Medical Association – Civilav Med Tue, 17 May 2022 14:47:22 +0000 en-US hourly 1 Medical Association – Civilav Med 32 32 Mazzoccoli awarded with Veterinary College Scholarship Tue, 17 May 2022 14:47:22 +0000

Alyssa Mazzoccoli, a sophomore at the University of Illinois College of Veterinary Medicine, recently received a scholarship. Mazzoccoli is originally from Chicago, Illinois.

Mazzoccoli was awarded the Dr. Frances Joan Masser Scholarship, awarded for academic merit. At the College of Veterinary Medicine, Mazzoccoli is the class of 2025 representative for the surgery club as well as Hill’s student representative. She is also a member of the University of Illinois Chapter of the Student American Veterinary Medical Association, the Companion Animal Veterinary Association, the Production Medicine Club, the Illinois Student Chapter of the American Association of Equine Practitioners, the Chicago Veterinary Medical Association, and the American Veterinary Society for Animal Behavior.

Mazzoccoli graduated from Main South High School (Park Ridge, Illinois) in 2017. She also graduated from Texas A&M University, College Station, Texas, and earned a Bachelor of Science in Biomedical Science with a minor in Neuroscience and a Certificate in development of biomedical research in 2021.

The University of Illinois College of Veterinary Medicine is one of 32 veterinary schools in the United States. He launched an innovative veterinary program that emphasizes the integration of clinical skills and basic sciences relevant to veterinary practice throughout the four-year doctoral program. Students in the Illinois program, unlike those in other veterinary programs, spend 15 weeks during the first two years of study in areas of veterinary practice and practice clinical skills in an expansive learning center equipped with models and simulations.

]]> NQ Pharmacy Pilot: another way to prevent doctors from going to rural areas Sun, 15 May 2022 20:27:47 +0000

THE trouble-plagued North Queensland pharmacy pilot would worsen labor shortages in the region, with more than 50% of GPs saying the pilot and its impact on patient safety would deter them from working In the region.

Respondents to an Australian Medical Association (AMA) survey of Queensland criticized the Queensland government’s trial allowing pharmacists to diagnose and sell prescriptions for urinary tract infections (UTIs).

In June 2020, Queensland Health launched the 2-year Urinary Tract Infection Pharmacy Pilot – Queensland (Queensland-wide UTI Pilot) enabling pharmacists across Queensland to provide treatment to women with suspected UTIs . This involves pharmacists diagnosing, prescribing and providing treatment for UTIs, after 120 hours of online training. Although the AMA Queensland, the Royal Australian College of GPs, the Australian College of Rural and Remote Medicine, the National Aboriginal Community Controlled Health Organization and the North Queensland Primary Health Network have withdrawn their participation in the trial, the Government of Queensland extended the trial for 6 more months from June 2022, based on an assessment by Queensland University of Technology which has not been made public.

This expansion would facilitate autonomous prescription by pharmacists for 23 conditions from June 2022.

The AMA Queensland survey had 1,307 respondents, of whom 52% were general practitioners, 26% other specialists and 12% doctors in training. The survey was open to all physicians in Queensland from March 18-28, 2022. Access to the survey was made public through the Queensland Medical Community, GP Alliance, Australasian Medical Publishing Company (publishers of Preview+), the Facebook Business for Doctors group, local medical associations and communications with AMA Queensland members via the bi-monthly Connect newsletter and direct messaging.

More than 50% of GPs who responded said they had been deterred by the pilot from traveling to North Queensland due to “the expectation that GPs would need to ‘pick up the pieces’ and to deal with the consequences of pilot and weakened patient safety”.

Patient safety was the biggest objection to the pilot project by responding physicians, with 96% citing it as their top concern.

With good reason – 240 patient complications have been reported as a result of the UTI pilot.

“The women did not receive the care they needed and an alarming number became sicker as a result of their participation in the trial,” said AMA Queensland President Professor Chris Perry.

“Weirdly, three doctors reported seeing men with complications when the pilot was specifically limited to ‘uncomplicated cystitis in non-pregnant women’.

“At least six pregnant women were sold dangerous antibiotics during the first trimester. One of them had a life-threatening ectopic pregnancy.

“At least nine patients ended up in hospital with sepsis or kidney and bladder infections due to ineffective or delayed treatment.”

More than a third of respondents to the AMA Queensland survey had trained in pharmacy before graduating from medicine, and those respondents were the most scathing about the pilot.

“As a pharmacist, I thought I could [diagnose and treat] and said it several times. However, having trained as a doctor, I realize how insufficient my knowledge and training was in the area of ​​prescribing,” said one pharmacy-trained respondent.

“Pharmacists are not trained to diagnose or treat patients. Having studied both pharmacy and medicine, the latter involves two full-time clinical years seeing patients and learning how to take a history, perform a physical examination, order investigations, and make diagnostic and treatment decisions. management. This process is not able to be delivered over the counter of a pharmacy,” said another.

The AMA Queensland survey also revealed that patients were not completely honest in the pharmacy setting.

“A common theme among doctors’ comments, particularly regarding misdiagnosis of [sexually transmissible infection (STIs)], was patients’ reluctance to provide complete and candid information to a pharmacist in the presence of other customers or to discuss their sexual history over the counter. Failure to disclose sensitive or embarrassing information due to a lack of confidentiality may have contributed to misdiagnoses,” the survey authors reported.

Concerns have also been raised about conflicts of interest and upselling.

“Conflicts of interest related to potential financial incentives in the diagnosis and sale of products have been raised on several occasions. Similarly, physicians were concerned about the upselling of non-essential products and the possibility that pharmacists would feel pressured to sell a drug for every condition, even when conservative management would be more appropriate.

Other results from the AMA Queensland survey:

  • The most common misdiagnosis was that the patient had an STI rather than a UTI. These included chlamydia, herpes and gonorrhea. A number of patients have also been reported to have pelvic inflammatory disease.
  • Pregnancy has been misdiagnosed as a UTI on at least six occasions, with a number of patients prescribed dangerous antibiotics during the first 12 weeks of pregnancy.
  • A patient was reportedly treated for a urinary tract infection when her symptoms were actually related to an ectopic pregnancy.
  • Cancerous conditions have been overlooked on at least nine occasions, with doctors reporting incidents of patients being treated for a UTI when symptoms were related to cancer or precancerous conditions, including cancers of the bladder, bowel, cervix and vulva.
  • Other misdiagnosed conditions treated as urinary tract infections included lichen sclerosis, prolapse, menopausal symptoms, atrophic vaginitis, 15 cm pelvic mass, renal colic, ruptured ovarian cyst, bladder pain syndrome, pyelonephritis and interstitial cystitis.
  • After misdiagnosis, inappropriate or ineffective use of antibiotics was the second most common complication. Of the 240 incidents reported to the survey, about 30% were related to antibiotics;
  • Specifically, the comments focused on the resistance of bacteria causing UTIs to the prescribed antibiotic, on the prescription of repeated courses of the same antibiotic, and on the prescription of an antibiotic to which the patients were allergic.
  • Through the survey, doctors reported eight cases where misdiagnosis or ineffective treatment led to hospitalization of patients with urosepsis or pyelonephritis.
  • Three doctors said they saw complications in male patients being treated for UTIs despite the pilot being specifically limited to “uncomplicated cystitis in a non-pregnant woman.”

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Student-created mentorship groups shine through UMass LIGHT Fri, 13 May 2022 12:07:17 +0000

Three groups of UMass Chan Medical School students have partnered in a mentorship program called UMass LIGHT (The Leadership Institute for Growth, Health, and Transformation). The goals of UMass LIGHT are to increase diversity, equity and inclusion; promote career growth; and create professional development opportunities through mentorship and community events. On Saturday, May 14, UMass LIGHT is hosting its first conference at the Beechwood Hotel across from the Worcester Medical School campus.

Uchechi Nna and Daniel Ugochukwu

UMass LIGHT, which pairs students with faculty members, includes programs originally created by UMass Chan Chapters of the Student National Medical Association (SNMA), American Medical Women’s Association (AMWA) and the MD/PhD program. Organizers say UMass LIGHT has grown since its inception last year to include more than 300 students and faculty.

“There aren’t many places where underrepresented students can have casual conversations with people who have a lot of experience in this field to find support around nuanced things – things that aren’t necessarily exams and things step by step, but how, for example, to look for opportunities,” said Uchechi Nna, a student at TH Chan School of Medicine.

Nna, a former SNMA board member, came up with the idea for UMass LIGHT with fellow medical student Daniel Ugochukwu.

“We were thinking about how we could leave a lasting impact on the school, and we thought about mentorship and the fact that there aren’t a lot of mentorships for minority students here,” Ugochukwu said.

The groups are working with Mark Johnson, MD, PhD, the Maroun Semaan Chair in Neurosurgery, president and professor of neurological surgery and senior vice provost for mentorship, leadership, and transformation at UMass Chan. Dr. Johnson has been working with other UMass Chan leaders to create a mentorship and leadership institute since being named senior vice provost last year.

“During the pandemic, I think it’s become very clear to a lot of us that we need to be more connected,” Johnson said. “The institute’s goal is to help students and faculty realize their full potential, help them be more connected, and feel more included at UMass Chan.”

The conference will take place on Saturday, May 14 from 9 a.m. to 3:30 p.m. Speakers include Mary Ahn, MD, professor of psychiatry and vice provost for faculty affairs; Rick Sontag, MBA, Founder and President of the Sontag Foundation, which aims to improve the quality of life for brain tumor patients; Terence R. Fleet, MD, the Professor Celia and Isaac Haidak, Executive Vice Chancellor, Provost and Dean of TH Chan School of Medicine; and Jack Rossin, presentation trainer and instructor at the Harvard TH Chan School of Public Health.

Participants will also have the opportunity to develop leadership and mentorship skills.

AMWA medical student Niharika Kareddy and medical/doctoral students Melanie Barbini and Michela Oster helped make the event happen.

Those interested in attending the event can register here. Additional information is available on the UMass LIGHT website. Questions can be directed to

Current articles related to UMass Chan:
‘Mentoring community’ changes culture at UMass Chan
TH Chan School of Medicine Students Create Mentorship Program for Accepted Students
UMass Medical School Welcomes First Learners of Color Orientation
Mark Johnson named council’s senior vice president for mentoring, leadership and transformation

Ministry of Health to meet stakeholders tomorrow on poisons bill Wed, 11 May 2022 06:39:57 +0000

KUALA LUMPUR, May 11 – The Ministry of Health (MOH) will hold a face-to-face discussion tomorrow with private GPs, community pharmacists and veterinarians on the Poisons (Amendment) Bill 2022.

Pharmacy associations like the Malaysian Pharmacists Society (MPS) and the Malaysian Community Pharmacy Guild (MCPG), as well as medical groups like the Malaysian Medical Associations (MMA), Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM) , the Malaysian Association of Medical Practitioners Coalition (MPCAM) and the Malaysian Association of Muslim Doctors (Perdim) and veterinary groups like the Malaysian Veterinary Medical Association (MAVMA) are among the 10 invited groups.

Three representatives from each group are invited to attend the one-hour meeting to be held at the Ministry of Health headquarters in Putrajaya, according to the ministry circular dated May 9 seen by code blue.

The meeting, which will be chaired by Health Minister Khairy Jamaluddin tomorrow at noon, aims to bring together stakeholders to “discuss the issues” of the Poisons Amendment Bill which was tabled for first reading in the last Parliament meeting on March 14.

According to the program of the meeting, a briefing on the Government’s proposed amendments to the Poisons Act 1952 which regulates medicines is scheduled for 20 minutes, with a question and answer session for the 10 invited groups scheduled for an additional 25 minutes.

“We leave with an open mind, but wonder how the comments of so many groups will be documented in 25 minutes,” MPCAM Chairman Dr. Raj Kumar Maharajah said. Code blue.

“Fundamentally, we are unhappy with the sweeping powers to be given to law enforcement officers, which we believe is draconian. Do not give doctors the opportunity to defend themselves. Laws like this will forever destroy the reputation of doctors, even if they are found innocent later,” he added, when asked what MPCAM would raise at tomorrow’s meeting with officials from the Ministry of Health.

“It could also affect the defendant’s mental health and is similar to the intimidation that is entrenched in the Ministry of Health and its hospitals.”

Several health professional groups have already spoken out against the Poisons Amendment Bill 2022, including MMA, MPCAM, FPMPAM and the Malaysian Dental Association (MDA).

The Poisons Amendment Bill dramatically increases penalties for medicine-related offenses committed by health care providers and allows raids on clinics or pharmacies similar to raids for banned narcotics by strengthening the powers of running government pharmacies.

The proposed changes revise the general penalties for poisons law offenses from the maximum prison sentence of one year to five years imprisonment, in addition to increasing the maximum fines of 3,000 by 17 times. RM at 50,000 RM.

Under the Amendment Bill, appointed drug enforcement officers may also search any premises and forcibly seize any drugs, machinery, equipment, records, documents or computerized data if there is “reasonable cause. to suspect that an offense is being committed.

These include breaking and opening any door, gate or fence that obstructs entry to the premises and detaining anyone found on the premises until the search is complete.

Many of the changes proposed in the Poisons Amendment Bill 2022 are similar to existing provisions of the Dangerous Drugs Act 1952 which prohibits narcotics ranging from heroin to cocaine and marijuana – such as damages indemnification clauses, the admissibility of agent provocateur evidence, and the seizure and forfeiture of drugs.

However, the Dangerous Drugs Act does not state that an individual cannot sue the government, unlike the Poisons Amendment Bill which proposes a clause that protects authorized officers from civil suits or criminal charges for any act if it was done “in good faith and in the reasonable belief”.

The amendment bill was tabled in the Dewan Rakyat on March 14 by the Deputy Minister of Health, Dr. Noor Azmi Ghazali, for the first reading; the government is expected to try to pass the law at the next meeting scheduled for 12 days from July 18 to August 4.

Should health insurers cover the cost of fertility treatment? | Lost Coast Outpost Mon, 09 May 2022 14:22:10 +0000

Annabel Adams paid nearly $50,000 in fertility treatment costs. Photo by Pablo Unzueta for CalMatters

Californians seeking to start a family using in vitro fertilization often have to pay the full cost of the treatment, in the tens of thousands of dollars. The cost could deter some people from having children, and it could leave others in exorbitant debt.

While 17 states have laws that require health insurers to cover fertility treatments, most of which include in vitro, California does not.

The debate over whether health insurance plans should provide fertility coverage isn’t new to Sacramento, but even in a state where Democrats like to brag about their fight to advance reproductive health, these efforts did not go very far. The main heist is money.

Assemblywoman Buffy Wicks, a Democrat from Oakland, is trying again this year. His 2029 Assembly Bill would require some health insurance plans to cover fertility treatments, including in vitro fertilization. The bill also expands the definition of infertility so that more people can be diagnosed and treated, including singles, same-sex couples and transgender people.

Wicks recently agreed to amendments in an effort to reduce the cost of his bill, which as originally drafted had a $715 million price tag for employers and health plan enrollees. The coverage mandate in his revised bill would only apply to large group health insurance, which covers about 9 million Californians. Small group and individual market plans would be exempt. Even as first drafted, the bill would not apply to Medi-Cal, the insurance program for low-income residents.

“This is the third time I’ve done this,” Wicks said. “We’re trying to get that adopted and that means making changes to reduce it.”

Wicks said the issue is personal to her — her second child is the product of in vitro fertilization. (In 2020, Wicks took her then a newborn to the Capitol to vote for a family leave bill.) The goal, she said, is to take a piecemeal approach and expand the benefits to more people over time.

California law currently requires insurance companies to offer fertility treatments, excluding in vitro treatments, but it is up to the employer or group to decide whether this is included in the covered benefits. This bill would make such coverage mandatory.

Annabel Adams, who recently testified in favor of Wicks’ bill, paid nearly $50,000 for three cycles of in vitro fertilization. Born with a chromosomal inversion that makes it difficult for her to sustain a pregnancy, she suffered six losses.

Her doctors recommended in vitro fertilization, or IVF, a process in which eggs are retrieved from ovaries and fertilized by sperm in a lab. The fertilized egg, or embryo, is then transferred to the uterus. For Adams, this process allows her doctors to test the embryos to make sure they are unaffected by her genetic condition, which increases her chances of having a lasting pregnancy.

Her first round of treatment, including the drugs, cost her $25,600, she said. His Kaiser insurance plan, offered by his employer at the University of California, did not cover him. Her husband’s insurance helped cover some of the costs for the second and third rounds.

“Every pregnancy is filled with terror. These are wanted pregnancies; these are children we envision and plan a future around,” said Adams, a Long Beach resident and founder of California Fertility Advocates. essentially the cure for my illness and knowing that it wasn’t readily available to me, it felt like an extra layer of evil.”

The health insurance lobby and business groups oppose Wicks’ bill, citing the cost. They say that, like other pieces of legislation that require new benefits to be covered, this bill would lead to higher health insurance premiums for employers and employees.

According to the California Association of Health Plans, it’s the most expensive bill the organization has opposed this year, and Wicks’ recent amendments don’t change its position.

“Every pregnancy is filled with terror. These are wanted pregnancies; these are children we envision.
— Annabel Adams, Founder of California Fertility Advocates

“As health plans, we need to be concerned about costs for everyone,” said association spokeswoman Mary Ellen Grant. “We don’t dispute the merits of this bill, but they increase healthcare costs for Californians. It’s just not something health plans can support.

Grant said lawmakers must consider the sum of all benefit mandates they choose to pass, not just a single bill. This year, the association is opposing 14 bills that would require new benefits to be covered — collectively, these bills could increase annual premiums by $1.5 billion, the association said.

The California Chamber of Commerce and various local chambers, representing business interests, have also expressed opposition to the bill because of its cost. The bill is then directed to the Assembly Appropriations Committee, which assesses the fiscal impact of a bill.

In 2019, California enacted a law specifying that insurers must cover the cost of storing eggs, sperm or embryos for patients undergoing treatment for conditions affecting their ability to have children. Of them previous bills introduced by Wicks in 2019 and 2020, targeting fertility coverage more broadly, have not moved forward. While much of the conversation around Wicks’ current bill focuses on in vitro fertilization, as it is the most expensive type of fertility treatment, the bill addresses the broader issue of overall fertility coverage, said Dr. Marcelle Cedars, a reproductive endocrinologist at the University of California, San Francisco. Not all infertile people need in vitro fertilization.

“It’s really about acknowledging infertility as a disease,” Cedars said. “As with any other disease, all evidence-based and medically valid treatment options should be available to patients.”

Cedars said it has patients whose diagnosis is covered by their insurance, but not their treatment. “You would never say, ‘Oh, by the way, you have diabetes, but we’re not going to give you insulin to treat it.’ I mean, that’s crazy, what other disease would you treat like that?”

It is estimated that infertility affects about one in eight couples, or about 15% of the population in the United States. . Treatment is often considered elective.

“Reproductive health is tricky in this country, as we’ve seen this week,” Cedars said, referring to news of a leaked draft opinion that showed the U.S. Supreme Court was on the hook. point to nullify Roe v. Wade. “Reproductive health is really a spectrum, it’s not about having kids when you don’t want them and being able to have them when you want them.”

In the abortion debate, California is positioning itself as a safe haven state for out-of-state people seeking to terminate a pregnancy. Democratic lawmakers have drafted a package of bills going through the Legislature to protect abortion access and affordability. Governor Gavin Newsom has already signed into law one such bill, eliminating out-of-pocket fees for abortions.

Wicks and supporters of his bill said that ultimately this bill is also about choice — allowing people to start families if and when they choose. “That’s why I’m working on bills for safe and legal abortion and making sure doulas are covered,” Wicks said. “All of these things for me are very intertwined.”


CalMatters COVID and Healthcare Coverage is supported by grants from the Blue Shield of California Foundation, California Health Care Foundation, and California Wellness Foundation. is a nonprofit, nonpartisan media company explaining California policies and politics.

]]> Abortion doulas offer emotional and practical support. Now their work can become critical Sat, 07 May 2022 14:36:26 +0000

By Brooklyn Neustaeter

Click here for updates on this story

May 6, 2022 (CTV Network) – As tens of millions of women in America risk losing access to abortion, experts in Canada say the services offered by sexual health groups and doulas in the abortion to help navigate the process could become more crucial on both sides of the border. According to data from the Canadian Medical Association, it is estimated that one in three Canadian women will have an abortion in her lifetime. However, it remains difficult to obtain in many provinces. Monica Reagan says that’s where she comes in. Reagan is a full-spectrum doula who focuses on abortion support and works with the nonprofit Birth Mark doula organization in Toronto. A doula is a trained companion who is not a medical professional, but who supports another person through a significant health-related experience, most commonly pregnancy and childbirth. Reagan told that as an abortion doula, she provides emotional, informational and logistical support to someone seeking or having an abortion. “We provide impartial, non-directive emotional support to help the person manage their feelings about the abortion. We encourage self-advocacy and informed decision-making through evidence-based information and resources, and we can help develop a realistic abortion plan that aligns with the client’s values ​​and needs,” said Reagan. during a phone interview with on Thursday. Often, Reagan said, those seeking an abortion contact a doula because they don’t know how or where to access an abortion, and may be confused by information they find online. “A lot of the time harmful propaganda like pro-life movements hides on the internet and appears as a safe space where people can talk to someone about access to abortion and they can be misled. So reaching out to a doula can help mitigate that misinformation,” she said. In addition to helping gain access, Reagan said doulas can also help find providers specific to location or gestational age, as well as clinics that “provide culturally competent and inclusive care.” Reagan, who does not charge for her abortion support services, noted that abortion can be an upsetting and sometimes frightening event in life. She said abortion doulas can be there to offer support not just before the procedure, but also during and after. During the procedure, Reagan said abortion doulas can suggest comfort measures such as position changes, comforting touches, movement, visualization and breathing techniques, as well as reflective listening and other supports in the postpartum period that follows. “We will stay with the client until they feel they are done with doula support,” she said. “We are not advisers, but we… can be a very big comfort to the person, so we will talk to them or support them physically afterwards. Reagan said an abortion doula is an important resource for those who may not have anyone else to turn to during the abortion process. “You might not have someone close to you who is a safe person to talk to about abortion…or you might have these people but somehow don’t want to establish a relationship with them. Having an abortion doula provides that comfort and support while providing the security of keeping it separate from their personal life,” she said.

THE IMPACT OF ABORTION-RELATED STIGMA Jessa Miller, of Action Canada for Sexual Health and Rights, says the stigmatization of abortion as something wrong or shameful is one of the biggest barriers to access to care. Miller told that makes it harder for people to get care or seek help when they need it. “The stigma around abortion contributes to a lack of education, training and informal conversation on the subject. Because abortion is stigmatized, it is often shrouded in secrecy and not discussed openly, leading to a lack of knowledge,” Miller said in an email Friday. Miller said stigma can lead to a lack of abortion providers, leading to longer wait times for services and sometimes the need to travel long distances to reach a provider. To help fight abortion stigma, Miller said everyone working in medical fields should receive education and training about abortion services, as well as make information about abortion and how readily available online and at medical clinics. “People can also help de-stigmatize abortion by talking about it more openly in social situations where they feel safe and by responding with kindness, acceptance and support when someone talks about abortion with you,” he said. -she adds. Concerns about access to abortion in Canada have resurfaced over the past week after a leaked draft document suggests that US Supreme Court justices plan to overturn the Roe v. . Wade on abortion rights south of the border. The release of the draft itself will not immediately affect access to abortion in the United States. However, if the majority votes as expected, the decision would be overturned with the official publication of the court’s decision, which is expected to take place in June. If the decision is overturned, Reagan said the support offered by abortion doulas and sexual health organizations would be critical to getting care. “As an abortion doula, I will continue to bridge the gap between factual information about abortion access and people seeking abortions,” she said. “I’ll listen to their story — as much as they’d like to share — and connect them with the health care service they’re looking for, regardless of their situation or gestational age. “I will support you and that includes the people of the United States”

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]]> LCD Addresses NAAT Panels for Infectious Disease Testing Thu, 05 May 2022 14:30:48 +0000

Although Medicare is a federal program, the 50 states, plus the District of Columbia and Puerto Rico, are divided into 12 jurisdictions. Medicare then contracts with private companies to administer the program for those jurisdictions. These private contractors are called Medicare Administrative Contractors (MAC) or Carriers. Each MAC has flexibility in developing policies for payment protocols if the policies do not violate national Medicare guidelines. Each MAC is also responsible for responsibly protecting Medicare beneficiaries. The Centers for Medicare & Medicaid Services has an interactive map of Medicare jurisdictions showing state and MAC with contact information on the Medicare website:

Over the years, Medicare has encouraged MACs to develop location-based policies with input from state physicians working in conjunction with state medical organizations. The system has evolved. We understand that MACs are encouraged to communicate with each other to ensure consistency across jurisdictions when developing payment policies; however, they are not required to mimic payment policies developed for other jurisdictions. Medicare requires all MACs to adhere to updated processes to develop and publish a payment policy and participate in supporting a centralized policy locator tool; Medicare continues to develop national policies at the central level when deemed appropriate.

Under current Medicare protocol, carriers are permitted to develop Local Coverage Determinations (LCDs) based on current medical practice and the need to provide general coverage guidance for services provided to Medicare beneficiaries. Each LCD should be developed with active stakeholder participation and after being published as a proposed policy with a comment period before being finalized and adopted. MAC is required to respond to all comments submitted during the designated review period. After considering the comments, the MAC may revise and publish the policy.

The coding/billing instructions associated with an LCD are communicated in Local Coverage Articles (LCAs) because the LCD is intended to outlast any possible coding changes that might occur each year. A MAC may issue an ACL without a corresponding LCD to provide encoding direction for services that may not require a full LCD. LCDs and LCAs can be found on the Medicare coverage database and MAC websites.

On April 17, 2022, a Multi-Jurisdiction LCD for Multiplex Nucleic Acid Amplification Testing (NAAT) Panels for Infectious Disease Testing was released. This has not been adopted for all jurisdictions but rather for the following MACs: Wisconsin Physician Services Insurance Corporation; Directors CGS, LLC; Noridian Healthcare Services, LLC; and Palmetto GBA.

The LCD followed the Medicare protocol, with several national meetings with stakeholder participation in 48 states and Puerto Rico. Comments on the LCD originally published in 2021 resulted in an amended LCD based on feedback from stakeholders attending meetings and submitted separately during the designated comment period.

Each MAC also issued an associated ACL with encoding instructions and coverage limitations. All LCD and ACL affected states participate in the MolDX program administered by Palmetto GBA. The ACV includes coverage and coding instructions for using these 5+ tests per sample (often called PCR tests) for urinary tract infections (UTIs) and sexually transmitted infections.

In summary, each laboratory in these jurisdictions that performs infectious disease NAAT panels will need to request a Z code through the MolDX program. More specifically, each laboratory will have to request a unique Z code for each panel of tests ordered/performed.

For example, if a urology group has 3 separate UTI test panels, the group will need to get its own unique Z code for each test panel. For groups using a reference lab for such panels, the lab will need to request a Z code and request sharing. If a group has multiple lab locations and each lab performs the same test, only one request is required for the entity to which the clinical lab enhancement changes are assigned.

Once the application is submitted, MolDX will perform a technical assessment before issuing the Z-code. Once the technical assessment is complete and the Z-code is issued, the lab will receive a notification, Z-code, and billing instructions. Billing for a panel test is usually linked to a CPT type code and is not reported with the Z code issued. The following link will provide additional information on the process:

It should be noted that in the ACLs for each of the MACs, there is a reference – either in the article which came into effect on April 17, 2022, or in the comments in response to inquiries from those within the MAC – that there are no FDA-approved UTI panels. Billing for UTI NAAT (PCR) tests will not be allowed until the technical evaluation is complete and the Z code is issued, nor will the system allow retroactive billing for these tests.

The remaining MACs (First Coast Service Options, National Government Services and Novitas Solutions) do not participate in the MolDX program and therefore Z codes are not required. However, these MACs may implement these LCDs or the like if they choose to pursue this in the future. Instead of the Z codes for these states, panel tests will likely be reported under the Current Procedural Terminology (CPT) codes of Proprietary Laboratory Analysis (PLA). PLA codes can be obtained from CPT and are alphanumeric. Obtaining a PLA code does not take as long as standard CPT code applications. PLA codes are issued quarterly by the American Medical Association. PLA codes were designed to allow specific lab test protocols/panels to assign a bulk service code for accurate reporting and decision. If you practice in a jurisdiction served by one of the MACs that does not participate in the MolDX program and has not issued an LCD, you will not be required to change your current billing practices.

Regardless of location, MACs’ response to this issue indicates that charging for PCR services has been noted as a potential area for abuse. We have spoken with many practices considering and/or implementing this tool for the diagnosis and subsequent treatment of UTIs and other urological issues. Most groups understand the requirement, regardless of published billing protocols, that all claims submitted for payment must be medically reasonable and necessary. The number of tests ordered/performed and the patient’s complaint/condition should be accurately noted in the medical record. Many practices have also developed clinical guidelines for the appropriate use of PCR testing. As more published and peer-reviewed articles discuss these tests, we expect Medicare and other payers to adapt payment policy and coding guidelines to any new clinical findings. .

Send coding and refund questions to Rubenstein and Painter c/o Urology Time®to

Questions of general interest will be selected for publication. The information in this column is designed to be authoritative and every effort has been made to ensure its accuracy at the time of writing. However, readers are encouraged to check with their carrier or private payers for updates and confirm that this information complies with their specific rules.

Mothers accuse pediatrician of crossing the line Tue, 03 May 2022 17:29:00 +0000

HONOLULU (HawaiiNewsNow/Gray News) — Several mothers have said their children’s doctor in Hawaii tried to establish an inappropriate relationship with them.

They were all single moms at the time, and they say he crossed the line.

“He’s literally going after vulnerable women, and that’s not okay,” Aila Umiamaka told Hawaii News Now.

After her daughter’s doctor’s appointment last Tuesday, Umiamaka – a single mother of two – said she received text messages from her daughter’s pediatrician.

He told her that it “looks like she might need a friend” and that if she’s interested, he could help her.

The doctor then appeared to offer her money and texted her, “Oh we can match because I have money and you need money, laugh out loud.”

Umiamaka was offended by the text and took it as an insult.

“For me, it was not trivial,” Umiamaka said. “It’s just that he picks on me over my disadvantage.”

Umiamaka posted the conversation online and other people told similar stories.

“The first thing he made a point of saying was, like, how good looking I was, how beautiful my figure was, and his tone and body language was like, he was looking me up and down,” said Keakealani Iona. “It was really uncomfortable.”

Kevi Ann Andrade said the doctor “started making remarks like, ‘Well, if you’re not seeing anyone, maybe we should hang out. “”

Other mums said this has been happening since 2014.

Gethsemane Reissig said the doctor offered her his home when she was 19 and living in a domestic violence shelter.

“I went to see a doctor, he started asking me if I wanted to stay with him, he had a big house and it was empty,” she said. “His daughter moved out and he wanted me to come and stay there with my kids.”

Reissig said he complimented her, which made her feel uncomfortable.

Professor Will Weinstein, who teaches ethics courses at the University of Hawaii, said the doctor’s alleged actions were not acceptable.

“Most ethical issues are gray, this one is black and white,” Weinstein said. “There is no possibility that it is in any way ethical. And by the way, I think it’s not legal and the AMA, American Medical Association, strictly prohibits this stuff.

Weinstein said if you think a doctor has crossed the line, you should contact a lawyer.

Copyright 2022 Hawaii News Now via Gray Media Group, Inc. All rights reserved.

James Alan Genin, MD Sun, 01 May 2022 20:51:00 +0000

BRIDGEPORT, W.Va (WDTV) – James Alan Genin, MD, was born May 27, 1946, in Clarksburg, WV, to Alphonse N. Genin and Helen R. Drwall Genin, died suddenly Saturday, April 30, 2022, at United Hospital Center. He was a graduate of the Washington Irving High School Class of 1964. He then graduated from West Virginia University in 1968. He earned his medical degree from West Virginia, where he later interned at the University. from Washington in neuropathology, a surgical internship at the University of Cincinnati General Hospital, and finally a residency in ophthalmology at the Medical College of Virginia.Dr. Genin established a successful eye practice in Clarksburg, WV, eventually joining a partnership with Regional Eye Associates. He retired after 45 years of community service in October 2021. He was married for 51 years to Stephanie Thomas Genin (née Doxanas) and has three sons, Matthew Genin and his wife Stephanie, Michael Genin and Dr Jason Genin and wife Cindy; and five grandchildren Lucas, Alexa, Mikayla, Katya and Dimitri.Dr. Genin was a member of the AMA, the American Academy of Ophthalmology, the West Virginia Academy of Ophthalmology, where he served as president, and the West Virginia State Medical Association. He was on the medical staff of the United Hospital Center and the Harrison County Medical Society, where he served as president of both organizations. He was also a member of the YMCA, Lion’s Club, Railroad Club of Clarksburg, and OSS Society. Family and friends may call Amos Carvelli Funeral Home, 201 Edison Street, Nutter Fort, WV Tuesdays 4:00 p.m. – 8:00 a.m. . There will be a prayer vigil at 7:30 p.m. to conclude the visit. A Christian Burial Mass will be celebrated at Immaculate Conception Catholic Church, 126 East Pike Street, Clarksburg, WV, Wednesday, May 4, 2022, 11:00 a.m. with Father Casey Mahone officiating. Interment will follow at Bridgeport Cemetery. Expressions of sympathy may be extended to the family at A service of Amos Carvelli Funeral Home.

Copyright 2022 WD TV. All rights reserved.

DOJ challenges Alabama law that bans gender-affirming care for trans youth Sat, 30 Apr 2022 07:59:52 +0000

The Justice Department filed a lawsuit Friday challenging a recently enacted law in Alabama that criminalizes certain types of gender-affirming medical care for transgender youth.

Driving the news: The DOJ alleges that the law, one of dozens targeting trans youth across the country, “discriminates both on the basis of sex and on the basis of transgender status, each in violation of the Equal Protection Clause.” .

What they say : “The law discriminates against transgender minors by unjustifiably denying them access to certain forms of medically necessary care… [that are] well recognized within the medical community as medically appropriate and necessary, while placing no comparable limitation on medically necessary care by cisgender minors,” the complaint alleges.

  • A doctor is allowed to prescribe testosterone to a cisgender teenager if he has delayed pubertal development, but “the law makes it a crime for the same doctor to prescribe the same testosterone to a young transgender man for affirm their gender identity,” according to the complaint.
  • The DOJ also notes that the American Academy of Pediatrics agrees that gender-affirming care is “a safe, effective, and medically necessary treatment for the health and well-being of some children and adolescents with gender dysphoria.”

To note: Two doctors, along with the families of two transgender teenagers, have filed a lawsuit to have the Alabama law struck down.

The big picture: Medical associations, including the American Medical Association, have urged governors to oppose such measures, saying trans and non-binary gender identities are “normal variations of human identity and expression.” .

  • Health experts and pediatricians have also expressed concern that the flood of bills criminalizing gender-affirming care could contribute to a new wave of mental health crises among trans children.
  • A January poll found that more than two-thirds of young LGBTQ people said recent debates over state laws targeting trans people had a negative impact on their mental health.

Go further: Culture war over caring for transgender children escalates