The federal No Surprises Act (the Act), which was signed into law Dec. 27, 2020, as part of the Consolidated Appropriations Act of 2021, ensured that all Americans had protection from surprise medical billing/balance billing when using out-of-network providers or facilities under certain circumstances. On July 1, 2021, the Biden administration released a series of regulations to implement the Act, which includes rules from the U.S. Departments of Health and Human Services, Treasury, Labor and the Office of Personnel Management (the Rules). The Rules are categorized as an “interim final rule with comment period,” meaning that they are mostly final, but some adjustments may be made based on comments submitted by stakeholders.… Read more

As we emerge from the worst pandemic in a century, businesses and employers are struggling with issues involving the rapidly developed vaccines that have begun to sharply curb the spread of COVID-19. These vaccines, offered by Moderna, Pfizer and Johnson & Johnson, have been granted emergency use authorizations (EUAs) from the Food and Drug Administration and full unrestricted approval is anticipated in the coming months. As of June 4, 2021, 54.7% of Pennsylvanians age 18 older have been fully vaccinated, and the AMA reports that 96% of practicing doctors in the United States are vaccinated. 

Still, there are many who have not received the vaccine for a variety of reasons – legitimate medical contraindications; religious objections; unavailability of vaccines in disadvantaged communities; or fear spread through misinformation.… Read more

Introduction

The Centers for Medicare & Medicaid Services (CMS) announced last month that it will begin recovering payments from all Medicare providers and suppliers who requested and received COVID-19 Accelerated and Advanced Payments (CAAPs) from CMS during the COVID Public Health Emergency (PHE). Those repayments could have begun as early as March 30, 2021, depending upon the one-year anniversary of when the provider received the first CAAP installment payment.

Background

CAAPs is not a new concept. The existing Accelerated and Advanced Payments Program, sometimes referred to as only AAPP to distinguish it from the CAAP-COVID program has existed for quite some time.Read more

Newborn screening (NBS) has been cited by the U.S. Center for Disease Control (CDC) as one of the most impactful public health initiatives of the 20th century, and in the 21st century has undergone significant expansion through improved techniques of high throughput biochemical analysis, enzymatic activities and specific molecular defects. Screening is particularly indicated for medical conditions in which early treatment is more effective than treatment in later stages of the condition. Population screening adds a requirement of broader societal benefit to those related to individuals. Until recently, more than 130,000 babies a year in the Commonwealth of Pennsylvania underwent 10 mandated tests for rare genetic and metabolic diseases in addition to tests for hearing loss and cardiac defects.Read more

Allegheny County Medical Society

In a Dec. 10, 2020, decision, the D.C. Circuit Court denied a woman’s second attempt to obtain a preliminary injunction to force a fertility clinic to take her back as a patient pending a lawsuit she had filed against them.1 The case was decided on two factors. The first factor was the plaintiff’s likelihood of success on the merits, which the court determined was unlikely. The second factor was whether the issuance of a preliminary injunction was “in accord with the balance of equities or public interest.” Due to the deterioration of the physician-patient relationship, the court determined that her reinstatement as a patient was not feasible.

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“Lead, follow, or get out of the way,” goes the old admonition, attributed variously to Thomas Paine, Gen. George S. Patton and Chrysler’s Lee Iacocca. When it comes to innovative health payment mechanisms, the Department of Health and Human Services (DHHS) has chosen the third path by adopting what they dubbed the “Regulatory Sprint to Coordinated Care,” beginning in 2018. The goal of this initiative is to remove or reduce regulatory obstacles that have frustrated the development and growth of alternatives to the traditional fee-for-service payment system, and to facilitate the transition toward value-based coordinated care models. Among the hurdles targeted for removal are elements of the Stark physician referral law (Stark), the Medicare and Medicaid Anti-Kickback statute (AKS) and the Civil Monetary Penalties Law (CMPL).

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Opinion

Executive Committee …………..5
COVID-19 vaccines: Protect yourself, protect your loved ones and help return our world to a better place
Raymond E. Pontzer, MD, FACP

Editorial ………………………………6
Lessons for ‘the After’
Deval (Reshma) Paranjpe, MD, MBA, FACS

Editorial ……………………………..7
Finding my niche – training to be a physician scientist
Andrea G. Witlin, DO, PhD

Editorial ……………………………..9
Disruptive technology
Richard H. Daffner, MD, FACR

Perspective ………………………12
‘The Few’
Timothy Lesaca, MD

Perspective ………………………14
Symbolism in American political parties:
How a donkey and an elephant came to represent Democrats and Republicans
Kris Gopal, MD

Departments

Membership Benefits …………16
Society News …………………….18
• Pittsburgh Ophthalmology Society
• Pennsylvania Geriatrics Society – Western Division
Activities & Accolades ……….20
Classifieds ………………………..20

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Opinion

Editorial …………………………. 369
Gratitude
Deval (Reshma) Paranjpe, MD, MBA, FACS

Editorial …………………………..370
Finding my niche: A kind, well-shaven face
Anthony L. Kovatch, MD

Editorial …………………………..373
Rightly forgotten
Richard H. Daffner, MD, FACR

Perspective ……………………..376
Reducing disparities in musculoskeletal care: Focusing on bone and joint health
Anthony M. DiGioia III, MD
Gina Edwards
Angela DeVanney
Gigi Crowley

Perspective ……………………..378
A physician’s reflection on Roberto Clemente and his leadership legacy
Johanna Vidal-Phelan, MD, MBA, FAAP

Departments

Society News …………………..380
• Fit with Your Physician walk held
• ACMS Foundation awards medical student scholarship
• ACMS member assists with removal of prior auth code
• Pennsylvania Geriatrics Society – Western Division

Classifieds ………………………381
Activities & Accolades………382
Membership Benefits………..384

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October was National Cybersecurity Awareness Month, and government agencies and private cybersecurity companies alike offered tips to stay secure online. Cybersecurity awareness is particularly necessary in 2020: Ransomware attacks against health care providers and entities that support them have continued in full force after a 350% increase in the fourth quarter of 2019. Even the U.S. Department of Health and Human Services suffered a cyberattack in March. COVID has not slowed hackers and other cybercriminals. eResearch Technology, a company that sells software used in clinical trials – including trials for a vaccine for the coronavirus – suffered a ransomware attack in mid-September.

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Opinion

Editorial …………………………..329
Fall nourishment
Deval (Reshma) Paranjpe, MD, MBA,FACS

Editorial …………………………..331
Roentgen and the discovery that changed medicine
Richard H. Daffner, MD, FACR

Miller Time ………………………335
A Viral Ode
Scott Miller, MD, MA, FAAHPM

Editorial ………………………….336
Physicians in mourning: Grieving with purpose
Anna Evans Phillips, MD, MS

Editorial …………………………..338
Lost too soon: An ode to Micah Man
Andrea G. Witlin, DO, PhD

Perspective………………………340
The Donora Smog
Kristen Ann Ehrenberger, MD, PhD

Perspective………………………342
Reflections on physician wellness and the challenges of COVID
Lawrence R. John, MD

Articles

Membership Benefits ……….344
Society News …………………..346
• ACMS Foundation opens Pediatric Asthma Clinic
• Pittsburgh Ophthalmology Society

Activities & Accolades ……..348

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