The
Bulletin Saginaw County Medical Society
Winter 2021 | Volume 79 | No 3
Proposed Revisions to SCMS Foundation Bylaws p. 9
ASAM Treatment of Opioid Use Disorder Course p.11
www.SaginawCountyMS.com
Guide to Surprise Billing Provisions in the Consolidation Appropriations Act of 2021 p. 16
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The
Bulletin Saginaw County Medical Society
2020-2021 OFFICERS AND DIRECTORS President Mildred J. Willy MD President-Elect Anthony M. Zacharek MD Past President Julia M. Walter MD Secretary Caroline G.M. Scott MD Treasurer Miriam T. Schteingart MD
contents 9-10 •
• •
11
Board of Directors Jorge M. Plasencia MD Tiffany K. Kim MD Mark G. Greenwell MD Harvey K. Yee MD Elizabeth A. Paulus MD Furhut R. Janssen DO Bulletin Editor Louis L. Constan, MD Resident Representative Anushka N. Magal MD MSMS Delegates Elvira M. Dawis MD Julia M. Walter MD Mildred J. Willy MD Anthony M. Zacharek MD
4 5
SCMS FOUNDATION Proposed Revisions to SCMS Foundation Bylaws Medical Student Loan Applications Available Due March 31, 2021 Nursing Scholarship Applications Available Due March 31, 2021
President-Elect’s Letter Update on 2021 Meetings and Events
5
SCMS Leaders Promote COVID Vaccine
5 6 7 8 8
Free Limited Legal Consultation From the Editor Peer Review Ethics Committee Barb Smith SR&RN Health Professional Recovery Program
Christopher J. Allen MD Miriam T. Schteingart MD
Obtaining CME Credit
MSMS Alternate Delegates
15
CMU College of Medicine CMU Health
Caroline G.M. Scott MD Waheed Akbar MD Mohammad Yahya Khan MD Virginia R. Dedicatoria MD Steven J. Vance MD Joseph P. Contino MD Kristine K. Spence DO Karensa L. Franklin MD Scott E. Cheney MD Michael W. Warren MD Peer Review Ethics Committee Waheed Akbar, MD, Chair Caroline G.M. Scott, MD James R. Hines, MD MSMS Region 7 Director Thomas J. Veverka, MD Executive Director Joan M. Cramer Administrative Assistant Keri Benkert
Free Confidential Counseling for Frontline Healthcare Workers
13
Mental Health First Aid Resilience
16
AMA Guide to Surprise Billing Provisions in the Consolidation Appropriations Act of 2021
FREE CME ASAM Treatment of Opioid Use Disorder Course April 17, 2021 Register Now!
12 SCCMHA 14 CMU OCME – Update on
Jorge M. Plasencia MD
12
21
Key Provider of the Month Covenant HealthCare
22 24
Ascension St. Mary’s Hospital MSMS Reimbursement Advocate Alert
25 THRIVE 26 In Memory 27 Fulfill Your Board of Medicine
Requirements on Your Time
28 30 30
Covenant HealthCare Advertiser Index Caduceus Meeting for Recovering Health Care Professionals
31 32
Birthdays – March and April Update on 2021 Meetings and Events
The Bulletin can be viewed online at www.SaginawCountyMS.com under the Bulletin tab.
COVER PHOTO: AYUSHI KUMAR M-1, DR. STEVE VANCE AND JACOB LYNN M-3 WORKING THE COVID VACCINE CLINIC EDITOR Louis L. Constan, MD EXECUTIVE DIRECTOR Joan M. Cramer DESIGNER Lori Krygier
PUBLISHER Saginaw County Medical Society 350 St. Andrews Rd., Ste. 242, Saginaw, MI 48638-5988 Telephone (989) 790-3590 | Fax (989) 790-3640 Cell (989) 284-8884 | jmcramer@sbcglobal.net Hours By Appointment | SaginawCountyMS.com
All statements or comments in the Bulletin are those of the writers, and not necessarily the opinion of the Saginaw County Medical Society. Contributions are welcome. We publish committee reports, letters to the editor, Alliance reports, public health activities of the members, and some personal items (birthdays, weddings, graduations and like events). The Editor determines which are accepted. Advertisements are accepted as space is available at our going rates. Members may advertise office information, professional services, skills, and procedures, also at our going rates. We do not accept advertisements from nonmembers, or non-Saginaw hospitals. The Bulletin is mailed free of charge to SCMS members as part of their membership. Complimentary copies are sent to various other parties. Others may subscribe at the rate of $50 per year.
The Bulletin | Winter 2021 3
PRESIDENT-ELECT'S LETTER
The Importance of Physician Leadership Anthony M. Zacharek, MD MHA From the Executive Director Due to the pandemic, the SCMS did not have an annual meeting in 2020 at which time the President-Elect would have taken office, and new officers, directors, delegates and alternates would have been elected. The 2019-2020 board graciously agreed to extend their service for an additional year. Dr. Millie Willy continues as President until the May 2021 annual meeting when Dr. Tony Zacharek takes office. Drs. Willy and Zacharek are sharing responsibilities until that time, with Dr. Zacharek agreeing to write articles for The Bulletin. We thank all of our leaders for their extraordinary service during a very difficult time.
W
e can all agree the past year has been a trying one. Challenges during the pandemic have ranged from keeping practices open to keeping hospitals running as efficiently as possible. An important aspect of confronting these challenges is leadership, and specifically, the physician leadership of those involved. With the new year 2021 upon us, the importance of physician leadership is worth discussing. As I completed my masters in healthcare administration degree from Saginaw Valley State University in August 2020, I was left pondering many issues in healthcare that challenge physicians and healthcare professionals in general. One important issue is the growing need for physician leadership in 21st century U.S. healthcare.
With changes constantly occurring in healthcare, physicians are needed to help coordinate care and communicate among diverse groups of stakeholders. For example, with growing numbers of ACOs (accountable care organizations) in U.S. healthcare, physician leaders are needed to help coordinate high quality, low cost care to the communities we serve. This need will only continue to grow as the healthcare system looks for ways to increase the value of care delivered. What makes an effective leader is the subject of many books recently written and these books suggest that the characteristics of good leaders are based on teamwork, trust, and good listening skills. As the Saginaw County Medical Society (SCMS) enters its 119th year of service to the community, the values that represent effective leadership will keep this organization
going for another 119 years. These values deserve discussion, and are the subject of several books written on healthcare leadership. According to “Love Works – Seven Timeless Principles for Effective Leaders,” the qualities of effective leaders include the ability to be patient, kind, trusting, unselfish, truthful, forgiving and dedicated. (Manby, J., 2012). If we remember these qualities as a medical society and apply them daily, our relationships with one another and with our patients will become even greater. As leaders, we need to listen to one another, to be kind and trusting, and to be dedicated to our purpose of serving each other. Another book on leadership by Amer Kaissi discusses similar traits of effective leaders – humility, compassion, kindness and generosity continued on page 5
As leaders, we need to listen to one another, to be kind and trusting, and to be dedicated to our purpose of serving each other.
4
The Bulletin | Winter 2021
continued from page 4
(Kaissi, A., Intangibles - The Unexpected Traits of HighPerforming Healthcare Leaders, 2018). Every physician member of the SCMS may already be exhibiting these traits of effective leaders, but it never hurts to remind ourselves of these qualities. The SCMS serves many purposes, but perhaps one of its greatest purposes is for physicians of this community to support one another through compassion and kindness. These are traits of effective leaders and can make all physicians in this community not only more caring towards each other, but also more caring towards our patients. As the SCMS and U.S. healthcare continue to change, physician leadership will continue to be important as a means to address challenges that are inevitable in healthcare. So, get involved any way that you can and start applying your leadership skills to making healthcare better in Saginaw County and beyond. Consider getting more involved in your county medical society. With physician leadership at all levels of healthcare, from private practices to hospital administration to health insurance companies, the value of care provided to our communities will certainly improve. I wish you all a healthy and productive new year.
UPDATE ON 2021 MEETINGS AND EVENTS The SCMS Board continues to meet virtually on the third Tuesday of every month. Please mark your calendar for the ANNUAL MEMBERSHIP MEETING and the ANNUAL FOUNDATION MEMBERSHIP MEETING to be held concurrently via Zoom on Tuesday, May 18, 2021, at 7 p.m. Members will be contacted in late April to register. We hope to have in-person meetings on Tuesday, September 21 and Tuesday, October 19. Keep an eye on your inbox and The Bulletin for details when available. The SCMS will not host it’s Annual Health Fair in 2021. Additionally, the SCMS Foundation Golf Outing has been cancelled. We hope to have both events back up and running in 2022.
SCMS LEADERS PROMOTE COVID VACCINE
The SCMS Board would like to thank Drs. Waheed Akbar and Steve Vance for their work to promote the COVID vaccine to the public. On Friday, January 22, both were guests on Art Lewis’ show on WSGW. While Dr. Akbar was remote, Dr. Vance was at Art’s home studio and gave him his first COVID shot on air. Click HERE to view (Note: Video starts at the 11:36 mark and runs through 54.25). Dr. Akbar also did an interview with Rachel Geddes of My961 that is being aired on Cumulus radio stations. With the assistance of Barb Sheltraw at KCQ, Dr. Akbar recorded a public service announcement MacDonald Broadcasting is graciously running on all of their radio stations. To hear Dr. Akbar’s PSA, click HERE. The SCMS thanks Art Lewis, Rachel Geddes and Cumulus Media, and Barb Sheltraw and MacDonald Broadcasting for their cooperation in spreading the word on the safety of the COVID vaccine!
DID YOU KNOW? Free and Limited Consultation From MSMS Legal Counsel Did you know that SCMS/MSMS members have a free and limited consultation from Legal Counsel should they want it? To get a consultation, please visit http://MSMS. org/AskOurLawyer (the form may take a minute to load).
All statements or comments in The Bulletin are those of the writer, and not necessarily the opinion of the Saginaw County Medical Society. The Bulletin | Winter 2021 5
FROM THE EDITOR
America By Louis L. Constan, MD “God Bless America, land that I love, stand beside her, and guide her, through the night, with a light from above.”
T
hese words, in the song by superstar songwriter Irving Berlin, inspired Americans during some of the darkest hours of World War II. Dark hours…how do you get past them? How do you get past those dark, dark hours of the past year? How do you get past them to that light? Psychologists tell us that you need two things: Forgiveness and thankfulness. It seems natural to be angry at those responsible for the darkness. They have made mistakes. They have taken actions, perhaps, that have hurt us personally during the last year. They, perhaps, have, in our opinion, hurt our country during the last year. They, perhaps, have actually diminished our sense of security; lessened our ability to go about our lives in safety. But anger, psychologists (and also religious leaders) tell us is not good for us. It hurts us in many ways and does nothing to change the behavior of others. Only an effort to understand and ultimately to forgive…is helpful. Thankfulness. Thankfulness refocuses our minds on positive thoughts. We make a list of three to five blessings every day. Endorphins rise, blood pressure falls. Good stuff! As I do that, I find myself thankful for none other than George Washington who left his comfortable
farm and risked his life for four long years trudging around the countryside fighting the British. I am also thankful for Abraham Lincoln who sacrificed a peaceful and prosperous life in smalltown Illinois to hold our country together in most trying times. I am especially thankful for my own grandparents who courageously left their friends and family back in the Balkans during the early 20th century to carve out a life in Chicago. They faced wrenching cultural and language challenges and did their best to overcome them, with mixed success…but they never gave up. And I am thankful for those far-sighted donors to the University of Chicago who supplied the scholarship money to a poor kid from the South Side who would not otherwise have been able to attend college. As I now look back at my career, which is far from over, I can see many, many other people to be thankful for. People in Saginaw, Michigan. Especially Saginaw County Medical Society members, people like YOU, who have been an inspiration to me, who have been supportive of me, who have helped me in ways large and small. I am thankful for you. Now, and this may sound strange, I am also thankful for the extra time I have had during this pandemic, “confined” as I am at home. Many of my usual activities
have been put on hold, and I have had no excuse but to resume a project that I began about 20 years ago - writing a book, a book of insights gleaned about life, love and the practice of medicine in our fair town. “Two Minds, Your Body, Knowing what’s going on in your doctor’s head and getting that knowledge to work for you” is a book for patients about how to avoid common misunderstandings in the doctor’s office, and how to talk to doctors. It is peppered with true stories about patients’ foibles. Of interest to readers of the SCMS Bulletin…I have included some of my favorite columns from this and other magazines that, I feel, will help patients understand us better and the dysfunctional healthcare system under which we work. If you are a regular reader, I believe the book will bring back some interesting memories. It is available in Amazon Kindle e-books and paperbacks. It is my New Year’s wish that, as we are thankful for our Founding Fathers, for our mentors and for our colleagues, some of you readers out there might someday, perhaps, be thankful for the contribution I personally have made, as exemplified in this book, to the continued on page 7
As I now look back at my career, which is far from over, I can see many, many other people to be thankful for.
6
The Bulletin | Winter 2021
PEER REVIEW ETHICS COMMITTEE
continued from page 6
furtherment of the practice of medicine. That would make me very happy. And it is my further wish, a la Irving Berlin, that as we look for that “light from above” to get us through the long difficult night we are going through at present moment - we would realize that said light is here already, it is already guiding us and it is emanating from each and every one of us.
The Saginaw County Medical Society has a Peer Review Ethics Committee (“Committee”) which is comprised of Waheed Akbar, MD – Chair, Caroline G.M. Scott, MD and James R. Hines, MD. Members of the Committee are elected by the membership. The following is the definition of the Committee pursuant to Chapter IX Conduct and Discipline of Members of the SCMS Bylaws: Section 5. PEER REVIEW ETHICS COMMITTEE. This Society shall have a standing committee designated the Peer Review Ethics Committee, charged with duties and powers concerning the maintenance of standards of conduct and discipline of members including the duties and powers specifically set forth in this chapter. Whenever any matter of alleged misconduct is referred to the Peer Review Ethics Committee, such Committee shall have the right to conduct investigations and hearings thereon, both informal and formal, and to make findings of fact and recommendations for discipline. If you need to refer a matter to the Committee, please contact Drs. Akbar, Scott or Hines, or Joan Cramer at the Saginaw County Medical Society office. All matters are confidential and are not to be disclosed to the Board or membership.
HIRE ME. If you find it difficult to communicate with your doctor; if you find it hard to get personal attention from an 'impersonal healthcare industry'; if you don't understand all those insurance-company rules; if you don't know how to change your bad health habits; if you think you may be on unnecessary medications; if you are perplexed by those annoying health-product advertisements; and if you'd like to know which are your greatest health risks - you'll appreciate this Family Doctor's advice, gleaned from 44 years of practice. 1 Each chapter is illustrated with real-life examples from his and other doctors' practices. Each chapter ends with 'bonus' essays written by the author and published in newspapers and magazines giving the doctor's viewpoint. This will give you a unique perspective and allow you to 'get into the mind' of a doctor. Sweet! Available on Kindle (different cover but same book) and paperback. Available on Amazon by clicking HERE
Partner with a Graphic Designer to Promote and Grow your Business! Providing a singular source for marketing and design, I am here to deliver creative services for print and digital. Proud to be the Designer for the Saginaw County Medical Society Lori Krygier | Graphic Designer 989.239.1056 | lkrygier@charter.net lorikrygier.com
The Bulletin | Winter 2021 7
View the 2021 Impact Video HERE
Our Mission Prevent suicide through education and resources, and to support those impacted by suicide. Our Vision Eliminate suicide and reduce its impact. Are you in a crisis? Call 800-273-8255 or text TALK to 741741
Creating a
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community Our goal is to save lives through prevention, intervention, and aftercare.
Our Network trains individuals in evidence-based suicide prevention with the hope of destigmatizing suicide, increasing help-seeking behaviors, and caring for those impacted by suicide. To request trainings or resources, contact info@srrn.net I www.srrn.net I 989.781.5260 8
The Bulletin | Winter 2021
Health care professionals are not immune to substance abuse or mental health disorders. Many otherwise highly qualified professionals may develop these problems due to stress, long hours, a genetic predisposition, or a tendency to self-medicate. To assist health care professionals impaired by these disorders, consider the care monitoring services of the Health Professional Recovery Program (HPRP). The Michigan HPRP was established by legislation in 1993 to assist impaired professionals before their actions harm a patient or damage their careers through disciplinary action. Any licensed or registered health care professional in the State of Michigan is eligible to participate in the program. To maintain participant confidentiality, the HPRP is operated by a private-sector contractor under the authority of the Health Professional Recovery Committee (HPRC), a committee comprised of a representative from each of the health professional licensing boards. The Michigan Department of Community Health, Bureau of Health Professions provides administrative services to the HPRC. Participation in the HPRP is confidential. If a licensee/ registrant is referred to the program, has a qualifying diagnosis and complies with the HPRP requirements, his/her name will not be disclosed to state regulatory authorities or the public. Provided there is no readmission, records of HPRP participants are destroyed five years after successful completion. Referrals to the HPRP may come in the form of a self-referral from a licensee/registrant or from colleagues, partners, employers, patients, family members or the State. Any of the 20 health professional licensing boards may also refer licensees/ registrants to the HPRP for monitoring as a condition to regain or retain their license to practice. The names of individuals reporting a licensee/registrant suspected of impairment are also kept confidential. For more information on the HPRP, call 1-800-453-3784 or visit www.HPRP.org. Informational presentations on the HPRP are available to employers and health professional groups at no charge. Call the toll-free number to arrange a presentation at your facility.
TO MAKE A REFERRAL OR SELF REPORT, CALL 1-800-453-3784
If you have any questions or concerns about the proposed Bylaws, or if you would like to be considered for a position on the Foundation Board, please contact Joan Cramer at jmcramer@sbcglobal.net by April 1, 2021.
Foundation FOUNDATION The Saginaw County Medical Society (SCMS) Foundation was founded in 1968 by SCMS members, and is the charitable 501(c)(3) entity of the SCMS. All members of the SCMS are also members of the SCMS Foundation. MISSION The Foundation: • Provides low interest loans to medical students with ties to Saginaw with a maximum of $20,000 per student; • Forgives loan interest if the recipient returns to Saginaw to practice after completion of their residency; • Forgives 25 percent or a maximum of $5,000 loan principal per year if the recipient returns to Saginaw to practice after completion of their residency and is a dues paying member; • Awards scholarships and mentors Saginaw County high school students who are interested in becoming a physician; • Provides research grants and scholarships to medical students and residents through the CMU College of Medicine; and • Assists the SCMS Alliance in awarding nursing scholarships. FOUNDATION BYLAWS In 2019, the Foundation Bylaws were reviewed and revised to not only bring them up-to-date as they were written over 50 years ago, but also to increase the size of the Board of Directors. The proposed Bylaws will be voted on at the Tuesday, May 18, 2021, Annual SCMS Foundation Meeting and via electronic vote prior to the meeting. • View the original 1968 Bylaws by clicking HERE. • View the proposed Bylaws by clicking HERE. The Bylaws are available on the SCMS website under the FOUNDATION tab www.SaginawCountyMS.com. Current Foundation Officers and Trustees are as follows: • Thomas E. Damuth, MD – President • Iris A. Marteja, MD – Vice President/Secretary • Matthew D. Deibel, MD – Treasurer • Lowell A. Butman, MD – Trustee • Rao V.C. Gudipati, MD – Trustee • George J. Gugino, MD – Trustee
MEDICAL STUDENT LOAN APPLICATIONS The Foundation was established in 1968 and is funded through physician donation of earnings from educational and charity work. The Foundation makes low interest loans to medical students with ties to the Saginaw area. In the past, the amount of each loan has ranged anywhere from $1,000 to $10,000 with some students receiving loans several years in a row. Maximum loans awarded during medical school are $20,000 per student. The terms of these loans are generous. No interest is charged while the student is in medical school, simple interest is charged at a rate of four percent per annum during a residency program, and interest is charged at a rate of eight percent per annum upon completion of a residency program. The Foundation forgives all interest if the student returns to Saginaw upon completion of their residency to practice. Additionally, if the loan recipient returns to Saginaw to practice upon completion of their residency and they are a dues paying member of the SCMS/MSMS, 25 percent of the principal balance will be forgiven at the end of each year they are practicing in Saginaw County, with a maximum of $5,000 per year forgiven. The Foundation Board generally considers students who are past their first year of medical school, and among other things, according to: • Strength of connection to Saginaw • Financial need • Scholastic performance • Community service/extracurricular activities The intent of the Foundation loans are to assist and encourage students to return to Saginaw to practice medicine. Only applicants enrolled in a United States medical school will be considered. Medical Student Loan Applications are available on the SCMS website under the MEDICAL STUDENT LOANS tab at www.SaginawCountyMS.com or by contacting Joan Cramer at jmcramer@sbcglobal.net. Loan applications for 2021 will be accepted beginning February 1, 2021, and are due no later than March 31, 2021. continued on page 10
The Bulletin | Winter 2021 9
continued from page 9
NOTE: Prior award recipients must complete a new application packet with new letters of recommendation.
NURSING SCHOLARSHIP APPLICATIONS The Saginaw County Medical Society Alliance and Foundation provide $500 nursing scholarships to Saginaw County residents. Requirements for consideration: • Must be a permanent resident of Saginaw County; AND • Currently enrolled in a RN or BSN nursing program or beginning nursing clinical core courses for award year; AND • Overall college GPA no lower than 2.79. The following are not eligible: • RN/BSN to Master’s • RN/BSN to FNP or PA • High school seniors Application packet MUST be complete for consideration. Incomplete applications will be denied. Applications must include: • One-page essay describing your nursing career goals and how this scholarship would help you financially in completing your nursing degree • Two letters of recommendation from current professors • Current transcript • Current resume • Copy of driver’s license
Applications are available at www.SaginawCountyMS.com under the Nursing Scholarships tab and are due on March 31, 2021. 11TH ANNUAL ESSAY CONTEST FEATURING A SPECIAL SCHOLARSHIP IN HONOR OF ZUBEDA S. KHAN, MD Each year, the Foundation sponsors an Essay Contest for high school juniors and seniors who live and attend high school in Saginaw County who want to become physicians and hopefully stay in Saginaw to practice medicine. Students submit an essay of 500 words or less on “Why I Want to Be a Physician in Saginaw County,” in addition to completing an application and submitting a current resume. This year, a special $1,000 scholarship in honor of Zubeda S. Khan, MD will also be awarded. Dr. Khan was a longtime member of the SCMS, and served on the Board of Directors in various positions until her passing on January 30, 2021. The Foundation Board will also choose first through third place winners, receiving $1,000, $600 and $400 respectively. Applications for the 11th Annual Essay Contest are available on the SCMS website under the ESSAY CONTEST tab or by contacting Joan Cramer at jmcramer@sbcglobal. net. Essay Contest applications for 2021 will be accepted beginning February 1, 2021, and are due no later than March 31, 2021.
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The ASAM Treatment Opioid Use Disorder Course covers all evidenceSEP 16, 2017 | 8:00 am –of 12:00 pm LOCATION COST The ASAM Treatment of Opioid Use Disorder all evidenceSEP 16, 2017 | 8:00 am – 12:00 pm based practices and medications for treating Course patientscovers with opioid use LOCATION Live Virtual Learning FREE! The ASAM Treatment of Opioid Use Disorder Course is designed for: based practices and medications for treating patients with opioid use disorder. Live Virtual Learning COST REGISTRATION disorder. • Physicians, Nurse Practitioners, Physician Assistants, Certified Nurse COST FREE! https://elearning.asam.org/p/CMU The ASAM Treatment of Opioid Use Disorder Course is designed for: Midwives, Certified Registered Nurse Anesthetists, and Clinical FREE! April17 The ASAM Treatment of Opioid Use Disorder Course is designed for: REGISTRATION Nurse Specialists who wish to Physician obtain a waiver to prescribe • Physicians, Nurse Practitioners, Assistants, Certified Nurse REGISTRATION https://elearning.asam.org/p/CMU CONTACT buprenorphine in an office-based setting for opioid disorder. • Physicians, Nurse Practitioners, Physician Assistants, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, anduse Clinical https://elearning.asam.org/p/CMU April17 Project Coordinator 8:00 am – 12:00 pm disorder.
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Certified Registered Nurse and •Midwives, Clinicians and healthcare team members such RNs,Clinical MA/LPNs, Nurse Specialists who wish to obtain aAnesthetists, waiver to as prescribe
CONTACT Nurse Specialists wish to obtain a waiver to prescribe social workers, pharmacists, counselors, clinic administrators/office buprenorphine inwho an office-based setting for opioid use disorder. Email: hill1am@cmich.edu The Pyle Center, UW-Extension CONTACT Project Coordinator 8:00 am – 12:00 pm buprenorphine in an office-based setting for opioid use disorder. managers, and others working with providers who • Clinicians and healthcare team members such as RNs,prescribe MA/LPNs, 702am Langdon Project Coordinator 8:00 – 12:00Stpm Alyson McClintock Call: 989.746.7506 buprenorphine in an office-based setting to as treat opioid use • Clinicians and healthcare team members such RNs, MA/LPNs, social workers, pharmacists, counselors, clinic administrators/office Alysonhill1am@cmich.edu McClintock Email: The Pyle Center, UW-Extension Madison, WI 53706 disorder. social workers, counselors, clinic administrators/office OR hill1am@cmich.edu managers, and pharmacists, others working with providers who prescribe Email: The Center, 702 Pyle Langdon St UW-Extension Call: 989.746.7506 managers, and others working with providers who prescribe buprenorphine in anlive office-based setting to treat opioid use Course Format: 8 hours ASAM’s e-learning centerSt for 702 Langdon Call: 989.746.7506 Madison, WI 53706 buprenorphine in an office-based setting to treat opioid use disorder. ORtechnical support. COST - WI $199 Madison, 53706 Thisdisorder. training satisfies eight hours of education requirements for providers OR ASAM’s e-learning center for Email: education@ASAM.org ASAM’s for COSTcenter - $199 technicale-learning support. COST $199 technical support. Call: 301.656.3920 Email: education@ASAM.org Are you an NP or PA? ASAM also Email: education@ASAM.org Call: 301.656.3920 provides the additional 16 hours Call: 301.656.3920 required for NPs and PAs to qualify Are you an NP or PA? ASAM also for a waiver free of charge. Are you anthe NPadditional or PA? ASAM also provides 16 hours provides the additional 16 hours required for NPs and PAs to qualify required for NPs PAsato qualify will and receive $25 gift card forParticipants a waiver free of charge. forfor a waiver free of charge. participating and completing a brief
Course Format: hours live to qualify for a8DEA DATA2000 waiver. Upon completion of this course, Course Format: 8 hours live physicians qualify for the waiver to prescribe buprenorphine in an officeThis training satisfies eight hours of education requirements for providers based setting. NPseight and PAs canofqualify afterrequirements completing anfor additional This training hours education to qualify forsatisfies a DEA DATA2000 waiver. Upon completion of thisproviders course, 16 hours provided by ASAM, the American Association of Nurse to qualify for a DEAfor DATA2000 waiver. Upon completion of this course, physicians qualify the waiver to prescribe buprenorphine in an officePractitioners, and the American of PAs. physicians qualify forand thePAs waiver toAcademy prescribe buprenorphine in an officebased setting. NPs can qualify after completing an additional based setting. NPs by andASAM, PAs can qualify afterAssociation completingofanNurse additional 16 hours provided the American Lead Instructor 16 hours provided by ASAM, the American Association of Nurse Practitioners, and the American Academy of PAs. Practitioners, and the American Academy of PAs. Lead Instructor Co-Instructor Co-Instructor Lead Instructor Lead Instructor Lead Instructor Co-Instructor Co-Instructor Lead Instructor Co-Instructor Co-Instructor
questionnaire along with 8 hours of Participants will receive a $25 gift card Category 1will CME Participants receive a $25 giftacard for participating and completing briefJuliette Perzhinsky, MD, MSc for participating and completing brief questionnaire along with 8 hoursa of questionnaire along with 8 hours of Category 1 CME Juliette Perzhinsky, MD, MSc Category 1 CME Juliette Perzhinsky, MD, MSc
John Lopes, DHSc, PA-C
John Hopper, MD* *an original ASAM instructorJohn Lopes, DHSc, PA-C and board-certified AddictionJohn Lopes, DHSc, PA-C John Hopper, MD* Medicine physician John Hopper, *an original ASAMMD* instructor *an ASAM instructor andoriginal board-certified Addiction and board-certified Medicine physician Addiction Medicine physician ASAM is an approved provider by CSAT/SAMHSA of DATA 2000 training.
ACCME ACCREDITATION STATEMENT: The American Society of Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
ASAMSociety is an approved CSAT/SAMHSA of DATA training. AMA CREDIT DESIGNATION STATEMENT: The American of Addictionprovider Medicineby designates this live activity for2000 a maximum of 8 AMA PRA Category 1 Credits™. Physicians should claim ACCME ACCREDITATION STATEMENT: Theextent American Society Addiction Medicine (ASAM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide only the credit commensurate with the of their participation in the activity. ASAM isofan approved provider by CSAT/SAMHSA of DATA 2000 training. medical iseducation forbyphysicians. ACCME ACCREDITATION STATEMENT: The American Society of Addictioncontinuing Medicine (ASAM) accredited the Accreditation Council for Continuing Medical Education (ACCME) to provide
continuing medical education for physicians. AMA CREDIT DESIGNATION STATEMENT: The American Society of Addiction Medicine designates this live activity for a maximum of 8 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the AMA CREDIT DESIGNATION STATEMENT: The American Society of Addictionactivity. Medicine designates this live activity for a maximum of 8 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Bulletin | Winter 2021 11
Free Confidential Counseling for Frontline Healthcare Workers SCCMHA is offering hospital employees, first responders, healthcare professionals and their immediate family members, throughout the Great Lakes Bay Region, an opportunity to seek and receive mental health counseling assistance free of charge, beyond support provided by an Employee Assistance Plan (EAP).
COVID-19 has Increased the Demand for More Care. We are Responding with More Hours. Due to the COVID-19 pandemic, Saginaw County Community Mental Health Authority (SCCMHA) is responding to an increased need for services with expanded hours at multiple locations. As people grapple with how to deal with stress and anxiety caused by the pandemic, behavioral health services have never been more important. To increase access to care, SCCMHA is extending case management, clinical and crisis service hours, including mental health and substance use disorders, to better serve consumers and our community. Hours have been extended at all SCCMHA locations, including their main
site on Hancock Street and the Towerline and Bay Road locations. These facilities will now be open on Mondays and Wednesdays from 8 a.m. to 7 p.m. and Fridays from 8 a.m. to 6 p.m. Additional hours will provide greater access to services that include case, clinical and crisis management with services like evaluation, screenings, treatments and referral. Substance use
intervention services are also available. SCCMHA is committed to getting our community through this crisis with important supports and services. For more information or to schedule an appointment, visit sccmha.org or call 989-797-3400 or 800-258-8678. Crisis Services remains open 24 hours a day, 7 days a week, including holidays, at 989-792-9732 or 800-233-0022.
A new service to support and assist frontline healthcare workers with behavioral health services is now available from the Saginaw County Community Mental Health Authority.
Free Confidential Counseling for Frontline Healthcare Workers Free, confidential counseling services are available for healthcare professionals and their immediate family to provide help coping with the stress and anxiety due to the COVID-19 pandemic. Professional counselors provide primary care screening, assessment and monitoring of key health indicators. These services are available to those that need extra help coping during this extremely stressful time. There is no shame in talking, in person or virtually, with someone.
Call the Saginaw Community Care HUB at
989.498.2266
for an immediate appointment 12 The Bulletin | Winter 2021
Mental Health First Aid Resilience Every year, we try to find a word to encompass the past 12 months, and there were some to be expected - coronavirus, pandemic and lockdown. But the one we chose may be less obvious - resilience. There is no denying that 2020 was hard. But for all of its trials and tribulations, we made it to 2021. The Oxford Dictionary defines resilience as “the capacity to recover quickly from difficulties; toughness. The ability of a substance or object to spring back into shape; elasticity.” It’s what we’ve needed to practice in 2020, and what we need as we move forward in the new year. Stress related to COVID-19 is at an all-time high - the American Psychological Association’s Stress in America report found that nearly eight in 10 adults say COVID-19 is a major factor in their stress levels. Resilience includes our ability to bounce back from adversity and come back stronger, and while that may not come effortlessly, it is achievable. Here are some tips to help you get started: 1. Accept change. We all got a good dose of change in 2020! Whether we were working from home, virtual learning, or staying indoors for days at a time, we had to adapt to something completely new. Managing your expectations and allowing for flexibility are great places to start, so if things don’t happen as planned, you can continue to adapt. 2. Keep things in perspective. This takes practice, but a great place to begin is thinking about and writing down what you’re grateful for. When you focus on the positives around you, the negatives don’t feel as overwhelming. How you organize your thoughts matters and realizing that some things are out of your control can free you from harmful thought patterns. It helps to think about the big picture. You can’t always change what happens, but you can control how you react to it. 3. Take care of yourself. We can’t emphasize self-care enough, as it really can help bring you to a more positive and
P 989.755.2116 F 989.755.2120 Let us build a relationship with you. Please call Dornbos for your printing needs!
hopeful mindset. Doing nice things for yourself or planning activities you enjoy can promote a better mood, and it’s a great excuse to do something enjoyable for yourself if you’ve been feeling down. Try going for a brisk walk, watching a funny movie or crafting – anything that’s going to make you feel more like you. 4. Prioritize relationships. Connecting with other people and cultivating relationships are innately human activities; we are social by nature. Lean on your social network for support if you need it. You are not alone in feeling “2020 fatigue,” and investing time in your relationships will help foster a sense of solidarity. Your friends and family may need some support from you as well, so be sure to offer them help too. 5. Seek professional help. Last year was far from the norm, and if you’re finding it hard to adjust, know that help is available. A licensed mental health professional can help you find some strategies for staying afloat and moving forward. Community organizations and faith-based groups are also available for support. The important thing to remember is that you are not alone, and your well-being is the top priority. No matter how difficult or transformative 2020 felt, the new year is here, and you can take full advantage of this symbolic chance to start over. One day, COVID-19 will be a memory but your resilience will remain. Staying resilient in 2021 will keep us strong, positive, and hopeful – the days are going to keep coming and new challenges will undoubtedly arise as the year unfolds. But with the right tools and strong support systems, you can tackle this year with renewed strength and confidence. You’ve already come so far, and that in itself is reason to celebrate. For more tips on staying resilient in the face of hardship, take a Mental Health First Aid course this year so you can #BeTheDifference for yourself and those around you in 2021. Courtesy of Mental Health First Aid USA on January 8, 2021
COMPLETE DESIGN SERVICES Letterheads • Business Cards Envelopes • Brochures • Calendars Flyers • Cookbooks • Annual Reports Note Sheets • Newsletters • Mailings Large Format Posters • and much more… PRINT SERVICES Offset Printing • Die Cutting Foil Stamping • Embossing • Film Output Thermography • Black & White Copies Color Copies • Laminating • Union Bug The Bulletin | Wintee 2021 13
CMU Office of Continuing Medical Education 2021 UPDATE: How to Obtain CME/CE Credit CMU OCME has updated its credit claiming process. Additionally, the website has been updated to provide easier navigation of live and CME ONLINE. To claim CME credit for AMA PRA Category 1 CreditTM, AOA Category 1-A or 1-B, Social Work or other credit, go to MED.CMICH.EDU/CMECERT The new and updated CME Menu will appear:
Activities remain OPEN for 30 days. A Certificate is available immediately and the activity is added automatically to your transcript. Please contact us with any questions at CMEDCME@cmich. edu or call (989)-746-7602 or (989)-746-7555. Central Michigan University College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME®) and awarded the ACCME’s highest level of accreditation: Accreditation with Commendation. Accreditation in the ACCME System seeks to assure the medical community and the public that Central Michigan University College of Medicine Office of Continuing Medical Education and Continuing Education delivers education that is relevant to clinicians’ needs, evidence-based, evaluated for its effectiveness, and independent of commercial influence."
NEW USERS must create a profile, then sign-in and follow onscreen instructions. Click Claim Credit on the left banner, then click on the specific discipline, grand rounds or conference type.
NEW USERS must create a profile, then sign-in and follow onscreen instructions. Click Claim Credit on the left banner, then click on the specific discipline, grand rounds or conference type. NEW USERS must create a profile, then sign-in and follow onscreen instructions.
Click Claim Credit on the left banner, then click on the specific discipline, grand rounds or conference type.
Focusing our practice on the needs of our community, we provide the following services for both individuals and businesses: n Monthly Accounting n Tax Planning n Financial and Business Consulting Service n Payroll Service n Tax Preparation Service n Retirement Planning Contact us for a complimentary visit at 989-791-1040.
www.SaginawCountyMS.com 14 The Bulletin | Winter 2021
Three convenient locations to serve you in: Saginaw | Vassar | Frankenmuth
“Attention to detail since 1980.”
CMU Medical Education Partners and Covenant HealthCare Announce New Pediatric Residency
CMU Seeks Clinical Educators and Partnerships in MAT to Treat Opioid Use Disorders
Healthcare for children in the Great Lakes Bay Region will soon be more available as Central Michigan University Medical Education Partners establishes a pediatrics residency program that will reduce the region's pediatrician shortage. CMU Partners anticipates the program will welcome residents in July 2022. "We are pleased to launch this program with Covenant HealthCare, an established partner of Central Michigan University and the region's leader in pediatric services," said Samuel J. Shaheen, MD, Executive Director of CMU Medical Education Partners. "Building on the high standard of quality, compassionate care at Covenant, the residency program will create outstanding learning opportunities and expand an already significant array of specialty services to include pediatric neurology, endocrinology and infectious disease, allowing more families to receive first-class care close to home." The new residency program exemplifies the synergies between CMU and regional communities to meet the population's critical healthcare needs. CMU residents and medical students will benefit from the program's learning opportunities. In addition, the program brings more than $1 million in graduate education funding from the U.S. Centers for Medicare and Medicaid Services into the community. "Expanding medical education is a strategic investment in the improvement of human health in our communities," said George E. Kikano, MD, CMU Vice President for Health Affairs and Dean of the CMU College of Medicine. "The College of Medicine's mission is to educate physicians to provide excellent care to the underserved. Because the majority of physicians remain in the area where they conducted their residency, we are addressing the region's short and long-term need for pediatricians." Covenant HealthCare is a part of CMU Medical Education Partners, the nonprofit entity that oversees the CMU College of Medicine's residency programs in Saginaw. "As the major provider of pediatric care in the Great Lakes Bay Region and beyond, Covenant HealthCare is excited to be working with CMU's College of Medicine to bring a new pediatric residency to Saginaw," said Michael W. Sullivan, MD, Covenant's Chief Medical Officer. "This new academic program will certainly enhance the extraordinary care provided to the children we serve and their families."
Opioids (including prescription opioids, heroin and fentanyl) killed 46,802 people in 2018, and nearly 70 percent of all opioid overdose deaths involved a prescription opioid. The opioid epidemic is hitting close to home – Michigan has experienced a 16 percent increase in synthetic opioid related deaths in 2018. The COVID-19 pandemic has led to increased opioid use and overdoses, which emphasizes the need for clinicians to become MAT prescribers. CMU College of Medicine and the CMU PA Program have worked to implement a MAT training program into the curriculum for medical and PA students. Phase 1 of the curriculum is to combat the opioid epidemic by training medical and PA students with 8-hours of mandatory classroom learning (and additional 16-hours online for PA students) using the American Society of Addiction Medicine’s (ASAM)-accredited curriculum with medication-assisted treatment (MAT) Drug Addiction Treatment Act (DATA) waiver training requirements. Phase 2 of the curriculum is providing these students with an opportunity in a clinical setting working with patients receiving MAT for opioid use disorder at certified Opioid Treatment Facilities or at primary care offices offering MAT for opioid use disorder in the form of office-based outpatient treatment. We are seeking partnerships with clinical educators at certified opioid treatment facilities or primary care offices that offer MAT to host our students for this clinical experience. If you are interested in hosting students, please contact Alyson McClintock at hill1am@cmich.edu or at (989) 746-7506. Thank you. Juliette Perzhinsky, MD, MSc and Alyson McClintock, Project Coordinator SAVE THE DATE: Free 8-hour MAT DATA Waiver Training Through ASAM – Saturday, April 17, 2021, from 8:30 a.m. to 4:30 p.m. (see page 11 for information and to register)
Dr. Pruitt Appointed to Protect Michigan Commission Delicia J. Pruitt, MD, CMU Health physician and associate professor of family medicine for CMU College Of Medicine, is paving the way for public health in the Great Lakes Bay Region and beyond. continued on page 20
The Bulletin | Winter 2021 15
Guide to Surprise Billing Provisions in the Consolidation Appropriations Act of 2021
F
ollowing is an initial guide to the major provisions in the “No Surprises Act,” the surprise billing legislation that was included in the Consolidated Appropriations Act COVID-19 relief bill signed into law on December 27, 2020. The No Surprises Act allows for price transparency, provider directories, and patient financial protections that impact health plans, physicians, facilities, and other non-MD/DO licensed health care professionals. The law goes into effect on January 1, 2022. The intent of the law is not to preempt state surprise billing laws. However, there is some ambiguity in the statutory language that will require further clarification before and during the rulemaking process, including when the surprise billing protections apply to patients in self-funded ERISA plans. The AMA will work with Federation members and other stakeholders to seek clarification to address these ambiguities, and will revise this guide accordingly as new information becomes available. Terri Marchiori Director, Federation Relations Terri.Marchiori@ama-assn.org The Consolidated Appropriations Act COVID-19 relief bill signed into law on December 27, 2020, is a comprehensive, $1.4 trillion legislative package that includes COVID-19 related relief for physicians and provides funding for health care related government operations through the end of fiscal year 2021. This new law includes the “No Surprises Act” (the Act), which allows for price transparency, provider directories, and patient financial protections that impact health plans, physicians1, facilities, and other non-MD/DO licensed health care professionals effective January 1, 2022. The following guide details the important provisions of the Act.
Patient Protections (Surprise Billing) Scope of Protections The Act protects patients from surprise medical bills when they receive unanticipated out-of-network care in emergency and nonemergency settings. Specifically, the law applies to out-of-network providers (see footnote 1) and facilities delivering emergency care and out-of-network providers delivering emergency and nonemergency care at in-network facilities. The law also protects patients from surprise bills from out-of-network air ambulance services.
Cost-Sharing Patients are only responsible for cost-sharing amounts that would be their responsibility if care had been provided in-network (emphasis added). Additionally, providers will be barred from holding patients liable for higher amounts. The patient’s cost-sharing is based on the recognized amount2. Impact on Uninsured The Act requires the Secretary of Health and Human Services (HHS) to establish an Independent Dispute Resolution (IDR) process by January 1, 2022, for circumstances in which an uninsured patient’s bill is “substantially in excess” of a good faith estimate. For the purposes of the Act, “uninsured” means that a patient does not have “benefits” for the item or service.
Process for Resolving Payment There must be an initial payment (determined by the plan) directly from the plan to the provider, or a notice of a denial, within 30-days after the provider transmits the bill to the plan. If the provider is not satisfied with the payment from the plan, they may begin a 30-day open negotiation period. If an agreement cannot be reached in the open negotiation period, the plan or provider has four calendar days to notify the other party and Secretary of HHS that they are initiating an Independent Dispute Resolution process.
Independent Dispute Resolution (IDR) IDR Process The IDR process establishes an arbitration procedure that allows independent review of provider-plan disputes. Within three days following the date the IDR process is initiated, the provider and plan must jointly select a certified IDR entity. IDR is initiated when the provider or plan submits a notification to the other party and Secretary of HHS. The parties may continue negotiating during the 30-day IDR process, and may agree on a payment amount before the end of the IDR process (in such case both parties will share the cost to compensate the IDR entity). Within 10-days of selecting the IDR entity, the parties must submit final offers, information requested by IDR entity, and additional information (subject to certain exceptions) the parties believe are relevant to their offers. continued on page 17
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The party whose offer was not chosen by the IDR entity pays the costs of IDR (emphasis added). Payment for the disputed services must be made to the provider within 30-days of the IDR entity’s determination. Batching is allowed for claims submitted within a 30-day period that meet the following criteria: • Services furnished by same provider or facility. • Services provided to patients under the same plan. • Services are for treatment of similar conditions. The party that initiated IDR cannot initiate a new IDR process with the same party and for same services for 90 days. However, once the 90-day period is up, the party may submit (appropriately batched) claims from that 90-day period to IDR. Factors Considered by the IDR Entity Within 30 days, the IDR entity selects one of the offers submitted and must consider: • Offers by both parties; and • Qualifying payment amount (see footnote 2) for the same service in the same geographic region. The IDR entity can also consider the following factors: • Training, experience, quality and outcomes measurements; • Market shares of parties; • Acuity of patients/complexity of cases; • Teaching status, case mix, scope of services of facility; and • Good faith efforts by parties to contract and contracting rate history from last four years. The IDR entity cannot consider: • Usual and customary rates; • Billed charges; and • Payment rates by public payors, including Medicare, Medicaid, CHIP and Tricare.
Notice and Consent Requirements for Providers Out-of-network providers providing scheduled services at in-network facilities may not bill a patient more than the innetwork cost-sharing requirements or balance bill the patient unless notice and consent requirements are met. Such notice and consent requirements are met if: • The patient is provided written notice and consent 72 hours in advance of appointment. • Documents provided to patients must include a good faith estimate of the costs of the services (the language specifies this advanced notice does not constitute a contract). • Patients must also receive a list of in-network providers at the facility, and information regarding medical care management, such as prior authorization. At in-network facilities, the notice and consent exception does not apply to out-of-network providers of radiology, pathology, emergency, anesthesiology, diagnostic, and neonatal services; or to assistant surgeons, hospitalists,
intensivists, and providers offering services when no other innetwork provider is available. The Secretary of HHS may apply civil monetary penalties of up to $10,000, but may provide a hardship exemption or waive the penalties for providers and facilities that did not knowingly violate the requirements laid out under the statute.
Provider Directories Effective January 1, 2022, health plans must ensure provider directories are current and accurate, with regular verification of provider contract status and updates required at least once every 90 days. Providers are required to submit regular updates to group health plans and insurers to assist with their verification and update process, including notice of material changes to their provider directory information. The database of provider directories must be updated within two business days of the health plan receiving such data. Health plans must also respond to enrollees about a provider’s network status within one business day of a request and establish a database of in-network providers. In addition, they must retain communication records for two years, retain a website directory with contracted providers and relevant information (name, address, specialty, number, digital contact information) and post information on balance billing protections including, if provided under state law, the amount providers/facilities may charge, and appropriate federal and state agency contacts to report violations. Effective January 1, 2022, providers must have a process in place to ensure timely provision of directory information to a plan. At minimum, the provider must submit directory information when beginning a network agreement, when the provider terminates an agreement, when any material changes (e.g., practice location) are needed to the content of provider directory information, and any other time determined appropriate by Secretary of HHS. If a patient provides documentation that they received and relied on incorrect information from a plan about a provider’s network status prior to a visit, the plan cannot impose a cost-sharing amount greater than in-network rates, and it must count toward the patient’s in-network out-of-pocketmaximum and in-network deductible. If a provider submits a bill to an enrollee in excess of in-network cost sharing amount and enrollee pays, the provider must refund that excess amount with interest.
All Payer Claims Databases (APCD) The Act authorizes HHS to make one-time grants to states to establish an All-Payer Claims Database (APCD) or improve an existing one. The grants will be offered for a period of three years for a total of $2.5 million. States receiving grants will allow access for researchers and entities (including health care continued on page 18
The Bulletin | Winter 2021 17
continued from page 17
providers and plans) for purposes of quality improvement or cost-containment (pending application and approval). HHS may prioritize applicants that will work with other states APCDs to establish a single application for access to data across multiple states. The Secretary will create an advisory committee to establish a standardized reporting format for self-insured plans to submit claims to APCDs.
Additional Transparency and Consumer Protections Provider Price Transparency The Act includes provider transparency measures, effective January 1, 2022. Among other provisions, the Act requires an out-of-network provider to deliver to the patient’s health plan (or directly to the patient if uninsured) a “good faith estimated amount” of all billing and service codes for all items and services expected to be furnished to the patient, prior to obtaining the patient’s consent to treatment. Providers must share these estimates with the relevant party at least three days prior to rendering the scheduled services, and within one day of scheduling unless the services are scheduled more than 10-days later (in which case the provider must disclose such information within three business days of scheduling). Furthermore, the HHS Secretary must establish by January 1, 2022, a “patient-provider dispute resolution process” to resolve any disputes concerning bills received by uninsured individuals that substantially differ from a provider’s good faith estimate provided prior to the service being rendered. The Act contains additional new transparency measures, such as mandating that providers make publicly available on their website a short explanation of federal and state requirements and prohibitions related to balance billing. This explanation must include contact information for relevant enforcement agencies aggrieved patients may contact to file complaints. The HHS Secretary is empowered to establish a formal consumer complaint process through future notice and comment rulemaking, expected within the next six months.
Health Plan Benefits and Price Transparency The Act implements new requirements for health plans that bolster price transparency and improve consumers’ access to health plan information. Beginning January 1, 2022, health plans must provide enrollees with an “Advanced Explanation of Benefits” (AEOB) prior to scheduled care or upon patient request prior to scheduling. The AEOB requirement is triggered by a provider sending the health plan a “good faith estimated amount” for such scheduled services, and must contain the network status of the provider, information on prior authorizations, estimates of any applicable rates, the enrollee’s expected out-of-pocket expenses, the health plan’s expected expenses, and the amounts already incurred 18
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towards the enrollee’s out-of-pocket limits. While a health plan must send the AEOB either within three days of receiving a request or a notice that a service has been scheduled at least 10 business days later, or within one business day of receiving the notice if the service is scheduled within 10 business days of receipt, the Act grants the HHS Secretary the authority to modify such timing for certain services. Additionally, the Act regulates elements of health plan contracts with both providers and enrollment assistance services. It prohibits “gag clauses” in agreements between health plans and providers that directly or indirectly restrict a health plan from disclosing, or a plan sponsor, referring provider, or group or individual market consumer from accessing, provider-specific price, cost or quality data. This gag clause prohibition extends to contractual terms that would bar access to de-identified service codes, claims and encounter data, and provider information. The Act permits a provider to place “reasonable restrictions” on the public disclosure of the information subject to the gag clause prohibition; the bounds of such restrictions remain undefined and subject to interpretation. The Act further regulates health plan contracts by requiring brokers of and consultants to employersponsored, individual market, and short-term limited duration health plans to disclose any direct and indirect compensation they may receive for enrollment services. The Act also imposes new obligations on health plans to report, among other data, plan-specific prescription drug spending and hospital spending information to the HHS, Labor, and Treasury Secretaries. These disclosures will inform new tools detailing drug pricing trends that will be published on the HHS website and made available to consumers.
Transparency Regarding In-Network and Out-of-Network Deductibles and Out-of-Pocket Limitations A group health plan or a health insurance issuer offering group health insurance coverage and providing or covering any benefit with respect to items or services shall include, in clear writing, on any physical or electronic plan or insurance identification card issued to the participants or beneficiaries in the plan or coverage the following: Any applicable deductible, any out-of-pocket maximum limitation, and a phone number and website through which consumer assistance may be sought.
Patient Financial Protections Protecting Patients and Improving the Accuracy of Provider Directory Information As noted earlier, additional provider directory information is required to improve accuracy and protect patients including establishing a verification process, response protocol and a more detailed database. continued on page 19
continued from page 18
Continuity of Care If a provider contract is terminated without cause, a “continuing patient” can continue to receive services from the newly excluded provider for either 90 days or the date when the services are no longer needed, whichever is earlier.
State Law Implications The intent of the law is not to preempt state surprise billing laws (emphasis added). However, there is some ambiguity in the statutory language that will require further clarification before and during the rulemaking process, including when the surprise billing protections apply to patients in self-funded ERISA plans. The AMA will work with Federation members and other stakeholders to seek clarification to address these ambiguities and will provide updates as new information becomes available.
Required Reports • HHS report with the Federal Trade Commission and U.S Attorney General on effects of the Act on integration, costs, and access. • Government Accountability Office (GAO) report on impact of surprise billing changes on networks, access, premiums, out-of-pocket costs. • GAO report on network adequacy. • GAO report on IDR and potential financial relationships.
Effective Dates The No Surprises Act goes into effect on January 1, 2022, including the following: • The Secretary of HHS must establish the IDR process to resolve surprise medical billing disputes. • The Secretary of HHS must establish a dispute resolution process for when an uninsured patient’s bill is “substantially in excess” of the good faith estimate. • Health plans must ensure provider directories are current and accurate, with regular verification of provider contract status and updates required at least once every 90 days. • Providers and facilities must have a practice in place to ensure timely provision of directory information to a plan. • Health plans must provide enrollees with “Advanced Explanation of Benefits” (AEOB) prior to scheduled care or upon patient request prior to scheduling. The statute’s use of the term “provider” includes physicians and other non-MD/DO licensed health care professionals. 2 The recognized amount is the: (1) Amount under specified state law (as applied to plans regulated by state law); (2) Qualifying payment amount; or (3) If the state has an All-payer model agreement, then the amount the state approves. 1
The qualifying payment amount in 2022 is the median of the contracted (i.e., in-network) rates as determined by all plans of a plan sponsor or all coverage offered by the health insurance issuer in the same “insurance market” on 1/31/19, increased by the consumer price index for all urban consumers (CPIU). The qualifying payment amount in 2023 is: (1) Based on previous year + CPIU; (2) For new plans, the HHS Secretary determines methodology; or (3) If there is insufficient info to determine, the plan will use database allowed by Secretary of HHS. © 2021 American Medical Association. All rights reserved.
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Healthway Compounding Pharmacy 2544 McLeod Dr. N. | Saginaw, MI 48604 | 989.791.1691 | www.healthwayrx.com The Bulletin | Winter 2021 19
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Governor Gretchen Whitmer appointed Dr. Pruitt, Medical Director for the Saginaw County Health Department, and other local leaders to the bipartisan Protect Michigan Commission. Delicia J. Pruitt, MD The commission will help raise awareness of the safety and effectiveness of an approved COVID-19 vaccine, as well as, educate and help protect the health and safety of all Michigan residents. READ MORE
CMU Medical Students Administer COVID Vaccine CMU medical students joined with the Saginaw County Health Department, Covenant HealthCare and Ascension St. Mary’s in an effort to vaccinate citizens in Saginaw County, age 65 and older. Students staffed a drive-thru clinic to administer safe and effective vaccines. We appreciate our students’ dedication to our community, to their profession and to the mission of the College of Medicine to provide compassionate, competent care. We do caring. We do community. We do. #CentralMichiganUniversity
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1 20 The Bulletin | Winter 2021
HE MONTH
IDER OF T KEY PROV
for emergency care
no one beats
covenant In an emergency, seconds count. Count on Covenant HealthCare Emergency Center for: • The region’s only specialized pediatric and senior emergency care • The region’s first Accredited Geriatric Emergency Department • The only Level II Trauma Center in the area verified for both adult and pediatric trauma care • Extraordinary safety, awarded an “A” grade in patient safety from the Leapfrog Group • Board-certified emergency physicians and specially trained nurses, named Team of the Year by Press Ganey Associates in 2019 • 65 private patient rooms Don’t settle for less. In an emergency, no one beats Covenant.
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Ascension Medical Group Consolidates Orthopaedics and Sports Medicine to a New Location It is with great excitement that Ascension St. Mary’s announces a new home for Ascension Medical Group (AMG) Orthopaedic and Sports Medicine. Located near Ascension St. Mary’s Towne Centre in Saginaw Township, AMG Orthopaedics and Sports Medicine is officially now on the second floor of Medical Arts Three Building, 4677 Towne Centre Road. The newly renovated space now features 22 exam rooms, two x-ray rooms and a large waiting room area. In addition, there is a casting room and state-of-the-art durable medical equipment (DME) room, complete with supplies on site. All AMG orthopaedic and sports medicine providers are now centrally located at the new site. This includes: Waheed Akbar, MD Angel Bermudez, MD Nathan Krebs, DO Kevin Lawson, MD David Lemos, MD
Laura Reitz, DPM Tarek Taha, MD Pervez Yusaf, MD Molly Bonnington, NP Tiffany Wirtz, NP
Services offered include the treatment of sports-related injuries including degenerative problems of the shoulders, knees, ankles, feet and elbows; non-operative and surgical services including complex reconstructive procedures (both arthroscopic and open); joint replacement including MAKO for total hip and knee procedures. AMG Orthopaedic and Sports Medicine is open Monday Thursday from 8:30 a.m. to 5 p.m. and Friday from 8:30 a.m. to 12 p.m. The office can be reached at (989) 790-6719.
• have a body mass index (BMI) greater than or equal to 35 • have chronic kidney disease • have diabetes • have immunosuppressive disease • are currently receiving immunosuppressive treatment • are 65 years of age and older The treatment is not curative; however, it has been shown to help patients recover quicker by reducing the severity of symptoms and the length of the illness by a day (on average). If you are notified that one of your patients is COVID positive and they meet the criteria for inclusion in the therapy, please consider contacting your patient to discuss the option of this treatment. Treatment is offered at Ascension St. Mary’s COVID Infusion Center, 4599 Towne Centre Road, Saginaw. Hours of service are Monday-Friday by appointment. To schedule an appointment, or for more information, please call (989) 907-4187. A final determination for receiving the therapy will be made upon arrival at the Infusion Center (if symptoms were to worsen or resolve, the person would not receive therapy even if they have a scheduled appointment). Individuals will be billed for infusion therapy services but not for the drug.
Ascension St. Mary’s Opens New Emergency Care Center Addition
Monoclonal Antibody Therapy Infusion Center Offered at Ascension St. Mary’s Towne Centre Ascension is proud to offer one of the latest therapeutics available for COVID patients - monoclonal antibody infusion - which is an experimental drug under Emergency Use Authorization from the FDA. The therapy is available at Ascension St. Mary's - Towne Centre, Ascension Standish Hospital and Ascension St. Joseph Hospital. These locations are using Bamlanivimab for this therapy and may use Regeneron in the near future. There are many inclusionary and exclusionary criteria for the appropriate patient population. Generally, this treatment is intended for mild to moderate COVID-19 positive patients - adults and pediatric patients at least 12 years of age who do not require hospitalization but are at high risk for progressing to severe COVID-19 and/or hospitalization. High risk is defined as patients who meet at least one of the following criteria: 22
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On Monday, January 4, Ascension St. Mary’s opened their new Emergency Care Center addition. The newly constructed building provides patients with an airport style drop-off/pick up and continuous drop-off canopy for inclement weather. Individuals will also find a new registration and triage area which will improve patient flow and increase capacity and efficiency. The waiting area is larger, more spacious and features modern day furnishings to improve the patient and visitor experience. Access for ambulances is also greatly improved with a new point of entry and multiple parking bays. The $17.6 million expansion project began in October 2019 with six phases of work. Phase two is now complete. The next phases of work will involve the existing emergency continued on page 24
Saginaw’s only Comprehensive Stroke Center Advanced stroke care close to home Ascension St. Mary’s is certified as a Comprehensive Stroke Center which means we provide the highest level of care available anywhere in the greater Saginaw area. Should you or your loved one need it, you’ll have access to advanced training, technology and capabilities all located within Ascension St. Mary’s Hospital. Our stroke specialists work quickly to understand your situation and deliver the care you need, including follow-up care, when you need it.
To talk to a doctor about your risk for stroke - call 844-960-1435..
If you are experiencing a life-threatening emergency, go directly to the ER or dial 911.
© Ascension 2020. All rights reserved.
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MSMS REIMBURSEMENT ADVOCATE ALERT MSMS provides periodic updates to members and their offices on new and relevant payer policies. Please find some recent highlights below. For a comprehensive accounting of a health plan's announcements, please consult the payer’s official communications.
BCN - Fee Schedule Request BCN has set up a new mailbox, feeschedule@bcbsm.com, for physicians to request copies of Blue Care Network fee schedules. Fee schedules are reviewed and updated annually. The following information is needed when emailing BCN to request a fee schedule: • A copy of your signed licensing agreement (a copy of the licensing agreement can be requested from customer service or by calling Provider Inquiry at 1-800-344-8525. There is a link to a recent licensing agreement in the Claims chapter of the BCN Provider Manual, in the section titled, “Pricing and fees.”) • Type 2 NPI • Specialty • Tax ID number • Medical Care Group affiliation • Primary practice address
If there are questions about the fee schedule, contact your provider consultant. Note: BCN only provides fee schedules to physicians who participate in the network. If you are not currently contracted and would like to become a participating provider, go to https://www.bcbsm.com/providers.html and click Join our network, or contact Provider Enrollment at 1-800-822-2761.
BCBSM and BCN Members Will Pay Zero Out-ofPocket Costs for COVID-19 Treatment Through September 30 BCBSM and BCN will continue to waive cost sharing for members who are diagnosed and treated for COVID-19 through September 30, 2021. This extension of a temporary benefit ensures members will not pay out-of-pocket costs - copays, deductibles or coinsurance - for the medical care associated with COVID-19. The temporary waiver applies to all commercial and Medicare Advantage plans offered by Blue Cross and Blue Care Network. Please contact Stacie Saylor or 517-336-5722 for questions or concerns.
Ascension St. Mary's continued from page 22
department space to create new, larger exam rooms and trauma suites. All of the enhancements will transform the facility into a state-of-the-art emergency and Level II Trauma Care Center with 24 exam/treatment rooms and two trauma rooms. As Michigan’s northernmost Comprehensive Stroke Center, the new Emergency Care Center will further strengthen the hospital’s ability to provide high quality stroke care.
PerfectServe Mobile Application Just a reminder if you haven't downloaded the PerfectServe Mobile App, please do so and log in. PerfectServe will be used at Ascension St. Mary's as a primary source of communication. 24
The Bulletin | Winter 2021
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By Louis L. Constan, MD
It Could Happen to Anyone Let’s admit it. We who have been steeped in the “real” physical sciences of Anatomy, Microbiology, Pharmacology and Physiology, have sometimes viewed the “behavioral sciences” as the inferior step-child of medicine. This has been going on for so long that no one even remembers when it started, but it was probably when Abraham Flexner conceived the modern American Medical School in 1910. The result is that while physical-science-medicine has soared, behavioralscience-medicine has had far less attention and support. Mental health hospitals closed, beds cancelled, residencies underfunded, research funding anemic. The upshot: While we have cures for cancer, genetic disease and clogged arteries, we are failing at treating diseases of the mind. Cases in point: Depression is now the number one cause of work life lost to disability1; suicide is now the number three cause of death in young Americans; and, also in America, this year and every year, one in five adults will have a mental health problem that impairs their ability to function. Morbidity is the important concept here. The ability to function is paramount. If we treat the patient for a physical disease such as heart disease or cancer but they do not recover sufficiently to go back to work or to care for their family, it is not proper to regard the treatment as an unqualified success. The patient still has some morbidity. And that is exactly the way to look at mental issues. Mental illness is hard to quantify with imaging or lab tests…but it can be quantified thru inability to function, morbidity; and that morbidity is now looming ominously over our world. Now think about how this morbidity might impact you as a physician. You see a great many people on a day-to-day basis, patients, staff, colleagues; and there is no getting around the probability that some of them will be impaired and that will affect their interaction with you. Could such impairment affect your ability to practice? Quite possibly. Now expand this idea and think about how such morbidity might affect the ability of our community to achieve its economic goals. Many community leaders have been concerned about this for some time. And so, we are very, very fortunate that mental health is one of the key areas of focus in THRIVE. This intervention will continue to connect dozens of key leaders bringing their efforts to bear on this problem. So far we see important progress in the region. Our Psychiatric infrastructure has been augmented with: • New Psychiatrists working for CMU in their new Residency Program, but also seeing patients.
• Eight new CMU Psychiatric Residents graduating each year. • A Psychiatric Nurse Practitioner program at SVSU which trained 16 new providers in 2020. • Healthcare systems adding a number of licensed social workers to primary care settings. Now, much more needs to be done. It is estimated that in a given year, one in five adults will experience a mental illness, and 46 percent of adults will experience a mental illness in their lifetime. Applying these statistics to the Mid-Michigan adult population, THRIVE estimates that 119,000 adults in Mid-Michigan will experience a mental illness in their lifetime. This will require an additional 311 mental health providers to adequately take care of them. With so much more to do, we require a generational effort here. First, we must counteract the prevalent stigma of We must educate people mental disease. We must of all ages that mental educate people of all ages illness is real, it is serious, that mental illness is real, it is serious, we need to we need to recognize it recognize it when it occurs, when it occurs, and we and we need to know what need to know what to do to do when we see it in a friend or loved one. when we see it in a friend Educational efforts are or loved one. being planned - starting in young children and moving up through college-aged students, young adults and even seniors. There are also efforts to train parents, teachers, seniors and doctors. With a problem this serious, this prevalent, this generation, we need all-hands-on-deck. That means YOU! THRIVE is creating the framework for us all to collaborate. It is time for all of us to do our part. Check out https://thrivegreatlakesbay. org/ to be on the distribution list for THRIVE, and be open to the various actions to improve mental health and resilience. We must educate ourselves, our staffs and our patients. And we must recognize and assist those with mental illness, be it family members, friends or patients, to obtain treatment.
1 This is worldwide statistic from the United Nations Department of Economic and Social Affairs
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IN MEMORY Please keep the families of those who passed in your prayers. Zubeda Saied Khan, MD On January 30, 2021, we lost our beloved friend, Dr. Zubeda Saied Khan. Dr. Khan is survived by her husband, Dr. Mohammad Y. Khan, her two daughters, Mariam and Angubeen, and two brothers. Dr. Khan was born in Pakistan in 1962, where she earned her medical degree from Dow Medical College in 1987. Shortly after she met her husband, Dr. M.Y. Khan, and they married in 1989. Dr. Khan completed her family medicine residency at Saginaw Cooperative Hospitals, Inc., and then joined Janes Street Academic Health Center. She then spent several years with Covenant MedExpress and St. Mary’s of Michigan in Birch Run before joining Phoenix Family Physicians in Saginaw. Dr. Khan spent the last few years in private practice. A pillar in the local community, Dr. Khan was a teacher and mentor to many through the Islamic Center of Saginaw. She was knowledgeable on many subjects including history and world religions, an avid gardener and reader, talented chef, and she enjoyed many crafts including embroidery, knitting and sewing. Dr. Khan joined the SCMS Board as an Alternate Delegate in 2009. She went on to serve as a Delegate, Director and President-Elect. Due to her illness, she resigned from the SCMS Board before serving her term as President, but she will always be remembered for her commitment and compassion in serving the Saginaw community, and she will be missed by us all. In accordance with Muslim tradition, funeral and burial services were held on January 30. Those planning an expression of sympathy may to consider the Saginaw East Side Soup Kitchen or the Islamic Center of Saginaw. Phyllis Joy Love, beloved wife of Dr. Neil W. Love Phyllis Joy Beach was born in Akron, Ohio, on June 24, 1930. She left this earthly life on Friday, January 15, 2021. She was born later in life to her mother and father, and had three older sisters. She said it was wonderful growing up because she was so spoiled. It was like she had four mothers instead of one. Phyllis married Neil W. Love, MD on December 30, 1952. They eloped while Neil was on Christmas break during medical school. They were married for 68 years and had a 26
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wonderful life together. His family practice was connected to their home, where she worked in the office, even helping deliver a few babies during those years. She organized the Club 30 Dance Club in Frankenmuth back in the day, and their parties were legend. Phyllis was a great entertainer, social chairman and cook. She would tell you that her greatest accomplishment and joy was raising her three children; Jeff Love (Nicole Bertram-Love) of Shady Side, MD; Jill Love (Rodney Marlow) of Pinckney, MI; and Janet Love (Brent Polak) of Superior Twp., MI. She raised her children with love and devotion in Frankenmuth. She also leaves her beloved eight grandchildren and 10 great-grandchildren. Being a homemaker was, in her eyes, God’s work and she was proud to devote her life to it. Phyllis loved flower gardening and traveling. She had a passion for pro football, usually siding with the underdog, so everyone ‘had a turn’ she’d say. She enjoyed knitting, collecting seashells and adding to her jewelry collection. She was proud to be a member of PEO, an organization she participated in for over 25 years. She loved strong and her love lives on. Arrangements were handled by Cederberg Funeral Home in Frankenmuth. A memorial will be held this summer in the hopes all can gather together and celebrate her life. Those planning an expression of sympathy are invited to make a donation to Unity Church of Bay City, 3736 State Street Road, Bay City, MI 48706, home to her spiritual mentor, Aelola James, or to a charity of your choice. Mary “Jackie” Martin, beloved wife of the late Dr. Jack Martin Mary "Jackie” Martin, age 88, of Chelsea, Michigan passed away on Saturday, January 16, 2021. Jackie was born in Dexter, Michigan on July 25, 1932, the daughter of William and Grace (Duris) Shields. Jackie attended primary school at St. Thomas the Apostle Catholic School in Ann Arbor. After high school, Jackie attended college at the University of Michigan in Ann Arbor where she received her business degree in 1955. During this time, Jackie was set up on a blind date by her sorority sisters with Jack Martin, a pre-med student from Belding, Michigan. The date was a success as Jack and Jackie were married in 1956. Together, they formed a partnership filled with love, laughter, respect, adventure and adoration that lasted for 63 years, until Jack's passing on February 18, 2020. Jackie began her career as an accountant at General Motors and supported her husband through medical school. Once Jack continued on page 27
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completed his training, Jackie would become the chief financial officer for his orthopedic practice in Saginaw, as well as, chief executive officer in the home, raising their two children, Bradley and Brian. The Martin's would go on to become beloved and active members of the Saginaw community and parishioners of St. Stephen Church for more than 30 years. At just five feet tall, Jackie was living proof that the best things come in small packages. Her passion for business and sports were on full display at the Saginaw Country Club, where she was both president of the Ladies Golf Association and a perennial club champion. Fellow members ultimately urged Jackie and her golf partner and lifelong neighbor, Jane Bommarito, to "break up the band" in order to give someone else a shot at glory. With the kids off to college, Jackie and her friend, Maureen McCabe, opened a silk flower plant shop from 1986 through 1992. Even if sales of fake plants to corporate offices never sailed through the roof, their shared laughter and joy always did. Jackie was a diehard alumni fan of the University of Michigan football team, as well as, her beloved Detroit Tigers. While her opinions of each team ran as hot and cold as Michigan's inclement weather, she remained mostly loyal to both to the end. Truth be told, as an Irish Catholic, Jackie (and yes, even Dr. Jack) also had a not-so-secret love affair with the Golden Dome of Notre Dame.
Upon retirement, Jackie and Dr. Jack migrated up north for the next 20+ years, eventually settling down in Bay Harbor, Michigan, where they attended St. Francis Xavier Catholic Church in nearby Petoskey. Friends, family and grandchildren would visit regularly for a round of golf, a trip to the slopes or a saucer down the drive, Christmas morning presents, Fourth of July fireworks, eat out, order in, catch a movie, shop at the local galleries and bookstores, go for a boat ride, or simply sit on the deck and bask in the afterglow dusting the sky over Lake Michigan. Jackie and Dr. Jack lived their last few years in the Chelsea Retirement Community where their loving bond and endearing devotion to one another was a continual source of inspiration and light to Jackie's wonderful and dedicated caretakers. Jackie will forever be remembered as a force of goodness and grace in this world; an adoring wife, loving mom, doting grandma and aunt, loyal friend and powerful woman of character with an enduring faith in God. Jackie's smile and laugh filled every room, but despite her diminutive stature, there was never any doubt as to who was in charge. The neighborhood kids called her "The General,” but her late husband called her his wild Irish "Rose." Jackie is survived by son Bradley (Kathleen) Martin; and son Brian (Jenny) Martin; and grandsons Jackson Pursell Martin and Benjamin Yerrick Martin. Jackie was preceded in death by her husband Jack F. Martin, MD, her sister Patricia (Shields) DeLoof, and her parents William and Grace (Duris) Shields. Funeral services were held on Saturday, February 6, 2021, at St. Thomas the Apostle Church in Ann Arbor. Those planning an expression of sympathy are asked to consider donations to the Alzheimer’s Association through Jackie’s Tribute page at http://act.alz.org/goto/Jackie_Martin Alzheimer's Association.
Fulfill Your Board of Medicine Requirements on Your Time MSMS offers numerous on-demand webinars that fulfill the Michigan Department of Licensing and Regulatory Affairs requirements for continuing medical education, including: • A series of 12 covering Pain and Symptom Management • Three on Medical Ethics • Human Trafficking Download and watch at your convenience 24/7. For a complete list and to register click HERE
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Covenant HealthCare Board Announces President/ CEO Ed Bruff Retirement and Successor After a fulfilling 38-year career, Ed Bruff, Covenant HealthCare President/CEO, has announced his retirement on June 30, 2021. As such, the Covenant HealthCare Board of Directors also shared that Beth Charlton will officially transition into the role beginning July 1, 2021. Bruff started with the former St. Luke’s Hospital in 1983 as the Director of Materials Management and shortly thereafter, was promoted to Vice President of Support Services. In 1994, he advanced to Vice President of Inpatient Services. Ed held that position until May of 2000, and at that time, he assumed the role of Executive Vice President and COO. Then in January of 2015, he transitioned into the role of President/CEO. “To see the amount of growth since I began is incredible. When I started, St. Luke’s Hospital consisted of one building,” says Bruff. In 1998, a merger between St. Luke’s Hospital and Saginaw General created Covenant HealthCare. “Now, there is a large medical campus with the CMU College of Medicine, construction of the Mary Free Bed at Covenant rehabilitation hospital, six urgent care locations, LifeNet air ambulance, the hybrid OR and the entire Covenant Medical Group. The evolution and adaptation of this organization is amazing.” Throughout his career, Bruff has served many roles with organizations in the community including Vice Chairman of CMU Medical Education Partners Board, Vice Chairman of Mobile Medical Response Board, Past Chairman of Saginaw Valley Medical Control Authority, Past Chairman of Saginaw Future, Inc., member of Saginaw County Chamber of Commerce Board and Associate for the American College of HealthCare Executives. Bruff has a Master of Science in Administration from Central Michigan University, and a Bachelor of Business Administration in Marketing and Industrial Relations from Michigan Technological University. At Bruff’s recommendation, and with unanimous support of the Covenant Board, Beth Charlton will transition from the Executive Vice President/COO/CNO position, to President/CEO of the organization. “I could not be more pleased for Beth, and I take great comfort in knowing that the culture and the values we created will be continued into Covenant’s future; she will do an outstanding job, ” says Bruff. Beth Charlton, a life-long Saginaw resident, began her career in May 1989 at the former St. Luke’s Hospital as a student nurse extern. Today, Charlton brings nearly 32 years of hands-on healthcare experience. She has served in many 28
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capacities throughout the organization, including bedside nurse in the pediatric ICU, clinical manager for areas such as critical care, heart failure, and birth center, project manager for electronic medical records implementation, and Director of Critical Care, Progressive Care and Stroke Programs. Since 2015, Charlton has been the Chief Nursing Officer, adding Executive Vice President/Chief Operating Officer to her title in 2019. Charlton has a Master of Healthcare Administration from Central Michigan University, and a Bachelor of Science in Nursing from Saginaw Valley State University. Bruff states, “I consider Covenant as one of the premier organizations in the State of Michigan. This has been achieved because of our extraordinary employees, medical staff and volunteers. As I reflect back, I take great pride in what Covenant has accomplished over the years for the benefit of our patients in the community we serve.”
Covenant HealthCare & Wellspring Lutheran Services Are Teaming Up A Partnership to Enhance Skilled Nursing Care in the Community Covenant HealthCare leadership has been actively evaluating the current skilled nursing operation at the Transitional Care Unit (TCU) within the Covenant Michigan campus, and exploring ways to enhance skilled nursing care delivery in the future. After exploring several options, Covenant identified that a partnership between Covenant and Wellspring Lutheran Services offers the most extraordinary way to enhance skilled nursing care in our region. The Covenant and Wellspring Boards approved the establishment of a joint venture between the two organizations in late 2020. “We’re very excited about this partnership with Covenant as it represents a significant opportunity to impact quality of care for seniors throughout the Great Lakes Bay Region,” said David Gehm, President & CEO of Wellspring Lutheran Services. “Together, our two non-profits with deep roots in the region, bring together not only that demonstrated commitment, but also their respective expertise, resources and dedicated staff that represents the best of both.” Ed Bruff, President & CEO of Covenant HealthCare stated, “The Covenant mission, is to provide extraordinary care for every generation, something we must live out. When choosing a partner, we took our time and thoroughly evaluated all options in order to do what is best for the patients we serve. After extensive review, we felt Wellspring was the best fit to support our mission." continued on page 29
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Wellspring is a recognized leader in skilled nursing care and has a growing statewide network. Covenant HealthCare has a long history of providing extraordinary skilled nursing care to patients in our community. Through this new partnership, the organizations expect to provide a higher level of skilled care in Saginaw and increase the number of patients served. Additionally, the partnership further strengthens the Lutheran tradition of both organizations. As part of the agreement, the management of the service transitioned to Wellspring on January 1, 2021. All therapy for skilled nursing patients will be conducted and managed by Mary Free Bed at Covenant. The partnership will initially utilize the existing TCU space on the Covenant Michigan campus. However, plans call for the renovation of a new 39-bed facility at Wellspring’s Saginaw Senior Living campus located at Shattuck and Wieneke Roads. The new facility design calls for large private rooms with full, private bathrooms for all patients. It is expected to open in late 2021.
Covenant Medical Group Welcomes New Providers Covenant MedExpress Urgent Care Services Dr. Michael Gallo and Dr. Jacquelyn Small Join Covenant Medical Group-MedExpress Covenant HealthCare welcomes Michael Gallo, MD, and Jacquelyn Small, DO, as members of the Covenant Medical Group joining the Covenant MedExpress team providing urgent care services to the community. For more information on Covenant MedExpress locations, visit www. covenantmedexpress.com. Wound Healing Center Dr. Scott Byron Joins Covenant Medical Group Wound Care Covenant HealthCare welcomes Scott Byron, DPM, as a member of the Covenant Medical Group. Dr. Byron joins the Covenant Wound Care team located at 900 Cooper Ave, 4th Floor, Saginaw, MI 48602 and can be reached at 989.583.4401. continued on page 30
Wound Healing Center WE LEAD IN EXTRAORDINARY CARE • Wounds that fail to respond to traditional treatment after 30 days, have become infected, or appear to heal but continue to recur • Diabetic ulcers, especially on the feet • Venous or lower leg ulcers • Pressure ulcers, such as bed sores • Skin tears or lacerations • Failing skin/muscle grafts or flaps • Slow or non-healing surgical wounds • Post-operative infections • Bone infections (osteomyelitis) • Radiation tissue injuries • Lymphedema • Burn care • Brown recluse spider bites © 2020 Covenant HealthCare. All rights reserved. PK 1/20 11672
COVENANT HEALTHCARE WOUND HEALING CENTER 900 Cooper, Saginaw, Michigan 989.583.4401 covenanthealthcare.com
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Medical Staff Leaders Announced The Covenant Medical Executive Committee ratified the slate of Medical Staff officers and leaders for 2021-2022. Congratulations to the following elected Medical Staff leaders who began their roles 1/1/2021. Many thanks to those who served 2019-2020 for their leadership, participation and direction for the Covenant Medical Staff. Medical Staff Officers Chief of Staff - Kathleen M. Cowling, DO Vice Chief of Staff - Sanjay J. Talati, MD Secretary/Treasurer - Mayar Jundi, MD Past Chief of Staff - Michael L. Fiore, MD Members-At-Large Christa M. Persyn, MD and James A. Fugazzi, MD DEPARTMENTS/SECTIONS Maternal/Family Care Department Department Chairman - Thomas M. Minnec, MD Family Medicine Section Chief - Bernard D. Noveloso, MD Pediatrics Section Chief - Nicole Sinclair, MD OB/GYN Section Chief - Thomas M. Minnec, MD Medicine Department Department Chairman - Rakesh S. Chokshi, MD Cardiology Section Chief - Peter G. Fattal, MD General Medicine Section Chief - Muhammad U. Khan, MD
ADVERTISER INDEX When you have a need for a service, please consider our dedicated advertisers first! Advanced Diagnostic Imaging, P.C. Ascension St. Mary’s Hospital Barb Smith SR&RN Covenant HealthCare Covenant Wound Healing Center Dornbos Printing Impressions Jan Hauck – Century 21 Healthway Compounding Pharmacy Lori Krygier Graphic Designer Norton + Kidd Accounting & Consulting, P.C. Peak Performance PC Services Print Express Shields Chiropractic 30
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Surgery Department Department Chairman - Todd G. Richardson, MD Orthopedics Section Chief - Brian C. deBeaubien, MD General Surgery Section Chief - Ryan J. Kim, MD Clinical Services Department Department Chairman - David L. Stockman, MD Anesthesia Section Chief - Vasil Mamaladze, MD Emergency Medicine Section Chief - Matthew D. Deibel, MD Pathology Section Chief - David L. Stockman, MD Radiology Section Chief - Peter C. Morden, MD Hospital Medicine Section Chief - Abdo A. Alward, MD Committee Chairs Medical Staff Quality Improvement - Matthew D. Deibel, MD Cancer - Sussan M. Bays, MD Pharmacy & Therapeutics - Andrew M. Bazakis, MD Investigational Review Board - Andrew S. Wagner, MD
www.SaginawCountyMS.com
Caduceus Meeting for Recovering Health Care Professionals Third Thursday of each month at 7 p.m. Zion Lutheran Church 454 7th Street, Freeland, Michigan (Behind Pat’s Grocery Store on Midland Road in Freeland)
Caduceus meetings are available to health care industry professionals, and have adopted many of the principles of 12-Step programs. Caduceus meetings are “closed” meetings for recovering health care professionals including, but not limited to, nurses, doctors, dentists and pharmacists. We engage in group discussions where members may want to speak up, ask questions or share thoughts with fellow members.
BIRTHDAYS MARCH
APRIL
Luigi Maresca MD Michelle M. McLean MD Kurt A. Menapace MD Alec Merlington Student Omer S. Mirza MD Sally T. Nagia Student Nobou Nakagawa MD Sajeda Nusrat MD Kelsey Perry Student Eric A. Pitts DO A. O. Rajagopal MD Happy Special Birthday! Joseph A. Reed Student Conchita D. Riparip MD Happy Special Birthday! Jennifer R. Schmidt DO Shiraz H. Shariff MD Maxim Shaydakov MD Alexa M. Shepherd MD Michael J. Slavin MD Wael A. Solh MD Kristine K. Spence DO Jared P. Steinberger MD Dorothy Wong Student Scott C. Woodbury MD Harvey K. Yee MD Yong C. Yoon MD Jea Ho Yu Student Asim Yunus MD
Faith Abbott DO Robert P. Ainsworth MD Joseph N. Aquilina MD Jaspreet K. Batth MD Edward S. Bernreuter MD Aditya D. Bulusu MD Louis F. Byrne MD Adriana E. Calderon Student Brenda M. Coughlin MD Jonathon P. Deibel MD Stephanie J. Duggan MD Danielle C. Duncan MD Anna Eisenberg Student Jessica H. Ledyard Faris MD Thomas G. Ferreri MD Maher Ghanem MD Katherine A. Grayden Student Timothy R. Hackett MD Thomas E. Hyland Student Pramod K. Kalagara MD Timothy H. Kaufman MD Asif H. Khan MD Andrew M. LaFleur MD James R. LaFleur MD James A. Letson, Jr. MD Veronica E. Lorenzo MD Omar N. Marar MD
Lauren Aiello Student Abiola A. Alaka Student Sindhura Ananthaneni MD Kathryn A. Becker DO H. Joseph Blair MD Samuel Borer Student David W.T. Chen MD Seth D. Coombs MD Erinn E. Croco DO Brian C. deBeaubien MD Megan J. Dutcher DO Daniel L. Elieff MD Peter G. Fattal MD E. Malcolm Field MD Joseph Haddad MD Victoria A. Haddad MD Theodore B. Hennig DDS Chelsea P. Houthoofd MD Michael Huber Student Mohamed K. Hussein MD C.R. Indira MD M. Sohail Jilani MD Min H. Kim MD Narendra R. Kumar MD H.F. Labsan MD Happy Special Birthday! Phillip W. Lambert MD
Peter A. Lassing MD Matthew Lee Student Toby C.J. Long MD Bapineedu Maganti MD Khalid M. Malik MD Joseph F. Marshall MD James McCourt MD Robert M. McNier MD Faizan Memon MD Felipe A. Pacheco Granda MD Zachary J. Pierson DPM Aida B. Ponce MD Vasantha Rajagopal MD Sundhar R. Ramasamy MD Clinton E. Rogers MD Miriam T. Schteingart MD Zachary Schwager MD Caroline G.M. Scott MD Constance L. Scott DO Carrie L. Selvaraj MD Aaron K. Smith MD Timothy A. Smith MD Jung K. Suhr MD Robert D. Thill MD Vina V. Tran MD Aiden M. Van Loo Student Lisa M. WintonLi MD Michael J. Wolohan MD Samantha A. Wong DO
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The Bulletin | Winter 2021 31
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2019-2021 KEY PROVIDERS
These Area Businesses Support Saginaw County Medical Society Membership Meetings. When you have a need for a service, please consider our Key Providers.
SCMS MEETINGS AND EVENTS The SCMS Board continues to meet virtually on the third Tuesday of every month. Please mark your calendar for the ANNUAL MEMBERSHIP MEETING and the ANNUAL FOUNDATION MEMBERSHIP MEETING to be held concurrently via Zoom on Tuesday, May 18, 2021, at 7 p.m. Members will be contacted in late April to register. We hope to have in-person meetings on Tuesday, September 21 and Tuesday, October 19. Keep an eye on your inbox and The Bulletin for details when available. The SCMS will not host it’s Annual Health Fair in 2021. Additionally, the SCMS Foundation Golf Outing has been cancelled. We hope to have both events back up and running in 2022.
All statements or comments in The Bulletin are those of the writer, and not necessarily the opinion of the Saginaw County Medical Society.
Joan Cramer/SCMS | Office 790-3590 | Fax 790-3640 | Cell 284-8884 | jmcramer@sbcglobal net | www.SaginawCountyMS.com