Take advantage of GAFP’s virtual KSA offerings and earn up to 16 CME credits!

Both KSAs below will be held on Saturday, May 6.

Register now!

9 AM – 1 PM: Behavioral Health

The AAFP has reviewed Behavioral Health Care Virtual KSA and deemed it acceptable for up to 8.00 Knowledge Self-Assessment, Live AAFP Prescribed credits.

2 PM – 6 PM: Care of Women 

The AAFP has reviewed Care of Women Virtual KSA and deemed it acceptable for up to 8.00 Knowledge Self-Assessment, Live AAFP Prescribed credits.

The Georgia Academy of Family Physicians & the Georgia Primary Care Association invite you to attend the 2023 Summer Family Medicine CME Weekend in Isle of Palms, SC.

Stay up to date with our sessions on:

• Children and Youth with Special Health Care Needs
• A Narrow Window of Opportunity: Diagnosis and Management of Rheumatoid Arthritis in Underserved Populations
• Innovative Approaches to Address Agitation in Alzheimer’s Disease
• Risks in the Changing Tide: Protecting Emotional Health in Menopause
• Blood Pressure Control
• Taking the Stress out of Managing Patient Complaints
• Women’s Health
• Pediatric Mental Health
• Additional clinical and leadership topics coming soon!

Make plans now to join your friends and colleagues at THE BEST MEETING of the summer.

Get full details & register here

Reprinted from AAFP

The Biden Administration renewed the COVID-19 public health emergency (PHE) for the final time in February and announced that the PHE declaration will expire May 11. The end of the PHE means that many temporary policies initiated in response to the pandemic will cease or be phased out. Here are five payment and practice-related changes to start preparing for in your practice.

1. COVID-19 testing and treatment coverage will change.Over-the-counter COVID-19 tests will no longer be free for many patients. Those with traditional Medicare will no longer receive free over-the-counter or at-home tests, and coverage for patients with Medicare Advantage or private insurance will vary based on their plan.

Tests a physician or other health care professional orders and administers will still be covered by insurance but may not be free for the patient. Traditional Medicare will continue to cover the test itself at no cost to patients but may apply cost-sharing to the associated office visit. Practices may want to inform patients of this beforehand. For patients with Medicare Advantage or private insurance, cost-sharing for both the test and the office visit will depend on the individual plan. Patients on Medicaid can continue to receive free at-home tests as well as tests ordered and administered by a physician or other health care professional through September 2024.

Pharmaceutical COVID-19 treatments purchased by the federal government will continue to be available without cost-sharing, regardless of the patient’s insurance, for a short time after the PHE. The Biden Administration has indicated that it intends to transfer procurement to the traditional marketplace in the late summer or early fall of 2023. At that point, coverage and cost-sharing may shift. For patients with traditional Medicare, treatments will remain covered but may be subject to cost-sharing. This includes oral antivirals such as Paxlovid, which will be covered under Medicare Part D. Private plan coverage and cost-sharing policies will vary. Patients without insurance coverage will pay the full cost for treatments, but safety net clinics may be able to offer treatments on a sliding scale based on the uninsured patient’s income.

2. COVID-19 vaccines and boosters will continue to be free, but only while the federal stockpile lasts.Once the federal supply is exhausted, practices that want to keep offering COVID-19 vaccines and boosters will need to purchase their own supply from the traditional marketplace. But the majority of patients with public or private insurance will still be able to receive the vaccines and boosters at no cost to them. After the government-purchased supply runs out, children without insurance will be able to receive the vaccine for free through the Vaccines for Children Program. There may also be a limited supply of free vaccines available for uninsured adults through the Section 317 Immunization Program. Otherwise, patients without insurance will pay the full cost but may be able to receive the vaccine for a sliding scale fee from a safety net clinic.
3. Medicaid redeterminations will restart.Continuous Medicaid enrollment will end March 31, 2023, and states will be required to restart Medicaid and CHIP eligibility reviews. Patients who no longer qualify for Medicaid will need to transition to other coverage, such as through the Healthcare.gov marketplace. Patients who do not complete the renewal form will lose their coverage, even if they are still eligible. Additional information and resources are available on the Medicaid website, including a communication toolkit you can give patients to inform them of the steps they need to take and a timeline of when states will start unwinding renewals. The AAFP has developed an informational flyer that highlights what family physicians can do to prepare, such as remind patients to update their contact information with their Medicaid provider, check their mail for renewal notices, and complete paperwork promptly.
4. Telehealth will continue to be available after the PHE.The Consolidated Appropriations Act (CAA) of 2023 extended Medicare’s coverage of telehealth for two years. Medicare patients can receive telehealth services at home and can use either audio-video technology or audio-only technology. While coverage itself is extended, there may be shifts in the types of services covered as well as the billing and coding requirements. The Centers for Medicare & Medicaid Services (CMS) plans to release more information on this soon. You can find a list of currently covered Medicare telehealth services on the Medicare Telehealth webpage. The CAA only applies to Medicare patients. Some private payers have already shifted to permanent telehealth policies.

The Drug Enforcement Administration is still developing regulations regarding prescribing controlled substances via telehealth, including buprenorphine for opioid use disorder.

The expanded evaluation and management codes Medicare allowed to be provided without supervision under the primary care exception will end May 11.

5. HIPAA enforcement will resume.When the PHE ends, practices will need to transition to a HIPAA-compliant telehealth platform if they’re not already using one. During the PHE, the Office for Civil Rights (OCR) has exercised enforcement discretion and has not imposed penalties if a practice provided telehealth services with a non-public facing communications platform (e.g., Apple’s FaceTime). But when the PHE ends, the OCR will resume penalties for breaches of electronic patient health information in violation of the HIPAA Security Rule. All telehealth services, including audio-only services, will need to be provided using a HIPAA-compliant platform. The OCR intends to release a notice to a public when it is no longer exercising its enforcement discretion. Additional information is available on the HHS HIPAA and COVID-19 webpage.

These are just a few of the top items for practices to be aware of as we move toward the end of the PHE. More tips are available from AAFP News. CMS and HHS have released initial guidance and will continue to issue additional information on a rolling basis:

• Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap,
• Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency,
• Coronavirus Waivers and Flexibilities,
• Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19,

The Kaiser Family Foundation has also produced several helpful resources:

• What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access,
• The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access,
• Commercialization of COVID-19 Vaccines, Treatments, and Tests: Implications for Access and Coverage.

— Erin Solis, AAFP Manager of Practice and Payment

The Georgia Composite Medical Board voted in a recent meeting to update language for the mental health question on all licensure applications.

The question now reads:

“Are you currently suffering from any condition for which you are not being appropriately treated that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical, and professional manner?

“NOTE: If you are currently enrolled in Georgia PHP, you may answer NO.”

“The Board believes this is a step in right direction to address clinician burnout and encourage mental health care while still protecting patients from impaired professionals,” said GCMB Chair Matthew Norman, M.D. “Applicants should not fear loss of a license or denial of a licensure application for seeking mental health services.”

Applicants and licensees who enroll in the Georgia Professional Health Program may answer “no” to the question. The Georgia PHP is a nonprofit organization formed in 2012 to assist all licensees of the GCMB who develop potentially impairing conditions, mental illnesses, substance abuse, and other addictive disorders. The Georgia PHP is not a treatment provider but interacts with assessors of its participants, coordinates this care with the healthcare entities that employ those individuals and monitors disease status in its participants. The primary goal of the PHP is to ensure that the professionals who return to the practice of medicine do so only if they can practice with reasonable skill and safety.

The change is consistent with guidance from the Federation of State Medical Boards and the Dr. Lorna Breen Heroes’ Foundation.

The Kathelen and Dan Amos Medical Student Loan Forgiveness Program: Improving Access to Primary Care in Georgia accepts applications from eligible Emory School of Medicine students who are willing to commit to primary care practice in Georgia.

• Recipients commit to two to five years of primary care practice in Georgia commensurate with the level of assistance they have received.
• For students who train at Emory in primary care disciplines such as geriatric medicine, general internal medicine, family medicine, and general pediatrics, this debt forgiveness program will allow them to practice in these clinical areas without the burden of financial strain that comes with lower-salary career paths.
• Emory will initiate this tuition relief program in a number of ways. Recent School of Medicine graduates in medicine, family medicine, pediatric, or geriatric residencies will be encouraged to remain in or return to Georgia for primary care practice. This approach will allow for a more immediate impact on Georgia’s growing deficit of physicians.
• Additionally, Emory will introduce this incentive to first- through fourth-year medical students who commit to residency training in a primary care field with the goal to return to Georgia for practice.
• Given the pressing need to attract geriatricians to Georgia, this program will also support Emory medical students who have completed geriatrics fellowship programs or graduates of another medical school who are completing or have recently completed the Emory geriatrics fellowship.

Being an Amos Scholar

Emory School of Medicine is launching a $5 million student loan forgiveness program funded by a gift from the Amos Family Foundation.

The Emory University School of Medicine is getting a financial shot in the arm to help relieve the effects of a shortage of primary care doctors in Georgia.

Kathelen and Dan Amos, CEO of Aflac Inc. (NYSE: AFL), have pledged $5 million to create the Kathelen and Dan Amos Medical Student Loan Forgiveness Program.

“Our goal is to encourage and financially enable Emory medical school students to be on the front line of patient care and to make that a financially attractive option by eliminating some of their debt,” said Kathelen Amos, trustee of the Daniel P. Amos Family Foundation, during an exclusive interview with Atlanta Business Chronicle.

The program, which launched this month, provides relief in $40,000 increments to medical students and residents. They can receive up to four consecutive awards, for a total of $160,000.

In exchange, recipients must agree to work in Georgia at a duration commensurate with their financial award.

Those who receive $40,000 must work two years in Georgia. For $160,000 in loan forgiveness, five years of service is required.

Emory plans to give out about two dozen $40,000 awards this year.

The loan forgiveness program will not eradicate students’ debt. At Emory, annual medical school tuition and fees top $53,000. That does not include other expenses such as books, supplies and transportation. But the initiative could reduce the pressure some students feel to pursue more lucrative specialties and practice in metropolitan areas to earn enough money to pay back their loans — leaving a dearth of medical talent in rural areas and lower-paying disciplines.

“I’ve been struck by the shortage of primary care physicians,” said Amos, who is also a registered nurse in Columbus, Georgia. She said she has noticed an increase in the number of people who come to Columbus for primary care because they have limited access in surrounding rural counties.

“We hope this [program] levels the playing field, so that people choose to be of service and to go back to their community,” said Dr. Ted Johnson, director for the Division of General Medicine and Geriatrics at Emory.

Geriatric medicine, which focuses on older adults, is one area of primary care where the need is great, but the pay is not.

In Georgia’s metropolitan areas, there are 0.4 geriatricians per 100,000 residents, according to the Georgia Board of Healthcare Workforce. The rate drops to 0.1 per 100,000 residents in rural areas.

The spread is also stark between rural and urban parts of the state for family medicine, internal medicine and pediatrics, which also fall under the primary care umbrella.

“We hope that over time, this gift will bear fruit throughout the state,” said Amos, who became aware of medical student debt a couple of years ago when Home Depot co-founder Ken Langone announced a plan to donate $100 million to cover tuition for New York University’s medical school students. Amos, an Emory alumna and trustee, said her family wanted to contribute in a similar way to Emory’s medical school.

“I did not realize how finance figures into whether students enter specialties,” Amos said.

Starting salaries for geriatricians ($91,000), pediatricians ($120,000) and family physicians ($150,000) come in less than those for other specialties such as cardiologists ($210,000) and gastroenterologists ($240,000), according to data from ZipRecruiter.com.

“I didn’t fully understand what my family was doing to help get me get through medical school,” said Johnson, who attended Northwestern University. He said he was “insulated” from having to choose a career based on his future earnings. But Johnson, who is also a professor, said the “financial constraints are real,” and so is the impact on students and the community.

According to the National Institutes of Health, states with a higher ratio of primary care physicians to residents have better health outcomes and lower rates of mortality. And regular visits to the doctor lead to lower healthcare costs in the long run.

U.S. News and World Report ranked Georgia 43rd out of 50 states for how well it meets residents’ healthcare needs. Georgia came in 46th for access to preventative care.

On Saturday, February 25, the District 7 Director and Alternate Director to the GAFP Board of Directors, Drs. Pamela Obi and Christina Douglass, respectively, hosted a wildly successful event in their district in Rome at a lovely new venue, called Grace Events.

Guests were treated with mimosas, delightful brunch treats, and even had the ability to decorate their own cookies to take home. Mini massages for all topped off the day and with the weather being so beautiful, guests were seen chatting and engaging both indoors and out on the patio. 

About 50 GAFP members of all types gathered with a large student delegation joining the group from various locations including the Augusta University group in Rome as well as some pre-medical students from Shorter University. Local area residents and their families also joined in the fun as did many of the GAFP active members, including Board Chair Dr. Susana Alfonso, who were on hand to engage with the students and residents.

Many topics of interest to all members were discussed, which ranged from the Joy of Family Medicine as a career, member benefits for all members types, leadership opportunities, the wide range of careers that family medicine has to offer and an update on the GHFA Northwest GA Strike Force. Many of the active physicians spanned across many of the different choices of family medicine as a career and they were able to share much of this with the student group in attendance.

Everyone there remarked on the event’s success and we are sure we will see a spike in attendance and leadership engagement as a result!

Family physicians have until May 15 to review and, if needed, dispute data reported to CMS about their interactions with pharmaceutical and medical device manufacturers in 2022.

Any data not disputed by the May 15 deadline will be published June 30 as part of the Open Payments™ Program, a national transparency initiative that collects and publishes information about financial relationships between the medical products industry and physicians and certain other health care entities.

Learn more: Review Your Open Payments Data for 2022 by May 15