National Hispanic Medical Association Newsletter – Feb./March 2016 

Washington, DC 



Third Health Insurance Marketplace Open Enrollment

According to a final enrollment report released today, Health Insurance Marketplaces nationwide signed up 4.9 million new customers for 2016 coverage during the third Open Enrollment period. In total, 12.7 million people signed up or automatically renewed their plans for 2016 coverage. More than 9.6 million people (76 percent) signed up or were automatically enrolled in the 38 states that use the platform, and an additional 3.1 million (24 percent) were signed up in State-based Marketplaces. These figures do not include the additional 400,000 people who signed up on the New York and Minnesota Marketplaces for coverage through the Basic Health Program. About 20 million uninsured Americans have gained coverage because of the Affordable Care Act. 


NHMA Early Child (0 to 8 years old) Healthy Weight AdvocacyWe are proud to partner with the W.K. Kellogg Foundation on our Health Education Campaign to physicians and their patients and to policymakers about the importance of early childhood healthy weight activities – nutrition and physical activity. According to an independent panel on obesity commissioned by the World Health Organization, data show childhood obesity rates are increasing, with 41 million children younger than 5 considered obese or overweight worldwide, up from 31 million in 1990.


Here are 3 Federal Programs NHMA is partnered with:


·         President’s Challenge for Fitness K-3, Office of the President’s Council on Fitness, Sports, and NutritionThe new PYFP Fitness Club provides you with materials to help students in grades K-3 learn about the FITNESSGRAM® test items and earn recognition for their accomplishments all while having fun. A teacher instruction sheet identifies the testing cues a student must follow in order to check-off each health-related fitness test you select. FITNESSGRAM® tests include the Powerful PACER, Balanced Body Composition, Terrific Trunk Lift, Perfect Push-Up, Stretchy Sit and Reach.  A colorful classroom poster with test descriptions allows students to track their own progress. Once students have checked all boxes (it may take multiple attempts or a few years for them to get there), a certificate can be awarded to recognize their accomplishment!


·         Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities recognizes the importance of physical activity for people of all ages and abilities. It calls on Americans to be more physically active through walking and calls on the nation to better support walking and walkability. Improving walkability means that communities are created or enhanced to make it safe and easy to walk and that pedestrian activity is encouraged for all people. NHMA is a partner.


·         First Lady’s Let’s Move- In 2010, she launched Let’s Move!, bringing together community leaders, educators, medical professionals, parents, and others in a nationwide effort to address the challenge of childhood obesity. Let’s Move! has an ambitious goal: to solve the epidemic of childhood obesity within a generation. Whether it's providing healthier food in our schools, helping kids be more physically active, or urging companies to market healthier foods to our children, Let’s Move! is focused on giving parents the support they need to make healthier choices for their kids.'s_Move_Fact_Sheet_for_Hispanics.pdf


Puerto Rico in Fiscal Crisis – Health Care Reforms Proposed by HHS:


HHS has taken a number of steps to help ensure that the 3.5 million residents of Puerto Rico continue to have access to quality and affordable health care and a more sustainable future. As part of the President’s FY17 Budget, the Administration detailed its proposal to improve health care outcomes in Puerto Rico and prevent more than 600,000 Americans from losing access to health care by reforming Medicaid in Puerto Rico and the other territories.


The proposal is to lower prescription drug costs through access to the Medicaid Drug Rebate program. However, the most meaningful measures for Puerto Rico will require legislation. Here, HHS and the Administration have proposed to:

·         Reform and Strengthen Puerto Rico’s Medicaid program - The President’s FY17 Budget proposal would transform the Medicaid program in Puerto Rico and territories throuh three core reforms: 

o   Lift the federal cap on Medicaid funding to Puerto Rico and the other U.S. Territories.

o   Raise the federal Medicaid share from 55 percent to 83 percent over time.

o   Expand eligibility to 100 percent of the federal poverty level.


Helping Puerto Rico and the Other Territories Respond to Zika Virus

Locally transmitted Zika virus has been reported in the Commonwealth of Puerto Rico, the U.S. Virgin Islands, and American Samoa. The Administration’s Zika supplemental request to Congress would expand vector control programs to reduce transmission of the Zika virus by Aedes Aegypti mosquitos and enhance lab capacity for Zika and other infectious disease testing in Puerto Rico and the U.S. Territories. 

As noted above, unlike states, Puerto Rico and the territories’ Medicaid funding is capped, which has limited their capacity to respond to emergent and growing health needs. HHS has requested that Congress enact a temporary one-year increase in territories’ federal Medicaid share to provide an estimated $250 million in additional federal assistance to support health services for pregnant women at risk of infection or diagnosed with Zika virus and for children with micocephaly, and other health care costs. This request does not make any changes to Puerto Rico’s underlying Medicaid program, and the additional funding will not be counted towards Puerto Rico’s current Medicaid allotment.


o   Provide a More Robust Accounting for Low Income Patients and Uncompensated Care –The FY17 Budget proposes to give the Secretary authority to adjust Medicare’s disproportionate share (DSH) payments to better account for the higher costs of low income patients in Puerto Rico.  Both DSH and uncompensated care payments depend, in part, on patients being eligible for Supplemental Security Income (SSI) which Puerto Ricans do not receive. As indicated in the FY 2016 Inpatient Prospective Payment System (IPPS) final rule, HHS will further address the distribution of uncompensated care payments to Puerto Rico in the 2017 rulemaking process, if CMS proposes to continue to determine uncompensated care payments using SSI days.  

o   Increase Payment Rates for Hospitals in Puerto Rico – HHS is moving forward with accelerated implementation of new legislation passed by Congress at the end of last year that aligns the formula to pay hospitals in Puerto Rico with the formula used in the 50 states, increasing hospital payment rates in the Commonwealth by approximately 5 percent.    

Strengthening the Health Care System in Puerto Rico

HHS has already made ongoing investments to improve the quality and accessibility of the health care system in Puerto Rico as part of a systemic effort, led by the Secretary’s Puerto Rico working group, to look across the Department’s programs and identify opportunities to support Puerto Rico.

From 2009-2014, HHS has invested over $9.5 billion in Puerto Rico to improve the health and well-being of the 3.5 million Americans living in Puerto Rico. Among other programs, the administration has invested in expanding early childhood education and child care programs; provided access to health insurance and health care services through the Children’s Health Insurance Program (CHIP) and Medicaid;  supported food safety and security monitoring projects, and helped people with disabilities and older adults to live with dignity and independence.  In addition, 20 HHS-funded health centers in Puerto Rico treated over 330,000 people (99% racial or ethnic minorities; over 97% below the federal poverty level; 12% uninsured) in 2014 and established eight new service delivery sites with the help of $5 million in funding in 2015.



On Jan. 19, Senate Agriculture, Nutrition and Forestry Committee Chairman Pat Roberts (R-KS) and Ranking Member Debbie Stabenow (D-MI) have completed their personal work on the Improving Child Nutrition Integrity and Access Act of 2016, and got it approved today with a unanimous vote of their Committee members.  The bill reauthorizes federal child nutrition programs, including the school breakfast and lunch programs. NHMA urged the full Senate to support the measure and for the House of Representatives to take a similar bipartisan approach to reauthorizing these important programs. The Improving Child Nutrition Integrity and Access Act would maintain the major nutrition-related standards for sodium, whole grains and increased fruits and vegetables in school lunches established under the 2010 Healthy, Hunger-Free Kids Act. It would also require the U.S. Department of Agriculture to revise guidelines for sodium and whole grain content to provide any struggling schools with additional time to meet the sodium standards and flexibility for whole grains. The bill would also support efforts to provide adequate kitchen equipment, technical assistance and training to school districts in need.

NHMA is planning a Briefing in Sacramento, CA to call for the continued improvement of diabetes and obesity programs for Latino children through education, public health and provider education programs.

The program effort is funded by the W.K. Kellogg Foundation.


See for more information on programs.  We encourage participation – call (202) 628-5895 or send email to Program Officer: Andrew Robles Sol:   This email address is being protected from spambots. You need JavaScript enabled to view it.


·         NHHF and NHMA Early Child Obesity Prevention Policies Summit with California Latino Caucus and State Public Health Leaders, Sacramento, CA --- and Media speakers needed on obesity for TV/Radio Telemundo --- contact Sara Reinoso at This email address is being protected from spambots. You need JavaScript enabled to view it. if interested.


·         NHMA 20th Annual Conference “Advancing Hispanic Health: the Next 20 Years”– in collaboration with the Hispanic Dental Association, Renaissance Hotel, Washington, DC April 21 – 24, 2016. 


Join the NHMA Annual Conference to learn new clinical updates, medical education and faculty development, health services research, and Federal health policy issues that impact the healthcare delivery to Hispanic populations!  CME to be provided. We expect 1000 participants. If interested in being a sponsor – please call Elena Rios, MD (202) 628.5895. For more information go to


Posters for Hispanic Health Research or Service Learning Deadline: March

NHMA Medical Faculty Development Program to support travel, hotel of Residents, Fellows, Young Faculty to April 21 seminar, NHMA Conference April 22-24


·         CMS Transforming Clinical Practice Initiative (TCPI)


The Transforming Clinical Practice Initiative (TCPI) is one of the newest programs initiated by the Centers for Medicare & Medicaid Services (CMS) uniquely designed to support clinician practices through nationwide, collaborative, and peer-based learning networks that facilitate practice transformation. The TCPI is one part of a strategy advanced by the Affordable Care Act to equip more than 140,000 clinicians with the necessary tools, strengthen the quality of patient care and spend health care dollars more wisely. 


NHMA encourages all physicians (academic, private practice, hospitalists) to join this opportunity today! We have a goal of 5000 physicians among our partners – AAIP, NCAPIP, NMQF and NMA.


What You Will Receive by Signing Up for TCPI

    • Receive FREE training, customized technical assistance, educational materials and peer coaching on clinical practice transformation
    • Receive a practice transformation readiness survey
    • Receive FREE training on the collection and use of data, stratified by race, ethnicity and language
    • Learn how to effectively engage patients and families with in care planning
    • Receive performance measurements for diabetes outcomes, when necessary
    • Receive FREE sensitivity training on cultural and linguistic delivery of care, when requested


Go to


·         CDC PACT Act Against AIDS Campaign- strategically disseminating HIV prevention messaging and communications within local Hispanic communities through the NHMA channels of communication to our physicians and partners, as well as implementing concurrent national engagement efforts that focus on HIV prevention and treatment awareness. 

·         NHMA partners with Association of State and Territorial Health Officers to increase awareness of our networks about Flu Vaccine for Adults, and we are planning a Leadership Meeting in Brooklyn, NY on May 11 with NY State and City officials to meet with Hispanic physicians and community leaders to discuss vaccine uptake issues with Latino patients.

o   2014-15 Season Update:Flu activity is decreasing slightly, but remains widespread across most of the U.S. and severity indicators are still high. The reduced protection offered by the flu vaccine this season makes the appropriate use of influenza antiviral (or "anti-flu") medications more important than usual. CDC recommends that all hospitalized and high-risk patients (either hospitalized or outpatient) with suspected influenza should be treated as soon as possible with one of three available influenza antiviral medications, without waiting for confirmatory influenza testing.

o   Flu Season Continues; Severe for People 65 and Older, was published on February 6, 2015. Mismatched H3N2 flu viruses continue to predominate across the country, and flu is hitting older people hard. The flu-associated hospitalization rate among people 65 years and older is the highest rate recorded since CDC began tracking that data in 2005. People who are at high risk for influenza complications, including those 65 and older, should see a healthcare provider promptly if they have flu symptoms, even if they have been vaccinated this season. For more information:


·         NHMA HepC: Hispanic Leadership Summit, Rayburn House Office Bldg, Washington, DC was a great success in educating national advocates and congressional staff on the importance of education of public and physicians




Fabian Sandoval, MD

Presented on Clinical trials and NHMA to the Merck all day meeting on diversity in clinical trials; receives Award from Clinicians in Research organization


Nereida Correa, MD appointed to the Office of Population Affairs (OPA) and Centers for Disease Control and Prevention/Division of Reproductive Health Expert Working Group which met on February 25 – 26, 2016, to revise the Providing Quality Family Planning Services Recommendations (QFP)


Sam Arce, MD traveled to Cuba with a healthcare professional group to learn about the success of the health system caring for its poor population


Joxel Garcia, MD moves to MD Anderson and was at the White House last month with the Vice President Biden Cancer Moon Shot Program Task Force – federal agencies working with MD Anderson and others


Elena Rios, MD, participated in the Press Conference of the National Hispanic Leadership Agenda (NHLA) at Capitol Hill with Congressman Becerra and other national Hispanic leaders launching the 2016 Hispanic Policy Recommendations for Congress, Federal Government and the Democratic and Republican Conventions on Feb. 25th.


NHMA Physicians who are Mentors for the NHHF-UHF Scholars Class of 2015:

Christina Arce, MD, Columbus, OH

Carlos O’Bryan, MD, Los Angeles, CA

Juan Malo, MD, Arlington Heights, IL

Luis Ontiveros, MD, Los Angeles, CA

Yury Parra, MD, Philadelphia, PA

Gabriela Pichardo-LaFontain, MD, Round Rock, TX


Ilan Shapiro, MD is seeking young physicians to be on the leadership of the NHMA Council of Young Physicians nationally and in the NHMA Six Regions;


Victor Cueto, MD is seeking residents and fellows to be on the leadership of the NHMA Council of Residents  --- contact Sara Reinoso at This email address is being protected from spambots. You need JavaScript enabled to view it. if you would like to serve to be our ambassadors and network with your colleagues.


Abner Murray – LMSA President gains approval of his Board to respond to the medical student demands for increasing the awareness of NHMA physician faculty to be informal/formal advisors and mentors in the medical schools of the country. Student clubs have advisors assigned from volunteer faculty who may not be Latino or with knowledge of Latino medical student career needs.  LMSA and NHMA Board members met at 2015 NHMA Conference that resulted in this recommendation.  We need volunteer faculty ---- contact This email address is being protected from spambots. You need JavaScript enabled to view it. if interested.


ACTION ALERT: This is a call for you to join NHMA as a Premier Members and have many opportunities to develop leadership -- Join at The National Hispanic Medical Association is excited to kick off our annual membership drive and we look forward to welcoming you as a new Premier member to our organization.  For all those who are NHMA Leadership Fellows or past members, we urge you to rejoin and participate as speakers, nominees to boards and advisory committees and to serve as spokespersons for the NHMA media project.   


Apply online at  For more information contact Sara Reinoso at This email address is being protected from spambots. You need JavaScript enabled to view it. or call 202-628-5895.




 Cancer Moonshot: Please send us any resources and/or contacts from your respective networks that should help inform the strategy as we move forward on this initiative. HHS Provider Roundtable has requested our partnership.


CDC ZIKA VIRUS ALERT: The CDC has expanded to 22 the number of countries and territories pregnant women should not visit because of the risk of contracting Zika virus, a mosquito-transmitted disease that may be causing microcephaly in infants born to infected mothers. Although initial concern has focused on Brazil, where 3,893 suspected cases of microcephaly have been reported with a major uptick since 2010, the World Health Organization said Monday that the virus will likely reach all of the Americas except Chile and Canada


Zika virus infection should be considered in patients with acute onset of fever, maculopapular rash, arthralgia or conjunctivitis, who traveled to areas with ongoing transmission in the two weeks prior to illness onset. Clinical disease usually is mild. However, during the current outbreak, Zika virus infections have been confirmed in several infants with microcephaly and in fetal losses in women infected during pregnancy.


Healthcare providers are encouraged to report suspected Zika virus disease cases to their state health department to facilitate diagnosis and to mitigate the risk of local transmission. State health departments are requested to report laboratory-confirmed cases to CDC. CDC is working with states to expand Zika virus laboratory testing capacity, using existing RT-PCR protocols.


Clinical Disease
About one in five people infected with Zika virus become symptomatic. Characteristic clinical findings include acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis. Clinical illness usually is mild with symptoms lasting for several days to a week. Severe disease requiring hospitalization is uncommon and fatalities are rare.


No vaccine or preventive drug is available. The best way to prevent Zika virus infection is to:

·                     Avoid mosquito bites.

·                     Use air conditioning or window and door screens when indoors.

·                     Wear long sleeves and pants, and use insect repellents when outdoors. Most repellents, including DEET, can be used on children older than two months. Pregnant and lactating women can use all Environmental Protection Agency (EPA)-registered insect repellents, including DEET, according to the product label.  Zika virus information for clinicians:



The National Quality Forum, in an effort to better engage with patients and consumers in its work to develop health quality measures, is seeking nominations for participants for Standing Committees in numerous new projects. The new projects will cover several topics, including Perinatal and Reproductive Health, Palliative and End of Life Care, Cancer, and Cardiovascular. Specific details for topics are available in the respective links, including deadlines to submit nominations. If you have any questions, please contact Karen Johnson at This email address is being protected from spambots. You need JavaScript enabled to view it..

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