The United States Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) recently issued an important final rule (the “Final Rule”) that makes significant changes to existing “Safe Harbors” under the Federal Anti-kickback Statue (“AKS”) and that adds new Safe Harbors that provide protection from AKS sanctions for certain types of arrangements. > Read complete alert

Under these updated metrics, Red, Orange and Yellow Zones will now be determined as follows:

A Red Zone will be implemented when a region reaches a critical hospital capacity—that is, when 90 percent of beds are full (after measures to increase capacity have been taken).

An Orange Zone will be implemented if an area has a 4 percent positivity rate over the past 10 days (on a 7-day average) and is located in a region that has reached 85 percent hospital capacity.

A Yellow Zone will be implemented if an area has a 3 percent positivity rate over the past 10 days (on a 7-day average) and is in the top 10 percent in the state for hospital admissions per capita over the past week and is experiencing week-over-week growth in daily admissions.

Although the COVID-19 pandemic has spurred innovations throughout healthcare, many medical practices are wrestling with a stubborn trend: Due to anxiety about potentially contracting the virus, many patients are putting off in-person appointments. According to the Centers for Disease Control and Prevention (CDC), by June 30, 2020, an estimated 41 percent of U.S. adults had delayed or avoided medical care, including urgent/emergency care and routine care, because of concerns about COVID-19.

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> Access the ACS Be Prepared Toolkit

The New York Chapter ACS, working with its specialty partners, issued a letter to the to the Governor, NYSDOH and Senate and Assembly Members calling on the administration to protect access to surgical care.  The joint letter provides the following recommendations and calls on New York to:

• Define a clear plan to decompress ICUs
  
•  Maintain emergency access to critical medical and surgical care
  
• Avoid a prohibition on medically necessary / essential surgeries
  
• Operationalize a safe and effective vaccination program
  
• Support interventions to secure additional PPE

> Read the letter

These steps must be completed by December 18th

Step One - Register for the Immunization Information System:

Healthcare providers are strongly recommended to register in NYSIIS for providers in NYS, outside of NYC, and with CIR for providers located in NYC. This is because all COVID-19 Vaccination Program providers (each location submitting a profile) will need a NYSIIS account (for providers outside of NYC) or CIR account (for providers located in NYC). Your organization may currently have a NYSIIS or CIR account, but it is important to ensure that the appropriate staff have access.

• For health care providers located in NYS outside of NYC, take the following steps for new users in NYSIIS - see the Checklist to Go Live with NYSIIS: 1). NYSIIS is located on the Health Commerce System (HCS). If responsible staff do not yet have an HCS account, they must apply for one, 2). Take the NYSIIS Administrative User Training.
• For health care providers located in NYC, go to the online CIR registration page.

Step Two – Enroll in the COVID-19 Vaccination Program:

• In addition to registering with NYSIIS or CIR, providers must enroll in the COVID-19 Vaccination Program. NYSDOH and NYC DOHMH are implementing a phased approach to provider enrollment and will notify healthcare facilities, providers and professional groups as each new group is opened for enrollment.
• Providers in NYS, outside of NYC, will enroll in the NYS COVID-19 Vaccination Program through the Health Commerce System application "COVID-19 Vaccine Program Provider Enrollment"  and should review the NYSDOH COVID-19 Vaccination Program Enrollment Letter for guidance.  Providers in NYC will enroll in the NYC COVID-19 Vaccination Program through the CIR.
• Networks with facilities or providers in both NYS and NYC should enroll their facilities or providers outside of NYC in the NYS COVID-19 Vaccination Program through the Health Commerce System and enroll their facilities or providers in NYC in the NYC Covid-19 Vaccination Program through the CIR.

Step Three – Ordering, Receiving and Administering Vaccine

• When COVID-19 vaccine is available, providers will order COVID-19 vaccine through NYSIIS (for providers in NYS, outside of NYC) and CIR (for providers in NYC). Orders will be reviewed and approved by NYS DOH and shipped directly from the vaccine manufacturer or CDC distributor.
• When vaccine is available, providers will monitor vaccine inventory; enter doses administered and/or perform data exchange (uploading and downloading data) between the provider's electronic health system and NYSIIS/CIR; enter vaccine returns and wastage; and generate reports for internal review (e.g. doses administered) in NYSIIS/CIR.

For questions, call the NYSDOH, Bureau of Immunization (518) 473-4437 or NYSDOH COVID-19 hotline 1-888-364-3065. Health care providers interested in learning more about the COVID-19 Vaccine Program may contact the NYSDOH at covid19vaccine@health.ny.gov. NYC providers with enrollment questions may contact NYC DOHMH at nycimmunize@health.nyc.gov or COVID-19: Vaccines.

For more information - click here

For months, physicians and practice managers have been in crisis mode due to COVID-19 and have faced daunting challenges daily. What the future holds relative to the evolution of COVID-19 remains unknown, but it is certain that litigation for COVID-related claims is on the horizon and will impact physicians in all medical specialties and practice models.

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Nuances of patient characteristics demand a sophisticated approach to pain management.

Master the complexities of perioperative pain management with the real-life strategies highlighted in this new online program. Challenging patient scenarios across preoperative, intraoperative, and postoperative periods are used to demonstrate the array of pain management approaches essential for effective surgical care. The Optimizing Perioperative Pain Management course includes eight interactive, case-based modules:

1. Understanding Pain Mechanisms
2. Risks of Perioperative Opioids
3. Expectation Setting
4. Multimodal Pain Therapy
5. Outpatient Postoperative Opioid Prescribing
6. Pre-Existing Opioid Use
7. Substance Misuse History
8. Pain Management at the End of Life: Final Hours to Days

Under the leadership of John A. Weigelt, MD, FACS, a group of prominent surgeon and nonsurgeon experts in pain management collaborated to create this invaluable, concise resource. 

Perioperative pain management remains the domain of surgeons. Expert use of available resources and a multidisciplinary approach will help take your surgical care to the next level.

Learning Objectives

After completing Optimizing Pain Management: An Evidence-Based Approach, learners will be able to:

• Outline the array of pain management approaches essential for effective surgical care, including multimodal therapies and pain management with and without the use of opioids.
• Describe differences in appropriate pain management approaches for straightforward and complex patient profiles across preoperative, intraoperative, postoperative, and end-of-life periods.
• Discuss the implications of opioid use in perioperative patients and the strategies to manage patients with profiles ranging from opioid naïve, to opioid use for chronic pain, and to opioid dependency.
  

 Top things to know

How Was Western Washington State So Effective in Managing COVID-19? A JACS Highlight The Fight Continues: Contact Congress to Support Legislation Preventing Medicare Cuts! Power of Purpose: The Importance of Managing Occupational Well-Being during COVID-19 You're Invited! Attend the Virtual 2020 ACS Board of Governors' Awards Program The ACS SSR Makes MIPS 2020 Reporting Easy—Learn More and Submit by January 6, 2021 Don't Miss the Opportunity for FREE CME! Clinical Congress Content Still Available

Last Updated: November 16, 2020 at 1:14 PM

What You Need to Know

• Bars, restaurants and gyms, as well as any State Liquor Authority-licensed establishment, must close in-person service from 10 p.m. to 5 a.m. daily.

• Indoor and outdoor gatherings at private residences are limited to no more than 10 people. 

• New travel guidelines are in effect that allow out-of-state travelers to “test out” of the mandatory 14-day quarantine. 

• A new cluster action initiative is addressing COVID-19 hot spots that have cropped up across the state.

• Go to New York's COVID Report Card to find COVID-19 positive case data for every school district in the state.

• To report violations of health and safety restrictions and requirements for businesses, gatherings and individuals, please choose the appropriate link below:

  • File a complaint about a business, location or incident in your community.

  • File a complaint against your employer or place of work.

• Go to forward.ny.gov to find: Industry guidance on re-opening; regional dashboards for monitoring how the virus is being contained; and information on loans for small businesses.

• New Yorkers without health insurance can apply through NY State of Health through December 31, 2020; must apply within 60 days of losing coverage.

• Health care workers can text NYFRONTLINE to 741-741 to access 24/7 emotional support services. Any New Yorker can call the COVID-19 Emotional Support Hotline at 1-844-863-9314 for mental health counseling.

Following the killing of George Floyd, the Board of Regents of the American College of Surgeons, as a leader in surgery in the United States, recognized its responsibility to address the issue of structural racism within the American College of Surgeons and within the profession of surgery. A task force was appointed to evaluate these factors as a result.

The task force was chaired by J. Wayne Meredith, MD, FACS, MCCM, American College of Surgeons President 2020–2021, and populated by members who are committed to the issue of eliminating racism, who are senior leaders of the American College of Surgeons that have a strong understanding of its operations, and who are influential and empowered to make changes.

We concluded that current national attention provides an opportunity to potentially make great progress on the issue of structural racism in the American College of Surgeons and in the profession of surgery. As such, our recommendations are focused on antiracism and helping our own professional organization and our surgeons approach issues of race with excellence, skill and fidelity. 

In the report, we identify Five Focus Areas of Progress, which include:

• Just & Inclusive Environment
• Cultural Competency
• Diversity in the Workforce
• Public Health Research
• Advocacy & Legislative Reform

The report from the Anti-Racism Task Force can be accessed here. The Anti-Racism Task Force recommendations were enthusiastically endorsed by the American College of Surgeons Board of Regents, and the Board of Regents appointed a Regental Committee to expeditiously carry them out. 

All our recommendations are important; some can be completed quickly, some in an intermediate phase, and some will take years to accomplish. Over the next few months, the Regental Committee will communicate progress in implementing the Anti-Racism Task Force recommendations and share periodic updates on activities.

Thank you,

J. Wayne Meredith, MD, FACS, MCCM
President, American College of Surgeons
Chair, Anti-Racism Task Force

L. Scott Levin, MD, FACS
Chair, Board of Regents, American College of Surgeons

Timothy J. Eberlein, MD, FACS
Regent, Board of Regents, American College of Surgeons
Chair, Anti-Racism Committee

David B. Hoyt, MD, FACS
Executive Director, American College of Surgeons