Pierce County Medical Society Fall Bulletin

Fall 2021 PIERCE COUNTY MEDICAL SOCIETY

BULLET N Serving Our Members and Community Since 1888

Inside this Edition

• President’s Message • Executive Director Report

• TPCHD Update • 2021 PCMSF Grantees

Visit us at www.pcmswa.org

Table of Contents

PIERCE COUNTY MEDICAL SOCIETY

BULLET N Serving Our Members and Community Since 1888

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Passing of the Gavel

5

Patience is a Virtue

7 DOH finalizes PMP-EHR hardship waiver rulemaking 9

TPCHD: Rx Vax is your prescription for COVID-19 conversations

11

Federal balance billing law takes surprise turn to favor insurers

15 Congratulations to the 2021 PCMS Foundation grantees

PCMS Officers/Trustees

Dina C. Titova, MD, PhD, President C. Blake Perry, MD, President-Elect Ann Goetcheus Gehl, MD, Past President Julian S. Arroyo, MD, Vice President Courtney M. Kennel, DO, Secretary/Tresurer Neil Batta, MD H. Matt Davis, MD Christine L. Hammer, MD Nicholas Rajacich, MD Camille P. Samujh, DO, MPH

PCMS Foundation

Charles Weatherby, MD, President Lawrence A. Larson, DO, Vice President Mark S. Grubb, MD Mary Eversole, Secretary

Staff

Executive Director: Mary Eversole Membership Coordinator: Tanya McClain

The Bulletin

is published quarterly by PCMS. Contact Tanya McClain regarding deadlines for submitting articles and advertisements: tanya@pcmswa.org or 253-572-3667.

The Bulletin

is dedicated to the art, science and delivery of medicine and the betterment of the health and medical welfare of the community. The opinions herein are those of the individual contributors and do not necessarily reflect the official position of PCMS. Acceptance of advertising in no way constitutes professional approval or endorsement of products or services advertised. The Bulletin reserves the right to reject any advertising.

Managing Editor: Mary Eversole Advertising Information: 253-572-3667; tanya@pcmswa.org

1019 Regents Blvd Ste 202, Fircrest WA 98466 Phone (253) 572-3667 Fax (253) 572-2470 Email pcms@pcmswa.org

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PIERCE COUNTY MEDICAL SOCIETY

President’s Page

Passing of the Gavel Ann Goetcheus Gehl, MD

As my year as president comes to an end, I am optimistic about the future of Pierce County Medical Society and proud to be the first female president in almost twenty years. With our Executive Director, we plunged into complex real-estate transactions with the divesting of the PCMS building. We are on the brink of shoring up the future for our members and the organization. This achievement would not have been possible without my peers on the Board of Trustees. While there is more strategic work to do, we are on our way to PCMS 2.0.

At the board table, the impact of COVID-19 is a frequent topic of conversation. When I was installed as PCMS President, Phase 1A of the vaccine rollout was moving to Phase 1B. Currently, everyone five years and older is eligible to receive this life-saving vaccine and as a mother of two young girls, I am excited about the prospect that they may be able to receive their first COVID-19 vaccine!

Even though vaccine rates are climbing, we are still far from our goal. In response, we have partnered with the Tacoma-Pierce County Health Department to create Rx Vax, which provides tools and resources to inspire your patients to get the COVID-19 vaccine and increase our vaccination rate.

It is a valuable asset for all providers, whether you’re a surgeon, anesthesiologist, rheumatologist, dermatologist, or a family medicine doctor. A recommendation from one’s healthcare provider is among the top reasons people give for choosing to get vaccinated.

I am ecstatic to pass the virtual gavel to president-elect, Dr. Dina Titova of MultiCare Rheumatology Specialists. She will be the fifth female president in PCMS history and will lead the organization to new heights.

As a result of my term as president, may others that are underrepresented in medicine also feel inspired to take on leadership roles. My fervent hope is that PCMS will continue to successfully advocate on behalf of our medical community. It has been my honor to serve as your president and I thank you for the opportunity.

FALL 2021

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In Memoria m

PIERCE COUNTY MEDICAL SOCIETY

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PIERCE COUNTY MEDICAL SOCIETY

Executive Director Report

Patience is a Virtue Mary Eversole

A former colleague told me once I had “the patience of Job.” We were collaborating on a project to raise awareness for the plight of child soldiers in Uganda. I was reliant on his team to complete my tasks and it seemed I would never receive what I needed for good reason. I would check in, nudge, email but all I could do was wait. I had no control of the situation. Patience got me through and a wonderful campaign advocating for children in need was launched.

Today, where we prize instant everything, the concept of waiting seems illogical. But I think we have all learned to be more patient and adapt to living through a global pandemic. Wait for businesses to reopen, wait for schools to resume, wait for elective surgical procedures to return and good luck ordering an appliance.

At PCMS we’ve had to learn to wait and be patient too. Admittedly, our recent real estate transaction tested my patience.

Forget Job. I would say that practicing patience teaches many lessons. Most importantly it allows us to make better decisions. It has been said that patience radically increases your capacity for success. I like those odds.

Leading an organization during a public health emergency teaches patience as well. And proves that it allows us to make better decisions. Like everything else, there has been a lot of waiting in determining if we would be able to hold an in-person event during the holidays. I waited patiently until October to decide if PCMS would convene as a community for the Annual Meeting and holiday gathering.

Unfortunately, the decision was no, and we all know why... An outside event in December isn’t an option due to this phenomenon called rain. While disappointed, the good news is we will come together in May to formally install the Board of Trustees, celebrate Community Service Award winners and raise money for the PCMS Foundation in a new way. In between, we have plans to get together as a community earlier in the Spring.

Remember, as the Greek playwright Plautus said, patience is the best remedy for every trouble.

Bulletin Submissions If you have a clinical best practice to share with your colleagues, a success story about individual physicians or PAs or a health system, or news about health care innovation taking place in Pierce County that you would like considered for inclusion in an upcoming edition of the PCMS Bulletin, please send your submission to Mary Eversole at mary@pcmswa.org.

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Wish you could consult with a psychiatrist on psychiatric or addiction issues when you need to?

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877-WA.PSYCH (877-927-7924)

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Call 877-WA-PSYCH (877-927-7924)

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of callers said they would recommend PCL to their colleagues

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Providers with patients under 18 will be directed to the Partnership Access Line (PAL); providers caring for pregnant or new moms will be directed to the PAL for Moms line. The UW Psychiatry Consultation Line is funded by the State of Washington.

PIERCE COUNTY MEDICAL SOCIETY

DOH finalizes PMP-EHR hardship waiver rulemaking

Senate Bill 5380 requires PMP integration for some practices by Jan. 1, 2022 Senate Bill 5380, a measure aimed at addressing the opioid epidemic, was signed into law during the 2019 legislative session.

Starting next year, a prescription monitoring program-electronic health record integration mandate for practices with 10 or more prescribers will go into effect. Originally scheduled to take effect this past January, the WSMA successfully advocated for a delay to Jan. 1, 2022 to prevent the associated administrative requirements from burdening organizations already strained by the pandemic.

The WSMA secured a hardship waiver in the legislation for practices that are not able to comply with the mandate due to certain circumstances, including: • • • •

Economic hardship Technological limitations outside the control of the practice Other exceptional circumstances Unforeseen circumstances, such as widespread health care emergencies

The Washington State Department of Health recently finalized rulemaking around that process. The WSMA is waiting on a response from the DOH regarding when and how practices may submit hardship waivers, and will keep members apprised of developments.

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Visit tpchd.org/ rxvax

The tools and support you need to inspire patients to get COVID-19 vaccine.

Your patients trust you. Be ready to help them.

Visit tpchd.org/rxvax, a partnership of Tacoma-Pierce County Health Department and Pierce County Medical Society.

You’ll find data-driven graphics, easy-to-read handouts, answers to frequently asked questions, video resources and more.

A recommendation from their healthcare provider is one of the top reasons people give for choosing to get vaccinated.

Thank you for helping to protect the health of the people and places of Pierce County!

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tpchd.org/rxvax PIERCE COUNTY MEDICAL SOCIETY

Patients trust you.

You rely on us.

Rx Vax is your prescription for COVID-19 vaccine conversations Patients trust you to meet their health needs. They come to you for accurate information. They see you as a valuable source to learn more about COVID-19 vaccines.

Many providers, specialists, and doctors rely on Tacoma-Pierce County Health Department for specific information to answer their patients’ questions and concerns about getting vaccinated.

We want you to be ready to tackle tough conversations about COVID-19 vaccine with your patients.

Pierce County Medical Society has partnered with the Health Department to meet this need.

Rx Vax—online tools to help you talk with your patients about COVID-19 vaccine.

Rx Vax is a webpage built specifically for healthcare providers. With printable, easy-to-read, data-driven graphics, frequently asked questions and answers, and links to updated data—it will spark conversations and prepare you to answer patients’ questions about COVID-19 vaccine and encourage more people to get the COVID shot.

Rx Vax also goes beyond the doctor’s office to help you find ways to reach out to your community. Videos and links to resources connect you with local community organizations and businesses so you can speak about COVID-19 vaccine safety and effectiveness.

We receive feedback for Rx Vax from providers and will continue to update the site to reflect your needs and priorities. We want you to have easy-to-use resources to respond to the emerging questions and concerns your patients may have about COVID-19 vaccine.

Healthy Campus 253 RX Vax is just one strategy we are using to encourage more people to get vaccinated.

We have also partnered with Pierce County colleges and universities to give students and staff tools they need to stay healthy. Our Healthy Campus 253 campaign will be a one-stop shop. College and university students can get data about why COVID-19 is important to them, like young adult case rates and costs of a hospital stay.

The Health Status of Pierce County

Anthony Chen, MD, MPH Infographics, social media graphics, and testimonials from student trusted messengers will give students an easy way to spread accurate information with their friends. College and university students will join the ranks of our trusted messengers to help spread the facts about COVID-19 and encourage others to get the shot.

The website will help general college health, too. We will have reminders about the flu vaccine and other health tips.

Supporting businesses to get more people vaccinated We partner with businesses and other organizations to get more people vaccinated, because it’s good for health, it’s good for business, it’s good for our school children, and it’s good for our community.

The Health Department developed a toolkit for businesses to help.

We focus on working with businesses to help normalize COVID-19 vaccines.

We have met weekly for the past few months with a group of business leaders from around the county, including members of the economic development board, chamber of commerce and hospitality association, to find collaborative, innovative solutions to work together to limit the spread of COVID-19.

Those discussions include how we can support businesses that want to voluntarily require some form of vaccination among customers or employees.

We are developing an outreach team and toolkit to help businesses navigate the federal vaccine mandate for those with 100 or more employees. We are focused on helping businesses prepare for all possibilities and supporting their effort to get more people vaccinated.

You are a critical partner as we continue the work to limit the spread of COVID-19.

You are essential in the effort to keep people healthy, children in school, and our businesses open and healthy.

Please visit tpchd.org/rxvax, and if you have suggestions for improvements, please contact Elizabeth Wang at ewang@tpchd.org.

FALL 2021

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NEEDS YOU!

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Vascular Surgeon | Anesthesiology Otorhinolaryngology | Primary Care | CRheumatology P I E R C E CPlastic O U N T Y MSurgery EDICAL SO IETY

PCPA proudly maintains a 1% patient no show rate!

Federal balance billing law takes surprise turn to favor insurers

Late last year Congress passed the No Surprises Act, which bans balance billing at the federal level effective Jan. 1, 2022.

The law applies to emergency care and out-of-network physicians and other practitioners treating patients at in-network facilities, generally prohibiting them from billing patients directly for care provided. Federal agencies have been working on rulemakings to implement the law, which took a turn recently when the latest set of rules dramatically favored insurance carriers, potentially skewing the impact of the law on physicians and shifting even more leverage and profits to insurers.

As passed by Congress, the federal balance billing law largely tracks with Washington state’s Balance Billing Protection Act, which went into effect in 2020. In the event care is delivered by an out-of-network physician (or other practitioner) subject to the law, insurance carriers are directed to pay the physician, which the physician can contest through arbitration if the payment is insufficient. The difference between the two laws is that the federal law defers to carriers to set the initial payment rate based on their internal methodologies, and last week’s rule instructs arbitrators to assume the insurer’s payment is appropriate, stacking the deck against any physician who questions payment through arbitration.

The American Medical Association and national physician specialties were quick to criticize the rule, noting in a statement from AMA President Gerald Harmon, MD, that the rule “disregards the insurance industry’s role in creating the problem of surprise billing at the expense of independent physician practices whose ability to negotiate provider network contracts continues to erode.”

The Washington State Office of the Insurance Commissioner has indicated that it will be pursuing legislation in the 2022 session that begins in January to align elements of the state and federal laws, such as the services that are covered under state law and the calculation of patient cost-sharing. The WSMA was one of the principal negotiators of the state balance billing law—which is generally seen as one of the more physician-friendly balance billing laws across states—and will be working to ensure the negative elements of the federal law are not mirrored in state statute.

WSMA Outreach & Advocacy Report

FALL 2021

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PIERCE COUNTY MEDICAL SOCIETY

Benefiting Pierce County Non-Profits Help Up Raise $70,000 for Pierce County Non-Profits

The needs of Pierce County Non-Profits remains high to serve those in need.

Your tax-deductible donation of $500, $350, or $100 will make a difference!

watch your mail box for information on how to participate in this year's Holiday Sharing Card Campaign!

www.pcmswa.org/pcms-foundation promoting good health for all citizens of Pierce County

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New Member Section

New BOT Appointee!

Neil Batta, md INTERVENTIONAL PAIN MANAGEMENT

Introducing Dr. Neil Batta.

education

As a pain physician, Neil R. Batta, MD provides a comprehensive approach to non-operative pain management.

Dr. Batta’s wide array of skills range from medication management, fluoroscopic (x-ray) and ultrasound-guided procedures, peripheral nerve blocks, joint injections, nerve conduction studies/electromyography, Botox injections for migraines or muscle pain, and neuromodulation.

He has a particular interest in integrating functional recovery along with improvement in pain for his patients by addressing appropriate lifestyle changes and providing insight on exercise or daily routine. He plans to provide the most up to date treatment for his patients through a multidisciplinary practice.

Undergraduate Saint Bonaventure University Medical School The George Washington University School of Medicine and Health Sciences Residency Physical Medicine & Rehabilitation at the Hospital of the University of Pennsylvania

Dr. Batta completed his residency in Physical Medicine & Rehabilitation at the Hospital of the University of Pennsylvania, while also serving as Chief Resident. After completing residency, he continued his training through the Anesthesia department at the University of Pennsylvania with a Pain Medicine fellowship.

Pain Medicine Fellowship Anesthesia – Pain Medicine Hospital of the University of Pennsylvania

neospine.com

GIG HARBOR | SILVERDALE

FALL 2021

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2022 EVENTS

ST. PADDY'S SOCIAL March 17, 2022 | 5:30 pm to 7:30 pm* Time subject to change

PCMS ANNUAL MEETING May 11, 2022 | Pt. Ruston Silver Cloud RESIDENTS' ANNUAL SOCIAL August 18, 2022 Check pcmswa.org for updates or call 253.572.3667 for more info

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PIERCE COUNTY MEDICAL SOCIETY

In Memoriam

Colonel (Ret.) Elmer Michael (Mike) Casey, Jr, MD 1943 - 2021

Colonel (Ret.) Elmer Michael (Mike) Casey Jr MD, age 77, died on Wednesday, June 2 at Madigan Army Hospital as a result of complications due to COVID-19.

Beloved husband of 45 years to Linda E. Casey, devoted brother of Laurette Alkidas of Rochester Hills, MI, James Casey of Tacoma, WA and David Casey of Costa Rica; fond uncle of Laura, Alex, Marisa, Lianne, Kristy, Marina, Michael and David Lee. Reprinted from The News Tribune, Jun 11, 2021

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Select benefits: Physician referrals Professional & collegial activities Quarterly bulletin Resource for practice information Seasonal member perks 20% off first year full active membership special rate for US military, USPHS & VA residents | first year practice join free

Pierce County Medical Society has been supporting Pierce County physicians and patients over 130 years.

PCMS represents the interests of local physicians and physician assistants from all specialties and practice types at all stages of their careers.

www.pcmswa.org