The “War on Opioids” Needs to End

“With the first cut of the scalpel, excruciating pain exploded in my foot, and I was shocked speechless. I froze, paralyzed, terrified that any movement would jostle that knife digging into my flesh.” Angelika Byczkowski, a patient suffering from Ehlers-Danlos Syndrome (EDS) has felt multiple surgeries through anesthetics.

The unforgettable recollection above was from a procedure that was done on her foot to remove a plantar wart. She also felt pain when she received stitches, which had anesthetics applied. Her doctor told her it was impossible that she was feeling pain, so she stuck to it and all the while, feeling extreme amounts of pain run through her body, she sat there quietly because she did not want to question authority. She thought she was going crazy. However, once she was 54 years old, she was finally diagnosed with EDS. EDS in many patients has brought them pain even after being numbed through local anesthetics. However, now that the medical world has gotten more advanced, we can help people with EDS with what is called by many a last resort: Opioids.

There is a four-step procedure to be taken before providers prescribe opioids:

Step 1: Initial Assessment

An Evaluation of the patient’s pain, which should include; location of pain, duration of pain, characteristic of pain, what relieves the pain, and what time of day the pain occurs. There should also be a check on how the patient’s past treatments and medication have worked out. A look at the patients personal and family history of alcohol or substance abuse should be taken into precaution.

Step 2: Informed Consent and Treatment Agreement

Before prescribing opioids for the treatment of chronic pain, a practitioner should obtain an informed consent agreement and a treatment agreement.

Step 3: Initiating and Monitoring Treatment

Once the decision has been made to initiate the opioid treatment, it should start as a therapeutic trial for a defined period (not to exceed 30 days). The patient should know that the trail will be carefully monitored to assess the benefits and harm that may occur and to evaluate the level of and change in pain.

Step 4: Red Flags and Aberrant/Diversionary Behavior

There is no exhaustive list of behaviors that might be considered red flags. However, it is a must for practitioners to recognize such behaviors and to document them in the medical record as well as what actions have been taking, including discontinuance of opioid treatment or discharging the patient.

With all of that in mind, opioids are there to help the patient try to function normally in day to day life. It should not be the medical professional’s fault for the patient’s actions. The war on opioids is not helping anyone in this situation because it can cause more problems for the patient by not giving them the drug sooner. Medical professionals are doing everything they can to help their patients; it’s their job, and most often their passion. The war on opioids has been causing more problems than solutions in the medical field and has even led to medical professionals to be questioned.

At Emerald Coast Medical Association, we always have your back. Our Board of Governors routinely take their time to advocate for patients and physicians at the local, state, and federal level. Why wait when you can join today?

Click below to join now!

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Big Hospitals Sue HHS

Hospitals are beginning to follow in the footsteps of the American Hospital Association and are suing the Trump Administration for its decision to institute site-neutral payments.

The change, which is part of the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule-making for 2019, would lower reimbursements for hospital outpatient department services to match rates set by the physician fee schedule for clinic visits. This would mean lower costs for a patient’s insurance. However, hospitals would lose about $380 million in 2019 alone and possibly up to $760 million in 2020.  The colossal loss of money is causing an uproar with (as of right now) 38 hospitals signing the lawsuit.

This isn’t even helping the patient from what CMS Administrator Seema Verma says, “It doesn’t make sense for taxpayers, and it certainly doesn’t make sense for patients because they end up having to pay more depending on the site of service.”

However, this can be looked at as taking down the money hungry hospitals. University of Michigan health law professor Nicholas Bagley was among the observers who praised the Trump administration for the proposal, saying CMS is “picking a fight with powerful hospitals because it’s the right thing to do.” The site-neutral payments would mean, hospitals would have to offer the same care at lower prices.

The previous system had Medicare paying higher rates for services provided at the hospitals outpatient facilities. The Centers for Medicare & Medicaid Services projects the policy change will save the beneficiaries $150 million in co-payments annually; dropping the average copay from $23 to $9.

“The different payment rates also pushed hospitals to purchase independent practices to increase their reach and take advantage of the higher reimbursement rates,” Verma said. “Neutralizing payments would increase provider competition.” Competition could potentially turn into one hospital bettering the others, just because they have more resources and more funding.

However, Farzad Mostashari, MD, co-founder, and CEO of Aledade, said in a series of tweets that hospitals will fight the OPPS rule “bitterly” but that there could be a long-term benefit for them in it.

“The truth is that this proposal could help hospitals be more competitive in value-based contracts/ alternative payment models, and they should embrace the changes,” Mostashari wrote. “If rural hospitals or AMCs need subsidies, then we should do it directly, not through distorting payment policies.”

Here at Emerald Coast Medical Association, we care about your health too. Since 1981, over 50 local physicians banded together to create a Physician’s Security and Benefit plan.

The primary goals are:

  • Provide affordable health insurance to employees, physicians, and their families
  • Upon the death of a physician, provide insurance for the spouse and children of the physician
  • Use each others’ premium dollars to pay claims for those physicians and their family members who had serious medical conditions
  • To provide a premium-rating schedule that did not discriminate against those physicians and their employees who had incurred large medical claims
  • Avoid implementing “gatekeeper” type “managed care” features
  • Promote access to virtually all providers in and out of the state
  • Establish a stable alternative to those carriers who often abandon the insurance marketplace

You can get all this and more for being an Emerald Coast Medical Association Member.

No reason to wait, sign up today. We want to help you and your practice stay healthy and up to date on relevant information.

Join Today

ECMA Cares About Preventing Doctor Suicide


Time and time again, people fail to address the scale of suicide and mental illness in the medical profession. Emerald Coast Medical Association wants to change that. By becoming a member of Emerald Coast Medical Association, you will always be supported by our other members and us.

Dr. Leanne Rowe, M.D. wrote an article on the five ways to help prevent doctor suicide, which we want to share with our members.

The first way to help prevent physician suicide is by destigmatizing mental illness for doctors and medical students. Although doctors are the ones who take care of people, they have the same risk factors for mental illness as the general population does. According to Dr. Rowe, when our patients talk about problems within their life, whether they be physical or mental, it can trigger us because of our own history. Having an understanding of our own vulnerabilities can help us when we experience these triggers.

While stress and burnout are recognized as “normal” in medical workplaces, they should be recognized as warning signs of mental illness. Mental illness is known to have a stigma surrounding it, but for doctors, it is even more so. It is important that if a coworker discloses something to you about feeling depressed or burnout that you address it with him and let them know they you do not judge them. That is why Emerald Coast Medical Association is an excellent place for doctors; they can all relieve stress and talk about how they feel without worrying about judgment.

The second way is to encourage doctors and medical students to have their own trusted doctors that they can seek help from if they need it. Although we can recognize the early symptoms of mental illness, we should not treat our coworkers or friends because we can not give them optimal care.

Only about 50 percent of doctors have their own independent doctor, and often times we see our doctor later rather than sooner as we should have. Dr. Rowe believes it is important to have routine mental health screenings.

The third way to prevent physician suicide is by providing optimal management of mental health problems in doctors and medical students. Dr. Rowe has said from experience she often sees doctors with a mixed pattern of depressive disorder, anxiety disorder, and post-traumatic stress disorder. All of which can come from being overexposed to patient misery, violence, abuse, and death, including suicide.

Physician suicide is actually more common than suicide in the general population. Structured formal mindful-based cognitive behavioral therapy has been found to be an effective treatment for doctors suffering from mental health disorders.

The fourth way is by changing our medical culture. A medical career is challenging and complex, and doctors require support. Many medical workplaces do not give doctors the time off that they need or help them out when they ask for a lower workload; this can put pressure on them and lead to them experiencing burnout.

According to Dr. Rowe, recent families of young doctors who have committed suicide have described the medical field as “soul-crushing.” Bullying, harassment, and discrimination in the workplace can cause safety issues, especially for doctors who are predisposed to mental health issues. Changing medical culture will take time but is well worth it as it will be beneficial in the long run.

The fifth and final way to prevent doctor suicide is by making our medical organizations work for us. Engage with your medical organization and work together to present a powerful unified voice of advocacy for doctors at a local, national, and global level. Medical organizations can provide more ways for doctors to deal with their mental health, such as conferences and training in care for mental illness.

It is important to remind ourselves of what makes us enjoy being doctors and why we chose this career in the first place. Coming together as a united team is what will really help to prevent physician suicide. Emerald Coast Medical Association is here to help prevent it, and we are ready for you to be a part of our team.

Unite with us, and help us prevent doctor suicide.

Join Today

You can find the original article by Dr. Leanne Rowe, M.D., here:

Three Ways to Apply Cost Control to Your Office

According to the Advisory Boards Annual Healthcare CEO Survey, cost control is now the healthcare system CEOs’ number one priority. This survey was nationwide and took place between December 2017 to March 2018. Of the 33 concerns outlined in the survey, 62% of the CEO’s surveyed chose cost control as the one of utmost importance. Emerald Coast Medical Association would like to help our members apply the principles necessary to address cost control in your practice and hospitals.

Investing in the people and processes serving in operational roles in your practice or hospital can prove to be successful for cost control for your healthcare facility. This investment does not have to be financial; it merely has to be putting time into these people and operational roles. There are three different ways your healthcare facility can “invest” in cost control.

Data measurement is an easy way to set goals to start the process of facilitating cost control. Setting goals for your team to work toward and to analyze the current state of your facilities departments is a significant first step towards working to getting your cost under control. Doing so will allow you and your team to align with the organization’s goals, establish milestones, and report progress. Pairing activity reports with data makes your information more precise and error-resistant, while also removing biases from discussions. Data provides concrete evidence, so that costly mistakes can be avoided while making better decisions and more accurate predictions on how to move forward with the company.

Another way to invest in cost control is employee engagement. Enhancing revenue can be an easy way to up employee engagement. An employee who feels valued is always more likely to go above and beyond in their work than an employee who does not. Lost productivity stemming from employee disengagement can cost a company anywhere from $450 billion to $550 billion annually. Asking your employees how they want to grow and what their goals are can spark an engaging conversation that will lead to them being more productive.

Not having the appropriate staff for a specific position can be an easy way to lose money. It is not uncommon for a facilities technician to be promoted to a leadership position just because of seniority rather than having the appropriate training, mentoring, or leadership ability. This mistake can lead to high turnover, a loss of organizational knowledge, and an increased reliance on external service contracts that will cost organizations far more than they would like to spend. Having to use outside services for help costs more money than it would to hire, train, and develop an already active employee. Investing in employees by either giving them the correct training or hiring someone who is ready for the job they are being recruited for can save tons of money.

Each of these actions has little to no cost for your organization, and can only help to improve your facility and patient care. These principles will help set your practice or hospital up for success while also saving money.

Click below to learn more about how Emerald Coast Medical Association can help you improve your practices productivity, among many other benefits!

Membership Benefits

Reasons for Patients Ignoring Physician Advice


It is a known fact among all of our members that patients often do not do what their physician advises them to after seeing them. As frustrating as it can be, it is important to us at Emerald Coast Medical Association to make our members know that this is not a failure on your part, as you can only do so much. Our meetings are open for our members to discuss these frustrations without judgment, and allow them to discuss among each other how to better address these types of situations.

Many patients disregard a physician’s advice because they have read an article on Facebook or Google that states the opposite of what the physician has advised. Many of these articles are from an inexperienced person who believes that they can give professional advice in the medical field. Many other patients listen to their friend’s claims, figuring that they should listen to those close to them rather than a random doctor. Although this can be infuriating to everyone in the medical field, it is more common than we all wish to think.

According to the National Academy of Medicine, many people have issues with “health literacy,” which means the ability to obtain, process, and understand basic health information and the services needed to make the appropriate health decisions and follow treatment instructions. Most doctors are aware that health literacy is significantly under-recognized, but it is a major issue that affects the care of patients. It is estimated that around 90 million adults struggle to understand what the doctor is explaining to them about their sickness, and how to take the proper steps to treat it. Anywhere between 20%-30% of prescriptions are never filled, resulting in more illnesses, hospitalizations, and in some cases, death. Existing data supports that although physicians believe they are accurately communicating advice to their patients, it can often be misinterpreted by the patient, which is a huge part of the problem.

An aspect to consider is moving away from the mindset of “telling” the patients what to do, but rather act as more of a partner and advocate for their health. Translating terms from the medical terminology you were taught all through medical school into easier and more common words can aid in how the patient will interpret it all. Having an understanding of the difficulties this patient may be having with their illness and factors aside from that, is a great first step towards gaining patient trust. Empowering and engaging a patient can lead to them being more likely to follow your advice as a physician.

Effective physician-patient communication increases the chances that the patient leaves your office and readily takes your professional advice. We encourage our members to consider all of this when treating your patients, as it can mean a better outcome for you and your patient.

Ready to join our community of medical professionals? Click below to get started!

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Post Hurricane Member Resources

Free Loaner Copy Machines

CPC Office Technologies is offering loaner copiers at no charge for 90 days to any companies affected by the hurricane. If your business or a business that you know of was affected, please let us know.

Kayla Obert
Account Manager
Direct (850) 530-2025
CPC Office Technologies

Managing Traumatic Stress After the Hurricane

Time will tell whether Houston, the Caribbean, and Florida manage to recover from the trauma of recent hurricanes mentally but while the physical injuries will fade and the houses will be rebuilt, the psychological impact is likely to worsen. Implementing targeted psychosocial care is both a humanitarian need and an economic necessity—saving lives, jobs, and families.





Free Trauma Counseling for You and Your Staff

ECMA members are blessed to have the support of some very strong and thoughtful Benefits Partners. Med Pro Group, Danna-Gracey and Barrett Liner and Buss have committed the financial resources to provide onsite trauma counselors for you and your staff over the next few weeks. I have Licensed Mental Health Counselors waiting to be scheduled to come to your office at your request.
I know that we are a very resilient group but physicians and their staff are already at the highest stress level. You can’t care for your patients if you and your staff are unable to relieve some of the pressure.

We have the funding and the resources to make sure that you have the opportunity to address the stress and trauma we are ALL feeling in this recovery period.

ECMA leadership had been planning to kick off a Physician Wellness and Resiliency program this coming January, but with a generous donation from our Partners of our Med Mal program and our Group Health Program, we are prepared to provide onsite service and resources right now.

To schedule your office email me at for questions, call my cell: 850-819-8273. Our ECMA office is not functional yet.

Physician Employment Opportunity


Bay County is the recipient of private and state funding that will bring a 3600 person survivor camp to Panama City. This will house people in need and does not require FEMA to be involved. This is an amazing resource for our community!! The VP of HR and I have been in close touch, and they need a physician as soon as Friday! Please call or email me if you are interested in this opportunity.

Here is a rough rundown of what we will need:

– Urgent care physician within 5-7 days (pending final contract signing on Tuesday)

– Would be based on a 10-12 hr day and on call. We would need coverage for 24/7, so perhaps multiple physicians on a rotational basis. Expected to have this person/persons for 1 month, with the possibility of extension. Would only be for Matrix employees, all adults.

– We estimate coverage for up to 120 people

– The daily patient volume will vary, could be zero, could be 10-15.

– Accommodations and meals provided, travel also provided for anyone not local

– Full med-tent and all supplies will be on site (may be missing something, which we will get upon request)

Amber Munce
Vice President, Human Resources
Matrix Aviation Solutions

Building Contract Available

The contractor below is working on the repairs for the ECMA office and is willing to work with any of our physician members. He is experienced in insurance negotiations and has been ahead of the game in getting everything lined up and ready to start.

Jon Pruitt
Addison Riley, LLC: Design – Build – Renovate
Blue Anchor Realty
Cell: (850) 426-1241
FL: CBC1261672
AL: 25802

2015 West Florida Home Builder’s Association Builder of the Year
Past President of the West Florida Home Builder’s Association
Rotary Paul Harris Fellow and Bequest Society

Make Sure You are Sending Us Updates and Check our Website, Facebook, Email, and Blog Posts Regularly for Updates to be Published From All Sources

Please continue to send your updates on the status of your practice. Physicians and the public are counting on our postings for current information.

ECMA Facebook:

Practice Updates for Hurricane Michael Impacted Areas:
We also have created a separate list of resources for you that includes office space available, contractors, insurance tips, etc. That is where I will post grant opportunities as they become available as well.

Hurricane Michael Recovery: Physician Resources:

Psychological resilience is the ability to cope with a crisis successfully and to return to pre-crisis status quickly. Resilience exists when a person uses mental processes and behaviors in promoting personal assets and protecting self from the potential negative effects of stressors.

Warm Regards,

Michelle Flaat
Executive Director of ECMA
Office: 850-784-2090
Cell: 850-819-8273

Providing Support to Those Experiencing Burnout

Emerald Coast Medical Association is aware that physician and nurse burnout is becoming more and more of a problem in the workforce. Recent reports have shown that factors such as the generation and role of the nurse can have a major impact on whether they experience burnout. We aim to provide our members with a compassionate community that supports each other through tough times. Our members communicate with each other to aid in problem-solving.

When looking at the resiliency of nurses across different roles and age groups, it was found that nurses who are millennials struggle the most with burnout. Burnout can also be referred to when talking about “activation,” meaning the ability to find joy or value in work. Being able to balance work and life outside of work is one of the most crucial ways to avoid burnout. Our members have access not only to each other but also to events put on by our association to relieve stress and allow each other to decompress.

Nurses with low levels of activation and decompression are usually more likely to leave their job. It is important to support nurses mental health in addition to physicians because of the various stress factors. It is essential to identify what makes a nurse want to stay at their job and find the joy and value in it to keep them working. Making sure people are activated is one of the most significant ways to make an impact on someone’s work drive.

Christy Dempsey, the chief nursing officer at Press Ganey, talked about how disengaged nurses represent $22,000 in lost productivity a year on average. It was also mentioned that disengaged nurses attitudes could affect others in the office and in turn cause low productivity.

Finding a way to accommodate nurses depending on their generation and role is one of the easiest fixes to burnout. Decompression is crucial to enjoying work, and ECMA has events that allow our members to do so, such as the CME beach retreat. Dempsey also stated that recognizing nurses for their work can cause a positive reaction and make them more eager to work. At ECMA meetings we take the time to recognize our members and spotlight on special topics, giving them the boost they need to continue work. The support in the ECMA community is overwhelming, and the perfect way to fight back against nurse burnout.

Not a member? Find out more about the benefits of joining by clicking below.

Membership Benefits

Hurricane Michael Recovery: Physician Resources

Listed Here are Resources Available for Physicians in Bay County and Surrounding Areas

Last Updated: 07/18/2019


Office space for rent – 3500 sq feet on Jenks Ave available in September.
Contact Stephanie Parrish 850-866-5223
Dear Colleagues and Friends:
Because of demographic, business and personal changes, I have found it increasingly

challenging to continue in solo practice. After Hurricane Michael, I became acutely aware of

the need to re-assess my professional path. I am writing to inform you, that after 17 years in

practice, I will be closing my practice on May 31, 2019. I will be able to serve my patient’s

medical needs until that date.

I have recommended that my patients make arrangements as soon as possible to select

a physician to take over their Allergy/Asthma/Immunology needs. Once they have made this

selection, they will need to complete an authorization to release their medical records so that I

can forward a copy of their records to their selected physician.

Thank you for having included me in the care of our mutual patients. It has been my

pleasure and honor to serve both you and our patients. Please let me know if you have any

questions or concerns.

Attached list of Medical Office Furniture/Equipment/Supplies for sale:
Click Here
Until 5/31/19, my service, mailing, and billing address will be:

2687 Jenks Ave.

Panama City, FL 32405

Tel: 850-747-3665

Fax: 850-747-3605

After that date, you may reach me at:

1000 W. 11th Street.

Panama City, FL 32401

Tel: 205-451-5471

Fax: 877-854-6787

Kindest regards,

Geeta Khare, MD

Hi, we are The Kaya Life.  We provide medical marijuana physician consultations and recommendations in the State of Florida so that patients and their loved ones can live well.
We are looking to hire physicians that are passionate about providing relief to patients with debilitating medical conditions when other treatments have failed.  We currently offer cannabis consultations to our patients on Tuesdays and Thursdays in our Santa Rosa Beach office and Mondays and Wednesdays in our Panama City office.  Positions available in both Santa Rosa Beach and Panama City.  If interested, please send your CV to

Part-time Psychiatrist Position Available

I am the Clinical Vice President for what use to be the Cope Center in DeFuniak Springs, Florida. I am looking for a Psychiatrist who would be wanting to work on a part-time basis for Walton County and was wondering if you know of any in the area. We would work with whatever schedule the Dr. would be willing to do. For example, telehealth or one day a week. We mainly need someone who we could pay to do supervision for an ARNP.

Any help you could give would be great!

Stephanie “Tia” Guidry, M.S. LMHC
Qualified Mental Health Counselor Supervisor
VP of Clinical Services
Chautauqua Healthcare Services
3686 U S HWY 331 S
DeFuniak Springs, Fl. 32435
(850) 892-8045 ext. 236


  • Florida Sportsmedicine and Orthopaedics

Dr. James Talkington
11501 Hutchison Blvd
Suite 109
Panama City Beach, FL 32407

Florida Sportsmedicine has 2 opportunities for office space that will be ready in April of 2019. We have approximately 3000 sq feet that for a long term lease we will build to suit. There is also the opportunity to share joint space with Dr. Talkington in the other suite of the building on Jenks Ave. Dr. Talkington’s suite has approximately 4000 sq feet, an xray machine, and 9 exam rooms.
Please contact Stephanie Parrish, 850-866-5223 for additional information.

  • Bluewater Plastic Surgery

Bluewater Plastic Surgery is subletting their office. One day or 2 if anyone is interested in a sublet. The office is :
2400 sq ft., address 4550 Hwy 20, 4 procedure rooms, $250 per day.

In addition, they have 3 Midmark 625 power tables for sale, basically brand new, $2500 each.

  • Coastal Luxury

Our 3400 sqft office is available for sale and will be vacant on December 17th, 2018.  The office consists of a large, open reception and waiting area, six exam rooms with sinks in every exam room, three private offices, a generous sized kitchen and break room area, triage station, multiple common area desk spaces, a lab space, storage space,  two half baths and 1 full bath. Newly renovated 2 years ago… please click on the mls link below for pictures and contact info. 

  •   Dr. Myra Reed

I have part of my office available for rent to a specialist.

  •  Dr. Alex Jones

I have office space available M, W, F if anyone needs.

Emerald Bay Surgical Associates, LLC

  • Nuwave Medical

10800 Panama City Beach Parkway
Suite 200
Panama City Beach, FL 32407

  • Connie Andrews

Physician office space on the beach is available. One Office and three exam rooms. Very modern and new.

Contact is Connie Andrews at 1-770-402-8805.

  • Ahmed Mohamed, MD

I have an office for rent:

8 rooms, another small room, large waiting area, kitchen, 2 bathrooms.
Across from Smith Pharmacy.
1109 Harrison Ave
Panama City, FL

1 year Rent: $3500 + utilities
2 year Rent: $3000 + utilities


MedPro Members Receive Premium Relief

The Emerald Coast Medical Association Board Members and I want to express our sincere condolences for any damages that you and your families have suffered during Hurricane Michael.

The Florida Office of Insurance Regulation has asked Insurance Carriers to permit billing fairness to policyholders affected by Hurricane Michael. MedPro Group, our ECMA Medmal Risk Purchasing Group Partner, will be offering premium relief as requested for our affected program members.

Please note that any medical malpractice insurance payments that are due on or after October 7, 2018, will be granted an extension until January 8, 2019, affording you additional time to make your payments.

Furthermore, no Notices of Cancellation for non-payment of premium will be issued during this grace period. Any such Notices of Cancellation that were generated on or after Sept. 27 have been lifted.

Note: Premium relief applies only to policies effective before Oct. 7, 2018, as outlined by the Florida Office of Insurance Regulation.

The counties in our ECMA program are as follows:

MedPro is in the process of compiling information and resources for medical practices who are dealing with these hurricane-related issues. Watch for further information.

Julie Danna, cyRM
Medical Malpractice and Cyber Liability Insurance Specialist
2352 Lisenby Avenue, Panama City, FL 32405
O: 888-720-0144 / 850-995-9118
C: 850-530-3924
F: 850-995-9120


The Florida Medical Association has disaster assistance funds available. Inquire for more information.

Florida Blue

Updated Information for Providers and Patients Affected by Hurricane Michael:

Florida Blue – Updated Information – Hurricane Michael Bulletin


  • Addison Riley, LLC: Design – Build – Renovate

The contractor below is working on the repairs for the ECMA office and is willing to work with any of our physician members. He is experienced in insurance negotiations and has been ahead of the game in getting everything lined up and ready to start.

Jon Pruitt
Addison Riley, LLC: Design – Build – Renovate
Blue Anchor Realty
Cell: (850) 426-1241
FL: CBC1261672
AL: 25802


We wanted to reach out to see if there are clinicians in the area that may have damage to their practices that need help. We have direct access to many suppliers of products that might be needed for reconstruction. If there are supplies needed in the area and for the pop-up clinics please also let us know.

William Houts, LEED AP BD+C
Office: 386-275-1482
Cell: 603-203-9470

  • Greetings from First Coast Service Options — your Medicare administrative contractor!

For those in the impacted areas in Florida, we hope this message finds you safe and beginning the healing and recovery process. We wanted to provide you with information and resources to help regarding Medicare patients and providers affected by Hurricane Michael. Please share this information with your members in those areas impacted by the storm, as well as assisting with recovery.
CMS announces administrative relief due to Hurricane Michael
Due to the state  of emergency for Florida and Georgia, the HHS Secretary declared a Public Health Emergency as a result of Hurricane Michael. This allows for certain CMS program waivers. CMS released the MLN Matters Special Edition Article SE18021 ( that outlines several blanket waivers CMS issued for the impacted areas to reduce administrative burden during this time of recovery. These waivers will prevent gaps in access to care for patients impacted by the emergency. This article also addresses the billing of a modifier “CR” on claims when billing for scenarios that invoke one of the waivers, to avoid any rejected claims. The SE article also provides links to current emergency information and Q&As related to the waivers.

Provider Enrollment Hotline
Specifically for provider enrollment issues, a special hotline has been established to fast track the provider enrollment process for providers assisting with the relief efforts: 1-855-247-8428. Here is an FAQ document from CMS outlining the purpose of the hotline:

First Coast’s Disaster Information  
In addition to the overall SE article and the provider enrollment hotline, we have our Disaster Information page: We will be sure to update this page with any new information as it is released.

Provider Customer Service
As always, you may contact our customer service line at 1-866-454-9007. Customer service should be able to assist with any other general inquiries.

We hope that this information provides assistance for those affected by Hurricane Michael. Our thoughts are with everyone. Please let us know if any questions arise regarding special circumstances.

KWB Pathology

We have been trying to communicate with our clients as we can and let them know we are up and running. Our couriers are picking up in the area again. We have picked up some specimens that were collected before the storm and are processing them. We tried to drop off the attached note to all our clients offices down there after the storm. Our couriers are trying to stop by all offices to check and see if anyone is in. If you will be in a temporary location, please let us know. Please call our Courier Department at 850-219-7610, Courier Supervisor at 850-508-8537 or our main line at 850-878-5143 if you do have any specimens that need to be picked up. Any other questions or needs, please call our Client Service Director Brian McMath at 850 219-7608 or 850-556-1210.