Colorito </p> <p><em>Members only; sign-in required.</em></p> <p> At 8 p.m. on Feb. 28, Jeff Tomlin, MD, CEO of EvergreenHealth in Kirkland, received the news he'd been dreading. Ettore Palazzo, MD, the chief medical and quality improvement officer, confirmed that Evergreen had its first case of COVID-19. </p> <p> Evergreen had been on alert since Jan. 20, after The Everett Clinic, some 20 miles north, reported the first U.S. case of the novel coronavirus. Evergreen recorded the state's first COVID-19 patient death on Feb. 29. That same day, Gov. Jay Inslee declared a state of emergency. </p> <p> Within 30 minutes, Evergreen activated its incident command system and sent its administration team to literally take the information to the front lines, an approach based on its belief that quality improvement needs to filter from leadership to teams to empower them to develop solutions that work. </p> <p> Dr. Tomlin was dispatched to the obstetrics floor, where nurses asked what they would do with expecting mothers and their families who may have COVID-19. "The staff weren't panicked. They were in problem-solving mode right away," says Dr. Tomlin. Two weeks later, obstetrics admitted a pregnant woman with fever and flu-like symptoms. "Thanks to that discussion, we had a structure in place to deal with that. It's an example of leadership being present and learning from the front-line staff," he says. </p> <p> Evergreen's response to the challenge flowed from the guiding principles of its quality improvement program—absolute safety, effective care, and service to the patient, says Dr. Tomlin. Like other health care providers throughout the state, Evergreen's QI infrastructure has been both validated and challenged by the rapidly unfolding pandemic. The lessons learned, say Drs. Tomlin and Palazzo and other QI leaders, will carry them not only through this crisis and others, but also in their day-to-day quest for quality improvement. </p> <h3>Preparation determines response</h3> <p> Beginning with the worldwide SARS outbreak in 2003, and the threats of H1N1 in 2009 and Ebola in 2014-16, pandemic preparedness has become an increasing concern of U.S. health care systems. </p> <p> For the last decade, EvergreenHealth has participated in the Northwest Healthcare Response Network, a coalition focused on building a disaster-resilient health care system. Through NHRN, 200 of Evergreen's QI and leadership staff have attended all-hazards training at the CDC's Center for Preparedness and Response in Alabama. UW Medicine and Seattle Children's are also NHRN members. </p> <p> "Your response is completely dependent on your preparation," says Dr. Tomlin. "It doesn't have to be a pandemic. If you don't have some of these systems in place to respond to any disaster... if you haven't thought of them in advance, your response is going to be delayed. And it's going to add uncertainty within your staff." </p> <p> Over the Cascades and 150 miles east of Seattle, Confluence Health activated its incident command on March 1, bracing for the worst. Three days later, Confluence recorded its first coronavirus case. The processes put in place early on prepared for the surge that came two weeks later, says CEO Peter Rutherford, MD. </p> <p> As nursing home cases and deaths increased in Kirkland, Confluence dispatched a palliative medicine rapid response team to local skilled nursing and assisted living facilities, adult family homes, jails, and homeless shelters. The focus was on teaching isolation measures and ensuring personal protective equipment in those facilities was adequate. "That really shut down outbreaks in those facilities and really saved us," says Dr. Rutherford. </p> <p> The palliative team also provided advance care planning that helped prevent the system from being overwhelmed, says Rachel Reeg, MD, a Confluence hospitalist and a member of WSMA's board of trustees. </p> <p> Making sure health systems have the necessary resources to adequately treat patients while protecting staff remains a top concern around COVID-19. Confluence's ethics committee changed the focus of its regularly scheduled meeting to address a potential resource shortage, says Dr. Reeg, the committee's vice chair since March. </p> <p> "We knew that many COVID patients would require intensive care. Our main response was preparing to coordinate crisis standards of care with regional and state committees, and then introducing the organization to the idea of crisis management and allocation of scarce resources through our virtual meetings," she says. </p> <h3>Communication and transparency matter</h3> <p> "Nature abhors a vacuum. And if you don't fill that with facts, it will get filled with rumor and innuendo and that's incredibly destructive," says Dr. Rutherford. </p> <p> Soon after its founding in 2013, Confluence's board of directors passed its first QI policy known as Speak Up, which encourages staff to voice any concerns regarding quality or safety to address problems in the moment, if possible. "That really set us up pretty well to move forward when this whole COVID endemic and then pandemic got started," says Dr. Rutherford. </p> <p> Specialists and other providers at Confluence have felt freed to do what they need to do, says Dr. Reeg. "Our organization has been extremely supportive of individual responses and willingness to help. A lot of people have been happy for the opportunity to contribute," she says. </p> <p> Communication and transparency breed trust, says Dr. Tomlin, a necessary component to keeping staff committed to the mission. "Having good quality improvement systems in place is important. But perhaps the most important aspect of those systems is 'have you developed the trust and collaboration with the groups that you are leading?' " he says. "If the staff doesn't have trust and a sense that you are working closely with the front lines to keep everyone safe, then it's hard to ask them to put themselves in harm's way." </p> <p> Effective risk communication— understanding how best to share information to not only health care workers, but also the public and the press—has proven critical for developing that trust, says John Lynch, MD, MPH, an associate medical director at Harborview Medical Center in Seattle. </p> <p> "Every infectious disease doc out there, because of the work we do, needs to be prepared in how we communicate to our facilities and colleagues," says Dr. Lynch. He also recommends that all doctors have a knowledge of incident command (IC) structure. "Especially with a novel pandemic, it's like an earthquake every day, so it's important for every doctor to have some sort of knowledge on their role in IC," he says. </p> <p> As the urgency grew at the end of February, Dr. Lynch, a University of Washington associate professor, was asked to lead the clinical response across the UW system. He and a team of 15 infectious disease, infection prevention and control, employee health, and QI experts spent the first two months working more than full time, seven days a week, almost exclusively on the crisis response. They provided guidance and support, but also empowered and relied on front-line staff to develop protocols and policies that made sense for them. </p> <p> The knowledge and credibility of these physicians have been the important leadership qualities needed to steer the UW system through the crisis, says Dr. Lynch. "The other doctors know we're there to offer support, not to hold data against them when they start seeing infections." </p> <p> Dr. Lynch says he also learned the value of well-being when it comes to managing a pandemic. At the request of Patricia Kritek, MD, Ed.M., a UW critical care and pulmonary physician, Dr. Lynch joined a weekly virtual town hall to field questions from front-line workers worried about the unknowns of the virus and looking for support and answers. </p> <p> The town halls average about 500 participants; one topped 1,000 people. "Taking an extra hour felt like a huge ask at the time when there was so much other emergency stuff going on, but it was absolutely the right thing to do," he says. </p> <h3>Rethinking improvement</h3> <p>To prepare for any crisis, quality improvement needs to be a continual process, says Dr. Palazzo. In September 2019, months before the coronavirus appeared in China, EvergreenHealth's infection control and QI team began meeting monthly to review its pathogen response policies and protocols. </p> <p> "It had been several years since we had performed a comprehensive review of our High Consequence Infectious Disease Pathogen protocol," says Dr. Palazzo. "When this all hit us in late February, we were fortunate that we didn't have to dust off any books on how to move areas to negative airflow or to cohort patients. It literally had been worked on the months ahead of time and that really put us in a good position when we got our first cases." </p> <p> While cost-benefit analysis factors into any QI program, COVID-19 caused financial considerations to take a back seat, says Dr. Rutherford, as health care systems halted elective surgeries and procedures to flatten the curve. </p> <p> "We took a perspective at the beginning of this that, as an organization, we were going to do the right thing for the community and deal with the financial impacts later; that having money in the bank in a broken care system later wasn't where we wanted to be," says Dr. Rutherford. Feeling freed from the financial considerations helped Confluence get a handle on the virus quickly, he says. </p> <p> The virus forced action on both immediate and long-term needs. Within a week, Confluence had converted its entire third floor to negative pressure. And it finally implemented telehealth capabilities, after years of discussing it. </p> <p> Despite the financial hit from COVID-19, Dr. Rutherford sees a silver lining going forward. "These aren't things that will go away. They are now done. They are part of our organization," he says. "It's really just, let the right people lead it. Let them do their piece." </p> <p> <em>Rita Colorito is a freelance journalist who specializes in covering health care. She is a regular contributor to WSMA Reports.</em> </p> </div>7/2/2020 12:00:00 AM1/1/0001 12:00:00 AM
small_steps_to_wellnessSmall Steps to WellnessLatest_NewsShared_Content/News/Latest_News/2020/July/small_steps_to_wellness<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="WSMA Reports: July/August 2020 issue cover" src="/images/Newsletters/Reports/2020/COVER-WSMA_JulyAug-2020-645x425px.jpg" class="pull-right" /></div> <h5>July 2, 2020</h5> <h2>Small Steps to Wellness</h2> <p> By Pat Curry </p> <p><em>Members only; sign-in required.</em></p> <p> When health care leaders pay attention to quality improvement, physician wellness is a beneficiary. Virginia Mason saw an example of this with one of its early QI efforts: standardizing exam rooms in the outpatient primary care department.That meant finding out what was in the rooms and talking to clinicians to find out what they needed at their fingertips to do their jobs well, says Carrie Horwitch, MD, an internal medicine physician at Virginia Mason Medical Center. </p> <p> "Now, I know any room I go into anywhere in my section is the same. I can find anything I need in my room; I don't have to go looking for things." </p> <p> It may seem like a small thing, but it means physicians can give better care to their patients. When systemic failures keep doctors from doing it, it contributes to what many refer to as burnout. Dr. Horwitch prefers the term "moral distress" or "moral injury." </p> <p> "If I can't do my work well to care for my patients, that causes distress to me as a physician because that is my obligation," Dr. Horwitch says. "The tenor of an organization comes from its leaders. If they value, respect, and truly care for the people who work for them, you'll have more engagement and, I think, less moral distress." </p> <p> It's essential, Dr. Horwitch says, for health care leadership to not only have skill in the financial areas of medicine, but also to have compassion for the people doing the caregiving. "Emotional intelligence is really important and it needs to be taught to head leadership and middle management leadership as well," she says. </p> <p> The value of quality improvement on physician wellness became extraordinarily apparent during the COVID-19 pandemic, when Virginia Mason was able to make what seemed like an "overnight transition from in- person to virtual visits," Dr. Horwitch says. "We turned something that could have been a several-months project into a couple weeks, making sure we could take care of our patients and keep ourselves safe." </p> <p> For her, the rapid implementation of telehealth was evidence that Virginia Mason cared about her well-being. </p> <p> "It made me feel valued making sure we have adequate protective equipment and having systems in place to keep us safe," she says. "It made me feel very good." </p> <h3>Broken systems</h3> <p> Edward Walker, MD, MHA, who just retired from a 40-year career at the University of Washington, works on the connection between leadership, quality improvement, and physician wellness. As a former senior medical executive and psychiatrist, he has coached physician leaders in the art of self- and organizational transformation as a pathway to wellness. One of the ways physicians can become distressed is working within systems that were not designed properly to support their effort, he says. </p> <p> "Instead of telling our colleagues that they need to do mindfulness or yoga to deal with this stress, we should be helping them learn to transform their systems to support better care," he says. "When I see a distressed patient in clinic, the first thing I do is try to figure out whether the person is experiencing an abnormal reaction to a normal situation or a normal reaction to an abnormal situation. </p> <p> "Quite often, physician burnout is an understandable and appropriate reaction to a very broken system," he says. "The solution to broken systems is quality improvement, and the key to quality improvement is leadership." </p> <p> As lead educator for the WSMA, Dr. Walker has mentored nearly 1,000 individuals through its Physician Leadership Course. System transformation is a learnable skillset involving quality improvement, emotional intelligence, and community building; the skills taught in the course are invaluable to quality improvement and gaining buy-in from front-line physicians. </p> <p> "I think some people approach quality improvement as a technical, analytic skill without fully understanding the leadership component and the connection to wellness," he says. </p> <p> Leaders not only have to know what to do, but they have to build consensus around best practice standards and then "gently inspire and nudge" colleagues to follow and maintain those standards. Efficient and safe care is better for the patient, but it also feels better for the physician. </p> <p> Physician-led systems have the advantage of designing work processes that are more directly influenced by the needs of the doctor-patient relationship and the ability of the physician to practice the art, as well as the science, of medicine. </p> <p> "I've never met a physician who didn't feel fulfilled realizing he or she had done the absolute best for a patient," he says. "Quality improvement makes that possible." </p> <h3>The search for joy</h3> <p> Quality improvement and physician wellness is so vital to health care that the American Medical Association has a provider satisfaction, practice sustainability department. Its overall goal is to identify where "joy, purpose, and meaning can be possible for our health care professionals," says Kevin Taylor, MD, the AMA's director of organizational transformation. </p> <p> "It sounds odd to have organizational transformation as part of a physician wellness program," Dr. Taylor says. "It's actually crucial to this kind of work. We understand there are major drivers of burnout and dissatisfaction or lack in meaning in your work. A good portion of that is the inefficiencies of our current workflow and the leadership culture in the systems we're part of." </p> <p> Many evidence-based strategies can save physicians and care teams time that then can be devoted to their patient care. Dr. Taylor recommends the AMA StepsForward website, <a href="mailto:stepsforward.org">stepsforward.org</a>. </p> <p> "There are dozens of modules that will enhance your clinical workflow and restore meaning in your work," he says. </p> <p> Direct leaders of our physicians have a major influence on the culture of their health system and as a result, have an impact on their colleagues' sense of well-being and burnout. To help drive physician satisfaction, "leaders need to be active and visible; they need to actively listen, engage, and empower physicians to identify problems and help them to become part of the solution." </p> <p> For many physicians, the health care culture has taken away their autonomy, choice, and agency. "Autonomy is an internal motivator for physicians," Dr. Taylor notes. "They want to have a voice in the system design and workflow but feel they are losing influence as the care delivery systems become more and more complex." </p> <p> To be successful, physician leaders should take time to listen to their colleagues, give them the opportunity to identify the "pebbles in their shoes," and empower them to work with their teams to develop action plans that will improve their care delivery. </p> <p> Physicians also need coaching on how to work collaboratively in a participative leadership style, he says. This is not a skill physicians learn in medical school, but they need it in the current health care environment where teams are so important. This requires new skills with process improvement and change management tools to effectively communicate and facilitate teams to achieve our mutual goals. </p> <p> "You must be able to collaborate with your care teams to be successful in a clinically integrated network," Dr. Taylor says. "Participative leadership is the new reality for our physicians." </p> <p> <em>Pat Curry is senior editor of WSMA Reports.</em> </p> <p><em> This article was featured in the July/August 2020 issue of WSMA Reports, WSMA's print newsletter.</em> </p> </div> <br /> <div class="telerik_paste_container" style="border-width: 0px; position: absolute; overflow: hidden; margin: 0px; padding: 0px;"> </div>7/2/2020 12:00:00 AM1/1/0001 12:00:00 AM
the_crucible_of_covid_19The Crucible of Covid-19Latest_NewsShared_Content/News/Latest_News/2020/July/the_crucible_of_covid_19<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2020/COVER-WSMA_JulyAug-2020-645x425px.jpg" class="pull-right" /></div> <h5>July 2, 2020</h5> <h2>The Crucible of Covid-19</h2> <p> By Nariman Heshmati, MD </p> <p><em>Members only; sign-in required.</em></p> <p> When the first known COVID-19 patient in the United States was admitted to my local hospital, we quickly understood this would be a far-reaching battle that would surely involve many more patients. </p> <p> As that case made national news, colleagues from around the country called, texted, and emailed asking how things were going in Washington state and how they could help. Even as they were reaching out, we were coordinating between health care systems, together trying to understand a path forward, to provide guidance to state officials, and to ensure we were prepared to take care of our communities. </p> <p> When the epicenter of COVID-19 shifted to New York and overwhelmed their health care systems, soon I was calling, texting, and emailing those same physicians to see how they were faring. And as a practicing OB-GYN, I was shocked when I heard that New York hospitals were not allowing laboring women to have their partners be present with them. Obviously, one-to-one emotional support during labor is critical and can improve outcomes. </p> <p> The day I read those news reports, I walked into an exam room to see one of my own patients. Terrified that she would be forced to give birth alone, she was considering a home birth. This, despite evidence that even low-risk home birth outcomes are worse than those in a hospital setting. As a high-risk pregnancy, she was last person who should deliver anywhere but in a resource-rich hospital prepared for emergencies. I reassured her that physician leaders overseeing labor units in Washington were supportive of having partners present during labor. </p> <p> Ultimately, New York state reversed its policies and allowed laboring women to have partners present, but I wondered: What was the difference between Washington and New York? We faced the same crisis, but responded to it differently. The answer? Here in Washington, we relied more on physician leadership. </p> <p> We've seen more clearly how physician leadership can make a difference as a result of the COVID-19 crisis. As physicians, being involved in leadership ensures that the future health care system is one in which our patients not only will receive the best care, but also one in which physicians want to practice. We can make a difference on a large scale even when not faced with a worldwide pandemic. </p> <p> Studies show that health care systems with physician CEOs have improved quality and outcome measures over those that do not. Physicians bring a unique perspective when taking on leadership roles in health care organizations. We understand the struggles on the front line, we have been exhaustively trained to gather data and make rapid difficult decisions, and we view scenarios through the lens of clinical care. </p> <p> Times of crisis such as the COVID-19 pandemic can illuminate the shortcomings in our systems, but more importantly, they demonstrate our immense ability to adapt nimbly and respond to care needs in ways we could never otherwise imagine. </p> <p> We also put our patients first. And my anxious patient? She had a beautiful and safe hospital birth with the support of her husband at her side. </p> <p> <em>Nariman Heshmati, MD, is an OB-GYN at The Everett Clinic and serves as the secretary-treasurer on WSMA's executive committee.</em> </p> <p><em> This article was featured in the July/August 2020 issue of WSMA Reports, WSMA's print newsletter.</em> </p> </div>7/2/2020 12:00:00 AM1/1/0001 12:00:00 AM
$15_billion_is_being_distributed_to_medicaid_providers_by_hhs_has_your_practice_received_its_share$15 Billion Is Being Distributed to Medicaid Providers by HHS. Has Your Practice Received its Share?Latest_NewsShared_Content/News/Latest_News/2020/June/$15_billion_is_being_distributed_to_medicaid_providers_by_hhs_has_your_practice_received_its_share<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>June 30, 2020</h5> <h2>$15 Billion Is Being Distributed to Medicaid Providers by HHS. Has Your Practice Received its Share?</h2> <p>The federal CARES Act appropriated $175 billion to physicians, providers, and health care facilities through a variety of mechanisms. The most recent distribution that was <a href="https://www.hhs.gov/about/news/2020/06/09/hhs-announces-enhanced-provider-portal-relief-fund-payments-for-safety-net-hospitals-medicaid-chip-providers.html">announced by the Department of Health and Human Services</a> is $15 billion dedicated for eligible physicians and providers who participate in Medicaid and the Children's Health Insurance Program. </p> <p> To be eligible for this funding, clinicians must have billed their state's Medicaid/CHIP programs or Medicaid managed care plans between Jan. 1, 2018, and Dec. 31, 2019. Additionally, they must not have received payments from the earlier $50 billion Provider Relief Fund general distribution based on Medicare utilization. </p> <p> Washington state's Medicaid agency, the Health Care Authority, has raised concerns with HHS about the Medicaid distribution, asserting the funds allotted are insufficient and that it's administratively burdensome for practices to tap into. Perhaps most concerningly, practices were not aware that accepting the Medicare general distribution would preclude them from receiving Medicaid funds, where the latter may have been financially advantageous for a practice. Further, there is no mechanism for a practice to return the Medicare funds to create eligibility for the Medicaid distribution. </p> <p> If you believe you're eligible for a payment under the Medicaid distribution, HHS provides an <a href="https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/for-providers/index.html">Enhanced Provider Relief Fund Payment Portal</a> that allows you to report your annual patient revenue, as well as information such as the number of Medicaid patients you serve, which will be used as factors in determining your payment. Distributions to eligible providers will equal to at least 2% of reported gross revenues from patient care. </p> <p> If you have concerns pertaining to the Medicaid distribution or anything related to the Provider Relief Fund under the CARES Act, the WSMA wants to know. Share your perspective with us by emailing <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <p> Find more information on financial relief measures for physicians and practices in our <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">COVID-19 Resources webpages</a>. </p> </div>6/30/2020 12:00:00 AM1/1/0001 12:00:00 AM
washington_mandates_masks_to_combat_covid_19Washington Mandates Masks to Combat COVID-19Latest_NewsShared_Content/News/Latest_News/2020/June/washington_mandates_masks_to_combat_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/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>June 26, 2020</h5> <h2>Washington Mandates Masks to Combat COVID-19</h2> <p><em>Updated July 8, 2020</em></p> <p> The mandatory use of face masks is now in effect statewide. The order applies to anyone who is: </p> <ul> <li>Inside of, or in line to, enter any indoor public space.</li> <li>Seeking health care services.</li> <li>Waiting for or riding public transportation.</li> <li>Outdoors and unable to keep six feet away from others not in their household.</li> </ul> <p> There are exceptions to this order for children under the age of five and people with a medical condition, mental health condition, or disability that prevents them from wearing a face covering. In no case should children under two years of age wear a face covering due to the risk of suffocation. </p> <p style="margin-left: 40px;"><span style="font-size: 16px;"><strong>WSMA guidance on masks for patients</strong> </span> <br /> WSMA President Bill Hirota, MD, on <a href="https://vimeo.com/435813422" target="_blank">“What your doctor wants you to know: Why wear a mask?”</a> <br /> WSMA President Bill Hirota, MD, on <a href="https://vimeo.com/436165430" target="_blank">“What your doctor wants you to know: How to wear a mask safely.” </a> <br /> Download these videos and find more patient resources on 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">COVID-19 Patient Education page</a>.</p> <p> Washington state purchased 3.6 million cloth face masks to provide two masks to every person in Washington below 200% of the federal poverty level (which means, for example, a family of four earning $52,400 or less). They have already sent 2.8 million masks to local emergency management programs that are working with various community organizations and service providers to deliver to people who need them. </p> <p> If you have patients in need, masks are available through your <a href="https://www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions">local public health department</a> and other community organizations. </p> <p> If you need masks for your medical practice, the WSMA is partnering with the Washington State Hospital Association, and its subsidiary Washington Hospital Services, to supply FDA-approved disposable ASTM Level 1 simple procedural masks to medical groups and physician practices throughout the state at bulk pricing. Orders will be filled on a first-come, first-served basis. Submit your order by 9 a.m. each Monday to be included in that week's distribution. <a href="[@]WSMA/Resources/COVID-19_Response/PPE/WSMA/Resources/COVID-19/PPE/PPE.aspx">Learn more and place your order</a>. </p> <h3>State guidance on state masking requirements</h3> <ul> <li>Washington State Secretary of Health John Wiesman's <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/Secretary_of_Health_Order_20-03_Statewide_Face_Coverings.pdf" target="_blank">order mandating face coverings</a></li> <li> Washington State Department of Health <a href="https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/ResourcesandRecommendations/ClothFaceCoveringsandMasks/ClothFaceCoveringsandMasksFAQ">information and guidance on cloth face coverings</a></li> <li>Washington State Coronavirus Response website's <a href="https://coronavirus.wa.gov/information-for/you-and-your-family/face-masks-or-cloth-face-covering">guidance on the new face covering mandate</a></li> <li>For employers: L&I guide: <a href="https://lni.wa.gov/forms-publications/F414-168-000.pdf" target="_blank">Which Mask for Which Task</a></li> </ul> <h3>State guidance on masks for your patients/office</h3> <ul> <li>Washington State Department of Health (DOH) <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/ClothFacemasks.pdf" target="_blank">guidance on cloth face coverings</a> (pdf download and print for your waiting room/offices)</li> <li><a href="https://coronavirus.wa.gov/sites/default/files/2020-06/FacemaskOnlyGuidanceGeneral.pdf" target="_blank">Flyer: Please wear a face mask (pdf)</a></li> <li>DOH cloth face coverings and masks <a href="https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/ResourcesandRecommendations/ClothFaceCoveringsandMasks/ClothFaceCoveringsandMasksFAQ">FAQ</a></li> </ul> <p>Find more patient information and guidance on 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">COVID-19 Patient Education page</a>.</p> </div>6/26/2020 12:00:00 AM1/1/0001 12:00:00 AM
covid_19_practice_updates_telemedicine_parity_epcs_mandate_and_moreCOVID-19 Practice Updates: Telemedicine Parity, EPCS Mandate, and MoreLatest_NewsShared_Content/News/Membership_Memo/20200625/covid_19_practice_updates_telemedicine_parity_epcs_mandate_and_more<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>June 25, 2020</h5> <h2>COVID-19 Practice Updates: Telemedicine Parity, EPCS Mandate, and More</h2> <p>Regulatory updates and other practice guidance, including a call to action for our members, as Washington state continues to respond to the COVID-19 pandemic.</p> <h3>Telemedicine parity, other priority emergency policies extended</h3> <p>The Legislature extended Gov. Jay Inslee's order enforcing telemedicine payment parity, <a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-29%20Coronovirus%20OIC%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery">Proclamation 20-29</a>, through July 1. The proclamation implements <a href="https://app.leg.wa.gov/billsummary?BillNumber=5385&Initiative=false&Year=2019">Senate Bill 5385</a>, requiring payment parity from state-regulated health plans, ahead of the legislation's Jan. 1, 2021 effective date. Another temporary emergency order requiring telemedicine parity, <a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-20-02_3.pdf" target="_blank">OIC Emergency Order 20-02</a>, was extended by the OIC until July 19. The order requires OIC-regulated fully insured health plans to pay at parity for telemedicine services and requires all state-regulated carriers to permit and reimburse for care provided over non-HIPAA compliant platforms, including video chat applications and telephones.</p> <p>While the WSMA was glad to see these important orders extended, <strong>we continue to advocate for these policies to be extended further</strong>. In the case of the governor's proclamation, until the end of the year when SB 5385 takes effect; with the OIC orders, through the duration of the public health crisis.</p> <p><strong>Urge your state legislators to extend these telemedicine parity policies</strong></p> <p>You can help our efforts on these issues. Please take a moment to write your local legislators, urging them to:</p> <ol> <li>Extend the governor's telemedicine parity proclamation through Dec. 31, 2020.</li> <li>Call on the OIC to extend its emergency telemedicine order for the duration of the public health crisis.</li> </ol> <p><a href="https://takeaction.wsma.org/urge-your-state-lawmakers-to-support-telemedicine-payment-parity-policies/">Click here to send a message through our advocacy platform</a>. Physicians and practices need certainty that these policies will remain in effect as the pandemic continues to play out in Washington state. Please act today.</p> <p><strong>Other emergency policies extended</strong></p> <p>Other WSMA priority proclamations and emergency orders recently extended include:</p> <ul> <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">Governor's proclamation 20-32</a>, concerning health care worker licensing requirements, through July 1.</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">Governor's proclamation 20-27</a>, concerning electronic notary, through July 1.</li> <li> <p><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">Governor's proclamation 20-36</a>, concerning the Certificate of Need program, through July 8.</p> </li> <li> <p><a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-number-20-01-extension-2.pdf?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=">OIC emergency order 20-01</a>, which requires insurers to waive deductibles and copays for any consumer requiring COVID-19 testing and suspends prior authorization requirements for the testing and treatment of COVID-19, through July 3.</p> </li> </ul> <h3>COVID-19 case reporting now requires race/ethnicity data</h3> <p>For physicians or facilities that order lab tests for COVID-19 and enter COVID-19 case report data into an electronic medicalrecord, test documentation must now include race and ethnicity in the data fields. For details</p> <p>read <a href="https://www.doh.wa.gov/Portals/1/Documents/1500/CLR-LabProvDemoRptLtr.pdf" target="_blank">this June 8 letter from Scott Lindquist, MD, MPH, state epidemiologist for communicable diseases and deputy health officer</a>. If you have questions, please email <a href="mailto:doh-ncov-epi@doh.wa.gov">doh-ncov-epi@doh.wa.gov</a>.</p> <h3>Electronic prescribing mandate delayed until September 2021</h3> <p><a href="https://app.leg.wa.gov/billsummary?BillNumber=5380&Initiative=false&Year=2019">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 new law requires electronic prescribing for controlled substances beginning on Jan. 1, 2021. At the WSMA's request, Department of Health Secretary John Wiesman delayed the EPCS mandate out of consideration for the impact on physician practices during the COVID-19 public health emergency. Practices will now be required to e-prescribe by Sept. 30, 2021. This action aligns the EPCS mandate deadline with a WSMA-requested delay for electronic health record/prescription monitoring program integration requirement. By Sept. 30, 2021, practices with 10 or more prescribers will also be required to complete EHR-PMP integration.</p> <p>For practices facing barriers to both 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. We will continue to advocate for flexibility for physicians and their practices moving forward. Should you have questions on either mandate, contact the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p> <h3>Chronic opioid prescribing guidance during COVID-19</h3> <p>The Washington State Department of Health recently released "<a href="javascript://[Uploaded files/News and Publications/Newsletters/2020/Guidance on Chronic Pain Management Medications during the COVID.pdf]">Guidance on Chronic Pain Management Medications during the COVID-19 Pandemic</a>." The guidance, intended for health care workers and patients with chronic pain on long-term opioid therapy, includes information on telemedicine, filling prescriptions, and medication refill schedules.</p> </div>6/25/2020 12:00:00 AM1/1/0001 12:00:00 AM
 

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