DEA to Increase Hydrocodone Combination Product Oversight

Yesterday, the Drug Enforcement Administration (DEA) announced that it will enforce stronger regulations for individuals who handle hydrocodone combination products (HCPs).  This rule will shift HCPs from Schedule III to Schedule II of the Controlled Substances Act -- the designation for products that are most subject to abuse and mishandling.  This rule will go into effect 45 days from DEA's official announcement.   

What Could Black Boxes in Operating Rooms Tell Us?

According to HealthData Management, some hospitals have begun to develop black box mechanisms for their operating rooms (OR) in an effort to reduce preventable errors and increase transparency.  The goal is to use black boxes to record OR procedures to help improve patient safety by identifying errors and facilitating teachable moments for all practitioners.  The black boxes models would record both video and voice, as well as other elements, such as room temperature and noise levels.

Read more about it at HealthData Management.com.

ABIM Pledges to Examine MOC Requirements

In response to physicians' collective opposition to revised Maintenance of Certification (MOC) requirements, the American Board of Internal Medicine (ABIM) recently announced that it would lessen the financial and course requirements associated with the MOC process, as well as ensure that MOC requirements are clear and consistent across specialty boards.  ABIM also pledged to work closely with the American Board of Medical Specialties and specialty societies to improve the MOC process for all parties. 

Read more about ABIM's MOC initiative.

TJC Amends Standards in Response to May 2014 CMS Rule

The Joint Commission (TJC) announced that it has revised its hospital and critical-access hospital standards to align with CMS's May 2014 conditions of participation rule.  According to its website, TJC standards "clarify the requirements of a practitioner not appointed to the medical staff who is ordering outpatient services, governing body consultation with the medical staff, and medical staff structure for multihospital systems."

Learn more about CMS's final rule and TJC's revised standards for hospitals and critical-access hospitals. 

Fast Track For Primary Care Docs At One Calif. University

From Kaiser Health News:

Some doctors in the state of California will soon be able to practice after three years of medical school instead of the traditional four. The American Medical Association is providing seed money for the effort in the form of a $1 million, five-year grant to the University of California at Davis.

Read more online: http://capsules.kaiserhealthnews.org/index.php/2014/08/fast-track-for-primary-care-docs-at-one-calif-university/

FSMB Compact Could Ease Multistate Licensing

FSMB Compact Could Ease Multistate Licensing

Ken Terry
 

August 05, 2014

The Federation of State Medical Boards (FSMB) has unveiled a draft interstate compact for physician licensure that, it said, should make it easier to practice telemedicine across the country. The compact, which the FSMB expects to finalize in the next month or two, offers a "streamlined alternative pathway" for physicians who want to practice in multiple states, according to a federation news release.

Under current state medical board policies, physicians must be licensed in the state where a patient is located to diagnose or treat that patient, a stance that the FSMB recently reaffirmed in its model policy for telemedicine. As a result, physicians who consult remotely with patients in other states must be licensed in those states. That can create barriers to telehealth consultations, especially for on-call physicians who are not licensed in every state where patients may contact them online.

The FSMB's interstate compact would allow physicians to apply once and receive licensure in all states that are party to the compact.

Once the compact is finalized, individual medical boards can decide whether to endorse it and submit it to their state legislatures for approval. Three state boards, including the Texas and Oklahoma medical boards and the Washington State osteopathic medical board, have already approved the compact in principle, said Humayan J. Chaudhry, DO, president and chief executive officer of the FSMB.

"Many other boards have it on their agenda and are waiting for the final language before they can present it to their legislatures," he told Medscape Medical News, adding that 15 states are expected to approve the compact in the near term.

According to Chaudhry, a house of delegates representing the FSMB's 70 member boards asked the federation to study the concept of an interstate compact. What motivated the boards, he said, was the need to address the nation's growing physician shortage, to ease patient access issues related to the Affordable Care Act, and to facilitate telemedicine in both rural and more populated areas.

In addition, he said, the interstate compact could help physicians get licenses in metropolitan regions that cross state boundaries. He cited the situation of Washington, DC, physicians, many of whom have had to obtain separate licenses in Maryland and Virginia to treat their patients.

The draft interstate compact specifies that, to be eligible for multistate licensure, physicians must have passed the US Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination, must be board-certified, must have clean records, and must have been in practice for at least 3 years. Because they must also complete a residency program, the latter requirement might be dropped in the final version, Chaudhry said.

A "Baby Step"

Jonathan Linkous, president and chief executive officer of the American Telemedicine Association (ATA), told Medscape Medical News that the draft interstate compact falls far short of what is needed to promote telemedicine. "The federation is taking a step. But it's a baby step, and what we need is a giant leap."

The key area where the interstate compact falls short, he said, is that it would create a "clearinghouse," rather than reciprocity among states. Physicians would be able to apply for licensure to multiple states through a single entity but would still have to pay license fees to each state and would have to "follow every state's unique and peculiar rules regarding how you practice medicine."

There are some large differences in those rules, he noted. For example, 24 states allow physicians to prescribe medications in telehealth encounters with patients. The rest require prior patient visits, a presenter in the same room as the patient, or a live follow-up visit.

State license fees are also substantial, Linkous pointed out. The ATA performed an analysis in 26 states and found that for the fifth of physicians who had licenses in multiple states, license-related fees cost them about $300 million a year. He granted, however, that those costs might be reduced if physicians filled out a single application and did not have to provide original documents to each medical board.

The ATA does not favor national licensure of physicians. What it wants is reciprocity among all states, similar to the way they treat driver's licenses today. If a physician is licensed in one state, he or she should be able to practice in any state, Linkous said.

Medscape Medical News © 2014  WebMD, LL

Data Bank to Reduce Query Fees

From The Data Bank: Effective October 1, 2014, the new fee to query the National Practitioner Data Bank (NPDB) will be $3.00 for both Continuous and One-Time Queries and $5.00 for Self-Queries. All other aspects of querying will remain the same.

Read more online. 

From H&HN Daily: Concerns Raised Over IOM's Report on GME

Hospitals & Healthcare Networks Daily: An influential IOM panel recommended a monumental shift in how graduate medical education is governed and financed. Teaching hospital officials worry the proposed changes would negatively impact patient care and physician training.

Read the entire article here: http://www.hhnmag.com/display/HHN-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/Daily/2014/Jul/073014-weinstock-IOM-recommends-changes-to-GME&utm_source=daily&utm_medium=email&utm_campaign=HHN

Weinstock, Matthew. "Concerns Raised Over IOM's Report on GME." H&HN Daily 30 July 2014: n. pag. Web.