One of the bills passed out of the Opioid and Other Substance Use Disorders Study Committee in advance of the 2020 Colorado General Assembly is a prevention bill that would eliminate prior authorizations and step therapy for non-opioid pain medications and atypical opioids (buprenorphine, tapentadol/Nucynta and tramadol) and prohibit prior authorization requirements for nonpharmacological treatments, including physical therapy, occupational therapy and acupuncture. It would also place non-opioids and atypical opioids on a carrier's lowest cost-sharing tier and limit copays for non pharmacological treatments. The Colorado Medical Society joins the Colorado Pain Society in calling on physicians to contact their legislators to express support for this bill. Physicians are encouraged to share a personal experience or story about delays, denials of care, prohibitive costs for safer alternatives than generic opioids, and any resulting adverse outcomes. Find your legislators through this link. Also feel free to share your story directly with CMS by emailing president@cms.org. 

Community leaders and policymakers – including representatives from medicine, pharmacy, public health, psychiatry and criminal justice – are planning now for how to best use anticipated settlements from opioid lawsuits. A CMS member, who attended a convening on this issue, reported that the biggest themes currently in discussion include the following.

A blueprint from the Colorado Health Institute compiles recommendations and guidance, informed by stakeholders around the state. The authors recommend using the largest portion of the opioid settlement money to expand treatment and recovery efforts, particularly in rural areas. Read the full report here.

Register today for the 2020 Medical Student Component (MSC) Day at the Capitol. It will be held Jan. 21, 2020, 12-4 p.m. at the state Capitol in Denver. Last year’s event was highly praised by students, physicians and legislators. Plan to join us for this fun event where you gain firsthand knowledge from experts and elected officials on how to positively influence health care public policy. Register here.

Join the CU Anschutz Department of Psychiatry, Behavioral Health & Wellness Program, supported by the University of Colorado School of Medicine and Colorado Department of Public Health and Environment, as they share essential information on vaping, JUUL and cessation specifically targeted to providers. This webinar will be held Tuesday, Dec. 17, 12-1 p.m. MST, to help clinical care teams, public health professionals, and any individuals working with youth and adults that use or who are exposed to vape or other tobacco products navigate the rapidly shifting product landscape and support constructive discussions about vape use and cessation. This webinar is free but registration is required. Register here.

The Colorado Primary Care Payment Reform Collaborative has published its first Primary Care Payment Recommendations Report, which offers guidance on how Colorado can improve and advance primary care delivery. The Collaborative, created through HB19-1233 and convened by the Division of Insurance, part of the Department of Regulatory Agencies, has been meeting since July of this year to develop a set of recommendations aimed at increasing investments in high-quality primary care. Increased investment can lead to better access, and access to primary care is a key part of our health care system. Of note, the Collaborative is recommending a one percentage point increase in primary care spending by commercial insurance companies in 2021 and again in 2022, with reevaluation of its effectiveness in 2022. Though this is the first report, the Collaborative is tasked with delivering a report annually, every Dec. 15, to the insurance commissioner with recommendations concerning increased investment in primary care. Read the full report here.

The American Medical Association has partnered with the American Academy of Family Physicians and American College of Physicians to host Center for Medicare and Medicaid Innovation staff in a free 60-minute interactive webinar about the new Primary Care First Model on Monday, Jan. 6 from 5-6 p.m. MT. Primary Care First will be offered in 26 geographic regions starting in 2021, including statewide in Colorado. Applications are due Jan. 22, 2020. (Current CPC+ participants are not eligible to start in 2021 but will be invited to apply at a later date for a 2022 start.)

 

The webinar will include important information about the model and application process, examples of how practices could be paid under the model's monthly and performance-based payments, and attendees will be able to have their questions answered in an interactive session with CMS staff who designed the model. A key focus of the webinar will be helping practices understand how to determine whether participation in Primary Care First may be right for them. Click here to register for the webinar.

The American Medical Association presents a series of CME and educational activities to help physicians and health professionals understand evidence-based use of medical marijuana. Marijuana use has increased as more U.S. states legalize the drug for medical and recreational use. The drug and its derivatives are said to be effective for a host of medical conditions, often with limited or no supporting evidence. This course presents the evidence for marijuana: who’s using it, where it’s legal for medical use, the public health consequences of its broader use, and what it is and is not effective for. Access the courses here.

Last week the chair of Senate Health, Education, Labor and Pension (HELP) Committee and the chair and ranking member of the House Energy and Commerce Committee announced an agreement on federal legislation to end surprise medical bills. The agreement is a merging of surprise billing legislation passed earlier in the year by both committees. While the compromise legislation would protect patients by limiting their out-of-pocket costs to amounts they would have owed if they had been treated in-network, the American Medical Association reports that it also includes potentially devastating provisions that would resolve payment disputes between physicians and insurers by using a benchmark rate setting out-of-network payments at the median amount insurers pay for in-network care. The AMA urges all physicians to contact their congressional representatives on this issue. Read more here.

The nomination period for the 2020 Colorado Medical Society all-member election is open through Jan. 31, 2020. The Colorado Medical Society encourages all members to consider nominating a colleague or self-nominating for one of the open leadership positions: president-elect (one position open) or AMA delegation (two positions open). The election manual, which contains all of the information a potential candidate needs about the duties, eligibility, requirements and election process, is available on the CMS website, as is the current list of declared candidates. Read more here.

A group of retired physicians under the leadership of CMS past president M. Robert Yakely, MD, have been working with COPIC to develop an online catalog of volunteer opportunities for retired physicians who have elected to keep their Colorado medical license and malpractice insurance in force. Active or retired members who know of any such opportunities for physicians who wish to continue to make contributions to their communities to remain engaged are encouraged to contact ryakely@hotmail.com to add to this online list. Find the current list of volunteer opportunities here.

As we approach the upcoming legislative session, we need to hear from you concerning issues impacting your practice. In partnership with the Colorado Medical Group Management Association, the Colorado Medical Society seeks intelligence from practices on the "front lines." Please contact us at payerissues@cms.org with your payer issues.

And remember to use the members-only Know Your Legal Rights online catalog of provider protection statutes that you can use in disputes with health plans. It contains decades of public policy victories that may assist you in your dealings with payers. Make sure all of the physicians in your practice are members of the Colorado Medical Society so you have access to this great resource today!

*Accessing Know Your Legal Rights requires a CMS member login. Member physicians’ staff can obtain their own login by contacting Tim Yanetta at tim_yanetta@cms.org .