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king_county_seeks_physician_volunteers_for_recovery_centersKing County Seeks Physician Volunteers for Recovery CentersLatest_NewsShared_Content/News/Latest_News/2020/April/king_county_seeks_physician_volunteers_for_recovery_centers<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>April 6, 2020</h5> <h2>King County Seeks Physician Volunteers for Recovery Centers</h2> <p> Public Health - Seattle & King County is seeking active licensed and DEA-certified physicians who are available to work paid 12-hour day and night (7-to-7) shifts on-site at our Assessment Center and Recovery Centers (ACRC). PHSKC is seeking those with specialties in family practice, internal medicine, or emergency medicine backgrounds, and those with a buprenorphine waiver. </p> <p> If you are interested, please reach out to Melanie Maltry at <a href="mailto:mmaltry@kingcounty.gov">mmaltry@kingcounty.gov</a> as soon as possible. PHSKC is also seeking licensed physicians with similar backgrounds who are interested and available for on-call back up to support on-site staff at the ACRC, and our Isolation and Quarantine sites, by phone and telemedicine. </p> <p> Please also note that that an on-site orientation will be held on April 8 at our Shoreline ACRC site. Times and an agenda are pending. </p> <h3>About the PHSKC Assessment and Recovery Centers</h3> <p> Public Health - Seattle & King County has identified three locations, to date, that will create up to 657 spaces for assessment and recovery care for individuals who are not able to recover in their own homes, or do not have a home. These centers will also provide space for hospitals to discharge non-emergency COVID cases, freeing up hospital space for those with acute needs. <a href="https://www.kingcounty.gov/elected/executive/constantine/news/release/2020/March/25-kingcounty-seattle-covid-19-shelter.aspx">Learn more about PHSKC's efforts</a> to expand COVID-19 emergency shelter and housing response. </p> </div>4/6/2020 12:00:00 AM1/1/0001 12:00:00 AM
covid_19_financial_reliefCOVID-19 Financial ReliefLatest_NewsShared_Content/News/Membership_Memo/20200403/covid_19_financial_relief<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/April/Steth-Calc-Money-645x425px.jpg" class="pull-right" alt="Money plus stethascope" /> </div> <h5>April 3, 2020</h5> <h2>COVID-19 Financial Relief</h2> <p>The coronavirus pandemic is hitting physician practices acutely, in terms of both economic hardship and disruption to patient care. Since March 1, almost 100% (99.4%) of independent physician practices report a decrease in patient volume, resulting in millions of dollars in lost revenue. Our survey was shared with 5,000 physicians working in independent (non-networked) physician clinics in Washington state. Total responses equaled 384. After adjusting for multiple answers per practice site, the total response number was 311.</p> <p>Overall, almost 18% of respondents said their practice revenue has decreased by more than $1,000,000 since March 1. Sixteen percent said their revenue has dropped $21,000-$50,000 during that time period, while another 16% said their revenue has dropped in the range of $101,000-$200,000.</p> <p>Based on the reduction in patient volume since March 1, the majority of responding practices have furloughed staff:</p> <ul> <li>63% are laying off or furloughing staff.</li> <li>61% are changing office hours.</li> <li>26% have closed temporarily.</li> <li>Two practices reported they have closed permanently.</li> </ul> <p>When asked "Looking at the next three months, do you believe your patient volumes will increase or decrease?" 63% of all respondents said decrease. The loss in margin was widespread among all respondents:</p> <ul> <li>19% said $100,000-$250,000.</li> <li>19% said $500,000-$1,000,000.</li> <li>17% said $250,000-$500,000.</li> <li>14% said $1,000,000-$2,000,000.</li> </ul> <p>For questions about the WSMA survey, contact <a href="mailto:wsma@wsma.org">wsma@wsma.org</a>. The WSMA is using this data in our advocacy to try and ensure practices get the financial support they need to keep their doors open after the COVID-19 outbreak. Specific work in this regard includes:</p> <h3>CMS provides accelerated payments in Advance Payment Program</h3> <p>The WSMA has been advocating at both the national and state levels to not only ensure that you get necessary supplies and protection to care for your patients, but to ensure that your practice can be there for your community when the outbreak subsides. In very good news for physicians, the Centers for Medicare & Medicaid services has announced that it will pay physicians their 2020 Medicaid and Medicare payments in advance.</p> <p>The federal agency is expanding its Advance Payment Program to allow more physicians to qualify and receive expedited payments, interest-free. CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment. The expansion of this program is only for the duration of the public health emergency. Details on the eligibility and the request process are outlined in <a href="https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf?utm_campaign=government-affairs&utm_medium=email&utm_source=3.30.20%20Regulatory%20Alert&elqEmailId=10013">this CMS fact sheet</a>. While expansion of the APP is welcome, the WSMA continues to advocate to Washington's Congressional delegation and CMS to not subject practices to repayment or recoupment.</p> <h3>Paycheck Protection Program goes into effect today (Friday)</h3> <p>The federal stimulus package (aka CARES Act) is intended to provide financial relief to individuals and businesses through a number of programs. The <a href="https://www.sba.gov/funding-programs/loans/paycheck-protection-program-ppp">Paycheck Protection Program</a> is likely to be of most utility to physician practices, as it provides loans of up to $10 million to qualifying businesses of less than 500 employees that under some circumstances do not need to be repaid.</p> <p>The loans do not require collateral and can cover up to two months of your average monthly payroll costs from the last year, plus an additional 25% of that amount (with payroll calculations capped at $100,000 per employee). Provided that the funds are used to primarily cover payroll costs, and that staff and payroll are maintained for the duration of the loan, the loan can be forgiven. Beyond payroll, up to 25% of the loan may be used for operational expenses such as rent, interest on mortgages, and utilities.</p> <p>The Paycheck Protection Program launches on Friday, April 3. Given the projected demand for these loans, the WSMA strongly encourages physicians to act quickly. As a first step, consider reaching out to the bank your practice works with as all federally insured financial institutions are eligible lenders. The U.S. Treasury Department offers <a href="https://home.treasury.gov/system/files/136/PPP%20Borrower%20Information%20Fact%20Sheet.pdf" target="_blank">a fact sheet on the program</a>, and the application form can be found <a href="https://home.treasury.gov/system/files/136/Paycheck-Protection-Program-Application-3-30-2020-v3.pdf" target="_blank">here</a>. Finally, the Association of Washington Business will be hosting a webinar on the program at 10 a.m. on Monday, April 6. <a href="https://register.gotowebinar.com/register/3682124109688014859?source=AWB-resources">Register here</a>.</p> <h3>CMS covers phone visits at same rate as in-person visit</h3> <p>Another of WSMA's top line asks on behalf of our physician members during the pandemic was answered in the affirmative this week when CMS released an <a href="https://www.cms.gov/files/document/covid-final-ifc.pdf" target="_blank">interim final rule</a> temporarily expanding the <a href="https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes">list of covered telehealth services</a> and providing regulatory waivers to help hospitals and physician practices respond to the coronavirus outbreak. The new services and waivers are intended to help facilitate telehealth visits with Medicare beneficiaries, including permitting physicians to provide certain services by telephone to new or established patients using CPT codes 98966-98968; 99441-99443.</p> <p>For the duration of the public health emergency, telehealth services will be reimbursed at the same rate as a face-to-face visit. To implement this change, CMS instructs physicians to bill for Medicare telehealth services to report the POS code that would have been reported had the service been furnished in person and use modifier 95. These changes are effective retroactively, starting March 1, 2020. CMS will exercise its enforcement discretion on an interim basis and not conduct reviews to consider whether these services were furnished to established patients. For details, see <a href="https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf">this CMS fact sheet</a>. For further telehealth guidance for your practice during COVID-19, visit the WSMA's <a href="[@]WSMA/Resources/COVID-19_Response/Telehealth_and_Reimbursement/WSMA/Resources/COVID-19/Prepare_Your_Practice_for_COVID-19/Prepare_Your_Practice_for_COVID-19.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae">Telehealth and Reimbursement page</a>. For more detail or with questions, please reach out to <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p> </div>4/3/2020 12:00:00 AM1/1/0001 12:00:00 AM
establishing_liability_protections_during_covid_19Establishing Liability Protections During COVID-19Latest_NewsShared_Content/News/Membership_Memo/20200403/establishing_liability_protections_during_covid_19<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>April 3, 2020</h5> <h2>Establishing Liability Protections During COVID-19</h2> <p>The WSMA, along with the Washington State Hospital Association, the Washington State Nurses Association, the Washington Academy of Physician Assistants and others, have reached out to Gov. Jay Inslee's office to advocate for increased liability protections for physicians as they lead the response to COVID-19. Washington state does not have crisis standards of care law in our state, and our governor has limited ability to affect such laws via emergency orders given that he can only waive existing law, rather than creating new law. Working within those confines, we have proposed extending liability protections afforded to out-of-state volunteers under RCW 70.15 to in-state practitioners responding to the emergency.</p> <p>Recall just last week the Washington Medical Commission also sought to provide some reassurance to the physician and PA community on the governor's recent proclamation regarding hospitals and ASCs delaying elective surgeries or non-emergent procedures: "Practitioners who feel holding-off on a surgery would be a detriment to the patient's quality of life, or would result in a patient's condition worsening, should not fear disciplinary action for performing the surgery." <a href="https://wmc.wa.gov/news/wmc-pandemic-regulatory-intent">Read the full statement here</a>.</p> </div>4/3/2020 12:00:00 AM1/1/0001 12:00:00 AM
governor_waives_cme_mol_requirements_delegation_agreements_con_other_regulations_to_aid_state_responGovernor Waives CME/MOL Requirements, Delegation Agreements, CON, Other Regulations to Aid State ResLatest_NewsShared_Content/News/Membership_Memo/20200403/governor_waives_cme_mol_requirements_delegation_agreements_con_other_regulations_to_aid_state_respon<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>April 3, 2020</h5> <h2>Governor Waives CME/MOL Requirements, Delegation Agreements, CON, Other Regulations to Aid State Response</h2> <p>In anticipation of workforce and facility shortages during the pandemic, Gov. Jay Inslee issued two amended proclamations, one temporarily removing regulatory barriers that may hinder licensed health care practitioners' ability to serve during the pandemic, and the other waiving requirements for health care facilities to allow for greater bed capacity. The orders are in effect through the month of April. Here are key takeaways:</p> <h3>PA movement and delegation agreements</h3> <p>In an <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">amended proclamation addressing health care licensing</a>, the governor temporarily removes the need for a PA delegation agreement, which will allow physicians across the state to put PAs to work immediately to assist in the pandemic without the need for a delegation agreement to be vetted by the Washington Medical Commission. The Washington Academy of Physician Assistants is compiling a list of PA volunteers by county who are ready and able to join the health care workforce to assist in the COVID-19 response. If you are a PA who'd like to volunteer to work in a hospital setting in your county or another nearby county, email <a href="mailto:wapa@wapa.com">wapa@wapa.com</a>.</p> <h3>MD/DO licensure requirements</h3> <p>The governor's <a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-32%20-%20COVID-19%20DOH%20Healthcare%20Worker%20Licensing%20%28tmp%29.pdf" target="_blank">proclamation</a> also temporarily waives certain licensure requirements for allopathic and osteopathic physicians to enable uninterrupted health care service during the pandemic, including:</p> <ul> <li>Seven hours of HIV/AIDS education.</li> <li>Maintenance of Licensure requirement options including: <ul> <li>200 hours of CME every four years.</li> <li>Becoming board certified in the last four years.</li> <li>Obtaining an AMA PRA certificate in two of the last four years.</li> <li>Satisfying ABMS Maintenance of Certification requirements.</li> </ul> </li> <li>Suicide prevention training.</li> <li>Compensation limitations for retired active physicians.</li> </ul> <p>Additionally, the Washington Medical Commission conducted emergency rulemaking to remove requirements for retired active physicians, including compensation limitation and CME requirements, to encourage their return to practice. <a href="https://wmc.wa.gov/news/wmc-statement-proclamation-20-05-relating-md-license-cme-requirements">Read the Medical Commission statement</a>.</p> <p>In a separate announcement, the Washington State Department of Health has extended health profession license expiration dates for physicians and other health care providers whose licenses are up for renewal between April 1 and Sept. 30, 2020. Intended to allow physicians and providers to focus on patient care and to forestall further economic burden at this time, the move means that payment renewal for licensure won't be required until Sept. 30. More information on the announcement can be found <a href="https://www.doh.wa.gov/LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/LicenseExpirationExtensionFAQ">here</a>.</p> <h3>Certificate of Need</h3> <p>In a second proclamation related to health care facilities, the governor suspends "portions of the licensing and administrative statutes and rules relating to health care facilities to remove barriers to adding health care facilities and beds to meet the demands of the COVID-19 response," including Certificate of Need requirements. The orders state that the suspension of CON only apply to those "temporary increases in bed capacity and projects undertaken to provide surge capacity for the COVID-19 response, for which certificates of need must be obtained after the expiration of this waiver in compliance with the waived statutory and regulatory provisions." <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">Read the amended proclamation in full</a>.</p> </div>4/3/2020 12:00:00 AM1/1/0001 12:00:00 AM
wsma_urging_action_on_ppeWSMA Urging Action on PPELatest_NewsShared_Content/News/Membership_Memo/20200403/wsma_urging_action_on_ppe<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/April/mask-Mika-Baumeister-645x425.jpg" class="pull-right" alt="Protective mask" /> </div> <h5>April 3, 2020</h5> <h2>WSMA Urging Action on PPE</h2> <p>The WSMA has joined state leaders in urging action immediately by our federal government to relieve the shortage of personal protective equipment in Washington state. While a shipment of ventilators and PPE from the national stockpile was recently received and is being distributed, more - much more - is needed to protect our workforce from contagion. According to an <a href="https://www.msn.com/en-us/news/us/protective-gear-in-national-stockpile-is-nearly-depleted-dhs-officials-say/ar-BB122cFl?ocid=spartanntp">April 1 Washington Post article</a>, the national stockpile may be in short supply. The same time the Post story broke, Gov. Jay Inslee held a press conference urging Washington state manufacturers to repurpose their facilities to produce needed supplies. The state's coronavirus response website <a href="https://coronavirus.wa.gov/how-you-can-help">has details</a>. The Washington State Department of Health is expected to release new conservation strategies for PPE as well as a revised prioritization list soon. We will report out on this information when it is available.</p> <p>If your clinic or hospital needs personal protective equipment, the King County Medical Society Community Foundation created Frontline PPE, a nonprofit organization partnering with local garment manufacturers and professional tailors. This week, with the support of funding from Expedia, KCMS announced a partnership with Providence Health System and its manufacturer, Kaas Tailored, which will help expand the Providence "<a href="https://www.providence.org/lp/100m-masks">100 Million Mask Challenge</a>." If your practice, clinic, or hospital needs PPE, contact Salem Adisu at <a href="mailto:sadisu@kcmsociety.org">sadisu@kcmsociety.org</a>. Please indicate the numbers of mask, gowns, and caps needed. Additionally, if you have unused surgical wrap, the KCMS program can use it to make masks and return to the clinic as masks or distribute to others. Donations will be picked up. Interested parties can contact <a href="mailto:sadisu@kcmsociety.org">sadisu@kcmsociety.org</a>.</p> </div>4/3/2020 12:00:00 AM1/1/0001 12:00:00 AM
governor_announces_telehealth_payment_parity_in_response_to_coronavirus_outbreakGovernor Announces Telehealth Payment Parity in Response to Coronavirus OutbreakLatest_NewsShared_Content/News/Membership_Memo/20200326/governor_announces_telehealth_payment_parity_in_response_to_coronavirus_outbreak<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/Telemedicine_Consult_640px.jpg" class="pull-right" alt="Telemedicine consultation" /> </div> <h5>March 26, 2020</h5> <h2>Governor Announces Telehealth Payment Parity in Response to Coronavirus Outbreak</h2> <p><strong>Updated March 26, 2020</strong>: The WSMA thanks Washington state Gov. Jay Inslee, Health Care Authority Director Sue Birch, and Insurance Commissioner Mike Kreidler for their actions to ensure fair reimbursement for services that are delivered via telemedicine. Read our <a href="javascript://[Uploaded files/Resources/COVID19/wsma_telemedicine_parity_thank_you_letter.pdf]">thank you letter</a>, delivered March 26.</p> <p>Late Wednesday night (March 25), Gov. Jay Inslee signed a proclamation providing payment parity for services delivered via telemedicine. Specifically, the governor made <a href="[@]Shared_Content/News/Press_Release/2020/Physicians_Urge_Governor_to_Allow_Telemedicine_Payment_Parity_Bill_to_Go_into_Effect_Immediately_">implementation of Senate Bill 5385</a> effective immediately, which requires state-regulated insurance carriers to reimburse telemedicine services on par with what they would reimburse for covered services delivered in person. The order specifically prohibits health carriers from:</p> <ul> <li>Reimbursing in-network providers for telemedicine claims for medical necessary covered service at a rate lower than the contracted rate that would be paid if the services had been delivered through traditional (in-person) methods.</li> <li>Denying a telemedicine claim from an in-network provider for a medically necessary covered service due to an existing provider contract term with that provider that denies reimbursement for services provided through telemedicine.</li> <li>Establishing requirements for the payment of telemedicine services that are inconsistent with the emergency orders, rules, or technical advisories to carriers issued by the Office of Insurance Commissioner.</li> </ul> <p>The OIC on Tuesday, March 24 issued an order that allows all in-network providers to use non-HIPAA compliant communication platforms to provide patient care under certain circumstances (<a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-20-02_3.pdf?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=">read the OIC order</a>). This aligns with a <a href="https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html">recent federal announcement</a> around HIPAA enforcement discretion during the public health emergency. The order goes on to read that "All Regulated Entities shall treat the use of audio-only telephone as telemedicine, despite contrary language in RCW 48.43.735(8)(g)." The Washington State Health Care Authority took similar steps for our state's Medicaid and state employee plans on Monday, March 24 (<a href="https://www.hca.wa.gov/health-care-services-and-supports/hca-supports-increased-telehealth-options-medicaid-clients-public">read the HCA announcement</a>).</p> <p>At the national level, Medicare has also announced payment parity for most telemedicine services (<a href="https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet">read the CMS announcement</a>). The WSMA is reaching out to our Congressional delegation urging them to require telehealth parity policies for ERISA plans that cannot be regulated by the state - including for telephone visits, which, as we've heard from a number of our members, are reimbursed poorly.</p> <p>We expect to see more movement in the days ahead on this issue - we will keep you apprised as more parity policies are announced. The WSMA thanks Gov. Inslee, the OIC, HCA, CMS and insurance carriers such as Regence, United, and Molina, which had voluntarily adopted payment parity in advance of the orders, for taking these important steps during the COVID-19 crisis.</p> <p>Be sure to visit our <a href="[@]WSMA/Resources/COVID-19_Response/Telehealth_and_Reimbursement/WSMA/Resources/COVID-19/Prepare_Your_Practice_for_COVID-19/Prepare_Your_Practice_for_COVID-19.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae">COVID-19 Telehealth and Reimbursement page</a> for more resources and information, including other breaking updates.</p> </div>3/26/2020 12:00:00 AM1/1/0001 12:00:00 AM
state_response_to_covid_19_intensifies_wsma_presses_physician_concernsState Response to COVID-19 Intensifies; WSMA Presses Physician ConcernsLatest_NewsShared_Content/News/Membership_Memo/20200326/state_response_to_covid_19_intensifies_wsma_presses_physician_concerns<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>March 26, 2020</h5> <h2>State Response to COVID-19 Intensifies; WSMA Presses Physician Concerns</h2> <p>WSMA leadership and staff have been working around the clock to mobilize our advocacy in light of the worsening COVID-19 crisis. Gov. Jay Inslee's emergency order this week for Washingtonians to "<a href="https://www.governor.wa.gov/sites/default/files/proclamations/20-25%20Coronovirus%20Stay%20Safe-Stay%20Healthy%20%28tmp%29%20%28002%29.pdf" target="_blank">stay home and stay healthy</a>" - mandating the closure of non-essential businesses and ordering Washington residents to stay at home and avoid any unnecessary travel - reflected the urgency felt at the WSMA and by many in the physician community. In a <a href="[@]WSMA/Shared_Content/News/Press_Release/2020/WSMA_Supports_Gov._Inslee_s_Stay_Home_and_Stay_Healthy_Order_in__Response_to_COVID-19.aspx">press release</a> expressing support for the order, WSMA President William K. Hirota, MD, said, "We do not currently have the capability to test and isolate those infected with the virus, so we must do all that we can to blunt the curve. … We thank the governor for taking this courageous step and we join him in urging the public to listen."</p> <p>Gov. Inslee and Washington lawmakers continue to lobby U.S. Department of Health and Human Services for more personal protective equipment, with a shipment from the national stockpile arriving last weekend. For now, DOH is prioritizing supplies using a <a href="https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020/PPEPrioritization">tiering system</a> based on confirmed case management. We are pursuing several approaches, including assessing independent/rural practice needs and working with the state and municipalities on coordinating PPE donations, to help ensure more supplies can be secured and distributed to physician practices soon. It is imperative for practices and clinics throughout the state to have the resources they need to continue to operate, so that they can alleviate pressure on our state's hospitals.</p> <p>The governor’s ban on elective surgeries and procedures is now in effect. As <a href="https://www.governor.wa.gov/sites/default/files/20-24%20COVID-19%20non-urgent%20medical%20procedures%20%28tmp%29.pdf?utm_medium=email&utm_source=govdelivery" target="_blank">detailed in the proclamation</a>, Gov. Inslee's order applies to hospitals, ambulatory surgery facilities (ASC), dental, orthodontic and endodontic offices in Washington state. We want to assure members that the proclamation only applies to the entities listed in the actual proclamation. While hospital outpatient clinics are referenced, it is to distinguish them from the hospital setting. Clinics—hospital based or otherwise—are not covered by this proclamation. If a clinic operates as an ASC, they should follow the guidance and cancel/postpone elective/non-urgent procedures unless in their medical judgment a condition will be made worse. DOH has indicated it wants patients to continue to receive care in their communities, whether in person or virtually.</p> <p>Washington state has been a leader in its handling of the COVID-19 crisis - and now, the state's emergency response has a new leader. The governor has named retired Navy Vice Admiral Raquel C. Bono as <a href="https://www.governor.wa.gov/news-media/inslee-names-retired-navy-vice-admiral-raquel-c-bono-head-washington-state-covid-19">head of the Washington state COVID-19 health care response team</a>. Vice Admiral Bono will advise the governor and state agencies on actions needed to address the capacity and strain across the health care system. The WSMA has met with Vice Admiral Bono to express our concerns with PPE, testing and supplies, and will meet with her on a weekly basis as she maps out our state's collective response to the virus.</p> </div>3/26/2020 12:00:00 AM1/1/0001 12:00:00 AM
urge_lawmakers_to_support_physician_practices_during_covid_19_responseUrge Lawmakers to Support Physician Practices During COVID-19 ResponseLatest_NewsShared_Content/News/Membership_Memo/20200326/urge_lawmakers_to_support_physician_practices_during_covid_19_response<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/MembershipMemo/2020/March/Megaphone-Evergreen-645x425px.jpg" class="pull-right" /> </div> <h5>March 26, 2020</h5> <h2>Urge Lawmakers to Support Physician Practices During COVID-19 Response</h2> <p>Washington state physicians have embraced their professionalism in its highest form during the COVID-19 crisis and put the interests of those they serve above their own. We know that many of you have done so at risk of your health, the health of your family, and possibly at a great financial loss to your practice.</p> <p>The WSMA has been advocating at both the national and the state level to not only get more test and supplies into Washington state, but to ensure that physicians can keep their doors open as they experience dramatic shifts in volume and have moved to delay elective surgeries and non-emergency procedures. Lawmakers need to hear your personal stories as well.</p> <p>We encourage you to reach out to your elected officials, sharing your experience of testing and treating COVID-19 patients and the impact the virus has had on your practice by clicking the Take Action button below. Also, the WSMA is collecting data on the economic impact the virus has had on practices. Please complete our <a href="https://www.surveymonkey.com/r/CPZMLFY">short survey here</a>.</p> <p> <!--Large text button--> <a class="TextButton Button" href="https://takeaction.wsma.org/take-action-support-physician-practices-during-covid-19/">Take Action</a> </p> </div>3/26/2020 12:00:00 AM1/1/0001 12:00:00 AM
WSMA_Supports_Gov._Inslee_s_Stay_Home_and_Stay_Healthy_Order_in__Response_to_COVID-19WSMA Supports Gov. Inslee’s Stay Home and Stay Healthy Order in Response to COVID-19Latest_NewsShared_Content/News/Press_Release/2020/WSMA_Supports_Gov._Inslee_s_Stay_Home_and_Stay_Healthy_Order_in__Response_to_COVID-19<div class="col-md-12"> <div class="col-md-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>March 23, 2020</h5> <h2>WSMA Supports Gov. Inslee's "Stay Home and Stay Healthy" Order in Response to COVID-19</h2> <p> SEATTLE - The Washington State Medical Association, representing physicians and physician assistants across the state - many of whom are serving on the frontlines of the COVID-19 pandemic - supports Washington State Gov. Jay Inslee's action today mandating the closure of non-essential businesses and ordering Washington residents to stay at home and avoid any unnecessary travel. The policy strengthens the state's current COVID-19 emergency response by requiring all Washingtonians to "stay home and stay healthy" unless pursuing an "essential need." </p> <p> "We do not currently have the capability to test and isolate those infected with the virus, so we must do all that we can to blunt the curve," says William K. Hirota, MD, president of the association. "The data and modeling are clear and we are learning from the experience of South Korea and China, and we must act now to minimize the damage. We thank the governor for taking this courageous step and we join him in urging the public to listen." </p> <p> Given the virus' contagiousness during a protracted incubation period—and dramatic undertesting, which has crippled public health's ability to trace and contain infections—experts agree that the next few weeks and months will see a steady rise of patients presenting at ICUs and EDs with severe COVID-19 illness. The influx of COVID-19 patients threatens to overwhelm Washington state's hospitals and emergency responders, which has led to increasingly stronger pronouncements by the governor and public health leaders urging Washingtonians to stay home and help to slow the virus' transmission. </p> <p> "We recognize the once-in-a-lifetime challenge this is for everybody, health care workers and public alike," added Dr. Hirota. "There will be economic fallout for all of society, but our initial efforts should be to keep our health care system intact and capable of handling the surge to come. We also need to protect the health of our doctors, nurses, and first responders" </p> <p> Washington state also faces a severe shortage of personal protective equipment (PPE)—critical protection for emergency care and frontline health care personnel during the pandemic, and also for physician practices and clinics throughout the state, whose ability to screen and treat potential COVID-19 patients will be crucial in alleviating pressure on our state's hospitals. </p> <p> "This really is a perfect storm—we're facing a shortage of PPE, testing, ventilators in ICUs to help with respiratory illness, even health care workers, as more of our colleagues fall ill or test positive," says Nathan Schlicher, MD, JD, president-elect of the association and an emergency medicine physician with Team Health/CHI Franciscan. "It's radically impacting health care and it's severely altering the lives of our patients, who are facing major disruption in their lives. We are truly all in this together. The governor's announcement today was the right step—and we're looking forward to working with him and our public health leaders on the next steps: getting PPE out to our clinics, expansion of COVID testing, and strategies to address the social determinants of health, including the viability of the health system as a whole, just to name a few." </p> <p> </p> <p> For more information, contact: </p> <p> Cindy Sharpe<br /> 813.244.2883 (office/mobile)<br /> <a href="mailto:cindy@wsma.org">cindy@wsma.org</a> </p> <p> Graham Short<br /> 206.956.3633 (cell/text)<br /> <a href="mailto:gfs@wsma.org">gfs@wsma.org</a> </p> <p><strong>About the WSMA</strong></p> <p>The Washington State Medical Association represents more than 11,000 physicians, physician assistants, resident physicians and medical students in Washington state. The WSMA has advocated on behalf of the house of medicine more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.</p> </div>3/23/2020 7:51:02 PM1/1/0001 12:00:00 AM
covid_19_emergency_volunteers_neededCOVID-19 Emergency Volunteers NeededLatest_NewsShared_Content/News/Latest_News/2020/March/covid_19_emergency_volunteers_needed<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>March 20, 2020</h5> <h2>COVID-19 Emergency Volunteers Needed</h2> <!-- Content Below --> <p>As Washington takes <a href="https://medium.com/wagovernor/inslee-issues-emergency-proclamation-that-limits-large-events-to-minimize-public-health-risk-38b4d79a563d">more steps to reduce the spread of COVID-19</a>, the Washington State Department of Health will now enroll and activate emergency volunteer health practitioners in preparation for health system requests and surging. This will help the state meet emerging demands for health care workers.</p> <p>The DOH can perform this work under the authority of the Uniform Emergency Volunteer Health Practitioner Act (<a href="https://app.leg.wa.gov/RCW/default.aspx?cite=70.15">chapter 70.15</a> RCW), if an <a href="https://www.governor.wa.gov/news-media/inslee-issues-covid-19-emergency-proclamation">emergency proclamation by the governor</a> is in effect - as is the case in Washington as of Feb. 29, 2020.</p> <p>If volunteers are registered in the volunteer health practitioner system and verified to be in good standing in all states where they are licensed, they may practice in Washington without obtaining a Washington license once activated and assigned by DOH.</p> <p>In-state practitioners can become volunteers in two ways:</p> <ul> <li>Via RCW <a href="https://app.leg.wa.gov/RCW/default.aspx?cite=70.15">chapter 70.15</a> by registering and completing the Emergency Volunteer Health Practitioners Application which can be found<a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/EmergencyHealthcarePractitionersVolunteerApplication.DOCX"> here</a>.</li> <li>Via registering with their local Medical Reserve Corps; more information can be found at: <a href="https://mrc.hhs.gov/">https://mrc.hhs.gov</a>.</li> </ul> <p>Out-of-state practitioners may:</p> <ul> <li>Become volunteers via RCW <a href="https://app.leg.wa.gov/RCW/default.aspx?cite=70.15">chapter 70.15</a> by registering and completing the Emergency Volunteer Health Practitioners Application which can be found <a href="https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/EmergencyHealthcarePractitionersVolunteerApplication.DOCX">here</a>.</li> <li>Out of state MDs and DOs who would like an expedited Washington license and to volunteer, may use the <a href="https://imlcc.org/">Interstate Medical License Compact</a> and become <a href="https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020/HealthcareProviders/EmergencyVolunteerHealthPractitioners">registered under RCW 70.15</a>. At this time, we are limiting our request for health care practitioners to U.S. jurisdictions due to technical issues. We may expand the call to international jurisdictions in the future as needs arise.</li> </ul> <p>Applications will be screened by the DOH to ensure the potential volunteer’s health license is in good standing in each state they where they are licensed. The DOH will activate, deploy and deactivate approved volunteer health practitioners as needs are identified and requested. Please share this urgent request broadly with other organizations, national groups, stakeholders, followers, and readers.</p> <p>FAQs about RCW 70.15 are available <a href="https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020/HealthcareProviders/EmergencyVolunteerHealthPractitioners">here</a><strong>. </strong>Questions can be emailed to <a href="mailto:WAserv@doh.wa.gov">WAserv@doh.wa.gov</a> or 360.236.4090.</p> </div>3/20/2020 12:00:00 AM1/1/0001 12:00:00 AM
the_wsma_state_specialty_and_county_societies_support_gov_inslees_decision_on_elective_surgeriesThe WSMA, State Specialty and County Societies Support Gov. Inslee's Decision on Elective SurgeriesLatest_NewsShared_Content/News/Press_Release/2020/the_wsma_state_specialty_and_county_societies_support_gov_inslees_decision_on_elective_surgeries<div class="col-md-12"> <div class="col-md-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>March 20, 2020</h5> <h2>The WSMA, State Specialty and County Societies Support Gov. Inslee's Decision on Elective Surgeries</h2> <p> SEATTLE - Washington state Governor Jay Inslee has issued a proclamation that prohibits all hospitals, ambulatory surgery facilities, dental, orthodontic and endodontic offices in Washington state from providing health care services, procedures, and surgeries that, if delayed, are not anticipated to cause harm to the patient within the next three months, with some exceptions. </p> <p> As the facts and situation around novel coronavirus SARS-CoV-2 and its associated respiratory illness, COVID-19, continue to evolve, and in step with Gov. Inslee's proclamation, the WSMA and over 20 state specialty and county medical societies have issued recommended guidance for physicians in Washington state that follows the governor's mandate. </p> <p> "This is not guidance that we issue lightly," said Bill Hirota, M.D., president of the WSMA. "The spread of COVID-19 will be determined by our collective actions now. We believe by taking these recommended precautions, physicians can make a difference in helping to preserve the limited supply of PPE critical for emergency care and frontline health care personnel responding to the pandemic, and keeping themselves, their patients, and their communities safe." </p> <p> Examples of procedures to delay include joint replacements, most cataract and lens surgeries, cosmetic procedures and other non-urgent procedures. </p> <p> The order does not apply to outpatient visits delivered in hospital-based clinics. </p> <p> Also exempt are patients with emergency/urgent needs like heart attacks, strokes or motor vehicle accidents, and surgeries that, if not performed, would worsen the patient's condition. </p> <p> WSMA is also encouraging practices to move routine care and chronic care management to telehealth. </p> <p> "As health care professionals, we all have a role to play in slowing the spread of COVID-19 and 'flattening the curve,' by following sound scientific and public health advice, helping to limit infections, and slowing the spread of the virus," Hirota said. </p> <p> <strong>Signing in support of this statement:</strong><br /> Benton Franklin County Medical Society<br /> Clark County Medical Society<br /> Grays Harbor County Medical Society<br /> Jefferson County Medical Society<br /> King County Medical Society<br /> Kitsap County Medical Society<br /> Northwest Washington Medical Society<br /> Spokane County Medical Society<br /> Thurston-Mason County Medical Society<br /> Washington Academy of Eye Physicians and Surgeons<br /> Washington Academy of Family Physicians<br /> Washington Academy of Physician Assistants<br /> Washington Chapter of the American Academy of Pediatrics<br /> Washington Chapter of the American College of Emergency Physicians<br /> Washington Chapter of the American College of Physicians<br /> Washington State Chapter of the American College of Surgeons<br /> Washington State Council of Child and Adolescent Psychiatry<br /> Washington State Medical Oncology Society<br /> Washington State Orthopaedic Association<br /> Washington State Radiological Society<br /> Washington State Society for Post Acute and Long Term Medicine<br /> Washington State Urology Society<br /> Yakima County Medical Society </p> <p> For more information, contact: </p> <p> Cindy Sharpe<br /> 813.244.2883 (office/mobile)<br /> <a href="mailto:cindy@wsma.org">cindy@wsma.org</a> </p> <p> Graham Short<br /> 206.956.3633 (cell/text)<br /> <a href="mailto:gfs@wsma.org">gfs@wsma.org</a> </p> <p><strong>About the WSMA</strong></p> <p>The Washington State Medical Association represents nearly 11,000 physicians, physician assistants, resident physicians and medical students in Washington state. The WSMA has advocated on behalf of the house of medicine more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.</p> </div>3/20/2020 12:00:00 AM1/1/0001 12:00:00 AM
washington_health_benefit_exchange_reopens_enrollmentWashington Health Benefit Exchange Reopens EnrollmentLatest_NewsShared_Content/News/Latest_News/2020/March/washington_health_benefit_exchange_reopens_enrollment<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>March 20, 2020</h5> <h2>Washington Health Benefit Exchange Reopens Enrollment</h2> <p>In response to the potential spread of COVID-19, the Washington Health Benefit Exchange is offering a limited-time special enrollment period for uninsured individuals. This special enrollment period runs through April 8, giving uninsured individuals 30 days to enroll in health insurance coverage through Washington Healthplanfinder. Individuals seeking to enroll must contact the customer support center at 1.855.923.4633; TTY: 1.855.627.9604 between 7:30 a.m.–5:30 p.m. Monday-Friday and select a plan by April 8 for coverage start date beginning April 1, 2020. Patients may also select a plan through a local certified broker or navigator. Language assistance and disability accommodations are provided at no cost.</p> </div>3/20/2020 12:00:00 AM1/1/0001 12:00:00 AM
comcast_announces_comprehensive_covid_19_responseComcast Announces Comprehensive COVID-19 ResponseLatest_NewsShared_Content/News/Membership_Memo/20200318/comcast_announces_comprehensive_covid_19_response<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" /> </div> <h5>March 18, 2020</h5> <h2>Comcast Announces Comprehensive COVID-19 Response </h2> <p> Please reach out to <a href="mailto:policy@wsma.org">policy@wsma.org</a> with any questions or for guidance around this special COVID-19 telehealth update, or for questions about using telehealth as a COVID-19 response. More information and COVID-19 practice resources at <a href="[@]WSMA/Resources/COVID-19_Response/Prepare_Your_Practice_for_COVID-19/WSMA/Resources/COVID-19/Prepare_Your_Practice_for_COVID-19/Prepare_Your_Practice_for_COVID-19.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae">Prepare Your Practice for COVID-19</a>. </p> <p> For physicians or providers with patients who lack or have limited internet access, Comcast's new temporary policies may help facilitate access to telehealth services. </p> <p> For 60 days beginning March 13, Comcast will offer the following: </p> <ul> <li><strong>Xfinity WiFi Free for everyone:</strong> Xfinity WiFi hotspots across the country will be available to anyone who needs them for free – including non-Xfinity Internet subscribers. For a map of Xfinity WiFi hotspots, visit <a href="https://wifi.xfinity.com/">www.xfinity.com/wifi</a>. Once at a hotspot, consumers should select the "xfinitywifi" network name in the list of available hotspots and then launch a browser.</li> <li><strong>Pausing our data plan:</strong> With so many people working and educating from home, we want our customers to access the internet without thinking about data plans. While the vast majority of our customers do not come close to using 1TB of data in a month, we are pausing our data plans for 60 days giving all customers unlimited data for no additional charge.</li> <li>Internet Essentials free to new customers: As announced yesterday, it's even easier for low-income families who live in a Comcast service area to sign up for Internet Essentials, the nation's largest and most comprehensive broadband adoption program. New customers will receive 60 days of complimentary Internet Essentials service, which is normally available to all qualified low-income households for $9.95/month. Additionally, for all new and existing Internet Essentials customers, the speed of the program's internet service was increased to 25 Mbps downstream and 3 Mbps upstream. That increase will go into effect for no additional fee and it will become the new base speed for the program going forward.</li> </ul> <p> See <a href="https://corporate.comcast.com/covid-19">this Comcast website</a> for more information. </p> </div>3/18/2020 12:00:00 AM1/1/0001 12:00:00 AM
hhs_relaxes_telehealth_hipaa_rules_allows_for_video_chatHHS Relaxes Telehealth HIPAA Rules, Allows for Video ChatLatest_NewsShared_Content/News/Membership_Memo/20200318/hhs_relaxes_telehealth_hipaa_rules_allows_for_video_chat<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>March 18, 2020</h5> <h2>HHS Relaxes Telehealth HIPAA Rules, Allows for Video Chat</h2> <p> Please reach out to <a href="mailto:policy@wsma.org">policy@wsma.org</a> with any questions or for guidance around this special COVID-19 telehealth update, or for questions about using telehealth as a COVID-19 response. More information and COVID-19 practice resources at <a href="[@]WSMA/Resources/COVID-19_Response/Prepare_Your_Practice_for_COVID-19/WSMA/Resources/COVID-19/Prepare_Your_Practice_for_COVID-19/Prepare_Your_Practice_for_COVID-19.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae">Prepare Your Practice for COVID-19</a>. </p> <p> The Health and Human Services (HHS) Office for Civil Right (OCR) has announced that it is relaxing HIPAA rules for physicians and other health care providers using telehealth in response to COVID-19. This change is effective immediately. According to OCR, the agency "…will waive potential HIPAA penalties for good faith use of telehealth during the nationwide public health emergency due to COVID-19." The OCR has offered additional guidance: </p> <p> <em><strong>A covered physician or health care provider</strong> that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency <strong>can use any non-public facing remote communication product that is available to communicate with patients</strong>. OCR is exercising its enforcement discretion to not impose penalties for noncompliance with the HIPAA rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency. This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19.</em> </p> <p> <em>For example, a covered physician or provider in the exercise of their professional judgement may request to examine a patient exhibiting COVID- 19 symptoms using a video chat application connecting the physician's or patient's phone or desktop computer to assess a greater number of patients while limiting the risk of infection of other persons who would be exposed from an in-person consultation. Likewise, a covered physician or health care provider may provide similar telehealth services in the exercise of their professional judgment to assess or treat any other medical condition, even if not related to COVID-19, such as a sprained ankle, dental consultation, or psychological evaluation, or other conditions. </em> </p> <p> <em><strong>Under this notice, covered physicians and providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.</strong> Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications.</em> </p> <p> More information is available on this <a href="https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html">temporary policy change here</a>. </p> </div>3/18/2020 12:00:00 AM1/1/0001 12:00:00 AM
telehealth_benefits_for_medicare_beneficiaries_expandedTelehealth Benefits for Medicare Beneficiaries ExpandedLatest_NewsShared_Content/News/Membership_Memo/20200318/telehealth_benefits_for_medicare_beneficiaries_expanded<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2020/March/COVID-19-Response-645x425px.jpg" class="pull-right" alt="COVID-19 Response logo" /> </div> <h5>March 18, 2020</h5> <h2>Telehealth Benefits for Medicare Beneficiaries Expanded</h2> <p> Please reach out to <a href="mailto:policy@wsma.org">policy@wsma.org</a> with any questions or for guidance around this special COVID-19 telehealth update, or for questions about using telehealth as a COVID-19 response. More information and COVID-19 practice resources at <a href="[@]WSMA/Resources/COVID-19_Response/Prepare_Your_Practice_for_COVID-19/WSMA/Resources/COVID-19/Prepare_Your_Practice_for_COVID-19/Prepare_Your_Practice_for_COVID-19.aspx?hkey=ed7e0075-97a3-489f-b858-92a741fc58ae">Prepare Your Practice for COVID-19</a>. </p> <p> The Centers for Medicare & Medicaid Services has expanded telehealth coverage for Medicare beneficiaries and will temporarily pay clinicians to provide telehealth services beginning March 6. As COVID-19 poses greater risks to seniors, this will allow Medicare beneficiaries to manage health issues and receive a wider range of services from the comfort and safety of their homes. </p> <p> There are three main types of virtual services physicians and other professionals can provide to Medicare beneficiaries: telehealth visits, virtual check-ins, and e-visits. </p> <p> Telehealth visits – Key takeaways: </p> <ul> <li>Effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to patients in broader circumstances.</li> <li>These visits are considered the same as in-person visits and are paid at the same rate as regular in-person visits.</li> <li>Starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for professional services furnished to beneficiaries in all areas of the country in all settings.</li> <li>While they must generally travel to or be located in certain types of originating sites such as a physician's office, skilled nursing facility, or hospital for the visit, effective for services starting March 6, 2020 and for the duration of the COVID-19 Public Health Emergency, Medicare will make payment for Medicare telehealth services furnished to beneficiaries in any health care facility and in their home.</li> <li>The Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for physicians and health care providers to reduce or waive cost-sharing for telehealth visits paid by federal health care programs.</li> <li>To the extent the 1135 waiver requires an established relationship, HHS will not conduct audits to ensure that such a prior relationship existed for claims submitted during this public health emergency.</li> </ul> <p>Virtual check-ins – Key takeaways:</p> <ul> <li>Virtual check-in services can only be reported when the billing practice has an established relationship with the patient. </li> <li>This is not limited to only rural settings or certain locations.</li> <li>Individual services need to be agreed to by the patient; however, practitioners may educate beneficiaries on the availability of the service prior to patient agreement. </li> <li>HCPCS code G2012: Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.</li> <li>HCPCS code G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous seven days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment.</li> <li>Virtual check-ins can be conducted with a broader range of communication methods, unlike Medicare telehealth visits, which require audio and visual capabilities for real-time communication.</li> </ul> <p> E-visits – Key takeaways: </p> <ul> <li>These services can only be reported when the billing practice has an established relationship with the patient. </li> <li>This is not limited to only rural settings. There are no geographic or location restrictions for these visits.</li> <li>Patients communicate with their doctors without going to the doctor's office by using online patient portals.</li> <li>Individual services need to be initiated by the patient; however, practitioners may educate beneficiaries on the availability of the service prior to patient initiation. </li> <li>The services may be billed using CPT codes 99421-99423 and HCPCS codes G2061-G206, as applicable.</li> <li>The Medicare coinsurance and deductible would generally apply to these services.</li> </ul> <p> More information on the new rule can be found at this <a href="https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak">CMS webpage</a> and this <a href="https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet">Medicare telemedicine fact sheet</a>. </p> </div>3/18/2020 12:00:00 AM1/1/0001 12:00:00 AM
covid_19_concerns_cloud_positive_legislative_session_for_wsmaCOVID-19 Concerns Cloud Positive Legislative Session for WSMALatest_NewsShared_Content/News/Latest_News/2020/March/covid_19_concerns_cloud_positive_legislative_session_for_wsma<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/2020-Leg-Session-Social-Graphic-645x425px.jpg" class="pull-right" /> </div> <h5>March 17, 2020</h5> <h2>COVID-19 Concerns Cloud Positive Legislative Session for WSMA</h2> <p> The 2020 Washington State Legislative Session came to a close last Thursday, and while it featured passage of numerous budget and policy bills supported by the WSMA, the news from Olympia was overshadowed by the COVID-19 outbreak centered in Washington. Talk of the virus dominated legislative discussions over the final weeks of session, and lawmakers attempted to make provision for addressing the outbreak, dedicating $200 million to response in addition to funding for public health and other elements of the health care system. </p> <p> On the final day of session, the Legislature passed a supplemental budget increasing state spending by around $1 billion, bringing the two-year budget to more than $53 billion and leaving around $3.5 billion in reserves. The latter is important, as even while legislators were leaving town there was discussion of reconvening for a special session in the coming months to make additional provision for addressing the outbreak and related impact it will have on the state's residents and economy. Economists had long noted the state was overdue for a financial downturn that now seems inevitable given the ripple effect of the outbreak. </p> <p> In the short term, legislators tapped the state's "rainy day" reserve account to appropriate $175 million for emergency response efforts related to COVID-19, which will be paired with $25 million from the federal government for the same purpose. An additional $28 million was appropriated for Foundational Public Health Services. While the funding is well-intentioned, it's likely to be outstripped by what will ultimately be needed. Had the scale of the outbreak been known earlier in session, it's likely that more would have been done in terms of both budget and policy to address, but unlikely that the Legislature would have been able to conclude its work as scheduled. </p> <p> The WSMA came into the 2020 legislative session with an agenda focused on ensuring access to care by promoting budget items and policies to positively impact the financial viability of physician practices. This is even more important in hindsight, and we were successful in working to pass legislation directing insurance carriers to reimburse for telemedicine services at parity with what is paid for in-person care, and another bill generally making provision for services to be reimbursed while a provider's insurance credentialing application is pending. </p> <p> On the budget side, the headliner for WSMA was that after years of advocacy from our organization and our allies in the physician and health care provider community, funding was appropriated to increase Medicaid primary care rates. Beginning Jan. 1, 2021, a total of nearly $29 million in state and federal funds will be used to increase primary care rates in the Medicaid system by at least 15%, and for certain pediatric neonatal intensive and critical care codes the increase will be 21%. In the primary care setting the increase will be implemented along the lines of the temporary bump afforded by the Affordable Care Act in 2013-14. Ultimately, Medicaid rates need to be increased across all physician services to fully address the need to ensure access to care, but this investment is a positive first step in that direction. </p> <p> Other notable budget items include: </p> <ul> <li>$5 million to increase Medicaid reimbursement rates for certain behavioral health codes by up to 15% beginning Jan. 1, 2021.</li> <li>$34 million to resolve pending rural health center reconciliation payments that would have been due for 2014-17.</li> <li>$8.4 million to backfill lost federal grant funding for Title X family planning services.</li> <li>The creation of a Primary Care Collaborative at the Health Care Authority with representatives from the physician community and other stakeholders charged with making recommendations on what constitutes primary care and how much should be spent on those services.</li> <li>Increased investments in the state's behavioral health system, including more than $40 million for operations and staff training at Western State Hospital.</li> </ul> <p> While this was a "short" 60-day session, there was no shortage of policy wins for the house of medicine. Priority bills that the WSMA supported that were passed by the Legislature include: </p> <ul> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5385&Initiative=false&Year=2019">Senate Bill 5385</a> to require payment parity for services delivered via telemedicine and to remove a requirement for an in-person visit to precede covered services delivered via store-and-forward.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1552&Initiative=false&Year=2019">House Bill 1552</a> to generally allow for services to be reimbursed by health carriers while a physician or provider's credentialing application is pending.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6404&Initiative=false&Year=2019">Senate Bill 6404</a> to direct a report on health carriers' prior authorization practices, shining a light on the many circumstances in which prior authorization is a perfunctory barrier to care, and informing future legislative approaches on the subject.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2378&Initiative=false&Year=2019">House Bill 2378</a> to modernize the physician assistant practice act, expediting the ability of PAs to be employed and work to the limit of their license, while retaining the supervisory relationship between physicians and PAs.</li> </ul> <p> Of course, advocating for bills is only half the story in Olympia. It's equally important to stave off legislation that would negatively impact access to care, increase administrative burden on physician practices, or otherwise harm the house of medicine. Unfortunately, the Legislature failed to heed the call of the physician community to exempt physician practices and health care services from the business and occupation (B&O) tax increase on service businesses adopted last year. However, <a href="https://app.leg.wa.gov/billsummary?BillNumber=6492&Year=2019&Initiative=false">Senate Bill 6492</a>, passed by lawmakers this session, did make improvements to the tax policy by creating an exemption for businesses grossing less than $1 million and lowering the rate from 1.8% to 1.75% (up from the current 1.5%). Still, this tax increase will negatively impact the physician community and access to care at a time that could not be worse. </p> <p> In other areas of policy, legislators did follow the counsel of physicians, such as in the opioid arena, where several bad bills were defeated by the WSMA and our allies. We were also successful in working with a coalition to stop "qui tam" legislation that would have constituted a massive liability expansion for physician practices and other businesses. And the WSMA successfully opposed a bill that would have allowed for a payroll tax in King County on physician practices and other businesses that would have layered on top of the B&O tax increase. </p> <p> Scope of practice is a perennial topic of discussion in Olympia and WSMA was successful in opposing several proposals that would have jeopardized patient safety. <a href="https://app.leg.wa.gov/billsummary?BillNumber=1630&Initiative=false&Year=2019">House Bill 1630</a> would have expanded scope of practice for naturopaths and while the proposal shifted over the course of session, all iterations would have led to an inappropriate prescriptive authority increase. <a href="https://app.leg.wa.gov/billsummary?BillNumber=6609&Initiative=false&Year=2019">Senate Bill 6609</a> would have created a "psychiatric pharmacist" designation, allowing some pharmacists a massive scope of practice expansion to include many services currently provided by physicians in psychiatric settings without requiring stipulated education or training to do so. </p> <p> In all, the 2020 session was one of the most successful in record for the WSMA and the house of medicine. The session was also a reminder, however, that there are more important things happening in the world than what takes place in Olympia. Future action will be necessary in the short run to address the COVID-19 outbreak. And the economic fallout for patients, businesses, and government will likely be considerable – one of our primary points of focus is always access to care for patients and that will become even more vital in the coming months. </p> <p> Finally, we extend a huge thank you to all the physician and physician assistant members who have participated in our advocacy efforts in recent months. Whether through responding to WSMA's legislative calls to action, meeting with your legislators, attending the 2020 Legislative Summit, or taking other action to engage lawmakers, your direct advocacy is appreciated and critical to our success. Please stay in touch with our government affairs team with any questions or concerns you have with what's happening in Olympia and beyond (contact Sean Graham at <a href="mailto:sean@wsma.org">sean@wsma.org</a>). </p> </div>3/17/2020 12:00:00 AM1/1/0001 12:00:00 AM
Video__5_Things_to_Know_About_CoronavirusVideo: 5 Things to Know About CoronavirusLatest_NewsShared_Content/News/Latest_News/2020/March/Video__5_Things_to_Know_About_Coronavirus<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/WSMA/NewsAndEvents/News/hirota_covid19_patientvid_image645x425.jpg" class="pull-right" /> </div> <h5>March 7, 2020</h5> <h2>Video: 5 Things to Know About Coronavirus</h2> <p> WSMA President Bill Hirota, MD, on the 5 things your doctor wants you to know about coronavirus. A public service message from Washington State Medical Association and the Washington State Hospital Association. <a href="https://wsma.org/covid19#video">Watch the video</a>. </p> <p> Find all of our COVID-19 information and resources on our dedicated <a href="[@]WSMA/Resources/COVID-19/COVID-10_Response.aspx">COVID-19 Response webpage</a>. </p> </div>3/7/2020 5:13:45 PM1/1/0001 12:00:00 AM
WSMA_Statement_on_COVID-19WSMA Statement on COVID-19Latest_NewsShared_Content/News/Press_Release/2020/WSMA_Statement_on_COVID-19<div class="col-md-12"> <div class="col-md-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div> <h5>March 6, 2020</h5> <h2> WSMA Statement on COVID-19 </h2> <p>The physicians of Washington state want to reassure our patients as our state experiences an outbreak of coronavirus (COVID-19). As you know, physicians treat patients with illnesses, diseases, broken bones and the like every day.</p> <p>We are still learning about this new novel virus, but what we do know now is that by following the safety precautions being given by our public health leaders, you can protect yourself and your family from contracting and spreading the virus. For those that do contract the virus, the vast majority won’t require medical treatment or testing for COVID-19—for healthy younger or middle-aged individuals, symptoms will likely be mild, and self-quarantining at home, avoiding other people where possible, washing hands, etc., should be sufficient to recover and minimize further spread of the infection</p> <p>We want to emphasize that just because you're sick, you don't necessarily need to be tested; as testing becomes more widely available, we want to focus on keeping it available to those at highest risk for health complications.</p> <p>Here’s what you should know:</p> <p><strong>First</strong>, our state’s public health responders and health care community are working around the clock to contain its spread, and—with your help—we believe we can slow its transmission.</p> <p><strong>Second</strong>, for those of you who may experience symptoms that are associated with the virus, most likely you won’t need medical treatment or even need testing for COVID-19. Your symptoms will hopefully be mild and you and your family will benefit from the healthy practices you should follow for any viral infection, including:</p> <ul> <li>Washing your hands.</li> <li>Covering your mouth with a tissue when you cough then throwing the tissue away.</li> <li>If you feel sick, staying home and letting the virus run its course, using over-the-counter medicines to help relieve your symptoms.</li> <li>Frequently cleaning and disinfecting objects and surfaces around your home.</li> </ul> <p><strong>Third</strong>, the time to call your doctor is if you develop a high fever or severe symptoms such as difficulty breathing. If you do need to visit your doctor, make sure the office knows you may have COVID-19, so that they can take steps to prevent others from being exposed or infected.</p> <p><strong>Fourth</strong>, if you are experiencing flu-like symptoms, you may not need to be tested for COVID-19. The CDC is recommending testing for people at high risk for health complications, people who have been in close contact with someone diagnosed with COVID-19, or people who have recently traveled to areas with ongoing spread of the virus. While more COVID-19 testing is becoming available, capacity is still limited. Please be understanding with physicians and office staff if it’s determined COVID-19 testing isn’t right for you. Have confidence that your care team will do everything possible to give you the treatment you need to help you feel better.</p> <p><strong>Fifth</strong>, as we observe these precautions, remember that we’re all in this together. Let’s stay calm, take care of ourselves and each other, and do our best to keep our communities healthy and strong.</p> <p>If you still have questions, call the Department of Health call center at 1.800.525.0127. It’s open from 6 a.m.-10 p.m., seven days a week.</p> <p><strong>For more information, contact:</strong><br /> <br /> Graham Short<br /> WSMA Associate Director of Communications<br /> 206.956.3633  <br /> <a href="mailto:gfs@wsma.org">gfs@wsma.org</a></p> <p><strong>About the WSMA</strong></p> <p>The Washington State Medical Association represents nearly 11,000 physicians, physician assistants, resident physicians and medical students in Washington state. The WSMA has advocated on behalf of the house of medicine more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.</p> </div>3/6/2020 2:48:05 PM1/1/0001 12:00:00 AM
legislative_session_week_8_highlightsLegislative Session Week 8 HighlightsLatest_NewsShared_Content/News/Latest_News/2020/March/legislative_session_week_8_highlights<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/2020-Leg-Session-Social-Graphic-645x425px.jpg" class="pull-right" /> </div> <h5>March 6, 2020</h5> <h2>Legislative Session Week 8 Highlights</h2> <p>Monday, March 2 was the fiscal committee cutoff deadline for bills that have passed out of the opposite house. Each fiscal committee had late nights, holding public hearings and voting on up to 75 bills. The rest of the week, both chambers were on the floor voting on bills, with floor debates sometimes lasting until 2 a.m. Today, Friday, March 6 is the opposite house cutoff deadline; legislators have until 5 p.m. to pass bills from the opposite chamber (i.e. a bill that started in the Senate must be approved by the House and vice versa).</p> <p>Last week, both the House and Senate released their versions of the state supplemental budget. The Legislature is working to finalize the budget, which is expected to be released next week. In responding to the coronavirus outbreak, both chambers unanimously passed <a href="https://app.leg.wa.gov/billsummary?BillNumber=2965&Year=2019&Initiative=false">HB 2965</a>. This legislation appropriates $100 million from the Budget Stabilization Account and $25 million in federal funds for state agencies, local governments, and tribes to appropriately respond to the coronavirus outbreak.</p> <h3>Legislative session week eight (March 2-6): Health care highlights</h3> <p><strong>Prior authorization –</strong> <a href="https://app.leg.wa.gov/billsummary?BillNumber=6404&Initiative=false&Year=2019">SB 6404</a>, <em>WSMA supports</em></p> <p>Senate Bill 6404 would require insurance carriers to submit certain information related to prior authorization practicessuch as requests, approvals, denials, and response times to the Office of the Insurance Commissioner.The bill passed the House on March 6. The House amended the bill on the floor, so the bill will require a "concurrence" vote in the Senate to reconcile the two versions and send it to the governor for signature.</p> <p><strong>Telem<em><em></em></em></strong><em><em> ed <strong></strong></em></em><strong>icine payment parity –</strong> <a href="https://app.leg.wa.gov/billsummary?BillNumber=5385&Year=2019&Initiative=false">SB 5385</a>, <em>WSMA supports</em></p> <p>Senate Bill 5385 would generally require payment for services delivered via telemedicine to be on par with the rate paid for in-person visits. This bill passed the House 94-3 on March 5. The House amended the bill to include an emergency clause, so the bill will require a "concurrence" vote in the Senate to reconcile the two versions and send it to the governor for signature.</p> <p><strong>Health care provider credentialing</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=1552&Initiative=false&Year=2019">HB 1552,</a> <em>WSMA supports</em></p> <p>House Bill 1552 would generally require health carriers to retroactively reimburse for care delivered by a physician or provider during the time a credentialing application is pending. The bill is eligible to be voted on in the Senate.</p> <p><strong>Primary care Medicaid reimbursement</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=6676&Initiative=false&Year=2019">SB 6676,</a> <em>WSMA supports</em></p> <p>Effective Jan. 1, 2021, would raise Medicaid reimbursement rates for primary care services by at least 15%, and for certain pediatric services by at least 21%. While the bill is no longer moving, funding was provided for primary care Medicaid reimbursement rate increases in both versions of the supplemental budget. WSMA continues to advocate for this funding to be included in the final budget.</p> <h3>Other bills voted on during week eight (March 2-6)</h3> <p><strong>The Senate voted on the following bills this week that are supported by WSMA:</strong></p> <ul> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2378&Initiative=false&Year=2019">HB 2378</a>, physician assistant practice modernization</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2251&Initiative=false&Year=2019">HB 2251</a>, expiration date for notification of dispensing a biosimilar</li> </ul> <p><strong>The House voted on the following bills this week that are supported by WSMA:</strong></p> <ul> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6128&Initiative=false&Year=2019">SB 6128</a>, postpartum Medicaid coverage</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6063&Initiative=false&Year=2019">SB 6063</a>, Department of Corrections health care administration</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6526&Initiative=false&Year=2019">SB 6526</a>, prescription drug donation</li> </ul> <h3>What's happening this week (March 9-13)</h3> <p>The Legislature worked over the weekend on reconciling differences between the versions of bills that have been approved by the two chambers through the "concurrence" process. Sine die, the last day of the legislative session, is scheduled for March 12. Legislators may work up until midnight that day (and often do). We will provide post-session summary materials as soon as possible after the Legislature adjourns. Look for a quick run-down this Friday, provided that sine die occurs on Thursday as scheduled.</p> </div>3/6/2020 12:00:00 AM1/1/0001 12:00:00 AM
video_legislative_session_week_8_in_briefVideo: Legislative Session Week 8 in BriefLatest_NewsShared_Content/News/Latest_News/2020/March/video_legislative_session_week_8_in_brief<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/395830942"><img alt="" src="/images/News/Sean-Week-8-Update-3-5-play-button-645x425px%20(1).jpg" class="pull-right" /></a> </div> <h5>March 6, 2020</h5> <h2>Video: Legislative Session Week 8 in Brief</h2> <p> In this week's legislative update, WSMA Director of Government Affairs Sean Graham talks about the Legislature's response to the continuing outbreak of COVID-19 in Washington, and recaps the bills we're hoping to see cross the finish line before session's scheduled end next Friday, March 12. <a href="https://vimeo.com/395830942">Watch the video</a>. </p> <p> Watch all of our 2020 session update videos on our <a href="https://vimeo.com/showcase/5835487">Vimeo page</a> </p> </div>3/6/2020 12:00:00 AM1/1/0001 12:00:00 AM
 

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