In this edition:

• Summary of the Strengthen Opioid Misuse Prevention (STOP) Act
• NC Opioid Action Plan, Buprenorphine Training & Opioid Prescribing CME
• Ob/Gyns Gather in Charlotte for the 2017 NC Ob/Gyn Society Annual Meeting
• Additional NCTracks Regional Seminars Scheduled for July
• Leadership Training Opportunities
• M3 – Merging Medicine and Management – Conference, Sept. 14-16
• ACOG District IV Meeting, Oct. 6-8 in Charlotte
• CCNC Launches Community Care Physician Network
• 2017 Annual Meeting Sponsors & Exhibitors

Summary of the Strengthen Opioid Misuse Prevention (STOP) Act

Governor Roy Cooper signed into law on June 29 a bill that will regulate more closely Schedule II and Schedule III opioids (“targeted controlled substances”). Specifically, the STOP Act limits first-time prescriptions of targeted controlled substances for acute pain to ≤5 days (≤7 days for prescriptions following a surgical procedure). This initial prescription limitation does not apply to refills or to prescriptions for the treatment of chronic pain. Additionally, the new law requires providers to submit prescriptions for controlled substances electronically and to utilize the state’s Controlled Substances Reporting System prior to prescribing opioids. Dispensers are impacted as well by provisions that require their participation in the CSRS. The law also expands access to Naloxone and needle/syringe exchange programs.

Key STOP Act Provisions Impacting Prescribers:

• Limits first-time prescriptions of targeted controlled substances for acute pain to ≤5 days, effective January 1, 2018
• Exception: prescriptions following a surgical procedure limited to ≤7 days
• “Acute pain” is defined as pain expected to last for 3 months or less
• “Chronic pain” is defined as pain that lasts for longer than 3 months or beyond the time of normal tissue healing
• “Surgical procedure” is defined as a procedure that is performed for the purpose of structurally altering the human body by incision or the destruction of tissues
• Upon subsequent consultation for same pain, practitioner can issue any appropriate renewal, refill, or new prescription of a targeted control substance
• Limit does not apply to prescriptions for controlled substances that are to be wholly administered in a hospital, nursing home, hospice facility, or residential care facility
• Dispensers are not liable for dispensing a prescription written by a prescriber in violation of this limit
• Requires prescribers to check the CSRS prior to prescribing targeted controlled substances for the first time and then every 90 days thereafter if prescription continues, effective only after CSRS achieves certain improvements (TBD)
• Prescriber must review patient information in CSRS for past 12 months
• Prescriber must document CSRS check in medical record
• CSRS check not required for controlled substances administered in a health care setting, hospital, nursing home, outpatient dialysis facility, or residential care facility, or prescribed for hospice or palliative care or for the treatment of cancer pain
• DHHS shall conduct periodic audits of the review of CSRS by prescribers and shall report to the appropriate licensing board any prescriber found to be in violation of requirement to check CSRS; violation may constitute cause for licensing board to suspend or revoke prescriber’s license
• Streamlines the process of creating delegate CSRS accounts for prescribers in emergency departments, effective July 1, 2017
• Requires physician assistants and nurse practitioners who treat patients in a facility “that primarily engages in the treatment of pain by prescribing narcotic medications or advertises in any medium for any type of pain management services” to “personally consult” with their supervising physician prior to prescribing a targeted controlled substance if use of the substance will exceed/is expected to exceed a period of 30 days, effective July 1, 2017
• Must verify with supervising physician that prescription is medically appropriate
• Must re-consult with physician every 90 days if prescription continues
• Requires electronic prescribing of targeted controlled substances, effective January 1, 2020
• Exceptions:
• Practitioners who dispense to an ultimate user
• Practitioners who order a controlled substance to be administered in a hospital, nursing home, hospice facility, outpatient dialysis facility, or residential care facility
• Practitioners who experience temporary technological or electrical failure, if this reason is documented in medical record
• Prescriptions to be dispensed by a pharmacy on federal property, if this reason is documented in medical record
• Prescriptions written by veterinarians
• Dispensers are not required to verify that practitioners properly fall into one of the exceptions above before dispensing from valid written, oral, or facsimile prescriptions
• Requires DHHS to conduct a study in consultation with the Office of the Attorney General and the NC Veterinary Medical Board on how to implement the provisions of the STOP Act pertaining to electronic prescriptions and the submission of data to the CSRS as they relate to the practice of veterinary medicine; report to be submitted to legislature by February 1, 2018

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NC Opioid Action Plan, Buprenorphine Training & Opioid Prescribing CME

The STOP Act is among many efforts underway to combat the opioid poisoning epidemic that has gripped our country and state over the past two decades. Just days before signing the STOP Act into law, Governor Cooper announced a new Opioid Action Plan, which includes among its strategies expanding access to buprenorphine. Earlier efforts include a law passed in 2015 requiring physicians to obtain CME on opioid prescribing and treatment as part of their licensing with the NC Medical Board. 

Buprenorphine: Free Medication-Assisted Treatment (MAT) Waiver Training:
According to the Drug Addiction Treatment Act (DATA), which was passed in 2000, only “qualified” physicians can treat narcotic dependence through prescribing, or administering a controlled substance (i.e., buprenorphine). To be authorized to prescribe this treatment, a physician must go through approved training and thereby be granted a “waiver” by the DEA. Free MAT waiver training courses for providers, available online and in-person, are offered by the Providers’ Clinical Support System for Medication Assisted Treatment (PCSS-MAT).

New Opioid CME Opportunity:
The July 2017 issue of Obstetrics & Gynecology features four articles on opioid use with associated CME quizzes. Successful completion of each quiz constitutes one hour of CME. The featured articles, as well as the CME quizzes, can help to guide and inform you with respect to opioid prescribing and substance abuse. Completion of the activities count toward your CME requirement on opioid prescribing for your NC licensure.

Quizzes are available for the following articles:

1. Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes: Executive Summary of a Joint Workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, American Congress of Obstetricians and Gynecologists, American Academy of Pediatrics, Society for Maternal-Fetal Medicine, Centers for Disease Control and Prevention, and the March of Dimes Foundation (Reddy et al)
2. A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery (Prabhu et al)
3. Patterns of Opioid Prescription and Use After Cesarean Delivery (Bateman et al)
4. Postdischarge Opioid Use After Cesarean Delivery (Osmundson et al)

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Ob/Gyns Gather in Charlotte for the 2017 NC Ob/Gyn Society Annual Meeting

Dr. Kate Menard

Dr. Kate Menard was elected President of the NC Ob/Gyn Society at this year’s Annual Meeting in Charlotte. Under the excellent leadership of Annual Meeting Program Chair Dr. Elizabeth Livingston, this year’s exceptional meeting included 12 hours of CME programming, and social and networking opportunities. The meeting was held over the weekend of April 7-9 at the newly renovated Charlotte Marriott City Center. The Society thanks outgoing President Dr. Cecilia Grasinger (Boone) for her exemplary leadership. Dr. Grasinger will continue to support the Society in her new roles as Immediate Past President.

Your 2017-2018 NC Ob/Gyn Society Officers & Directors:

President - M. Kathryn Menard, MD, MPH (Chapel Hill)
President-Elect - A. Kellett Letson, MD (Asheville)
Secretary-Treasurer - C. Richard Kirsch, MD (Thomasville)
Immediate Past President - Cecilia F. Grasinger, MD (Boone)
Past President - James T. Al-Hussaini, MD (Mooresville)
Annual Meeting Program Chair - Elizabeth Livingston, MD (Durham)
Member-at-Large - Tana Hall, MD (Greenville)
Member-at-Large - Thor Svendsen, MD (Charlotte)

Congratulations to Dr. Jenna Beckham (UNC) who won the Resident Paper Presentation Competition with her paper titled, “Peripartum Prediction of Postpartum Preeclampsia. Residents from Duke, UNC, MAHEC and Carolinas Medical Center presented at the meeting. As always, registration is complimentary for residents. Paper presenters are also eligible for expense reimbursement and an honorarium. The paper competition winner receives a cash prize.

The NC Ob/Gyn Society extends our heartfelt condolences to Past President Dr. Jim Al-Hussaini and family on the passing of his father, Thamir Al-Hussaini.

Dr. Haywood Brown

Haywood L. Brown, MD, a Duke University Medical Center ob/gyn and maternal fetal medicine specialist and Past President of the North Carolina Obstetrical and Gynecological Society (2012-2013) was installed as President of the American Congress/College of Obstetricians and Gynecologists at the ACOG Annual Meeting in May 2017.

Throughout his career, Dr. Brown has been especially committed to the care of women who are at high risk of adverse pregnancy outcomes, particularly disadvantaged women. He has served as the co-medical director for the Indianapolis Healthy Babies Project and was active with the Indiana Perinatal Network, an organization dedicated to decreasing infant mortality and the racial disparity for infant mortality. He also has chaired the steering committee for the District of Columbia National Institutes of Health Initiative on Infant Mortality Reduction.

Congratulations, Dr. Brown!

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Additional NCTracks Regional Seminars Scheduled for July

Registration is now open for two additional Regional NCTracks Seminars scheduled for July 18 and 31. These sessions help educate new providers, educate new billing staff of existing providers, and serve as a refresher for current and experienced provider staff. They will also allow providers an opportunity to meet and become familiar with their Regional Provider Relations Representatives. Each of the seminars runs from 9:00 a.m. to 4:00 p.m. and they are being offered on different dates and locations across the state. Providers can register for the seminar most convenient for them:

• Tuesday, July 18 - 2610 Wycliff Rd., Raleigh, NC (Ground Floor Training Room)
• Monday, July 31 - 1450 Fairchild Rd., Winston-Salem, NC

Providers can register for the NCTracks Regional Seminars and the Provider Help Centers in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The sessions for the 2017 Annual Regional Seminar and the Provider Help Center can be found in the sub-folder labeled ILTs: On-site. Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort. The Provider Training page also includes a quick reference regarding Java, which is required for the use of SkillPort.

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The NCMS Leadership College Program builds and enhances physician and PA leadership skills and equips graduates to become more influential in motivating and inspiring their peers to be leaders in their medical settings and their communities. Applications for Leadership College are due July 20, 2017.

The NCMS Health Care Leadership and Management (HCLM) Program provides a critical framework for physicians based on economics, finance and leadership development. With this framework, graduates are provided the necessary vocabulary for the business realm and are equipped to take on greater leadership positions in their career. The curriculum is designed with greater emphasis on deeper leadership development and skills that include strategic planning, negotiation and financial literacy and application. Applications for HCLM are due August 18, 2017.

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M3 – Merging Medicine and Management – Conference, Sept. 14-16

The NC Medical Society (NCMS) and the NC Medical Group Management Association (NCMGMA) have joined forces to offer the educational conference of the year, focusing on practice improvement, leadership in health care and personal development. The M3 Conference will be held September 14-16 at the Raleigh Marriott Crabtree Valley. Registration will open soon. For more info, visit the M3 Conference website.

Presented by leading experts and industry professionals, the hand-selected educational sessions will help you understand and implement new payment and practice models, sharpen your leadership and management skills, adapt to changing technology and keep your practice ahead of the curve in the ever-changing world of health care.

This year’s M3 Conference features:

• Informative sessions led by health care leaders in North Carolina who are shaping policy, such as NC DHHS Secretary Mandy Cohen, MD;
• Insight into the latest legislative developments that could impact your practice, including a talk led by Robert L. Laszewski on “U.S. Health Care Policy in a New Administration, A New Era;”
• Camaraderie with your colleagues – physicians, PAs, administrators and managers from throughout the state. Attend receptions offering good food and fun or mingle with your colleagues in the expansive Exhibit Hall.

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ACOG District IV Annual Meeting, Oct. 6-8 in Charlotte

Registration is open for the ACOG District I & IV Annual Meeting, scheduled for October 6-8 in Charlotte, NC. The focus of this year’s meeting theme is “A Lifetime of Well-Being.” The program includes 13 hours of educational content with lectures on patient safety in the office and hospital system, modern management of common pregnancy complications, financial strategies and retirement planning for physicians, and many more! Participants will also enjoy social and networking opportunities, access to recreational activities, and a lively exhibit hall.

• Online registration
• Download the preliminary program for complete meeting details.
• Accommodations: Book your room online or call The Westin Charlotte at 1-866-837-4148 for reservations.
• Exhibiting Opportunities: Please share the Exhibitor Prospectus with the product and service representatives who call on your practice.
• CME & College Cognate Credit: The American College of Obstetricians and Gynecologists designates this live activity for a maximum of 13 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
  The American College of Obstetricians and Gynecologists designates this live activity for a maximum of 13 Category 1 College Cognate Credits. The College has a reciprocity agreement with the AMA that allows AMA PRA Category 1 Credits™ to be equivalent to College Cognate Credits.
• Submit your work and win a trip to Charlotte!
  Abstract Submissions
  Stump the Professor Submissions
  Film Festival Submissions

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CCNC Launches Community Care Physician Network

Community Care Physician Network, LLC (CCPN), is a clinically-integrated network of 2,000 of North Carolina’s independent primary care clinicians and other providers focused on improving the quality of healthcare they deliver. The aim is to preserve North Carolina’s proven community-based population management infrastructure and help prepare medical practices and clinicians to succeed in the new health care environment. For more information, please see the CCPN website.

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Thank You 2017 NC Ob/Gyn Society Annual Meeting Sponsors & Exhibitors!

Platinum Sponsor

Hologic

Gold Sponsors

LabCorp
Medtronic

Exhibitors: AbbVie | AMAG Pharmaceuticals | Babyscripts | Bayer Healthcare | CareSource | Carolinas Cord Blood Bank | Carolina Complete Health | Cooper Surgical | Cynosure | Eastern Carolina Pathology | GE Healthcare | Hands-on Postpartum IUD Placement | High Point University Dept. of Physician Assistant Studies | Hitachi Aloka Medical | Lina Medical | MagMutual | March of Dimes | Medical Mutual | MedMal Direct Insurance Company | Merck and Co., Inc. | Mission Pharmacal Company | MotherToBaby North Carolina | Nanosonics, Inc. | Neff & Associates | PathGroup | Philips | Practis | Pregnancy Medical Home | Quest Diagnostics | Sciton | SonoSim, Inc. | Syneron Candela | TherapeuticsMD | UNC Center for Maternal & Infant Health

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