MOA Action Alerts & Updates!
New CME Consortium to Create Greater
Continuing Medical Education Opportunities for Members
A twenty-one state “CME Consortium” (see states in red below) has been developed that will allow osteopathic physicians from the member states to attend CME conferences in each other’s states for member rates! Now when you attend a consortium state’s meeting, you get a better rate and your state association benefits as well, with a portion of your fee coming back to your state association.
It’s a great deal for you and provides revenue for your state osteopathic association!
Have you heard?! The CMEprn App has been developed to help you find those CME Consortium member events. Download the app to your smartphone or mobile device and you will see a map with pins denoting CME event locations.
Download the NEW CMEprn mobile app. It's FREE!
Android Users: Google Play Store Apple Users: Apple Store
On the CMEprn App: Green pins denote CME Consortium member events. The gold pin found centered in Missouri indicates on-demand CME available through the Association of Osteopathic State Executive Directors. Using this pin, you can access www.docme.org and choose from hundreds of recorded CME programs from around the country. The AOA allows 15 credits of online CME per 3-year cycle.
Need CME Credits Now? Complete Online Courses From Your Home or Office!
Sept. 9th, 2017
Patients are in jeopardy if Congress does not act by September 30. The Teaching Health Center Graduate Medical Education (THCGME) program has preserved primary care training opportunities for future physicians since 2011. The program trains primary care residents in community-based health care settings which is vital to filling our nation’s primary care gaps in rural and underserved communities. Nearly 800 osteopathic resident physicians have been trained through the THCGME program, with the majority of these programs providing AOA accredited residency training. Congress must reauthorize this program by September 30.
Congress introduced the “Training the Next Generation of Primary Care Doctors Act of 2017,” which reauthorizes the successful THCGME program for an additional three years, and would allow for the expansion of existing programs and creation of entirely new teaching health centers. This bipartisan legislation has 62 cosponsors in the House and 6 cosponsors in the Senate; however, we need your help. Unless Congress acts quickly, vital resident slots will be lost.
Click here to write to your Members of Congress and ask them to cosponsor “Training the Next Generation of Primary Care Doctors Act of 2017” to protect our fellow DOs and provide care to our nation’s most vulnerable populations.
Mark A. Baker, DO
HHS Adopts Final Version of Major Substantive and Routine Technical Rules on Opioid Prescribing
August 24, 2017, Maine Medicine Weekly Update
The rule will be effective 30 days following filing with the Secretary of State's office or a later date to be announced by the Department. But because these changes are already part of the law, prescribers and dispensers should comply with these provisions now.
(September 13, 2017) Various
Attention Cycle 2 Providers: MaineCare Provider Revalidation
Providers assigned to Cycle 2 are required to update and confirm their enrollment information beginning November 13, 2017. Providers will receive a letter 60 and 30 days prior to their assigned cycle. Providers assigned to this cycle should have received a letter during the week of September 11, 2017.
If you are required to revalidate with MaineCare during this cycle, you must initiate your revalidation application on or after November 13, 2017and complete and submit it by January 12, 2018. Failure to meet this deadline will impact your claims being processed for payment. In order to allow ample time to complete your revalidation during your assigned cycle, we recommend you complete all maintenance two weeks prior to the beginning of your revalidation cycle. An open maintenance case could delay your ability to begin your revalidation. If you are unsure which cycle you have been assigned to, please see the MaineCare provider revalidation schedule currently posted under the “Revalidate as a Current Provider” section of the MaineCare Provider Enrollment webpage.
MaineCare recommends that you review the updated Enrollment Checklists prior to revalidating or enrolling with MaineCare to verify that you have all the required documentation. The checklists include all new information related to the ACA that is required for MaineCare provider enrollment and revalidation for each provider type. Submitting an incomplete application may result in the delay or denial of your application.
MaineCare Services is committed to keeping you informed throughout the enrollment and revalidation process. We will offer free trainings through the Learning Management System (LMS) on topics related to enrollment and revalidation. Online webinar trainings will be scheduled throughout each of the revalidation cycles to offer a number of opportunities to attend each of the trainings. For additional information regarding provider revalidation training, please see the “Training Opportunities” section of the MaineCare Provider Enrollment webpage.
The following resources are available to assist you with the revalidation process:
Save Time and Effort: Submit Prior Authorizations (PA) through the MyHealth PAS Online Portal
Submitting a PA by logging into your Trading Partner Account on the portal will save you time and effort compared to submitting a PA by facsimile (fax).
Some benefits of submitting a PA through the portal include:
There is a potential for errors when keying information into the fax machine. By utilizing the portal, you minimize the possibility of this risk.
When faxing a PA, it can become lost or corrupt. By utilizing the portal, you minimize the chance of requests becoming lost or data becoming corrupt during transmission.
The portal requires you to complete specific fields before you can submit your PA request. If a field is left blank when submitting a PA by fax, the PA unit will request you to complete the fields and submit a new request before it can be processed. By submitting your PA request through the portal, you will ensure the request is complete and save time by avoiding multiple PA request submissions.
Although the PA still needs medical approval when submitted through the portal, you will receive a PA number immediately following submission. Many facilities require a PA number in order to schedule the service. This will allow you to schedule the service immediately after submitting the PA request.
The portal allows you to check the status of a PA online. You will no longer have to call to have someone check the status of your PA request for you.
Medically Urgent Prior Authorization (PA) Requests through the Health PAS Online Portal: Medically Urgent Field Added, CR 61353
An urgent field has been added to the Direct Data Entry (DDE) PA Request Screen on the Health PAS Online Portal. You now have the option to mark your PA as medically urgent before submitting the PA. Prior to this change, you were required to submit medically urgent PA request through fax or mail. We now encourage you to submit them through the portal.
Please note that this field should be utilized for medically urgent PA requests, not time sensitive ones.
If you have questions, please contact Provider Services at: 1-866-690-5585.
Sept 14th Correction Regarding Medically Urgent Prior Authorization (PA) Requests through the Health PAS Online Portal: Medically Urgent Field NOT Added, CR 61353
At this time, the Medically Urgent Field has NOT been added to the Direct Data Entry (DDE) PA Request Screen. It will added after testing is complete. Please see the e-message sent earlier today in error:
An urgent field has been added to the Direct Data Entry (DDE) PA Request Screen on the Health PAS Online Portal. You now have the option to mark your PA as medically urgent before submitting the PA. Prior to this change, you were required to submit medically urgent PA request through fax or mail. We now encourage you to submit them through the portal. Please note that this field should be utilized for medically urgent PA requests, not time sensitive ones.
If you have questions, please contact Provider Services at: 1-866-690-5585.
Maine Worker's Compensation Board:
INPATIENT FACILITY FEE SCHEDULE UPDATED - Effective 10/1/2017
The Board has updated its inpatient facility fee schedule (Appendix III) for dates of discharge on or after October 1, 2017. The fees are based on version 35 of the US Federal Government’s DRG Grouper for FY 18. Questions or concerns regarding the annual update may be addressed toKimberlee.Barriere@maine.gov.
Training Bulletin on Protected Health Information from the Office of Medical/Rehabilitation Services & Maine Worker's Compensation Board:
Brush up on Title 39-A M.R.S.A 208, which "allows for the release of medical information by health care providers to the employer without authorization if the information pertains to treatment of an injury or disease that is claimed to be compensable under the Act.
CLICK HERE to read download the Training Bulletin, which contains important details and definitions.
Register for the Maine Health Alert Network (MaineHAN) & Get important Public Health Updates:
Quality Payment Program Hardship Exception Application for the 2017 Transition Year Is Now Open
Clinicians can now submit Quality Payment Program Hardship Exception Applications through the Quality Payment Program Hardship Exception Application for the 2017 transition year via the Quality Payment Program website.
MIPS-eligible clinicians and groups may qualify for a re-weighting of their Advancing Care Information performance category score to 0% of the final score, and can submit a hardship exception application for any of the following reasons.
Insufficient internet connectivity
Extreme and uncontrollable circumstances
Lack of control over the availability of Certified EHR Technology (CEHRT)
For More Information, contact the Quality Payment Service Center at 1-866-288-8292 or TTY: 1-877-715-6222 or QPP@cms.hhs.gov.
Maine CDC Publishes Modified Opioid/PMP Rule
Friday, March 31st, saw the Maine CDC publish its "final" version of the opioid prescribing and PMP use rule. You can read the entire rule here.
Here are some of the new changes:
- the definition of "opioid medication" includes all controlled substances containing opioids, not just Schedule II drugs.
- the term "administer" is now defined.
- a prescriber's duty to review the PMP check done by a delegate is defined.
- prescriptions must include notations of the prescriber's DEA number; whether the pain being treated is acute or chronic; a notation of "acute" when prescription is for "acute on chronic" pain; and as any exemption being claimed
- notation of ICD-10 codes is only necessary when claiming the palliative care exemption
- a new exemption has been created for situations where a patient proves intolerant of a prescribed opioid and must get another (Code H)
- the rule sets out the types of information the CDC is looking for when reviewing PMP information
All physicians who prescribe opioids should review the new rule as soon as possible.
Electronic Opioid Prescribing Waiver Applications Now Available from Maine CDC
Maine's new opioid law, PL 2015 c. 488, includes a requirement that all opioid prescriptions be done electronically. Of course, there will be circumstances where that is either impossible, extremely difficult or burdensome. The Maine CDC has now (as of April 3, 2017) issued a waiver application that is available online at http://www.maine.gov/dhhs/samhs/osa/data/pmp/E-Prescribing-Waiver-and-Policy_Individual.pdf .
This is what the CDC says about the waiver requirements:
- "Waivers may be granted based on documentation by a practitioner that his or her ability to issue an electronic prescription is unduly burdened by: technological limitations that are not reasonably within the control of the practitioner; or other exceptional circumstances demonstrated by the practitioner. Detailed evidence of, technological limitations and other exceptional circumstances must be provided, including all steps that are being taken, in the interim, to meet this mandate. A waiver may be granted for a period determined appropriate by the department not to exceed twelve (12) months, although the Department may renew the waiver upon a new demonstration that the practitioner’s ability to issue an electronic prescription is unduly burdened."
CMS Releases New Resources to Help Clinicians Successfully Participate in QPP
CMS has recently revamped the look of the QPP website and also posted new resources to help clinicians successfully participate in the first year of the QPP. The following new resources have been posted to the website:
MIPS quick start guide: Outlines the steps clinicians participating in the Merit-based Incentive Payment System (MIPS) need to take between now and March 2018 to prepare for and participate in MIPS, including checking participation status, choosing to participate as an individual or as part of a group, deciding how to submit data, and selecting measures and activities.
Medicare Shared Savings Program and QPP fact sheet: Explains how the Shared Savings Program and the QPP align reporting requirements for participating ACOs and MIPS clinicians, and how certain tracks in Shared Savings Program ACOs meet Advanced Alternative Payment Model (APM) criteria under the QPP.
MIPS APM fact sheet: Provides an overview of a specific type of APM, called a "MIPS APM," and the special APM scoring standard used for those in MIPS APMs.
CMS releases "CAHPS for MIPS" conditionally approved survey vendor list
Physicians who plan on reporting the CAHPS for MIPS measure as one of their quality measures to satisfy MIPS requirements in 2017 must use a CMS-approved CAHPS for MIPS survey vendor. As conditionally approved survey vendors, these organizations have demonstrated they have the facilities, project experience and staff expertise required to conduct the 2017 survey administration with appropriate rigor, given the demands of the survey procedures and timeline.
Final approval of these organizations is dependent on satisfactory completion of CMS training and submission of a Quality Assurance Plan. A final list of the CAHPS for MIPS survey vendors approved by CMS to administer the 2017 survey will be made publicly available this summer.
Keep in mind, physicians who are reporting the CAHPS for MIPS measure must register and inform CMS by June 30, 2017.
An Update on Opioid Health Homes
MaineCare's new Opioid Health Home (OHH) program has begun accepting applications from organizations wishing to be considered for the designation. Amy MacMillan (previously Dix) at MaineCare can be reached at Amy.MacMillan@maine.gov. Currently, Section 93 Emergency Rule is in effect at https://www1.maine.gov/sos/cec/rules/10/ch101.htm/ Comments are being taken until May 18th. We encourage groups to submit comments at http://www.maine.gov/dhhs/oms/rules/proposed.shtml#anchor741339.
In addition, the Maine Office of Substance Abuse and Mental Health Services has a program to cover uninsured for MAT treatment. The coverage will be provided through contracts to agencies that are approved as providers for Opioid Health Homes. As applications are received and approved, the Office of Substance Abuse and Mental Health Services will reach out to OHHs to encumber funds. Mike Parks, Associate Director, DHHS, Office of Substance Abuse and Mental Health Services, can be reached at firstname.lastname@example.org for questions about this part of the program.