Prescription Monitoring Program Undergoing an Upgrade; Prescriber Action Required

The Office of Substance Abuse and Mental Health Services sent an e-mail communication to PMP registrants last week asking for verification of e-mail addresses by logging into their account and reviewing and updating the profile.  All accounts that share an email address must provide a unique email address for each user moving forward.

Although the date for completing this review was stated as the end of business on Wednesday, November 30th, MMA has asked for more time given that the notice was sent out the Wednesday before a two-day state holiday.  The reason for the review is that the PMP will be upgrading software systems to meet the required PMP enhancement required by the new opioid law, P.L. 2015, Chapter 488.  The program will be moving to the new software on Tuesday, December 20, 2016.  

MMA Leadership Listening Session on December 6th at Lucerne Inn in Dedham

Stop by for an appetizer and beverage on us and share with us your thoughts and opinions.

Today is Final Day to Apply for MaineCare Stage A Health Home

MaineCare re-opened applications for participation in Stage A health homes earlier this fall but the final day to apply is today, November 28th.  Participating practices receive a per-member, per-month payment to provide population-based health home services for both Stage A and B, which serves members with mental health needs.  Both adults and children may be enrolled in the health home program.  

Practices with more than one location must complete a separate application for each location.  Practices that apply and qualify will be able to participate in both stages A and B as of January 21, 2017.  Practices that are already participating in Stage A do not need to submit an application to participate in Stage B.  

MMA Legislative Committee Organizational Meeting December 5th

The MMA Legislative Committee will hold its organizational meeting for the 128th Maine Legislature at the Frank O. Stred Building, 30 Association Drive, Manchester, Maine on Monday, December 5th from 6:00 p.m. to approximately 8:30 p.m.  Dinner will be available at 6:00 p.m.

Members of the Legislative Committee, any interested MMA member, and medical specialty society representatives are strongly encouraged to attend. This meeting is very important because the Committee will be deciding administrative aspects of the MMA’s advocacy work during the next legislature, such as the day and time of the weekly Committee conference calls; reviewing the recent election results and what they mean for our advocacy work; and discussing the advocacy agendas of the MMA, the medical specialty societies, and other health care advocacy organizations with whom MMA frequently collaborates.

We urge you to make every effort to participate in the meeting in person, but the following conference call information will be available for those who cannot travel to Manchester.

Conference call number: 207-480-4790

Participant PIN:  057614#

Please RSVP to Sarah Lepoff at slepoff@mainemed.com or 622-3374, ext. 213. If you have any question about the meeting, please contact Andrew MacLean, Deputy EVP & General Counsel at amaclean@mainemed.com or 622-3374, ext. 214.

We look forward to seeing you on December 5th and to your participation in the MMA’s advocacy activities in the 128th Maine Legislature.

Thanks,

Katherine Pope, M.D. Co-chair Legislative Committee

Stephen Meister, M.D. Co-chair Legislative Committee

Registration Available for December 6th State Innovation Model (SIM) Annual Meeting in Augusta

On December 6th, State Innovation Model (SIM) stakeholders and interested parties will convene at the Augusta Civic Center to learn about the improvements that have been made in strengthening primary care, integrating physical and behavioral health, measuring outcomes, and more.  Attendees will hear from people impacted by the SIM work and learn about the continuing efforts to improve healthcare value in Maine.  Speakers include those from the Department of Health & Human Services and from hospitals and other providers.  There is no cost to attend.  Registration and details about the event can be found at www.maine.gov/dhhs/sim.
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The AMA's Post-Election Advocacy Agenda

In the near term, the AMA will focus on the following priorities:  the future of health system reform, reducing regulatory burdens, and the continued implementation of the Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act (MACRA).

Health system reform.  Following action taken by the House of Delegates during the 2016 AMA Interim Meeting, the AMA issued a press release and two-page statement outlining and reaffirming its existing policies on health system reform.  The AMA's comprehensive policy provides a solid foundation for upcoming deliberations on changes to the Affordable Care Act and other programs.  The framework addresses key issues such as covering the uninsured and expanding choice, ensuring patient access to care and the providers they need, improving health equity for underserved and special needs populations and advancing initiatives that enhance practice efficiency and professional satisfaction.

These materials were shared with the Trump transition team, the Obama administration, and congressional leaders, and the initial response has been positive.  In the coming weeks, the AMA will be hosting a series of discussions with Federation members to prepare and position medicine to effectively engage in the debate about the future of health system reform.

Regulatory relief.  The AMA will aggressively pursue new opportunities to secure significant reductions in regulatory burdens that take time from patient care and increase costs.  To be assured efforts begin with the most pressing concerns in mind, the AMA has asked for input from Federation groups on suggestions for a regulatory relief agenda.

The AMA's plan is to provide the Trump transition team and key congressional offices with an initial set of regulatory relief recommendations before Jan. 1, while continuing to augment this work over the next several months.

Further QPP improvements.  The first performance reporting period under the QPP begins Jan.1.  Although medicine was able to secure many improvements in final regulations issued this fall, there are provisions of the MACRA law that must still be implemented by the Centers for Medicare and Medicaid Services.

Proposed regulations expected to be issued in the spring of 2017 will offer opportunities to seek further improvements to the QPP.  As it has over the last 18 months, the AMA will seek to forge consensus across medicine on recommendations to improve the new Medicare payment system.

And, importantly, the AMA will continue its efforts to provide physician practices with the information and tools that will help them participate successfully in the QPP.  Visit the AMA MACRA resource page for information about upcoming webinars and regional seminars, links to instructional podcasts and websites, and for access to our Payment Model Evaluator tool.
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Important Notice About Cardiac Surgery Infections

Patients who have had cardiac surgery in the last several years may become aware of and raise questions about a rare bacterial infection related to a device called the Sorin heater-cooler, a component of the heart-lung bypass circuit.  Several centers using this instrument have reported nontuberculous mycobacteria (NTM) infections which have presented months or years following cardiac operations.  The number of reported infections, while alarming, is quite low; the risk is probably less than 1 in 1000.  Investigations have indicated that these infections are linked to heater-cooler devices that were contaminated at the time of manufacture. 

Maine Medical Center has not seen any NTM infections among our cardiac surgery patients.  Serial cultures of our Sorin heater-coolers have been negative for NTM.  Because of heightened public awareness of this issue, we are proactively notifying patients who have had cardiac surgery here about this problem.  Maine physicians may encounter questions form patients about this issue. Maine Medical Center has provided a contact number for concerned patients and families (Patient and Guest Relations, 207 662-2983.

The federal CDC recommends that clinicians who see cardiac surgery patients be aware of this unusual infection risk and consider NTM as a potential cause of unexplained chronic illness. Patients having surgery between 2010 and 2015 are considered at risk. Patients with NTM infections have presented with a variety of clinical manifestations, including endocarditis, surgical site infection, abscess, and bacteremia.   Symptoms of invasive NTM infection may include night seats, muscle aches, weight loss, fatigue or unexplained fever. 

It is important to obtain acid fast bacilli (AFB) cultures form infected sites and to obtain AFB smears from sputum if pulmonary infection is suspected. 

FMI

·      http://www.cdc.gov/HAI/outbreaks/heater-cooler.html

·      http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/CardiovascularDevices/Heater-CoolerDevices/ucm492582.htm

 
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Congress Likely to Vote on CURES Legislation this Week

From Today's Politico Pulse:

THE CURES VOTE IS FINALLY COMING - The goal is to pass the legislation this week. The House Rules Committee plans to take up the 996-page, $6.3 billion bipartisan bill on Tuesday and a floor vote will follow a day later. The Senate would then take it up without amendment.

Republicans celebrate, after months of negotiations. "The House vote on Wednesday will be an extraordinary opportunity to help almost every American family," House Energy and Commerce Chairman Fred Upton and Senate HELP Chairman Lamar Alexander said in a joint statement. "It will advance President Obama's personalized medicine initiative, Vice President Biden's cancer moonshot, Alzheimer's research and move many treatments and cures more rapidly and safely through the regulatory process and into doctors' offices."

Democrats remain wary. And they warn that the package may not be final. "Conversations are ongoing at the leadership level," a senior Democratic aide told POLITICO, but declined to provide details. Democrats also are "proposing some additional changes to the bill that are important to Democrats in order to garner strong bipartisan support," a Democratic Energy and Commerce spokesman said.

Where the dollars are going. The legislation calls for $4.77 billion in new funding for NIH over 10 years, including the Cancer Moonshot, Precision Medicine and BRAIN initiatives. It also would provide $1 billion over two years to combat the opioid epidemic - all key White House priorities.

But Cures funds will be subject to appropriations, Pro's Brett Norman writes. While Democrats wanted the funds to be mandatory, they gave up that demand after Donald Trump won the election and Republicans kept control of Congress. More for Pros.

What the industry is saying. Industry groups pointed to specific wins for their constituencies.

- Darrell Kirch, Association of American Medical Colleges: "We [are] gratified to see that off-campus teaching hospital outpatient departments, or HOPDs, already under development will continue to receive Medicare outpatient payment rates rather than the payment cuts imposed on new outpatient departments."

- Chris Hansen, the American Cancer Society Cancer Action Network: "Cures could help fund several of the Cancer Moonshot Initiative's Blue Ribbon Panel recommendations including, the development of a large-scale patient network to gather information about tumor profiles [and] create an immunotherapy clinical trials network."

 
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Health Insurance Marketplace 2017 Open Enrollment - November 1, 2016 through January 31, 2017

The Health Insurance Marketplace Open Enrollment period for 2017 began on November 1 and goes through January 31, 2017. If you enroll by December 15, your coverage will begin on January 1. 

Physicians Back Steps Toward Value-Based Drug Pricing

Value-based pricing has the potential to reduce prescription drug spending in the U.S. within view of recent spikes in drug prices directly affecting patients, the AMA House of Delegates looks to address increases by adopting new guiding principles to support value-based prescription drug pricing.

Prescription drug spending was $457 billion in 2015, accounting for 16.7 percent of spending on personal health care services, according to the Department of Health and Human Services (HHS).  Of that, 71.9 percent was for retail drugs at outlets that serve patients directly and 28.1 percent was for nonretail drugs.

Based on the results of a report of the AMA Council on Medical Service, delegates reaffirmed several existing AMA policies.  Some support the use of value-based insurance design that could determine patient cost-sharing requirements based on the clinical value of treatment.  Others establish guidelines to help maximize opportunities for clinical data registries to enhance the quality of care provided to patients.

Delegates also adopted new policy outlining principles to guide the support of value-based pricing programs, initiatives and mechanisms for pharmaceuticals.

Read more at AMA Wire®.
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Upcoming Events

American Medical Association MACRA Webinars November 21st & December 6th

The AMA will host two educational webinars to help physicians prepare for the new Medicare Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act. Both sessions will cover the same material. Registration is open for the first webinar on Nov. 21, at 7 p.m. EDT, and the second webinar on Dec. 6, at 8 p.m. EDT. Physicians and medical society staff are welcome.

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Job Openings

Maine Medical Partners is seeking a PT BC/BE internal medicine physician for their Internal Medicine Outpatient Clinic at Maine Medical Center in Portland, Maine. 

The Clinic is the primary outpatient teaching site for Maine Medical Center’s Internal Medicine Residency Program and is the medical home for a culturally diverse population.  The ideal candidate will have an interest in residency education and international/immigrant patient care.  The clinical portion of the position involves a mix of direct patient care and the precepting of Internal Medicine Residents. 

Maine Medical Center has 637 licensed beds and is the state’s leading tertiary care hospital, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School. 

For more information please contact Alison C. Nathanson, Director, MaineHealth Physician Recruitment Center at (207) 661-7383 or nathaa@mainehealth.org.

12/12/16

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