In Leadbitter, J. v. Keystone Anesthesia v. Petraglia1 (Leadbitter), the Pennsylvania Superior Court (Superior Court) further eroded the evidentiary privilege afforded by the Peer Review Protection Act (PRPA).2 Over the last several years, the protection offered to the proceedings and records of a review committee has been whittled down by a series of cases that are inapposite.

Statutory background. The Pennsylvania General Assembly’s goal in passing PRPA was “to serve the legitimate purpose of maintaining high professional standards in the medical practice for the protection of patients and the general public.” The General Assembly determined that “because of the expertise and level of skill required in the practice of medicine, the medical profession itself is in the best position to police its own activities.”

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Opinion

Editorial …………………………..234

The malady lingers on

Deval (Reshma) Paranjpe, MD, MBA, FACS

 

Editorial …………………………..238

Scientific misconduct

Richard H. Daffner, MD, FACR

 

Editorial ………………………….241

Reconnecting during COVID

Andrea G. Witlin, DO, PhD

 

Perspective ……………………..246

Telepsychiatry appointment adherence and productivity during COVID-19

Timothy Lesaca, MD

Pamela Pyle, AAS

 

Perspective ……………………..249

Reflections after 52 years

Richard L. Green, MD

 

Departments

 

Membership Benefits ……….244

Society News …………………..251

  • Pittsburgh Ophthalmology Society

Activities & Accolades ……..253

 

Articles

Materia Medica …………………254

Istradefylline (Nourianz®)

Samantha DeMarco, PharmD

Rachael Cardinal, PharmD, BCPS

Legal Summary ……………….256

Pennsylvania Superior Court decision: Further deterioration of the peer review privilege

Beth Anne Jackson, Esq.

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As medical practices and other workplaces begin to emerge from the closures and restrictions imposed in response to the COVID-19 pandemic, employers need to know what they can and cannot require of their employees. On March 21, 2020, the Equal Employment Opportunity Commission (EEOC) updated a 2009 publication that had been issued during the H1N1 influenza outbreaks to advise employers of their rights and responsibilities under federal employment laws. Further guidance was published on June 17, 2020, in the form of Technical Assistance Questions and Answers, and in a question-and-answer webinar published on the agency’s website. The EEOC publications address the impact of the Americans with Disabilities Act (ADA), the Rehabilitation Act, Title VII of the Civil Rights Act, the Age Discrimination in Employment Act (ADEA) and the Genetic Information Nondiscrimination Act (GINA).… Read more

Opinion  

Editorial …………………………..201

Nourishment: Pandemic edition
Deval (Reshma) Paranjpe, MD, MBA, FACS

Editorial …………………………..203
Gateway Medical Society celebrates new star – A history of supporting African American youth
Amelia A. Paré, MD, FACS

Editorial …………………………..207
12 essential leadership skills
Richard H. Daffner, MD, FACR

Editorial …………………………..214
Finding my niche: Residency and beyond
Andrea G. Witlin, DO, PhD

Perspective ……………………..215
COVID-19 masquerade
Wendy Palastro, MD

Departments
Membership Benefits ……….212
Society News …………………..218
Pittsburgh Ophthalmology Society
Activities & Accolades ……. 220
Community Notes ……………220

Articles
Materia Medica …………………222
Innovations in postmenopausal osteoporosis: Romosozumab (Evenity®)
Karen M. Fancher, PharmD, BCOP

Legal Report ……………………225
Avoid employment law violations when dealing with COVID-19
William H.

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Although physician offices were always classified as essential businesses under the Pennsylvania Emergency Closure Rules, and could always have remained open, many physician practices nevertheless opted to close the practices, reduce hours, or remain only open for emergency patients. Now that Pennsylvania is reopening to all businesses in stages, we thought it would be valuable to have a source of curated information specifically applicable to the reopening of physicians’ offices, similar to the COVID-19 Private Practice Checklist published by ACMS on March 19, 2020.

We believe the risk issues can be separated into four basic categories:

  1. Patient management
  2. Facility management
  3. Staff protection
  4. Patient consent forms and waivers

Patient management

The scheduling, management and testing of patients returning to the practice, and prioritizing their treatment based upon the severity of their medical conditions, will be one of the most challenging aspects of reopening the practice, if only because of your lack of actual control over patients’ conduct.

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Welcome to the second quarter of 2020! The coronavirus pandemic has changed the way physicians interact with their families, practice medicine and spend money. Perhaps you’ve been on the front lines in the critical care units. Perhaps you’ve been seeing patients by telemedicine or fielding lots of phone calls and trying to figure out how to get paid for what you do. Perhaps you’ve been isolating at home with not a lot to do, spending more time with family and doing some online CME. The question on your mind might be: When this pandemic ends, what position will I be in?

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Like most attorneys in the spring of 2020, I am working from home and composing this article on my laptop. Most of what I do can be done from anywhere that has an internet connection. Many forms of medical evaluation and treatment also can be performed remotely via commonly available technology. In some cases, telemedicine was already permitted, if not commonly used, before the advent of the novel coronavirus, COVID-19, and in other situations a number of regulatory and reimbursement barriers have been modified to respond to the crisis.

First, we should define what we mean by “telemedicine.”

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There is no doubt that medical and other personal information is more exposed in the cybersecurity realm than ever. When the Office of Inspector General (OIG) announced new proposed amendments to the existing Electronic Health Records (EHR) Safe Harbors in October 2019, perhaps OIG and the Centers for Medicare and Medicaid Services (CMS) were just acknowledging the serious privacy and cybersecurity challenges lurking in the vast scope of ostensibly legitimate sharing of PHI. Various state legislatures also are enacting far-reaching cybersecurity and privacy laws.

Electronic Health Records

By way of background, OIG first adopted the Safe Harbor for the donation of EHR software and training by hospitals to physicians in 2005, but placed limitations intended to discourage inducement or remuneration for referrals by requiring that physicians pay at least 15% of the cost and establishing a sunset provision, i.e.,

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The Honorable Jessica K. Altman
Insurance Commissioner
Pennsylvania Insurance Department
1311 Strawberry Square
Harrisburg, PA 17120

 

Re:   Improving Access to Telehealth Services during the State of Emergency in Pennsylvania

Dear Commissioner Altman:

 On behalf of the more than 3,600 members of the Allegheny County Medical Society, we urgently request that you issue an order applicable to all health insurance companies operating in Pennsylvania to expand payment for telehealth services.  During this state of emergency, Pennsylvanians enrolled in Commercial and Medicare Advantage plans now face uncertainty in accessing care normally provided in clinical settings. We ask you to order health insurance plans to increase the scope of covered telehealth services commensurate with the March 17th Centers of Medicare and Medicaid Services expansion of telehealth benefits.

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February 2020 Bulletin

Signed into law by Gov. Tom Wolf Nov. 27,1 Act 2019-112 (the Act) mandates the common practice among pain specialists of written agreements in connection with the treatment of chronic pain with opioids. Furthermore, the Act for the first time explicitly requires that treatment of chronic pain be “consistent with the Pennsylvania Opioid Prescribing Guidelines” (the Prescribing Guidelines). Notable exceptions include prescriptions for medical emergencies and for cancer, palliative care and hospice patients. Failure to abide by the Act, and its pending regulations, subjects prescribers to sanctions under their professional practice act by their licensing boards. The Act was effective immediately and emergency regulations are due to be promulgated by the Pennsylvania Department of Health by the end of February 2020.

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