Dear Michigan ACC Colleagues,

The COVID pandemic has descended here on the west side of the state since I last wrote to you. It has been an experience like no other.  I'm grateful that we had time to prepare and the benefit of the lessons learned by clinicians in east Michigan.  

Please know that while we’ve all been in the clinical trenches, the ACC advocacy team has led an advocacy and legislative surge in Washington and the Chapter team continues to work with the healthcare coalition in Lansing.  

Here are some of the latest developments…

Telehealth

The Centers for Medicare and Medicaid Services (CMS) issued a second final-interim rule on April 30 that includes several key measures, including expanded access to COVID-19 testing and telehealth services requested by the ACC and others from across the House of Medicine. Of note, is an increase in payment for the telephone codes 99441-99443 to parity with existing patient office visits 99212-99214 – a big win for those who care for patients without access to video telehealth. A summary on acc.org and the CMS press release have details on other proposals in the rule.

In Michigan, legislation that would require coverage of certain telemedicine services (HB 5415-5416) is expected to pass the House soon.  Also, a bill that would require telemedicine visits to be reimbursed at the same rate as in-person visits (SB 898) was introduced at the end of April.

Telehealth was a main topic of conversation on our Chapter webinar,  Practice Survival in the Midst of COVID, last month.  Slides from that webinar are posted here or you can access a recording here

Restart

On May 7, Governor Whitmer announced that Michigan is in phase three of the MI Safe Start Plan to re-engage Michigan’s economy.  Phase three, Flattening, is defined as “The epidemic is no longer increasing and the health-system’s capacity is sufficient for current needs.” See the MI Safe Start Plan here.

On May 3, Chief Medical Executive Joneigh Khaldun issued a letter to healthcare providers providing additional guidance related to elective medical procedures.  While the original order (2020-17) remains in place until the state of emergency expires, Dr. Khaldun strongly encouraged providers to reengage on services and procedures that are important for patient health and well-being. 

No doubt, we will face many difficult decisions on the path to reopening.  There are many useful videos and webinars here.  Also, I recommend the American Society for Preventive Cardiology Scientific Statement, Continuity of Care and Outpatient Management for Patients with and at High Risk for Cardiovascular Disease during the COVID-19 Pandemic which addresses many challenges related to patients in the ambulatory setting including cardiac rehab.

Note: The Republican legislature continues to challenge Democratic Governor Whitmer’s emergency and disaster declaration authority.  As of this writing, the current declarations (Executive Orders 67 and 68) are in effect through May 28.

Immunity

Legislation that would provide immunity for certain health care workers from civil or criminal liability during a declared state of emergency (SB 899) passed the Senate on May 7and has been referred to the House Judiciary Committee.

Resources

I’ve referenced these before, but it bears repeating that the ACC Covid Hub, Medaxiom, and the MSMS site are continually updated and are a treasure trove of information.

CON Cath SAC Nominations

The deadline for nominations to the Certificate of Need Cardiac Catheterization Standard Advisory Committee (SAC) has been extended to May 22.  The Department is specifically looking for nominations of consumers and purchasers. The SAC charge and nomination form can be found here

Clinician Well-being – Webinar May 14

Our new CV Team Liaison, Christopher Giuliano, PharmD, MPH, will host Coping with COVID: The CV Team Experience, a virtual meeting at 6:00 pm on May 14.  You’ll hear the frontline experience of Katie Leonard, NP and Stephane Edwin, PharmD and strategies for coping from Samuel Sears, PhD.  The focus of the meeting is the “open forum” time so all participants can share experiences and coping strategies. Details are here.

Chris would have had a ceremonial start of his term at the ill-fated ACC20, so I’ll officially welcome him in this e-venue.  He is a valuable addition to Chapter leadership and I look forward to working with him!


Take care,


David


David Wohns, MD, MBA, FACC

david.wohns@spectrumhealth.org

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