On Call: The Newsletter of the Alliance of Specialty Medicine

Fall 2021

November Push Brings Specialty Docs Back to the Hill (Virtually)


The start of November signaled the end-of-the-year sprint for unresolved health policy issues currently getting crowded out by the larger investment and infrastructure bills dominating the Congressional agenda. The Alliance of Specialty Medicine made the most of this timing by hosting its second virtual advocacy fly-in of the year on November 3rd, attended by thirteen Members of Congress and over 100 specialty physicians.

Top of mind for the Congressmen and Senators addressing the Alliance throughout the day were the looming Medicare pay cuts due to kick in on December 31st unless Congress intervenes.

The nearly 9% in scheduled payment cuts are due to a confluence of three major factors, including a 2% Medicare sequestration cut, a statutory 4% “PAYGO” cut triggered by the passage and cost of the American Rescue Plan earlier in the year, and finally, the 3.71% cut coming to physicians in the CY 2021 Medicare Physician Fee Schedule (MPFS) because of budget neutrality requirements resulting from changes to the codes for office and outpatient evaluation and management services.  Congress had passed a measure to stave off the MPFS cuts, but that measure will expire in January 2022, right when the other cuts will also kick in.  Separate and collectively, these cuts will profoundly affect physician practices still dealing with the financial implications of COVID-19.

Keenly aware of this issue, the Members of Congress pledged their support of efforts to stave off these cuts before 2022.

Other issues important to specialty care access raised during the fly-in were support of legislation to increase transparency and accountability and to reduce the burdens of prior authorization, the Improving Seniors’ Timely Access to Care Act (H.R. 3173/S. 3018) and step therapy, the Safe Step Act (H.R. 2163/S. 464). The Alliance physicians also discussed legislation to address physician workforce shortages, oversight of MACRA, and medical liability reform throughout the day. A complete set of issue briefs on these topics can be found on the Alliance website, and social media postings highlighting the day can be found by searching under #ASMFLYIN on Twitter and Instagram.

Retinal Specialists Launch “See For a Lifetime” Public Awareness Campaign



Millions of people in the US are at elevated risk for potentially blinding retinal conditions and may not realize it. In fact, vision loss and blindness account for $8 billion in lost productivity annually, posing a tremendous challenge to those who would otherwise remain in the workforce beyond age 65. In addition, most consumers are not aware that they should see a retina specialist if they are experiencing symptoms for the best chance of saving – and possibly improving – their sight and maintaining active and independent lives.

To remedy this, the Foundation of the American Society of Retina Specialists (ASRS) is embarking on a new public awareness campaign, See for a Lifetime See a Retina Specialist. By empowering the public to care for their vision, understand the risk factors, know the signs, recognize the symptoms and find a retina specialist, we can help prevent vision loss, and in many cases save people’s sight.

Employing a hearts and minds approach, the See for a Lifetime campaign utilizes storytelling that features both emotional and data-driven narratives to elevate retinal diseases as a major public health threat and champion better outcomes for the millions at risk for blindness in the U.S.

The campaign clarifies the role and importance of the retina specialist, highlights the advances in technology and treatment, and supports the importance of early diagnosis leading to enhanced outcomes. Each public service message promotes the website’s Find Your Retina Specialist search feature and offers the ASRS Foundation and Society websites as resources for those affected by retinal disease.

The launch of the campaign included distribution of a news release, a satellite media tour in English and Spanish, and execution of social and digital ads among many other activities. Already, our messages have reached an estimated audience of more than 20 million, and visits to our patient web pages are up 5,000% compared to one year ago.

To learn more and support the campaign, visit www.SeeforaLifetime.org and follow ASRS on Facebook and Twitter.

Derm Surgeons Applaud FDA for Safety Efforts on Needle-less Injector Devices



The American Society for Dermatologic Surgery Association (ASDSA) recently commended the U.S. Food and Drug Administration (FDA) for sending out a safety communication regarding needle-less devices, such as hyaluron pens (HA pens) for injection of dermal fillers. ASDSA had earlier sounded the alarm on these devices and has resources available on these devices, including a downloadable flyer, and raised this issue with the FDA.

ASDSA members are board-certified dermatologists and have found questionable social media videos in which children use these devices to self-inject and promote their use to peers. Consumers are told that these devices can create lift and fill lips, nasolabial lines, marionette lines, 11 lines, and forehead wrinkles. However, the FDA recommends not using these devices; buying or using lip or dermal fillers sold directly to the public; and injecting oneself or others with any filler (FDA-approved dermal fillers are indicated for prescription use only).

“I am pleased that the FDA has taken notice of this disturbing new trend, especially that of children using these devices on social media. We urge consumers to see a board-certified dermatologist before undertaking any cosmetic procedures to make sure all medical questions can be answered prior to treatment,” said ASDSA President Mathew Avram, MD, JD. “The complexity of facial anatomy requires in-depth knowledge and expertise, and patients should always have medical procedures done by a physician who also has knowledge of adverse events.”

ASDSA urges its physicians and patients to report adverse events to the CAPER Registry, a partnership between ASDSA and Northwestern University’s Department of Dermatology, as well as MedWatch, the FDA Safety Information and Adverse Event Reporting program.  ASDSA’s top priority is patient safety, and the FDA’s safety communication on these devices will help ensure consumers know the risks of self-injecting fillers.

Echocardiographers Applaud New Developments for Quality Improvement in CV Imaging


The American Society of Echocardiography (ASE) is proud to share that its innovative clinical data registry, ImageGuideEchoTM, has recently achieved several noteworthy milestones that directly impact physicians’ ability to adhere to best care practices and standards within the field of echocardiography.

First, the Registry has grown exponentially, with several large echo labs in the process of transferring their data by the end of 2021. The rapid acceleration of the data contained within the Registry serves to provide the field with clinical insights into guideline adherence, identify quality improvement needs, and ultimately improve patient care outcomes. ASE looks forward to ongoing increases in both institutional enrollment and echo data contained in its Registry, quickly growing to be the largest repository of Cardiovascular Ultrasound data and images.

Secondly, the ASE has continued to advance in its offerings to Pediatric Echocardiography by creating three additional registry modules focused on pediatrics: Normal anatomy/cardio-oncology, Tetralogy of Fallot, and Hypoplastic Left Heart Syndrome. With more disease states to follow, the Society looks forward to serving as a multi-institutional collaborative to positively impact pediatric patient care.

Finally, ASE has partnered with the Intersocietal Accreditation Commission (IAC), a CMS-approved accrediting body, to connect its Registry to echo lab accreditation. Facilities or physicians participating in ASE’s ImageGuideEcho Registry are now able to view accreditation-specific data within the Registry interface, reduce data entry redundancy, and streamline their regular accreditation application process by uploading the Registry’s QI documentation to report completeness and timeliness. All metrics are calculated automatically from data seamlessly extracted from institutions, which has created a process with minimal impact on clinical workflow – a key component of the Registry’s growth and ASE’s successful partnership with IAC.

By leveraging these new developments for the benefit of cardiology and the specialty of cardiovascular imaging, ASE looks forward to being at the forefront of patient care innovation and physician practice improvements.

Gastroenterologist Appointed to HHS Advisory Panel

Dr. Lawrence Kosinski takes on new role strengthening physician payment models



Lawrence Kosinski, MD, MBA, AGAF, was among three new members appointed to the Physician-Focused Payment Model Technical Advisory Committee (PTAC), advising the secretary of Health and Human Services on physician payment models.  Congress established PTAC in 2015 as part of the Medicare Access and CHIP Reauthorization Act or MACRA.

The American Gastroenterological Association (AGA) nominated Dr. Kosinski for this appointment due to his previous work on the AGA Governing Board and his current role on the AGA Quality Leadership Council.

Dr. Kosinski is the founder and chief medical officer of SonarMD, Inc., a value-based care coordination solution for complex chronic diseases. SonarMD was initiated as Project Sonar, the first PTAC approved Physician-Focused Payment Model. He has published extensively on value-based care and hosts a monthly podcast, “The Scope with Dr. K”, focused on achieving the quadruple goal of bringing patients, providers, plans, and payors together. Previously, Dr. Kosinski was a founder and managing partner of the Illinois Gastroenterology Group, the largest private gastroenterology group in Illinois. A board-certified gastroenterologist who practiced for 35 years in suburban Chicago, Dr. Kosinski received his medical degree and fellowship training from Loyola University Stritch School of Medicine and his MBA from Northwestern University’s Kellogg School of Management.

In the U.S. Government Accountability Office (GAO) announcement, Comptroller General of the United States and Head of the GAO Gene L. Dodaro said, “Congress directed the Department of Health and Human Services to shift Medicare from a program that pays based on volume to one that pays based on value. As part of this effort, PTAC can play an important role … After reviewing this latest round of extremely well-qualified candidates, I am pleased to share our 2021 selections for the committee.” Dr. Kosinski’s term will expire in 2024.