Mutual Matters

Opioids – The North Carolina STOP ACT

Posted by Blake Fagan, MD on Sep 14, 2017 12:30:00 PM

In the fight against the opioid epidemic, The North Carolina STOP Act (Strengthen Opioid Misuse Prevention) is a start.

As you may have heard, the STOP Act bill was signed into law on June 29, 2017. Here are some facts about how it will affect providers.

The following prescribing limits go into effect January 1, 2018:

  • If you are going to prescribe opioids for acute pain, you will be limited to a five-day supply or less with the initial prescription.
  • If you are going to prescribe opioids for post-operative pain, you are limited to a seven-day supply or less with the initial prescription.
  • Further opioid refills require a subsequent consultation. The provider may issue an appropriate refill with the consultation.
  • Providers should review a patient’s 12-month history in the NC Controlled Substance Reporting System (CSRS) prior to providing any opioid for pain and, if providing opioids on an ongoing basis, like for chronic pain, should review the patient’s history in the CSRS every three months thereafter. The review must be documented in the chart, or when applicable, document the technical reason that kept the provider from reviewing the CSRS.

The above rules are not required for hospice, palliative care, patients with cancer, patients in the hospital or in long-term care facilities.

So, now you know the summary of the law and how it affects us, but why did the government pass this law? Four people die every day in North Carolina from an opioid overdose. In 2015, patients in NC were dispensed 660 million opioid pills. We, as a medical community, were asked to prescribe less opioid pills. In 2016, patients in NC were dispensed 700 million opioid pills.  Furthermore, data shows that if an opioid naïve adult is prescribed a 30-day supply of an opioid prescription, he/she has a 35% chance of being on an opioid at one year and a 20% chance of being on an opioid at three years. The data shows that the increased risk of staying on an opioid starts to rise after five days of taking an opioid prescription.

To read the North Carolina Medical Board’s summary of the STOP Act, click here. To read the full text of the STOP Act, click here.

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Topics: Patient Safety

How do I know if MACRA impacts me?

Posted by Brandie Szuda on Sep 12, 2017 12:30:00 PM

Find out how MACRA will affect you and click below for more information and resources. 

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Topics: Legal and Regulatory

Hurricane checklist for your practice or hospital

Posted by Bill Kanich, MD on Sep 8, 2017 4:12:34 PM

With Hurricane Harvey’s recent devastation of the Texas gulf coast fresh in our memories, and Hurricane Irma about to make landfall in Florida, now is a good time to consider your practice’s preparation for a hurricane or any other disaster. It's not too late to prepare! While not every eventuality can be anticipated, there are a few basic steps you can take that will give your practice the best chance of returning to patient service as quickly and completely as possible after a natural disaster.

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Topics: Practice Management

Improve Collection Efforts at the Time of Service

Posted by Hoyt Torras, MPA, MHA on Sep 1, 2017 12:00:00 PM

Collecting from patients is one of the more difficult aspects of medical practice management. But few medical practices will survive without collecting a high percentage of amounts due from patients, whether they are insured or not.

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Topics: Hospital Management, Practice Management

DOJ Announces Establishment of Opioid Fraud and Abuse Detection Unit

Posted by Scott R. Grubman, Esq. on Aug 30, 2017 9:08:47 AM

Scott R. Grubman, Esq.
Gregory A. Tanner, Esq.

Chilivis, Cochran, Larkins & Bever, LLP

In response to the nationwide opioid epidemic, the U.S. Department of Justice (DOJ) has announced the creation of the Opioid Fraud and Abuse Detection Unit. 

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Topics: Legal and Regulatory

Updated Guidelines for Management of Pulmonary Nodules on CT

Posted by Marshaleen King, MD on Aug 24, 2017 1:00:00 PM

The Fleischner Society has published new guidelines for the management of incidental pulmonary nodules detected on CT images. The updated guidelines reflect new data in the field and are based on the consensus of a multidisciplinary group comprised of experienced thoracic radiologists, pulmonologists, surgeons, pathologists and other specialists. The guidelines apply to incidental nodules found in adults ≥ 35 years and should not be used in persons < 35, patients at risk for infection due to an immunocompromised state, individuals being screened for lung cancer or people with a known history of a primary cancer.

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Topics: Patient Safety

The Challenge of Patient Noncompliance with Medical Recommendations

Posted by Hall B. Whitworth, Jr., MD on Aug 15, 2017 11:30:00 AM

Part 1: Clinical impact, incidence, and potential causes

Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. 

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Don't Get Lost in Translation

Posted by Bill Kanich, MD on Aug 3, 2017 4:47:46 PM

Compliance requirements with ACA Section 1557

Last year, the U.S. Department of Health and Human Services (HHS), and the Office for Civil Rights (OCR) issued the final rule for Section 1557, the nondiscrimination provision of the Affordable Care Act (ACA).

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Topics: Healthcare Industry

The Social Doctor

Posted by Marshaleen King, MD on Jul 27, 2017 3:16:14 PM

Five ways to use social media to your advantage and become a social doctor:

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Topics: Healthcare Industry

eClinicalWorks Agrees to Pay $155 Million to Settle False Claims Act Allegations

Posted by Scott R. Grubman, Esq. on Jul 20, 2017 1:00:00 PM

Written by, Scott R. Grubman, Esq., Gregory A. Tanner, Esq., Chilivis, Cochran, Larkins & Bever, LLP

On May 31, 2017, the U.S. Department of Justice (DOJ) announced that eClinicalWorks (ECW), one of the nation’s largest vendors of electronic health records (EHR) software, along with certain individual employees, has agreed to pay $155 million to settle allegations that ECW violated the federal False Claims Act (FCA).

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Topics: Legal and Regulatory

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Sharing Insight on Mutual Matters

Here we share some basic insights on matters that are important to physicians, hospitals and healthcare professionals.

Topics include:

  • MACRA
  • Legislative updates that affect healthcare professionals
  • Patient safety guidance
  • Practice and hospital management advice
  • and more.