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June 16, 2017

Issue Spotlight

AMA launches opioid education microsite

As part of its continued advocacy efforts to help reverse the nation's opioid epidemic, the AMA last week launched a microsite focused on providing physicians with state- and specialty-specific education and training resources. The microsite, www.end-opioid-epidemic.org, includes nearly 300 education and training resources across three major categories:

  1. Recommendations from the AMA Opioid Task Force  
  2. State medical society resources
  3. Medical specialty society resources

Physicians can use the site's "State Selector" and "Specialty Selector" to find tailored education and training resources. The AMA Opioid Task Force also has identified numerous national education and training resources. The site highlights the progress physicians have made in using prescription drug monitoring programs, reducing the nation's opioid supply, increasing treatment capacity and increasing access to naloxone.

To further support physicians and patients locating physicians authorized to treat opioid dependency with buprenorphine by state, each state-specific page includes a link to the U.S. Substance Abuse and Mental Health Services Administration Buprenorphine Treatment Practitioner Locator.

"Physicians have made progress, but to truly reverse the nation's opioid epidemic, we all have much more work to do," said Patrice A. Harris, MD, MA, chair, AMA Opioid Task Force. "That's why the Task Force urges physicians to increase their efforts and use PDMPs, enhance their education, help prevent overdose deaths by co-prescribing naloxone, and improve access to the best treatment options available." 

While the initial launch of the website is focused on encouraging physicians to take action by using education and training resources, the next phase of the website will encourage physicians and patients to share their own stories.

America's medical community continues to focus on ways to support patients who need treatment as well as help increase overdose prevention efforts. The AMA Opioid Task Force also recently issued recommendations focused on safe storage and disposal, encouraging physicians to:

  1. Talk to your patients about proper use of opioid analgesics
  2. Remind your patients to safely store medicines away from children and never share prescriptions
  3. Urge your patients to safely dispose of expired, unwanted, and unused medications, utilizing pharmacy and law enforcement "Take Back" resources

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National Update

HHS update on WannaCry and new OCR resources on reporting after cyberattacks

The AMA recently notified physicians of a global ransomware attack known as WannaCry, which jeopardized the security of computers and medical devices. The U.S. Department of Health and Human Services (HHS) is cautioning providers that it is aware of two large, multistate hospital systems that are continuing to face significant challenges to operations because of the WannaCry malware.

This is not a new WannaCry attack, but rather an effect of the virus remaining on a machine even after the machine's Windows software is patched and anti-virus software has been run. Those two activities block the virus from executing its encryption stage. However, the virus may still disrupt Windows operating systems in varying ways. For example, it may cause the device to reboot or display a "blue screen." HHS states that the virus will not spread from a machine where it still exists to a patched machine.

HHS also released new emergency contact information for the U.S. Food and Drug Administration (FDA) in the event that a practice experiences a suspected cyberattack affecting medical devices: (866) 300-4374. Reports of impact on multiple devices should be aggregated at a system/facility level.

Finally, the HHS Office of Civil Rights has released an infographic and quick-response checklist to explain the steps a covered entity should take in response to a cyber-related security incident. It notes that covered entities must presume protected health information that is improperly accessed, acquired, used or disclosed at the time of a cyber-related security incident is a breach unless:

New tool available to test EHR interoperability

The ability to exchange and display relevant patient information is a major factor in how well an electronic health record (EHR) system works in your practice and supports patient care. Many physicians send and receive "summary of care" documents; however, these documents are often very long and important information—like office notes and findings—is not integrated back in to the patient's record. These issues are often a result of the EHR vendor's conformance to federal technical standards.

The AMA is a strong proponent of increasing the usability and interoperability of EHRs and continues to call on the Office of the National Coordinator for Health IT (ONC)—which manages the federal process for certifying EHRs for use in programs like Meaningful Use and the Quality Payment Program (QPP)—to require EHRs better conform to national interoperability standards.

Recently, ONC created a new scorecard tool for EHR interoperability. The ONC One Click Scorecard is designed specifically to test the quality of documents used to exchange patient health information between EHRs. This tool is the health IT equivalent of an internet speed test. The scorecard can help uncover if your EHR is properly configured to send, receive and display medical documents. In addition to providing both a numerical and letter grade, the scorecard provides a user-friendly, categorized report that pinpoints areas for improvement.

Communicating the grade and areas for improvement back to your EHR vendor can help them improve your EHR's interoperability and usability. For more information in this new tool and how to use it, please visit ONC's scorecard website and a recent ONC blog post about the tool.

AMA makes recommendations to president's opioid crisis commission

In March, President Trump established a commission to recommend federal strategies for ending the epidemic of opioid overdose deaths. Chaired by New Jersey Gov. Chris Christie, the commission will hold its first meeting on June 16, followed by a teleconference on June 26 to review a draft interim report. Commission members include Massachusetts Gov. Charlie Baker, North Carolina Gov. Roy Cooper and former Rhode Island Congressman Patrick Kennedy.

The AMA recently wrote to the commission offering eight recommendations for federal policy and action, including:

The AMA also urged the commission to support continued Medicaid coverage for patients who need treatment for pain and/or opioid use disorder. Information about the commission and its meetings is available on the White House website.

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Other News

New video shows how to avoid Medicare payment penalties

The Quality Payment Program (QPP) is here and reporting has begun. Physicians can pick their pace of participation in the QPP's Merit-based Incentive Payment System (MIPS) this year.

A new short video developed by the AMA, "One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting," offers step-by-step instructions on how to report so physicians can avoid a negative 4-percent payment adjustment in 2019. On this website, ama-assn.org/qpp-reporting, there are also links to CMS' quality measure tools and an example of what a completed 1500 billing form looks like.

During the week of June 26, help spread the word about this new video and website to ensure physicians know what they need to do this year under Medicare's new payment system, the QPP. The AMA will be e-mailing a template article to the Federation for use in their own publications.

Alternative Payment Model participants will get bonus payments

The Centers for Medicare and Medicaid Services (CMS) estimates that all physicians participating in five Medicare alternative payment models (APMs) designated as "advanced" APMs under the Quality Payment Program for 2017 will achieve the level of participation necessary to be awarded a five percent lump sum bonus payment in 2019. For more information, visit CMS' QPP website.

CMS releases 2017 MIPS Qualified Clinical Data Registry (QCDR) approved list

Under the Merit-based Incentive Payment System (MIPS), there are several data submission methods for earning an incentive, one of which is a Qualified Clinical Data Registry (QCDR). A QCDR approved by the Centers for Medicare and Medicaid Services (CMS) is an entity that collects clinical data from MIPS-eligible clinicians (both individuals and groups) and submits it to CMS on their behalf for purposes of MIPS.

A QCDR primarily supports the MIPS Quality Category, but can also be used to report improvement activity (IA) data. The majority of QCDRs are managed by medical specialty societies and provide routine feedback to clinicians. The QCDR reporting option is also different from a qualified registry because it is not limited to measures within MIPS. The QCDR can develop and submit to CMS approval QCDR measures that differ from other quality measures specifically approved for MIPS.

CMS has recently made available Version 1 of the 2017 CMS-Approved QCDR qualified posting. It includes approved QCDR measures that either:

Version 2 of the QCDR-qualified posting will be the final version, set to be published this month. Version 2 may contain additional approved QCDR measures in the "QCDR Measures Supported" column for inclusion in 2017. To learn more about QCDRs and the Quality Payment Program visit the AMA's QPP web page.

CMS shares five steps to prepare for the Social Security Number Removal Initiative

As mentioned in previous May 18 and June 1 editions of Advocacy Update, CMS is taking steps to remove Social Security Numbers from Medicare cards through the Social Security Number Removal Initiative (SSNRI). CMS has shared with the AMA five steps that physician practices can take today to prepare for the transition:

The AMA will continue to update physicians on this initiative as additional information becomes available.

The campaign trail starts here

For AMA members, their spouses, medical students and residents and state medical association staff who want to become more involved in campaigning process, the 2017 AMPAC Campaign School will be taking place Oct. 27–29 at the AMA offices in Washington, D.C.

Running an effective campaign can be the difference between winning and losing a race. That's why the Campaign School is designed to give you the skills and strategic approach you will need out on the campaign trail. Our team of political experts will teach you everything you need to know to run a successful campaign.

During the two-and-a-half day, in-person portion of the program, under the direction of our political experts, participants will be broken into campaign staff teams to run a simulated congressional campaign using what they've learned during group sessions on strategy, vote targeting, social media, advertising and more.

Note: Faculty, materials and all meals during the meeting are covered by the AMA. Participants are responsible for the registration fee and hotel accommodations at the Hyatt Regency Washington on Capitol Hill.

For more information or to apply visit: www.ampaconline.org/apply or contact politicaleducation@ama-assn.org.

News and views from the 2017 AMA Annual Meeting

As another AMA Annual Meeting came to a close this week, physicians adopted a number of new policies to improve the health of the nation.

Highlights include:

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