GA Rep. Allen Peake Discusses Medical Marijuana Legislation

Representative Allen Peake serves the citizens of Georgia’s 141st District, which includes Macon. He is in his sixth term in the Georgia House. In 2015, Representative Peake sponsored Haleigh’s Hope Bill – a measure that was signed into law that allows Georgians who have specific conditions – including children who have seizures – to possess medical cannabis oil in Georgia. He is now sponsoring a bill that would expand the list of conditions that are covered by that law – as well as legislation that would allow a public vote on whether Georgia should allow the production and distribution of medical cannabis.

Neonatal Abstinence Syndrome

This week Womens Telehealth CEO, Tanya Mack hosts Dr. Meg Prado to talk about Neonatal Abstinence Syndrome.  With the continued rise in rates of prescription medications, coupled with high incidence of illicit drug use, it is becoming all-too-common for babies to be born who are addicted to prescription and/or illicit drugs.

Dr. Prado joined us to talk about the scope of this problem, along with what clinicians who care for pregnant mothers and/or newborn infants need to look out for to identify these babies as soon as possible to be able to adequately care for them.

House HHS chair addresses flawed eye care bills on ‘Top Docs’ show 

Georgia Rep. Sharon Cooper (R-Marietta) – the chair of the Georgia House of Representatives Health and Human Services Committee – discussed several bills that she believes would place thousands of Georgians at risk of blindness and other serious eye complications when she appeared on a special edition of the Medical Association of Georgia’s (MAG) ‘Top Docs Radio’ program on the Business Radio-X Network on February 23. Click here to listen to a recording of the show.

Rep. Cooper addressed her concerns surrounding H.B. 416 and S.B. 221, measures that would allow optometrists to perform a variety of extraocular injections.

MAG President Steven M. Walsh, M.D., shares Rep. Cooper’s concerns, stressing that, “MAG is opposing these measures because they would inappropriately expand optometrists’ scope of practice and they would undermine patient care.”

Rep. Cooper also notes that, “Medicine is effectively under attack these days, so it is imperative for doctors to get involved in the legislative process.”

She is encouraging physicians and patients to (to what action…contact who?) to encourage lawmakers to oppose H.B. 416 and S.B. 221.

Rep. Cooper has sponsored key legislation that has been enacted in Georgia, including an HIV screening bill for pregnant women, the Georgia’s Smoke Free Air Act, and the Health Share Volunteers in Medicine Act.

MAG sponsors the ‘Top Docs’ program at 12 p.m. on the second and fourth Tuesday of every month. Between downloads and live listeners, MAG’s ‘Top Docs’ show has reached more than 9,000 listeners – which includes people in all 50 states and 84 countries.

MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.

Contact MAG Government Relations Director Derek Norton at dnorton@mag.org or 404.274.4210 with questions related to H.B. 416 and S.B. 221.

Surprise Insurance Coverage Gaps

After receiving emergency care at an “in-network” hospital, patients often discover that they
received care from an “out-of- network” physician and owe a lot of money. This is the “surprise
insurance coverage gap.” The patient pays their monthly premium, yet they receive unexpected
“balance bills” for amounts their insurance company refuses to cover – keeping in mind the
insurers are narrowing their networks to reduce costs and maximize profits by subjecting
physicians to inadequate, take-it- or-leave- it contracts.

Physicians in Georgia believe that it is critical to end the surprise insurance gap in emergency
medicine care settings. Physicians have seen their patients’ financial burden increase in dramatic
ways as health insurance companies have narrowed their networks. Health insurance is so
ambiguous that the most sophisticated patients have trouble understanding the rules.

Many patients try to do the right thing and go to a hospital that is in their insurance network during an
emergency – but they often don’t have any way of knowing when a doctor they need to see is in or
out of their network.  The Medical Association Georgia and other physician and patient advocacy organizations are calling for state lawmakers to put an end to balance billing in emergency care settings by passing legislation that will close the surprise coverage gap. MAG is also supporting the ‘End the Surprise Insurance Gap’ campaign.

Dr. Matthew Keadey has been an emergency physician in the Atlanta area for nearly 20 years. He
began his career at Emory Healthcare. He now works in the Emory and Grady Health systems. He
is the president-elect of the Georgia College of Emergency Physicians, and he is a member of the
Medical Association of Georgia. Dr. Keadey is an expert in emergency department billing, coding
and reimbursement.

Dr. Mark Bernardy has been a private practice general/interventional radiologist in Georgia for 30
years. He is a member of the Georgia Radiological Society’s Board of Directors. Dr. Bernardy is
the vice chair of the American College of Radiology’s Economics Commission and a board
member of the Radiology Business Management Association. He is active in Georgia politics,
advocating for radiologists, physicians, and patients. His advocacy efforts started with colon
cancer screening.

Drs. Keadey and Bernardy are leading advocates for ensuring that patients have access to fair
insurance coverage in emergency care settings in Georgia.

Representative Sharon Cooper Talks Georgia Healthcare

The legislative process is an important way to improve Georgia’s health care system and the practice environment. MAG spent a lot of time reaching out to lawmakers and other important stakeholders after the General Assembly ended in 2015 to ensure that it would be in a good position to effect pro-physician and pro-patient change during this year’s legislative session. MAG is focused on several key areas in 2016, including physician autonomy, Medicaid, health insurance, tort reform, and prescription drugs.

Representative Sharon Cooper is the chair of the House Health and Human Services Committee. She has been a champion for key legislation for patients and physicians in Georgia, including an HIV screening bill for pregnant women, Georgia’s Smoke Free Air Act, and the Health Share Volunteers in Medicine Act. She is known for being one of the hardest working and most honest and straightforward legislators in the state. It is also worth noting that she was married to the late Dr. Tom Cooper, who co-founded MAG’s Doctor of the Day program at the State Capitol.

Special Guest:

Sharon Cooper, Georgia House of Representatives Distric 43, Chairman-House Health & Human Services Committee

Sharon Cooper, R-Marietta, GA District 43

Telemedicine in Neurology and Beyond

Womens Telehealth CEO, Tanya Mack sat down with Emory Healthcare’s Dr. Gregory Esper.  Gregory Esper, MD, MBA is currently Associate Professor and Vice Chairman of Clinical Affairs for the Department of Neurology, and he also is Director of General Neurology and Neuromuscular Diseases. He serves Emory Healthcare in the capacity as the Director of New Care Models.

Dr. Esper shared his perspective of the role of telemedicine in neurology, as well as how Emory Healthcare is evaluating other areas of need for access to care where telemedicine can be deployed to simultaneously provide greater efficiency for patient and care provider, as well as improving the health of the population served.

We talked about how patient information is protected while using this technology, as well as some of the current limitations that confound expansion of telemedicine to the patient’s home on a larger scale.

Throughout the world and US, there is a shortage of neurologists, which is expected to worse, not improve in the coming years. The access is outstripped by the demand, especially in rural areas, where
geographical disparities exist. Georgia has over 100 counties that have no neurologist.

Telemedicine improvements and patient and provider adoption, especially over recent years, has proven that in many cases, reliable remote diagnosis can be made, patient outcomes are positive and costs can be saved.

Treatment of stroke, multiple sclerosis, Parkinson’s, epilepsy and some urgent neuro problems can be
managed via telestroke medicine. In 2016, Emory University opened a remote telemedicine service.
Listen in as Dr. Greg Esper updates us on new developments in telestroke and Emory’s new program.

MAG’s 2017 Legislative Priorities

Out-of- Network Billing & Network Adequacy: MAG will 1) support reforms that will require appropriate

network adequacy standards for health insurers and 2) call for health insurers to be more transparent in

their contracts with physicians’ practices and 3) support legislation that will result in physician payment

methodologies that are adequate and sustainable for out-of- network emergency care.

Medicaid Payment Parity: MAG will be an advocate for the General Assembly to continue to fund the

Medicaid parity payment program for all areas of primary care.

Maintenance of Certification: MAG will 1) work to ensure that MOC is not a condition of licensure or a

condition of hospital credentialing and 2) support efforts that will alleviate the costly and burdensome

aspects of MOC for physicians.

Patient Safety: MAG will be an advocate for legislation that improves patient safety.

Opioid Abuse

One of the MAG Foundation’s key programs is the ‘Think About It’ campaign to reduce prescription drug

abuse. The MAG Foundation has 1) funded 18 prescription drug disposal boxes, which allows Georgians to

dispose of their unneeded or expired prescription drugs in safe and anonymous and secure manner and 2)

distributed more than one million educational leaflets in the state and 3) given presentations at more than

50 town halls and 20 physician education events and 4) established social media and/or other educational

campaigns on 10 college campuses as part of its ‘Higher Education TAKE-BACK Initiative.’ The MAG

Foundation is also managing ‘Project DAN’ (Deaths Avoided by Naloxone), which has provided first

responders in 13 counties in Northeast Georgia with more than 1,300 doses of naloxone – which can be

used to save patients who are suffering from a drug overdose. This effort has already been credited with

saving 18 lives in northeast Georgia. It’s also worth noting that Georgia DPH Commissioner Dr. Brenda

Fitzgerald recently issued a standing order that authorizes pharmacies to dispense naloxone.

www.rxdrugabuse.org

HealtheParadigm

HealtheParadigm is a new, physician-led health IT solution that enables physicians to generate

sophisticated patient data reports that they can use to improve patient outcomes and fulfill the new quality-

based payer metrics. HealtheParadigm will enable physicians to improve care coordination, establish better

relationships with their patients, fulfill the new payer performance metrics, and reduce the administrative

burden for them and their staff. www.healtheparadigm.com

Talking Depression With Dr. Mark Rappaport

Mark Hyman Rapaport, M.D., the chair of the Department of Psychiatry and Behavioral Sciences and the Reunette W. Harris Professor at the Emory University School of Medicine and the chief of Psychiatric Services at Emory Healthcare, will discuss depressive disorder when he appears on the Medical Association of Georgia’s (MAG) ‘Top Docs Radio’ program on the Business Radio-X Network at 12 p.m. today, Tuesday, December 27.

“Major depressive disorder has a lifetime prevalence rate of more than 15 percent,” says Dr. Rapaport. “That means some 900,000 people in the Atlanta region alone will suffer from an episode of major depressive disorder at some point in their lives.”

He explains that, “Major depression is associated with increased overall mortality, increased suicide rates, and marked dysfunction at work and in social settings. In addition to the individual, depression affects the patient’s loved ones and colleagues and friends.”

According to Dr. Rapaport, depression is highly comorbid with other medical conditions such as heart disease or high blood pressure or diabetes, and it adds exponential costs to the treatment of those disorders.

He also points out that a World Health Organization study determined that depression is the second greatest cause of disability in the world – and the first among women who are over the age of 18.

Dr. Rapaport will discuss major depressive disorder care, including evidence-based psychotherapies, pharmacological treatments, and somatic therapies – stressing that, “One in three patients who suffer from depression have a form of depression that tends to be resistant to most typically employed treatment interventions…more than 300,000 people suffer from treatment resistant depression in the Atlanta area.”

MAG sponsors the ‘Top Docs’ program at 12 p.m. on the second and fourth Tuesday of every month. Between downloads and live listeners, MAG’s ‘Top Docs’ show has reached more than 8,300 listeners – which includes people in all 50 states and 84 countries.

MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.

Click to listen to ‘Top Docs Radio’

Click for Emory Department of Psychiatry and Behavioral Sciences web page

Mental Health Resources

Emory Outpatient Clinic: 404.778.5526

Emory Treatment Resistant Depression Clinic: 404.712.8732

National Suicide Prevention Hotline: 800.273.8250

Georgia Crisis and Access Line (for immediate assistance): 800.715.4225

Depression and Bipolar Support Alliance/Atlanta Chapter: www.atlantamoodsupport.com

Mental Health America/Georgia Chapter: www.mhageorgia.org

National Institute of Mental Health: www.nimh.nih.gov

National Alliance on Mental Illness: www.nami.org

Centering Pregnancy

On this week’s show, Womens Telehealth’s Tanya Mack sat down with Certified Nurse Midwife, Anna Cherry, of Providence Women’s Health Care of Roswell, to learn about how the centering pregnancy prenatal care program their practice has been participating in is improving outcomes for the patients they serve.

Centering Healthcare Institute explains how centering pregnancy works:  Centering group prenatal care follows the recommended schedule of 10 prenatal visits, but each visit is 90 minutes to two hours long – giving women 10x more time with their provider. Moms engage in their care by taking their own weight and blood pressure and recording their own health data with private time with their provider for belly check.