The Georgia Academy of Family Physicians is bringing you webinars with key information that is vital to Georgia’s family physicians and your patient population.  These educational webinars offer a streamlined, comprehensive approach to services that are needed and accessible to clinicians. Please register and plan on participating to hear the latest updates.

Tuesday, April 24^th – Choosing Quality Measures to Maximize your MIPS Quality Score – 7:00pm – 8:00pm

Webinar Objectives:

• Participants will understand the major changes in reporting and scoring for the 2018 Performance Year of the Quality Payment Program
• Participants will understand the benchmarks of measures and how these benchmarks affect the Quality Score
• Participants will understand how to obtain bonus points under the quality category

Please click the link to register for the Tuesday, April 24^th webinar.

https://attendee.gotowebinar.com/register/6621522194652043779

Wednesday, April 25^th – Congenital Syphilis   – April 25^th at 12:00 pm – 1:00 pm

Webinar Objectives:

• Describe the epidemiology of primary and secondary syphilis, particularly among women of reproductive age in Georgia
• Apply Georgia state laws and guidelines from the Centers for Disease control and Prevention, The American College of Obstetricians and Gynecologists, and U.S.
• Preventive Services Task Force related to syphilis screening and treatment during pregnancy
• Describe common barriers to screening for and treatment of syphilis in pregnancy during a clinical encounter, and demonstrate ways to overcome the barriers

Please click the link to register for the Wednesday, April 25^th webinar.

https://attendee.gotowebinar.com/register/246382253124167683

Can’t Listen Live? Register anyway – and we’ll send you the link once it’s posted on our website

The Georgia Academy, in collaboration with the Georgia Department of Public Health, is seeking nominees for the Georgia Department of Public Health 2018 Award. This award is given to members who have supported Georgia’s mothers and children above and beyond the scope of family medicine.  Last year’s awardee was Jonathan Lynch, MD of Cairo, is the Medical Director of First Option Care, a comprehensive outreach clinic for mothers with unplanned pregnancies and limited resources.

We are looking for you or a colleague to let us know about what you are doing in your community.  Please email Tenesha Wallace (twallace@gafp.org) with the name of your nominee and a few sentences about what makes them unique in their support of healthy mothers and children.  The award will be presented at our Summer CME meeting in June.  Please send your response no later than April 12^th.

The Georgia Academy of Family Physicians want to remind GAFP members that if you have a DEA number – it is mandatory that you register with the Prescription Drug Monitoring Program.  The deadline has passed – so please register today!

The Georgia Prescription Drug Monitoring Program (PDMP) is an electronic database used to monitor the prescribing and dispensing of controlled substances. The PDMP can help eliminate duplicative prescribing and overprescribing of controlled substances and provide a prescriber or pharmacist with critical information regarding a patient’s controlled substance prescription history and protect patients at risk of abuse.

The deadline for prescribers to register in PDMP was Jan. 1, 2018. Please see the letter below for an important message from Commissioner Pat O’Neal. Commissioner O’Neal’s PDMP letter

Georgia House Bill 249

During the 2017 legislative session, the Georgia General Assembly passed House Bill 249 which provided for several changes to the PDMP:

1. Effective July 1, 2017, dispensers will be required to enter prescription information for Schedule II, III, IV, V controlled substances within 24 hours. This will provide prescribers more efficient access to information with less wait time as they make the best clinical decisions possible for their patients.
2. All prescribers will be required to register in the PDMP by Jan. 1, 2018. Currently only about 10 percent of prescribers in Georgia are registered in the PDMP. Prescribers already registered DO NOT need to re-register.
3. Beginning July 1, 2018, prescribers will be required to check PDMP before prescribing opiates or cocaine derivatives in Schedule II drugs or benzodiazepines. (Prescribers are currently encouraged to check the PDMP but are not yet required to do so.)

Register in PDMP

To register in PDMP, go to georgia.pmpaware.net/login. You will need:

• Your name and business address
• Primary phone number
• Last 4 digits of SSN
• DEA number
• NPI number
• Professional license number and type
• Health care specialty

Under the new law prescribers and dispensers are allowed to register two delegates (staff without a DEA number) per shift or rotation to check the PDMP and enter prescription information. However, to ensure prescribers and dispensers are all registered by their mandated date, DPH will register new users in two phases. In the first phase, DPH will ensure all prescribers are registered by Jan. 1, 2018, and in the second phase, DPH will allow new delegates to register.

Georgia PDMP Understanding Your Responsibilities Delegate Training

Help Using PDMP

If you have any questions about the PDMP or registering, please send an email to pdmpsupport@dph.ga.gov or call 404-463-1517.

REGISTERING IN PDMP FAQ

1. Who is required to register in the Georgia PDMP?

Individuals with a DEA number must register in the PDMP including: physicians, physician assistants, pharmacists, licensed pharmacist delegates, dentists, optometrists, podiatrists, nurses with prescriptive authority, medical residents and interns with prescriptive authority.

2. Where do I go to register in the Georgia PDMP?

The URL for registration is https://dph.georgia.gov/pdmp.

1. What information do I need to register in the Georgia PDMP?

Go to https://georgia.pmpaware.net/login and enter your request for an account. You will need your business address, email address, last 4 digits of your SSN, DEA number, NPI number, professional license number and type, primary phone number and health care specialty.

1. Why are physicians and health care providers required to register in the Georgia PDMP?

The PDMP will give you specific information on your patients’ history of filled prescriptions over the last two years.  By using the PDMP, physicians can reduce duplicative prescribing and overprescribing of controlled substances.

I do not practice or live in Georgia but see Georgia residents as patients. Am I required to register in the Georgia PDMP?

No.

1. Do veterinarians have to register in the Georgia PDMP?

No.

1. I live near the state line and practice in two. Is it necessary to have a different DEA number for each state?

Yes, if you prescribe controlled substances in two states. Here is what the DEA says:

“DEA individual practitioner registrations are based on a state license to practice medicine and prescribe controlled substances. DEA relies on state licensing boards to determine that practitioners are qualified to dispense, prescribe or administer controlled substances and to determine what level of authority practitioners have, that is, what schedules they may dispense, prescribe or administer. State authority to conduct the above-referenced activities only confers rights and privileges within the issuing state; consequently, the DEA registration based on a state license cannot authorize controlled substance dispensing outside the state.

1. Is a Veterans Affairs or military prescriber required to check the Georgia PDMP?

A prescriber who is a federal employee practicing on federal property is not required to register for the PDMP or to check it before writing a prescription. However, they are eligible to do so, and the Georgia Department of Public Health encourages prescribers to register and use the PDMP for their Georgia patients.

1. What if health care practitioners choose to ignore the requirements of the law?

Failure to comply with the requirements of the law may subject a health care practitioner to discipline by their licensing board.

USING THE GEORGIA PDMP

1.  When am I required by law to begin using the Georgia PDMP?

You can begin using the system as soon as your account is activated by Georgia PDMP. Beginning July 1, 2018, you will be required to check the PDMP before prescribing some Schedule II drugs or benzodiazepines

1.  When is a prescriber required to check the Georgia PDMP?

A prescriber is required to check the PDMP before writing a prescription for the first time for:

1. Benzodiazepines
2. Opiate drugs or cocaine derivatives listed in Schedule II

Thereafter, if the prescription continues, the prescriber should check the PDMP at least every 90 days.

The prescriber is not required to check the PDMP in these four situations:

• If the prescription is for no more than a three-day supply and no more than 26 pills
• If the patient is in a health care facility, such as a hospital, nursing home, intermediate care home, personal care home or hospice, which provides patient care and prescriptions to be administered to the patient on the premises
• If the patient has had outpatient surgery at a hospital or ambulatory surgical center and the prescription is for no more than a 10-day supply and no more than 40 pills
• If the patient is receiving treatment for cancer

1.  Are prescribers required to check the Georgia PDMP before writing prescriptions for ANY Schedule II drugs?

No. Prescribers are only required to check the PDMP before writing a prescription for a benzodiazipine or one of the opiate drugs listed in Schedule II. Other Schedule II drugs do not require checking the PDMP before prescribing.

1.  Where can I find a complete list of drugs that require checking the Georgia PDMP?

A list of drugs that require checking PDMP can be found here.

1.  Can I see prescriptions that have been dispensed under my DEA number?

Yes, log in to https://georgia.pmpaware.net/login. Click on RxSearch, then click on MyRx. It will give you parameters to search for prescriptions for Schedule II, III, IV, V drugs and benzodiazepines.

1.  Does the Georgia PDMP offer a way for me to compare my controlled substances prescribing against that of other practitioners?

No.

1.  How can I review prescriptions written by my delegates?

Log in to https://georgia.pmpaware.net/login.From the home screen, click on RxSearch, then click on MyRx and enter your delegate’s DEA number.

1.  How do I run a report to view the prescription history of my patient?

Once you are logged in to the Georgia PDMP, click on RxSearch, and then click on Patient Request. You will be asked to provide as much information about the patient as you are able. Click search at the bottom of the screen and the system will display the patient report.

1.  May I share information in the Georgia PDMP with a patient’s insurer?

Information may be shared with a patient’s insurer if the patient has authorized you to make the disclosure, or if the patient’s insurer needs that information in order to provide treatment, payment or health care.

1.  Will health care practitioners be able to find out what controlled substances might have been previously dispensed by out-of-state dispensers?

The Georgia Department of Public Health has entered into agreements with the states of Alabama, South Carolina, Massachusetts and North Dakota for the purpose of sharing and disseminating data and information in the Georgia PDMP.

1.  If I believe that an investigation into a health care practitioner may be appropriate, where do I report my concern?

You should report your concerns to the licensing board with regulatory jurisdiction over that health care practitioner

1.  Are there required steps of action if I suspect a patient is doctor shopping?

You are not required to report a patient whom you suspect of doctor shopping. However, you may wish to discuss your concerns directly with the patient or explore alternatives to the drugs being prescribed.

1.  If I find that a patient is receiving prescriptions for the same substance I am about to prescribe, am I bound legally or merely advised to withhold my prescription?

The PDMP is a tool for prescribers and the use of PDMP information is left to the prescriber’s clinical judgment and discretion.

GENERAL QUESTIONS AND TECHNICAL ISSUES

1.  If I have general questions about the Georgia PDMP, how do I resolve them?

For general questions, contact the Georgia Department of Public Health PDMP staff at 404-463-1517 or email pdmp.support@dph.ga.gov.

1.  If I am having trouble uploading my prescription data what should I do?

Appriss handles all prescription data uploads, so if you are a prescriber or pharmacy having difficulties uploading your data, please call Appriss at 1-855-542-4767 for assistance.

1.  What do I do if I’ve registered in the Georgia PDMP but I’ve forgotten my password?

Go to https://georgia.pmpaware.net/login and enter your email address. Then click on “reset password.” A link will be emailed to you with instructions on resetting your password.

26. How do I register in the Georgia PDMP if I don’t have an NPI number because I don’t take Medicare, Medicaid or any third-party reimbursement?

You must enter 10 digits to register. Use the number “9999999999” to register if you do not take Medicare, Medicaid or third-party reimbursements.

1. Do I have to manually key in my assigned login ID each time I log in to Georgia PDMP?

Yes.

1.  Do all dispensing reports have to be filed electronically?

All dispensing reports must be filed electronically, unless the dispenser has obtained a waiver from the Georgia Department of Public Health on the grounds of undue hardship.

1.  How do I report if the Georgia PDMP is down?

Please send an email to pdmp.support@dph.ga.gov with as much detail as possible about the issue and your contact information.

Through a partnership with the Georgia Department of Public Health, GAFP is offering a webinar on Innovations in Transition from Pediatric to Adult Health Care.

This month’s webinar will be held on March 28^th at 12:30 pm and will feature a presentation by Patience White, MD, MA, Co-Project Director, Got Transition. She will be accompanied by Margaret McManus, MHS, President of The National Alliance to Advance Adolescent Health, a non-profit organization based in Washington, DC. From this webinar, you’ll learn how to examine the relationship between quality improvement activities with pediatric and adult primary care practices and improvements in transition from pediatric to adult care.

At the end of this webinar participants should be able to:

1. Recognize the national case and evidence for pediatric to adult health care transition (HCT) improvements
2. Discuss the 6 Core Element process and tools for Family Medicine clinicians to implement the AAP/ACP/AAFP HCT Clinical Report
3. Describe lessons learned from implementing HCT process in primary care settings
4. Discuss HCT reimbursement codes
5. Discuss what you and your practice can do

Please click the link to register for the March 28^th webinar.

https://attendee.gotowebinar.com/register/3914880808966364419

Can’t Listen Live?  Register anyway – and we’ll send you the recording once it’s posted on our website.

Monique Davis-Smith, M.D., FAAFP, Residency Directory- Department of Family Medicine Medical Center of Central Georgia

Tenesha Wallace, MA, Communication and Public Health Manager

Children 1^st Referrals-Why It’s Important

The early years of life are the most critical time for child development. Identifying issues early and providing interventions can make a world of difference for children and their families. During well-child visits, if a child is at risk for developmental delays or a developmental delay is identified, there are programs available within the Georgia Department of Public Health (DPH) to assist physicians with linking families to early intervention services and support available in their communities. Physicians may also refer families with medically complex children and youth (birth to 21 years of age) with chronic medical conditions to the Department for care coordination services, access to specialty care clinics, and transition from pediatric to adult health care preparation and planning. Early intervention and children and youth with special health care needs services are accessed through the Children 1st program.

Children 1st serves as the single point of entry into all DPH, Maternal and Child Health programs. Services are designed to provide family support, education, linkage to a medical home, and community resources to improve health and developmental outcomes for children as well as enhance parenting skills.

Who should be referred? If there are children in your practice with suspected or confirmed developmental delays, families needing additional support to care for their child with a chronic illness as well as children with significant biological, social and/or emotional risk factors, make a referral to Children 1st. See Table 1.

How do I make a referral?  Referring to Children 1st is simple and can be completed during an office visit. Children 1st is available in every county in Georgia.  Physicians can refer a child by completing the Children 1^st Screening and Referral Form and faxing it to their local Children 1st office. Referrals can also be made online and by phone.

1. Visit the Children 1st website (https://dph.georgia.gov/children1st) to download and complete the Screening and Referral form. When completing the Screening and Referral form, please ensure:

• There is clear patient information on referral form (Name, address, phone number) to reach the family being referred.
• Identified risk factors are clearly indicated on both pages of the screening and referral form.
• Physician notes, discharge summaries and all other associated paperwork with the child’s diagnosis, including ICD-10 codes are attached with the referral form.
• Any developmental screenings that have been completed are attached to the referral form.
• The physician order for therapy or other services being requested are attached to the referral form.
• The physician’s name and contact information is clearly identified on the screening and referral form.

2. Fax the completed Screening and Referral form to the local Children 1st District Coordinator. Using the Maternal and Child Health Locator (https://sendss.state.ga.us/sendss/!mch.coord_search), select the county in which the child currently resides; select the Children 1st program and click search for locations.

3. Contact a local public health Children 1st District Coordinator and make the referral by phone (See the Maternal and Child Health Locator).

4. Complete a referral via the Georgia Department of Public Health’s central intake referral system by phone 1-855-707-8277 or online (https://goo.gl/hBMLBq).

Common Risk Factors for Referral to the Children 1st Program

Table 1

“I have personally had the opportunity to work with Children 1st with several of my patients. Premature births, babies born to teenage mothers, and developmental delay noted on the exam are just a few of the clinical situations that prompted the referral. I found the experience to be extremely simple to initiate. I completed the paper form and my office staff faxed it to the appropriate office. The patient’s families appreciated the care and concern of the Children 1st staff. The communication and feedback I received from the organization was timely and well documented. The patients benefited greatly from the experience. More than half of the children eligible for these services are not identified or referred until school age. This is very unfortunate because early interventions are more effective and less costly than those initiated later in the process. The Children 1st Coordinator is a true friend of the family physician. Please utilize the services and resources Children 1st has to offer your patients. “

-Y. Monique Davis-Smith, M.D., FAAFP

Tenesha Wallace, MA (Manager of Communications and Public Health, GAFP)

18 million U.S. adolescents, ages 18–21, are moving into adulthood and will need to transition from pediatric to adult-centered health care. According to the 2009-2010 National Survey of Children with Special Health Care Needs, only 40% of youth with special health needs are receiving needed transition preparation. Although most providers are encouraging youth with special needs to assume responsibility for their own health, far fewer are discussing transfer to an adult provider and insurance continuity.

Improving transition from pediatric to adult health care is a national priority, a medical home standard, and a meaningful use requirement for electronic health records.  Got Transition aims to improve transition from pediatric to adult health care through the use of new and innovative strategies, clinical recommenations, and transition tools for health professionals, youth and families. The goals in supporting transitions include supporting adolescents in understanding their health care needs and how to manage them, advocating for themselves and communicating their health care needs and realizing their goals in ongoing education, career and personal life.  To achieve this goal requires an organized transition process to support youth in acquiring independent health care skills, preparing for an adult model of care, and transferring to new providers without disruption in care.

Got Transition has updated the clinical resources on transition from pediatric to adult health care.  The Six Core Elements of Health Care Transition 2.0 defines the basic components of transition support.  These core elements are consistent with 2011’s “Clinical Report on Health Care Transition,” which was jointly developed by the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians for use by Pediatrics, Family Physicians and Med-Peds Providers.  The Six Core Elements of Health Care Transition includes the following steps:

1. Transition Policy: Discuss Transition Policy
2. Transition Tracking and Monitoring: Track Progress
3. Transition Readiness: Assess Skills
4. Transition Planning: Develop Transition Plan
5. Transfer of Care: Transfer documents
6. Transition Completion: Confirm completion

Janice Nodvin, Executive Director at the Adult Disability Medical Home (ADMH), started using the Got Transition “Transition Readiness” tool and found it to be supportive with their families. ADMH is a comprehensive medical practice for teens and adults with Down syndrome and other developmental disabilities. ADMH revamped their readiness assessment tool and received feedback from families such as, “the tool helps us think about our young adult’s future medical needs.”  In addition, Janice found that helping families setup an Emergency Plan and repeatedly verbalizing the message helps families to move from planning to preparation.

The American Academy of Pediatrics has just released a 2017 Transition Coding and Reimbursement Tip Sheet to support the delivery of health care transition services in pediatric and adult primary specialty care settings.

The tip sheet includes:

• An updated list of transition-related CPT codes (including the new code for transition readiness assessment) with current Medicare fees and relative value units (RVUs).
• Seven clinical vignettes with recommended CPT and ICD-10 codes.
• Detailed CPT coding descriptions for transition-related services with selected coding tips.

Health Care Transition Resources for Georgia Providers:

• Health Care Transition from Pediatric to Adult Primary Care – Guide for Physicians to Support Youth and Young Adults with Special Health Care Needs
  • https://issuu.com/georgiamaternalandchildhealth
• Georgia Department of Public Health – Transitioning Youth to Adult Care https://dph.georgia.gov/transitioning-youth-adult-care
• Got Transition, The National Alliance to Advance Adolescent Health http://www.gottransition.org/
• Parent to Parent of Georgia – Special Needs Database & Transition Roadmap to Success
  • http://p2pga.org/

Contact Information

Georgia Department of Public Health

Children and Youth with Special Health Care Needs (CYSHCN)

2 Peachtree Street NW

Atlanta, GA 30303

404-657-2850