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May 15, 2017

In This Issue
IN THE SPOTLIGHT
Anthem Asks U.S. Supreme Court to Overturn Rejection of Proposed Anthem-Cigna Merger
Cigna Abandons Merger Efforts
MMA, Lown Institute and Colleagues Present "Challenges to Professionalism in a Time of Change" in Portsmouth, June 17
New England AMA Delegation Meets in Providence, R.I.
MIPS Web-interface and CAHPS for MIPS Registration Open Until June 30
Maine DHHS Now Accepting Applcations for Opioid Health Homes
Physician-focused Payment Models Recommended to Secretary Price
MMA Leadership Listening Session in Machias on May 22
Updates on Opioid Health Homes, Pharmacist-Provider Meetings & Opioid Task Force
Online Learning Opportunities Offering CME Credits - from the Northern New England Practice Transformation Network
128TH MAINE LEGISLATURE
Weekly MMA Legislative Committee Conference Call Information
Legislative Highlights of the Week
Save the Date! Physicians' Day at the Legislature, May 31st
L.D. 46 Eliminating Physician Exemption from Jury Duty Poses Threat to Physician Practices
UPCOMING EVENTS
Maine Chapter, American College of Surgeons Annual Meeting - May 19-21
Learn How You Can Be Ready for the E-Prescribing Mandate: Free Webinars on May 24 and June 7
How Can I Choose Wisely? A Community Conversation on Healthcare Changes and Rising Costs June 8
HEALTHCARE EMPLOYMENT OPPORTUNITIES
Family Medicine Physician - Pittsfield, ME
Physician Assistant or Nurse Practitioner Hospitalist - Full Time or Per Diem, Bridgton Hospital
Family Medicine Physician - Maine Medical Partners Primary Care - Standish, ME
Primary Care Physician - Eastern Maine Medical Center
Outpatient Only - Internal Medicine with Loan Repayment & Sign-on Bonus
Part-time Clinical & Part-time Research Position in Central Maine
Family Medicine Physician - Winthrop, ME
DO or MD Physician - Augusta, ME
Family Medicine Physician - Waterville, ME

 
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Maine DHHS Now Accepting Applcations for Opioid Health Homes

The Opioid Health Homes are a new component of MaineCare’s Value-Based Purchasing Initiative, providing counseling, care coordination, medication-assisted treatment, peer support and medical consultation for individuals who have been diagnosed with an opioid dependency.

This OHHs will provide services to MaineCare members and the uninsured through grant-funded contracts with the Department of Health and Human Services’ Office of Substance Abuse and Mental Health. The upcoming application and the program requirements apply to programs serving both the MaineCare population and the uninsured (with a few minor exceptions).

To be an OHH, an organization must:

  • Be currently using an Electronic Health Record (EHR)system;
  • Have a full team at time of application, to include at least the following personnel:
    • Clinical Team Lead;
    • Medication-Assisted Treatment Provider;
    • Nurse Care Manager;
    • Certified Clinical Supervisor;
    • Licensed Alcohol and Drug Counselor; and
    • Peer Recovery Coach.
  • Have full implementation of the Core Standards as evidenced by reporting examples of current work for the following:
    • Demonstrated leadership;
    • Team-based approach to care;
    • Population risk stratification and management;
    • Enhanced access;
    • Practice integrated care management;
    • Behavioral-physical health integration;
    • Inclusion of patients and families;
    • Connection to community resources and social support services;
    • Commitment to reducing waste, unnecessary healthcare spending, and improving cost-effective use of healthcare services; and
    • Integration of health information technology (Access to HeathInfoNet for OHHs serving uninsured members). 
  • Demonstrate that they:
    • Can monitor treatment adherence and sustain recovery for their OHH members;
    • Have an infrastructure within the organization to perform population risk stratification and population management; and
    • By using a report, have a way to track their own performance over time.

More information is at http://www.maine.gov/dhhs/oms/rules/emergency.shtml.

There are two options for reimbursement:

  • Option A:  Opioid Health Homes directly administering buprenorphine, buprenorphine derivatives and naltrexone in an office setting with a pharmacist on site will be reimbursed at a rate of $1,000 per member, per month. 
  • Option B:  Opioid Health Homes providing a prescription for buprenorphine, buprenorphine derivatives and naltrexone to be filled at an outside pharmacy will be reimbursed at a rate of $496 per member, per month.

(Thanks to Dr. David McDermott and the Maine Hospital Association for permission to share this article which first appeared in MHA's Friday Report)

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