MACOMB COUNTY MEDICAL SOCIETY - April/May/June 2025

April/May/June 2025 | Vol. 33 | No. 2

Bhutanese Greetings

macombcms.org

Cover Photo The Tiger's Nest Monastery in Bhutan Editor Narendra D. Gohel, MD Managing Editor Heidi L. Leach Graphic Designer Lori Krygier 2025 MCMS OFFICERS & DELEGATES President Narendra D. Gohel, MD President-Elect Lawrence F. Handler, MD Treasurer & Secretary Daniel M. Ryan, MD Delegates Terrence P. Brennan, MD Narendra D. Gohel, MD Lawrence F. Handler, MD Jareer S. Hmoud, MD Khaled M. Ismail, MD Carolann Kinner, DO Cheryl D. Lerchin, MD Akash R. Sheth, MD

Toll Free 877-264-6592 | E-Mail HLeach@macombcms.org , macombcms@gmail.com Web www.macombcms.org

April/May/June 2025 | Vol. 33 | No. 2

In This Issue Beyond Burnout: What Bhutan can Teach us About Healing & Happiness........................ 3-4 Health Department News: Measles Alert........................................................................................... 5 Foundation News: Thank You Letters................................................................................................... 6 Reportable Disease Summary: March 2021-2025........................................................................... 7 BCBS Settlement Update.......................................................................................................................... 8 Members’ Birthday List.............................................................................................................................. 8 Membership Report................................................................................................................................... 9 Tri-County Legislative Committee......................................................................................................... 9 In Memoriam: Adrian J. Christie, MD............................................................................................10-11 Hospital News ......................................................................................................................................12-14 Member Benefit: MSMS Reimbursement Advocate.....................................................................14 MCMS Spring Membership Meeting..................................................................................................15 CMS Telehealth: Key Changes & Billing Updates.....................................................................16-17 Upcoming Events......................................................................................................................................17 MSMS Update.......................................................................................................................................18-19 AMA News .............................................................................................................................................20-21 Advocacy In Action...................................................................................................................................22 Macomb County Legislators Contact Guide....................................................................................23

MSMS Region 2 Director Daniel M. Ryan, MD

Macomb Medicus Journal is published quarterly by the Macomb County Medical Society. Winter: Jan/Feb/ Mar, Spring: Apr/May/Jun, Summer: Jul/ Aug/Sep, Fall: Oct/Nov/Dec. Subscription to the Macomb Medicus is included in the society’s annual membership dues.

Executive Director Heidi L. Leach

Statements and opinions expressed in articles published in the Macomb Medicus are those of the authors and not necessarily those of the Macomb County Medical Society. Advertisements do not represent approval or recommendation of the Macomb County Medical Society.

Address changes and all communications relative to articles and advertising in the Macomb Medicus should be addressed to: Editor, Macomb County Medical Society, P.O. Box 551, Lexington, Michigan 48450-0551 or email HLeach@macombcms.org.

All material for publication, including advertisements, must reach the Society office no later than the 10th (business) day of the month preceding the date of issue, e.g. December 10 for the Winter issue. Thank you.

No portion of the Macomb Medicus may be used for publication elsewhere without permission from the publisher.

2 Macomb Medicus | April/May/June 2025

EDITOR'S PAGE

Beyond Burnout: What Bhutan Can Teach Us About Healing and Happiness By: Narendra Devisinh Gohel, MD Editor and MCMS President "My country is not one big monastery populated with happy monks," Bhutan's former Prime Minister Tshering Tobgay once said during a 2016 TED Talk [1]. "We are a small, underdeveloped country doing our best to survive." Yet Bhutan stands out globally-not because of its GDP-but because of its bold national philosophy: Gross National Happiness (GNH) [2].

While most nations measure success through economic output, Bhutan measures it through collective well-being, rooted in cultural values and environmental sustainability. The GNH framework, introduced in 1972 by the Fourth King of Bhutan, Jigme Singye Wangchuck, includes four core pillars: sustainable and equitable socioeconomic development, environmental conservation, cultural preservation, and good governance.

These are further expanded into nine domains: psychological well-being, health, education, time use, cultural diversity and resilience, good governance, community vitality, ecological diversity and resilience, and living standards [3].

As a physician, visiting Bhutan and neighboring Sikkim (state in India) last month offered a profound shift in perspective. While Bhutan faces pressing challenges - youth unemployment at 29% and economic growth averaging only 1.6% in recent years it remains steadfast in its pursuit of GNH. Despite lacking representation in the 2025 World Happiness Report due to missing Gallup polling data, Bhutan's commitment to happiness as national policy endures [4].

The Bhutanese people embody warmth, politeness, and a deep-rooted spirituality influenced by Vajrayana Buddhism.

Their everyday lives are steeped in ornate dances, rituals, and traditional attire, such as the gho for men and kira for women, which are worn with pride. Photographs of the King and Queen are pinned to their garments-not out of obligation, but admiration.

The contrast with much of the modern world is striking. In many Western nations, culture is often seen as an intangible luxury. National budgets for the arts and humanities are slashed, dismissing culture's invisible yet vital role in human life. Bhutan, on the other hand, enshrines cultural preservation in its constitution and considers it essential to well-being.

As physicians, we know too well the toll of burnout - excessive workload, limited autonomy, and eroding work-life balance [5].

However, there is a deeper wound affecting many in the profession:

Giant Buddha Statue

moral injury. This occurs when clinicians are forced to act in ways that contradict their ethical values - whether by witnessing substandard care, lacking resources to advocate for patients, or feeling powerless in a profit-driven system [6,7].

Moral injury differs from burnout; it is not simply about exhaustion but a betrayal of what we hold sacred. And unlike burnout, moral injury is often irreversible. Bhutan's approach to national well-being provides an unexpected yet powerful lens to reimagine physician care and resilience. continued on page 4

Macomb Medicus | April/May/June 2025 3

continued from page 3

EDITOR'S PAGE

The teachings of Bhutanese spiritual masters, such as the Fifth Reincarnate and head of the Sangchen Ogyen Tsuklag Monastery, Rinpoche, emphasize four key pillars of happiness: loving-kindness, compassion, non-attachment, and karma.

According to Rinpoche, karma is not about punishment, but about understanding cause and effect - owning one's impact and striving toward transformation. "You must love yourself and truly know that no matter the circumstances, you are good enough. From there, you can spread that compassion to others," he teaches [8].

This message is more than spiritual - it is also practical. Physicians need to be treated with the same care we are expected to offer others. We must rebuild autonomy in decision-making, uphold moral integrity, and cultivate systems of governance that promote well-being, not just productivity [9]. We must also protect the cultural fabric of medicine itself - its humanism, mentorship, shared rituals, and patient stories.

Bhutan's forest-covered mountains (72% of the country is under forest cover, constitution mandates minimum of 60%) and its deliberate slowness in adopting modernity reveal a nation that prioritizes harmony over haste. Perhaps this is what we need in healthcare too: a deliberate pause, a realignment with purpose, and the courage to define success not by efficiency, but by happiness.

Bhutanese guide wearing national dress with lapel pin showing the king and queen Wood carving artist with cerebal palsy using chisel with his foot - supported by the Bhutanese government.

In reimagining wellness for physicians, the GNH framework could serve as a radical remedy. We may not all live in the Himalayas, but we can learn from their wisdom. Healing the healer begins with honoring what truly matters: dignity, compassion, and the space to thrive.

Tashi Delek (wishing you well), Kadrinchey La (thank you) References

[1] Tobgay T. This country isn't just carbon neutral - it's carbon negative.

TED Talk. 2016.

[2] Dorji T. Gross National Happiness and Development: An Essay.

Centre for Bhutan Studies. 2005.

[3] Ura K, Alkire S, Zangmo T, Wangdi K. A Short Guide to Gross National Happiness Index. Centre for Bhutan Studies and GNH Research. 2012.

[4] World Happiness Report 2025. Sustainable Development Solutions Network.

[5] West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529.

[6] Dean W, Talbot S, Dean A. Reframing Clinician Distress: Moral Injury Not Burnout. Fed Pract. 2019Sep;36(9):400-402.

[7] Litz BT, Stein N, Delaney E, et al. Moral injury and moral repair in war veterans: A preliminary model and intervention strategy.

Clin Psychol Rev. 2009;29(8):695-706.

[8] Dzongsar Jamyang Khyentse Rinpoche. What Makes You Not a Buddhist. Shambhala Publications; 2007.

[9] Dyrbye LN, et al. Burnout among Health Care Professionals.

NAM Perspectives. 2017. F

4 Macomb Medicus | April/May/June 2025

Buddhist Temple

Mask Dancer

ACTIVATE YOUR POLITICAL VOICE

The Michigan Doctors’ Political Action Committee (MDPAC) is the political arm of the Michigan State Medical Society.

MDPAC supports pro-medicine candidates running for the State legislature, Michigan Supreme Court and other statewide positions. Join today!

HEALTH DEPARTMENT NEWS

MICHIGAN MEASLES ALERT

The Michigan Department of Health and Human Services is alerting all providers to consider measles in any patient presenting with a febrile rash illness, especially if unvaccinated or vaccination status is unknown or with international travel or domestic travel to a known outbreak location in the last 21 days.

Immediate isolation, appropriate specimen collection, and notification are crucial to expedite public health action, including post-exposure prophylaxis, that can limit and control disease transmission. For additional guidance on clinical features review: Clinical Overview of Measles | Measles (Rubeola) | CDC.

o PCR specimens should be sent to MDHHS Bureau of Laboratories (BOL). o Serum sent to BOL will be processed at CDC or can be sent to a commercial lab for testing. o Complete Test Requisition Form DCH-6084 for specimens sent to BOL. Report • Immediately notify your Local Health Department of the patient’s residence on any suspicion of measles to facilitate expedited testing at MDHHS BOL. • Contact infection control if available at your facility.

Limit Spread • Do not use exam rooms for at least two hours after a suspected measles patient has left the room.

• Work with local health departments to immediately identify people potentially exposed to the patient (i.e., any one who has spent any amount of time in the shared air space of an infected person).

• People with confirmed measles should isolate for four days after they develop a rash.

rs: Stay Alert for Measles Cases viders: Stay Alert for Measles Cases Measures to take if you suspect measles:

Isolate • Immediately mask and isolate the patient in a private room with a closed door (airborne infection isolation room if available). Follow airborne precautions.

• Permit only staff immune to measles to be near the patient.

• Wear N-95 masks.

Test • Collect a nasopharyngeal (NP) or oropharyngeal (OP) synthetic swab (e.g., flocked or polyester) in a viral transport medium for PCR testing AND a blood specimen to detect IgM antibodies in serum.

Take every opportunity to ensure patients are up to date on measles, mumps, rubella (MMR) vaccine. Two doses are 97% effective in preventing measles. For more information, including guidelines for patient evaluation, diagnosis, and management, visit: For Healthcare Professionals – Diagnosing and Treating Measles | CDC, About Measles | MDHHS F

measles cases ported 712 measles cases the total in the total in elethan double seven %)toare linked to seven Healthcare professionals should stay alert stay for measles Healthcare professionals should alert for SLIDE TITLE Healthcare Providers: Stay Alertfor forMeasles Measles Cases SLIDE TITLE Healthcare Providers: Stay Alert Cases ted were those infected were symptoms:symptoms: fever, cough, coryza, conjunctivitis, and rash. fever, cough, coryza, conjunctivitis, ation vaccination status. nown status.

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Cases in 2025 - 712 U.S.U.S. Cases in 2025 - 712 U.S. Casesinin2025 2025- -11% 884 of 712) U.S. Hospitalizations U.S. Hospitalizations in 2025 - 11% (79(79 of 712) U.S. Hospitalizations in 2025 11% (94 of 884) U.S. Deaths in 2025 andinvestigation 1 death under investigation U.S. Deaths in 2025 - 3 - 3 nder *2 confirmed deaths from measles, and 1 death under investigation U.S.measles, Deaths 2025under - 3 investigation *2 confirmed deaths from andin 1 death Michigan Cases in 2025 – 9 Michigan Cases in 2025 Michigan Cases in 2025 – 4– 4

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Macomb Medicus | April/May/June 2025 5

FOUNDATION NEWS

Take Charge of Your Mental Health

Thank You Letters January 28, 2025

Dear MCMS Foundation, Achieving and maintaining mental wellness is the foundation for keeping the entire body healthy.

To support that effort, Macomb County Community Mental Health is proud to offer a great on-line, personalized program, My Strength.

“The health club for your mind,” MyStrength provides programs and support for many types of emotional and physical challenges, including: • Reducing stress • Improving sleep • Managing depression • Managing anxiety

• Mindfulness & meditation • Balancing intense emotions • Pregnancy & early parenting • Managing chronic pain

MyStrength offers daily tips for the mind, body and spirit, and: • Is Safe, Secure, and Confidential—Your privacy is our top priority, and MyStrength maintains the highest level of security available to create a completely confidential and safe environment.

• Has Proven Resources—based on the latest research and professional advice from best-selling authors.

• Is Packed with Tools — MyStrength offers many resources to improve mental health, with the latest research and professional advice.

Thank you for your gift of $2,110, proceeds from your annual Holiday Sharing Card program. We are grateful for your support of our mission. Together, we are building a legacy of positive change to support survivors, while working to end violence and oppression in our communities.

In 2025, we proudly celebrate our 45th Anniversary of empowering survivors of domestic violence, sexual violence, and human trafficking. What began as a small group of women sheltering two families in a church basement has grown into an agency serving 27,000 survivors and community members annually.

Turning Point’s comprehensive, free, and confidential services are made possible by your generosity. Services including: a 24/7 Hotline, Emergency Shelter, Housing, Forensic Nurse Exams, Trauma Advocates, Counseling, Personal Protection Order support, and Community Prevention Education.

Know that every day survivors benefit from the great work we’re doing together. The success of our mission is possible because of your support – we are truly grateful.

We are grateful for your continued support!

Sincerely, Sharman Davenport, PhD President and CEO, Turning Point February 3, 2025 Dear MCMS Foundation, On behalf of the volunteer Board of the Macomb Food Program, I want to thank you for your organization’s generous donation of $1,920, it is greatly appreciated! We rely on the generous support of our neighbors and friends to support our mission to feed the hungry in Macomb County.

It’s easy to get started; Go to mystrength.com and enter access code MCCMHComm and begin your journey to stronger overhall health!

MyStrength has helped many people across the country from the comfort and privacy of their homes.

There is no cost to join, and it is simple to get started.

Go to www.mystrength.com. Select “Sign Up” and enter the access code: MCCMHComm. Complete the Wellness Assessment (it takes about ten minutes) and be on your way with personalized tools and supports.

Go Mobile! Using the access code, get the myStrength app for IOS and Android devices at www.mystrength.com/mobile 6 Macomb Medicus | April/May/June 2025

Higher grocery prices have led even more families to seek support from local food pantries this past year. And those pantries struggle to meet both the increased need and costs. In the last year, the number of households served by Macomb County food pantries has increased to 148,388, an increase of 17% over the previous year. A 70% increase since 2021!

Every dollar of your donation will be used exclusively to purchase food and only for distribution to Macomb County pantries though the Community Food Bank of Macomb County.

On behalf of your Macomb County neighbors in need, we thank you for your generosity.

Sincerely, Cheryl Siecinski, Chair Macomb Food Program F

Macomb County Health Department Reportable Diseases Summary Diseases Reported in Macomb County Residents* Cumulative total for previous years, year-to-date total for March 2025b 2025

2024

2023

2022

2021

2025

2024

2023

2022

2021

AMEBIASIS

0

0

0

0

0

LYME DISEASE

2

11

14

11

11

BLASTOMYCOSIS

1

0

1

2

1

MALARIA

1

1

1

2

0

BOTULISM -FOODBORNE

0

0

0

0

0

MEASLES

1

1

0

0

0

BOTULISM -INFANT

0

0

0

0

0

MENINGITIS VIRAL

0

15

12

26

18

BRUCELLOSIS

1

1

0

0

0

CAMPYLOBACTER

MENINGITIS BACTERIAL/BACTEREMIA

16

86

109

91

124

(EXCLUDING N. MENINGITIDIS)

2

5

4

8

15

CHICKENPOX

5

32

37

29

24

MENINGOCOCCAL DISEASE

0

1

1

0

0

CHLAMYDIA

675

2,765

3,072

3,105

3,310 MPOX

0

1

4

41

-

COCCIDIOIDOMYCOSIS

0

4

4

1

0

MULTISYSTEM INFLAM. SYND.

1

1

3

8

15

CREUTZFELDT JAKOB

0

1

1

0

1

MUMPS

0

0

2

0

0

CRYPTOCOCCOSIS

0

0

0

0

0

NOVEL CORONAVIRUS COVID19 4,174

CRYPTOSPORIDIOSIS

1

7

14

7

3

PERTUSSIS

18

91

3

2

5

CYCLOSPORIASIS

0

0

2

1

0

POLIO

0

0

0

0

0

DENGUE FEVER

0

1

0

0

0

PSITTACOSIS

0

0

0

0

0

DIPHTHERIA

0

0

0

0

0

Q FEVER

0

0

0

0

0

EHRLICHIOSIS

0

1

0

0

0

RABIES ANIMAL

0

0

13

1

1

ENCEPHALITIS PRIMARY

1

1

0

0

0

RABIES HUMAN

0

0

0

0

0

ENC POST OTHER

2

7

2

1

2

REYE SYNDROME

0

0

0

0

0

FLU-LIKE DISEASE

2,278

4,054

6,286 ROCKY MNTN SPOTTED FVR

0

0

0

1

0

GIARDIASIS

4

19

26

16

15

RUBELLA

0

0

0

0

0

GONORRHEA

213

970

1,065

970

1,405 SALMONELLOSIS

14

70

59

65

62

GRANULOMA INGUINALE

0

0

0

0

0

SHIGELLOSIS

2

17

9

18

8

GUILLAIN-BARRE SYN.

3

8

9

5

6

STEC**

3

13

25

22

17

H. FLU INVASIVE DISEASE

1

30

17

16

4

STREP DIS, INV, GRP A

23

67

63

30

15

HEMOLYTIC UREMIC SYN.

0

0

0

0

3

STREP PNEUMO, INV + DR

29

61

56

61

29

HEPATITIS A

0

1

3

1

1

SYPHILIS CONGENITAL

2

5

4

2

2

HEPATITIS B (ACUTE)

2

8

7

5

5

SYPHILIS

51

182

232

203

227

HEP B (CHRONIC)

20

78

80

62

62

TETANUS

0

0

0

0

0

HEPATITIS C (ACUTE)

1

9

9

13

25

TOXIC SHOCK SYNDROME

0

0

0

1

0

HEP C (CHRONIC)

47

226

199

201

272

TUBERCULOSIS

6

14

16

14

16

HEPATITIS D

0

0

0

0

0

TULAREMIA

0

0

0

0

0

HEPATITIS E

0

0

0

0

0

TYPHOID FEVER

0

0

2

1

0

HISTOPLASMOSIS

0

6

4

4

2

VIBRIOSIS

0

1

2

0

2

HIV^ INFLUENZA KAWASAKI SYNDROME

15,579 14,973

8

48

49

57

52

VISA

0

0

0

0

1

5,529

4,846

3,523

5,557

170

VRSA

0

0

0

0

1

0

6

11

5

3

WEST NILE VIRUS

0

6

1

1

14

0 2 0

0 3 0

0 3 0

0 1 0

0 0 0

LEGIONELLOSIS 5 44 60 36 74 YELLOW FEVER YERSINIA ENTERITIS LISTERIOSIS 0 0 0 2 3 *Includes both Probable and Confirmed case reports.

ZIKA **Shiga-toxin producing Escherichia coli per MDHHS; combo of E. coli & Shiga Toxin 1 or 2. ^ Previously reported as "AIDS" b

16,164 26,233 123,256 121,445

2025 total is tentative at this time.

17-Apr-25

BCBSA Settlement Update and Important Dates

P

hysicians who provided health care services to patients insured by Blue Cross Blue Shield (BCBS) plans from July 2008 to October 2024 may be eligible to submit a claim for a share of the $2.8 billion settlement reached in November 2024. This settlement, which is the largest antitrust settlement in the history of the U.S. health care sector, is the result of a class action lawsuit against BCBS initiated over ten years ago by physicians, hospitals, large health systems, and provider organizations. Plaintiffs alleged that BCBS violated the Sherman Antitrust Act of 1890 by colluding to limit competition and lower reimbursement.

The official website for Settlement Class Members in the Blue Cross Blue Shield antitrust litigation has been created and includes important information such as FAQs, timeframes to submit claims, and provider and facility eligibility. It also is where providers and facilities must submit claims for a share of the Net Settlement Fund. The deadline to submit a claim is July 29, 2025. Physicians are encouraged to visit the BCBS Provider Settlement Website for more information.

Class Members who submit a valid approved claim (“Authorized Claimants”) will receive a payment from the Net Settlement Fund if the Settlement is approved.

In addition to the monetary payment, BCBS has agreed to implement changes that will benefit physicians and other

providers by increasing transparency, efficiency and accountability in claims processing, including the process of BlueCard claims.

Important Dates and Deadlines October, 14, 2024 – Settlement Agreement Filed December 4, 2024 – Preliminary Approval Granted March 4, 2025 – Opt-Out/Objection Deadline July 29, 2025 – Claims Submission Deadline July 29, 2025 – Final Approval Hearing F

HAPPY BIRTHDAY The MCMS would like to wish the following members a very Happy Birthday!

APRIL Todd Adelson, DO Henri Bernard, MD Lawrence Blaty, MD Leland Brown, MD Donald Campbell, MD Stephen D'Addario, MD Keith Defever, MD Vijayalakshmi Donthireddy, MD Judy Fontana, MD Paul Gradolph, MD Sachinder Hans, MD Davide Iacobelli, MD Shin Young Kang, MD Amin Khan, MD Lawrence Loewenthal, MD Kevin Lokar, MD Patricia Milani, MD Suraj Nighoon, MD Michael Noorily, MD Chan Kee Park, MD Peter Rowsell, MD Aaron Sabbota, MD

Mark Segel, MD Manaf Seid-Arabi, MD Anne White, MD MAY Fanar Alyas, MD Elie Banna, MD Brian Barbish, MD Ronald Barnett, DO Bradley Berger, MD Mark Berkowitz, MD Laura Clark, MD David Davis, MD Ben Fajardo, MD Gertrude Gregory, MD Antwan Hall, MD Roger Harris, DO Pasquale Iaderosa, MD Harpal Jande, MD Elena Jdanova, MD Daniel Jensen, DO Harold Katzman, MD Sherezade Khambatta, DO

8 Macomb Medicus | April/May/June 2025

Karl Kish, MD Russell Miller, MD Kirsten Miller-Unger, MD Tara Nelson, DO Antoun Oska, MD Chakrapani Ranganathan, MD Carl Sarnacki, MD Luay Sayed, MD Theodore Schreiber, MD Laurie Stanczak, MD Andrew Sulich, MD Shobana Sundaram, MD William Ventimiglia, MD JUNE Waqas Abid, MD Leandro Africa, MD Mariana Atanasovski, MD Olabola Awosika, MD Prameela Baddigam, MD Ashraf Berry, MD Raymond Buzenski, MD Chaker Diab, DO

Brian Engel, MD Jason Hafron, MD Cameron Heilbronn, MD Jennifer Hichme, MD Kenneth Kernen, MD Sayeed Khan, MD Kent Krach, MD Jay Novetsky, MD Paul Paonessa, MD Joel Pelavin, MD Paavan Railan, MD Dennis Ramus, MD Sudarshan Reddy, MD James Relle, MD Youssef Rizk, DO Aaron Sable, MD Richard Schiappacasse, MD Alfred Schneider, MD Theodore Tangalos, MD Alec Wilson, MD Jixian Wu, MD Mark Zainea, MD

MEMBERSHIP REPORT We would like to welcome the following New Members!

Olabola Awosika, MD Dermatology Medical School: Howard University College of Medicine, 2015. Post Graduate Education: Mercy Medical Center (MD), completed in 2016; George Washington University (DC), completed in 2018; Henry Ford Health System, completed in 2021. Currently practicing at Hamzavi Dermatology, 43151 Dalcoma Dr., Ste. 1, Clinton Twp., MI 48038, ph. 586-286-8720, www.hamzaviderm.com.

Miguel A. Herrera-Martinez, MD Dermatology – Board Certified Medical School: Wayne State University School of Medicine, 2016. Post Graduate Education: University of Tennessee, completed in 2021; BIDMC/Harvard University (MA), completed in 2022. Currently practicing at Lighthouse Dermatology, 26901 Harper Ave., St. Clair Shores, MI, 48081, ph. 248-726-7646, fx. 586-238-2151, www.lighthousedermatology.com.

Shobana Sundaram, MD Pediatrics – Board Certified Medical School: Calicut Medical College (India), 1991.

Post Graduate Education: BJ Medical College Maharashtra University; completed in 1994; University of Michigan Sparrow Hospital, completed in 2003; University of Illinois College of Medicine, completed in 2004. Hospital Affiliation: Corewell Beaumont Royal Oak, Corewell Beaumont Troy.

Currently practicing at Pediatric & Adolescent Care Associates, 43184 Dequindre Rd. Ste. 208, Sterling Hts., MI 48314, ph. 586-731-1500, fx. 586-731-1363, www.specialtypediatrics.com.

SHARE YOUR NEWSWORTHY ITEMS!

Have you or a MCMS colleague been elected to a position (specialty society, hospital, community based program, etc.) or honored for your volunteer service within the community or abroad?

Let us know. We would like to recognize MCMS members in the “Member News” section of the Medicus.

Contact Heidi Leach at HLeach@macombcms.org with newsworthy information.

Publication is subject to availability of space and the discretion of the Editor.

Tri-County Legislative Committee Lawmakers want and need to hear from professionals in the field of medicine!

The Tri-County Legislative Committee meets quarterly with legislators from Macomb, Oakland, and Wayne Counties. These meetings provide an open forum for physicians to engage directly with legislators who are often seeking physician input and education on healthcare related legislation.

2025 Meeting Dates Monday, May 19 – Virtual, 7 pm Monday, September 15 – In Person, 6:30 pm, location TBD Monday, November 17 – Virtual, 7 pm Anyone interested in joining the Committee please contact Heidi Leach at HLeach@macombcms.org.

Macomb Medicus | April/May/June 2025 9

IN MEMORIAM Adrian J. Christie, MD December 1, 1940 – January 31, 2025

Dr. Adrian Christie, a respected pathologist, dedicated medical editor, and longtime member of the Macomb County medical community, passed away on January 31, 2025, at the age of 84.

Dr. Christie graduated from the Welsh National School of Medicine in Cardiff and trained in pathology in the UK, with a year-long residency at Mount Sinai Hospital in New York (1967–68), Graduation, Welsh National School of Medicine in 1967 where he studied under the renowned pathologist and hepatologist, Professor Hans Popper. He became a Fellow of the Royal College of Pathologists (FRCPath) before immigrating to North America in 1973 with his wife and three children. Settling first in Windsor, Ontario, he obtained Canadian licensure and fellowship of the Royal College of Physicians and Surgeons before moving to Michigan in 1976. There, he secured his American medical licensure and board certification in pathology before joining the Langston Walker & Associates pathology group at South Macomb Hospital.

Dr. Christie spent the majority of his career as a pathologist at St. John Macomb-Oakland Hospital, where he became Laboratory Director in 1994, a role he held for 20 years before passing the leadership to a longtime junior colleague. A board-certified pathologist in both anatomic and clinical pathology, he was highly respected for his expertise in diagnostics and laboratory medicine. He was also a Professor at Michigan State University, where he contributed to the education and mentorship of medical students. In recognition of his contributions to medicine, Dr. Christie was honored with the Ascension Macomb-Oakland Hospital (AMOH) Tenure Award in January 2022.

he also served on the Michigan State Medical Society Board of Directors from 2014 to 2021, advocating for physicians and the future of healthcare policy in Michigan.

As Editor of the Macomb Medicus, the journal of the Macomb County Medical Society, Dr. Christie not only oversaw its publication but was also a prolific contributor, writing editorials that blended medicine, history, and personal reflections.

His essays covered an extraordinary range of topics, from the impact of COVID-19 on international travel to the history of timekeeping, the ethics of modern healthcare, and even personal anecdotes from his lifelong curiosity about the world.

Whether discussing medical advancements or recounting his travels, his writing always reflected a sharp analytical mind, a deep appreciation for history, and a storyteller’s sense of detail.

Beyond his professional achievements, Dr. Christie also dedicated time to medical and community service.

He worked as a ringside physician for Detroit boxing and wrestling matches, treating both amateur and professional fighters, including Sugar Ray Leonard and Tommy Hearns. He was on the board of Don Bosco Hall, a Detroit organization supporting at-risk youth, for over 30 years.

Detroit Free Press, March 26, 1985 He was also active in fundraising efforts for Turning Point, a nonprofit providing support for survivors of domestic abuse.

Dr. Christie is survived by his beloved wife of 59 years, Mynetta, a talented artist whose Dr. Christie with his wife Mynetta, dancing and in Prague drawings and paintings—including watercolors inspired by their travels— have always enlivened their homes. He was grateful to share his life with someone whose enthusiasm for literature, film, theatre, and art —spanning genres and continents—matched his own.

Throughout his long and distinguished career, Dr. Christie was deeply involved in medical leadership and professional advocacy.

He was the longest-serving member of the Macomb County Medical Society Board of Directors, holding a seat from 1997 until his passing. He served two terms as President of Their daughter, Dr. Helen Edelberg, MD, MPH, is currently the Macomb County Medical Society, first in 1998 and again Deputy Director of Safety in the Office of New Drugs (OND) at in 2014. His influence extended beyond Macomb County, as the FDA. A strategic regulator, physician, and former biophar10 Macomb Medicus | April/May/June 2025

IN MEMORIAM maceutical executive, she has spent over 20 years advancing patient safety and public health. Previously, she served as an Assistant Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center before joining the faculty at Mount Sinai School of Medicine.

Dr. Helen Edelberg’s husband, Dr. Jay Edelberg, MD, PhD, a cardiologist and researcher, has played a key role in developing groundbreaking medications, including treatments for high cholesterol and familial cardiac hypertrophy. He is the Co-Founder and Head of Research and Development at Prolaio, a company dedicated to integrating connected platforms and data science to enhance heart care and serves as the Chief Medical Officer at Kardigan, a company focused on modernizing cardiovascular drug development.

Dr. Christie’s grandson, Daniel Edelberg, recently earned his PhD in Applied Mathematics from Yale University, after five years of intensive study.

Dr. Christie’s younger daughter, Dr. Christie and his grandson Daniel Leona Christie, is an Associate Professor of Studio Art at the University at Albany, State University of New York (SUNY).

In collaboration with her brother Gavin, she has created a body of work that re-presents Dr. Christie and his daughter Leona his autistic lists as art, highlighting their poetic and visual qualities. This project has been exhibited in gallery and museum exhibitions, both regionally and nationally, with themes ranging from memory to typing, and was featured on CBS News Detroit radio.

Dr. Christie’s son, Gavin, a valued employee at Kroger, has worked as a grocery bagger for 6 and a half years, where he is known for his friendliness and dedication. He worked tirelessly throughout nearly the entirety of the pandemic, earning him recognition as a Hometown Hero by the Birmingham Chamber of Commerce.

beyond his professional field. He found joy in fly-fishing, collecting antique watches, and a long-running membership in a hamburger tasting club, where he and friends exchanged detailed reviews after each meal. Every summer from 1976 until 1993, he spent a working vacation as the camp doctor at Camp Maplehurst on Torch Lake, near Traverse City, bringing his family along to enjoy the summers Dr. Christie with his watch collection in Northern Michigan.

Dr. Christie is survived by his wife, Mynetta; daughter, Dr. Helen Edelberg (Dr. Jay Edelberg); daughter, Leona Christie; and son, Gavin Christie; grandson, Daniel Edelberg PhD; and siblings, Lester (Linda) Christie, Melodie Rawel, and Nina (Raad) Al-Bahrani.

Dr. Christie was the dear brother of the late Victor (Adrienne) Christie and the late Theodore Christie; the devoted son of the late Maxwell and Sonya Christie; and the dear brother-in-law of the late Alan Rawel.

Interment was at Clover Hill Park Cemetery. Contributions in his memory may be made to Magen David Adom or the Jewish Hospice & Chaplaincy Network. F

ADVERTISE IN THE MACOMB MEDICUS! Reach your audience with a print and digital publication.

Your digital ad will be hyperlinked to your website.

Contact Heidi Leach at HLeach@macombcms.org for more information

A lifelong learner, Dr. Christie Dr. Christie and his son Gavin biked regularly to his Torah study group, believing that intellectual engagement extended

Macomb Medicus | April/May/June 2025 11

HOSPITAL NEWS

Henry Ford Macomb Hospital

“We’ve seen over the past 23 years how effective this model can be. Some years we literally have zero suicides within our patient population,” said Brian K. Ahmedani, PhD, lead author of the study and director of research for Behavioral Health Services at Henry Ford Health. “As health systems across the country and around the world begin to adopt this strategy, it was important to prove its effectiveness beyond our health system.”

“Prior to the Zero Suicide Model, health systems may have lacked organized programs to identify and address suicide risk. These studies support the implementation of the Zero Suicide Model and reinforce the need for policies to support widespread, comprehensive implementation,” said co-author Gregory E. Simon, MD, MPH, psychiatrist and senior investigator at Kaiser Permanente Washington Health Research Institute.

HENRY FORD MACOMB HOSPITAL MAKES HISTORY WITH MONARCH QUEST WORLD-FIRST: Our team at Henry Ford Macomb Hospital, led by cardiothoracic surgeon Dr. Raed Alnajjar, has made history as the first globally to use the MONARCH robotic bronchoscopy platform with MONARCH QUEST - an AI-powered navigation system designed to improve precision in targeting lung nodules. With real-time 3D imaging, this next-generation technology aids clinicians in reaching early-stage lesions in the periphery of the lung that traditional bronchoscopy struggles to access. Congratulations to our team on this groundbreaking advancement in lung cancer detection.

RESEARCHERS HAVE A PROVEN PRESCRIPTION FOR REDUCING SUICIDE RATES

Nearly every person who dies by suicide visits a doctor’s office within a year of their death. A new body of research suggests that by adopting a specific protocol, health systems can reduce suicide rates among those patients by 25%.

Researchers say the findings support comprehensive widespread adoption of a method audaciously named The Zero Suicide (ZS) Model, as suicide remains among the leading causes of death in the U.S. In 2022, 49,000 people died by suicide in the U.S. Suicide was the second leading cause of death among people ages 10 to 14 and 20 to 34, and it was third leading cause among those 15 to 19.

Over the course of eight years, researchers at Henry Ford Health and Kaiser Permanente examined implementation of the ZS Model in primary care and behavioral health settings. Previously, the method had only been studied at Henry Ford Health, the Detroit-based health system where the model was founded in 2001.

12 Macomb Medicus | April/May/June 2025

Data shows more than 80% of people who die by suicide and more than 90% of people who attempt suicide visit a doctor’s office in the months and weeks leading up to their death.

The ZS Model starts with suicide risk screening that patients fill out before they see their doctor. Providers immediately evaluate the survey; if a patient says they have frequent thoughts about self-harm, they are further assessed for suicide risk. Those at high-risk for suicide work with a specialized member of the care team to create a safety plan that covers who they can call if they’re in distress; cognitive tools for reducing suicidal thoughts; and what they can do to try to make their home environment safe. Then, the patient is referred to an outpatient behavioral health provider for psychotherapy focused on suicide prevention.

The ZS Model Implementation Study published in JAMA Network Open examined implementation in behavioral health clinics at five Kaiser Permanente health systems in California, Oregon, Washington and Colorado, as well as Henry Ford Health locations in Michigan.

Embedded researchers within each system collaborated with outpatient behavioral health care providers to document components of the ZS Method incorporated into the care of over 300,000 patients per month over the age of 13 from 2012 to 2019.

The researchers tracked suicide attempts and suicide deaths after implementation and found rates dropped by as much as 25%.

“These statistics are incredibly significant, particularly when you consider patients who engage with behavioral health specialists are at a higher risk for suicide than those who visit a general practitioner,” Ahmedani said.

In a concurrent study, researchers examined ZS Model implementation among more than 475,000 patients in 19 primary continued on page 13

HOSPITAL NEWS care practices within the Kaiser Permanente system in the state of Washington. Again, the rate of suicide attempts was 25% lower with the ZS Model approach. “‘Zero Suicide’ may seem like an impossible goal, but we believe we should strive every day to try to prevent suicide among our patients,” Ahmedani said. “This is the best evidence yet that we have the tools to recognize those in distress, intervene, and help them change course.”

If you or someone you know is seeking support for mental health issues, the 988 Suicide and Crisis Lifeline can be reached by dialing 988 or 1-800-273-8255. A free, 24/7 and confidential crisis text line with trained listeners is also available by texting HELLO to 741741.

McLaren Macomb Hospital

MCLAREN GME CELEBRATES MATCH DAY SUCCESSES

Friday, March 21 proved to be a day to celebrate for McLaren Health Care Graduate Medical Education.

The annual Match Day — the day on which medical students learn the results of their residency or fellowship applications and receive their assignments to continue their training — concluded with McLaren GME filling its 149 available positions.

This marks a 100% fill rate across the 42 GME programs throughout the system.

“The result of Match Day 2025 further demonstrates the merit and proficiency of our GME program and the quality of the training our residents and fellows can expect,” said Dr. Robert Flora, McLaren Health Care Chief Academic Officer. “We are very pleased to welcome the new class of physicians as they join our greater GME number of trainees and continue their development to becoming skilled and compassionate clinical professionals, with the goal being to retain them in Michigan to continue serving our patients.”

When the members of this latest class join their colleagues at system training sites across Michigan in July, nearly 600 future attending physicians and surgeons will be training in the McLaren GME program.

MCLAREN MACOMB ACHIEVES REACCREDITATION AS A COMPREHENSIVE STROKE CENTER

McLaren Macomb, the most technologically advanced and clinically experienced stroke program in the county, has earned reaccreditation as a Comprehensive Stroke Center from The Joint Commission, a leading independent health care accrediting body.

As a Comprehensive Stroke Center, McLaren Macomb is certified in its ability to receive and treat patients with the most complex stroke cases.

McLaren Macomb is the first hospital in the county to earn this highest achievable designation, originally receiving accreditation in 2022 after having previously earned Primary Stroke Center designation.

“The stroke team’s clinical leaders have every reason to be proud of the work they are doing,” said Tracey Franovich, McLaren Macomb President and CEO. “Their commitment to always putting the patient at the center of everything they do — motivated by providing them and their families with the best possible care — is impressive by any standard. Our hospital and all of Macomb County are fortunate to have this level of expertise readily available to them, and they have our sincere appreciation and gratitude.”

This accreditation was earned following a rigorous and thorough onsite evaluation by health care professionals experienced in the care of stroke. All advanced Joint Commission accreditations are assessable only to those hospitals that are already accredited by the organization, which McLaren Macomb has maintained since 2016.

Several elements of McLaren Macomb’s stroke care process were evaluated, ranging from staffing, on-site technology for stroke-specific diagnostic imaging and procedures, to demonstrating that certain neurological and interventional stroke procedures have been consistently performed, among other clinical care, performance, and quality metrics.

McLaren Macomb has routinely earned national recognition for its care, treatment, quality and outcomes, and was the first program in Macomb County capable of performing the potentially life-saving interventional thrombectomy procedures.

Part of the McLaren Stroke Network, McLaren Macomb provides 24/7 initial evaluations by interventional neurologists for all suspected-stroke patients, a unique and significant step in the program’s procedure to fully and efficiently diagnose a stroke and initiate a care plan.

Learn more about the stroke capabilities of the McLaren Stroke Network at www.mclaren.org/stroke. continued on page 14

Macomb Medicus | April/May/June 2025 13

continued from page 13

HOSPITAL NEWS

MCLAREN MACOMB NAMES HASSAN BEIZ, MD, FACP, CHIEF MEDICAL OFFICER McLaren Macomb has named Hassan Beiz, MD, FACP, as its Chief Medical Officer.

Serving in the same role at McLaren Oakland since July 2023, Dr. Beiz will assume the leadership position at McLaren Macomb following several years of distinguished service from Dr. Andrew Staricco.

of clinical quality at a mid-Michigan hospital. He also maintains roles in academia, serving as internal medicine core faculty, residency site director, assistant program director, and assistant professor of medicine, all at the Central Michigan University College of Medicine. He also served as the founding medical director of CMU’s academic hospital medicine program.

Dr. Beiz earned his medical degree from Ross University School of Medicine and completed his residency in primary care internal medicine at The University of Connecticut before returning home to practice in Michigan. F

Dr. Beiz’s transition to McLaren Macomb follows the appointment of Tracey Franovich as hospital President and CEO in the spring of 2024 after having served in the same position at McLaren Oakland, where she was instrumental in bringing Dr. Beiz to the organization.

“In working closely with Dr. Beiz and getting to know him, he clearly demonstrated himself to be an effective leader and influential partner to all clinical teams,” Franovich said.

“The focus of his energy is on creating an environment and maintaining a staff that best serves the needs of our patients while also providing a caring and compassionate experience.

I am very pleased to again be working alongside Dr. Beiz and welcome him to McLaren Macomb.”

An internal medicine hospitalist by training, Dr. Beiz brings experience as a physician leader across a range of roles. Immediately prior to joining McLaren, he served as medical director

MSMS/MCMS Members Receive Expert Help From MSMS’s Reimbursement Advocate

D

id you know that you have access to help with payer issues through the MSMS Reimbursement Advocate, Stacie J. Saylor, CPB, CPC, just for being a member of the Michigan State Medical Society and the Macomb County Medical Society?

Stacie has over 30 years of medical billing background that has been instrumental in helping MSMS members fight erroneous denials of payment, resolve provider enrollment issues, advocate for policy change with health plans, assist billers with proper coding and help get claims “unstuck” in the system and reimbursed, to name a few.

As the MSMS Reimbursement Advocate for 22 years, Stacie has invaluable relationships with health plan representatives, experience navigating varied inquiries, and a passion for advocating for timely and accurate payment for physicians. One example is the need to continuously push back on health plans that automatically down code office visit levels of care and automatically request medical documentation when certain 14 Macomb Medicus | April/May/June 2025

modifiers are appended to claims.

This is an unfair administrative burden to practices that often results in reimbursement delays.

When your practices has exhausted the health plan resources available to you and the issue has not been resolved to your satisfaction, contact Stacie through email, ssaylor@msms.org or by calling 517-336-5722, to see how she can assist you. Health plans do manage inquiries from MSMS as a priority, understanding that the practice has already taken appropriate steps to resolve the issue through the health plan, with unsatisfactory results.

The MSMS Reimbursement Advocate is a highly valued benefit available exclusively to members of the Michigan State Medical Society (MSMS) and the Macomb County Medical Society (MCMS). F

MACOMB COUNTY MEDICAL SOCIETY

Spring Membership Meeting “Michigan State Medical Society: Working For You, With You”

This Meeting is FREE for MCMS Members and Non-Member Physicians Join Your Colleagues for an Evening of Socializing and Networking

OUR SPEAKER

TOPIC HIGHLIGHTS: How MSMS is working to improve the lives of Michigan’s physicians.

Proactive efforts to promote the value of physicians as the leaders of the health care team and advocates for their patients.

Current legislative, regulatory, and payer hot topics.

Available MSMS resources.

Tuesday, May 13, 2025 6 pm Cocktails ~ 6:30 pm Dinner 7 pm Program

Ike’s Restaurant

STACE Y HETTIGER

Senior Director, MSMS Advocacy & Payor Relations

8550 Van Dyke (just south of 17 Mile Rd.) in Sterling Heights

Registration is REQUIRED by Friday, May 9th Email HLeach@macombcms.org ~ Call 810-712-2546 ~ Register Online

CMS Telehealth Deadline Extended: Key Changes, and Billing Updates

T

elehealth has become an integral part of health care delivery, providing patients with greater access to health care services while offering physicians and providers more flexibility in care delivery. To keep pace with evolving needs and in response to pressure from interested parties, the Centers for Medicare & Medicaid Services (CMS) continues the work to finalize its telehealth policies.

Initially set to expire on March 31, 2025, the expanded telehealth services have been extended through September 30, 2025. This extension allows Medicare patients to continue receiving a wide range of telehealth services from their homes, without geographic restrictions. All eligible Medicare providers can furnish these services, and Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) are authorized to serve as distant site providers for non-behavioral/ mental telehealth services during this period.

Additionally, the requirement for an in-person visit within six months of initiating a behavioral/mental telehealth service, and annually thereafter, has been waived through September 30, 2025, and through January 1, 2026 for FQHCs and RHCs Health Plan

under specified circumstances. Non-behavioral/mental telehealth services can continue to be delivered using audio-only communication platforms through September 30, 2025. This provision ensures that beneficiaries without access to video technology can still receive necessary care.

Meanwhile, certain flexibilities have been made permanent for behavioral and mental health services. Medicare patients can continued on page 17

Telemedicine Codes Payable

Additional Information

Aetna

Self and fully insured plans cover 98000 - 98007 & G0546, G0547, G0548, G0549, G0550 and G0551 [covered with or without telemedicine modifiers]

BCBSM/BCBSM Commercial

98000 - 98016 Effective 1/1/2025

CMS/Medicare/MA Plans

98016 is payable, but 98000 - 98015 are designated as "I" inactive = not payable.

Self-funded plans will NOT reimburse audio-only codes 98008 - 98015. Fully insured plans WILL reimburse audio-only codes 98008 - 98015. Bill Telemedicine visits as you have been doing using codes 99202 - 992015 with the appropriate telemedicine modifier for those product lines that do not reimburse the new telemedicine services codes.

99202 - 99215 are still payable codes for telemedicine visits through 6/30/2025. Use an appropriate modifier to indicate a telemedicine visit. Effective 7/1/2025, these codes will no longer be paid for telemedicine visits.

Bill telemedicine visits as you have been doing using codes 99202 - 99215. CMS recommends appending modifier 93 if it is an audio only service.

Health Alliance Plan (HAP)

Following CMS guidelines and currently not reimbursing 98000 - 98015. 98016 is being reimbursed.

Priority Health

98000 - 98016 payable for commercial plans.

United HealthCare

Following CMS guidelines on all product lines.

16 Macomb Medicus | April/May/June 2025

Bill telemedicine visits as you have been doing using codes 99202 - 99215. CMS recommends appending modifier 93 if it is an audio only service.

Bill telemedicine visits as you have been doing using codes 99202 - 99215. CMS recommends appending modifier 93 if it is an audio only service.

Bill telemedicine visits as you have been doing using codes 99202 - 99215. CMS recommends appending modifier 93 if it is an audio only service.

TO KEEP PACE WITH EVOLVING NEEDS AND IN RESPONSE TO PRESSURE FROM INTERESTED PARTIES, THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) CONTINUES THE WORK TO FINALIZE ITS TELEHEALTH POLICIES. continued from page 16

receive behavioral/mental telehealth services in their homes without geographic restrictions. FQHCs and RHCs can permanently serve as distant site providers for these services.

Audio-only communication platforms are permanently permitted for delivering behavioral/mental telehealth services.

CMS has indicated that any changes to the list of Medicare telehealth services will be effective on an annual basis, with changes proposed in the summer and finalized by November each year. With another deadline on the horizon, physicians

and others health care partners are advocating for further extensions or, ideally, permanent adoption of these telehealth services to ensure continued access to care for Medicare beneficiaries.

All these changes have led to some confusion with what payers in Michigan are reimbursing, and what codes to use when billing for telehealth visits. MSMS has gathered Health Plan specific telehealth coverage and billing information for your reference.

Please refer to payer instructions and information as they may make changes or updates. F

UPCOMING EVENTS May 13 ~ MCMS Spring Membership Meeting Free for MCMS Members, 6 pm cocktails, 6:30 pm dinner, 7 pm program, at Ike’s Restaurant in Sterling Heights. Speaker: Stacey Hettiger, MSMS Senior Director of Advocacy & Payor Relations.

Registration is required.

May 14 ~ A Plethora of New Avenues for Chronic Head and Neck Pain MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/ PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

May 14 ~ Appropriate Coding for Social Determinants of Health Incentives MSMS Practice Management Series, Live Webinar, 1 pm – 2 pm, 1 AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

May 16 ~ A Day of Board of Medicine Renewal Requirements MSMS In-Person Meeting, 8:30 am – 4:45 pm, Holiday & Suites in Troy. Earn the mandated Michigan Board of Medicine CME - all in one day! Conference fulfills: 3-hrs Pain Management, 1-hr.

Controlled Substances, 3-hrs DEA MATE Act, 1-hr Medical Ethics, 3-hrs Implicit Bias. 7 AMA/PRA Category 1 CME Credits. Cost: FREE for Active, Active Emeritus, & Resident members; $180 Retired/ Emeritus/Life members; $350 for non-members.

May 21 ~ The Structure of Public Health in Michigan Michigan's Public Health Webinar Series, Live Webinar, 12 pm – 12:45 pm, .75 AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/ Retired/Life members.

June 9 ~ Reimagining Healthcare: A Workshop on Racism, Empathy & Transformation MSMS Monday Night Medicine, Live Webinar, 5:30 pm – 8 pm, 3 AMA/PRA Category 1 CME Credit. Meets LARA’s 3-hr. Implicit Bias requirement. Cost: FREE for Active, Active Emeritus, & Resident members; $140 for Emeritus/Retired/Life members; $190 for non-members.

June 11 ~ From Pathogen to Patient: A Deep Dive into Gastrointestinal Tract Infectious Disorders MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/ PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

June 11 ~ Knowing When to Say When – And How to Ensure a Smooth Transition MSMS Practice Management Series, Live Webinar, 1 pm – 2 pm, 1 AMA/PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

July 9 ~ The Utility of Oral Fluid Testing in a Clinical Setting MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/ PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

August 13 ~ Navigating Employee Terminations: Best Practices for Successful Off-Boarding MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/ PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

September 10 ~ Specimen Collection and Test Interpretation in Microbiology: What do you need to know?

MSMS Grand Rounds, Live Webinar, 12 pm – 12:45 pm, .75 AMA/ PRA Category 1 CME Credit. Cost: FREE for Active members & office staff; $25 for non-members & Emeritus/Retired/Life members.

September 15 ~ Reducing Unconscious Bias - an Imperative (RUBI) MSMS Monday Night Medicine, Live Webinar, 5:30 pm – 8 pm, 3 AMA/PRA Category 1 CME Credit. Meets LARA’s 3-hr. Implicit Bias requirement. Cost: FREE for Active, Active Emeritus, & Resident members; $140 for Emeritus/Retired/Life members; $190 for non-members.

Macomb Medicus | April/May/June 2025 17

MSMS UPDATE MSMS extends its deepest gratitude to all members who participated in this important day of advocacy.

MSMS LEGISLATIVE PRIORITIES

By: Daniel M. Ryan, MD, MSMS Region 2 Director

MSMS ADVOCACY DAY: PHYSICIANS UNITE FOR THE FUTURE OF MEDICINE

With the new legislative session underway, House Health Policy Chair VanderWall has indicated an interest in working on a health data utility, the 340b drug pricing program, and pharmacy benefits managers reforms. Over in the Senate, Health Policy Chair Hertel is interested in working in the opioid and substance use disorder space. MSMS will monitor all proposed items and remains committed to advancing the priorities of our members, in line with our legislative agenda.

Ensuring Access to Physician-Led Care • Expand and support the physician workforce throughout the learning and practice continuum • Protect and promote physician-led, team-based health care • Support patients’ right-to-know through health professional credentials disclosure • Enhance resources for physician health needs

Medical students, alliance members, board members, practicing physicians, and retired physicians from every corner of Michigan and across all specialties came together in Lansing for MSMS Advocacy Day on March 19, 2025. With a shared commitment to patient care and the future of the medical profession, participants met with legislators—primarily from the House and Senate Health Policy Committees, as well as legislative leadership—to discuss pressing issues, including physician burnout, recruitment, and retention and the importance of physician-led care teams. Key messages delivered by Advocacy Day participants included: • Every patient, regardless of location, should have access to physician-led, team-based care.

• Physicians in Michigan face increasing burnout due to excessive administrative burdens, workforce shortages, and an overwhelming number of regulatory mandates.

• Increased state investment in programs that incent physicians to practice in Michigan, such as loan repayment programs e.g., MIDOCS, MSLRP), is necessary to help retain and increase Michigan’s physician workforce.

Physician advocacy plays a critical role in shaping policies that protect patients and ensure high-quality care. By engaging directly with lawmakers, MSMS members can reinforce the need for policies that support physicians in delivering the best care possible. Your voices help safeguard the integrity of the profession and promote a healthcare system that prioritizes patient well-being.

18 Macomb Medicus | April/May/June 2025

Improving Michigan’s Health Care Environment • Support programs and policies to make Michigan a desirable location to practice medicine • Maintain legislative intent and enforceability of our medical liability laws to maintain a stable, fair, and balanced environment • Oppose regulations, policies, and contractual requirements that interfere with patient care • Reject proposed legislative and regulatory mandates Advancing Public Health and Health Equity • Expand access to care for patients with Medicaid and the Healthy Michigan Plan, with reimbursement increases a key component to accomplish this goal • Ensure health care is fully inclusive and attainable so that everyone has access to necessary medical services and improved outcomes • Expand access to mental health and substance use disorder treatment

MSMS PUBLIC HEALTH WEBINAR SERIES

MSMS debuted its new monthly webinar series, Michigan's Public Health on March 13. The inaugural session featured the state's Chief Medical Executive, Natasha Bagdasarian, MD, MPH, FIDSA, FACP. Dr. Bagdasarian provided updates on seasonal flu, avian flu, and the measles outbreak. She shared that the Michigan Department of Health and Human Services (MDHHS) issued a measles alert to health care provider earlier that week.

The purpose of the webinar series is to keep members current continued on page 19

continued from page 18

MSMS UPDATE

on pressing public health issues in Michigan. These sessions are FREE to all active MSMS members. To view the recording click here. Future dates are in the works, watch Medigram for more information.

NEW MSMS LEGAL ALERT ON CREDITORS’ RIGHTS FOR MEDICAL PRACTICES

The Michigan State Medical Society’s latest Legal Alert, Creditors’ Rights for Medical Practices Following Chapter 11 Bankruptcy Filing, was prompted by concerns from members who were owed money from Wellpath Holdings, Inc., the former healthcare provider for the Michigan Department of Corrections. Wellpath filed for bankruptcy in November 2024. MSMS Legal Counsel prepared an overview of the Chapter 11 bankruptcy process to assist medical practices seeking to recover outstanding balances owed from an entity that files for Chapter 11 bankruptcy protection. View the legal alert here.

FREE CONTINUING MEDICAL EDUCATION: AN INVESTMENT THAT PAYS FOR ITSELF

Physicians are faced with the constant challenge of staying updated with the latest medical research, techniques, treatment guidelines, and licensure requirements. The demands of medical practice, coupled with the need for lifelong learning, can often make it difficult for doctors to balance professional development, patient care and real life. That's where the Michigan State Medical Society (MSMS) comes in. In addition to offering strong advocacy for physicians, one of the most compelling reasons to become a member of MSMS is access to FREE Continuing Medical Education (CME) courses – just 4 hours of classes cover the full cost of your membership.

The free CME offerings are a tangible benefit that not only keeps physicians compliant with licensure requirements but also with new clinical and regulatory guidelines. By becoming an MSMS member, you are making a direct investment in your career, ensuring that you remain equipped to deliver exceptional care to your patients.

Click here to explore our comprehensive calendar of upcoming events and stay updated on all MSMS continuing medical education.

NEW PREFERRED PARTNER PROGRAM

MSMS is excited to announce the launch of the new Preferred Partner Program. It is designed to bring innovative healthcare solutions and technologies to our valued members.

This program connects you with trusted industry leaders offering cutting-edge tools, services, and resources to enhance patient care, streamline operations, and support your practice's success.

Program Highlights: • Exclusive Access: MSMS members gain access to vetted partners offering advanced health care technologies and solutions including, revenue cycle, telehealth platforms, practice management tools, business operations, workforce solutions, and more.

• Cost Savings & Increased Revenue: Get access to innovative solutions designed to reduce operating cost and increase revenue.

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As health care continues to evolve, staying ahead with access to the right tools and solutions essential. The Preferred Partner Program streamlines your search for reliable, high-quality solutions, allowing you to focus on what matters most to your patients and your organization.

For more information about the Preferred Partner Program, contact Rebecca Blake at (517) 336-5729 or rblake@msms.org.

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For more information, contact Angela Criswell, Group Insurance Agent at 517-336-7534 or at acriswell@msms.org. F

Macomb Medicus | April/May/June 2025 19

AMA NEWS

AMA: CONGRESS SHOULD LISTEN TO MEDPAC ON MEDICARE REFORM

The Medicare Payment Advisory Commission (MedPAC) voted on April 10 to urge Congress to link Medicare payment updates for physician practices to the growth in the cost of providing care—a timely recommendation as lawmakers wrestle with how to handle yet another cut in physician pay.

MedPAC joined the American Medical Association (AMA) in supporting this Medicare reform, which would ensure patients maintain access to care.

“In studying options, MedPAC saw the overwhelming evidence that a new approach was needed. We appreciate that the commission recommended an automatic, yearly update to reflect the increasing costs of running a practice.

This is the approach Medicare has long used for other health care providers, and it has a record of ensuring stability,” said AMA President Bruce A. Scott, MD. Among the evidence MedPAC weighed was that physicians are experiencing a fifth consecutive year of payment cuts while medical inflation remains high. Physicians are abandoning private practice, and patients—especially in rural and underserved areas—face obstacles to accessing care. The recommendation comes as Congress failed to stop or reverse the 2.8% cut in Medicare payments for this year despite several proposals to do so.

“It’s been said that a crisis is a terrible thing to waste. Sadly, we are in a crisis. We hope lawmakers listen to MedPAC about the need to stop doing the same thing while expecting different results. Let MedPAC be a catalyst for change,” Dr. Scott said.

“Congressional leaders have indicated that they intend to address physician payment updates this year. While previous commitments have not panned out, doctors across the country remain closely engaged on this issue.”

The MedPAC vote follows the decision to increase by 5% the payment rates for Medicare insurers. This move will generate more than $25 billion in additional revenue for the industry.

“Increasing pay to insurance companies—which are enjoying record profits—while cutting pay for physicians who are struggling to keep our practices afloat suggests a case of misaligned priorities. Physicians are the very foundation of health care.

Regardless how flush insurers are, patient access will suffer if physicians close their practices,” Dr. Scott said.

For three consecutive years, MedPAC has consistently urged Congress to increase Medicare physician payment. In its March 2025 Report to Congress, the commission recommended tying Medicare updates to the Medicare Economic Index (MEI), or 20 Macomb Medicus | April/May/June 2025

practice cost inflation for 2026. The recommended update to physician practices was for MEI minus 1 percentage point. At the meeting on April 10, MedPAC voted to recommend that Congress change the baseline increase to physician payment from 0.25% (or 0.75% if participating in an alternative payment model) under current law to a portion of MEI, such as MEI minus1 percentage point, every year for the foreseeable future.

The AMA and all of organized medicine continue to urge Congress to pass legislation instituting an annual update that fully reflects the MEI. “We appreciate that MedPAC experts recognized the status quo is bad medicine for our patients,” Dr. Scott said. “We suggest Congress listen to the experts.”

AMA RENEWS CALL FOR MIPS DEREGULATION

In a letter to the Centers for Medicare & Medicaid Services (CMS), the AMA wrote there is no better opportunity to fulfill President Trump’s Executive Order 14192, Unleashing Prosperity Through Deregulation, than by cutting the morass of complicated rules and requirements for compliance with the ineffective Merit-based Incentive Payment System (MIPS) program in the 2026 Medicare Physician Fee Schedule (MPFS) proposed rule.

Despite being implemented in 2017, MIPS has yet to demonstrate better health outcomes for Americans or lower avoidable spending. Nevertheless, the program imposes steep compliance costs on physicians. Even worse, the program disproportionately hurts small and rural practices, which are small businesses, by cutting their Medicare reimbursement up to –9% despite being “approximately as effective as chance in terms of identifying high versus low quality performance,” according to a JAMA study. The AMA provided detailed recommendations to reduce the regulatory burden of MIPS, including: • Awarding multi-category credit and ensuring MIPS Value Pathways are clinically relevant so patients can compare quality and cost across physician practices • Reducing unnecessary quality measure reporting burden and eliminating arbitrary scoring rules that drive up the cost of compliance with MIPS and dis-incentivize reporting on new and substantially revised measures • Fixing the long-standing inaccuracies with the MIPS cost measures and nullifying their negative impact on Medicare physician payment and patient access to care until these issues can be properly addressed • Sharing timely, critical MIPS performance data and Medicare claims data with physicians to facilitate better quality and lower costs • Maximizing usage of electronic health records and other emerging technologies while minimizing wasteful “check the box” reporting exercises continued on page 21

continued from page 20

AMA NEWS

LEGISLATION INTRODUCED TO REFORM HOW PRIOR AUTHORIZATION REQUESTS ARE EVALUATED

On March 27, Representatives Mark Green, MD (R-TN) and Kim Schrier, MD (D-WA), reintroduced H.R. 2433, the Reducing Medically Unnecessary Delays in Care Act of 2025. This bipartisan legislation seeks to reform prior authorization requirements in Medicare, Medicare Advantage, and Part D prescription drug plans by ensuring that only specialty board-certified physicians review treatment decisions.

A 2024 AMA survey revealed that 94% of physicians believe prior authorization requirements negatively impact patient care, while 23% reported that these requirements have directly led to patient hospitalizations.

“The overuse of prior authorization is a persistent obstacle that prevents patients from receiving quality care from their physicians. Often, prior authorization requests are reviewed – and denied – by insurance company representatives who lack the medical expertise to appropriately judge what level of care is necessary for a patient. This welcome legislation would require the reviewers to be physicians with actual experience in the field of medicine they are passing judgment over. Our patients deserve no less,” said AMA President Bruce A. Scott, MD. AMA appreciates the leadership of both Congressman Green, a former Army emergency room physician, and Congresswoman Schrier, a pediatrician, who bring firsthand experience to this issue. H.R. 2433 has already garnered bipartisan support, including backing from the GOP Doctors Caucus and 10 cosponsors.

services non-functional. A data breach experienced by an individual provider poses nearly zero risk of industry disruption; however, the sheer size and volume of data loss by industry giants—such as national health plans and clearinghouses—can lead to crucial disruptions that endanger patients. The Security Rule’s structure should take into account the potential attack surface of a regulated entity, and the possible impact of a breach on industry disruption.

In addition, the AMA asks OCR to retain the current built-in flexibilities for regulated entities based on an organization’s specific situation and risk assessment. The AMA urges OCR to reinstate addressable implementation specifications to provide regulated entities, particularly small- to medium-sized physician practices, with the flexibilities that they need to develop an appropriate cybersecurity posture that suits their practice environment and the resources that are available.

The AMA has long supported positive financial incentives for physician practices to adopt cybersecurity best practices and help secure bidirectional information sharing. Overall, comments underscored how practices need resources to implement cybersecurity best practices that are affordable, attainable, and approachable for physicians without extensive health IT knowledge, experience, or budgets. F

CME Requirements for Licensure

AMA SUBMITS PUBLIC COMMENTS ON HIPAA SECURITY PROPOSED REGULATION

The AMA offered comments on the Department of Health and Human Services Office for Civil Rights (OCR) Health Insurance Portability and Accountability Act (HIPAA) Security Proposed Rule emphasizing that cybersecurity is a national priority for physicians and a patient safety issue.

Physician practices prioritize cybersecurity to better serve their patients, and physicians want to take appropriate actions to secure patient data and do their part to ensure that their information technology systems are delivering proper protections.

The AMA recommended that the Proposed Rule needs significant revisions and cannot move forward in its current iteration and must be reworked to recognize the significant role that physician practices occupy in care delivery and the extraordinary burden that practices would incur from the stringent requirements in the Proposed Rule. Absent major revisions, the AMA advised that these proposals must be withdrawn.

The letter also recommends that OCR focus the Security Rule’s proposed standards on the regulation of larger health care entities that pose the greatest threat to industry disruption if their cybersecurity defenses are breached, rendering their

Every three years physicians are required to complete the following continuing education for license renewal.

150 hr. Continuing Medical Education 75 hr. of which must be Category 1 CME credits for MDs 60 hr. of which must be Category 1 CME credits for DOs

3 hr. Pain & Symptom Management with 1 hr. Controlled Substance Prescribing

1 hr. Medical Ethics 3 hr. Implicit Bias Additional Requirements One time – training for Identifying Human Trafficking Victims One time – training for Opioids & Controlled Substances Awareness for Prescribers One time – the Medication Access and Training Expansion (MATE) Act, requires DEA registered prescribers to have 8 hrs. training in opioid use disorders Macomb Medicus | April/May/June 2025 21

ADVOCACY IN ACTION

Exercise Your Voice!

Physician engagement is essential to the success of a pro-medicine legislature. Join us in fighting for legislation that helps physicians practice medicine without interference from over regulation and protects patients with decisions made by doctors not politicians.

Lawmakers want and need to hear from professionals in the field of medicine!

Current Legislation: House Bills 4037

Records: health; health information exchange; establish certain requirements to operate a health data utility

support

Referred to Cmte on Health Policy | Hearing held, vote expected

4038

Insurance: other; allocation of revenue under the insurance provider assessment act; modify

support

Referred to Cmte on Health Policy | Hearing held, vote expected

4077

Health: medical examiners; process for medical certification of a death record; modify

support

Referred to Cmte on Health Policy | Unanimously approved by committee

4078

Health: medical examiners; requirements for an investigation of the cause and manner of death

support

Referred to Cmte on Health Policy | Unanimously approved by committee

4277

Health: licensing; questions pertaining to mental health; remove from application for licensure and registration.

support

4307

Health occupations: physicians; voluntary reporting to secretary of state patients with certain conditions that affect ability to operate a motor vehicle; modify

monitor

Referred to Cmte on Health Policy

support

Referred to Cmte on Finance, Insurance & Consumer Protection

Referred to Cmte on Health Policy

Senate Bills 3

Health: pharmaceuticals; prescription drug cost and affordability review act; create

4

Insurance: health insurers; compliance with the prescription drug cost and affordability review act; require

support

Referred to Cmte on Finance, Insurance & Consumer Protection

5

Human services: medical services; compliance with the prescription drug cost and affordability review act; require

support

Referred to Cmte on Finance, Insurance & Consumer Protection

94

Health: pharmaceuticals; drug manufacturers from engaging in certain conduct with pharmacies participating with a 340B program; prohibit. TIE BAR WITH: SB 0095'25

monitor

Referred to Oversight | Passed by Cmte | Approved by full Senate | Awaiting House Action

95

Health facilities: hospitals; collection of debts; prohibit if hospital is not in compliance with price transparency laws. Creates new act. TIE BAR WITH: SB 0094'25

monitor

Referred to Oversight | Passed by Cmte | Approved by full Senate | Awaiting House Action

107

Insurance: health insurers; coverage for immunization agents and certain laboratory tests administered and ordered by a pharmacist; require

monitor

154

Crimes: other; preventing access to a health care facility; prohibit

monitor

Referred to Health Policy | Approved by Cmte

Referred to Cmte on Civil Rights, Judiciary & Public Safety

SHARE YOUR NEWSWORTHY ITEMS! Have you or a MCMS colleague been elected to a position (specialty society, hospital, community based program, etc.) or honored for your volunteer service within the community or abroad?

Let us know. We would like to recognize MCMS members in the“Member News” section of the Medicus.

Contact Heidi Leach at HLeach@macombcms.org with newsworthy information.

Publication is subject to availability of space and the discretion of the Editor.

22 Macomb Medicus | April/May/June 2025

MICHIGAN SENATE

Sen. Stephanie Chang (D) Senate District 3 SenSChang@senate.michigan.gov (517) 373-7346 Sen. Kevin Hertel (D) Senate District 12 SenKHertel@senate.michigan.gov (517) 373-7315 Sen. Ruth Johnson (R) Senate District 24 SenRJohnson@senate.michigan.gov (517) 373-1636 Sen. Veronica Klinefelt (D) Senate District 11 SenVKlinefelt@senate.michigan.gov (517) 373-7670 Sen. Daniel Lauwers (R) Senate District 25 SenDLauwers@senate.michigan.gov (517) 373-7708 Sen. Michael Webber (R) Senate District 9 SenMWebber@senate.michigan.gov (517) 373-0994 Sen. Paul Wojno (D) Senate District 10 SenPWojno@senate.michigan.gov (517) 373-8360

COMMITTEES House – Appropriations Kimberly Edwards (D), District 12 Thomas Kuhn (R), District 57 Donavan McKinney (D), District 14 House – Appropriations Subcommittee LARA, Insurance & Financial Services Donavan McKinney (D), District 14 – Vice Chair

2025 Macomb County Legislator Contact Guide

MICHIGAN HOUSE Rep. Joseph Aragona (R) House District 60 JosephAragona@house.mi.gov (517) 373-1785 Rep. Jay DeBoyer (R) House District 63 JayDeBoyer@house.mi.gov (517) 373-1787 Rep. Kimberly Edwards (D) House District 12 KimberlyEdwards@house.mi.gov (517) 373-0852

Rep. Jaime Greene (R) House District 65 JaimeGreene@house.mi.gov (517) 373-1775 Rep. Thomas Kuhn (R) House District 57 TomKuhn@house.mi.gov (517) 373-1706 Rep. Mike McFall (D) House District 14 MikeMcFall@house.mi.gov (517) 373-0140

House – Appropriations Subcommittee Public Health Tom Kuhn (R), District 57 - Vice Chair

House – Health Policy Alicia St. Germaine (R), District 62

House – Appropriations Subcommittee Medcaid & Behavioral Health Tom Kuhn (R), District 57 House – Families & Veterans Doug Wozniak (R), District 59 Mai Xiong, (D), District 13

House – Insurance Joseph Aragona (R), District 60 Senate – Appropriations Kevin Hertel (D), District 12 Veronica Klinefelt (D), District 11

Rep. Donavan McKinney (D) House District 11 DonavanMcKinney@house.mi.gov (517) 373-0849 Rep. Denise Mentzer (D) House District 61 DeniseMentzer@house.mi.gov (517) 373-1774 Rep. Ron Robinson (R) House District 58 RonRobinson@house.mi.gov (517) 373-1794 Rep. Josh Schriver (R) House District 66 JoshSchriver@house.mi.gov (517) 373-0839 Rep. Alicia St. Germaine (R) House District 62 AliciaStGermaine@house.mi.gov (517) 373-0555 Rep. Douglas Wozniak (R) House District 59 DouglasWozniak@house.mi.gov (517) 373-0832 Rep. Mai Xiong (D) House District 13 MaiXiong@house.mi.gov (517) 373-0845 Senate – Health Policy Kevin Hertel (D), District 12 Veronica Klinefelt (D), District 11 Michael Webber (R), District 9 Paul Wojno (D), District 10 Senate – Regulatory Affairs Kevin Hertel (D), District 12 Dan Lauwers (R), District 25 Michael Webber (R), District 9 Paul Wojno (D), District 10

Macomb Medicus Journal of the Macomb County Medical Society The Macomb Medicus is the official quarterly journal of the Macomb County Medical Society. It is a full-color glossy magazine published both electronically and in hard copy format. It is a valued news source for our 600 plus physician members of all specialties and their staff throughout Macomb County. In addition to members the Macomb Medicus is sent to hospital executives, Michigan State Medical Society staff, other county medical society staff, and healthcare related businesses/organizations in Macomb County.

The Macomb Medicus is read by an impressive cross section of the healthcare community and is electronically available on our website at www.macombcms.org.

FREE Hotlink to Your Website & Free Advertising Design!

For advertising rates and information, please contact: Heidi Leach, Executive Director & Managing Editor Macomb County Medical Society, PO Box 551, 810-712-2546 HLeach@macombcms.org | www.macombcms.org Publication Dates: 1st Quarter / Winter Feb. 1 | 2nd Quarter / Spring May 1 | 3rd Quarter / Summer Aug. 1 | 4th Quarter / Fall Nov. 1

Macomb Medicus | April/May/June 2025 23

PRESORTED STANDARD U.S. POSTAGE PAID LANSING, MI PERMIT NO. 689

Macomb County Medical Society P.O. Box 551 Lexington, Michigan 48450-0551

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