HOUSTON
35 Years of Impact: How Komen is Helping Save Lives in Houston and Beyond
By Brandice Pierre Executive Director, Gulf Coast Susan G. Komen
Althoughwe have seen significant advances in breast cancer care over the past several decades, which have led to a 44% decline in the breast cancer mortality rate in the U.S. since 1989 – too many lives are still lost, and too many families still face this devastating disease. Susan G. Komen continues to work to end this disease for good. This year, Komen is celebrating its 35th year in the Houston market, and within those 35 years, the organization has continued to raise funds and advocate for the breast cancer community.
Komen has invested nearly $1.1 billion in research to date, leading to new ways to prevent, detect, diagnose and treat breast cancer. In celebration of 35 years of Komen in Houston, here are a few of Komen’s offerings that fuel breakthroughs for those impacted by breast cancer and save lives in the Texas area and beyond.
Advocacy
Government action is critical for making broad, systemic and lasting changes that will end deaths from breast cancer forever. Susan G. Komen’s Center for Public Policy focuses our efforts on three key policy areas: accelerating research, ensuring access and alleviating patient burden. Komen is advocating for policies that ensure health care is accessible and affordable for all, so that the most vulnerable populations receive the lifesaving care they need.
Patient Care
services and resources, emotional support and more. Through an email to helpline@komen.org or phone call to Komen’s Breast Care Helpline at 1-877 GO KOMEN, people can free personalized support from a culturally responsive patient navigator. Komen’s PCC helps people overcome many of
from screening to support including Questions to Ask Your Doctor, online educational programs, such as Know More, Breast Cancer Breakthroughs, the Metastatic Breast Cancer Impact Series, as well as in-person events, including the Worship in Pink Program.
...within those 35 years, the organization has continued to raise funds and advocate for the breast cancer community
the barriers to care they encounter through direct support and assistance.
Education
The Komen Patient Care Center (PCC) is a trusted, go-to source for timely, accurate breast health and breast cancer information, access to
Delayed screenings and diagnoses lead to more advanced cases and higher mortality rates; We want everyone to work with their health care providers to discuss their risk and personalize a screening plan that is right for them. To find out more, Komen has many educational resources on komen. org that include topics that span the breast cancer continuum of care
Research By funding innovative research projects, convening with experts and patients to tackle big issues, and conducting internal studies, Komen is making significant advances in breast cancer research. In 2024, Komen awarded nearly $10.05 million in research grants to improve the lives of patients through better treatments for advanced and metastatic disease.
Health Equity
Achieving breast health equity is a complex challenge requiring time, research, investment, diverse voices and active listening. In response to the findings of Closing the Breast Cancer Gap: A Roadmap to Save the
Herman Receives Grant
Legal Matters
Virtual Oversight, Real Impacts: “Incident-To” and Beyond
By Sean A. Timmons, J.D.
Joelle M. Wilson, J.D. Polsinelli, PC
In the recently released Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule, the Centers for Medicare and Medicaid Services (CMS) signal a significant shift toward modernizing Medicare’s supervision requirements for “incident to” services. Specifically, CMS proposes to make permanent the ability to meet the direct supervision requirement
through real-time, two-way audiovisual technology (excluding audio-only), a flexibility broadly introduced during the COVID-19 Public Health Emergency (PHE).
What is Direct Supervision?
Under CMS’s established framework, Part B services may be subject to one of three supervision levels: general supervision, direct supervision or personal supervision. Direct supervision has historically required that the physician (or other supervising practitioner) be present in the office suite and “immediately available” to furnish assistance and direction throughout the performance of the service. CMS has historically considered “immediate availability” to mean in-person, physical, not virtual, availability. One of the more common billing scenarios requiring direct supervision is when services are provided “incident to” a physician’s (or
non-physician practitioner’s (NPP’s)) professional services in a physician office or clinic.
PHE Era Flexibilities (Temporary, Through December 31, 2025)
As a result of the PHE, CMS temporarily amended the definition of “direct supervision” to state that the necessary presence of the physician (or other practitioner) for direct supervision includes virtual presence through real-time, interactive audio-video technology. Instead of requiring the supervising physician’s or NPP’s physical presence, the temporary amendment permitted a supervising physician or NPP to be considered ‘‘immediately available’’ through virtual presence for diagnostic tests, pulmonary rehabilitation
services, cardiac and intensive cardiac rehabilitation services, certain hospital outpatient services and importantly, incident-to services. This policy has been extended multiple times and is currently set to expire on December 31, 2025.
CY 2025 Final Rule (Effective January 1, 2026)
As the end of the PHE neared, CMS recognized that an immediate reversion to the pre-PHE definition of direct supervision, which required physical presence, could create significant disruptions in care delivery, particularly for incident-to services. Stakeholder feedback highlighted how
$25 million gift to Houston Methodist establishes the Charles W. Duncan Jr. Department of Medicine
Houston Methodist has received a transformational $25 million commitment from The Duncan Fund to support the Houston Methodist Department of Medicine
In recognition of this gift, the hospital will rename the largest department in its system the Houston Methodist Charles W. Duncan Jr. Department of Medicine.
“We are deeply appreciative of the Duncan family’s support, which allows us to further programs at the intersection of personalized medicine and preventive health care to benefit our patients,” said Dr. Eleftherios Mylonakis, chair of the department and the Charles and Anne Duncan Presidential Distinguished Chair.
Mylonakis said The Duncan Fund gift represents a fundamental shift in the work of the department, which comprises 14 clinical programs,
five of which are nationally recognized by U.S. News & World Report.
“Our vision is to redefine how care is delivered in our country by creating a national model for true continuity — one that follows the patient across every transition, from home to hospital and back again,” said Mylonakis. “We are also advancing a deeper understanding of health span, shifting from reactive treatment to a proactive, lifelong strategy that maximizes not just how long we live but how well we live.”
Specific clinical and research areas the philanthropic commitment will target include: streamlined coordination of complex, multi-disciplinary care
Welcome to your retreat in Houston.
by hospitalist physicians; programs that leverage data and artificial intelligence to tailor treatments and preventive strategies as well as reduce readmission rates; and the addition of five endowed fellowships, including a new MedTech Innovator fellowship to empower students to play a crucial role in research and technology advances.
Longtime supporters of Houston Methodist, the Duncan family has also served in key leadership roles at the institution. The late Charles W. Duncan Jr., an entrepreneur and statesman, was a lifetime member of the hospital board, and his son, Charles W. “Carlos” Duncan III, currently serves on the Houston Methodist Hospital Foundation Board. The family’s most recent gift expands their multigenerational support of the Department of Medicine and the hospital’s ongoing efforts in translational research, training and education.
“Houston Methodist’s commitment to its patients, research and future physician leaders is admirable. We’ve seen this firsthand both as patients and as our family has supported the
see Duncan ...page 13
Eleftherios Mylonakis, MD, PhD, FIDSA
Oncology Research
The Fight Against Prostate Cancer: How Texas Men and Their Families Can Win in 2025
By Steven Sukin, M.D. Texas Urology Specialists and Texas Oncology
September 2025
This September, as we observe Prostate Cancer Awareness Month, Texas faces a sobering reality: approximately 18,000 men in our state will be diagnosed with prostate cancer this year, and 2,400 will lose their lives to this disease. But here’s what every Texas family needs to know—early detection and the right support team can change everything.
The Texas Challenge Prostate cancer remains the second-leading cause of cancer death among American men, with national projections showing 313,780 new cases
and 35,770 deaths in 2025. In Texas, these numbers translate to real families facing difficult decisions, often without the knowledge they need to navigate this journey successfully.
The disease is particularly insidious because six in ten cases occur in men over 65, and symptoms often don’t appear until cancer has progressed. This “silent progression” is why proactive screening and caregiver education are literally matters of life and death.
Early
Detection: Your First Line of Defense
The good news? When caught early, prostate cancer has a 98% five-year survival rate. The PSA blood test, combined with advanced imaging and genetic testing when appropriate, remains our most powerful early detection tool. For high-risk men and those with family histories, earlier and more frequent screening can be lifesaving.
Revolutionary Treatments Changing
the Game
2025 has brought unprecedented advances in prostate cancer treatment:
• Niraparib + Abiraterone + Prednisone: Phase 3 trial data show a remarkable 37% reduction in disease progression or death for metastatic cases
• Theranostics and Radioligand Therapy: Precision treatments that target cancer cells while protecting healthy tissue
enhanced precision
• AI-Powered Diagnostics: The ArteraAI Prostate Test analyzes biopsy images to predict treatment response, preventing unnecessary interventions
• PARP Inhibitors: Offering new hope for patients with BRCA mutations
• Tulsa Pro (Focal Therapy): Targeted treatment for localized disease that preserves healthy tissue and function
• Robotic-Assisted Laparoscopic Prostatectomy: Minimally invasive surgical approach with
• Advanced Radiation Therapy: Comprehensive radiation options tailored to individual patient needs
• Expanded Access: Immunotherapy and targeted treatments are now more widely available across Texas Caregivers: The Unsung Heroes
Behind every prostate cancer patient is a network of caregivers— spouses, children, friends—who provide emotional support, coordinate care, and help navigate complex treatment decisions. These caregivers need tools and knowledge to advocate effectively.
The Framework
Memorial Hermann Northeast Hospital Expands Cardiac Services with New Cardiac Surgery Program
Memorial Hermann Northeast Hospital has enhanced its cardiac care services with the launch of a new cardiac surgery program, which opened earlier this month. Under the leadership of Dr. Viacheslav Bobovnikov, MD, a cardiothoracic and vascular surgeon and assistant professor at UTHealth Houston, the surgical team performed its first case on Aug. 5.
This $13 million expansion, which includes a new operating room and cardiovascular intensive care unit, will enable the hospital to offer higher levels of complex care to cardiac patients in the surrounding community.
“With the opening of our cardiac surgery program, we are
directly investing in the health of our community for future generations to come,” said Nikki Roux, vice president and chief operations officer for Memorial Hermann Northeast. “We deeply value the trust our patients place in us, and this new program allows us to build upon the exceptional care they have come to know and rely on from
SHOULDN’T YOU BENEFIT
our teams.”
The new program offers a wide range of cardiac procedures such as coronary artery bypass graft and heart-valve surgery and will provide comprehensive cardiac services from diagnostic care to surgery to cardiac rehab.
Memorial Hermann Northeast
Hospital, a 257-bed facility, has been serving the north Houston and Kingwood communities for over 30 years. The hospital has been repeatedly recognized for excellence in patient care, most recently receiving a Platinum Performance Award from the American College of Cardiology’s NCDR Chest Pain – MI Registry.
How Healthcare Professionals Can Counter Medical Misinformation and Support Engaged Patients
By Lisa M. McCorkle, MSN, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company
In 2021, the American Health Information Management Association Foundation surveyed 1,059 U.S. residents age 18 or older in a nationally
representative sample. The survey found that Americans typically seek out health information by contacting their doctor and the internet equally. Of those who secure health information from the internet, 86 percent are confident the information is credible.
This can sometimes be a challenge
for healthcare practitioners, because health misinformation—information that is false, inaccurate, or misleading according to the best available evidence at the time—is abundant on the internet. Health misinformation is a significant obstacle in healthcare, as it can lead to misunderstandings, poor health decisions, and adverse outcomes for patients. In a recent survey of physicians by The Doctors Company, 64 percent of physicians named misinformation on social media one of the most challenging aspects of practicing medicine.
In particular, social media has profoundly influenced plastic surgery,
The Ones Who Know...
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offering a platform for surgeons to showcase their work and connect with potential patients. However, experts warn that it can also promote unrealistic expectations by emphasizing only the positive outcomes and downplaying the realities of procedures and recovery. Calling Dr. Google
Patients’ engagement in their personal health can be an advantage, with the proper guidance and support from practitioners. However, when patients consult “Dr. Google,” some websites may provide inaccurate or misleading content.
This issue of accurate versus inaccurate online medical information was highlighted during the COVID-19 pandemic. In 2021, the U.S. Surgeon General’s advisory Confronting Health Misinformation focused on this serious threat to public health and called on all of us to limit the spread.
Challenges for Practitioners
Correcting misinformation requires time and effort: Practitioners are encountering longer visit times when there is a need to discuss internet-collected health information with patients. Patients can sometimes have a strong belief in and be adamant about the assembled misinformation, which can result in increased patient anxiety.
Practitioners who dismiss or criticize the online search efforts of patients may negatively impact practitioner-patient trust. It can also be a challenge to change patient perspectives when misinformation is deeply believed, even when the practitioner is providing information from a trusted source.
Addressing Health Misinformation With Patients
Former American Medical Association (AMA) president Gerald E. Harmon, MD, noted in a 2022 press release regarding a new AMA policy addressing public health disinformation that “physicians have an ethical and professional responsibility to share truthful information, correct misleading and inaccurate information, and direct people to reliable sources of health information.”
It’s often said that trust is the medical currency of healthcare, and in partnering with patients to help them understand medicine, practitioners are making deposits. Ruth Carrico, PhD, DNP, APRN, explained to the American Association of Nurse Practitioners (AANP) her view that overcoming medical misinformation is a journey on which to partner with the patient, first
Healthy Heart
Houston Healthcare CEO Takes the Helm to Save Lives
Lisa Wright Mobilizes Houston’s Corporate Leaders to Build Community of Lifesavers as Chair of American Heart Association Heart Walk
By Dion Bart American Heart Association
Lisa Wright, President and CEO of Community Health Choice, will lead the charge as the 2025 American Heart Association Heart Walk Chair to build a community of lifesavers in Houston. Under Lisa Wright’s leadership, top executives throughout the Greater Houston Area are uniting to recruit companies and organizations to join the Heart Walk, a year-round campaign aimed at raising funds to fight cardiovascular disease while equipping people with education, knowledge and resources to act in the face of a cardiac emergency by learning CPR.
The American Heart Association, which has been saving lives for more than 100 years, has put a spotlight on
CPR education as a critical element of the Heart Walk campaign. According to the Association, nine out of ten people who suffer cardiac arrest outside of a hospital die , however immediate CPR can double or even triple the chances of survival . Through this initiative, Wright and a team of top executive leaders are ensuring that more Houstonians are prepared to respond effectively in life-or-death situations.
“The Heart Walk gives residents and employees an extraordinary opportunity to address a critical issue in our community,” said Tracie Morden, Vice President of the American Heart Association in Houston. “Cardiac arrest can strike anyone, anywhere, and the difference between life and death often hinges on the quick actions of a bystander. Through the Heart Walk, we are not just raising funds; we are raising
awareness, enhancing CPR training, and building a network of lifesavers. With Lisa Wright at the helm, we are confident this year’s campaign will have an even greater impact in saving lives.”
This year, companies participating in the Heart Walk will play a crucial role in the American Heart Association’s Nation of Lifesavers™ initiative, a national effort aimed at doubling cardiac arrest survival rates by 2030.
“When I realized nearly 5,000 of our members are living with
heart disease—including 2,000 with congestive heart failure and 3,000 with coronary artery disease—I knew this wasn’t just a statistic. It’s a call to action,” said Lisa Wright. “That’s why I chose to chair the American Heart Association’s Heart Walk. It’s deeply connected to our mission and offers a direct way to support the health and future of the communities we serve.” By participating in the Heart Walk, companies are helping transform
Memorial Hermann-Texas Medical Center Receives Grant for Innovative Proposal to Strengthen the Nursing Workforce
Memorial Hermann-Texas Medical Center (TMC) is one of 20 organizations selected to receive a 2025 Nursing Innovation Fund award.
AARP and the American Association of Critical-Care Nurses (AACN Critical-Care) have awarded over $355,000 for projects offering innovative and replicable solutions to strengthen the nursing workforce by creating and sustaining healthy work environments and improving recruitment and retention rates of registered nurses.
Strengthening the nursing workforce and sustaining healthy work environments are crucial to addressing a shortage that has already resulted in the loss of 100,000 registered nurses during the COVID-19 pandemic, per a 2023 National Council of State Boards
of Nursing report. Another 600,000 nurses have reported intent to leave the workforce by 2027, according to the same report, raising significant concerns for our nation’s health care system. Creating healthy work environments is essential for recruiting and retaining a strong nursing workforce. Nurses cannot optimally contribute to care delivery across the continuum without healthy work environments. Healthy work environments reduce stress, enhance overall job satisfaction, and foster a sense of belonging for patients, families, and health care team members.
Designed in partnership with the Memorial Hermann Foundation and the Memorial Hermann Institute for Nursing Excellence, Memorial Hermann-TMC’s project
3100 WESLAYAN
will pilot staff-requested and evidence-supported approaches and tools to improve bidirectional communication and access to information across frontline nurses, managers, and executive leadership. It will focus on four components including a monthly templated newsletter, a quarterly video series led by the Chief Nursing Officer, enhanced annual training and a dedicated nursing channel on Memorial Hermann’s internal platform MHOne.
“Effective communication between bedside staff and our nursing leadership at all levels is vital to building a high reliability environment,” said project lead Rose Richmond, MSN, MBA, RN, CCRN-K, CLSSGB. “We are excited to receive this generous gift as we work to pilot approaches and tools to improve bidirectional communication in three of our nursing units. This gift allows us to involve our bedside staff, who are critical players of effective communication, and apply evidence-based approaches that will empower others and lead to new platforms to improve patient safety and staff satisfaction that can be adapted to other units.”
“Nurses play a critical role in protecting the health of our nation, but they need healthy work environments to effectively deliver care,” said Alan Weil, senior vice president, public policy and director of AARP Public Policy Institute. “AARP is proud to provide ongoing support to ensure a strong nursing workforce across all care settings where nurses practice.”
“Nurses represent the largest segment of the health care workforce, which positions them as essential catalysts for addressing health care challenges while driving innovation and transformation in the field,” said Vicki Good, DNP, RN, CENP, CPPS, AACN chief clinical officer. “Creating supportive healthy work environments isn’t just beneficial for nurses, it creates a ripple effect that can improve patient outcomes and strengthen family experiences.”
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As Questions Linger About the Safety and Effectiveness of Cannabis, More Turn to It to Manage Chronic Conditions and Health Disparities
New Study on Cannabis Use Among Non-Hispanic Black and Hispanic Men Offers Insights to Reduce Risks and Promote Safer Use
By Ann Kellett, PhD
The study’s findings could help shape public policy on cannabis use.
Cannabis use is gaining popularity in the United States, driven by growing legalization, public acceptance and diverse methods of consumption.
More people than ever before support its legal medicinal and recreational use, and more adults— mainly men—are turning to cannabis for relief from physical and mental health symptoms.
Now, health behavior experts from the Texas A&M University School of Public Health, along with collaborators from three other universities, have taken a closer look at this dual use among Hispanic and
non-Hispanic Black men living with chronic health conditions.
“We believe our study is the first to focus exclusively on these associations among non-Hispanic Black and Hispanic men with chronic conditions—groups that experience chronic disease at higher rates and may be increasingly turning to cannabis as an alternative to prescription medication,” said Benjamin Montemayor, PhD, who led the study.
As examples, he noted that non-Hispanic Black and Hispanic men disproportionately experience chronic conditions such as arthritis, cancer, depression and anxiety. In addition, socioeconomic stress, limited access to care, distrust of health care institutions, and cultural norms around masculinity can all make it harder to prevent or
manage these conditions.
While some turn to cannabis to cope with these challenges, evidence suggests that heavy use— whether for recreational or medicinal purposes— can lead to issues such as memory problems, rapid heart rate, respiratory issues and even cannabis use disorder.
“Cannabis use disorder not only makes quitting difficult but also can affect financial stability, emotional well-being and physical health,” Montemayor said. “Our findings could help inform policy and intervention and risk reduction efforts for these populations.”
For the study, published in the Journal of Community Health, the team surveyed a nationally representative sample of 1,982 non-Hispanic Black or Hispanic men age 40 and older who
reported having at least one chronic condition. Participants shared how many days they used cannabis in the past 30 days.
They also reported whether a health care professional had ever diagnosed them with any of 19 chronic health conditions—such as arthritis, cancer, chronic pain and depression or anxiety—conditions that cannabis is
see Cannabis ...page 13
The Power of Humankindness: How St. Luke’s Health is
Redefining Care
By Sarah Logan, St. Luke’s Health
In a world often fractured by division, St. Luke’s Health champions “humankindness” as the bedrock of its brand and patient care. This concept, more than just polite gestures, recognizes our shared humanity.
From August 25-31, “Be Kind to Humankind Week” affirms St. Luke’s Health’s daily commitment. Their ethos, “Hello Humankindness,” is more than a slogan; it’s a dedication to treating each individual with dignity, seeing them as unique human beings,
Firstly, kindness is contagious. Witnessing kindness inspires similar benevolent behaviors, creating a “pay-it-forward” effect. This positive feedback loop fosters a more compassionate society.
Secondly, kindness boasts physiological benefits. Acts of kindness boost the immune system, linked to the release of oxytocin, the “love hormone.” Oxytocin lowers blood pressure and improves heart health, strengthening the body’s defenses. This links emotional well-being to physical health, underscoring the importance of a kind environment in healthcare.
not just diagnoses.
This focus stems from understanding the patient experience. Individuals are vulnerable in medical settings, feeling anxious and overwhelmed. St. Luke’s Health recognizes that true healing extends beyond medical procedures. It encompasses empathy, connection, and treating the whole person—mind, body, and spirit.
“Hello Humankindness” manifests in countless ways: a nurse’s smile, a doctor’s explanation, or comfort from support staff. It’s embedded in protocols for privacy and respect, and training emphasizing compassionate communication. Patients feel seen, heard, and valued, believing this holistic approach aids their healing. The ripple effect of kindness is scientifically proven:
Finally, kindness reduces stress. Engaging in kindness shifts focus from personal anxieties to others’ needs. This altruism is therapeutic, providing purpose and connection, mitigating anxiety, and promoting calm.
For St. Luke’s Health, Be Kind to Humankind Week amplifies these messages. Their commitment to “Hello Humankindness” is a powerful reminder that exceptional healthcare blends medical expertise with a deep belief in every human being’s inherent worth.
St. Luke’s Health leads in demonstrating humankindness’s transformative power. Learn more about St. Luke’s Health at commonspirit.org/ stlukes-health-texas.
Financial Forecast Cryptocurrency
By Grace S. Yung, CFP Midtown Financial Group, LLC
Cryptocurrency has grown from an experimental idea into a mainstream conversation about money and investing. It was designed as a decentralized currency outside the control of governments and banks. Today, it is viewed both as a potential monetary alternative and as a speculative investment.
This article reviews the origins of cryptocurrency, its lack of regulation and risks.
Origins and the Regulation Gap
Thousands of cryptocurrencies have launched, with Ethereum introducing smart contracts and newer
experimenting with crypto exposure.1 Still, calling cryptocurrency a true “asset class” remains debated. Unlike stocks, cryptocurrencies generate no income or cash flow. Their value depends on supply, demand, and sentiment, which contributes to extreme volatility.
Risks to Consider
Investing in cryptocurrency carries distinct risks:
• Volatility: Price swings of 50% or more can occur in weeks or even days.
• Security: Direct holders must safeguard private keys, with hacks a constant concern.
• Liquidity: While Bitcoin and Ethereum are liquid, smaller tokens may not be.
• Regulation: Sudden policy shifts could restrict access or impose new taxes.
• Technology: Bugs, outages, or flaws in protocols could undermine confidence.
networks like Solana and Cardano expanding the ecosystem.
Despite growth, cryptocurrencies remain largely unregulated. Governments still debate how to classify them - securities, commodities, or something else. In the past the absence of oversight created freedom and risk. More recently, oversight has just been applied through the Genius Act. While investors can transact globally, they are still exposed to potential fraud, hacking, and sudden collapses, as seen in the FTX exchange failure of 2022.
Cryptocurrency as an Asset
Class
What began as “digital money” has evolved into an asset that some investors consider a hedge against inflation, like gold. Institutional adoption has increased, with hedge funds and retirement plans
Crypto vs. Traditional Hedges
Comparisons are often drawn between cryptocurrency and gold. Gold has long served as a trusted store of value. Cryptocurrency shares gold’s limited supply but lacks history and does not produce income.
Conclusion
Cryptocurrency is an innovative yet speculative market. It has expanded beyond its origins as a peer-to-peer payment system, but volatility, lack of regulation, and security challenges make it unsuitable as a monetary substitute.
Since every financial situation is unique, working with a Certified Financial Planner practitioner can help design a portfolio that balances opportunity with risk and supports long-term goals.
Legal Matters
Continued from page 3
virtual direct supervision had enabled more flexible and efficient use of clinical staff, expanded access to care, and supported continuity of treatment during staffing shortages.
In response, in the CY 2025 PFS Final Rule, CMS finalized a permanent, though narrower, policy to preserve virtual supervision flexibility for certain incident-to services. Specifically, beginning on January 1, 2026, virtual direct supervision may be provided for incident-to services where (1) the applicable service is furnished by auxiliary personnel who are employed
by the physician (or other practitioner) and working under the physician’s (or other practitioner’s) direct supervision; and (2) the applicable service either (a) has a Healthcare Common Procedure Coding System (HCPCS) code with a PC/TC indicator of ‘5’ (i.e., generally services where there is no separate payment under the PFS); or (b) is described by CPT code 99211 (office or outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care practitioner).
Importantly, the permanent policy that goes into effect on January 1, 2026, only applies to the aforementioned subset of incident-to
services and does not apply to other services (including other incident-to services that do not meet the requirements of the rule) required to be furnished under direct supervision.
Proposed CY 2026 Virtual Direct Supervision Expansion
In the CY 2026 PFS proposed rule, CMS is now proposing to expand virtual direct supervision to cover nearly all “incident-to” services. This is a considerable expansion in policy, particularly for incident-to services. This proposal goes beyond the limitations of the CY 2025 Final Rule by removing the need for services to be tied to a PC/TC indicator of 5 or CPT code 99211. Instead, virtual direct supervision would be permissible for all
services billable as “incident-to,” except for those assigned a global surgery indicator of 010 or 090 (i.e., procedures with 10-day or 90-day global periods – CMS justifies this exclusion on the basis of clinical complexity and the importance of in-person availability during perioperative periods).
Implications for Providers If finalized, this proposal could reshape how clinical supervision is operationalized in outpatient settings, particularly for primary care and specialty practices, compliance teams, risk management, and state law alignment. CMS’s proposed rule for CY 2026 reflects a continued shift toward modernizing Medicare’s approach to care delivery and clinical oversight.
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organization over the years. Through The Duncan Fund, our family foundation, we are pleased to honor dad’s lifetime of service to Houston Methodist and to offer our support as the Department of Medicine continues
Healthy Heart
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our community from bystanders into lifesavers—ensuring that when a cardiac emergency strikes, someone is ready to step in and make a difference.
The American Heart Association
Cannabis
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often used to relieve.
Researchers also asked about the number of physically and mentally unhealthy days experienced in last month, the severity of their pain and stress, and their overall quality of life.
“We found that pain, stress and a having a higher number of chronic conditions were key factors associated with cannabis use among these men— consistent with previous findings on self-managing symptoms,” Montemayor said.
Of the 1,982 men surveyed, about 58% were non-Hispanic Black and 42 percent were Hispanic, with an average age of just under 57.
to leave its mark for those in Houston and beyond,” said Carlos Duncan.
In addition to this new commitment to the Duncan Department of Medicine, the family has championed several academic and medical programs at Houston Methodist, establishing the Charles and Anne Duncan Scholars Program and endowed chairs in nephrology and
endocrinology.
“The Duncans have been a cherished part of the Houston Methodist family for decades, and their unwavering commitment to our mission continues to help us change lives and lead medicine,” said Marc L. Boom, M.D., president and CEO of Houston Methodist. “We’re deeply grateful to Anne, Leslie and Carlos, and
Mary Anne and Bill Dingus for their steadfast support. Their generosity will continue to make a meaningful impact for years to come.”
is a global leader in resuscitation science, education, and training, and the official publisher of CPR guidelines. Through the Nation of Lifesavers initiative, the Association is committed to empowering individuals everywhere to act in the event of a cardiac emergency, making sure that no one is left without
the help they need when seconds count.
The year-round Heart Walk campaign will culminate on October 25, 2025, at TMC Helix Park, where thousands of participants will walk to save lives while raising essential funds to advance lifesaving research, increase CPR education and training and
drive equitable health for all people. Companies interested in participating can contact Tracie Morden at Tracie.Morden@heart.org. For more information about the Houston Heart Walk, visit Houstonheartwalk.org.
Cannabis use was more common among non-Hispanic Black men. Overall, a little more than 21% (422 men) reported using cannabis in the last 30 days. Nearly half of these men reported using it recreationally, and many also reported having multiple chronic health conditions.
The most commonly reported diagnoses were chronic pain (37%), depression or anxiety (32%), arthritis/ rheumatic disease (30%) and cancer (14%). The analysis also found that men with more chronic conditions were more likely to use cannabis.
On average, current cannabis users were younger, had lower education levels and reported lower annual household incomes compared to non-users. They also reported a lower quality of life, including more days of
poor physical and mental health, higher levels of physical pain and greater stress.
“This could suggest a two-way relationship, which could be determined by a longitudinal study,” Montemayor said. “Individuals with declining health or more chronic conditions may be likely to use cannabis, but cannabis use itself could also contribute to worsening physical and mental health over time.”
The study identified the following tactics for increasing awareness and reducing cannabis-related harm among high-risk populations:
• Community-wide interventions, including regulatory strategies and targeted health campaigns
• Standardized health warning labels on cannabis products
• Alternative approaches to managing pain and stress, such as
mindfulness activities
• Open communication between patients and medical providers, so that patients have access to evidence-based information and supportive discussions about non-prescription medication options
“Important questions about the safety and effectiveness of cannabis continue to emerge as policies on cannabis and CBD legality remain in flux in some states, more people are diagnosed with chronic conditions and concern about managing multiple prescriptions is growing,” Montemayor said.
35 Years
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Lives of Black Women in America, a 2021 report which highlighted the underlying causes of the inequities in breast cancer care, Susan G. Komen launched Stand for H.E.R. – A Health Equity Revolution. The program is
Oncology
Continued from page 5
Critical Questions Every Caregiver Should Ask:
• What are the short- and long-term risks of each treatment option?
• What’s the likelihood of progression over the next 5-10 years?
• What’s our plan if the cancer returns or progresses?
• Are there clinical trials that might benefit our patient?
• How can we maintain quality of life throughout treatment?
Knowledge is Power
As I tell every family I work with: knowledge is 90% of the battle.
Patient Support
Continued from page 7
understanding why patients turn to the sources they do for medical guidance.
The AANP offers an infographic tool, A Clinician’s Guide to Medical Misinformation: Communication Is Key, to support clinicians in combating medical misinformation.
Patient Safety Strategies
Engaging with patients who are relying on health misinformation requires a thoughtful approach to ensure patient safety, retain trust, and promote health literacy. Here are some strategies practitioners can use:
• Listen to patients’ concerns and beliefs without judgment. This fosters open communication and shows that you respect their perspective. By actively listening to concerns and providing clear, evidence-based information, practitioners can build trust and encourage patients to participate in their healthcare journey.
• Show empathy and understanding toward patients’ fears and misconceptions. Acknowledge their feelings and provide reassurance.
• Use plain language to explain complex medical terms in simpler
Komen’s commitment to decrease breast cancer disparities through focused interventions that break down barriers to quality care, so Black people have the same chances of surviving breast cancer as anyone else.
Proceeds from Komen events, like the Houston Race for the Cure fund critical patient care services, which served 3,711 people and provided
Caregivers who understand the disease, treatment options, and their loved one’s personal goals are equipped to make informed decisions that align with what matters most.
The Path Forward
Despite rising case numbers, we have reasons for optimism. Advances in precision medicine, early detection technology, and comprehensive survivorship care are dramatically improving outcomes for Texas men and their families.
The challenge now is ensuring equitable access—that every patient, regardless of location or background, receives both cutting-edge treatments and compassionate, informed care. This requires not just medical
language. Avoid medical jargon and ensure that patients fully understand the information being provided. To support this, apply universal health literacy precautions—an approach that assumes all patients may have difficulty understanding health information and therefore emphasizes clear, accessible communication for everyone. Clear communication helps prevent misunderstandings and misinformation.
• Share reliable, evidence-based sources of information. Use reputable websites, peer-reviewed articles, and official health guidelines. (See the resources listed below.)
• Using the Teach-Back Method, ask patients to repeat the information in their own words to ensure they have understood correctly. This helps identify any misunderstandings.
• Use visual aids such as diagrams, charts, and videos to explain complex medical concepts. Visuals can make information more accessible and easier to understand.
• Gently correct misinformation by providing accurate information and explaining why the misinformation is incorrect. Use facts and evidence
$814,400 in financial assistance in the Texas area last year. Join us on Saturday, October 4, 2025, for the Houston Race for the Cure. For more information on the Houston Race for the Cure and how you can help support Susan G. Komen programs, please visit komen.org.
innovation, but educated, empowered caregivers who can navigate the system and advocate for the best possible outcomes.
Your Next Steps
If you’re over 50, or over 45 with risk factors, talk to your healthcare provider about PSA screening. If you’re supporting someone through a prostate cancer diagnosis, remember that your role is crucial. Seek out resources, ask tough questions, and never hesitate to get a second opinion.
Together, we can ensure that more Texas families hear the words every cancer patient wants to hear: “Your treatment was successful.”
to support your explanations.
• Help patients develop critical thinking skills by teaching them how to evaluate the credibility of sources and recognize biased information. Critical thinking skills are essential in identifying and rejecting misinformation.
• Maintain a trustworthy and transparent relationship with patients. Be honest about what is known and what is still uncertain in the medical field. When patients are well-informed, they can actively participate in discussions about their care, leading to decisions that are aligned with their values and preferences.
• Schedule follow-up appointments to address any ongoing concerns and reinforce accurate information. Continuous follow-up and support maintain positive patient engagement. Through these strategies, practitioners can effectively combat health misinformation and empower patients to make informed health decisions.
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