Happy Tuesday! Enjoy your NCMS Morning Rounds!

November 9, 2021


NCMS Welcomes Medmastery As Marketplace Partner

The North Carolina Medical Society (NCMS) is pleased to announce Medmastery as a Silver level member of our Marketplace of services to benefit our members.

Medmastery offers NCMS members a 25% discount on all subscriptions to their comprehensive, CME accredited, online medical education platform.

Medmastery is just the latest addition to NCMS Marketplace, which provides a comprehensive listing of vendors offering services in areas of most use to physician and PA practices throughout the state. The website provides an easily navigated, tiered vendor system for easy comparison as well as the ability to search by specialty.

About Medmastery

As a leading online medical education platform, Medmastery teaches essential clinical skills to doctors, nurses, other medical practitioners, and students around the world. In fact, Medmastery is ACCME accredited, is highly commended by the British Medical Association (BMA), and won the Comenius EduMedia Award several times.

2022 Medicare Physician Fee Schedule Final Rule

On November 2, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the CY 2022 Medicare physician fee schedule. American Medical Association (AMA) staff are thoroughly analyzing the 2400+ page rule and will provide a comprehensive summary in the near future. Notably, the 2022 Medicare conversion factor will be reduced by approximately 3.85% from 34.8931 (2021) to 33.5983. This is largely a result of the expiration of a 3.75% increase to the conversion factor at the end of calendar year 2021, as averted in 2021 by Congressional action. The AMA continues to strongly advocate for Congress to avert this significant cut and extend the 3.75% increase for 2022, as it further compounds the growing financial instability of physician practices due to the severe reduction in revenue caused by the continued COVID-19 PHE.

Additionally, CMS finalized provisions that extend coverage of services that were added to the Medicare telehealth list on an interim basis in response to the COVID-19 PHE until the end of 2023 and eliminated geographic barriers, allowing patients in their homes to access telehealth services for diagnosis, evaluation, and treatment of mental health disorders. In addition, CMS announced plans to permanently increase payment for immunization administration, beyond COVID vaccines, and relied on information from the AMA and the RUC in developing the improved payment rates. CMS is also moving forward with the first round of seven MIPS Value Pathways (MVPs) that will be available, beginning with the 2023 performance year.

The text of the proposed rule can be accessed here.

Biden Administration Rules on Vaccination Mandates

On November 4, the Biden administration released two rules mandating vaccination in the workplace.  First, the Center for Medicare and Medicaid Services issued an Interim Final Rule (IFR) mandating that health care workers at facilities participating in Medicare and Medicaid be fully vaccinated – either two doses of Pfizer or Moderna, or one dose of Johnson & Johnson – by January 4th.  Second, the Department of Labor’s Occupational Safety and Health Administration (OSHA) is issuing an Emergency Temporary Standard (ETS) requiring employers with 100 or more employees to ensure each of their workers is fully vaccinated or tested for COVID-19 on at least a weekly basis by January 4th. OSHA will also require employers to provide paid-time for employees to get vaccinated, and ensure all unvaccinated workers wear a face mask in the workplace.

The facility types covered by the CMS IFR are hospitals, ambulatory surgical centers, dialysis facilities, home health agencies, and long-term care facilities. The requirement applies to both clinical and non-clinical staff at these facilities, including: employees, students, trainees, and volunteers. Additionally, this also includes individuals who provide care, treatment, or other services for the facility and/or its patients under contract. It also applies to physicians admitting and/or treating patients in a facility.  This regulation does not apply to physician offices (unless part of a larger system) because they are not subject to CMS health and safety regulations.  The CMS IFR takes priority over other federal vaccination requirements.  While the IFR goes into effect immediately, CMS will accept comments for 60 days.

Under the OSHA ETS, covered employers will be required to develop, implement, and enforce a mandatory COVID-19 vaccination policy. As alternative to a mandatory vaccination requirement, employers have the option to develop, implement and enforce a policy for employees not fully vaccinated that requires weekly testing and mandatory face coverings while in the workplace. The vaccine mandate applies to all employers under OSHA jurisdiction of at least 100 employees firm- or corporate-wide, but does not include employees who do not report to a workplace where other employees are present. Employers must determine vaccine status of all employees, obtain proof of vaccination from all employees, and maintain records of employee vaccination status. Employers must also provide support for employee vaccination, including at least four hours of paid leave to receive the vaccine, as well as reasonable paid time off for recovery of vaccine side effects. Employees who elect to not receive the vaccination will be subject to weekly testing, but employers are not required to cover those testing expenses. Additionally, all unvaccinated employees will be required to wear a face covering when indoors or occupying a vehicle with other employees. Employers may not prevent any employee from voluntarily wearing a face covering at any time unless it creates a serious occupational hazard.

While comments on the OSHA ETS will be accepted for 30 days, the ETS is effective immediately. All requirements other than the testing requirement must be met within 30 days of publication for employees who have not completed their vaccination series. Testing requirements must be met within 60 days for all employees not vaccinated.

Here are links to key documents:

November 4 OSHA and CMS Announcements

In the News

Not All Covid Waves Look the Same. Here’s A Snapshot of the Delta Surge, STAT, 11-8-21

Learning Opportunity 

Autoinflammatory Disorders in Children: What All Practicing Immunologists Should Know. Wednesday, November 10th 2021, 8:00 PM EST

Microsoft Teams meeting / Join on your computer or mobile app

Click here to join the meeting

Video Conference ID: 128 727 510 4

Alternate VTC instructions

Or call in (audio only)

+1 470-582-0116,,780600549#   United States, Atlanta

Phone Conference ID: 780 600 549#


Welcome Address –

  • Padmaja Gayam, MD – President of NCAAIS
  • Marni Bird, PharmD, BCPS – Novartis Medical Science Liaison

Case Discussion –

  • Claire Atkinson, MD – Fellow at UNC-CH- Presenter
  • Michelle Hernadez, MD – Mentor Presenter

Q&A to follow


If you have policies you’d like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!