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- Annals of Internal Medicine (6848)
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Physician Open Payments (Sunshine Rule)
The following information will help you and your staff understand the Physician Payment Sunshine Rule (also referred to as the National Physician Payment Transparency Program, or Open Payments), which requires transparency in defined payment relationships with physicians and teaching hospitals by applicable manufacturers and group purchasing organizations.
Overview and Compliance Resources for Anti-Kickback Regulations and Stark Law
On November 20, 2020, the Office of Inspector General (OIG) and Centers for Medicare & Medicaid Services (CMS) jointly finalized changes to outdated federal regulations that have burdened health care physicians with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The physician self-referral law (known as the Stark Law) generally prohibits a physician from making referrals to an entity for certain health care services if the physician has a financial relationship with the entity.
No Surprises Act
The No Surprises Act (NSA) prohibits balance billing insured patients who receive emergency or non-emergency services from out-of-network providers at in-network facilities for amounts greater than the patient’s in-network cost-sharing requirement for such services. The NSA also establishes a payment dispute resolution process and requirements to provide good faith estimates to uninsured or self-pay patients. (Note: This rule applies to private pay patients because Medicare and Medicaid already have protections agai
Regulatory Compliance for Medical Practices | ACP
Everything you need to know to stay compliant with federal regulations and avoid penalties.
Displaying 101 - 110 of 6848 in Annals of Internal Medicine
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- View Annals of Internal Medicine CME by topic here.
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Displaying 101 - 110 of 500 in Annals of Internal Medicine: Clinical Cases
Maggots: Antimicrobial Stewards and Life Savers | Annals of Internal Medicine: Clinical Cases
Maggots have been used in wound care for centuries. Their larvae secrete digestive enzymes and antimicrobial compounds that reduce the bacterial load within a wound and promote the growth of new, healthy tissue. We will discuss a series of patients with complex, nonhealing and life-threatening sacral wounds who developed multidrug-resistant sacral osteomyelitis. These wounds had failed to respond to standard and advanced strategies. Medicinal maggots were offered as a last-ditch effort in each case. In addition to saving the patients’ lives, these maggots demonstrated their underappreciated and underused role as antimicrobial stewards.
Facial Synkinesis After Bell Palsy | Annals of Internal Medicine: Clinical Cases
This is a clinical image with an accompanying video demonstrating facial synkinesis after the development of idiopathic cranial nerve VII palsy (Bell palsy). Facial synkinesis is a complication in up to 20% of children and 30% of adults after cranial nerve VII palsy. Therefore, it is very important for health care providers to know about and recognize this.
Euglycemic Diabetic Ketoacidosis in a Patient Post Cardiac Surgery Receiving Continuous Renal-Replacement Therapy | Annals of Internal Medicine: Clinical Cases
Euglycemic diabetic ketoacidosis is an often-underrecognized endocrine emergency. We highlight an unusual presentation of euglycemic diabetic ketoacidosis in a patient with a history of hypertension, type 2 diabetes mellitus, and stage 3b chronic kidney disease who had elective aortic and mitral valve–replacement surgery. She developed acute kidney injury requiring temporary continuous renal-replacement therapy. Despite hemodialysis, the patient had persistent anion-gap metabolic acidosis. Additional evaluation resulted in the diagnosis of euglycemic diabetic ketoacidosis. Successful care in this patient population entails a high index of suspicion, early diagnosis, and appropriate management.
Alternating Transient Monocular Vision Loss Due to Giant Cell Arteritis | Annals of Internal Medicine: Clinical Cases
Giant cell arteritis is a systemic granulomatous vasculitis commonly involving the temporal artery and associated with visual deficits. The most common ocular presentation of giant cell arteritis involves anterior ischemic ocular neuropathy with sudden unilateral vision loss. We present a rare case of alternating painless monocular vision loss in an older man who responded clinically to prolonged glucocorticoid therapy, tocilizumab, and intraocular pressure–lowering ophthalmic medications.
Regional Myocarditis due to Legionella Masquerading as Dual-Chamber Cardiac Arrhythmia | Annals of Internal Medicine: Clinical Cases
Myocarditis, an inflammatory myocardial condition, often is associated with arrhythmias. Enhanced diagnostic capabilities have emerged from advanced imaging techniques such as fluorine-18–labeled deoxyglucose positron emission tomography and cardiac magnetic resonance imaging with late gadolinium enhancement. We present a rare case of Legionella myocarditis with concurrent dual-chamber arrhythmias while using multimodality imaging for diagnosis.
Staphylococcus saprophyticus, an Unusual Cause of Pyelonephritis and Sepsis in Pregnancy | Annals of Internal Medicine: Clinical Cases
Maternal sepsis accounts for 13% of U.S. maternal deaths, with an estimated 2.2 deaths per 100 000 live births. Early identification and treatment are critical in sepsis. Maternal sepsis is often a polymicrobial condition. Common causative agents include Escherichia coli, Group B Streptococcus, anaerobes, and Staphylococcus aureus. Staphylococcus saprophyticus is a rare cause of pyelonephritis-associated sepsis in immunocompetent patients and is especially uncommon during pregnancy. Only a handful of cases are reported in the literature, with only 2 cases associated with pregnancy. The case being presented describes an adolescent gravid patient who was diagnosed with pyelonephritis-associated sepsis caused by S saprophyticus.
Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) With Eosinophilic Cholecystitis Triggered by Topical Diclofenac | Annals of Internal Medicine: Clinical Cases
A 64-year-old man presented with a diffuse rash accompanied by abdominal fullness and anorexia. Two and a half weeks earlier, he injured his foot and began applying topical 1% diclofenac gel several times a day. His clinical course was notable for fever, an absolute eosinophil count of 7.49 × 109 cells/L, transaminitis, and eosinophilic cholecystitis. An extensive work-up for other causes of eosinophilia was negative, and the patient met clinical criteria for drug reaction with eosinophilia and systemic symptoms (DRESS). His symptoms and laboratory abnormalities gradually improved without corticosteroid treatment. This represents, to our knowledge, the first case of DRESS triggered by topical diclofenac.
Hand, Foot, and Mouth Disease: Extensive Facial Involvement Preceding Hand and Foot Lesions | Annals of Internal Medicine: Clinical Cases
Hand, foot, and mouth disease is an acute, highly contagious viral illness that commonly affects children younger than 5 years. It is typically caused by enterovirus 71 or coxsackievirus A16, leading to an asymptomatic infection or mild disease. This disease results in flat, erythematous spots that can evolve into painful vesicles and blisters on the palms of the hands, soles of the feet, the oral cavity, and throat.
EBV Acalculous Cholecystitis Secondary to Cystic Duct Node Lymphadenitis With Positive EBER in Situ Hybridization | Annals of Internal Medicine: Clinical Cases
Primary Epstein-Barr virus (EBV) infections are commonly subclinical and seen in adolescents. Although infectious mononucleosis is the most common manifestation, EBV has diverse manifestations within the gastrointestinal system. We describe a rare case of a 27-year-old woman with acute EBV acalculous cholecystitis and hepatitis secondary to cystic duct node lymphadenitis causing compression. EBV-encoded RNA in situ hybridization stained positive within sinusoids of liver and cystic duct lymphoid tissue but negative in gallbladder tissue. Work-up for a cause of hepatitis was negative except for serology confirming primary EBV infection. She underwent laparoscopic cholecystectomy, with a resolution of symptoms.
Cerebral Fat Embolism in a Patient With Hemoglobin SC Disease Associated With Vaso-Occlusive Crisis and COVID-19 | Annals of Internal Medicine: Clinical Cases
Sickle cell disease is characterized by episodic vaso-occlusive events triggered by a combination of inflammation, increased adhesion to vascular endothelial cells, and activation of hemostasis. This vascular obstruction results in acute vaso-occlusive pain, stroke, and acute chest syndrome, which are more commonly observed when patients are admitted for acute vaso-occlusive crisis. Although fat embolism syndrome is most associated with orthopedic trauma, individuals with sickle cell hemoglobinopathy are at increased risk for nontrauma-related fat embolism syndrome. Here we describe a young woman with a history of hemoglobin SC disease who presented with fat embolism syndrome following a vaso-occlusive crisis precipitated by COVID-19 infection.
Displaying 101 - 110 of 225 in ACP Store
High Value Care Cases Bundle
ACP High Value Care Cases Learn ACP’s 5-step framework to help eliminate unnecessary health care costs and improve patient outcomes while earning CME and ABIM MOC patient safety and medical knowledge points.
High Value Care Cases 4: Care Setting and Cost
ACP High Value Care Cases Learn ACP’s 5-step framework to help eliminate unnecessary health care costs and improve patient outcomes while earning CME and ABIM MOC patient safety and medical knowledge points.
High Value Care Cases 2: The Cost of Care
ACP High Value Care Cases Learn ACP’s 5-step framework to help eliminate unnecessary health care costs and improve patient outcomes while earning CME and ABIM MOC patient safety and medical knowledge points.
High Value Care Cases 1: Eliminating Health Care Waste
ACP High Value Care Cases Learn ACP’s 5-step framework to help eliminate unnecessary health care costs and improve patient outcomes while earning CME and ABIM MOC patient safety and medical knowledge points.
Module 3: Understanding and Addressing Disparities in Diagnosis: Case 2
Module 3: Understanding and Addressing Disparities in Diagnosis: Case 2
Module 2: Understanding and Addressing Disparities in Diagnosis: Case 1
Module 2: Understanding and Addressing Disparities in Diagnosis: Case 1
Module 1: Understanding and Addressing Disparities in Diagnosis
Module 1: Understanding and Addressing Disparities in Diagnosis
SUD Video Bundle from 2023 Internal Medicine Meeting
Captured from Internal Medicine Meeting 2023, this video bundle package provides 2.5 hours of high-yield video content covering strategies and management options for treating substance use disorder. Note: 2023 Premium registrants can access this content hereor CME 160 purchasers can findit here. Addiction Medicine for the Hospitalist - MTP 039 Dr. Kerri Holmes-Maybank, MSCR addresses best approaches, including pharmacologic interventions, to treating alcohol and opioid use disorders in patients admitted to the hospital. High-value care is also discussed, especially regarding ongoing management and avoiding readmissions. Outpatient Management of Opioid Use Disorder - MTP 083 Dr. Ann Garment, FACP discusses optimal strategies to best reduce barriers for treating Opioid Use Disorder (OUD), and addresses many practical OUD management topics, including working with patients to decide between buprenorphine and methadone for OUD, examining the evidence and potential drawbacks behind injectable naltrexone, naloxone overdose kits, needle exchange programs, supervised injection facilities, benzodiazepine co-prescription, and hepatitis C treatment.
POCUS Course Bundle
The POCUS Pathway Bundle includes the following courses: Foundational Skills for Internal Medicine Physicians This hands-on 2-day course is designed to teach core POCUS skills to internal medicine physicians, centering on the needed skills to use ultrasound as a patient assessment tool in a variety of settings. POCUS Mentorship Program Build on your point-of-care ultrasound (POCUS) learning and become increasingly proficient in practice. This live, virtual course provides highly-personalized, 1:1 POCUS training through expert mentorship to help Internal Medicine Physicians solidify and advance skills, with training that is customized to your learning needs. Practical POCUS Skills for Internal Medicine Physicians Continue your POCUS training and expand your outpatient clinical assessment skills with 1-day advanced, hands-on POCUS training from expert faculty. Topics include a PEARLS approach to a multisystem ultrasound physical, AAA screening, skin and soft tissue, and musculoskeletal ultrasound. Plus full access to ACP’s POCUS online curriculum (14+ hrs. of content). Purchasers of the POCUS Pathway Bundle will be granted early access to register for these courses. Here’s how it works: · Pay for the bundle now to access member-exclusive savings · You’ll be notified when course registration opens · When you register for a course, the amount due will be $0 · Your bundle purchase has no expiration date so you can register based on your scheduled preferences
SUD Video Bundle from 2022 Internal Medicine Meeting
Captured from Internal Medicine Meeting 2022, this video bundle package provides 3 hours of high-yield video content covering strategies and management options for treating substance use disorder. Note: 2022 Premium registrants or CME 170 purchasers can find this content here.