The Maine Osteopathic Association's Weekly E-Newsbriefs:

Important Updates & News Sent Weekly to your inbox.

Contact Amanda Richards, arichards@mainedo.org to sign up now!

 

This Week's E-Newsbrief: 

Welcome to the MOA E-newsletter for April 3rd, 2020:

  • MOA News: Announcing our Virtual Convention Keynote Phil Skiba, DO: Engineering the 2 Hour Marathon, Click Here to share how COVID-19 is affecting you, your practice and your patients.
  • News to Use: Good News: AACOM Announces Students Assist America program launching today in Ohio to deploy medical students to assist in COVID-19 Crisis, COVID-19- Latest News & Updates: Maine Up to 9 Deaths, 432 confirmed cases, Osteopathic Health Policy Fellowship Application information now available, New Physician Assistant Law Active in Maine
  • Public Health: FDA Relaxes Blood Donation Restriction, Maintaining Childhood Immunizations during COVID-19
  • Practice Management: Administration Provides Financial Relief for Medicare Providers
  • Classifieds: Belgrade Regional Health Center Seeks BC/BE Family Med Physician-- contact Communications@HealthReach.org

MOA News

2020 MOA Virtual Convention: June 5-7th, 2020
Now Announcing our Virtual Convention Keynote Speaker: Phil Skiba, DO


Register online for our virtual Convention HERE. 


ICYMI --An Important Message from your MOA President
David Scaccia, DO, MPH--March 27, 2020

Members-- Click Here to View


How are YOU Doing? Image result for check up

As Osteopathic Healthcare professionals, residents, students and support, our members are vital to the front lines of the COVID-19 Pandemic. 

Please tell us how COVID-19 is directly impacting how you practice, teach, study and even how its impacting you personally. As believers in the balance of the body, it is important we band together to ensure we can all find the balance amidst the chaos. 

*The information share here will not be distributed in any way and is intended to better assist the MOA in serving our members, your input is greatly appreciated*

Share Your Story With Us Here.

More to Come- We are working on an online community forum for members to easily
communicate with each other. Stay tuned!


News to Use

AACOM is Mobilizing the Future Health Care Workforce: Students Assist America

The health care system in the United States is in crisis due to the spread of the COVID-19. Shortages of equipment, supplies and personnel are devastating hospitals. As the disease hits more and more people across the nation, the number of fatalities is climbing exponentially. And yet, the non-COVID 19-related health care needs of millions of Americans still need to be met. Through the leadership of the American Association of Colleges of Osteopathic Medicine, thousands of students across the health professions will have an opportunity to answer that call.

Medical students and students from a variety of other health professions are being deployed in safe, clinically appropriate ways to help the nation’s health care system continue to function during this unprecedented pandemic. With a focus on students who have completed the majority or all of their clinical education, future physicians, physician assistants, nurses, social workers, public health experts and others have joined together as an interdisciplinary safety net to ensure that the weight of the COVID-19 emergency does not crush the daily operations of the health care system and put individuals and communities at further risk.

Students will only be assigned to health care settings where patient safety and their own personal health can be assured with proper supervision and the use of remote technologies. Working with institutions such as local hospitals, Departments of Health and Medical Reserve Corps units, these students will supplement the public health network to address the COVID response, and provide care matched to their education level and expertise. Core services could include chronic disease management; screenings; wound care; telehealth visits; mental health support and other assistance depending on the state and local need. The goal is to protect the public health by relieving the burden on medical staff who must focus on the specialized treatment for acute respiratory illness associated with COVID-19.

A model approach enabled by the Students Assist America collaboration is launching today in Ohio. Through a joint effort of Governor Mike DeWine, the Ohio University Heritage College of Osteopathic Medicine and the Ohio Department of Health, and with implementation help from the Ohio National Guard, the Ohio Medical Reserve Corps, the Ohio Association of Community Health Centers and the Ohio Association of Health Commissioners, the college’s entire 3rd year class of 250 students will deploy to local health agencies starting April 13.

In virtual class and online settings, students will receive immediate training in key areas such as general knowledge of COVID-19, appropriate use of personal protective equipment, quarantine, social distancing, and public health topics such as clinician wellness, epidemic preparedness, messaging and containment.

For more information on the Students Assist America mobilization, please contact Virginia Bader at the American Association of Colleges of Osteopathic Medicine at vbader@aacom.org.


 

Image result for coronavirus

COVID-19 Headlines

Notes from ME CDC Briefing: Sr. Shah April 3rd, 2020

Maine COVID-19 Data
Updated: April 3, 2020 at 12:00 PM
Confirmed Cases1 Recovered Hospitalized Deaths
432 113 75 9

Dr. Shah reported today that PPE shipments are going out to EMS, law enforcement, hospitals, and congregate livings centers. The dept. ordered an additional 300,000 N95 masks, which are expected to be delivered April 20th. although delays or international shortages make delivery of full order unlikely. He also addressed the number of ICU beds and other crucial equipment and staff: Using 110 out of 289 ICU beds in Maine. Total of 324 ventilators, 267 available. 200 Alternative ventilators are available. 120 Respiratory Therapists currently available to Maine's hospitals. 

In answer to the rhetorical "Is social distancing working?" Dr. Shah reported that traffic volume in Maine has decreased 50% since measures were enacted, and an additional 17% since the Gov's Stay at Home Order on Tuesday.

Dr. Shah also acknowledged that this is a disorienting time. Science fiction is now science fact. Many feel like this is a dream. However, Dr. Shah emphasized that we are in control of the outcome of this story. We are working to write the next chapter and he urged Mainers to have faith and continue to take the advised measures to protect themselves and others. 

Other New Headlines/Updates:

Number Of Confirmed Coronavirus Cases Around The World Passes One Million

USA Today (4/2) reports that as of Thursday, there are more than 1 million confirmed cases of coronavirus in the world. However, the number was probably reached earlier, because of untested cases including “asymptomatic individuals; people who may have died of complications of the virus without anyone knowing it; and those whose symptoms were not serious enough to qualify for testing.”

        The Hill (4/2) reports that the US “has more than 234,000 cases and 5,600 deaths,” while “Italy and Spain follow with more than 115,000 and 110,000 cases, respectively, and over 24,000 deaths between them.” Meanwhile, China has “reported more than 82,000 cases and 3,300 deaths from the virus, though U.S. intelligence agencies have reportedly concluded that Beijing has underreported both the total number of cases and confirmed deaths.”

        Newsweek (4/2) reports that in the US, “New York continues to report the country’s highest number of cases, with more than 83,700 confirmed infections to date, including 47,439 cases in New York City, the office of New York Governor Andrew Cuomo confirmed as of Wednesday.”

 

Researchers Say Diarrhea Can Be First Or Only Symptom Of Coronavirus Infection

Newsweek (4/2) reports researchers found that “diarrhea may be the first or only symptom” for some patients with coronavirus, according to a study (PDF) published in The American Journal of Gastroenterology. The study “involved 206 patients at the Union Hospital, Tongji Medical College, in Wuhan,” and “the patients were classed as having mild...cases as they didn’t have shortness of breath or respiratory distress, and had a relatively high blood oxygen saturation level.”
 

Governor Mills Issues Stay Healthy at Home Mandate--March 31, 2020-Governor Janet Mills today issued a series of substantial new mandates to protect public health and safety in the face of COVID-19, including a Stay Healthy at Home directive that requires people living in Maine to stay at home at all times unless for an essential job or an essential personal reason, such as obtaining food, medicine, health care, or other necessary purposes. The Executive Order takes effect at 12:01 a.m. on April 2, 2020 and will last until at least April 30, 2020. The Governor may amend, rescind, or renew this timeline at her discretion. The Governor also extended the closure of restaurants and bars statewide for dine-in customers until at least April 30, 2020 to align with today’s Executive Order.

The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) -- Passed into law 
Highlights of Provisions Most Relevant to Physicians and Medical Students from the AOA (see 
attached) The AOA has a running list of FAQs relating to COVID-19 on their website. Take a look here.
 
CMS Updates-- Courtesy of FSMB

(Monday, March 30th), CMS announced the release of additional blanket waivers to address hospital staffing issues and to increase access to Medicare telehealth services during this COVID-19 national emergency. As you know, CMS had already put in place several “1135 Waivers” that have been available on the FSMB COVID-19 Website. The new CMS Fact Sheet outlines the additional blanket waivers and clarifies certain elements of waivers that had already been released – including the need for practitioners to follow state licensure laws and emergency waivers when practicing across state lines. The fact sheet released yesterday is available here.

CMS also released an Interim Final Rule with Comment Period (CMS-1744-IFC) that revises several Medicare and Medicaid regulations in response to the COVID-19 national emergency, including approved telehealth services. As of today, this IFC can be viewed here.

Board of Osteopathic Licensure Experiencing Phone Issues-- State office phones have been having sporadic connectivity issues since Monday, March 30th. If you are trying to reach the Maine Board of Osteopathic Licensure and not able to get through, please use the Board's cell phone number cell at 207/446-4205 for urgent licensing matters/questions.

The DO Board also has an emergency COVID-19 locum tenens license – issued for 90 days. Click Here for more info. Please tell your colleagues that may be interested! 

Other Important Licensing Note: Gov. Mills Executive Order Keeps DO/MD Licenses from expiring or needing to be renewed for 30 days after the declaration of the emergency (including CME requirements): It Also:

  • Allows the expedited licensure (at no cost) of qualified retired physicians and physician assistants to provide assistance for the duration of the emergency;
  • Allows the expedited licensure (at no cost) of qualified physicians and physician assistants licensed in other jurisdictions to provide assistance for the duration of the emergency;
  • Suspends the requirement of supervision or collaboration for nurses and physician assistants for the duration of the emergency;
  • Maximizes the use of telemedicine and telehealth and eliminates the need for some in-person patient visits for the duration of the emergency by: Allowing voice-only technology to be used; and Suspending any laws or rules related to state medical record privacy and HIPAA that would interfere with the use of telemedicine and telehealth technology.

Maine Responds-- Option to register as willing to provide services during a disaster or emergency situation. The registration system will collect basic information about you and your professional skills. Maineresponds.org 

Webinars/ Updates:

  • Maine CDC Weekly Updates for Clinicians-- Thursdays at 12:30PM-- New Call-in: https://zoom.us/j/399715702?pwd=MmNwUUZKa2Nldm1BSmV1SHhHQWJiZz09 Meeting ID: 399 715 702, Password: 348750 Dial:+16465588656,,399715702# US (New York)
  • Telehealth Town Hall for Maine Healthcare Providers -- Held March 26.Nearly 1,000 participated. If you missed it, here  is a Link to the Telehealth Town Hall Recording, 
  • AOA is hosting frequent webinars on Teleheath, which you can findon their COVID-19 Response Page here.

COVID-19 Resources for DOs, By DOs

The AOA recently shared these resources on The DO. The information in these resources is not endorsed by the AOA or the MOA.

Below are two COVID-19 resources that family physician Frances Southwick, DO, recently shared with the AOA, and two telemedicine workflow charts shared by Michael Brown, DO.

Telehealth or office visit decision tree for reception staff: Michael Brown, DO, created this workflow chart for the reception staff at his Missouri health system, which fully blends live patient visits with telemedicine visits. The chart encourages reception staff making appointments for Medicare and Medicaid patients to set up remote appointments whenever possible.

Telehealth visit workflow chart: Dr. Brown also created this chart to help guide the check-in and followup process for telehealth appointments. Learn more about the recent changes to telemedicine regulations here.

COVID-19 patient recommendation information sheet: Dr. Southwick created this information sheet that physicians can provide to patients who likely have COVID-19. It’s a Word document that physicians can personalize with local information and their clinic’s details.

COVID-19 phone screening tool for acutely ill patients: Dr. Southwick also created a phone screening checklist for physicians conducting interviews with acutely ill patients to determine if they are likely to have COVID-19. Common answers to common questions are ranked concerning, equivocal and less concerning, and physicians can tally all the responses for visual guidance in determining a patient’s likelihood of having COVID-19.


Being a Physician Assistant. What New Maine Law Takes Effect Concerning Physician Assistant Scope of Practice
Adapted from MMA's Maine Medicine weekly Update April 1, 2020

LD 1660, An Act To Improve Access to Physician Assistant Care, was signed into law by Governor Mills on March 18. Because it was amended by the Legislature as an emergency law consistent with legislative rules in response to the COVID-19 pandemic, the law was effective the day it was signed. MOA, AOA, MMA and many other groups voiced reservations with many of the provisions of this legislation in stakeholder meetings and committee meetings at the legislature.

What The New Law Does

  • Eliminates the requirement that physician assistants render care under the supervision and control of a physician and by extension any ‘plan of supervision.’
  • Eliminates the requirement that physician assistants complete a training program approved by the licensing board(s)
  • While physician assistants will still be required to be licensed, the new law eliminates the registration requirement. Licensure can still be obtained by the physician assistants’ choice of licensing boards.
  • Allows physician assistants to delegate “certain activities relating to medical care and treatment” to the “physician assistants employees, support staff or members of the health care team” and accepts liability for delegation.
  • The Board of Osteopathic Licensure and the Board of Licensure in Medicine will jointly adopt rules for the licensure and practice of physician assistants. Rules may include but are not limited to:
  • Education requirements: Requirement for collaborative agreements and practice agreements (*replaces a written plans of supervision)

Scope of Practice

Physician assistants “may provide any medical service” as “prepared by their education, training and experience and is competent to perform.” The scope is to be determined by practice setting  and includes hospitals, physician employers “or an independent practice setting” among others with a system of credentialing and granting of privileges.

Collaborative Agreements

  • For physician assistants with LESS than 4,000 hours of documented clinical practice
  • Collaborative agreement is defined as a document agreed to by a physician assistant and a physician that describes the scope of practice as determined by the practice setting and describes the decision-making process for a health care team including communication and consultation among health care team members. A “health care team” and ‘may’ include a physician. Other professions listed are, APRN, physical therapist, occupational therapist, speech therapist, social worker, nutritionist, psychotherapist, counselor, or other licensed professional.
  • Physician assistants with less than 4,000 hours of practice must work under a collaborative agreement. They may, however, used a system of credentialing and granting of privileges and scope of practice agreement from a health care facility in place of a formal individual collaborative agreement.
  • The collaborative agreement, or scope of practice agreement must be sent to the Board of Osteopathic Medicine or Board of Licensure in Medicine for approval.
  • (Note: while the agreement needs to be between the PA and physician, there’s no requirement that the decision-making process, communication or consultation needs to be with a physician, although the physician has ultimate control over that process through development of the collaborative agreement).

Practice Agreement

  • For physician assistants with MORE than 4,000 hours of documented clinical practice
  • Defined as, “a document agreed to by a physician assistant who is the principal clinical provider in a practice and a physician that states the physician will be available for collaboration or consultation.” 
  • Physician assistants may be the principal clinical provider in a practice without a physician partner but must have a practice agreement with a physician, “and other health professionals as necessary,” that describes the physician assistant’s scope of practice. The practice agreement must be approved by the Board of Osteopathic Medicine or Board of Licensure in Medicine. 
  • A special paragraph in the law states the sections covering scope of practice, consultation, collaborative agreements and practice agreements “must be liberally construed” to authorize physician assistants to work at the full extent of their education, training and experience in accordance with their scope of practice as determined by their practice setting. 

Consultation

A physician assistant SHALL consult, with, collaborate with, or refer the patient to an appropriate physician or ‘other health care professional’  when indicated by consideration of a patient’s condition along with the education, competencies and experience of the physician assistant, and standard of care. The level of consultation will be determined by the practice setting. The law does require that a physician must always be available to a physician assistant  for consultation. (Note: According to this definition the consult could be with another physician assistant as defined by ‘health care professional’ and ‘practice setting’ includes ‘private practice.’ The law does not prohibit physician assistants from opening their own private practice.)

Prescriptive Authority

Allows physician assistants to prescribe schedule II through schedule V and will be allowed to dispense prescription or legend drugs only when a pharmacy service isn’t available, it’s in the best interests of the patient or in an emergency.

Miscellaneous Provisions

  • Physician assistants are considered primary care providers and/or medical practitioners and/or health care professionals under:
  • managed care health insurance plans,
  • laws concerning drawing blood specimens to determine OUI,
  • probate court guardianship matters,
  • expediated partner therapy,
  • minors and abortions,
  • employee substance use testing,
  • provision of care concurrent with emergency medical services

One physician assistant will be added to the Board of Osteopathic Licensure AND the Board of Licensure in Medicine.


Maine COVID Sitters - UNE Students are volunteering to provide childcare, pet services, and household support to those on the front line of the COVID-19 pandemic. 

A little bit about how our program works: we are a group of health care professional students (DO, MD, PA, dentistry, pharmacy, etc) in and around Portland, Maine, modeled after the MN CovidSitters. Using this intake form you can identify your needs, may they be child care, pet walking, grocery or pharmacy runs. You will then be connected with a  “pod” of 1-5 students who will provide support solely to your family. This is done to distribute the responsibilities evenly among students who still have academic requirements, and promote social distancing in accordance with CDC guidelines. You will then be able to coordinate with your pod to get the services that you require. Please know that we are students and not certified childcare providers, nor are these services affiliated with our respective institutions. 

We encourage you to share this information widely, so we will be able to reach any and all health care workers that need a helping hand.  We are attaching a document of frequently asked questions to address any concerns you may have. If you have any additional questions or concerns, you can contact us at maineCOVIDsitters@gmail.com


Urgent Call to Action from the Maine Association of Psychiatric Physicians

COVID-19 is an unprecedented challenge to Maine. Our front line clinicians will soon be dealing with a much greater volume of patients at a time when we have no specific vaccine, limited testing, and little to offer in the way of specific treatment. Our colleagues will soon be facing extremely difficult situations with large numbers of critically ill patients and at the same time the lack of sufficient beds, ICU capacity and shortages of medications, supplies and personal protection equipment. OUR MAINE FRONT LINE PROVIDERS ARE ALREADY FEELING STRESSED. COVID-19 WILL IMPACT OUR COLLEAGUES AND THE EFFECTIVENESS OF THE HEALTHCARE SYSTEM ON WHICH WE ALL RELY.

MAPP is partnering with Maine psychologists, social workers, Psych NP's and PA's and other mental health professionals to SUPPORT our clinical front line staff and first responders during this crisis. We will do a short training with on volunteers on the principles of Psychological First Aid. We will connect with particular clinicians or organizations that have requested assistance from us. We will be helping out 'virtually', on-line or by phone, in pairs or teams. We will stay connected with our front line providers as long as there is a need and we will all make it through this, together.

ALL OF US CAN HELP. Many of us are appropriately "sheltering in place" at home at the moment- WE CAN GIVE MUCH NEEDED SUPPORT WITHOUT LEAVING OUR HOME. Whatever amount of time you can give will make a difference.

It's easy to participate. To start, please complete the following SHORT QUESTIONNAIRE:    https://www.surveymonkey.com/r/3B7X822

We will be in touch shortly with more information. Thank you for helping to make a difference!

Edward Pontius, MD, DLFAPA 
Portland, Maine


Osteopathic Health Policy Fellowship

The application cycle for the Osteopathic Health Policy Fellowship Class of 2020-2021 is now open.

As you may know, the Fellowship is designed for practicing and/or teaching osteopathic physicians and osteopathic college faculty and staff who are preparing for leadership roles in the profession and positions of influence in health policy.  Fellows are required to attend an intensive academic orientation and nine additional three-day seminars across the year.  Between monthly seminars, Fellows are expected to devote a minimum of 20 hours to reading, research, and completing written assignments.

Graduates of the program join a cadre of health policy experts from which the profession can draw to staff committees and task forces at the federal and state levels, testify on issues relevant to osteopathic medicine and education, and develop policy positions.  The AOA, AACOM, specialty groups, and state and regional associations have supported the program continuously since its beginning.

October 4-6:          University of New England College of Osteopathic Medicine

Please note – all dates are confirmed at this time.  COVID-19 and other circumstances may result in altering the dates of some sessions.

Working with the AACOM staff, we have revised the application to be more user friendly and to expedite the review process.  The main application uses type-in-boxes, drop down lists, and radio buttons to increase efficiency and to provide more uniform information.  All supporting materials (personal statement, CV/resume, and letters of reference) are  uploaded electronically.  Applicants are advised to review the schedule to assure full participation in the program.  All application materials must be completed by April 26, 2020, with acceptance decisions made in mid-May.

Please forward this information widely and encourage applications to the Osteopathic Health Policy Fellowship Class of 2020-2021 at the following link:

https://research.aacom.org/jfe/form/SV_eJ2cmfRxOVqkAip

If you or the applicant have questions or require additional information, please contact Al Pheley, Co-Director at alpheley@gmail.com.


The State of Maine will hold its second annual Governor Mills Opioid Response Summit:  Compassion, Community, Connection on July 23rd and 24th, 2020 at the Cross Arena in Bangor Maine.  
Expanding on the success of our past conference this summit will focus on leadership, prevention, overdose rescue, treatment and recovery within the opioid epidemic.  It is being designed to enlighten, inform, and assist in our strategy of reducing negative health and economic impacts of opioid use disorder on individuals, families, and the communities in Maine.

The Opioid Response Summit Committee invites you to participate in our call for presentations in a wide variety of topics to best meet the interests and learning needs of our attendees. Proposals from individuals and panels are accepted. Multidisciplinary panels are encouraged and include perspectives from physicians, nurses, psychologists, basic scientists, pharmacists, recovery support and people in recovery. Proposals that include both basic and clinical science are encouraged.  

Call for abstracts deadline extended to April 18th- more information here.


Public Health Updates

Private labs urged to report COVID-19 test results to OSDH daily ...Important Information from Maine CDC on COVID-19 Testing

1. Testing at state lab (HETL): 
Testing at state lab (HETL) as of March 25, 2020. Maine now meets U.S. CDC’s criteria for a Moderate level of community transmission. At present, a limited national supply of laboratory materials inhibits Maine’s testing capacity. Therefore, consistent with U.S. CDC guidelines, Maine is now creating a prioritization system to test individuals in high-risk categories.

To preserve Maine’s specimen collection and testing supplies for patients who may develop severe COVID-19 illness over the coming months, effective immediately, Maine Health and Environmental Testing Laboratory (HETL) will prioritize testing to high-risk individuals and will only accept specimens for testing from symptomatic individuals who have fever or respiratory symptoms and who fall into one of the following high-risk categories: 

Tier 1:
- Those who are hospitalized
- Health care workers
- First responders (e.g., EMS Police, Fire)

- Patients living in congregate setting (e.g., LTCFs, group homes, assisted living facilities, jails, shelters)

Tier 2:
- Patients older than 60 years
- Patients with underlying medical conditions

Testing within these categories is likely to be prioritized further based on availability of laboratory materials.  Presently the emphasis will be on groups within Tier 1.  This guidance is in general accordance with U.S. Department of Health and Human Services (DHHS) recommendations for prioritizing COVID-19 testing for individuals.
 
Note:
- Samples sent to HETL that do not have completed paperwork or that do not meet one of the above criteria will be discarded.
- Samples from individuals who do not fall into any of these six categories should be sent to a commercial laboratory.

2. Swabs for testing: 
U.S. CDC now recommends collecting a single nasopharyngeal (NP) swab in viral transport media. Throat (OP) swabs are no longer required.

3. Lab Results: 
HETL will send lab results only to the ordering provider.  Maine CDC and HETL do not release results to individuals. U.S. CDC has stated that any positive results from a commercial or state lab will now be considered final and confirmed.

4. Discontinuation of home isolation without testing: 
On March 16, 2020, US CDC released Interim Guidance on Discontinuation of Home Isolation for Persons with COVID-19.  Patients have to be fever-free (without the use of fever-reducing medications) for 72 hours and have to have improvement in respiratory symptoms (cough or shortness of breath).  If this timeframe means it is less than 7 days since symptom onset, they have to wait until 7 days after onset of symptoms before they can be released from isolation.

5. Keep up to date with COVID information from key state agencies and patient populations:

6. Sign up for Maine CDC’s Health Alerts (HANs) here 
Please sign up UNDER THE ORGANIZATION THAT YOU WORK FOR. The CDC receives a lot of new account requests from folks who work one place, but think they need to sign up under the CDC, DHHS, and MEMA.  If you work at a hospital, you will find your facility under “Hospitals” – the same is true for FQHCs.


FDA Relaxes Restrictions On Blood Donations From Men Who Have Sex With Men

The New York Times (4/2) reports the FDA announced “it was significantly loosening its recommendations for blood donations from gay and bisexual men, reducing the amount of time men who have had sex with men should wait before they give blood to three months from one year in hopes of ameliorating a drastic drop in supply during the coronavirus pandemic.” In a statement, the agency said “current policies regarding certain donor eligibility criteria can be modified without compromising the safety of the blood supply.”

        CNN (4/2) reports the FDA “is also making changes to its blood donation guidelines for people who have traveled to countries where malaria is endemic – the recommended deferral period changes from 12 months to 3 months.” In addition, “for people who spent time in European countries or military bases where there was risk of transmission of Creutzfeldt-Jakob disease or variant Creutzfeldt-Jakob disease, the agency is eliminating recommended deferrals.”


Maintaining Childhood Immunizations During COVID-19 Pandemic

The COVID-19 pandemic is changing rapidly and continues to affect communities across the United States differently. Some of the strategies used to slow the spread of disease in communities include postponing or cancelling non-urgent elective procedures and using telemedicine instead of face-to-face encounters for routine medical visits.

Ensuring the delivery of newborn and well-child care, including childhood immunization, requires different strategies. Healthcare providers in communities affected by COVID-19 are using strategies to separate well visits from sick visits. Examples include:

  • Scheduling well visits in the morning and sick visits in the afternoon
  • Separating patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits.
  • Collaborating with providers in the community to identify separate locations for holding well visits for children.

Because of personal, practice, or community circumstances related to COVID-19, some providers may not be able to provide well child visits, including provision of immunizations, for all patients in their practice. If a practice can provide only limited well child visits, healthcare providers are encouraged to prioritize newborn care and vaccination of infants and young children (through 24 months of age) when possible. The U.S. CDC and Maine CDC are monitoring the situation and will continue to provide guidance as it becomes available. Should you have additional questions, please feel free to call the Maine Immunization Program at 207-287-3746.


Practice Management

Administration Provides Financial Relief for Medicare Providers
Action comes to aid providers and suppliers facing challenges in responding to COVID-19 pandemic

Under the President’s leadership, the Centers for Medicare & Medicaid Services (CMS) is announcing an expansion of its accelerated and advance payment program for Medicare participating health care providers and suppliers, to ensure they have the resources needed to combat the 2019 Novel Coronavirus (COVID-19). This program expansion, which includes changes from the recently enacted Coronavirus Aid, Relief, and Economic Security (CARES) Act, is one way that CMS is working to lessen the financial hardships of providers facing extraordinary challenges related to the COVID-19 pandemic, and ensures the nation’s providers can focus on patient care. There has been significant disruption to the healthcare industry, with providers being asked to delay non-essential surgeries and procedures, other healthcare staff unable to work due to childcare demands, and disruption to billing, among the challenges related to the pandemic.

“With our nation’s health care providers on the front lines in the fight against COVID-19, dollars and cents shouldn’t be adding to their worries,” said CMS Administrator Seema Verma. “Unfortunately, the major disruptions to the healthcare system caused by COVID-19 are a significant financial burden on providers. Today’s action will ensure that they have the resources they need to maintain their all-important focus on patient care during the pandemic.”

Medicare provides coverage for 37.4 million beneficiaries in its Fee for Service (FFS) program, and made $414.7 billion in direct payments to providers during 2019.  This effort is part of the Trump Administration’s White House Coronavirus Task Force effort to combat the spread of COVID-19 through a whole-of-America approach, with a focus on strengthening and leveraging public-private relationships.

Accelerated and advance Medicare payments provide emergency funding and addresses cash flow issues based on historical payments when there is disruption in claims submission and/or claims processing. These expedited payments are typically offered in natural disasters to accelerate cash flow to the impacted health care providers and suppliers. In this situation, CMS is expanding the program for all Medicare providers throughout the country during the public health emergency related to COVID-19.  The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.

To qualify for accelerated or advance payments, the provider or supplier must:

  • Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/ supplier’s request form,

  • Not be in bankruptcy,

  • Not be under active medical review or program integrity investigation, and

  • Not have any outstanding delinquent Medicare overpayments.

Medicare will start accepting and processing the Accelerated/Advance Payment Requests immediately. CMS anticipates that the payments will be issued within seven days of the provider’s request.   

An informational fact sheet on the accelerated/advance payment process and how to submit a request can be found here: www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf

This action, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Coronavirus Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.


CMS COVID-19 REGULATORY UPDATE

New Expanded Telehealth Services During COVID-19 Public Health Emergency
On March 17, the U.S. Department of Health and Human Services (HHS) used its authority granted under section 1135 of the Social Security Act and the Coronavirus Preparedness and Response Supplemental Appropriations Act to waive certain Medicare telehealth restrictions during the COVID-19 nationwide public health emergency.

Details on Centers for Medicare & Medicaid Services (CMS) policy changes and guidance are available in a new AOA practice guide.

For MaineCare Telehealth Guidance, click here.

HIPAA Enforcement Relaxed for Telehealth Platforms
Additionally, the HHS Office for Civil Rights (OCR) is exercising its enforcement discretion and, effective immediately, will not impose penalties on physicians using telehealth communication tools that are not Health Insurance Portability and Accountability Act (HIPAA) compliant.  Under the OCR notice, physicians may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype. Physicians should not use Facebook Live, Twitch, TikTok or other public facing communication services.

New CPT Code for COVID-19 Testing

CMS has adopted the new Common Procedure Coding System (HCPCS) codes to use for COVID-19 testing. Details on the new codes can be found on the AOA’s new COVID-19 resource page.


MOA Medical Economics Updates & Useful Info

MOA Staff attended the AOA's LEAD meeting in February 2020, where Cindy Penkala, Director of Practice Management and Education for the AOA gave a great update on Pesky Payers.  See slides 24-45 for tips on OMT documentation and management of appeals and audits.

February 7th Medical Economics Committee Co-Chair Kiran Mangalam, DO addressed the membership to share an update on the committee's work over the past year. You can view the slide presentation here.
 
The Committee Supported two educational sessions during the Midwinter Symposium from Edward Roche, PhD, JD and Thomas Force, Esq. on all things billing/coding, audits and recoupments. Slides for both presentations are below.

Recoupments-- Thomas Force, Esq.
Dealing with Audits, Edward Roche, PhD, JD

Quick Resource Links:

Maine Osteopathic Association
Phone: 207-623-1101
Email: info@mainedo.org

AOA Physician Services
Phone: (888) 62-MYAOA
Email: physicanservices@osteopathic.org

AOA Private Payor Advocacy Page:

https://osteopathic.org/practicing-medicine/business-of-medicine/private-payer-
advocacy/?_zs=WxmiD1&_zl=vjNV5

Sign up for the AOA's Quarterly Newsletter: https://osteopathic.org/private-payer-newsletter-
signup/?_zs=J0wiD1&_zl=9TcW5

 

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Classified Ads & Job Postings

Belgrade Regional Health Center Seeking BC/BE Family Medicine Physician 

Belgrade Regional Health Center seeks Physician (BC/BE in Family Medicine) to provide primary care to people of all ages. As a NCQA-Patient-Centered Medical Home, the health center offers accessible, high quality healthcare with integrated behavioral health services.

Founded in 1977, we serve over 2,300 residents and travelers each year. We reside in the peaceful, picturesque, and welcoming Belgrade Lakes region in the heart of central Maine, renowned for its chain of seven sparkling lakes and abundant streams. We offer competitive salary and benefits, pension plan with employer match, malpractice coverage, and loan repayment options. EOE. Contact: Recruiter, HRCHC, 10 Water Street, Suite 305, Waterville, ME 04901 | (207) 660-9913 | Fax: (207) 660-9901 | Communications@HealthReach.org | www.BelgradeCHC.org

Belgrade is a practice of HealthReach Community Health Centers, a system of eleven Federally Qualified Health Centers in Central and Western Maine. Dedicated providers deliver high quality medical and behavioral health care to citizens in over 80 rural communities. To ensure access for everyone, HealthReach accepts Medicare, MaineCare and major insurances. In addition, a sliding fee program is available to uninsured and underinsured residents as well as assistance with applications for programs that help with the cost of health care and medications including the Health Insurance Marketplace. A private, non-profit with a 44-year history, HealthReach is funded by patient fees, grants and individual donations.


 


 

Position open:  Assistant/Associate Clinical Professor/Department of Primary Care at UNE COM. This position involves clinical work with MatureCare and potential teaching assignments on campus. Please open the below link for details. Contact Daniel M. Pierce, D.O., Associate Professor of Clinical Medicine and Medical Director of MatureCare with questions and interest. Dpierce3@une.edu

 

 https://une.peopleadmin.com/postings/6574


Image result for McManus osteopathic treatment tablesIconic McManus Osteopathic Treatment Tables $100 Or Best Offer

 

 

Early 1900's classic McManis White Porcelain and Brass antique exam table. Available for pickup in Southern Maine. 

 

Contact Ira Stockwell, DO -- 207-232-8235 or 207-854-1143

 

 

MOA Upcoming Events:

Click Here for more info about our Virtual Convention

 

Save the Date for 2021 Events:

2021 Midwinter Symposium
February 12-14th, 2021

Holiday Inn by the Bay, Portland, ME

110th Annual Convention
The Samoset Resort, Rockport, ME
June 11-13, 2021

 


 

Visit docme.org to get your CMEs from home.


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Check out our website for the latest updates on the conference, including the latest topics and speakers. 


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© Copyright 2020
Maine Osteopathic Association, PO Box 315, Manchester, ME 04351
www.mainedo.org | P. 207.623.1101 |  F. 207.623.4228