A message from KMS Executive Director Rachelle Colombo:
We have heard from many of you regarding the Governor’s executive order on medical services. Concerns about her authorization of unlicensed, unsupervised providers without malpractice coverage and questions about what protections are afforded to physicians are warranted and not yet easily answerable. Although KMS has made requests for liability protections both for COVID-19-related care and care which has been delayed or deferred due to COVID-19, Executive Order 20-26 does not reflect our requests or suggested provisions.
We were somewhat surprised and perplexed by the Governor’s order, because Kansas is fortunately not experiencing the surge in COVID-19 that some other states are, nor do we have a shortage of trained medical personnel prepared to provide COVID-19-related care to patients. This action seems truly unnecessary, and counter to KMS’s position that medical care should be delivered by a physician-led team with appropriate training and experience.
Unfortunately, the Governor’s order introduced even more uncertainty into our already unclear liability climate at a particularly problematic time. Depending on how the courts eventually sort it all out, it could prove to have complicated the delivery of COVID-19 care while undermining the physician-led teams that will be needed when we emerge from this pandemic.
We are disappointed by this action and will continue to advocate with legislators for meaningful, clear liability protections for all Kansas physicians. We understand that many of you are seeking answers about how to interpret the implications of this order and its effect on your collaborative practice and other supervisory agreements or protocols, as well as your malpractice coverage. We encourage you to be very specific in your supervisory, collaborative practice and other agreements regarding both COVID-19 and non-COVID-19 care with any non-physician provider with whom you have such arrangements. The order simply does not easily mesh with current law governing licensure, supervisory requirements, medical care, or malpractice coverage. We are working with our legal advisors to better understand the implications of this order and will continue to keep you updated as more direction becomes available.
New CMS guidance on non-essential procedures
This week, CMS issued new guidance on non-essential or elective procedures for communities that have relatively low and stable incidence of COVID-19 cases. The recommendations update previous guidance from CMS on limiting non-essential medical procedures. As part of the guidance, CMS said every state and local official will need to assess the situation on the ground to determine the best course forward. Health care providers are encouraged to coordinate with local and state public health officials, and to review the availability of personal protective equipment (PPE) and other supplies, workforce availability, facility readiness, and testing capacity when making the decision to re-start or increase in-person care. The new recommendations can be found here. The guidance from CMS is a part of the plan issued by the White House last week for re-opening parts of the country.
Podcast: Kansas Chapter of the ACS discusses new guidance on elective procedures
This week, the American College of Surgeons (ACS) issued new guidance that offers a set of principles to help facilities plan for resuming elective procedures. The ACS document outlines 10 distinct considerations to be addressed locally before elective surgery may be safely reinstituted. As COVID-19 rates reach their peak in Kansas over the next week or two (depending on location), practices may use this guidance to determine that resuming elective operations would be safe and in the best interest of their patients’ health.
Dr. Scott Coates—General Surgeon at Labette Health and Governor of the Kansas Chapter of the ACS—joins us in today’s podcast to help walk through the 10 considerations outlined in the new ACS guidance.
→ Listen to the podcast episode via any of the services below or click here to load the mp3 file.
Documents referenced in this podcast are:
- ACS Local Resumption of Elective Surgery Guidance
- CDC PPE Burn Rate Calculator
- Medically Necessary Time-Sensitive (MeNTS) Prioritization scoring system
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