Implications of the CARE Act for prescribers and data protection

News and announcements

MMS thanks members for strong advocacy efforts

Alain A. Chaoui, MD, president of the Massachusetts Medical Society, this week released a video message to colleagues, Gov. Charlie Baker, and the Massachusetts Legislature expressing on behalf of the organization his thanks for their high-impact and effective advocacy efforts during recent months. Dr. Chaoui lauded his peers for their advocacy-based action and Massachusetts lawmakers for listening to the voices of physicians and patients when considering measures that affect public health. Dr. Chaoui encourages all MMS members to contact him with any concerns and to share with their colleagues the recent success of advocacy work done on behalf of their patients and their profession. To watch the 3-minute video, click the button below. Scroll down this email for relevant updates stemming from the CARE Act addressing the opioid crisis.

MDPH: Increase in opioid overdose with cocaine use

The Massachusetts Department of Public Health (MDPH) reports a significant increase in opioid-related deaths associated with concurret cocaine use, and cocaine now surpassing heroin in opioid-related deaths. Fentanyl presence is increasing and is now a factor in nearly 90 percent of opioid-related deaths. Fentanyl has particularly rapid onset and samples of illicit fentanyl have highly variable potency. People who use cocaine, who do not have tolerance to opioids, and are not familiar with the risks of opioid overdose are at exceptionally high risk when using cocaine with fentanyl present. Similar risks could emerge among people who use methamphetamine. Click the button below to read the MDPH and Bureau of Substance Abuse Services (BSAS) advisories.  

MDPH recommends that providers: 

• Educate patients about the dangers of the potential presence of fentanyl in illicit drugs, and the danger of mixing opioids with other substances, including alcohol
• Encourage those who use drugs, and their families and friends, to carry naloxone
• Administer naloxone in drug overdoses when non-opioids are suspected or indicated; emergency services should be present until the patient is discharged
• Refer patients with Substance Use Disorder for treatment: The BSAS requires its licensed and contracted providers to appropriately assess and use all available screening tools for all individuals regardless of the substance they are using, and not to deny treatment access based solely on the type of primary substance used or polysubstance use

2018-19 influenza recommendations

The Advisory Committee on Immunization Practices (ACIP) recently released its influenza vaccination recommendations for the 2018-19 flu season. Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Changes include a recommendation that LAIV4 may be administered to those for whom it is appropriate, and that persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine, including (IIV, RIV4, or LAIV4). Resources include:

• Influenza Recommendations for the 2018-19 flu season
• Summary of Recommendations, viewable either as an interactive  website or as a  4-page pdf document
• Current CDC influenza Vaccine Information Statement (VIS)
• Influenza VIS in other languages and additional tools
• Questions about flu vaccine recommendations? Call (617) 983 6800 and ask for an immunization epidemiologist
• Questions about state-supplied flu vaccine availability and ordering? Call (617) 983 6828

Symposium on Men's Health (Oct 11)

Join the MMS Committee on Men’s Health for the 16^th Annual Symposium on Men’s Health. The event will include a reception, networking, and the presentation of the 2018 Men’s Health Awards. The evening’s CME program will address The First Penile Transplant: The Surgeons and Patient Report. The event will be held on Thursday, October 11, 5:30 – 9:00 p.m., at MMS Headquarters, Waltham. Space is limited. For more information including CME accreditation, and to register, click the button below or call (800) 843-6356.

Forum: Challenges in immigrants' health care access (Oct 17)

This unique event brings together active advocates to discuss the challenges affecting immigrant health care access — especially undocumented immigrants — locally, given the political climate nationwide. Find out about the physician’s responsibilities and resources available on the state and community levels, as well as non-profit health care and law organizations. This free event is on October 17 at the MMS Headquarters, Waltham. It is hosted by the MMS Committee on Senior Volunteer Physicians; for information and registration, click the button below.

MassHealth Payment and Care Delivery Innovation Phase III: Community Partners webinars

Webinars during September will introduce the MassHealth Community Partners (CP) Program. This program is available to MassHealth members with complex Behavioral Health (BH) and Long-Term Services and Supports (LTSS) needs enrolled in ACOs and MCOs, as well as certain MassHealth members enrolled in the Department of Mental Health’s (DMH) Adult Community Clinical Services (ACCS). The 1-hour webinar (which runs four more times) is open to all providers. Primary care providers, practice managers, and physician group administrators are strongly encouraged to attend. To register, click the button below to visit the MassHealth Learning Management System (LMS); create your profile and select your preferred course.  

Convergence 2018: Executive conference (Nov 5–7) 

Join your peers to explore the deeper collaboration that convergence allows. Convergence lets providers and payers operate independently while leveraging each other’s strengths to optimize care delivery. Convergence 2018 is a two-day conference in Boston providing a forum for decision-makers from across the health care sector to discuss and learn from one another. Conference sessions will provide specific, concrete examples of the strategies and enabling technologies that are key to solving today’s care gaps, redundant workflows, and expensive, confusing patient experiences. This event will offer CME credits. A large discount on tickets is available to verified providers. Click the button below for more information and registration. 

Democratizing Healthcare: Conference (Oct 17)

The Society for Participatory Medicine is holding its annual conference on October 17 at the Seaport World Trade Center. Unlike other conferences, SPM2018 brings together patient, caregiver, doctor, nurse, healer, nutritionist, trainer, therapist, and others. The event will feature Participatory Medicine Heroes — people who’ve partnered with others to make change and understand the value of diversity — and enables you to join their ranks. For more information and registration, click the button below.

Apply for a LGBTQ health disparities grant: Due Oct 5

The MMS is currently accepting grant proposals from medical students and residents/fellows whose curriculum development or research addresses health disparities in the LGBTQ community. Grant proposals are due October 5. Download the  Application and Guidelines; click the button below.

What’s up in advocacy and policy

Inside the CARE Act: Protections for prescribing data

Over the next few weeks, VSTW will feature relevant sections of the CARE Act, the recent substance use disorder treatment bill passed by the legislature in July.

A provision contained in the CARE Act, supported by the MMS and the ACLU, has increased the requirements for law enforcement officers seeking to access prescribing data in the prescription monitoring program. Before the passage of this bill, law enforcement could access any prescribing data related to a “bona fine investigation.” Many raised concerns that this could allow local prosecutors to broadly access prescribing data related to any overdose investigation and lead to the erroneous filing of complaints by licensing boards. Law enforcement will now need to establish probable cause, and apply for a warrant, prior to accessing prescribing data. For more information about the CARE Act, click the button below.

Reminder: Change to MassPAT requirements

Please click on the social media buttons (below right) to share this announcement with your networks.

The CARE Act addressing the opioid crisis has slightly changed prescribers' requirements regarding MassPAT, the state’s prescription monitoring program. Prescribers are now required to query MassPAT before issuing every benzodiazepine prescription. Previously, MA law required such a query only before the first benzodiazepine prescriptions (as well as before all schedule II and III narcotic prescriptions). The MMS encourages physicians to develop systems, including the use of delegates when appropriate, to ensure regular querying of MassPAT, especially for patients with long-term benzodiazepine and narcotic prescriptions. To read more about MassPAT, click the button below.

Reminders: Stuff you should click on

Practice management helpline: Call or email free

Ever feel you could use a helpline for practice management issues? You have one. The Physician Practice Resource Center (PPRC) at the MMS takes your questions by phone or email. Call us for free support with coding, billing, and reimbursement denials, as well as workflow issues, retirement and succession planning, and more. The PPRC Helpline is the physician’s pain relief, available without charge to members and nonmembers. Call (781) 434-7702 or email pprc@mms.org.

MMS grants for International Health Study; apply by Sept 15

Medical students and resident physician members of the MMS are eligible to apply for grants of up to $2,000 to defray the costs of studying abroad. The primary goal of these International Health Studies (IHS) grants, provided by the Massachusetts Medical Society and Alliance Charitable Foundation, is to encourage international education, particularly focusing on under-served populations. Preference will be given to projects providing health care-related work and/or training of staff, and to applicants planning careers serving underprivileged populations. Research projects that do not involve direct clinical care or teaching will not be considered. Programs must last at least three weeks to receive consideration. Applications are due by September 15, 2018. For more about the grants and application expectations, click below.

Well-being strategies and community opportunities when retiring (Oct 3)

A major concern that senior physicians may have about retirement is the fear of losing their primary identity or purpose due to the at-times consuming nature of the profession of medicine. Other concerns are burnout, coping with lifestyle changes, and social isolation. Learn and discuss with your colleagues strategies for psychological and social well-being and ways to be involved in your communities. This free event is on October 3, 2018 at the MMS headquarters, Waltham. Spouses and partners are welcome, and is hosted by the Committee on Senior Physicians. Click the button below for more information and registration.

How to be a more effective leader and colleague (Nov 1–2)

Managing Workplace Conflict: Improving Leadership and Personal Effectiveness is an interactive course based in real-life medical workplace scenarios. In a recent evaluation, all participants perceived substantive advances in their own relevant skills: 

• “Fantastic course – should be required of all physicians. This was a gift!”
• “Uncommon honesty of the group in sharing their workplace problems and helping others to improve [their] handling [of] these conflicts.”
• “Where great theory and data meet!”

The program is designed for physicians in clinical practice, and those in administration and leadership. It takes place on November 1–2 at MMS Headquarters in Waltham. Click the button for information (including CME credits) and registration. 

Educational programs and events

Live events

Conference on Universal Health Care
Wednesday, October 3  

The First Penile Transplant: The Surgeons and Patient Report
Thursday, October 11 

Gender and Bias in Medicine – Effect on Physicians, Impact on Patients
Friday, October 19

Featured online CME: Concussion

Concussion Treatment, Management and Prevention: In School and on the Field

Quote of the week

“Calling something a poison is a great way to get YouTube views, but unless you stir-fry the coconut oil with some arsenic, it’s an exaggeration.”
— Cheryl Wischover, senior reporter, Vox, on the coconut oil controversy 

Tweet of the week

Women in PM&R
Physical Medicine & Rehabilitation Physicians #womeninmedicine #physiatry

What’s new in health care

Check out the most clicked-on stories from this week's MMS Media Watch. Sign up for daily Massachusetts media roundups by email. Some publications are fully accessible only to their subscribers.

Nurses get leading role in ad war over Question 1 (Boston Globe) 

The two factions warring over ballot Question 1, a measure that seeks to regulate nurse staffing in hospitals, have both released ads — and both are using nurses in scrubs to argue their case. Their ads may appear similar, but their messages are vastly different, part of the escalating rhetoric in the leadup to the Nov. 6 election. A coalition backed by the Massachusetts hospital industry launched the first ad, which warns that the ballot question could have damaging effects on health care delivery statewide. Hospitals say staffing regulations would be extraordinarily costly. 

Study suggests nurse ratios don't help patients (Boston Business Journal)

"Our results suggest that the Massachusetts nursing regulations were not associated with changes in staffing or patient outcomes," said Dr. Anica C. Law, a staff physician in the Division of Pulmonary, Critical Care, and Sleep Medicine at BIDMC, and lead author of the study. "The modest changes in nurse staffing we saw in Massachusetts — approximately one extra nurse per 20-bed ICU per 12-hour shift — remained unassociated with changes in hospital mortality." In November, voters will be asked whether the state should to establish certain patient-to-nurse limits in different areas of the hospital.

MCPHS has grown to almost 2,000 students and 18 buildings (Worcester Business Journal)

When it came to Worcester, MCPHS – then the Massachusetts College of Pharmacy and Health Sciences – had outgrown its main Boston campus, which is located among Harvard Medical School, Boston Children's Hospital, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center. That has put it in great company, but also without any room for new classrooms. "We can't grow in Boston," said Charles Monahan, the MCPHS president since 1997. "There isn't a square foot to rent or buy."

Harvard freshmen required to take sleep course (CommonHealth)

The course, which takes about 45 minutes, includes practical information on how to optimize sleep and what can get in the way. At Harvard, the impetus to teach better sleep arose from a freshman seminar taught by leading sleep researcher Dr. Charles Czeisler. He highlights three main factors in healthy sleep: "The first one is making sure that you have enough time for sleep. The second is, be consistent, and so the timing of sleep is very important as well. And third is the quality of sleep."