COVID-19 Update June 12, 2020
Leaders Inspiring Hope
“He is the best physician who is the most ingenious inspirer of hope.“
Samuel Taylor Coleridge
Last weekend our AMA was scheduled to hold its Annual House of Delegates in Chicago. However, due to Covid-19, an in-person meeting was impossible and a remote, special meeting was convened instead. Your entire New York Delegation participated via virtual attendance. New leaders were elected and the work of organized medicine on a national level moved forward.
We heard via video broadcast from both our outgoing and incoming AMA presidents. Outgoing AMA president, Dr. Patrice Harris spoke of hope declaring “I do have hope, however, but that hope is up to us … America’s physicians and the AMA, to demonstrate how to understand more, and to fear less—to be the voices our country can trust in this time of trial, and to lead on action to move us forward in this difficult, perilous time.”
MSSNY leaders will be among those voices of trust to whom Dr. Harris is pegging hope. MSSNY past president Dr. Thomas Madejski was elected to the AMA Board of Trustees; our former MSSNY House of Delegates Speaker, Dr. Kira Geraci-Ciardullo was selected as the Chair of the AMA Council on Science and Public Health and the Co-chair of our MSSNY Committee to End HealthCare Disparities, Dr. Erick Eiting was elected to the AMA Council on Medical Service. These seasoned MSSNY leaders will carry the New York messages forward and help right our nation.
Our incoming AMA President, Dr. Sue Bailey, had equally inspiring words of hope saying, “We need not fear the dark times on our journey. We need only to lean on one another to take care of each other and to keep our eyes fixed on the horizon.” Dr. Bailey spoke of our journey through the pandemic and our continued fight for our patients and for the practice of medicine.
As we forge onward with our new AMA president Dr. Bailey, I see the darkness fading for when the House of Medicine Stands United, hope abounds and our practices, patients and our country’s health all thrive.
Notes from Governor Cuomo’s Briefing
– Governor reiterated the need to focus on monitoring daily test results
– Cuomo continued, reviewing daily test results in NYC and hotspots in minority
– 42 lives lost as of yesterday (32 in hospitals, 10 in nursing homes)
– Yesterday: COVID-19 increasing in 21 states, 14 states are seeing new high
– Today: COVID increasing in 23 states, 15 states are seeing new highs
– States that reopened to quickly are beginning to close again
– In NYC, we have reopened, but numbers continue to decrease
– Governor explained a slide from Instagram showing data on the rate of
– NYS had the lowest rate of transmission at .77
MSSNY President: COVID-19 “Devastated” Physicians Practices Statewide
PHYSICIAN IMPACT: Dr. Bonnie Litvack, president of the Medical Society of the State of New York, said in a statement issued Thursday that a new study from Fair Health confirms the “absolutely devastating” impact that the COVID-19 crisis has had on physician offices across the state. “We again urge the New York congressional delegation to continue its efforts for dedicated grant funding in the next stimulus package for these hard-hit community practices—not only to preserve the hundreds of thousands of jobs physician offices provide across the state, but most importantly to ensure we can continue to treat our patients, who depend on our services,” Litvack said. (Crain’s Health Pulse, June 12)
Community Practice Impact
Medical Society of the State of New York President Bonnie Litvack urged the state’s congressional delegation Thursday to include grant funding for community physician practices hit hard by the Covid-19 pandemic in the next stimulus package. Litvack noted that the new FAIR Health report found 80 percent drops in patient visits and revenue at such practices in recent months, echoing the findings of similar recent MSSNY surveys. (Politico, June 12)
Garfunkel Wild Presentation on Reopening Your Practice in the COVID-19 Era
Garfunkel Wild partners of the healthcare law firm, Barry Cepelewicz MD, and Roy Breidenbach, recently presented “Re-Opening Your Practice in the COVID-19 Era,” that is now available for MSSNY members on our website at www.mssny.org and on YouTube here.
NY State of Health Valuable Resources for Physicians
Below is a list of national, State, and local resources for our grantees and other partners that may help their organizations and the New Yorkers they serve during these difficult times. NYSHealth will continue to add more resources and initiatives as they are made available.
- Manatt, “A Practical Guide for Small Businesses to Obtain a Paycheck Protection Loan Under the CARES Act” (national)
- S. Department of Labor, “Coronavirus Resources for Workers and Employers” (national)
- S. Department of Labor, “Disaster Unemployment Assistance” (national)
- S. Small Business Administration, “Paycheck Protection Program SBA Loans” (national)
- New York State Department of Labor, “Unemployment Insurance” (statewide)
- New York State Department of Labor, “ Worker Adjustment and Retraining (WARN) Act” (statewide)
- New York State Department of Labor, “New” (statewide)
- NYC Department of Education, “Regional Enrichment Centers for Children of Front-line Workers” (local)
- NYC Small Business Services “Assistance & Guidance for Businesses Impacted Due to Novel Coronavirus” (local)
FAIR Health Releases Study on COVID-19 Impact on Revenue and Utilization Associated with Healthcare Professionals
FAIR Health released its third COVID-19 study, Healthcare Professionals and the Impact of COVID-19: A Comparative Study of Revenue and Utilization. In this new brief, FAIR Health draws on its repository of private claims data to analyze, on a monthly basis, changes in utilization and estimated in-network reimbursement amounts for healthcare professionals in the first four months of 2020 as compared to the same months in 2019 (adjusted by Consumer Price Index). The second part of the study focuses on seven specialties: cardiology, dermatology, oral surgery, gastroenterology, orthopedics, pediatric primary care, and adult primary care.
Among the findings of the study:
- In April 2020, in the midst of the COVID-19 pandemic, healthcare professional services declined 68 percent in utilization and 48 percent in revenue based on total estimated in-network amounts compared to April 2019 nationally.
- In the Northeast, the region hit hardest at that time by the pandemic, professionals experienced particularly sharp drops in utilization (80 percent) and revenue (79 percent) in April 2020.
- Of specialties studied, oral surgery had the largest decreases in utilization and revenue in both March and April 2020. In March 2020, oral surgery utilization declined by 80 percent, and revenue based on total estimated in-network amounts dropped 84 percent; in April 2020, oral surgery utilization declined 81 percent and revenue 92 percent. Gastroenterology had the second largest decreases in all four categories.
- Of specialties studied, pediatric primary care had the smallest decreases in March 2020 utilization (52 percent), March 2020 revenue based on total estimated in-network amounts (32 percent), April 2020 utilization (58 percent) and April revenue (35 percent).
- Across many specialties from January to April 2020, office or other outpatient evaluation and management (E&M) visits became more common relative to other procedures, both by utilization and total estimated in-network amounts. This may have been due in part to the fact that many of these E&M services could be rendered via telehealth, whereas certain other procedures that became less common required in-person visits.
The first brief in FAIR Health’s series on the COVID-19 pandemic examined projected US costs for COVID-19 patients requiring inpatient stays, and the second the impact of the pandemic on hospitals and health systems. For the new brief, click here.
Protests Essential Despite Risk of Coronavirus Spread, Healthcare Workers Say
Though the protests that erupted after a black man died in police custody might result in spikes of COVID-19, some healthcare workers say that they are important, as racial disparities in healthcare is also a public health issue, according to The Wall Street Journal.
Public health experts and healthcare workers across the country are joining in the protests that began after George Floyd died at the hand of police in Minneapolis in late May. He is the most recent example of police brutality against black people and joins a long list of deaths of African Americans in police custody.
Healthcare experts and workers are saying though the protests may result in a new wave of coronavirus cases, the issue at hand is more important and the potential benefits outweigh the risks, especially since the risk of transmission is lower outside than inside when precautions are taken.
Darrell Gray, MD, a black gastroenterologist at the Ohio State University Wexner Medical Center in Columbus, has been attending protests, telling the Journal, “I prioritize being at protests and peaceful demonstrations because I strongly believe that they can be leveraged to produce change.” He said that he is taking precautions, wearing a face mask and distancing himself as much as possible.
Dr. Gray also said that the pandemic has disproportionately affected black communities, as the underlying conditions that are linked to more severe COVID-19 illness, such as diabetes and high blood pressure, are more rampant in those communities…..More than 1,000 public health and infectious disease experts and community stakeholders signed an open letter last week saying that demonstrations were important for combating race-based health inequities, largely a result of racism, the Journal reports.
CMS Encourages Resumption of In-Person Care: 8 Things to Know
CMS is encouraging healthcare organizations to reopen facilities for nonemergency care and released a new set of guidelines and considerations for them to follow.
Many health systems suspended elective procedures in mid-March to keep patients and providers safe and ensure capacity to care for COVID-19 patients. Efforts to restart those procedures safely are underway.
“While telehealth has proven to be a lifeline, nothing can absolutely replace the gold standard: in-person care,” CMS Administrator Seema Verma said. “Americans need their healthcare, and our healthcare heroes are working overtime to deliver it safely. Those needing operations, vaccinations, procedures, preventive care or evaluation for chronic conditions should feel confident seeking in-person care when recommended by their provider.”
Eight things to know:
- The new guidelines are for states that are in phase two of the federal reopening plan, which means that the state or region has no evidence of a rebound and has already satisfied the Gating Criteria, which are items that states or regions needed to hit before proceeding to phase one of the reopening plan.
- CMS recommends that providers prioritize resuming services for at-risk populations and for procedures that, if deferred, would likely result in patient harm.
- Facilities should take steps to reduce the risk of COVID-19 exposure and transmission. This may include establishing a separate area where all patients can be screened for COVID-19 symptoms. It also includes dedicating a separate space for COVID-19 patients and avoiding crossover of patients, staff, and supplies.
- It is recommended that clinical staff who work with COVID-19 patients, or in a unit that may be exposed, are screened upon arrival, and tested when appropriate.
- The number of visitors allowed in a hospital or outpatient site should still be minimized, CMS said.
- For hospitalized patients or those undergoing an operation, testing for COVID-19 should be prioritized and performed 24 hours prior to the procedure. If a test is not available, patients should self-isolate for 14 days.
- CMS also recommends that staff wear surgical face masks at all times in the facility unless they are working with COVID-19 patients and need an N95 respirator.
- The workforce must be sufficient and able to adjust and respond quickly to support COVID-19 care if necessary.
Access the full set of guidelines and considerations here. (Becker’s Hospital Review June11)
MLMIC’S Resource Center to Reopening for Physicians
MLMIC has assembled a complete package of “Reopening Resources” comprised of select documents designed to serve as guides for medical professionals as they begin to un-pause and reemerge into what is sure to be a different world than what it was in early March. While much of this material is also available on the MLMIC website, we want to make it easy to sort through the volume of information available and the attached document highlights key components. The full range of COVID-19 materials from MLMIC is available here.
MLMIC will continue to develop and distribute new tools as needed, to help make navigating the new landscape a little less overwhelming for our valued policyholders and we will continue to share the materials with you. As a reminder, it is important for policyholders that updated their coverage to part time or leave of absence as a result of the pandemic to let MLMIC know right away when the time is right for them to increase their office hours and/or return to full time practice. Ensuring that all have the coverage to return to their patients confidently and protectively is why we are here.
FBI Warns Hackers Are Targeting Mobile Banking Apps
The FBI on Wednesday warned that malicious cyber actors were targeting mobile banking apps in an attempt to steal money as more Americans have moved to online banking during the coronavirus pandemic.
In a public service announcement, the FBI noted it expects to see hackers “exploit” mobile banking platforms, which have seen a 50 percent surge in use since the beginning of the pandemic. “With city, state, and local governments urging or mandating social distancing, Americans have become more willing to use mobile banking as an alternative to physically visiting branch locations,” the agency wrote. “The FBI expects cyber actors to attempt to exploit new mobile banking customers using a variety of techniques, including app-based banking trojans and fake banking apps.”
The FBI specifically pointed to threat of banking trojans, which involve a malicious virus hiding on a user’s mobile device until a legitimate banking app is downloaded. Once the real app is on the device, the banking trojan then overlays the app, tricking the user into clicking on it and inputting their banking login credentials. Fake banking apps were also cited as a threat, with users in danger of being tricked into downloading malicious apps that also steal sensitive banking information.
In order to combat these threats, the FBI recommended that Americans only download banking apps from official app stores or from banking websites and that banking app users enable two-factor authentication on their accounts and use strong passwords.
“If you encounter an app that appears suspicious, exercise caution and contact that financial institution,” the FBI emphasized. “Major financial institutions may ask for a banking PIN number, but will never ask for your username and password over the phone.”
The PSA is not the first warning the FBI has put out during the COVID-19 pandemic, as hackers have stepped up efforts to target individuals working and socializing online. (The Hill, June 11)