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Legal Considerations in Telemedicine

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telemedicine

Bill Boling, Mason Reid

telemedicine

Tanya Mack

Legal Considerations in Telemedicine

This week, Tanya hosted healthcare and telemedicine legal experts, Bill Boling and Mason Reid, of Boling and Company, to talk about legal considerations in telemedicine.

Affordable, quality telemedicine is on almost everyone’s mind! Telemedicine is a tool that is being used more frequently to provide access when and where needed and to decrease costs. One analyst recently predicted that 2020, the telemedicine market would be worth $36B dollars.

Although technology improvements have enable a new generation of telemedicine services, policy makers have been slower to adopt telemedicine.  Recently, however, a number of telemedicine related bills have been introduced that could fuel escalated telemedicine adoption by patients, payers and providers.

Bill and Mason discussed such topics as parity law, telemedicine informed consent, provider licensure requirements, telepresenter regulations, provider-patient encounter requirements, security and telemedicine clinical standards of care.

Special Guests:

Bill Boling, Founder, Boling and Company

 

Mason Reid, Associate, Boling and Company

 

AMA Talks Opioid Abuse and MACRA

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Opiod

AMA Talks Opioid Abuse and MACRA

Patrice A. Harris, M.D., M.A., is a psychiatrist from Atlanta. She is the chair of the American Medical Association’s Board of Trustees (BOT), and she is the chair of AMA’s Task Force to Reduce Opioid Abuse. Dr. Harris has been the president of the Georgia Psychiatric Physicians Association, and she has served on the Medical Association of Georgia’s Council on Legislation.

In 2001, Dr. Harris was honored as the Georgia Psychiatric Physicians Association’s
Psychiatrist of the Year. After she earned her medical degree at West Virginia University, she did her residency in psychiatry and fellowships in child psychiatry and forensics at Emory.

She was also a Barton senior policy fellow at the Emory University School of Law. Dr. Harris was the director of Health Services for Fulton County, and she served as the medical director for the Fulton County Department of Behavioral Health and Developmental Disabilities.

Opioid abuse is a crisis in America. More than 40 people in the U.S. die from an opioid overdose every day, while many more are becoming addicted. The American Medical Association (AMA) Task Force to Reduce Opioid Abuse – which is comprised of 27 physician organizations and the American Dental Association – has announced several recommendations to address this epidemic.

It is urging physicians to register for and use state-based prescription drug monitoring programs (PDMPs) as part of the decision-making process when they consider treatment options.  When fully-funded and available at the point of care, PDMPs are an effective tool for physicians to identify patients who may be misusing opioids and can be used to implement treatment strategies, including referral for those in need of further care.

AMA will also continue to work with the administration and Congress to develop balanced approaches to end prescription opioid misuse, as well as supporting congressional and state efforts to modernize and fund PDMPs. Finally, AMA has initiated an educational effort and communications campaign to promote safe,
effective and evidence-based prescribing within the medical profession.

Georgia PDMP registration: www.hidesigns.com/gapdmp

MACRA

According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changed how Medicare health care providers will be paid in several important ways. MACRA
1) eliminated the Sustainable Growth Rate (SGR) formula and 2) created a new framework to “reward health care providers for giving better and not just more care” and 3) combined the existing quality reporting programs (EHR, PQRS) into one new system. According to CMS, this new “Quality Payment Program (QPP)” will replace “a patchwork system of Medicare reporting programs with a flexible system that allows you to choose from two paths that link quality to payments: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models.”

Special Guest:

Dr. Patrice Harris, Chairman, Board of Trustees, American Medical Association

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Opiod

Dr. Patrice Harris

Zika Virus

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Zika

Dr. Cherie Drenzek

zika

Dr. Patrick O’Neal

Zika Virus

The Zika virus has been making news over the past year as we approach the coming Olympics in Brazil, a known location heavily populated by the species of mosquito known to carry the virus.  I sat down with Dr. Patrick O’Neal of the Georgia’s Department of Public Health, and Dr. Cherie Drenzek, Epidemiologist for the State of Georgia to talk about what we need to be thinking about here in Georgia.

Dr. Cherie Drenzek grew up in Detroit and received her bachelor’s degree in Biological Sciences and her Master’s degree in Food Microbiology from Wayne State University. She attended Michigan State University College of Veterinary Medicine and received her DVM in 1995. She then entered the Epidemic Intelligence Service program at CDC and was stationed in the Rabies Section. Following EIS, Dr. Drenzek was employed as an Assistant Professor of Epidemiology at the University of Georgia College of Veterinary Medicine.

Dr. Drenzek has been employed at the Georgia Department of Public Health since 1999 and has served in a variety of roles, including infectious disease medical epidemiologist and State Public Health Veterinarian. She served as Director of the Acute Disease Epidemiology Section and Deputy State Epidemiologist since October 2005 and was named State Epidemiologist and Director of the Epidemiology Program in 2011.

Dr. Patrick O’Neal is the Director of Health Protection for the Georgia Department of Public Health (DPH), where he has oversight responsibility for Emergency Medical Services (EMS), Trauma, Emergency Preparedness, Epidemiology, Infectious Disease, Immunizations, and Environmental Health. For 29 years prior, he practiced
emergency medicine at DeKalb Medical Center in Decatur. He received his medical education at the Tulane University School of Medicine in New Orleans.

Zika virus (pronunciation: zee-kah) is a viral disease that is primarily transmitted to people by infected Aedes species mosquitoes. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis. The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito.

However, there can be more severe clinical outcomes, and Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects.  Prior to 2015, outbreaks have occurred in Africa, Southeast Asia, and islands in the Pacific Ocean.  In May 2015, Zika virus transmission was confirmed in Brazil and outbreaks are currently occurring in many countries in the Americas and worldwide.

No local mosquito-borne Zika virus disease cases have been reported in the continental U.S., but there have been travel-associated cases, as well as cases associated with sexual transmission from travelers to affected areas. These imported cases could result in local spread of the virus in areas of the United States where the Aedes mosquito vectors are found. A list of countries where Zika virus is currently being spread can be found at the CDC website http://www.cdc.gov/zika/geo/index.html. Zika is an unprecedented public health emergency that poses significant risks to pregnant women.

This is the first time in more than 50 years that a virus has been linked to serious birth defects and poor pregnancy outcomes (and the first-ever mosquito-borne cause!).  Georgia has not documented any local transmission of Zika virus, but as of the end of April 2016, has confirmed more than a dozen travel-associated Zika infections.

For general information about Zika virus and surveillance for mosquito‐borne diseases in Georgia, call your District or County Health Department or the Georgia Department of Public Health at 404‐657‐2588. You may also visit the Georgia Department of Public Health website at dph.georgia.gov. Also go to the CDC website at cdc.gov/zika/index.html.

Special Guests:

Dr. Cherie Drenzek, Epidemiologist, Georgia Department of Public Health

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Dr. Patrick O’Neal, MD, Director of Health Protection, Georgia Department of Public Health

 

Georgia’s Philadelphia College of Osteopathic Medicine

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Philadelphia College of Osteopathic Medicine

Dr. Bill Craver

Georgia’s Philadelphia College of Osteopathic Medicine

I hosted Dr. Bill Craver to talk about the Georgia campus of Philadelphia College of Osteopathic Medicine.  Dr. Craver is the dean and chief academic officer of the osteopathic medical program at the Georgia Campus of the Philadelphia College of Osteopathic Medicine, which is also known as GA-PCOM, in Suwanee.

Dr. Craver is a professor of surgery, is board certified by the American Osteopathic Board of Surgery, and is a fellow of the American College of Osteopathic Surgeons. Dr. Craver earned a degree in physical therapy from the University of Delaware. He worked in the areas of physical therapy and sports medicine at the Hershey Medical Center before enrolling at Philadelphia College of Osteopathic Medicine, where he earned a doctor of osteopathic medicine degree with honors.

Dr. Craver completed a residency in general surgery at the Osteopathic Medical Center of Philadelphia. He cared for patients in Jasper, Georgia and Hardinsburg, Kentucky before coming to GA-PCOM.  GA-PCOM is a private, not-for-profit branch of the fully accredited Philadelphia College of Osteopathic Medicine, which has a 117-year tradition of excellence. Located in Suwanee, GA-PCOM was established in 2005.

It offers a Doctor of Osteopathic Medicine degree, a Doctor of Pharmacy degree, a Master of Science degree in Biomedical Sciences, and a Master of Science degree in Physician Assistant Studies.   The campus also includes the Georgia Osteopathic Care Center, which is an osteopathic manipulative medicine clinic that is open to the public by appointment.

What is osteopathic medicine and what does it mean to be a D.O.? Andrew T. Still, M.D., was dissatisfied with the effectiveness of 19th century medicine. He was one of the pioneers of osteopathic medicine – and he was one of the first of his time to study the attributes of good health to better understand disease. Dr. Still’s philosophy is based on the unity of all body parts and views the musculoskeletal system as a key element of health.

Dr. Still introduced the idea of returning the body to health through manipulation based on a thorough understanding of the body’s systems.  Along with M.D.s, today’s D.O.s are licensed to prescribe medication and perform surgery in all 50 states.  Osteopathic physicians practice a “whole person” approach to medicine, treating the entire person rather than just the symptoms.

With a focus on preventive health care, D.O.s help patients develop attitudes and lifestyles that don’t just fight illness but help prevent it as well. D.O.s are trained to be doctors first and specialists second. The majority of D.O.s are family-oriented primary care physicians. Many D.O.s practice in small towns and rural areas,
where they often care for entire families and communities.

Special Guest:

Dr. Bill Craver, Dean and Professor of Surgery, Georgia campus, Philadelphia College of Medicine  issuu  instagram-logo-transparent-png-i11 (16x16)  twitter_logo_small  youtube logo  facebook_logo_small3  linkedin_small1

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WellCare of Georgia and Diabetes

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Dr. John Johnson of WellCare of Georgia talks diabetes

WellCare of Georgia and Diabetes

Dr. John Johnson is the Senior Medical Director at WellCare Health Plans, Inc. – which is one of the Medicaid CMOs in Georgia. His areas of responsibility include utilization review, care management, quality improvement and clinical outcomes.  Dr. Johnson graduated from the University of Medicine and Dentistry of New Jersey in Rutgers. He completed his residency at Emory University Hospital. Dr. Johnson is Board Certified in internal medicine.

He also has an MBA from Emory University’s Goizueta School of Business. Dr. Johnson owned and operated a practice in Douglasville that cares for patients with acute and chronic medical conditions for more than 13 years. Before joining WellCare in 2014, Dr. Johnson was the medical director for Blue Cross Blue Shield of Georgia. While there, he oversaw utilization review and case management for more than 600,000 State Health Benefit Plan patients.  Dr. Johnson is a member of MAG, the AMA, and the American College of Physicians.  He is a also colonel in the U.S. Army Reserves Medical Corps.

Diabetes is becoming more common in the United States. It afflicts more than 29 million Americans, including more than one million Georgians. One quarter of the people who are affected by it aren’t aware that they have the disease. An additional 86 million people have pre-diabetes, which means that their blood glucose (sugar) is higher than normal but not high enough to be classified as diabetic. Estimates project that as many as one in three American adults will have diabetes by 2050.

In addition to its detrimental health effects, the American Diabetes Association reports that the U.S. spends $174 billion a year to treat the disease.  The primary risk factors for diabetes include being overweight; sedentary; over the age of 45; and having a family history of diabetes. African Americans, Hispanics/Latinos, Native Americans, Asian Americans, and Pacific Islanders are at an increased risk for developing the disease.

Diabetes is the nation’s seventh-leading cause of death. It is also a leading cause of kidney failure, non-traumatic lower-limb amputations, new cases of blindness, heart disease, and stroke. A significant number of Georgians who are struggling with diabetes, particularly those in low-income and medically underserved populations, do not fully understand how to manage diabetes on a day-to-day basis.

WellCare is working to address the needs the diabetic population by collaborating with patients, providers, family members, and the community using a variety of mechanisms, including value-based care, telemedicine, field-based case management, the patient-centered medical home, and advocacy.

Special Guests:

Dr. John Johnson, MD, Senior Medical Director, WellCare of Georgia  

diabetes

  • Doctor of Medicine, University of Medicine and Dentistry of New Jersey
  • Board Certified, Internal Medicine
  • MBA, Goizueta Business School, Emory University
  • Colonel, US Army

Donald Palmisano, CEO, Executive Director of Medical Association of Georgia  twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • JD Law, Loyola School of Law
  • Board of Directors, Physician Advocacy Institute
  • Medical Payment Subcommitte Member, State Board of Workers’ Compensation
  • Treasurer, Board of Directors, Physicians’ Institute for Excellence in Medicine
  • Former Director, Government Relations/General Counsel/Director, GAMPAC

Georgia Physicians Leadership Academy

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Georgia Physicians Leadership Academy

Dr. Bill Clark talks Georgia Physicians Leadership Academy

Georgia Physicians Leadership Academy

Dr. Jim Barber talks GPLA

Georgia Physicians Leadership Academy

Wednesday 1/27 was Physicians at the Capitol Day for members of Medical Association of Georgia.  I caught up with two MAG members who traveled to the capitol to engage with legislators, Dr. Jim Barber, orthopedic surgeon, and Dr. Bill Clark, opthamologist.  We talked about the Georgia Physicians Leadership Academy, an educational offering offered by MAG to nominated candidates each year.

More information soon!

 

Blue Cross Blue Shield of Georgia

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Blue Cross Blue Shield of Georgia

Blue Cross Blue Shield of GA CEO, Jeff Fusile

Blue Cross Blue Shield of Georgia

On this week’s episode with our partner, Medical Association of Georgia, MAG CEO, Donald Palmisano, Jr., joined me in studio.  We hosted Jeff Fusile, the recently-appointed President for Blue Cross Blue Shield of Georgia.  Jeff joined the company in the lead role, coming over from Anthem in November of 2015.

Jeff Fusile is president of Blue Cross and Blue Shield of Georgia (BCBSGa), the state’s oldest and largest health insurance company. He oversees sales, account service, marketing, underwriting, and customer relationships. Jeff is involved in corporate strategy planning and execution, and he serves as the primary contact for state regulators to ensure compliance and manage any state-related matters.

Jeff previously served as Senior Vice President and Chief Financial Officer for the Commercial & Specialty Business Division of Anthem, Inc., which is Blue Cross and Blue Shield’s parent company. He joined Anthem in 2011 after spending 22 years as a strategic management consultant with PricewaterhouseCoopers. Jeff is a licensed CPA. He has qualified as an expert witness in insurance and the broader health care industry. He is widely recognized as an industry leader in health care strategy, corporate governance, compliance, enterprise risk management, HIPAA, and ICD-10.

As the health care landscape undergoes an unprecedented transformation, the traditional relationships between providers and payers are also evolving. With the largest network of providers in the state, Blue Cross and Blue Shield of Georgia (BCBSGa) serves more than 3 million Georgians and is the only plan offered in all 159 counties.  BCBSGa President Jeff Fusile will discuss how BCBSGa is developing programs to facilitate better collaboration with providers, make health care more affordable for consumers and simplify the access to care. Reaching out to rural communities and the impact of technology on delivering innovative solutions was also discussed.

Special Guest:

Jeff Fusile, CEO, Blue Cross Blue Shield of Georgia  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3  youtube logo

Cryotherapy

  • BS, Accounting & Finance, Florida State University College of Business
  • Certified Public Accountant
  • Previous Managing Partner, PriceWaterhouseCoopers
  • Former Senior VP/CFO, Commercial & Specialty Business, Anthem

Radiation Oncology

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Radiation Oncology

On this week’s show I sat down with Radiation Oncologist, Dr. Chad Levitt. We talked about how he decided he wanted to go into radiation oncology as his chosen field of practice. He shared how he enjoyed the fact that the specialty allowed him to call on his liberal arts schooling, helping him to be able to be perceptive to his patients’ needs and concerns, and allowing him to communicate effectively with them in a period of significant stress.

Chad explained how important it is for oncology physicians to make time to insure their patients’ questions are answered and that their concerns have been addressed. He believes the patient needs to be well-informed so they can hopefully experience less anxiety and allow them to make educated choices about their care. He stated the patient should be the “Captain of the Ship” and the health team the crew that helps them get to where they want to go.

We talked about the importance of getting 2nd and even 3rd opinions when facing life-changing illnesses such as cancer. Chad shared that it is vital to do so before engaging in treatments that cannot be undone. Given the political and personal alliances that can be present in a given hospital ecosystem, it is wise to seek 2nd opinions in hospitals or systems that are outside that of the primary physician to allow for likelihood of a more objective opinion.

Special Guest:

Dr. Chad Levitt, MD, of Radiotherapy Associates of Forsyth

Radiotherapy Associates of Forsyth