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CRAIG MORGAN PERFORMS AT KAPA’S BOOT SCOOTIN’ BALL

KAM KNOXVILLE ACADEMY OF MEDICINE

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Join us for KAPA’s

KNOXVILLE AREA

A Program of the Knoxville Academy of Medicine )RXQGDWLRQ

Saturday, September 28, 2019 Family Bowl Strike & Spare 213 Hayfield Lane, Knoxville, TN 37922 9:00 am Bowler’s Brunch & Registration 9:30 am Tournament Begins

Presentation of Trophies immediately following For more information visit www.knoxvilleareaprojectaccess.org For sponsorship and team registration contact David Caudill at dcaudill@knoxvillemedicine.org or 865-531-2766 ext. 2280

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Academy Officers Tim Wilson, MD PRESIDENT

Jeff Ollis, MD

PRESIDENT ELECT

Daniel Bustamante, MD SECRETARY

Brian Daley, MD TREASURER

Neil Coleman, MD

IMMEDIATE PAST PRESIDENT

Kimberly Weaver, PhD CEO

Board of Trustees Michael Brunson, MD David Harris, MD Zac Jumper, MD James Choo, MD

Ex- Officio Board Members Mark Browne, MD Richard Briggs, MD Debbie Christiansen, MD Randal Dabbs, MD Elise Denneny, MD Richard DePersio, MD Jerry Epps, MD Terry Nowell, MD Robert Page, MD Kirstin Kropilak -KAMA

Publisher Kim Weaver, PhD

Editor Jonathan Weaver

Production/Advertising Margaret Maddox

ADVERTISING: For advertising information, call the Academy offices at (865) 531-2766. The magazine is published four times per year by the Knoxville Academy of Medicine (KAM). All rights reserved. This publication or any part thereof may not be reproduced without the expressed written consent of the KAM. The appearance of advertising in KAM publications is not a KAM guarantee/endorsement of the product or the claims made for the product by the manufacturer. The fact that an advertisement for a product, service, or company has appeared in a KAM publication shall not be referred to in collateral advertising. The KAM reserves the right to accept or reject any advertising in

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the publication.

PRESIDENT’S MESSAGE

KAM KNOXVILLE ACADEMY OF MEDICINE

Summer is just around the corner and the work of your Knoxville Academy of Medicine and Tennessee Medical Association continues to advocate for physicians and their patients. In May, your fellow East Tennessee physicians joined with physicians from all over the state in Nashville as part the of the TMA House of Delegates to discuss issues that affect us all as practitioners, as well as, the health care delivery system. Just a few of the topics we discussed and adopted as part of TMA’s future advocacy strategic plan included: • Expansion of resources and patient access to treatment options for substance and mental health disorders • Medical records for children in foster care • Truth in advertising for the sale of CBD oil • Improving communication between hospitals and primary care physicians • The regulation of physician-led, collaborative practice between physicians, APRN’s and PA’s Let me take this opportunity to thank all the delegates that took time away from their busy schedules to participate in this forum. I am proud to say that KAM and Region 7 had the largest delegation in attendance. Additionally, congratulations to KAM member, Elise Denneny, MD, who was installed as the 2019-20 TMA President. Furthermore, let me congratulate Matt Mancini, MD on receiving the TMA Distinguished Physician Award; Sister Mariana Koonce, MD on receiving the TMA Community Service Award for her work with the Legacy Mobile Clinic; and David Gerkin, MD on receiving an award for his many years of service to the TMA in numerous roles, especially, as the Editor of the TMA Journal. Knoxville truly was represented well at this annual meeting. The next TMA House of Delegates will meet again May 15-17, 2020. If you would like to be a delegate, please contact Kim Weaver at kweaver@ knoxvillemedicine.org and we would be happy to submit your name to the nominating committee this fall. Also in May, we held our annual KAM Day at the Smokies sponsored by SVMIC. If you have never attended this event, let me encourage you to join us next year! Once again, we had the large skybox on the first base line and a wonderful meal catered by Calhoun’s. This year’s event was on Star Wars night and all the kids (and the young-at-heart) received a free

light saber. Social events are a great way to meet new physicians and network with your colleagues. Our next social event will be later this summer when we do our annual picnic with the KAM Alliance. Details to come! The TMA Advocacy Team just finished up another successful session with the TN General Assembly. Top advocacy Initiatives for 2019 included: • Preservation of a physicianled, team-based health care system in Tennessee • Continue to advocate for payment reform and further education among our legislators about the flaws of Episodes of Care • Continue to provide solutions to the TN opioid abuse crisis while still advocating for needed access to care for patients with chronic pain • Continue to promote reduction of administrative hassles associated with health insurance plans • Preservation of the physicians’ right to balance bill out of network • Continue to protect liability reforms previously established through years of advocacy efforts. These are just a few of the many legislative issues we are pushing in Nashville to protect our patients, advocate for physicians and keep the medical profession from over regulation. On another note, thank you to all who were sponsors or attended the KAPA’s Boot Scootin’ Ball this spring! Our special guest performer was Craig Morgan, and we had a record attendance! With fundraisers such as the Boot Scootin’ Ball, KAPA can continue the good work that the KAM Foundation began more than 13 years ago. Currently, through the KAPA program, we have coordinated more than $325 million dollars in donated care to our neighbors in need and helped more than 30,000 low-income, uninsured people in East TN! As always, it is vital that we speak with our colleagues who are not members of the Knoxville Academy of Medicine and TMA. Please encourage them to join us! Our voice has never been stronger in Nashville, but we need everyone involved to continue to speak with a united voice! Thank you for supporting your Knoxville Academy of Medicine and Tennessee Medical Association! Timothy S. Wilson, MD

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ACADEMY NEWS New Members A big welcome to our newest members! We are excited that you have decided to join the Knoxville Academy of Medicine. TONYA BAKER, MD

JEFFRY KING, MD

________________________________________________

ROBERT CAPPS, MD

JAMES MCLOUGHLIN, MD

________________________________________________

MARCIN GORNISIEWICZ, MD

MURAD SALAITA, MD

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HOSPITALIST UT Hospitalists 1924 Alcoa Hwy #56 Knoxville, TN 37920

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CORRECTION: IN THE PREVIOUS MAGAZINE SAM KABBANI, MD WAS ERRONEOUSLY LISTED AS A NEW MEMBER. DR. KABBANI HAS BEEN A KAM MEMBER SINCE 1988. THE KAM APOLOGIZES FOR THIS ERROR. Left Column Top to Bottom: Tonya Baker, MD; Robert Capps, MD; Marcin Gornisiewicz, MD. Right Column Top to Bottom: Jeffry King, MD; James McLoughlin, MD; Murad Salaita, MD.

Additionally, We would like to welcome the following new KAM Resident and Student Members: Jeremy Kade Ansley Kelsey Brown Lucas Canaan Taylor Chaney

Resident: Samuel G. Treat, MD Students: Sanaz Abbasialaei

The Knoxville Academy of Medicine mourns the recent loss of these physician members

Clayton L. Crawley William Harden Juliana Martinez Robert Minns

Devin Narwani Jay Nguyen Kathleen M. O’Neil Brandon Theriault

OUR COMMUNITY. OUR COMMITMENT. Home Federal Bank is proud to support Knoxville Academy

of Medicine. Alliance. OUR COMMUNITY. We’re committed to serving OUR COMMITMENT. the people, businesses W. Bedford Waters, MD 4/15/1956 - 5/25/2019 18 year member

and communities who

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call East Tennessee home.

of Medicine Alliance. We’re committed to serving

Toivo E. Rist, MD 5/21/1946 - 1/1/2019 41 year member

N. Lynne Taylor, MD

3/13/1955 - 2/14/2019 the people, businesses 18 year member

and communities who

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KAM Matthew Mancini, MD Passes TMA’s Presidential Gavel to KAM physician, Elise Denneny, MD KAM Member, Elise Denneny, MD, an otolaryngologist with Greater Knoxville Ear Nose and Throat (GKENT) was recently installed as the 165th Tennessee Medical Association President. Dr. Denneny, who is just the third female to hold this position, accepted the presidential gavel from fellow KAM physician, Matthew Mancini, MD, who has served as the TMA President for the past year. For the first time, the TMA presidency will be held back to back with physicians from the same medical society. For members in Region 7, this means that never before has the voice of East Tennessee physicians been louder. The leadership strength that comes from this area is evident in the way that our physicians step up and lead the charge to further the medical profession. Dr. Denneny has been a KAM member since 1988 and has served in many KAM leadership positions including the office of KAM President in 2013, Chair of the KAM Legislative Committee, and currently serves on the KAM Foundation Board of Governors. Locally she has served on the board pf the Metropolitan Drug Coalition, East Tennessee Opioid Drug Task Force, East Tennessee Health Information Network, Health Trust Physician Advisor, Health Care 21, and has had numerous other Knoxville area

KNOXVILLE ACADEMY OF MEDICINE

civic appointments. The drive and passion to serve others combined with her sense of gratitude is what sets Dr. Denneny apart. She was recently quoted as saying, “I am grateful to my physician colleagues for giving me the opportunity to serve. Physicians have many opportunities to lead how care is delivered and regulated, as healthcare is increasingly fragmented. I believe it is our professional privilege – for some even an obligation – as leaders of the healthcare delivery team to collectively advocate for what is best for our patients. We believe in placing the patient at the center of healthcare. We bring the physicians’ voice to the healthcare table, striving for changes that bring access, quality, and value to each patient’s experience in Tennessee. I am honored to be our (TMA) association’s ambassador for the next year.” With a focus being on a unified voice that represents and protects both physicians and patient care, you can expect to see plenty of progress during her time as the TMA President. Congratulations to Dr. Denneny and to Region 7 for continuing to lead Tennessee in initiatives to improve patient wellness.

Edward Capparelli, MD Honored for his Service on the TennCare Pharmacy Committee Congratulations to Roane-Anderson Medical Society President, Edward Capparelli, MD, who was recently honored by the TennCare Pharmacy Committee for 25 years of service on that task force. Renee Williams-Clark, PharmD, Director of TennCare Clinical Pharmacy Services presented Dr. Capparelli with a flag that had been flown at the TN Capitol building in his honor on April 15, 2019, along with a signed certificate from Governor Bill Lee. The flag was flown and taken down in full military protocol. Thank you Dr. Capparelli for your service to Tennessee’s uninsured population through your dedication to this committee!

Marty Prince, MD participates in Race Across America to Benefit the Patricia Neal Rehab Center This June, a team of six riders including a KAM member, Marty Prince, MD is participating in the Race Across America (RAAM). They will ride out of San Diego on June 15th and into Annapolis, Maryland, eight days later, raising funds for the Innovative Recreation Cooperative (IRC) of Patricia Neal Rehabilitation Center. IRC programs and clinics strive to remove barriers so that individuals who have suffered a life-changing illness or injury can learn to enjoy leisure activities and a healthier lifestyle. The race will cover 3,100 miles with at least one team member on the road at all times, 24 hours a day. RAAM is considered the most difficult bicycle endurance event in the world. You can keep track of his progress during the race at www.raceacrossamerica.org. Individual and corporate sponsorships of the ride for Dr. Prince’s team can be made by going to fsregional.com/giving and click the text link at the top “Make an online donation.” You will be taken to a secure portal where you can direct your funds to the Patricia Neal Rehab Center. Add “RAAM 19” in the test box.

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ACADEMY NEWS KAPA’s Boot Scootin’ Ball April 5, 2019

Craig Morgan Performed at Near Sold-Out Crowd for KAPA’s Boot Scootin’ Ball

On April 5th, the award-winning artist, Craig Morgan, brought his “A” game to a near sold out crowd for this year’s KAPA’s Boot Scootin’ Ball. The annual event is hosted by the Knoxville Academy of Medicine Foundation and all proceeds benefit Knoxville Area Project Access, also known as KAPA. The event included a private, energetic, concert by Craig Morgan that included many hits such as: International Harvester, Love Remembers, What I Love About Sundays, Red Neck Yacht Club and This Ain’t Nothin’; but in the end, it was his rendition of “Good Ole’ Rocky Top” that had the fully engaged crowd on their feet. In addition to the high energy show attendees enjoyed a delicious western-themed dinner complete with homemade apple pie and Mayfield’s Ice Cream. As always, guests also enjoyed the free moonshine tasting, bottomless beer along with this year’s specialty drink, the KAPA Black and Blue Shiner! The event’s success lies with the support that we receive from our sponsors. Many thanks to Covenant, Tennova, UT Medical Center, Bandit Lites, Dynasty Spas, WBIR, and WVIK for their support as Diamond Sponsors. Other sponsors for this event included Highlands Bank, UPA, Ole Smoky Tennessee Moonshine, Stages West, AlphaGraphics, Home Federal Bank and Sun Trust. Additionally, many thanks go out to this year’s Corporate table sponsors were Capital Financial, Ogle, Elrod and Baril, Oliver Smith Realty, London & Amburn, TeamHealth, University General Surgeon’s, University Anesthesiologists, Dermatopathology Partners, Greater Knoxville Ear Nose and Throat, PerfectServe, Ear Nose and Throat Consultants of East Tennessee, First Tennessee Bank and Miller & Drozdowski,PC. This year’s silent auction featured over 85K in donated items and was a highlight of the evening. The largest KAPA silent auction to date featured an array of treasures, everything from jewelry, vacation getaways, art, a luxurious hot tub and collectibles. KAPA’s Boot Scootin’ Ball helps continue the work of a much needed program in our area. Since 2006, KAPA has coordinated more than $325 million in donated care to low income individuals that have no any other access to health care through either government programs or employer-sponsored insurance. KAPA is always looking for physicians to join the fight and serve our neighbors in need. If you are not currently participating in this program, contact KAPA Executive Director Danielle Sims at 531-2766.

KAM KNOXVILLE ACADEMY OF MEDICINE

A Special Thanks To Our Boot Scootin’ Ball Sponsors!

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Creating Value in Healthcare

By: Terry Nowell, MD PGY1 UTMCK, Department of Anesthesiology The answer to who paid residents was at one time much simpler. During the first half of the 20th century, hospitals began to be a place to heal and not solely a place to die. With this paradigm shift, hospitals needed physicians to be in house 24/7. What was their solution? Hire young doctors to live in the hospital, and ipso facto “residents” were made. In the 1950’s, these residents were paid directly by the hospital approximately $25 per month.1 Today, residents are paid approximately $50k annually, but the complexity of who is footing the bill has increased dramatically. In 1965, Congress passed Medicare and the onus of paying residents was no longer on the hospitals. Medicare began to pay hospitals “its share” of costs to fund graduate medical education (GME), which allowed for open-ended reimbursement. Hospitals wrote an invoice and Medicare paid it. However, two factors resulted in the end of the hospitals setting the price of education: first, concern for an imminent physician shortage led to an increase of 33% in medical school enrollment and 25% in residency slots; second, a lack of consistency in hospital-deemed costs necessitated a more specific reimbursement model. Thus, in 1986 GME reimbursement was split into direct GME (DGME) and an indirect medical education (IME) costs. The purpose of the DGME payment is for the cost of salaries and benefits of residents, supervising physicians, and administrative support. This is the essential “per-resident amount” paid to each teaching hospital. Next, IME payments to teaching hospitals became uncoupled from DGME to cover

the cost of being a higher level of care (i.e. trauma centers, cutting-edge technology, etc.). Finally, out of concern for a physician oversupply, the 1997 Balanced Budget Act (BBA) capped the number of residency slots Medicare would fund. This legislation has widely been pointed to as a key cause of the impending physician shortage. Since 1996, hospitals have had to fund new resident positions with alternative funding from other governmental departments (VA, Department of Defense, Medicaid), state governments, or private donors. Furthermore, in Tennessee much of this non-Medicare funding is first paid to the states’ four medical schools that oversee residencies (ETSU, Meharry, UTHSC, and Vanderbilt). These medical schools then finance the residency positions by paying the hospitals. Simple enough, right? Although it is virtually impossible to uncover who can give residents a raise, it is clear that a shortage of an estimated 46,900-121,900 physicians by 2032 will necessitate additional residency positions. In Tennessee, Governor Bill Lee has supported this effort by funding 100 additional primary care positions through TennCare. Nationally, the Resident Physician Shortage Reduction Act of 2019 (HR1763 / S348) proposed by bipartisan legislators would generate 15,000 new positions by 2025, but this effort has very little traction in Congress. So, the question still looms - who is going to pay the residents?

Blount County Medical Society Quarterly Update By: Travis Groth, DO - BCMS President

“Few will have the greatness to bend history itself; but each of us can work to change a small portion of events, and in the total of all those acts will be written the history of this generation.” –Robert Kennedy. Memorial Day always reminds me of the great liberties and freedoms we have as Americans. I am grateful and appreciate all those who have served or are currently serving in our armed forces. Without those brave men and women, we would not have the freedom to practice medicine in this great country. I was fortunate to attend the Tennessee Medical Association (TMA) House of Delegates meeting in Nashville in May. Delegates for Blount Medical Society included myself along with Drs. Bob Proffitt and Marvin Beard. We also had the honor of having Dr John Ingram, founder of the John Ingram Physician Leadership Institute and past president of TMA, present to represent East Tennessee (Blount County sector) at the TMA. Blount County Medical Society (BCMS) would also like to congratulate Dr. Elise Denneny on her installment as the new president of TMA. To briefly recap the day, an emergency resolution proposed by Dr. Nita Shumaker to ban the sale of flavored vaping products in Tennessee passed unanimously along with actions to push for truth in regards to advertising cannabidiol and other CBD products and the need to address the rapidly growing number of medical students graduating

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with limited GME spots. This will most definitely be an exciting year in medicine! Other news from the BCMS includes the commencement of Beers with Peers at the local microbrewery (Round 6) which was a success. The second Thursday of every month will be a time for colleagues of the Blount Medical Society to enjoy good conversation and cold beer (or other nonalcoholic beverages). The medical society hopes to improve comradely and communication with the great physicians of our community. This summer we will be hosting another Pig Roast at Dr Jennifer Winbigler’s home on September 21st. Stay tuned for more details but if you missed out last year, it was a blast with great food and football. We have a lot to be thankful for as physicians and healthcare professionals in East Tennessee. Don’t forget to let our veterans and military know how much we appreciate their service for our country. Together, we can shape our history and make changes for the medical profession that will benefit not only our patients but our future generations. I encourage everyone to participate and not forget that together we can make change for the betterment of our society. I am grateful for the opportunity to serve as President of the Blount County Medical Society and will strive to lead by the example that I have seen by so many before me.

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ACADEMY NEWS David Gerkin, MD Honored At the TMA House of Delegates Knoxville Academy of Medicineâ€™s member David Gerkin, MD, was honored during the 2019 Tennessee Medical Association House of Delegates for his years as Editor of the TMA Journal. Dr. Gerkin has devoted many years to organized medicine and has taken great pride in his efforts as the Editor for the TMA Journal, which has recently ceased publication. The impact of his work will continue on for many years to come. The Knoxville Academy of Medicine joins in thanking Dr. Gerkin for his dedication and his contribution to medicine.

Matthew Mancini, MD Receives the TMA Distinguished Service Award In May, Matthew Mancini, MD, a surgeon with University Surgeons Associates at the University of Tennessee Medical Center Knoxville (UTMCK) was awarded the 2019 Tennessee Medical Association Distinguished Physician Award for his service to the medical profession and the patients of Tennessee. Dr. Mancini just recently concluded his year as the TMA President and is a Past President of the Knoxville Academy of Medicine. As the 2018 TMA President, Dr. Mancini took available opportunities to promote the benefits of organized medicine and share the importance of actively serving and having a voice united, strong, and impactful. His outspoken vigilant efforts fought back at the rolling out of increased Episodes of Care, and with the collective group he led the charge to pause and patch this flawed program. His desire to truly make his time as President one that could impact organized medicine was evident and clear as he spoke to many groups, listened to concerns, worked closely with residents and made time to visit area medical schools. Congratulations, Dr. Mancini on your award! The physicians of East Tennessee and TMA thank you for your service to the profession!

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KAM KNOXVILLE ACADEMY OF MEDICINE

Day on the Hill

In March, KAM and TMA partnered to provide area physicians to provide an opportunity to participate in the Annual Doctor’s Day on the Hill. East Tennessee physicians traveled via chartered motor coach to Nashville to join their colleagues from across the state to discuss issues important to medicine with legislators. Physicians had the opportunity to convey with a unified voice positions on many bills concerning Opioids, Balance Billing, MOC and Episodes of Care. This year offered a strong presence with a record breaking number of attendees. Additional topics of discussion included increasing funding for graduate medical education, scope of practice regulations, ensure health plan network adequacy for hospitalbased services, and approve a joint resolution to encourage health insurance companies to adequately cover medication assisted therapies for mental health diseases. Thank you for all those who attended and we look forward to seeing you next year!

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ACADEMY NEWS

KAM

St. Mary’s Legacy Clinic receives TMA Community Service Award

KNOXVILLE ACADEMY OF MEDICINE

KAM Member Sister Mariana Koonce, MD and the St. Mary’s Legacy Clinic received the TMA Community Service Award in May for their efforts in providing healthcare to the poor and medically underserved in the rural areas of East Tennessee. By providing medical education and primary health services at no cost to the patient, they are impacting the lives of many Appalachian residents who have no other avenue for health care. The St. Mary’s Legacy Clinic offers primary care services as needed such as medical evaluations and treatment plans provided by health care professionals, prescriptions, laboratory work, orders for diagnostic imaging, and referrals to Knoxville Area Project Access for specialty services. Their commitment is to regular scheduled visits for these communities with patient education and the distribution of limited donated medications. Currently the mobile unit serves the areas around Crab Orchard, Washburn, Athens, Decatur, Rutledge, and Gatlinburg. This fully mobile clinic, is truly a labor of love from the Sisters of Mercy, has served the uninsured since 2013 and has served over 5,000 people, traveled over 34,000 miles and has offered additional services to East Tennessee residents through Remote Area Medical (RAM) and Gatlinburg community after the wildfire ravaged the area. The Sisters of Mercy continue to reach deep into the communities that they serve to enrich the lives and build better communities. Thank you Sister Mariana for your dedication to serving our neighbors in need!

Calendar of Events JULY 18

Tacos & Tequila Resident Mixer Soccer Taco on Market Square, 6:00 - 8:00 pm

AUG 8

Raise Some Dough, Fundraising event for KAPA 20% of proceeds from your meal go to KAPA! Blaze Pizza - Cedar Bluff, 11:00 am - 8:30 pm

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Striking Down Barriers Bowling Tournament Strike & Spare Family Bowl, 9:00 am, Benefit for KAPA! For sponsorship or to enter a team, contact David Caudill at dcaudill@knoxvillemedicine.org

OCT 15

London Amburn & KAM Health Law Seminar The Foundary, 10:00 am - 2:00 pm

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LEGAL NEWS

KAM KNOXVILLE ACADEMY OF MEDICINE

HHS Signals Changes to ACA Civil Rights Regulations, Continued Commitment to HIPAA Enforcement By: Luke P. Ihnen London & Amburn, P.C.

On May 24, 2019, the U.S. Department of Health and Human SerThe new proposal announced by HHS conforms with the injunction vices (HHS) announced two proposals with potentially sweeping conand removes gender identity and termination of pregnancy from Section sequences. The first, a new HIPAA fact sheet, provides a compilation 1557. 3 The proposed rule also eliminates the burden on covered entities of all of the provisions through which a business associate can be held from including the “tagline” notices informing patients and customers directly liable under HIPAA. 1 The fact sheet makes clear that the HHS of their ability to have “significant documents” translated in at least 15 Office for Civil Rights (OCR) can only enforce the provisions found languages. In 2016, HHS estimated that the notices would costs about on the fact sheet against business associates; however, OCR’s recent $7.2 billion in the first five years; however, the rule did not account enforcement actions show that the agency is interpreting the provifor printing and mailing costs and, according to HHS, underestimated sions broadly and holding business associates and subcontractors more the burden of the requirements by $3 billion over five years. ⁴ The new accountable. For example, if a business associate’s agreement with a proposed rule would eliminate the burden imposed by the 2016 rule and covered entity requires the business associate to disclose a copy of the save an estimated $3.2 billion by providing access for translators and individual’s electronic PHI upon the individual’s request, and the busiinterpreters to address the individual needs of non-English speakers. ness associate fails to do so, OCR has enforcement authority directly Disclaimer: The contents of this article are for general informaover the business associate. tional purposes only and are not to be construed as legal advice. You Some of the violations leading to liability under HIPAA include: should consult an attorney regarding any specific legal questions. taking retaliatory action against any individual for filing a HIPAA com1 A copy of the fact sheet may be found here: https://www.hhs.gov/ plaint or participating in any investigatory process; impermissible uses hipaa/for-professionals/privacy/guidance/business-associates/factand disclosures of PHI; failure to provide breach notification; failure to sheet/index.html enter into business associate agreements with subcontractors that create 2 Id. or receive PHI; failure to take reasonable steps to address a material 3 A copy of the proposed regulations may be found here: https://www. breach or violation of a subcontractor’s business associate agreement; hhs.gov/sites/default/files/1557-nprm-hhs.pdf failure to provide a copy of electronic PHI to a covered entity or indi⁴ See, https://www.hhs.gov/sites/default/files/factsheet-section-1557. vidual (or individual’s designee) when requested. 2 pdf The fact sheet is another example of HHS extending its reach for HIPAA violations down the chain to business associates and subcontractors. Despite HHS’s warnings, many of these practices are still not standard across the industry and entities would do well to head the warning signs. Healthcare providers should remain vigilant not only regarding their internal HIPAA compliance efforts but also the compliance record and activities of their third-party vendors that are business associates. The other proposal affects Section 1557 of the Affordable Care Act. Section 1557 directs HHS to apply existing civil rights laws and regulations to healthcare and ACA Exchanges, including Title IX’s provisions prohibiting discrimination on the basis of sex. In 2016, HHS issued a new rule that redefined discrimination “on the basis of sex” to include “termination of pregnancy” and “gender identity.” On December 31, 2016, a federal court enjoined the new rule as contrary Visit suntrust.com/wealth to the Civil Rights Act, Religious Freedom Restoration Act, and the Administrative Pro©2019 SunTrust Banks, Inc. SunTrust is a federally registered service mark of SunTrust Banks, Inc. cedure Act.

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ACADEMY NEWS KAM Day at the Smokies - MAY THE 4th BE WITH YOU! The physicians of East Tennessee celebrated May 4th this year at the KAM Day at Smokies, which just happened to be the Smokies’ “May the 4th Be With You,” Star Wars’ Day! Almost 70 physician and family members met for a wonderful evening of baseball, steak dinner, and even free light sabers for the kids. Of course, any trip the ballgame is not complete without hot dogs and popcorn, and the folks from Calhoun’s set it all out for our members in their private skybox area. This was the fifth year for the KAM Day at the Smokies which is open to members from KAM, Blount, Roane-Anderson, and Monroe County Medical Societies. A big thank you to SVMIC for once again sponsoring this event that continues to be a favorite among the membership! If you have never participated in this event, be sure and join us next year!

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KAMA CORNER By: Judy Akers, KAMA President It is my pleasure to introduce myself as the KAMA President for the year 2019-2020. I look forward to interacting with KAM and its members throughout the next fiscal year. Having been inducted in May as President I would like to give a big thank you to Tina Callicutt, Kirstin Kropilak and Lili Vincent for creating a fun ceremony where the gavel was passed. Past Presidents were honored and a delightful time of sharing took place. A huge thank you goes out to Kirstin for a magnificent year of leadership. Under her leadership, we were able to distribute to the community $70,500 dollars which benefited scholarships in the health fields, as well as, support of non-profit organizations throughout Knoxville. It is through all volunteer work by KAMA members that we are able to have an impact and we are so thankful to everyone who supports our organization. The

fact that we care about the community is the reason we come together with various talents and give our time to make a difference in people’s lives. To quote one of the recipients, “Thank you so much for the overwhelming donation that you all made to the clinic. We were speechless upon receiving it!”. We were also given a Resolution of Appreciation from one of the colleges where we support scholarships for nursing students. These are just a few of the examples of the gratitude expressed by the organizations that have received funding through KAMA. We look forward to a fun and exciting year ahead with Fashiondrama 2019, Doc Rock 2020, monthly meetings with interesting programs and fellowship, hiking, working with Metropolitan Drug Commission, providing meals at Ronald McDonald House and various other activities where we are involved. The Knoxville Academy of Medicine Alliance (KAMA) is open to all spouses of physicians. Please feel free to contact me. judyakers5@gmail.com

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