“As a Floridian with close family ties to the area, I am proud of Steward’s significant investment in the people of South Florida, whose tight-knit communities and vibrant diversity have always represented the very best of American culture,” de la Torre said in a statement.

Steward’s operations will be directed by Dr. Sanjay Shetty, president of Steward North America. The transaction is expected to close in the third quarter of this year.

Tenet’s ambulatory facilities, operated by United Surgical Partners International, will remain with Tenet and are not included in the transaction.

Source: Miami Herald 

https://www.miamiherald.com/article252208343.html

This afternoon, the Senate voted 90-2 to pass an agreement reached by Leaders Schumer and McConnell to extend the 2 percent Medicare sequester moratorium that expires on April 1. The bipartisan legislation, offered as an amendment by Senators Shaheen and Collins, would provide a nine-month extension of the moratorium, through December 31. It also contains some technical corrections related to rural health clinics and disproportionate share hospitals.

The House of Representatives passed different legislation earlier that would both extend the moratorium through the end of the pandemic and eliminate an additional 4 percent Medicare sequester scheduled to take effect on January 1, which was required by PayGo rules to offset part of the cost of passing the American Rescue Plan COVID-19/stimulus package. Consequently, the House will need to pass the Senate language when it returns from its Easter recess in mid-April. The House is expected to vote favorably, and the Centers for Medicare & Medicaid Services is expected to hold off on processing April claims until then to avoid making reduced payments.

Physician and other stakeholder groups affected by the upcoming 4% sequester scheduled for January 1 expect legislation to be considered later in the year to waive those cuts.

The Florida SHOTS system, the system that records and maintains Florida vaccination records including COVID-19 vaccinations, will be unavailable beginning on March 27, 2021 at 8:00 A.M. EST and will return to service on March 28, 2021 at 8:00 A.M. EST. The reason the Florida SHOTS system will be unavailable is because the system is migrating to a new server to improve and protect the system.

During the time when the Florida SHOTS system is unavailable, both users who enter data directly into the system and users who upload spreadsheets into the system will not have the ability to access the system for either data entry or spreadsheet upload.

The Florida SHOTS team is also working with electronic health record software companies to ensure that any data transmitted from providers and hospitals through their electronic health records during this time is effectively received by the Florida SHOTS system as soon as it is back online at 8:00 A.M. EST on March 28, 2021.

If you have any questions, please reach out to the Florida SHOTS Help Desk by email at flshots@flhealth.gov or by phone at 877-888-7468. Regular business hours are Monday-Friday, 8:00 A.M-5:00 P.M. EST.

Feb. 25, 2021, WESTON, Fla.: The National Pancreatic Foundation (NPF) has recognized Cleveland Clinic Florida’s Weston Hospital as a nationally approved Center of Excellence, which reflects the organization’s leadership in pancreatic cancer treatment, patient advocacy, educational awareness, and financial assistance.

Weston Hospital is one of only four Centers of Excellence in Florida, and the only one to earn the distinction in Broward County.

“We are honored to be recognized as a Center of Excellence for pancreatic cancer treatment,” said Cleveland Clinic Florida surgeon Mayank Roy, MD, MRCS, FACS. “This achievement demonstrates our entire multidisciplinary team’s delivery of excellent patient care. Working together, we are able to customize the best possible treatment for patients across South Florida and the Treasure Coast, and provide improved quality of life.”

The American Cancer Society estimates more than 60,000 Americans will be diagnosed with pancreatic cancer in 2021, including 4,700 Floridians. Nationally, an estimated 48,220 people will die as a result of the disease, with 3,700 of them Florida residents.

According to NFP, an approved Center of Excellence must meet the criteria developed by a task force comprised of invited subject matter experts and patient advocates. The criteria include having expert physician specialists such as gastroenterologists, pancreas surgeons, and interventional radiologists, along with patient-focused programs such as pain management, psychosocial support and more.

“We are thrilled to expand our NPF Centers of Excellence Program to better serve the needs of patients suffering from pancreas disease,” said David Bakelman, CEO of the National Pancreas Foundation. “The NPF Centers of Excellence Program is one of the pillars of NPF, and we look forward to working with our current and new Centers.” 

Weston Hospital has been recognized for quality care nationally. It was named byU.S. News & World Reportas the No. 1 hospital in the Miami-Fort Lauderdale metro area for 2020-2021, the third year in a row to claim that honor. The Gastroenterology and GI Surgery Program at Weston continues to be recognized nationally, as it was ranked 29th in the United States. It is the only gastroenterology and GI surgery program in South Florida to be ranked nationally and one of only four in the state.

###

About the Cleveland Clinic Florida region
The Cleveland Clinic Florida region is a nonprofit, multi-specialty healthcare provider that integrates clinical and hospital care with research and education. The Florida region now includes Cleveland Clinic Indian River Hospital, Cleveland Clinic Martin Health, and Cleveland Clinic Weston Hospital, with five hospitals and numerous outpatient centers in Broward, Palm Beach, Martin, St. Lucie and Indian River Counties. The Florida region is an integral part of Cleveland Clinic in Ohio, where providing outstanding patient care is based upon the principles of cooperation, compassion and innovation. Physicians at Cleveland Clinic are experts in the treatment of complex conditions that are difficult to diagnose. For more information about Cleveland Clinic Florida, visit www.clevelandclinicflorida.org. Follow us on Twitter and Facebook.

Today, the Centers for Medicare & Medicaid Services (CMS) finalized a signature accomplishment of the new Office of Burden Reduction & Health Informatics (OBRHI). This final rule builds on the efforts to drive interoperability, empower patients, and reduce costs and burden in the healthcare market by promoting secure electronic access to health data in new and innovative ways. These significant changes include allowing certain payers, providers and patients to have electronic access to pending and active prior authorization decisions, which should result in fewer repeated requests for prior authorizations, reducing costs and onerous administrative burden to our frontline providers. This final rule will result in providers having more time to focus on their patients and provide higher quality care.

“Today, we take a historic stride toward the future long promised by electronic health records but never yet realized: a more efficient, convenient, and affordable healthcare system,” said CMS Administrator Seema Verma. “Thanks to this rule, millions of patients will no longer have to wrangle with prior providers or locate ancient fax machines to take possession of their own data. Many providers, too, will be freed from the burden of piecing together patients’ health histories based on incomplete, half-forgotten snippets of information supplied by the patients themselves, as well as the most onerous elements of prior authorization. This change will reverberate around the healthcare system for years and decades to come.”

The “CMS Interoperability and Prior Authorization” rule is the next phase of CMS interoperability rulemaking, aimed at improving data exchange while simultaneously reducing provider and patient burden. This final rule requires the payers regulated under this rule (namely, Medicaid and CHIP managed care plans, state Medicaid and CHIP fee-for-service programs (FFS) and issuers of individual market Qualified Health Plans (QHPs) on the Federally-facilitated exchanges (FFEs)) to implement application programing interfaces (APIs) that will give providers better access to data about their patients, and streamline the process of prior authorization. APIs are the foundation of smartphone applications, and when integrated with a provider’s electronic health record (EHR), they can enable data access at the touch of a button.  By exchanging relevant health information between patients, providers and payers, APIs support a better health care experience for patients. Patients have easier access to their own health information, their providers have a more complete picture of their care, and patients can take their information with them as they move from plan to plan, and from provider to provider throughout the healthcare system. This ensures more coordinated, quality care, and less repetitive and unnecessary care that is costly.

Today’s final rule requires Medicaid and CHIP (FFS) programs, Medicaid and CHIP managed care plans, and issuers of individual market QHPs on the FFEs to include, as part of the already established Patient Access API, claims and encounter data, including laboratory results, and information about the patient’s pending and active prior authorization decisions. These payers are also required to share this data directly with patients’ providers if they ask for it and with other payers as the patient moves from one payer to another. In this way, patients, providers, and payers have the data when and where they need it, to help ensure that patients receive the best possible care. While Medicare Advantage plans are not included in and therefore not subject to this final rule, CMS is considering whether to do so in future rulemaking.

Prior Authorization Burden Reduction 

Payers use prior authorization as a way to manage health care costs and ensure payment accuracy.  For certain services, providers request approval from payers before rendering care to ensure that the payer will determine that the care is medically necessary, a threshold requirement for care to be reimbursed under the patients’ health coverage. This administrative process can be burdensome, and the challenges of the prior authorization process have motivated industry efforts to develop tools to increase automation. This final rule aims to reduce the inefficiencies and burdens of the prior authorization process for providers, and give them back time to focus on what matters most, treating patients in a timely manner.

The final rule requires Medicaid and CHIP FFS programs, Medicaid and CHIP managed care plans, and issuers of individual market QHPs on the FFEs to build, implement, and maintain APIs using the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard to support automation of the prior authorization process, specifically addressing the challenges raised by both providers and payers. The requirements of this rule specify that each of these payers will build an API-enabled documentation requirements look-up service, and make these public so providers may access documentation and prior authorization requirements from their EHR platforms.  Once a provider knows what is required for each prior authorization, the next step is submitting it electronically.  The final rule also requires Medicaid, CHIP, and QHP payers to implement and maintain prior authorization support APIs using the HL7 FHIR standard, which will advance a streamlined approach for communicating prior authorization requests and responses between those payers and provider EHR platforms or other practice management systems.

The final rule also requires Medicaid and CHIP (FFS) programs, and Medicaid and CHIP managed care plans to meet reduced decision timelines for prior authorizations. These payers will now have a maximum of 72 hours to make prior authorization decisions on urgent requests and seven calendar days for non-urgent requests, and all payers subject to the rule are required to provide a specific reason for any denial, which will allow providers some transparency into the process beginning January 1, 2024 or the rating period that starts on or after January 1, 2024.  In addition, to promote accountability, the rule requires these payers, to make public, prior authorization metrics that demonstrate how they operationalize the prior authorization process.  All of these requirements together will promote a more streamlined and efficient prior authorization process for providers and payers alike.

The rule will improve the patient experience as well.  When a patient sees, for instance that a prior authorization is needed and has been submitted for a particular item or service, they will better understand the timeline for the process and be able to work with their provider to plan accordingly.

Today’s final rule aims to improve longstanding inefficiencies in the healthcare system —including the lack of data sharing and access. This final rule expands the current Administration’s goals of quality and lower costs in health care as payers and providers will now have access to more complete patient histories, allowing for more coordinated and seamless patient care.

The final rule is available to review today at: https://www.cms.gov/files/document/11521-provider-burden-promoting-patients-electronic-access-health-information-e-prior.pdf

HHS Secretary Azar has extended the COVID-19 Public Health Emergency (PHE) declaration effective Jan. 21, 2021 for an additional 90 days. This means that all of the telehealth and other waivers and flexibilities that have been implemented during the PHE will remain in effect until at least April 21, 2021.

In addition, as indicated in the summary and impact table distributed earlier this week, the Consolidated Appropriations Act that was signed into law on Dec. 27, 2020, included provisions that offset most of the 10.2% budget neutrality adjustment that had been slated to take effect for Medicare-covered services provided as of Jan. 1, 2021. CMS has now confirmed that it is implementing the following provisions of this legislation and that there will be no delay in claims processing for 2021 services; that is, claims will be paid on time at the correct 2021 rates that reflect this legislation.

Message from CMS:

On December 27, the Consolidated Appropriations Act, 2021 modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS):

• Provided a 3.75% increase in MPFS payments for CY 2021
• Suspended the 2% payment adjustment (sequestration) through March 31, 2021
• Reinstated the 1.0 floor on the work Geographic Practice Cost Index through CY 2023
• Delayed implementation of the inherent complexity add-on code for evaluation and management services (G2211) until CY 2024

CMS has recalculated the MPFS payment rates and conversion factor to reflect these changes. The revised MPFS conversion factor for CY 2021 is 34.8931. The revised payment rates are available in the Downloads section of the CY 2021 Physician Fee Schedule final rule (CMS-1734-F) webpage.

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would improve the electronic exchange of health care data among payers, providers, and patients, and streamline processes related to prior authorization to reduce burden on providers and patients. By both increasing data flow, and reducing burden, this proposed rule would give providers more time to focus on their patients, and provide better quality care.

The COVID-19 pandemic has shone a harsh light on many longstanding inefficiencies in the health care system—including the lack of data sharing and access. Today’s proposed rule aims to improve this for patients navigating care. The proposed rule would build on the Trump Administration’s Interoperability and Patient Access final rule published by the CMS in May.

“This proposed rule ushers in a new era of quality and lower costs in health care as payors and providers will now have access to complete patient histories, reducing unnecessary care and allowing for more coordinated and seamless patient care. Each element of this proposed rule would play  a key role in reducing onerous administrative burden on our frontline providers while improving patient access to health information,” said CMS Administrator Seema Verma. “Prior authorization is a necessary and important tools for payors to ensure program integrity, but there is a better way to make the process work more efficiently to ensure that care is not delayed and we are not increasing administrative costs for the whole system.”  Prior authorization is not only a leading source of burden, it is also a primary source of provider burnout, and takes time away from treating patients. If just a quarter of providers took advantage of the new electronic solutions that this proposal would make available, the proposed rule would save between 1 and 5 billion dollars over the next ten years. With the pandemic placing even greater strain on our health care system, the policies in this rule are more vital than ever.”

The rule would require payers in Medicaid, CHIP and QHP programs to build application programming interfaces (APIs) to support data exchange and prior authorization. APIs allow two systems, or a payer’s system and a third-party app, to communicate and share data electronically  Payers would be required to implement and maintain these APIs using the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard. The FHIR standard is an innovative technology solution that helps bridge the gaps between systems so both systems can understand and use the data they exchange.

On behalf of HHS, the Office of the National Coordinator for Health IT (ONC) is also proposing to adopt certain standards through an HHS rider on the CMS proposed rule.

Improving Prior Authorization 

Prior authorization is an administrative process used in healthcare for providers to request approval from payers to provide a medical service, prescription, or supply. This process takes place before a service is rendered. The rule proposes significant changes to improve the patient experience and alleviate some of the administrative burden prior authorization causes health care providers. Medicaid, CHIP and QHP payers would be required to build and implement FHIR-enabled APIs that could allow providers to know in advance what documentation would be needed for each different health insurance payer, streamline the documentation process, and enable providers to send prior authorization requests and receive responses electronically, directly from the provider’s EHR or other practice management system. While Medicare Advantage plans are not included in today’s proposals, CMS is considering whether to do so in future rulemaking.

The proposed rule would also reduce the amount of time providers wait to receive prior authorization decisions from payers—the rule proposes a maximum of 72 hours for payers, with the exception of QHP issuers on the FFEs, to issue decisions on urgent requests and seven calendar days for non-urgent requests. Payers would also be required to provide a specific reason for any denial, which will allow providers some transparency into the process. To promote accountability for plans, the rule also requires them to make public certain metrics that demonstrate how many procedures they are authorizing. 

These policies, taken together, could lead to fewer prior authorization denials and appeals, while improving communication and understanding between payers, providers, and patients. They are the result of numerous listening sessions with plans and providers aimed at crafting a new process that balances the need for greater efficiency and consistency in prior authorization and its important role in preventing fraud, abuse, and unnecessary expenditures.

Increasing Patient Access to Health Information 

Building on that foundational policy, this rule would require impacted payers to implement and maintain a FHIR-based API to exchange patient data as patients move from one payer to another. In this way, patients who would otherwise not have access to their historic health information would be able to bring their information with them when they move from one payer to another, and would not lose that information simply because they changed payers.

These proposed changes would also allow payers, providers and patients to have access to more information including pending and active prior authorization decisions, potentially allowing for fewer repeat prior authorizations, reducing burden and cost, and ensuring patients have better continuity of care. To read more on the importance of these proposed changes, please visit CMS Administrator Seema Verma’s blog post by clicking here.     

For More Information:

• Proposed Rule: Comment period closes January 4
• Full press release
• Fact sheet
• Blog
• CMS Interoperability and Patient Access Final Rule webpage
• Register for December 16 listening session

JACKSONVILLE, Fla., Dec. 9, 2020 — The Alzheimer’s Association, along with the Florida Department of Elder Affairs and senior engagement technology provider iN2L, has announced the launch of "Project VITAL at Home," a new and innovative program specially designed for those living with Alzheimer’s disease or another dementia and their caregivers. Through Project VITAL at Home, participants will receive a wealth of engagement opportunities with an iN2L tablet and have direct access to the live and on-demand support and education programs of the Alzheimer’s Association.

“There are more than 580,000 Floridians living with Alzheimer’s and 1.2 million caregivers providing unpaid support to those individuals,” said Julie Shatzer, vice president of programs for the Florida region of the Alzheimer’s Association. “Social isolation and boredom are particular challenges for those living with Alzheimer’s and other dementias, as well as their caregivers. Having a way to provide purposeful and meaningful engagement by connecting with family, friends, healthcare providers and other VITAL caregivers means that you never need to go it alone.”

Project VITAL at Home is the latest expansion of the Project VITAL program. The Association launched Project VITAL (Virtual Inclusive Technology for All) in partnership with the Florida Department of Elder Affairs in April of 2020 to keep seniors connected with loved ones during social isolation. In Phases 1 and 2 of the program, more than 600 iN2L tablets were distributed to nursing homes and assisted living communities throughout the state.

“Project VITAL at Home has provided the Association the opportunity to extend our reach to not just those living with dementia at residential care communities, but to all seniors living with dementia in Florida who are vulnerable to the negative effects of social isolation,” Shatzer said. 

The tablets are preloaded with software programming from iN2L, enabling residents to engage, be entertained and connect with their loved ones via a simple one-touch video chat application. The senior-friendly tablet is preloaded with an expansive, easily personalized library of content items designed to support cognitive, emotional, social, physical and spiritual wellness for the ultimate person-centered engagement experience.

Older adults using the tablet will be able to access puzzles, games, movies, audiobooks, music and more to promote purposeful engagement. The tablet also provides ways for seniors to learn, relax and have fun, as well as stay connected with others near and far. Purposeful engagement is an excellent way to help prevent restlessness, frequent napping and anxiousness. For caregivers, it gives them an opportunity to connect with others in similar situations as well as access an expansive library of Alzheimer’s Association content and education programs.

“We are honored to continue working with the Alzheimer’s Association to provide even more individuals with our senior-friendly tablets as part of Project VITAL at Home,” said Lisa Taylor, iN2L CEO. “We know how important meaningful connection is to older adults’ health and well-being, and during this ongoing pandemic, we have seen how our tablets have helped facilitate connection for many senior living community residents. Now we can provide that same support for older adults at home.

“Our tablets include everything seniors and their caregivers need to stay connected to the people and experiences that matter most,” Taylor added, “including our easy one-touch video chat tool for virtual family visits, as well as over 1,000 content applications to connect them to their interests and passions. We are thrilled that our tablets will be helping more seniors in the state of Florida stay healthy, happy and entertained.”

The tablets will be available on a first-come, first-served basis until supplies last. Those interested in participating in the program must be caring for a person diagnosed with Alzheimer’s or another dementia at home; be willing to participate in a year-long research project, including six brief online surveys; commit to attend a monthly, one-hour feedback and support group; have a basic level of skill with online technology, a valid email address and a stable Wi-Fi signal; and agree to schedule at least one hour per day to use the tablets.

To be prescreened to receive a tablet, please fill out this form or call the Alzheimer’s Association 24/7 Helpline at 800.272.3900. 

About the Alzheimer’s Association

The Alzheimer’s Association leads the way to end Alzheimer’s and all other dementia – by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia. Visit alz.org or call (800) 272-3900.

About the Florida Department of Elder Affairs

The Florida Department of Elder Affairs, the State Unit on Aging, helps Florida’s elders to remain healthy, safe, and independent. The Department provides most direct services through its Division of Statewide Community-Based Services, which works through the state’s eleven Area Agencies on Aging and local service providers to deliver essential services to a vital segment of the population. For more information, please visit www.elderaffairs.org.

About iN2L

As the market leader in content-driven engagement for seniors, iN2L has been creating possibilities, enjoyment, and connection for older adults since 1999.  iN2L’s expansive content library promotes wellness, empowerment and engagement among older adults and is the foundation for activities that facilitate social interaction, cognitive and physical exercise and therapy, education, reminiscing, areas of interest and memory support engagement. iN2L is a critical part of the resident experience in more than 3,700 nursing homes, assisted and independent living communities, memory care settings and adult day programs across the U.S and Canada. For more information, visit www.in2l.com.

On December 1, CMS released the annual Physician Fee Schedule (PFS) final rule, prioritizing CMS’ investment in primary care and chronic disease management by increasing payments to physicians and other practitioners for the additional time they spend with patients, especially those with chronic conditions. The rule allows non-physician practitioners to provide the care they were trained and licensed to give, cutting red tape so health care professionals can practice at the top of their license and spend more time with patients instead of on unnecessary paperwork. This final rule takes steps to further implement President Trump’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors including prioritizing the expansion of proven alternatives like telehealth.

“During the COVID-19 pandemic, actions by the Trump Administration have unleashed an explosion in telehealth innovation, and we’re now moving to make many of these changes permanent,” said HHS Secretary Alex Azar. “Medicare beneficiaries will now be able to receive dozens of new services via telehealth, and we’ll keep exploring ways to deliver Americans access to health care in the setting that they and their doctor decide makes sense for them.”

“Telehealth has long been a priority for the Trump Administration, which is why we started paying for short virtual visits in rural areas long before the pandemic struck,” said CMS Administrator Seema Verma. “But the pandemic accentuated just how transformative it could be, and several months in, it’s clear that the health care system has adapted seamlessly to a historic telehealth expansion that inaugurates a new era in health care delivery.”

Finalizing Telehealth Expansion and Improving Rural Health

Before the COVID-19 Public Health Emergency (PHE), only 15,000 Fee-for-Service beneficiaries each week received a Medicare telemedicine service. Since the beginning of the PHE, CMS has added 144 telehealth services, such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, that are covered by Medicare through the end of the PHE. These services were added to allow for safe access to important health care services during the PHE. As a result, preliminary data show that between mid-March and mid-October 2020, over 24.5 million out of 63 million beneficiaries and enrollees have received a Medicare telemedicine service during the PHE.

This final rule delivers on the President’s recent Executive Order on Improving Rural Health and Telehealth Access by adding more than 60 services to the Medicare telehealth list that will continue to be covered beyond the end of the PHE, and we will continue to gather more data and evaluate whether more services should be added in the future. These additions allow beneficiaries in rural areas who are in a medical facility (like a nursing home) to continue to have access to telehealth services such as certain types of emergency department visits, therapy services, and critical care services. Medicare does not have the statutory authority to pay for telehealth to beneficiaries outside of rural areas or, with certain exceptions, allow beneficiaries to receive telehealth in their home. However, this is an important step, and as a result, Medicare beneficiaries in rural areas will have more convenient access to health care.

Additionally, CMS is announcing a commissioned study of its telehealth flexibilities provided during the COVID-19 PHE. The study will explore new opportunities for services where telehealth and virtual care supervision, and remote monitoring can be used to more efficiently bring care to patients and to enhance program integrity, whether they are being treated in the hospital or at home.

Payment for Office/Outpatient Evaluation and Management (E/M) and Comparable Visits

Last year, CMS finalized a historic increase in payment rates for office/outpatient face-to-face E/M visits that goes into effect in 2021. The Medicare population is increasing, with over 10,000 beneficiaries joining the program every day. Along with this growth in enrollment is increasing complexity of beneficiary health care needs, with more than two-thirds of Medicare beneficiaries having two or more chronic conditions. Increasing the payment rate of E/M office visits recognizes this demand and ensures clinicians are paid appropriately for the time they spend on coordinating care for patients, especially those with chronic conditions. These payment increases, informed by recommendations from the American Medical Association (AMA), support clinicians who provide crucial care for patients with dementia or manage transitions between the hospital, nursing facilities, and home. 

Under this final rule, CMS continues to prioritize this investment in primary care and chronic disease management by similarly increasing the value of many services that are similar to E/M office visits, such as maternity care bundles, emergency department visits, end-stage renal disease capitated payment bundles, and physical and occupational therapy evaluation services. These adjustments ensure CMS is appropriately recognizing the kind of care where clinicians need to spend more face-to-face time with patients.

“This finalized policy marks the most significant updates to E/M codes in 30 years, reducing burden on doctors imposed by the coding system and rewarding time spent evaluating and managing their patients’ care,” Administrator Verma added. “In the past, the system has rewarded interventions and procedures over time spent with patients – time taken preventing disease and managing chronic illnesses.”

In addition to the increase in payment for E/M office visits, simplified coding and documentation changes for Medicare billing for these visits will go into effect beginning January 1, 2021. The changes modernize documentation and coding guidelines developed in the 1990s, and come after extensive stakeholder collaboration with the AMA and others. These changes will significantly reduce the burden of documentation for all clinicians, giving them greater discretion to choose the visit level based on either guidelines for medical decision-making (the process by which a clinician formulates a course of treatment based on a patient’s information, i.e., through performing a physical exam, reviewing history, conducting tests, etc.) or time dedicated with patients. These changes are expected to save clinicians 2.3 million hours per year in administrative burden so that clinicians can spend more time with their patients.

Professional Scope of Practice and Supervision

As part of the Patients Over Paperwork Initiative, the Trump Administration is cutting red tape so that health care professionals can practice at the top of their license and spend more time with patients instead of on unnecessary paperwork. The PFS final rule makes permanent several workforce flexibilities provided during the COVID-19 PHE that allow non-physician practitioners to provide the care they were trained and licensed to give, without imposing additional restrictions by the Medicare program.

Specifically, CMS is finalizing the following changes:

• Certain non-physician practitioners, such as nurse practitioners and physician assistants, can supervise the performance of diagnostic tests within their scope of practice and state law, as they maintain required statutory relationships with supervising or collaborating physicians.
• Physical and occupational therapists will be able to delegate “maintenance therapy” – the ongoing care after a therapy program is established – to a therapy assistant.
• Physical and occupational therapists, speech-language pathologists, and other clinicians who directly bill Medicare can review and verify, rather than re-document, information already entered by other members of the clinical team into a patient’s medical record. As a result, practitioners have the flexibility to delegate certain types of care, reduce duplicative documentation, and supervise certain services they could not before, increasing access to care for Medicare beneficiaries.

For More Information:

• Final Rule
• Physician Fee Schedule Final Rule fact sheet
• Quality Payment Program Final Rule fact sheet and FAQs
• Medicare Diabetes Prevention Program fact sheet

The Office of the National Coordinator for Health IT (ONC) announced it is extending compliance deadlines for certain information blocking and health IT certification requirements. Originally, ONC’s Information Blocking Rule required all Actors—including physicians and hospitals—to come into compliance with information blocking requirements by November 2, 2020. Responding to the AMA’s advocacy efforts requesting additional time and flexibility due to the COVID-19 pandemic, ONC’s interim final rule now pushes the information blocking compliance date to April 5, 2021.

In anticipation of physician compliance with ONC’s information blocking rule, the AMA has created a two-part educational resource. Part 1 outlines what information blocking is, key terms to know, examples of information blocking practices, and a summary of exceptions for when physicians may restrict access, exchange, and use of electronic health information. Part 2 will help physicians start down the path of compliance, including questions to consider, considerations for maintaining a compliance program, and next steps. The AMA will continue to update these resources as the federal government releases new guidance.

Part 1: What is Information Blocking

Part 2: How do I comply with Information Blocking and where do I start?

The Federal Bureau of Investigation (FBI) and two federal agencies are warning of an "imminent cybercrime threat" to US hospitals and health care providers, noting that several hospitals across the country have already been hit. In a joint advisory, the Cybersecurity and Infrastructure Security Agency (CISA), FBI and the U.S. Department of Health and Human Services (HHS) said they have "credible information" that cybercriminals are taking new aim at health care providers and public health agencies as the COVID-19 pandemic reaches new heights. "Malicious cyber actors" may soon be planning to "infect systems with Ryuk ransomware for financial gain" on a scale not yet seen across the American healthcare system. Hospitals, physician practices, and public health organizations should take "timely and reasonable precautions to protect their networks from these threats." Malware targeting techniques often lead to “ransomware attacks, data theft, and the disruption of healthcare services." The agencies recommend several mitigation steps and best practices for health care entities to take to reduce their risk, including the following:

• Patch operating systems, software, and firmware as soon as manufacturers release updates.
• Regularly change passwords to network systems and accounts and avoid reusing passwords for different accounts.
• Use multi-factor authentication where possible.
  • Disallow use of personal email accounts
• Disable unused remote access/Remote Desktop Protocol (RDP) ports and monitor remote access/RDP logs.
• Identify critical assets; create backups of these systems and house the backups offline from the network.
• Set antivirus and anti-malware solutions to automatically update; conduct regular scans.

The AMA and the American Hospital Association (AHA) have created two resources to help physicians and hospitals guard against cyber threats. Those resources and additional cyber security information can be found at the AMA’s cybersecurity webpage.

Under President Trump’s leadership, CMS is taking steps to ensure all Americans, including the nation’s seniors, have access to the coronavirus disease 2019 (COVID-19) vaccine at no cost when it becomes available. On October 28, the agency released a comprehensive plan with proactive measures to remove regulatory barriers and ensure consistent coverage and payment for the administration of an eventual vaccine for millions of Americans. CMS released a set of toolkits for providers, states and insurers to help the health care system prepare to swiftly administer the vaccine once it is available. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate reimbursement for administering the vaccine in Medicare, while making it clear to private insurers and Medicaid programs their responsibility to cover the vaccine at no charge to beneficiaries. In addition, CMS is taking action to increase reimbursement for any new COVID-19 treatments that are approved or authorized by the FDA.

“Under President Trump’s leadership, we have developed a comprehensive plan to support the swift and successful distribution of a safe and effective vaccine for COVID-19,” said CMS Administrator Seema Verma. “As Operation Warp Speed nears its goal of delivering the vaccine in record time, CMS is acting now to remove bureaucratic barriers while ensuring that states, providers and health plans have the information and direction they need to ensure broad vaccine access and coverage for all Americans.”

To ensure broad access to a vaccine for America’s seniors, CMS released an Interim Final Rule with Comment Period (IFC) that establishes that any vaccine that receives Food and Drug Administration (FDA) authorization, either through an Emergency Use Authorization (EUA) or licensed under a Biologics License Application (BLA), will be covered under Medicare as a preventive vaccine at no cost to beneficiaries. The IFC also implements provisions of the CARES Act that ensure swift coverage of a COVID-19 vaccine by most private health insurance plans without cost sharing from both in and out-of-network providers during the course of the public health emergency (PHE).

In anticipation of the availability of new COVID-19 treatments, the IFC also establishes additional Medicare hospital payment to support Medicare patients’ access to these potentially life-saving COVID-19 therapies.  In Medicare, hospitals are generally reimbursed a fixed payment amount for the services they provide during an inpatient stay, even if their costs exceed that amount. Under current rules, hospitals may qualify for additional “outlier payments,” but only when their costs for a particular patient exceed a certain threshold. Under this IFC, hospitals would qualify for additional payments when they treat patients with innovative new products approved or authorized to treat COVID-19 to mitigate any losses they may experience from making these therapies available, even if they do not reach the current outlier threshold. The IFC also makes changes to reimbursement for outpatient hospital services to ensure payment for certain innovative treatments for COVID-19 that occur outside of bundled arrangements and are paid separately. In addition, CMS released information to prepare hospitals to bill for the outpatient administration of a monoclonal antibody product in the event one is approved under an emergency use authorization (EUA).

This rule also allows states to employ a broad range of strategies - based on local needs - to appropriately manage their Medicaid program costs. The guidance and flexibility provided to states in the IFC will help them maintain Medicaid beneficiary enrollment while receiving the temporary increase in federal funding in the Families First Coronavirus Response Act (FFCRA).

CMS is also taking continued steps to ensure that price transparency extends to COVID-19 testing during the PHE. Provisions in the IFC require that any provider who performs a COVID-19 diagnostic test post their cash prices online. Providers that are non-compliant may face civil monetary penalties.

In addition to these provisions, the IFC:

• Provides an extension of Performance Year 5 for the Comprehensive Care for Joint Replacement (CJR) model; and
• Creates flexibilities in the public notice requirements and post-award public participation requirements for a State Innovation Waiver under Section 1332 of the Patient Protection and Affordable Care Act during the COVID-19 PHE.

Along with these regulatory changes, CMS is issuing three toolkits aimed at state Medicaid agencies, providers who will administer the vaccine, and health insurance plans. Together, these toolkits will help ensure the health care system is prepared to successfully administer a safe and effective vaccine by addressing issues related to access, billing and payment, and coverage.

Increasing Access to Vaccines for Medicare & Medicaid Beneficiaries

The toolkits issued today give health care providers not currently enrolled in Medicare the information needed to administer and bill vaccines to Medicare patients. CMS is working to increase the number of providers that will administer a COVID-19 vaccine to Medicare beneficiaries when it becomes available, to make it as convenient as possible for America’s seniors. New providers are now able to enroll as a “Medicare mass immunizers” through an expedited 24-hour process. The ability to easily enroll as a mass immunizer is important for some pharmacies, schools, and other entities that may be non-traditional providers or otherwise not eligible for Medicare enrollment. To further increase the number of providers who can administer the COVID -19 vaccine, CMS will continue to share approved Medicare provider information with states to assist with Medicaid provider enrollment efforts. CMS is also making it easier for newly enrolled Medicare providers to also enroll in state Medicaid programs to support state administration of vaccines for Medicaid recipients.

Coverage

As a condition of receiving free COVID-19 vaccines from the federal government, providers will be prohibited from charging consumers for administration of the vaccine. To ensure broad and consistent coverage across programs and payers, the toolkits have specific information for several programs, including:

Medicare: Beneficiaries with Medicare pay nothing for COVID-19 vaccines and their copayment/coinsurance and deductible are waived.

Medicare Advantage (MA): For calendar years 2020 and 2021, Medicare will pay directly for the COVID-19 vaccine and its administration for beneficiaries enrolled in MA plans. MA plans would not be responsible for reimbursing providers to administer the vaccine during this time. Medicare Advantage beneficiaries also pay nothing for COVID-19 vaccines and their copayment/coinsurance and deductible are waived.

Medicaid: State Medicaid and CHIP agencies must provide vaccine administration with no cost sharing for most beneficiaries during the public health emergency. Following the public health emergency, depending on the population, states may have to evaluate cost sharing policies and may have to submit state plan amendments if updates are needed.

Private Plans: CMS, along with the Departments of Labor and the Treasury, is requiring that most private health plans and issuers cover a recommended COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost sharing. The rule also provides that out-of-network rates cannot be unreasonably low, and references CMS’s reimbursement rates as a potential guideline for insurance companies.

Uninsured: For individuals who are uninsured, providers will be able to be reimbursed for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA).

Billing and Payment

The toolkits also address issues related to billing and payment. After the FDA either approves or authorizes a vaccine for COVID-19, CMS will identify the specific vaccine codes, by dose if necessary, and specific vaccine administration codes for each dose for Medicare payment. CMS and the American Medical Association (AMA) are working collaboratively on finalizing a new approach to report use of COVID-19 vaccines, which include separate vaccine-specific codes. Providers and insurance companies will be able to use these to bill for and track vaccinations for the different vaccines that are provided to their enrollees.

Medicare Payment

CMS also released new Medicare payment rates for COVID-19 vaccine administration. The Medicare payment rates will be $28.39 to administer single-dose vaccines. For a COVID-19 vaccine requiring a series of two or more doses, the initial dose(s) administration payment rate will be $16.94, and $28.39 for the administration of the final dose in the series. These rates will be geographically adjusted and recognize the costs involved in administering the vaccine, including the additional resources involved with required public health reporting, conducting important outreach and patient education, and spending additional time with patients answering any questions they may have about the vaccine. Medicare beneficiaries, those in Original Medicare or enrolled in Medicare Advantage, will be able to get the vaccine at no cost.

CMS is encouraging state policymakers and other private insurance agencies to utilize the information on the Medicare reimbursement strategy to develop their vaccine administration payment plan in the Medicaid program, CHIP, the Basic Health Program (BHP), and private plans. Using the Medicare strategy as a model would allow states to match federal efforts in successfully administering the full vaccine to the most vulnerable populations.

The IFC (CMS-9912-IFC) is scheduled to display at the Federal Register as soon as possible with an immediate effective date and a 30-day comment period.

For More Information:

• Fact Sheet
• COVID-19 vaccine resources for providers, health plans and State Medicaid programs
• FAQs on billing for therapeutics

The Agency for Health Care Administration (Agency) recognizes the impact that the 2019 novel coronavirus (COVID-19) has had on Florida Medicaid providers. This alert provides updated information regarding the required provider enrollment revalidation process with Florida Medicaid during the State of Emergency.

On March 19, 2020, the Agency automatically extended the Medicaid provider revalidation date for six months for providers with a revalidation date between March 19, 2020 and September 30, 2020. Additionally, the Agency removed restrictions and extended revalidation dates for six months for any Florida Medicaid provider with revalidation dates of March 19, 2020 and forward, who had an active restriction on their file due to an incomplete revalidation.

Effective immediately, the Agency will restart the Medicaid provider enrollment revalidation process. The restart includes providers who had their revalidation dates extended as outlined above as well as those providers regularly scheduled for revalidation beginning October 1, 2020 and forward. A letter will be mailed to you highlighting your revalidation date.

Failure to complete the revalidation process prior to your revalidation date will lead to suspension of Medicaid payments and termination of your provider ID resulting in non-payment for services rendered after that date.

For questions related to this alert, or for assistance with provider enrollment, please call the Florida Medicaid Provider Enrollment Contact Center at 1-800-289-7799, Option 4.

During the 2020 Florida legislative session, an exemption to health care clinic licensure for Florida Medicaid providers was added to Section 400.9905, Florida Statutes.  As a result of this legislative change, Florida Medicaid providers are not required to seek health care clinic licensure. Effective July 1, 2020, Florida Medicaid does not require any provider to show proof of licensure as a health care clinic nor proof of exemption from licensure as a health care clinic.  Current, reenrolling, or new Florida Medicaid providers do not need to show proof of licensure as a health care clinic nor proof of exemption from licensure as a health care clinic. Florida Medicaid is working to update the Enrollment Policy (Appendix E) to remove these requirements to align with Section 400.9905, Florida Statutes for all of the below providers:

Florida Medicaid providers may voluntarily apply for a certificate of exemption from licensure as a health care clinic. Most health care providers who apply for an exemption certificate do so because Medicare or private insurance companies require documentation of licensure or exemption from licensure prior to authorizing reimbursement for services. If you choose to apply, application forms and information are online at http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/HealthCareClinic/hcc_exemption.shtml. Please note: The health care clinic rules and application forms have not yet been updated to reflect the recent statutory changes. If an entity is attempting to qualify under a newly added exemption, they can submit an application along with appropriate fees, a cover letter stating the exemption sought and appropriate supporting documentation. For additional assistance please contact the Florida Medicaid Helpline at 1-877-254-1055.

HHS announced today that it will be disbursing another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians that have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus.

Recognizing the negative impact of the COVID-19 pandemic has increased anxiety and depression in the country and behavioral health providers have continued to provide care through telehealth and other means, HHS is also announcing that the nation’s behavioral health care providers, including psychiatrists, are now eligible for funding. Previously ineligible physicians, such as those who began practicing in 2020, will also be eligible to apply. Physicians will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding.

CHICAGO — The American Medical Association (AMA) published an update to theCurrent Procedural Terminology (CPT^®) code set that includes two code additions for reporting medical services sparked by the public health response to the COVID-19 pandemic.

The update to the CPT code set was approved by the CPT Editorial Panel, the independent body convened by the AMA with authority to expedite the review of proposed modifications and additions to the CPT code set. The two additions to the CPT code set have been approved for immediate use.

“The CPT code set continues to quickly adapt during the COVID-19 pandemic to streamline the reporting of innovative tools and services now available to help reduce the COVID-19 disease burden, improve health outcomes and reduce long-term care costs,” saidAMA President Susan R. Bailey, M.D. “This update is the latest in a series of modifications to the CPT codessetto meet the needs of the health care industry as medical advancements expand the fight against COVID-19.”

The first addition, CPT code 99072, was approved in response to sweeping measures adopted by medical practices and health care organizations to stem the spread of the novel coronavirus (SARS-CoV-2), while safely providing patients with access to high-quality care during in-person interactions with health care professionals. The additional supplies and clinical staff time to perform safety protocols described by code 99072 allow for the provision of evaluation, treatment or procedural services during a public health emergency in a setting where extra precautions are taken to ensure the safety of patients as well as health care professionals. The AMA/Specialty Society RVS Update Committee (RUC) worked with 50 national medical specialty societies and other organizations over the summer to collect data on the costs of maintaining safe medical offices during the public health emergency and submitted recommendations today to the Centers for Medicare and Medicaid Services to inform payment of code 99072.

The second addition, CPT code 86413, was approved in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies, as opposed to a qualitative assessment (positive/negative) of SAR-CoV-2 antibodies provided by laboratory tests reported by other CPT codes. By measuring antibodies to SARS-CoV-2, the tests reported by 86413 can investigate a person’s adaptive immune response to the virus and help access the effectiveness of treatments used against the infection.

For quick reference, the two new Category I CPT codes and long descriptors are:

99072     Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease

86413     Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative

In addition to the long descriptors, short and medium descriptors for codes 99072 and 86413 can be accessed on theAMA website, along with several other recent modifications to the CPT code set that have helped streamline the public health response to the SAR-CoV-2 virus and the COVID-19 disease.

Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel that collects broad input from the health care community and beyond to ensure CPT content reflects the coding demands of digital health, precision medicine, augmented intelligence, and other aspects of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology, so it can fulfill its vital role as the trusted language of medicine today and the code to its future.
 

# # #

Media Contact:
Robert J. Mills
AMA Media & Editorial
(312) 464-5970
robert.mills@ama-assn.org

About the AMA
The AMA is the physicians’ powerful ally in patient care. As the only medical association that convenes 190+ state and specialty medical societies and other critical stakeholders, the AMA represents physicians with a unified voice to all key players in health care. The AMA leverages its strength by removing the obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises and, driving the future of medicine to tackle the biggest challenges in health care. For more information, visit ama-assn.org.

Attached is a letter to Congressional leaders that was organized by the American Medical Association and signed by 114 state medical societies and national specialty organizations opposing efforts to include surprise medical billing provisions in the new COVID-19 relief legislation under discussion in Congress. The letter makes the point that legislation to address the current public health emergency is not the appropriate vehicle or time to address this issue when agreement in significant outstanding issues remains elusive.

Additionally, Senate Republicans released their version of the fourth COVID-19 relief package late Monday. Known as the Health, Economic Assistance, Liability Protection, and Schools (HEALS) Act, the package is actually a compilation of eight separate bills addressing a broad range of issues such as restaurant worker support, reopening schools, and medical supply chain problems.

A few of the key health care issues addressed in the package include the following:

• Extending repayment terms under the Medicare Accelerated and Advanced Payment program, delaying the start of the repayment period from 120 to 270 days after receipt of funds and extending the length of the repayment period from 12 to 18 months.
• Increasing the Public Health Services Emergency Fund established by the CARES Act by $25 billion.
• Creating an exclusive federal cause of action for coronavirus medical liability claims, under which health care providers would be liable only for coronavirus-related injuries caused by gross negligence or willful misconduct.
• Expanding access to the Paycheck Protection Program to 501(c)(6) entities, which would include many health professional associations such as state medical societies and national specialty societies, and other program improvements.
• Providing authority to the Centers for Medicare and Medicaid Services to extend waivers and other telehealth policies through 2021.
• Maintaining Medicare Part B beneficiary premiums at 2020 rates through 2021.
• Requiring all personal protective equipment purchases for the National Strategic Stockpile to come from domestic suppliers whenever possible; state stockpiles of medical products and supplies would be established and supported by a $1 billion annual appropriation through 2030.
• Providing $16 billion for testing, contact tracing, and other COVID-related public health activities.

The total cost of the package is approximately $1 trillion, about one-third of the amount that would be provided by the House-passed HEROES Act. A staff-prepared summary of pertinent parts of the HEALS Act is attached.

This legislative package represents an initial offering by Senate Republican leadership. It will likely undergo significant revisions prior to debate on the Senate floor. Since various COVID-19 relief programs are expiring at the end of July, Congress faces pressure to send a final bipartisan package to the President for signature prior to adjourning for the August recess on August 10.

Summary of Drug Pricing Executive Orders - July 2020

The President of the United States signed four new executive orders (EO) on drug pricing on July 24th. Three were available to the public as of Friday afternoon. A fourth EO, on “Most Favored Nation” status for pricing on certain drug products, was not yet available for review as of 6:00 p.m. Friday. On a call with the White House late Friday, the Administration noted that this fourth EO would only go into effect if the drug manufacturers do not come to an agreement with the Administration on lower costs. They are meeting on Tuesday.

Access to Affordable Life-Saving Medications

This EO would direct the Secretary to establish a program that conditions grants to Federally Qualified Health Centers (FQHC) on their ability to establish programs allowing certain individuals to purchase insulin and epinephrine at the discounted price paid to acquire the drug under the 340B program.

Increasing Drug Importation and Lowering Prices for American Patients

This EO directs the Secretary to take action to allow drug importation through three programs:

• Grant waivers allowing for personal importation of prescription drugs, without limit on drug type or country of importation, so long as they meet program requirements ensuring safety
• Authorize the re-importation of insulin products at lower costs
• Finalize earlier proposals to create state-based importation programs allowing importation of certain drugs from Canada

The AMA submitted comments on the Administration's previous proposal to create state importation programs, raising concerns about the ability of these programs to ensure safety and to successfully secure lower priced drugs from Canada. 

Lowering Drug Prices for Patients by Eliminating Kickbacks to Middlemen

This EO directs the Secretary to complete the rulemaking process on earlier proposals pertaining to drug rebates. That proposal would end safe harbor protections for price reductions not applied at the point of sale, and would create a new safe harbor for those passed on to patients at the point of sale. The EO notes that before this rule is finalized there must be confirmation that it does not increase federal spending. The AMA provided comments on the proposed rule, generally supporting measures to pass drug price reductions directly to patients, but raised concerns about the potential unintended consequences, such as increased premiums and the potential to see no reductions in drug list prices.

MIAMI (July 22, 2020) – Dr. Cheryl Holder has been named Interim Associate Dean of Diversity, Equity, Inclusivity, and Community Initiatives for the Florida International University Herbert Wertheim College of Medicine (HWCOM).  

Holder is a highly respected clinician, educator, and community leader who has dedicated her medical career to serving underserved and vulnerable populations. 

“I am truly grateful that Dr. Holder has agreed to serve in this capacity, as she is not only an esteemed clinician and medical educator, but is also an advocate for vulnerable people globally and for social justice,” said Dr. Robert Sackstein, HWCOM dean and senior vice president for health affairs. 

As an associate professor in the Green Family Foundation NeighborhoodHELP program, Holder teaches and assesses the impact of social determinants of health on health outcomes. She was one of the first physicians to sound the alarm about the disproportionate effects of COVID-19 on the African American community. She has advocated for more testing sites in black neighborhoods and better messaging to educate African Americans about the virus. 

Her work also addresses diversity in the health professions through pipeline programs, like STEM Saturdays. Programs designed to provide opportunities for careers in health care to young people from demographic populations that are underrepresented. 

"I am excited to continue HWCOM's mission of ensuring our communities receive the care they need to achieve optimal health from a diverse, caring workforce," she said. 

Holder is the president of the Florida State Medical Association, a regional arm of the National Medical Association, the largest and oldest organization representing African American physicians and their patients in the United States. She also serves as co-chair of Florida Clinicians for Climate Action, working to increase climate literacy and enhance awareness of the impact of climate change on vulnerable populations. She recently gave a TEDMED talk about the link between climate change, health, and poverty. 

A board-certified internist and HIV specialist, Holder, is a veteran of the battle against AIDS. She continues to have a keen interest in treating HIV patients and studying transgender women – people born male who identify as women – the population most at risk for HIV. Most of the patients she sees in her clinical practice are black, homeless, or undocumented. 

Florida International University has honored Holder with the 2016 FIU Medallion Cal Kovens Distinguished Community Service Award, the 2017 Faculty Convocation Award in Service, and the 2019 Tow Humanism in Medicine Award. 

About Herbert Wertheim College of Medicine:

With admission of its first class in 2009, the Herbert Wertheim College of Medicine (HWCOM) became South Florida’s first public medical school. In addition to the Medical Doctor degree, the college offers a Master’s in Physician Assistant Studies, and Ph.D. degrees in biomedical sciences. The college emphasizes community service, together with scientific discovery and innovation, in the quest to improve patient outcomes. Through the innovative Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP), HWCOM students learn, first-hand, how social factors critically impact health and disease. In addition, HWCOM has world-leading research efforts in nanotechnology, glycobiology and cell-based therapeutics. Through the integration of medical education and clinical care together with cutting edge research, HWCOM is training the next generation of socially conscious physicians, scientists, and health professionals who are uniquely qualified to transform the health of patients and communities world-wide. 

About FIU:

Florida International University is Miami’s public research university, focused on student success. According to U.S. News and World Report, FIU has 44 top-50 rankings in the nation among public universities. FIU is a top U.S. research university (R1), with more than $200 million in annual expenditures. FIU ranks 15th in the nation among public universities for patent production, which drives innovation, and is one of the institutions that helps make Florida the top state for higher education. The Next Horizon fundraising campaign is furthering FIU’s commitment to providing students Worlds Ahead opportunities. Today, FIU has two campuses and multiple centers, and supports artistic and cultural engagement through its three museums: Patricia & Phillip Frost Art Museum, the Wolfsonian-FIU, and theJewish Museum of Florida-FIU. FIU is a member ofConference USA, with more than 400 student-athletes participating in 18 sports. The university has awarded more than 330,000 degrees to many leaders in South Florida and beyond. For more information about FIU, visitwww.fiu.edu