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Medical Association Recognizes Racism as a Threat to Public Health

Medical Association Recognizes Racism as a Threat to Public Health

At the most recent Board of Censors meeting, the Medical Association of the State of Alabama pledged to recognize and confront racism and racial inequalities within our society and the healthcare system. The Medical Association further recognizes the need to end systemic racism in our country and to work towards a better, fairer, and more just society. 

The Medical Association released the following statement following their meeting last week:

  • The Medical Association opposes all forms of racism
  • The Medical Association considers racism a public health crisis and a threat to public health
  • The Medical Association understands the elimination of health disparities will not be achieved without first acknowledging the contributions of all races to health and social inequalities
  • The Medical Association understands that we have a responsibility to actively work to eliminate discriminatory policies and practices across all of healthcare
  • The Medical Association supports ending racial discrimination in medical care and the equitable access to quality health care services
  • The Medical Association encourages current and future physicians to be advocates for justice

We recognize that worsening inequities, unequal access to care, and the racial disparities of practicing physicians all have roots in systemic racism and must be confronted. The Medical Association of the State of Alabama understands that there is still tremendous work to be done to ensure that everyone has the opportunity, resources, and conditions to achieve optimal health. The Medical Association is committed to being a part of that solution.

Sincerely,

President John S. Meigs, MD and Board of Censors

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Summary of Liability Protection from Starnes, Davis Florie, LLP

Summary of Liability Protection from Starnes, Davis Florie, LLP

Starnes, Davis, Florie, LLP has drafted a summary with some guidance on documentation for physicians concerning some protection in response to potential liability issues facing physicians during the COVID-19 declared emergency.  Governor Ivey’s March 13, 2020 Proclamation declared a state public health emergency.  The Proclamation grants certain immunity from lawsuits if a provider in a covered “health care facility” is practicing pursuant to an “alternative standard of care” plan.  The “alternative standard of care” must be set forth in the “health care facility’s” emergency operation plan, and the specific language or “standards of care” may differ from facility to facility.  Starnes suggests documenting the circumstances surrounding each patient and the reasons for clinical decisions.  [LINK to previous article].  Personnel and a facility are entitled to limited immunity when practicing consistent with those methods outlined in the alternative standard of care.  Physicians should look to the hospital for the specific protective language.

The PREP Act provides limited immunity for the administration or use of covered countermeasures to treat, diagnose, cure, prevent, or mitigate COVID-19.  The PREP Act covers providers for the administration or use of any antiviral, any other drug, any biologic, any diagnostic, any other device, or any vaccine used in the treatment of a COVID-19 patient.  

See Summary Here.

This information is not intended to provide legal advice, and no legal or business decision should be based on its content. No representation is made that the quality of legal services to be performed is greater than the quality of legal services performed by other lawyers.  Read full disclaimer.

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Medical Cannabis Passes Senate Committee

Medical Cannabis Passes Senate Committee

Last Wednesday, the Alabama Senate Judiciary Committee advanced a bill allowing cannabis to be recommended for up to 15 conditions for medicinal purposes.

SB165, informally named the Compassion Act and sponsored by Sen. Tim Melson, M.D., would allow physicians to recommend medical cannabis for conditions such as cancer, anxiety and chronic pain. It would also let patients with state-issued cannabis cards to purchase cannabis products at licensed dispensaries. Cannabis products dispensed to patients would be under strict state regulation from seed to sale, including testing products for consistency and to ensure no contamination.

Under Melson’s bill, medical cannabis would available to anyone 19 years or older whom a physician certifies as having a qualifying medical condition. Patients 18 or younger would need a parent or guardian to administer cannabis. The patient would have to apply for a medical cannabis card, which would cost no more than $65.

Cannabis will only be available in encapsulated form or a topical agent. The bill would also establish a fund using tax proceedings for increased research on cannabis.

Having passed the Judiciary Committee 8-1, the legislation will now receive a vote before the entire Senate. Should it pass the Senate, it still must go to through a committee and floor vote in the House.

After surveying its members, the Medical Association found Alabama physicians believe if cannabis for medicinal use is legalized, then the growth, cultivation and sale of cannabis should be highly regulated by the state, and any physician involvement should be regulated not by some new state agency, but by the Board of Medical Examiners. Likewise, the survey found physicians believe any administration or use of legalized medical cannabis should be limited to encapsulated form and topical agents.

While there was no overwhelming consensus found regarding physicians’ support or opposition to the legalization of medicinal cannabis, the Medical Association has worked tirelessly with the bill sponsor to bring the legislation in line with the areas of broad agreement in our member survey. We appreciate the willingness of Sen. Melson in working with us and will continue monitoring the bill as it moves forward.

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Senate Committee Approves Collaborative Practice Ratio Increase

Senate Committee Approves Collaborative Practice Ratio Increase

Last Wednesday, the Senate Health Committee approved an amended version of legislation dealing with the ratio of physicians to nurse practitioners in a collaborative practice.

Originally, the bill would have allowed physician collaboration with an “unlimited” number of full-time equivalent nurse practitioners or nurse-midwives. However, after significant input from the Medical Association, the legislation deletes “unlimited” and instead increases the number of nurse practitioners and physician assistants with whom a physician may collaborate.

Specifically, the amended legislation:

  • Deletes “unlimited” and instead increases the current ratio of FTEs from 1:4 to 1:9;
  • Adds physician assistants to the total collaborative ratio;
  • Maintains the collaborating physician’s autonomy and authority within the collaborative practice agreement;
  • Maintains the ability for exceptions to this new 1:9 ratio through regulation; and,
  • Maintains the current regulatory structure for physician assistants, nurse practitioners, nurse midwives, and collaborating physicians.

Collaborative practice is not “one-size-fits-all” and this newly-amended bill allows for flexibility in collaboration while also preserving physician authority. The compromise was a joint effort between the Medical Association, the Nurse Practitioners Alliance and the Alabama Physician Assistants’ Association. We now support this legislation.

The legislation (SB114) now moves to the Senate floor for a vote.

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Proposed Importation of Prescription Drugs from Canada

Proposed Importation of Prescription Drugs from Canada

On December 18, 2019, the Food and Drug Administration (“FDA”) issued a proposed rule (the “Proposed Rule”) to amend its regulations to implement a provision of the Federal Food, Drug, and Cosmetic Act to allow importation of certain prescription drugs from Canada.  The purpose of the Proposed Rule is to lower prices and reduce out-of-pocket costs for American patients.  If the Proposed Rule is finalized as proposed, States or certain other non-federal governmental entities and their co-sponsors, if any (collectively “Sponsors”), would be able to submit drug importation program proposals (each a “Drug Importation Proposal”) to the FDA for review and authorization.  If a Drug Importation Proposal were approved, it would be authorized for a 2-year period, with the possibility of extensions for additional 2-year periods. 

The Proposed Rule would require each Drug Importation Proposal to:

  • Specify the eligible prescription drug the Sponsor seeks to import;
  • Demonstrate that the proposed importation program will pose no additional risk to the public’s health and safety;
  • Provide an explanation as to why the Sponsor expects the importation program would result in a significant reduction in the cost of such prescription drug to the American consumer; and
  • Identify the foreign seller in Canada that would purchase the drug directly from its manufacturer and the importer in the United States that would buy the drug directly from the foreign seller. The foreign seller must be registered with the FDA as a foreign seller and be licensed by Health Canada as a wholesaler, and the importer must be a State or FDA licensed wholesale drug distributor or State-licensed pharmacist.

At least one State, tribal, or territorial governmental entity would be required as a Sponsor of a Drug Importation Proposal to offer enhanced accountability and to protect the public health.  Co-sponsorship is included in the Proposed Rule to allow the State, tribal, or territorial governmental entity to benefit from the experience of pharmacists and wholesalers. 

To be eligible to be imported, a prescription drug would need to be approved by the Health Products and Food Branch of Health Canada and, but for the fact that it deviates from U.S. labeling, also meet the conditions in an FDA-approved new drug application or abbreviated new drug application.  Essentially, eligible prescription drugs are those that could be sold legally on either the Canadian market or the American market with appropriate labeling.  An eligible prescription drug would need to be relabeled with the required U.S. labeling, prescribing information, and patient information before sold in the United States. Also, to be eligible for importation, the prescription drug must be currently marketed in the United States (which would allow the FDA to be better able to determine if there is a safety issue with an imported drug).  Several categories of prescription drugs are excluded from the Proposed Rule including controlled substances, biological products, infused drugs, intravenously injected drugs, and drugs that are inhaled during surgery. 

The FDA is seeking comments on the Proposed Rule until March 9, 2020.  Stay tuned for updates as to whether or not the Proposed Rule is revised or finalized as proposed. 

Anthony Romano practices with Burr & Forman LLP in the firm’s Health Care Industry Group. Anthony may be reached at aromano@burr.com.

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Competing Surprise Billing Measures Released

Competing Surprise Billing Measures Released

Early this week, Senator Lamar Alexander (R-TN), the Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Representatives Frank Pallone (D-NJ) and Greg Walden (R-OR), the Chairman and Ranking Member of the House Energy and Commerce Committee announced an agreement on legislation to end surprise medical bills. The two members issued a joint press statement with the hope of creating momentum to include their legislative agreement as part of any year-end omnibus appropriations bill.

The agreement is essentially a merging of the surprise billing legislation approved by both the House Energy and Commerce (H.R. 2328) and Senate HELP Committees (S.1895) earlier this year. Both bills aim to protect patients by limiting their out-of-pocket costs to amounts they would have owed if they had been treated by an in-network physician. However, both bills include provisions strongly opposed by physician and hospital groups (including the Medical Association of the State of Alabama) that would resolve payment disputes between physicians and insurers by using a benchmark rate setting out-of-network payments at the median amount each insurer pays for in-network care. The new agreement includes similar benchmark rate provisions as well as a very limited independent dispute resolution process with a $750 threshold that would only allow for the consideration of median in-network rates.

It was believed by many early in the week, that the surprise billing agreement would pass before the end of the year. However, the House Ways and Means Committee also has jurisdiction over the surprise billing issue and the committee was not included in this initial agreement. Ways and Means subsequently released its own bipartisan proposal that focuses on an arbitration process that protects the patient and said that the committee will consider the legislation in early 2020. With competing bipartisan bills now on the table, it is likely that any action on the legislation will be delayed until January.

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Opioid Cumulative Daily Morphine Milligram Equivalents Limit – MME Decrease

Opioid Cumulative Daily Morphine Milligram Equivalents Limit – MME Decrease

Effective December 2, 2019, the Alabama Medicaid Agency will implement hard edits on cumulative daily MME claims exceeding 200 MME/day. A phase-in period for claims exceeding 150 MME/day, but less than 200 MME/day, will also be implemented.

Examples of MME calculations/day include:
• 10 tablets per day of hydrocodone/acetaminophen 5/325 = 50 MME/day
• 6 tablets per day of hydrocodone/acetaminophen 7.5/325 = 45 MME/day
• 5 tablets per day of hydrocodone/acetaminophen 10/325 = 50 MME/day
• 2 tablets per day of oxycodone 15 mg = 45 MME/day
• 3 tablets per day of oxycodone 10 mg = 45 MME/day
• 10 tablets per day of tramadol 50 mg = 50 MME/day
• 1 patch per 3 days of fentanyl 25mcg/hr = 60 MME/day

More information regarding MME calculations

IMPORTANT: Only when the override is denied will the excess quantity above the maximum unit limit be deemed a non-covered service. Then the recipient can be charged as a cash recipient for that amount in excess of the limit. A prescriber must not write separate prescriptions, one to be paid by Medicaid and one to be paid as cash, to circumvent the override process. FAILURE TO ABIDE BY MEDICAID POLICY MAY RESULT IN RECOUPMENTS AND/OR ADMINISTRATIVE SANCTIONS. Source: Provider Billing Manual 27.2.3

Any policy questions concerning this provider ALERT should be directed to the Pharmacy Program at (334) 242-5050.

View the full ALERT here.

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ALAPAC Ends with Record Year!

ALAPAC Ends with Record Year!

 

Last week, ALAPAC capped off its FY 2018-2019 fundraising campaign on a high note. Although we narrowly missed our total fundraising goal, ALAPAC set multiple new giving records thanks to the generosity of Alabama physicians.

In total, nearly 120 physicians gave more than the standard amount of $250!

Specifically, 10 physicians contributed $1,000 or more; 44 physicians contributed over $500; and, 63 physicians contributed between $250 and $500.

Thank you! Thank you! Thank you!

Below is a list of the physician “top donors” who helped make 2019 a record year. ALAPAC sincerely appreciates all of our contributors and appreciates each and every dollar donated.

$1,000 + Donors

Aaron Timothy Shinkle, M.D.

Amanda Jean Williams, M.D.

Bradley Phillip Katz, M.D.

David P. Herrick, M.D.

Mark H. LeQuire, M.D.

Marnix Ernestus Heersink, M.D.

Patricia Louise Frierson, M.D.

Robert Howard Story, M.D.

Sarah Kathleen Mullican, M.D.

William Jay Suggs, M.D.

$500+ Donors

Alfred LaShawn Malone, M.D.

Charles R. Horton, Jr., M.D.

Collin King, M.D.

David Thomas Cozart, M.D.

Donald Hodurski, M.D.

Earl M.B. Wyatt, M.D.

Gregory Scott Tucker, M.D.

Grigor Merijanian, M.D.

Hernando Carter, M.D.

J. Eugene Lammers, M.D.

J. Noble Anderson, Jr., M.D.

James B. Byrne, Jr., M.D.

James D. Izer, M.D.

James Vann Worthen, M.D.

Jane Ann Weida, M.D.

John David Moorehouse, M.D.

John F. Cabelka, M.D.

John Lyman Drew, D.O.

John Olen Newcomb, M.D.

Jorge A. Alsip, M.D.

Julia L. Boothe, M.D.

Kurt Arnold Senn, M.D.

Leisa DeVenny, M.D.

Masoud Hamidian, M.D.

Michael F. DeVenny, M.D.

Michael W. Cantrell, M.D.

Michelle Downing, M.D.

Neil Yeager, M.D.

Patricia Wade, M.D.

Paul Michael Nagrodzki, M.D.

Paul W. Pickard, M.D.

Richard Henry Esham, Sr., M.D.

Robert Joseph Stanley, M.D.

Robert Wood Nesbitt, M.D.

Roland Spedale, Jr., M.D.

Ron Benton Pitkanen, M.D.

Sebastian B. Heersink, M.D.

Stephanie Snyder Jiminez, M.D.

Thomas Harvey McCulloch, M.D.

Thomas James Weida, M.D.

Thomas Martin, M.D.

Tim Melson, M.D.

William Bennett, M.D.

William Scheider, M.D.

$250+ Donors

Adam Jay Handwerger, M.D.

Alan Thomas Mann, D.O.

Albert Fox Haas, M.D.

Alexis Tanishia Mason, M.D.

Anthony DeVan Hollman, M.D.

Arden LeRoy Aylor, Jr., M.D.

Bendt P. Petersen, III, M.D.

Beverly F. Jordan, M.D.

Brett Lee Storm, M.D.

Burt Fowler Taylor, M.D.

Charles Henry Wilson, IV, M.D.

Charles Hugh Holloway, M.D.

Christopher Jason Green, M.D.

Christopher Rauf Ahmed, M.D.

Christopher T. Nichols, M.D.

Clint Thomas Wade, M.D.

Clinton W. Howard, IV, M.D.

Dewey H. Jones, IV, M.D.

Eric Conrad Lund, M.D.

Glenn M. Woods, M.D.

Guy Leslie Rutledge, III, M.D.

Ivan Daniel Sequera-Sanchez, M.D.

Jacob Fant Kidder, M.D.

James C. Mann, M.D.

James Keith Spain, M.D.

James L. West, III, M.D.

James M. Cockrell, M.D.

James Nicholas Rachel, M.D.

James Reza Fernandez, M.D.

James Scott Bolton, M.D., PC

Jeffrey M. Conrad, M.D.

John Sansbury Meigs, Jr., M.D.

Joseph F. McGowin, III, M.D.

Julia Ann Alexander, M.D.

Leon Williams Bell, III, M.D.

Liang Gu, M.D.

Lowell Dean Mason, II, M.D.

Matthew Lloyd Busbee, M.D.

Michael A. Eslava, M.D.

Michael Andrew Cochran, M.D.

Michael Devon Smith, M.D.

Michael F. Blum, M.D.

Michael Todd Ellerbusch, M.D.

Milton A. Wallace, Jr., M.D.

Nina L. J. Terry, M.D.

Richard E. Jones, III, M.D.

Richard Matthew McKean, M.D.

Robert Ball McGinley, M.D.

Robert Carl Baird, III, M.D.

Robert Evans Egbert, M.D.

Robert Neil Honea, Jr., M.D.

Robert Wayne Williams, Jr., M.D.

Sara Margaret Mullins, M.D.

Stephen B. Cope, M.D.

Stephen Louis Fernandez, M.D.

Suzanne S. Blaylock, M.D.

Thomas M. Barbour, III, M.D.

Timothy L. Frerichs, M.D.

Todd David Engerson, M.D.

Todd K. Volkman, M.D.

Weston James Welker, M.D.

William Isaiah Park, IV, M.D.

William W. Beckett, Jr., M.D.

 

 

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Alabama Hospitals Want to Limit Physician In-Office Procedures

Alabama Hospitals Want to Limit Physician In-Office Procedures
The Alabama Hospital Association (ALAHA) submitted a letter to a state health agency this week complaining of increasing instances of physicians performing interventional procedures in their offices instead of in acute care hospitals.  The ALAHA letter states “We strongly believe most interventional procedures should be done in a general acute care hospital setting.”  It further states “…the growing number of interventional/therapeutic procedures being done in a physician’s office setting where the providers are requesting letters of non-reviewability is alarming.”
Read the letter here, and provide us feedback.

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Sign-on Letter: Improving Seniors’ Timely Access to Care Act

Sign-on Letter: Improving Seniors’ Timely Access to Care Act

September 9, 2019

Dear Members of Congress:

The undersigned patient, physician, health care professional, and other health care stakeholder
organizations strongly support the Improving Seniors’ Timely Access to Care Act of 2019 (H.R.
3107) recently introduced by Reps. Suzan DelBene (D-WA), Mike Kelly (R-PA), Roger
Marshall, MD (R-KS), and Ami Bera, MD (D-CA). This bipartisan legislation would help
protect patients from unnecessary delays in care by streamlining and standardizing prior
authorization under the Medicare Advantage program, providing much-needed oversight and
transparency of health insurance for America’s seniors. We urge you to join your colleagues in
supporting this important legislation.

Based on a consensus statement on prior authorization reform adopted by leading national
organizations representing physicians, medical groups, hospitals, pharmacists, and health plans,
the legislation would facilitate electronic prior authorization, improve transparency for
beneficiaries and providers alike, and increase Centers for Medicare & Medicaid Services (CMS)
oversight on how Medicare Advantage plans use prior authorization. Specifically, the bill
would:

  • Create an electronic prior authorization program including the electronic transmission of
    prior authorization requests and responses and a real-time process for items and services
    that are routinely approved;
  • Improve transparency by requiring plans to report to CMS on the extent of their use of
    prior authorization and the rate of approvals or denials;
  • Require plans to adopt transparent prior authorization programs that are reviewed
    annually, adhere to evidence-based medical guidelines, and include continuity of care for
    individuals transitioning between coverage policies to minimize any disruption in care;
  • Hold plans accountable for making timely prior authorization determinations and to
    provide rationales for denials; and
  • Prohibit additional prior authorization for medically-necessary services performed during
    a surgical or invasive procedure that already received, or did not initially require, prior
    authorization.

The demand and need for such reforms is growing — particularly as more seniors choose
Medicare Advantage for their health insurance needs. According to a recently released Kaiser
Family Foundation report, “A Dozen Facts About Medicare Advantage in 2019,” Medicare
Advantage enrollment has nearly doubled in a decade. One-third (34%) of all Medicare
beneficiaries — 22 million people — are enrolled in Medicare Advantage plans, and nearly four
out of five enrollees (79%) are in plans that require prior authorization for some services. The
Congressional Budget Office (CBO) projects that beneficiaries enrolled in Medicare Advantage
plans will rise to nearly half of all Medicare beneficiaries (about 47%) by 2029. Recognizing the
need to protect a growing number of Medicare beneficiaries, more than 100 members of
Congress called for such reforms in a letter last year to the CMS.

For our seniors — and as representatives of organizations seeking to protect patients from delays
in care and relieve unnecessary administrative burdens that impede delivery of timely care—we
are committed to advancing this legislation in Congress and ask that you join Representatives
DelBene, Kelly, Marshall, and Bera in co-sponsoring H.R. 3107 and securing its enactment.
Thank you.

Sincerely,

ACCSES
Aimed Alliance
Alliance for Aging Research
Alliance for Balanced Pain Management
Alliance for Patient Access
Alliance of Specialty Medicine
Alzheimer’s Association
Alzheimer’s Impact Movement
AMDA – The Society for Post-Acute and Long-Term Care Medicine
American Academy of Allergy, Asthma & Immunology
American Academy of Dermatology Association
American Academy of Facial Plastic and Reconstructive Surgery
American Academy of Family Physicians
American Academy of Hospice and Palliative Medicine
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology – Head and Neck Surgery
American Academy of PAs
American Academy of Physical Medicine & Rehabilitation
American Academy of Sleep Medicine
American Alliance of Orthopaedic Executives
American Association of Clinical Endocrinologists
American Association of Clinical Urologists
American Association of Hip and Knee Surgeons
American Association of Neurological Surgeons
American Association of Nurse Practitioners
American Association of Orthopaedic Surgeons
American Association of Pediatric Ophthalmology and Strabismus
American Association on Health and Disability
American Autoimmune Related Diseases Association
American Brain Coalition
American Cancer Society Cancer Action Network
American Clinical Laboratory Association
American Clinical Neurophysiology Society
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Emergency Physicians
American College of Gastroenterology
American College of Mohs Surgery
American College of Obstetricians and Gynecologists
American College of Osteopathic Surgeons
American College of Physicians
American College of Radiation Oncology
American College of Radiology
American College of Rheumatology
American College of Surgeons
American Congress of Rehabilitation Medicine
American Dance Therapy Association
American Gastroenterological Association
American Geriatrics Society
American Glaucoma Society
American Group Psychotherapy Association
American Liver Foundation
American Medical Association
American Medical Rehabilitation Providers Association
American Medical Women’s Association
American Music Therapy Association
American Nurses Association
American Occupational Therapy Association
American Osteopathic Association
American Osteopathic Colleges of Ophthalmology and Otolaryngology
American Physical Therapy Association
American Psychiatric Association
American Psychoanalytic Association
American Society for Clinical Pathology
American Society for Gastrointestinal Endoscopy
American Society for Radiation Oncology
American Society for Radiology and Oncology
American Society for Surgery of the Hand
American Society of Anesthesiologists
American Society of Cataract & Refractive Surgery
American Society of Clinical Oncology
American Society of Echocardiography
American Society of Hematology
American Society of Interventional Pain Physicians
American Society of Nephrology
American Society of Neuroimaging
American Society of Neuroradiology
American Society of Nuclear Cardiology
American Society of Ophthalmic Plastic and Reconstructive Surgery
American Society of Plastic Surgeons
American Society of Retina Specialists
American Society of Transplant Surgeons
American Spinal Injury Association
American Urological Association
American Uveitis Society
American Vein & Lymphatic Society
American-European Congress of Ophthalmic Surgery
America’s Physician Groups
Arthritis Foundation
Association for Molecular Pathology
Association of Academic Physiatrists
Association of American Medical Colleges
Association of Black Cardiologists
Association of Rehabilitation Nurses
Association of University Professors of Ophthalmology
Beyond Type 1
Brain Injury Association of America
Bridge the Gap – SYNGAP Education and Research Foundation
Cancer Support Community
CancerCare
Caregiver Action Network
Child Neurology Foundation
Children with Diabetes
Christopher & Dana Reeve Foundation
Clinician Task Force
CMSC- Consortium of Multiple Sclerosis Centers
Coalition For Headache And Migraine Patients
College Diabetes Network
College of American Pathologists
Community Oncology Alliance
Congress of Neurological Surgeons
Cornea Society
Crohn’s & Colitis Foundation
Delaware Academy of Ophthalmology
Depression and Bipolar Support Alliance
Derma Care Access Network
Diabetes Patient Advocacy Coalition
DiabetesSisters
Digestive Disease National Coalition
Disability Rights Education and Defense Fund
Dystonia Advocacy Network
Dystonia Medical Research Foundation
Epilepsy Foundation
Eye and Contact Lens Association
Eye Bank Association of America
Federation of American Hospitals
Free2Care
GBS|CIDP Foundation International
Global Alliance for Behavioral Health and Social Justice
Global Healthy Living Foundation
Global Liver Institute
Healthcare Information and Management Systems Society
Hematology/Oncology Pharmacy Association
IFAA – International Foundation for Autoimmune & Autoinflammatory Arthritis
International Essential Tremor Foundation
International Foundation for Gastrointestinal Disorders
International Society for the Advancement of Spine Surgery
Interstitial Cystitis Association
Lupus and Allied Diseases Association, Inc.
Medical Group Management Association
METAvivor
Movement Disorders Policy Coalition
Multiple Sclerosis Association of America
National Alopecia Areata Foundation
National Association for the Advancement of Orthotics & Prosthetics
National Association of Rural Health Clinics
National Association of Social Workers
National Association of Spine Specialists
National Association of State Head Injury Administrators
National Association of State Mental Health Program Directors
National Comprehensive Cancer Network
National Diabetes Volunteer Leadership Council
National Health Council
National Infusion Center Association
National Lipid Association
National Medical Association, Ophthalmology Section
National Multiple Sclerosis Society
National Osteoporosis Foundation
National Pancreas Foundation
National Patient Advocate Foundation
NephCure Kidney International
North American Neuro-Ophthalmology Society
Ocular Microbiology and Immunology Group
Outpatient Endovascular and Interventional Society
Partnership to Advance Cardiovascular Health
Partnership to Fight Chronic Disease
Partnership to Improve Patient Care
Prevent Blindness
Pulmonary Hypertension Association
Remote Cardiac Services Provider Group
Renal Physicians Association
Restless Legs Syndrome Foundation
RetireSafe
Sjogren’s Syndrome Foundation
Society for Cardiovascular Angiography and Interventions
Society for Vascular Surgery
Society of Critical Care Medicine
Society of Gynecologic Oncology
Society of Hospital Medicine
Spine Intervention Society
The Headache and Migraine Policy Forum
The Leukemia & Lymphoma Society
The Marfan Foundation
The Michael J. Fox Foundation for Parkinson’s Research
The Retina Society
The Society of Thoracic Surgeons
Tourette Association of America
Treatment Communities of America
Uniform Data System for Medical Rehabilitation
United Spinal Association
US Hereditary Angioedema Association
Alabama Academy of Ophthalmology
Alabama Society for the Rheumatic Diseases
Lakeshore Foundation
Medical Association of the State of Alabama
Neurosurgical Society of Alabama
Alaska Rheumatology Alliance
Alaska Society of Eye Physicians and Surgeons
Denali Oncology Group Alaska Chapter ASCO
Arizona Medical Association
Arizona Neurosurgical Society
Arizona United Rheumatology Alliance
The Arizona Clinical Oncology Society
Arkansas Medical Society
Arkansas Ophthalmological Society
Arkansas Rheumatology Association
Association of Northern California Oncologists
California Academy of Eye Physicians and Surgeons
California Association of Neurological Surgeons
California Medical Association
California Rheumatology Alliance
Medical Oncology Association of Southern California, Inc.
Cedars/Aspens, non-profit society of ophthalmic surgeon educators
Colorado Medical Society
Colorado Neurosurgical Society
Colorado Rheumatology Association
Colorado Society of Eye Physicians and Surgeons
Connecticut Rheumatology Association
Connecticut Society of Eye Physicians
Connecticut State Medical Society
Delaware Society for Clinical Oncology
Delaware State Neurosurgical Society
Medical Society of Delaware
Medical Society of the District of Columbia
Florida Medical Association
Florida Neurosurgical Society
Florida Society of Clinical Oncology
Florida Society of Ophthalmology
Florida Society of Rheumatology
Georgia Society of Clinical Oncology
Georgia Society of Rheumatology
Medical Association of Georgia
Hawaii Medical Association
Hawaii Society of Clinical Oncology
Association of Idaho Rheumatologists
Idaho Medical Association
Idaho Society of Ophthalmology
Illinois Medical Oncology Society
Illinois Society of Eye Physicians & Surgeons
Illinois State Medical Society
Illinois State Neurosurgical Society
Indiana Academy of Ophthalmology
Indiana Chapter, American College of Cardiology
Indiana Oncology Society
Iowa Medical Society
Iowa Oncology Society
Midwest Neurosurgical Society
Kansas Chapter, American College of Cardiology
Kansas Hospital Association
Kansas Medical Society
LeadingAge Kansas
Midwest Rheumatology Association
Kentucky Academy of Eye Physicians and Surgeons
Kentucky Association of Medical Oncology
Kentucky Chapter, American College of Cardiology
Kentucky Medical Association
Louisiana Academy of Eye Physicians and Surgeons
Louisiana Chapter, American College of Cardiology
Louisiana Neurosurgical Society
Louisiana State Medical Society
Rheumatology Alliance of Louisiana
Maine Medical Association
Maine Society of Eye Physicians and Surgeons
Maryland Chapter, American College of Cardiology
Maryland DC Society of Clinical Oncology
Maryland Society for the Rheumatic Diseases
Maryland Society of Eye Physicians and Surgeons
MedChi, The Maryland State Medical Society
Massachusetts Society of Clinical Oncologists
Massachusetts Medical Society
Michigan Society of Eye Physicians and Surgeons
Michigan Society of Hematology & Oncology
Michigan State Medical Society
Minnesota Medical Association
Minnesota Neurosurgical Society
Mississippi Arthritis and Rheumatism Society
Mississippi Oncology Society
Mississippi State Medical Association
Missouri Oncology Society
Missouri Society of Eye Physicians & Surgeons
Missouri State Medical Association
Montana Medical Association
Montana Neurosurgical Society
Montana State Oncology Society
Nebraska Chapter, American College of Cardiology
Nebraska Medical Association
Nebraska Rheumatology Society
Nevada State Medical Association
Northern New England Clinical Oncology Society
New Hampshire Medical Society
Medical Oncology Society of New Jersey
Medical Society of New Jersey
New Jersey Academy of Ophthalmology
New Jersey Neurosurgical Society
New Mexico Medical Society
Empire State Hematology & Oncology Society
Medical Society of the State of New York
New York State Neurosurgical Society
New York State Ophthalmological Society
New York State Rheumatology Society
North Carolina Medical Society
North Carolina Rheumatology Association
North Carolina Society of Eye Physicians & Surgeons
North Dakota Medical Association
North Dakota Society of Eye Physicians and Surgeons
Ohio Association of Rheumatology
Ohio Chapter, American College of Cardiology
Ohio Hematology Oncology Society
Ohio Ophthalmological Society
Ohio State Medical Association
Ohio State Neurosurgical Society
Oklahoma Academy of Ophthalmology
Oklahoma Chapter, American College of Cardiology
Oklahoma Neurosurgical Society
Oklahoma State Medical Association
Oregon Academy of Ophthalmology
Oregon Medical Association
Oregon Rheumatology Alliance
Oregon Society of Medical Oncology
Pennsylvania Academy of Ophthalmology
Pennsylvania Medical Society
Pennsylvania Neurosurgical Association
Pennsylvania Rheumatology Society
Philadelphia Rheumatism Society
Pittsburgh Ophthalmology Society
Pennsylvania Society of Oncology & Hematology
The Hospital and Healthsystem Association of Pennsylvania
Puerto Rico’s Hematology and Medical Oncology Association
Rhode Island Chapter, American College of Cardiology
Rhode Island Medical Society
Rhode Island Neurosurgical Society
Rhode Island Society of Eye Physicians and Surgeons
South Carolina Medical Association
South Carolina Oncology Society
South Carolina Rheumatism Society
South Carolina Society of Ophthalmology
South Dakota Academy of Ophthalmology
South Dakota State Medical Association
Tennessee Chapter, American College of Cardiology
Tennessee Medical Association
Tennessee Rheumatology Society
State of Texas Association of Rheumatologists
Texas Medical Association
Texas Ophthalmological Association
Society of Utah Medical Oncologists
Utah Medical Association
Utah Ophthalmology Society
Vermont Medical Society
Medical Society of Virginia
Virginia Association of Hematologist & Oncologist
Virginia Chapter, American College of Cardiology
Virginia Society of Eye Physicians and Surgeons
Neurosurgical Society of the Virginias

Washington Academy of Eye Physicians and Surgeons
Washington Rheumatology Alliance
Washington State Medical Association
Washington State Medical Oncology Society
West Virginia Academy of Eye Physicians & Surgeons
West Virginia State Medical Association
West Virginia State Rheumatology Society
Wisconsin Academy of Ophthalmology
Wisconsin Association of Hematology & Oncology
Wisconsin Medical Society
Wisconsin Rheumatology Association
Wisconsin State Neurosurgical Society
Wyoming County Community Health System
Wyoming Medical Society
Wyoming Ophthalmological Society

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