MSSNY eNews: September 23, 2020 – DOH Commissioner: COVID-19 Medical Grand Rounds on Tuesday, Sept. 30


DOH Commissioner: COVID-19 Medical Grand Rounds on Tuesday, Sept. 30
We are excited to share the marketing materials for a special session of our 2020-2021 Commissioner’s Medical Grand Rounds series, which will take place on Wednesday, September 30th. This session, entitled NYSDOH Update on COVID-19: Current Knowledge and Best Practices for Primary Care During the COVID-19 Pandemic, we will bring together providers from various perspectives to discuss the unique and ongoing challenges in addressing primary care needs during a pandemic.
Two primary care physicians who responded to the COVID-19 crisis in some of the earliest and hardest-hit areas of New York will discuss their experiences, recommendations, and lessons learned. Our speakers will discuss the most up-to-date, evidence-based best practices for delivering care, addressing patient needs, and COVID-19 testing. A flyer is attached here—please feel free to share liberally among your networks.
This virtual session will take place on Wednesday, September 30th from 1:30 – 3:00 pm, and will be streamed via live webcast. The session will also be archived on the NYSDOH Website. The event is free-of-charge and open to all interested providers across New York State. The link to register can be found here.


DOH Issues Health Advisory on Reporting of COVID-19 and Influenza Test Results
The New York State Department of Health issued a health advisory regarding new data elements that need to be reported according to Executive Order 202.61.  The new order requires all health care providers who order or administer COVID 19 tests to collect and report where a patient attends or works in a school and the name and location of the school.

The order also requires listing of the patient’s local address if different from their permanent address.  This requirement applies to physicians’ office laboratories (POL) and to any point of care (POC) or rapid testing conducted by the healthcare provider.  All providers using POL and POC must report within 3 hours of receiving results of COVID 19 (testing through ECLRS, along with the required information.  Most importantly, clinical labs and POLCs or health care providers conducting POC influenza testing must report Influenza test results immediately through the ECLRS.  A copy of Commissioner Howard Zucker, MD letter and the health advisory can be found here.


US House Passes Measure to Continue Government Funding Through December; Expected to Pass Senate
Yesterday, the US House of Representatives passed legislation (H.R. 8337) by a bipartisan vote of 359-57 to fund federal government operations until December 11, 2020 and is intended to avert a potential government shutdown prior to the November elections.  It is expected to pass the US Senate later this week.  Among the notable health care provisions contained within the measure:

  • Extends the Medicare GPCI cost index floor, important for helping to prevent Medicare cuts to the upstate New York payment locality;
  • Holds the 2021 Medicare Part B monthly premium at the 2020 amount for the standard premium, plus an additional percentage, and establishes a “small surcharge” of approximately $3 for most seniors, on the monthly premium, until the Part B trust fund is repaid.
  • For physicians and other health providers receiving Medicare accelerated or advance payments between the date of enactment of the CARES Act, and through the end of the COVID-19 public health emergency, the continuing resolution extends the period “before repayment begins and the period before the balance must be repaid in full, reduces the recoupment percentage, and lowers the interest rate for payments” to 4%.

COVID Treatment Could Increase Cardiac Risk if Taken with Certain Drugs
Azithromycin, an antibiotic being studied as a potential COVID-19 treatment, could cause cardiac events if taken in combination with drugs that affect the heart’s electrical rhythm, according to research published Sept. 16 in JAMA Network Open.

The FDA issued a warning for azithromycin in 2012 saying it may be linked to cardiac events, but subsequent studies have not produced conclusive results. A new study conducted by researchers from the University of Illinois Chicago found that the drug itself does not increase the risk of cardiac events, but it could if taken in combination with a QT-prolonging drug, which refers to a drug that affects the interval in the heart’s electrical rhythm called the QT interval.

Common QT-prolonging medications include blood pressure drugs, opioids, certain antidepressants, antimalarial drugs, and some muscle relaxers.

“Our findings should give researchers and clinicians looking at azithromycin as a potential treatment for COVID-19 pause,” Haridarshan Patel, PharmD, one of the study’s authors, said in a news release. “We found that if taken together with drugs that affect the electrical impulses of the heart, the combination is linked with a 40 percent increase in cardiac events, including fainting, heart palpitations and even cardiac arrest.”

The study comes about three months after the FDA rescinded its emergency use authorization for hydroxychloroquine, the antimalarial treatment used by some physicians as a COVID-19 treatment. The FDA’s June 15 decision came after an impassioned debate in the medical community over hydroxychloroquine’s reputation for increasing the risk of cardiac events.


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US Dept. of Labor

Narrows Families First Coronavirus Response Act’s Definition of “Health Care Provider
On September 11, 2020, the United States Department of Labor (“DOL”) revised a definition of who is a “health care provider” for purposes of excluding those employees, i.e., not providing federal paid sick leave, from the Families First Coronavirus Response Act (“FFCRA”). The Revised Final Rule significantly narrows the prior definition, and employers in the health care industry should review and revisit their policies regarding eligible coverage (or exemption) under the FFCRA.

That revised Rule took effect on September 16, 2020. The FFCRA is a federal law that requires certain employers to provide employees with paid leave for certain COVID-19 related reasons. The FFCRA, however, allows employers to exclude “health care providers” from the paid leave requirement.

The DOL had previously defined the term “health care provider” broadly as “anyone employed at any doctor’s office, hospital, health care center, clinic, post-secondary educational institution offering health care instruction, medical school, local health department or agency, nursing facility, retirement facility, nursing home, home health care provider, any facility that performs laboratory or medical testing, pharmacy.”

On September 11, 2020, the DOL revised its definition of “health care provider” to narrow its scope. The Revised Final Rule makes it clear that it is “not enough” that an employee merely works for an employer that provides health care services. Instead, the exemption will now only apply to and allow for exclusion of employees who would fall under the Family Medical Leave Act (“FMLA”)’s definition of “health care provider” or who are employed to provide diagnostic services, treatment services, or other services that are integrated with and necessary to the provision of patient care which, if not provided, would adversely impact patient care.” Under the FMLA, a “health care provider” includes physicians and physicians’ assistants, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, nurse practitioners, nurse-midwives, clinical social workers, and Christian Science practitioners.

The DOL indicates that the revised definition may also include: (i) nurses, nurse assistants, and medical technicians; (ii) employees providing services under the supervision, order, or direction of, or providing direct assistance to, specifically identified health care providers; and (iii) employees that provide services that are “integrated with and necessary components to the provision of care,” such as laboratory and radiology technicians. Examples of employee positions that would not be covered by the health care provider exception include: information technology professionals, building maintenance staff, HR personnel, cooks and food service workers, record managers, consultants, and billers as employees that should not be exempted from coverage under the FFCRA.

To minimize the spread of COVID-19, DOL encourages employers to be judicious when using this exemption. For example, an employer may decide to exempt these employees from leave for caring for a family member, but choose to provide them paid sick leave in the case of their own COVID-19 illness.

Should you have any questions regarding the above, please contact the Garfunkel Wild attorney with whom you regularly work.


FDA to Announce Stricter Rules on Emergency Use Authorization for Vaccine
The FDA is expected to announce new standards for emergency use authorization of a COVID-19 vaccine as soon as this week, which would make it more difficult for any vaccine to be approved before Election Day, The Washington Post reported.

The new guidance would require manufacturers seeking emergency use authorization to monitor clinical trial participants in late-stage trials for at least two months after they receive a second dose of the vaccine. The agency will also likely look for at least five cases of severe COVID-19 in the placebo group as well as some in older people, according to the Post.

The new standards, in addition to the time it will take for drug makers to prepare their applications and the agency to review the data, make it highly unlikely any vaccine will be authorized before Election Day, the Post reported.

The FDA has said it is issuing the guidance to increase transparency and public trust, as public health experts have become increasingly worried that President Donald Trump’s prediction for a vaccine by Nov. 3 may cause Americans to reject the vaccine out of concern it was rushed.

The updated guidance is much more rigorous than what was used for hydroxychloroquine or convalescent plasma, the Post reported. The standards are being reviewed by the White House Office of Management and Budget.

Pfizer said Sept. 22 that it still plans to have data on the effectiveness of the vaccine by the end of October and that it plans to collect safety data for two years. Moderna has said it is unlikely to have data in October, according to the Post. AstraZeneca’s trial is still on halt in the U.S. while investigators try to figure out if a serious adverse reaction in a patient in Britain was caused by the vaccine.

Read the full article here.


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Is 6 Feet Enough? CDC Walks Back Its Walkback on Airborne Transmission of COVID-19
The Centers for Disease Control and Prevention, which quietly changed its guidance on coronavirus transmission through the air Friday, reversed field again Monday. On Friday, the CDC posted an update on its website saying 6 feet may not be sufficient to keep people safe and that ventilation was key to easing transmission indoors. That determination could be crucial for schools where desks are now set up 6 feet apart. Offices, restaurants and even church services also could be affected by the change. (KHN,9/21)


Employee Sick Leave Requirements Go into Effect September 30 for 2021
Earlier this year, the New York State Legislature enacted a new law that requires all New York employers to provide sick leave to employees. The legislation becomes effective next week, September 30. The amount of sick leave an employer is required to provide depends on the size and net income of the employer:

  • Employers with 4 or fewer employees and a net income of $1 million or less in the prior tax year must provide employees with up to 40 hours of unpaid sick leave in each calendar year;
  • Employers with 4 or fewer employees and a net income of greater than $1 million in the prior tax year must provide employees with up to 40 hours of paid sick leave in each calendar year.
  • Employers with between 5 and 99 employees must provide up to 40 hours of paid sick leave in each calendar year; and
  • Employers with 100 or more employees must provide up to 56 hours of paid sick leave in each calendar year.

Employees begin to accrue paid sick leave when the law goes into effect (September 30) or upon the employee’s date of hire, whichever is later. Although employees may begin accruing leave prior to January 1, 2021, employers are not required to begin to allow employees to take sick leave until January 1, 2021.

For summaries of this new law, click here.


 

Classifieds
Elegant, Custom Built Home with Unparalleled Craftsmanship – Rhinebeck, NY
Set on 10.6 acres in one of the most sought-after neighborhoods in Rhinebeck, this stunning home borders Drayton Grant Park at Burger Hill (a conservation land and the highest point in Rhinebeck). Features beautifully landscaped gardens with sweeping hilltop views and a well established vegetable garden and barn. This handsome home is generously proportioned throughout, with an inviting foyer entry with tastefully designed staircase, millwork, high ceilings, cherry wood floors and custom windows.Rhinebeck Estate for Sale A world class kitchen with a marble counter-topped island, enjoys both a cozy fireside seating area perfect for winter evenings, and glass doors in the hexagonal eat-in-kitchen opening onto the expansive stone terrace for three season enjoyment and entertaining.A luxurious Master suite, with high vaulted ceiling design, his and hers walk-in closets and a gorgeous master bath with cast iron clawfoot tub. The second floor also includes two spacious bedrooms with generous closets and 2 full bathrooms, An additional large sitting room/office could easily make a lovely fourth bedroom. Lower level features a media room, exercise room, bar, wine cellar and full bathroom. Additionally there is a two story barn equipped with water and electricity.
The house is located 7 minutes to the charming center of Rhinebeck village with its many superb restaurants, boutiques & shops. The highly rated Northern Dutchess Hospital, the excellent Rhinebeck schools and the County Fairgrounds, a most desirable venue destination throughout the year, are all nearby. Rhinecliff train station is a mile beyond with Amtrak service south to NYC(1hour 40 minutes) and north to Hudson, Albany, Niagara Falls and Montreal. View full listing Contact Nader Kayal, MD, 845-518-7780 / entdoc53@aol.com or Joshua M. Briggs at Heather Croner RE-Sotheby’s 917 213-9042 / jmb@jmbfineart.com.

UES Park Avenue Medical Office Space for Rent – One or Two Days a Week
Elegant office space on UES, in Park Avenue doorman building.  Enormous furnished windowed consult room, large exam room and private secretarial area.  Private elevator to office, huge waiting room and all shared office space. One – two days available; ideal for low volume Practitioner of any specialty. Please contact office manager Theresa – 212-288-2171 or via email at drfox.903parkave@gmail.com.

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Dermatology Practice for Sale – Staten Island, NY
Building includes 3 exam rooms, waiting area. Please respond by calling 718-987-3300 or email enbmd@aol.com