Researchers at Johns Hopkins Hospital reported that patients treated with buprenorphine for opioid use disorder show surprisingly significant improvements in adhering to medications for other chronic unrelated conditions.

Published in the journal Medical Care (2019;57[9]:667-672), the population-based, retrospective study reviewed medical records for more than 12,000 patients with a diagnosis of opioid use disorder (OUD) who were given buprenorphine, a partial opioid agonist widely used to treat OUD. Expanded use of buprenorphine is linked with the national epidemic of opioid misuse. In 2016, approximately 700,000 Americans filled buprenorphine prescriptions—more than double the number 10 years earlier. However, a recent study found disparities in access to the medication. The rate of Medicaid-covered prescriptions for buprenorphine was much lower in states that did not expand their Medicaid programs in accordance with the Affordable Care Act.

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Novitasphere, our free, secure internet portal, now provides users with access to Financial Information to obtain the following:

• Check number
• Check amount
• Check date
• Check status

In addition, users are able search using the Financial Control Number lookup tool to identify the claim involved.

Important reminder! Effective January 1, 2020, all claims submitted to Medicare must be billed with the Medicare Beneficiary Identifier (MBI) in place of the Health Insurance Claim number (HICN).  Use the MBI Lookup tool in Novitasphere to obtain your patients’ MBIs!  Angela from Professional Rehab Associates finds the MBI Lookup tool to be one of the most beneficial features in Novitasphere.  “I love that when patients give us their old Medicare cards, I can still look it up to get their new ID number.” 

The Trump administration has launched a smart new salvo in the public health offensive against the opioid epidemic.

Addiction to these prescription painkillers and related street drugs continues to wreak havoc in communities across the nation. Last week, the White House announced the launch of a new website that will make it easier to find specialized medical care close to home.

This confidential, easy-to-use resource has a name succinctly summing up its mission — FindTreatment.gov. It also allows individuals to customize their search results beyond location, a feature that existing “find a substance abuse provider” websites often don’t offer.

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Input Needed for 2020 Medical Quality Review Annual Audit Plan

The Division of Workers’ Compensation is asking for input on the 2020 Medical Quality Review Annual Audit Plan (Annual Plan). The Annual Plan sets the priorities for the Medical Quality Review Panel audits during the upcoming year.

More information is on the TDI website.

Research Group Releases Pharmacy Formulary Report

The Research and Evaluation Group has released a report on Texas pharmacy closed formulary outcomes. This study looks at injured employee outcomes such as return-to-work rates and health outcomes since the formulary was implemented.

Need just the key findings? Check the TDI website for our new snapshot tool on the pharmacy formulary report.

Physicians and Teaching Hospitals

• Learn how to register to review (and dispute) your financial data.
• Step by step guides available.
• Already registered?  Login here.

**Review and Dispute activities start on April 1st and can continue until end of the calendar year**

CALL FOR CASE STUDIES: The Texas Pain Society invites members and others to submit case studies to be considered for presentation at the 11th Annual Scientific Meeting.

The call for case study is open to Texas fellows and residents in a pain fellowship. Entries must be received before the cutoff date. All submissions will be reviewed by the committee and the top 5 submissions will be asked to present live at the TPS 11th Annual Scientific Meeting in October.

 2019 Winners!

Today, the U.S. Department of Health and Human Services published a new Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics - PDF. Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks.  But once a patient is on opioids for a prolonged duration, any abrupt change in the patient’s regimen may put the patient at risk of harm and should include a thorough, deliberative case review and discussion with the patient. The HHS Guide provides advice to clinicians who are contemplating or initiating a change in opioid dosage.

The Samuel J. Hassenbusch, MD, PhD Continued Learning Scholarships are annual scholarships sponsored by the Texas Pain Society & Texas Pain Foundation and created to honor the memory of TPS Board Member, Dr. Sam Hassenbusch.

Dr. Hassenbusch was an advocate for teaching and spent a majority of his life teaching others what he had learned.

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Description: 
The Texas Prescription Monitoring Program (PMP) helps health professionals make decisions about prescribing and dispensing and can be used to improve patient health. Four experts will share their knowledge about the Texas PMP, enhancements to the system, and new tools available to help you feel confident about sending someone home with opioids.

Learning Objectives:

• Describe the Texas PMP and what it can do. 
• Discuss how to register for and use the Texas PMP. 
• Examine free tools to aid patient conversations about opioid use, misuse, and safe disposal.

1.5 Continuing Education Credits/Contact Hours Available for the Following (live* event only):

Before the 2019 Texas Legislature passed House Bill 3703, the medical use of cannabidiol (CBD) products in Texas was confusing for physicians and authorized only a narrow group of patients: people with intractable epilepsy.

Thanks in part to the new state law, it’s still confusing and includes a somewhat larger group of patients – all patients with epilepsy as well as those with seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis (ALS), autism, terminal cancer, and incurable neurodegenerative diseases.

Confusion has been fueled by another 2019 measure: House Bill 1325 legalized the production and sale of hemp and some products derived from hemp that have high levels of CBD, which is non-euphoric and has low levels of tetrahydrocannabinol (or THC), the psychoactive element in marijuana.

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The Texas PMP is a patient care tool that can be used to inform prescribing practice and to address prescription drug misuse, diversion, and overdose. As the only statewide electronic database that stores all controlled substance information, the Texas PMP helps prescribers and pharmacists avoid potentially life-threatening drug interactions, decide when to make referrals to specialty treatment providers, and identify individuals obtaining controlled substances from multiple health care providers and pharmacies. The Texas PMP shares prescription data with 30 other states/entities, allowing prescribers and pharmacists to track prescriptions dispensed outside of Texas.

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Key findings

Data from the National Health and Nutrition Examination Survey and the Canadian Health Measures Survey

• Nearly 7 in 10 adults aged 40–79 used at least 1 prescription drug in the past 30 days in the United States (69.0%) and Canada (65.5%), and around 1 in 5 used at least 5 prescription drugs (22.4% in the United States and 18.8% in Canada).
• Among adults aged 40–59, the most commonly used drug types in the United States were antidepressants, lipid-lowering drugs, and ACE inhibitors; in Canada, they were analgesics, antidepressants, and lipid-lowering drugs.
• Among adults aged 60–79, the most commonly used drug types in the United States were lipid-lowering drugs, antidiabetic agents, and beta blockers; in Canada, they were lipid-lowering drugs, analgesics, and proton pump inhibitors.

Patterns of prescription drug use may reflect underlying patterns of health conditions and health care access in the population. Polypharmacy, often defined as the simultaneous use of five or more prescription drugs, is more common in an aging population where multiple coexisting chronic conditions often occur; however, safety concerns may arise (1). The United States and Canada share many cultural and historical ties, but with different models for health care delivery (2). This report describes the use of one or more and five or more prescription drugs among adults aged 40–79 in the United States and Canada.

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The PDMP Training and Technical Assistance Center (TTAC) continuously strives to keep prescription drug monitoring programs (PDMPs) and other stakeholders informed and current on the issues that concern and impact PDMPs. Legislative and regulatory change is an area TTAC monitors in order to provide an in-depth overview of PDMPs across the United States. TTAC has compiled a complete listing of all state PDMP statutes and regulations. The report is broken down by topic area (e.g., data transmitters, authorized recipients, mandatory query provisions) for each state, territory, and jurisdiction with a PDMP. The information in the report is based on the statutes and regulations in each jurisdiction and every effort has been made to ensure its accuracy. TTAC will strive to keep the information current with routine updates. The statutory and regulatory citations included in the report are current through June 30, 2019. A copy of the report can be found here: Statutes and Regulations.