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Maine Medicine Weekly E-Update, January 18, 2022

In This Issue
COVID-19 CORNER
National Public Health Emergency Extended
Johns Hopkins Public Health Podcast: COVID-19 Vaccines and Immunocompromised Patients
Research Suggests Nearly $130 Million Spent Annually on Ivermectin Prescriptions
U.S. Supreme Court Blocks Employer Vaccine Mandate; Lets Healthcare Mandate Stand
US Sets COVID Hospitalization Record
NEJM Evidence: A New Digital Journal
FDA NOTICES
FDA Warns About Dental Problems with Buprenorphine Dissolved In The Mouth To Treat OUD & Pain
FDA Recall: Metformin HCl Extended- Release Tablets USP, 750 mg by Viona Pharmaceuticals
Using Data to Improve Opioid Prescribing - new MICIS presentation now available
MAINE LEGISLATURE
State Legislature Back in Augusta; MMA Government Affairs Back at It
MMA Legislative Committee Meetings
SURVEY REQUEST
Maine AAP, Partnership for Children's Oral Health, Count ME In Survey Request
UPCOMING EVENTS
Maine AAP: Innovating / Integrating our Way Out of Maine's Oral Health Crisis (Jan 20)
AMA Webinar: Implementing the No Surprises Act (Jan 20)
Kick-Off Webinar for Implementing the Alliance for Innovation in Maternal Health (AIM) Severe Hypertension in Pregnancy Bundle in Maine - January 26 from 12-1pm
Community Health Center Virtual Round Table - February 8th from 12-1PM
Upcoming Specialty Society Meetings
HEALTHCARE EMPLOYMENT OPPORTUNITIES
Senior Physician Executive (SPE) - Northern Light Health
Nurse Practitioner - Nasson Health Care
Physician - Nasson Health Care
Transformational OB/GYN or Maternal Fetal Medicine Physician leader

 
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MAINE LEGISLATURE

State Legislature Back in Augusta; MMA Government Affairs Back at It

The 2022 Maine legislative session began on Wednesday, January 5. Because 2021 was the first year in a legislative biennium, or two-year cycle, many health-related bills from that session are active and remain on the calendar for 2022. Democrats continue to hold majorities in both chambers.

While the Capital building is open to the public, all policy committee meeting work (public hearings and work sessions) will initially be held virtually through Zoom and broadcast on YouTube. The House Speaker and Senate President plan to evaluate the operations of the legislature during a pandemic on a regular basis.

Despite a successful legislative year for MMA in 2021, a few very important MMA legislative priority policy issues remain to be settled before the scheduled session adjournment in mid-April.

The MMA’s Legislative Committee, chaired by Jay Mullen, MD MBA FACEP met for the first time Wednesday, January 12 to review continuing priorities for the 2022 session:

LD 1196An Act Regarding Targets for Health Plan Investments in Primary Care and Behavioral Health

Summary – The MMA was chosen by the Joint Standing Committee of Health Coverage Insurance, and Financial Affairs to convene a stakeholder group to assist in developing potential recommendations for increased investment in primary care. A final stakeholder report was delivered to the Committee in mid-January.

LD 1550 – An Act To End the Sale of Flavored Tobacco Products

LD 1423 Raising the Tax on Tobacco Products

Summaries – Two important public health bills to reduce tobacco use and illness – especially for young Mainers – by banning the sale of flavored tobacco products including cigars and e-delivery systems and increasing the tax rates for cigarettes while equalizing tax rates for other tobacco products.

Other Top Legislative Issues

  • How to spend $800 million in surplus money
  • Financial relief for Mainers due to the pandemic, inflation, energy costs
  • Affordable housing
  • Taxes
  • Pandemic response policy, including vaccinations policy

Upcoming Public Hearings & Work Sessions

 

Date

Comm

PH/WS

Bill/Resolve

Bill/Resolve Title

Summary

01/18/22

HHS

PH

LD 1758

An Act Regarding Access to Telehealth Behavioral Health Services during Public Health Emergencies - Representative Colleen Madigan

DHHS would not be allowed to require a licensed mental health facility or licensed substance use disorder treatment facility to obtain written informed consent as the only option from a patient during a federal or state public health emergency. Consent would be allowed verbally, electronically or in writing. 

01/18/22

HHS

PH

LD 1841

Resolve, Regarding Legislative Review of Portions of Chapter 283: Newborn Bloodspot Screening Rule, Section 14, a Major Substantive Rule of the Department of Health and Human Services, Maine Center for Disease Control and Prevention

Adds Mucopolysaccharidosis Type I (MPS-1), Pompe, Spinal Muscular Atrophy (SMA), X-linked Adrenoleukpdysrophy (X-ALD) to newborn screening. Clarifies designation of a contact person in each hospital and birthing center, timing of newborn blood specimen collection, parental/guardian refusal of newborn bloodspot screening (NBS) tests, conditions to be screened, types of records to be maintained, responsibilities for follow-up tests and reporting when necessary, storage and use of residual filter paper specimens; and identifies the fee charged for NBS testing.

01/18/22

HHS

PH

LD 1848

An Act To Increase the Availability of Assertive Community Treatment Services - Representative Colleen Madigan

Replaces the term psychiatrist with "prescriber" and defines prescriber for assertive community treatment teams under state law. Adds the option for a licensed practical nurse to be included on an ACT team in lieu of a registered nurse if the prescriber is not a certified nurse practitioner.
Defines "Prescriber" as a licensed health care provider with authority to prescribe, including a licensed physician, certified nurse practitioner or licensed physician assistant who has training or experience in psychopharmacology.

01/18/22

HCIFS

Confirmation

Agenda

Office of Affordable Health Care

Nominations

01/20/22

HCIFS

PH

LD 1776

An Act To Allow Pharmacists To Dispense an Emergency Supply of Chronic Maintenance Drugs (Emergency) - Representative Amy Roeder

Allows pharmacists to dispense an emergency supply of a chronic maintenance drug without a prescription if the pharmacist cannot get authorization for a refill AND the pharmacist has a prescription record for the patient, including the amount or unit(s). Does not apply to controlled substances, including opioids.  Also requires insurance companies to cover the emergency supply.

01/27/22

HCIFS

PH

LD 1858

An Act Regarding Delegating Authority for Services Performed by Emergency Medical Services Personnel in Health Care Facilities

Authorizes licensed EMS to provide medical services in health care facility settings that are not hospital settings under delegated authority if certain criteria are met.  Current law authorizes EMS to provide medical services in hospital settings under delegated authority. The medical service must be in the capacity as an employee or a contracted agent of the hospital or health care facility. Current law provides that the medical service must be rendered in the person's capacity as an employee of the hospital.

 

New Bills

1747An Act To Require Screening for Cytomegalovirus in Certain Newborn Infants

If a newborn infant fails 2 hearing tests or has other risk factors for cytomegalovirus, a hospital, birthing center or other birthing service shall test the newborn infant, or cause the infant to be tested, for the presence of cytomegalovirus and report aggregate data on the testing to the state. Includes a religious exemption.

The state must provide educational resources to pregnant women and women who may become pregnant on cytomegalovirus.


 

1758An Act Regarding Access to Telehealth Behavioral Health Services during Public Health Emergencies

A licensed mental health facility may obtain consent from a person receiving mental health services or substance use disorder treatment during a public health emergency. The state may not require only written informed consent.

1771Resolve, To Establish the Advisory Panel To Better Understand and Make Recommendations Regarding the Implications of Genome-editing Technology for the Citizens of the State

The bill is the same as LD 1601 (2021), except for date changes and changing the funding mechanism to a private source. The Maine Community Foundation offered to fund the study. The MMA and Maine, American Academy of Pediatrics formally supported LD 1601.

1776An Act To Allow Pharmacists To Dispense an Emergency Supply of Chronic Maintenance Drugs

"Chronic maintenance drug" means a medication prescribed to treat a chronic, long-term condition and that is taken on a regular, recurring basis.

A person can obtain an emergency supply IF the pharmacy in question has a record of a prescription, AND the pharmacist attempts but is unable to obtain authorization to refill the prescription, AND drug is not a controlled substance, including an opioid medication.  Carriers must make emergency supplies of chronic maintenance drugs part of coverage and the pharmacist shall fulfill all documentation and other requirements established by the board.

1781An Act To Align Postpartum MaineCare Coverage with Federal Law

Provide coverage for women (including a non-citizen who is ‘otherwise eligible’) during pregnancy and up to 12 months (from 6) following delivery when the woman's family income is equal to or below 209% (from 200%). Also a date change until August 1, 2022.

1822An Act To Improve Access to Behavioral Health Services by Prohibiting Cost Sharing by Insurers

Carriers cannot apply copayments, deductibles, coinsurance or other cost-sharing requirements other than premiums for behavioral health services. Behavioral health services includes, but is not limited to, mental health care and substance use disorder treatment.

1848An Act To Increase the Availability of Assertive Community Treatment Services

Assertive community treatment teams must include apsychiatristprescriber, registered nurse or licensed practical nurse, certified rehabilitation counselor or certified employment specialist, a peer recovery specialist and a substance use disorder counselor and may include an occupational therapist, community-based mental health rehabilitation technician, psychologist, licensedclinical social worker or licensed clinical professional counselor. A licensed practical nurse may be included on an ACT team in lieu of a registered nurse if the prescriber is not a certified nurse practitioner.

Defines "Prescriber" as a licensed health care provider with authority to prescribe, including a licensed physician, certified nurse practitioner or licensed physician assistant who has training or experience in psychopharmacology.

1858An Act Regarding Delegating Authority for Services Performed by Emergency Medical Services Personnel in Health Care Facilities

This bill authorizes licensed emergency medical services persons to provide medical services in health care facility settings that are not hospital settings under delegatedauthority if certain criteria are met.  Current law authorizes licensed emergency medical services persons to provide medical services in hospital settings under delegated authority.

The bill also provides that the medical service must be rendered in the person's capacity as an employee or a contracted agent of the hospital or health care facility.  Current law provides that the medical service must be rendered in the person's capacity as an employee of the hospital.

1860An Act To Address Maine's Suicide and Opioid Crises through the Construction of Affordable Recovery Facilities in Underserved Areas of the State

This bill is a concept draft pursuant to Joint Rule 208.

This bill proposes to direct new federal money to construct affordable recovery facilities in underserved areas in order to better address the State's suicide and opioid crises.

1868An Act To Restore Funding to the State's Tobacco Prevention and Control Program

This bill provides ongoing allocations to the Tobacco Prevention and Control Programto restore the level of funding provided for the program in fiscal year 2020-21.

1877An Act To Prohibit Prior Authorization Requirements and Step Therapy Protocols for Medications Addressing Serious Mental Illness for MaineCare Recipients

Prohibits MaineCare prior authorization or step therapy for prescription drugs used for the assessment or treatment of serious mental illness.

"Serious mental illness" means a mental disorder listed in the edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association that took effect October 1, 2021 that results in serious functional impairment that substantially interferes with or limits one or more major life activities. 

"Step therapy protocol" means a protocol that establishes a specific sequence in which prescription drugs for a specified medical condition are medically necessary for a particular enrollee and are covered under a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs.  

1909An Act To Remove Restrictions on Syringe Service Programs

Exchange programs may not limit the number of hypodermic apparatuses given or require the return of a used hypodermic apparatus as a condition for receiving a hypodermic apparatus.

1910An Act To Improve Children's Mental Health by Requiring Insurance Coverage for Certain Mental Health Treatment

This bill requires health insurance carriers to provide coverage for mental health treatment services that use evidence-based practices that are recommended by a provider for a child 18 years of age or younger. The bill defines "evidence-based practices" as clinically sound and scientifically based policies, practices and programs that reflect expert consensus on the prevention, treatment and recovery science published and disseminated by the United States Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. The bill’s requirements apply to health plans with an effective date on or after January 1, 2023.

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