Maine Medicine Weekly Update - Maine Medicine Weekly Update: 11/28/2021
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WHO Classifies New Variant as 'Highly Transmissible' Virus (Omnicron)

An advisory panel of the World Health Organization classified a new COVID-19 variant first detected in South Africa as a highly transmissible virus of concern and named it ``Omicron'' under its naming protocols system.

The WHO’s Technical Advisory Group on SARS-CoV-2 Virus Evolution met to review what is known about the COVID19 variant B.1.1.529. They advised WHO that it should be designated a Variant of Concern.

The announcement Friday marks the first time in months that WHO has classified a COVID-19 variant as such. The Delta variant, which has become the world's most prevalent, is in the same category.

However, many medical experts, including the World Health Organization, warned against any overreaction before the variant that originated in southern Africa was better understood.

*More Omnicron information below

Also in this Maine Medicine Weekly Update: It's quite the busy week for deadlines, webinars, surveys, and rules review so we've chosen to make this nearly an all Omnicron and 'What's Going on This Week' edition.

So grab your paper calendar, a pencil and a pencil sharpener (remember those little sharpeners) or your smartphone/smartpad/laptop and check out all that is coming.

Our regular and comprehensive Maine Medicine Weekly Update will be sent tomorrow.

Thank you for reading and of course for being a Maine Medical Association member. We hope your holiday weekend was spent with loved ones and provided some rest and relaxation.

Additional Omnicron Resources & Information

World Health Organization: Classification of Omicron (B.1.1.529): SARS-CoV-2 Variant of Concern (WHO)

New COVID-19 Variant Emerges with Old One Driving Record Cases in Maine (Bangor Daily News)

Explainer: What Is This New COVID Variant In South Africa? (Associated Press)

Explainer: How Worried Should We Be About the Omicron Variant? (Reuters)

COVID Variant Spreads to More Countries As World On Alert (Associated Press)

'Patience Is Crucial': Why We Won't Know for Weeks How Dangerous Omicron Is (Science.org)

Provider Relief Fund Reporting Deadline: November 30, 2021

If you got 1 or more Provider Relief Fund (PRF) payments totaling more than $10,000 during the first Payment Received Period, you must report by November 30, 2021 at 11:59 pm ET to avoid further enforcement actions like repayment or other debt collection activities. The original deadline to report on how you used the funds was September 30, 2021, but HHS observed a 60-day grace period to help providers who didn’t meet the Reporting Period 1 deadline.

To get started, register in the PRF Reporting Portal. Review technical assistance resources on the PRF Reporting webpage for updated FAQs and user guides. You can get real-time help through the Provider Support Line at 866-569-3522; for TTY dial 711. They’re open from 8 am – 10 pm central time, Monday through Friday.

Maine Bureau of Insurance: Notice of Public Meeting on Clear Choice Standardized Plan Designs (Dec 1 & Dec 20)

The Bureau of Insurance conducts an annual review of the Clear Choice plan designs in consultation with stakeholders, pursuant to 24-A M.R.S. § 2793(2) and Bureau of Insurance Rule Chapter 851, §5(1)(A).

The Bureau will hold its 2nd virtual meeting on Wednesday, December 1st, at 10:00 am, and its 3rd virtual meeting on Monday, December 20th at 1:00 pm. We hope you will be able to join.

The Bureau of Insurance conducts an annual review of the Clear Choice plan designs in

consultation with stakeholders, pursuant to 24-A M.R.S. § 2793(2) and Bureau of

Insurance Rule Chapter 851, §5(1)(A). The Bureau will hold its 2nd virtual meeting on

Wednesday, December 1st, at 10:00 am, and its 3rd virtual meeting on Monday, December

20th at 1:00 pm. We hope you will be able to join us.

During these meetings we will discuss:

Comments received by the Bureau

2023 Clear Choice small group proposed plans

Enrollment indications for 2022 plans

To join the meeting:

You will need to register using the “Public Event Notices & Related Documents”button on the Bureau’s home page www.maine.gov/insurance.

We will close registration one business day before the meeting and email the virtual event participation information to registered participants.

Registered participants may join via Microsoft Teams virtual link or by phone.

To submit written comments:

Please email them to Brittnee.L.Greenleaf@maine.gov or mail them to: Brittnee Greenleaf, Maine Bureau of Insurance, 34 SHS, Augusta, ME 04333.

If you have questions about registering or joining the meeting please reach out to Brittnee Greenleaf at Brittnee.L.Greenleaf@maine.gov

If you have questions about the meetings content, please reach out to Joanne.Rawlings.Sekunda@maine.gov

You can download a PDF of the aforementioned information here.

SUPPORT For ME Training and Technical Assistance Webinar (Dec 1)

MMA-CQI: SUPPORT for ME Training and Technical Assistance to Increase Access to Medication Assisted Treatment (MAT) in the Primary Care Setting

Wednesday, December 1, 2021 12:00-1:00pm REGISTER HERE

Substance Use Disorder Related Drug Screens and Lab Results - The Differences in Tests, Costs and Discussing Results
This webinar will provide information on the product options around testing as well as how to talk about unexpected lab results with your patient while still promoting their successes on the recovery journey. After attending this webinar participants will:

Review the types of drug screen tests and methods;
Evaluate which tests work best in certain circumstances;
Evaluate which test results should be discussed with patients without discounting the recovery journey.

Speakers: Eric Haram, LADC; Elisabeth Fowlie Mock, MD, MPH

AMA Designation Statement
The Maine Medical Education Trust designates this live internet activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Joint Sponsorship Statement
This activity has been planned and implemented in accordance with accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Maine Medical Education Trust and the Maine Medical Association-Center for Quality Improvement (MMA-CQI). The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.

This Support for ME Program is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,144,225 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

AMA: Payor Contracting 101 Virtual Bootcamp (Dec 1)

Wednesday, Dec. 1, 5:00 - 6:30 pm CST

Attorneys from Polsinelli Law Firm will provide a 1.5-hour virtual presentation and Q&A session focused on payor contracting for physicians in private practice. Content covered will include basic contract provisions and legal rules, commonly negotiated provisions, common disputes (subject matter and process), and innovative/non-traditional opportunities.

Payor Contracting 101 Virtual Bootcamp

Wednesday, Dec. 1, 5:00 - 6:30 pm CST

The Commonwealth Fund Fellowship in Minority Health Policy at Harvard University (Dec 1 deadline)

Applications are now open for this one-year, full-time, degree-granting program designed to prepare physician-leaders to improve health care access for minority, disadvantaged and vulnerable populations. Apply by December 1.

Purpose of the Fellowship

The Commonwealth Fund Fellowship in Minority Health Policy at Harvard University is designed to prepare physician-leaders who will, over time, improve the capacity of the health care system to promote policies and practices that improve minority, disadvantaged and vulnerable populations’ access to high quality care. The program provides strong academic training and coursework, including an MPH or MPA, for highly qualified physicians, and enhances the leadership ability of physicians, offering them substantive knowledge in health policy and management, while creating a network of physician-leaders capable of advancing successfully among the public, nonprofit, and academic sectors.

We seek applications from individuals who are highly motivated and have great leadership potential of becoming a change agent in health care delivery systems for vulnerable populations.

Eligibility

Physicians who have completed residency in the U.S., either BE/BC. Additional experience beyond residency, such as chief residency, is preferred.

Experience or interest in addressing and improving the health needs of minority, disadvantaged and vulnerable populations as well as in advancing system change in ways that improve the health for all populations, but with particular emphasis on vulnerable populations.

Strong evidence of leadership experience or potential, especially as related to community efforts, quality improvement, transformation of health care delivery systems, and/or health policy.

Intention to pursue a career in policy, public service, and/or academia.

U.S. citizenship or U.S. permanent residency.

How to Apply | The Commonwealth Fund Fellowship in Minority Health Policy at Harvard University

Maine DHHS Clinician Call: COVID-19 Oral Anti-Viral Therapies, Preview & Distribution (Dec 2nd)

Please join Maine DHHS on Thursday, December 2 at 7:30 AM for a preview of the upcoming/anticipated COVID-19 oral anti-viral therapies (e.g. molnupiravir) & a discussion of initial thoughts about the state of Maine’s plans for distribution of what we anticipate will (at least initially) be an extremely constrained supply of these therapies.

Of note, this is intended as an initial discussion with clinicians, but please feel free to share this with others in your organization who might be interested.

Please use Zoom info below

>>>>>>>>>>>>>>>

Join Zoom Meeting
https://mainestate.zoom.us/j/86166037339

Meeting ID: 861 6603 7339
One tap mobile
+16468769923,,86166037339#

Governor’s Opioid Response Seminar Webinar Series (Dec 3)

The Governor’s Opioid Response Seminar Webinar Series continues on Friday, December 3, 2021 from 11:30 a.m. to 12:30 p.m. with “Staying connected from a distance: How to build and maintain therapeutic relationships using telehealth”

Discussion to include the role of authentic virtual engagement when working with patients with substance use disorders, how to adapt communication styles to engage with a treatment team, and how to effectively connect with patients, teams and families using a virtual medium.

Speakers:

Jesse Higgins, Director of Integrated Behavioral Health at Northern Light Acadia Hospital
Brittany Barker, Integrated LCSW Clinical Supervisor, Northern Light Acadia Healthcare
Lisa Jacobs, ntegrated PMHNP Clinical Supervisor, Northern Light Acadia Healthcare.

Date: Friday, December 3, 2021

Time: 11:30 a.m. – 12:30 p.m.

Format: Zoom Webinar

This program constitutes 1 hours of training through AdCare Educational Institute of Maine, Inc.

Free Registration ( Certificate of Attendance )

$25 Fee For Continuing Education Credits

For more information on the credits that will be offered, Click HERE

Suicide Assessment & Management for Clinical Staff (Dec 6, 13 & 20 3-5pm)

NAMI Maine's Suicide Assessment and Management training is a 3-part virtual workshop designed to prepare a new or seasoned healthcare or mental health clinician to understand the risk of suicide, how to approach and complete an effective suicide risk assessment. This 3-part workshop is scheduled on 3 consecutive Mondays, December 6, 13 and 20, from 3-5pm.

NAMI Maine 3-part Virtual Workshop
Suicide Assessment & Management for Clinical Staff

Three consecutive Mondays: December 6th, 13th & 20th
3:00 - 5:00 pm
Virtual workshop (Zoom)
Instructor: Greg Marley, LCSW, Suicide Prevention Director

The ability to conduct an informed suicide risk assessment is a vital skill for any clinician working with high-risk populations. The Suicide Assessment and Management training is a 3-part virtual workshop designed to prepare a new or seasoned healthcare or mental health clinician to understand the risk of suicide, how to approach and complete an effective suicide risk assessment. The focus is on assessment skills across the lifespan.

For more information about the workshop and to register, visit
https://www.namimaine.org/events/clinicalassessment120621.

Contact: Amanda Bouffard, NAMI Maine Suicide Prevention Coordinator
(207) 622-5767 x2318 mspp@namimaine.org

AMA: Telehealth Immersion Program Mini-Bootcamp: What’s Next for Telehealth? (Dec 7)

December 7 at 4 PM CT

This interactive session will provide participants with a recap of the 2021 Telehealth Immersion Program, highlight physician, and practice wins, and provide an overview of the telehealth landscape for the future, including key policy changes for 2022. Register now

December 7 at 5 PM ET

5:00 – 5:15pm ET | Opening remarks, program highlights, and preview of 2022

Bernadette Lim, MBA, Project Manager, Digital Health, AMA

5:15 – 5:45pm ET | Key telehealth policy changes for 2022

Kim Horvath, JD, Senior Legislative Attorney, AMA

Sandy Marks, MBA, Senior Assistant Director, Federal Affairs, AMA

5:45 – 6:00pm ET | Practice Spotlight – Miami, Florida

Adrian Villarreal, DO, Owner and Family Medicine Physician, Adrian A. Villarreal, DO PLLC

6:00 – 6:15pm ET | Practice Spotlight – Batesville, Indiana

David Welsh, MD, President and General Surgeon, Surgical Associates of Southeastern Indiana

6:15 – 6:30pm ET | Practice Spotlight – Naples, Florida

Corey Howard, MD, CEO/President and Internal Medicine Physician, Howard Health & Wellness

6:30 – 6:45pm ET | Practice Spotlight – Quincy, Massachusetts

Dhrumil Shah, MD, CMIO and Primary Care Physician, Compass Medical

6:45 – 7:00pm ET | Closing remarks

Grayson Armstrong, MD, MPH, Ophthalmologist & Medical Director, Ophthalmic Emergency Services, Massachusetts Eye and Ear

Dec 7, 2021 5:00 PM in Eastern Time (US and Canada)

AMA: Physician Peer Support: Secret Weapon to Combat Physician Burnout (Dec 9)

Thursday, Dec. 9, 12:00 - 1:00 pm CST

Angela Chaudhari, MD, a practicing obstetrician-gynecologist and one of the original Scholars of Wellness fellows at Northwestern Medicine, created a pilot peer support program for the OB-GYN department that was eventually implemented hospital-wide. Learn how you too can successfully start a peer support program at your organization in this AMA STEPS Forward™ webinar.REGISTER HERE.

Physician Peer Support: An Organization's Secret Weapon to Combat Physician Burnout

Thursday, Dec. 9, 12:00 - 1:00 pm CST

Upcoming Specialty Society Meetings

Below you will find an on-going list of Upcoming Specialty Society Meetings. Any questions should be referred to the contact person listed for each specialty.

UPCOMING SPECIALTY SOCIETY MEETINGS

December 9, 2021
Maine Chapter – American College of Emergency Physicians
Holiday Meeting
Portland Regency Hotel – Portland, ME
Contact: Cathy Stratton 207-595-5725 or cstratton@mainemed.com

February 25-27, 2022
Maine Society of Anesthesiologists Winter Meeting
Sugarloaf Mountain Hotel – Carrabassett Valley, ME
Contact: Lisa Montagna 207-620-4015 or mesahq@gmail.com

March 18-20, 2022
Northern New England Urological Symposium
(Presented by the Maine Urological Association)
Grand Summit Resort Hotel & Conference Center – Newry, ME
Contact: Dianna Poulin 207-480-4194 or dpoulin@mainemed.com

March 23, 2022
3^rd Annual Richard Engel, MD Primary Care Symposium
Dana Center, MMC – Portland, ME
Contact: Warene Eldridge 207-215-7118 or mainechapteracp@gmail.com

April 6-9, 2022
30^th Annual Family Medicine Update & Annual Meeting
(Presented by the Maine Academy of Family Physicians)
DoubleTree by Hilton Portland – South Portland, Maine
Contact: Deborah Halbach 207-938-5005 or maineafp@tdstelme.net

April 28, 2022
Maine Association of Psychiatric Physicians Spring Conference
Theme: Eating Disorders
Hilton Garden Inn – Freeport, Maine
Contact: Dianna Poulin 207-480-4194 or dpoulin@mainemed.com

April 30 – May 1, 2022
Maine Chapter of the American Academy of Pediatrics
Samoset Resort – Rockport, ME
Contact: Dee Kerry 207-480-4185 or dee.kerry@maineaap.org

May 6, 2022
Maine Society of Eye Physicians and Surgeons Spring Educational Program & Business Meeting
Harraseeket Inn – Freeport, ME from 11:30am – 5:00pm
Contact: Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

September 23-25, 2022
ACP Maine Chapter Annual Scientific & Chapter Meeting
Atlantic Oceanside Hotel & Conference Center – Bar Harbor, ME
Contact: Warene Eldridge 207-215-7118 or mainechapteracp@gmail.com

October 7, 2022
Maine Society of Eye Physicians and Surgeons Fall Business Meeting
(Held in conjunction with the 21^st Annual Downeast Ophthalmology Symposium)
Harborside Hotel & Marina – Bar Harbor, ME from 10:30am – 11:45am
Contact: Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

October 7-9, 2022
21^st Annual Downeast Ophthalmology Symposium
(Presented by the Maine Society of Eye Physicians and Surgeons)
Harborside Hotel & Marina – Bar Harbor, ME
Contact: Shirley Goggin 207-445-2260 or sgoggin@mainemed.com

Maine Chapter of the American Academy of Pediatrics

Dee Kerry, Executive Director, Maine AAP

The Maine AAP, thanks to funding from the Bingham Foundation, has been working with COUNT ME IN for over two years to improve the health and wellbeing of students by increasing communications among families, schools and providers pertaining to chronic absenteeism stemming from physical and mental health challenges. Pediatricians and family physicians report success in streamlining protocols and meeting regionally to discuss best ways to connect. We have conducted focus groups with students and families and offered provider education.

We now have an opportunity to work with the Maine Partnership for Children's Oral Health to expand our work to better address oral health related absences and connect with dental practices.

To provide data to support this work and connect these efforts, we are asking all dentists and physicians who see children in their practice to participate in a short survey.

Your help with this project will be greatly appreciated and will help us continue this important work. Thank you!

Maine Board of Licensure of Medicine & Board of Osteopathic Medicine Proposed Rules

The following draft rules were posted this week on the Maine Secretary of State’s website.

CHAPTER NUMBER AND TITLE: Ch. 11, Joint Rule Regarding Telehealth Standards of Practice

PUBLIC HEARING: None planned.

COMMENT DEADLINE: Friday, December 10, 2021 by 4:30 p.m.

CHAPTER NUMBER AND TITLE: Ch. 12, Joint Rule Regarding Office Based Treatment of Opioid Use Disorder

PUBLIC HEARING: None planned.

COMMENT DEADLINE: Friday, December 10, 2021 by 4:30 p.m.

The following draft rules were posted this week on the Maine Secretary of State’s website.

Proposed Amendment Chapter 11 Telemedicine Standards of Practice

The Board of Licensure in Medicine and Board of Osteopathic Licensure propose amendments to the existing joint rule, which will also be adopted by the Board of Nursing.

The proposed amendments: change the chapter number and title of the rule from "Chapter 6 Telemedicine Standards of Practice" to Chapter 11 Joint Rule Regarding Telehealth Standards of Practice; update definitions to comport with definitions in P.L. Chapter 291 enacted June 21, 2021; and include terminology and requirements applicable to nurses.

Please review the complete document for full details. Comments are due by Friday, December 10, 2021 by 4:30 p.m.

Proposed Amendment Chapter 12 Office-based Treatment of Opioid Use Disorder

The Board of Licensure in Medicine, State Board of Nursing, and Board of Osteopathic Licensure propose amendments to a joint rule regarding office-based treatment of opioid use disorder. The proposed amendments: eliminate gender terms, change the term "medical records" to patient records, and update the definition of telemedicine to telehealth to comport with the definition in 2021 P.L. Chapter 291 enacted June 21, 2021.

Please review the complete document for full details. Comments are due by Friday, December 10, 2021 by 4:30 p.m.

Maine Independent Clinical Information Service: MICIS presentations & Academic Detailing

Schedule a 1-hour presentation at your medical practice or hospital, or request an individual Academic Detailing session.

The Maine Independent Clinical Information Service (MICIS) offers independent, evidence-based prescribing information directly to prescribers.

Schedule a 1-hour presentation at your medical practice or hospital.
Two topics are currently available.

Simplified Treatment of Hepatitis C in Primary Care Settings
Prescribing to Reduce Opioid Overdose Risk

Individual Academic Detailing sessions
One-on-one Academic Detailing sessions are available on these topics and can be scheduled for any time of day.

Level 2: Simplified Treatment of Hepatitis C in Primary Care Settings
Opioid Prescribing Discussion Including Maine Law
MAT (Medications for Addiction Treatment) Basics Discussion
MAT (Medications for Addiction Treatment) Advanced Discussion
Deprescribing Opioids & Benzodiazepines

Descriptions of presentations and Academic Detailing topics are available at https://micismaine.org/education-topics/. Contact MICIS at https://micismaine.org/contact/ for more information and scheduling. MICIS is a program of the Maine Medical Association.

CY 2022 Medicare Physician Fee Schedule (PFS) & Quality Payment Program (QPP) Final Rule Summary

On November 3, 2021, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Program; CY 2022 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; and Provider and Supplier Prepayment and Post-payment Medical Review Requirements final rule (scheduled to publish in the Federal Register on November 19, 2021 – Document number 2021-23972).

In addition, CMS published a press release and fact sheet highlighting the key provisions contained in the final rule.

The policies in the rule are scheduled to take effect on January 1, 2022, and cover diverse topics, including the CY 2022 rate setting and Medicare conversion factor, telehealth and other services involving communications technology, and updates to the Quality Payment Program (QPP) through Merit-based Incentive Payment System (MIPS) activities, methodology, and payment adjustments, amongst other provisions.

Below is a summary of select provisions finalized in the rule. The American Medical Association (AMA) continues to review and analyze the impact of key provisions contained in the final rule.

Download the AMA’s CY 2022 Medicare Physician Fee Schedule (PFS) andQuality Payment Program (QPP) Final Rule Summary. The document is also under the MMA Spotlight section of the MMA’s website.

CMS Releases Final 2022 Physician Fee Schedule & Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rules.

The Centers for Medicare & Medicaid Services (CMS) released the final 2022 Medicare Physician Fee Schedule (PFS) last week. It includes changes to the Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2022.

CMS also released the 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule. This rule finalizes CY 2022 OPPS and ASC payment rates and policies, including updates to improve transparency and quality reporting.

According to the Medical Group Management Association, key policy changes included in the 2400+ page rule:

Setting 2022 Medicare payment rates for physician services. For 2022, CMS finalized the proposed Conversion Factor of $33.5848 and $21.0442 for Anesthesia (a decrease of -3.75% and -2.39%, respectively, over final 2021 rates);

Delaying the payment penalty phase of the Appropriate Use Criteria (AUC) program to Jan. 1, 2023, or the Jan. 1 that follows the end of the COVID-19 public health emergency (PHE), whichever is later;

Allowing audio-only visits for the diagnosis, evaluation, or treatment of mental health disorders furnished to established patients in their homes past the COVID-19 PHE if certain conditions are met;

Delaying enforcement of the Electronic Prescribing for Controlled Substances mandate until Jan. 1, 2023, for prescribers of controlled substances covered under Medicare Part D;

Extending the CMS Web Interface as a quality reporting option through the 2024 performance year for Medicare Shared Savings Program participants;

Setting the 2022 MIPS performance threshold at 75 points, and the additional performance threshold for exceptional performance at 89 points; and

Setting 2023 as the first performance year of the new MIPS Value Pathways (MVPs), with participation options including individual clinicians, single specialty groups, multispecialty groups, subgroups, and APM entities.

The AMA is expected to provide a comprehensive summary of the fee schedule rule in the near future and indicates they will “continue to strongly advocate for Congress to avert this significant cut and extend the 3.75% increase for 2022, as it further compounds the growing financial instability of physician practices due to the severe reduction in revenue caused by the continued COVID-19 PHE.”

Additional information about the final rule can be found in the PFS fact sheet and the QPP fact sheet.

CMS’s media release describing the final rule, “announced actions that will advance its strategic commitment to drive innovation to support health equity and high quality, person-centered care. CMS’ Calendar Year (CY) 2022 Physician Fee Schedule (PFS) final rule will promote greater use of telehealth and other telecommunications technologies for providing behavioral health care services, encourage growth in the diabetes prevention program, and boost payment rates for vaccine administration. The final rule also advances programs to improve the quality of care for people with Medicare by incentivizing clinicians to deliver improved outcomes.”

Maine Medicine Weekly Update - Maine Medicine Weekly Update: 11/28/2021(Print All Articles)