New Hampshire Medicaid Telehealth Fact Sheet during COVID-19 State of Emergency Declaration March 18, 2020 This guidance is being issued in light of the State of Emergency, and the Governor’s March 18, 2020 Emergency Order #8 temporarily expanding telehealth services during the COVID-19 State of Emergency Declaration.

This expansion and guidance is only in effect for the duration of the State of Emergency. In order to protect the public’s health and mitigate exposure to, and the spread of, COVID-19, Governor Sununu has signed an emergency order, effective immediately, that expands the coverage of telehealth for Commercial insurance and Medicaid including for Managed Care Organizations (MCOs) in regards to eligible providers, originating site, and modality of telehealth platform.

Telehealth reimbursement typically requires live video and audio, however, during the declared state of emergency period related to COVID-19 in New Hampshire, audio only telehealth is eligible for reimbursement.

Eligible Providers:

• Physicians/Physician Assistants/APRNs/Clinical Nurse Specialists/Nurse Midwives Certified Registered Nurse Anesthetists Clinical Psychologists, Clinical Social Workers,
• Master’s Level Psychiatric Nurses School Psychologists licensed by the Board of Psychologists Pastoral psychotherapists,
• Marriage and Family Therapists,
• Clinical Mental Health Counselors LADCs, MLADCs, CRSWs,
• Applied Behavioral Analysts Providers licensed by the Board of Mental Health Practice Community Mental Health Programs designated by the Department of Health and Human Services.

Dentists Registered Dietitians or Nutritional Professionals Originating Sites: There are no restrictions, and may include a private residence.

Reimbursement: Medicaid pays the same rate as if the service was provided face-to-face. Billing for the service delivered should follow routine practices as if the service was provided face-to-face, with the addition of a modifier GT indicating the service was provided via telehealth and indicate place of service (POS 02: Telehealth). There is no additional payment to originating sites. Documentation standards follow the regular standards as if the service was delivered face-to-face. Confidentiality and Privacy Protection

Considerations: On March 17th, 2020, the Office for Civil Rights at the U.S. Department of Health and Human Services announced discretion in enforcement of HIPAA rules during the national declaration of a state of emergency related to COVID-19 in order to allow or expanded use of telehealth. In addition to HIPPA compliant telehealth platforms, practitioners may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype. Facebook Live, Twitch, TikTok, and similar video communication applications that are public facing, should not be used. Telephone only audio may also be used. If you have questions regarding please call the New Hampshire Medicaid Provider Call Center 866-291- 1674 or 223-4774, or email NHProviderRelations@conduent.com. Attachment: March 18, 2020 Emergency Order.

Clocktree Telehealth Platform

NAADAC has partnered with Clocktree Systems Inc. to provide an affordable, HIPAA compliant telehealth platform to its members. 

Try Clocktree for FREE for 90 days, then select the plan that's right for you!

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NAADAC members receive a 15% discount off all plans for the lifetime of their NAADAC membership. Enter promo code NAADAC when choosing a plan.

Clocktree’s pricing is unique in that monthly prices are per practice for unlimited practitioners and unlimited clients and no long-term contracts are required.

https://www.governor.nh.gov/news-media/emergency-orders/documents/emergency-order-8.pdf

COVID 19 (Coronavirus) is currently top of mind for most of us.  We want to assure you that NHADACA and NHTIAD is taking action to both fully maintain operations. As always, our members, colleagues, and our communities are our top priorities.   On March 16, Governor Sununu announced a state of emergency due to COVID-19 with a memo outlining the recommendations of NH Right to Know law RSA 91-A.- you may read those details attached.  Additionally, you will find practical tips from SAMHSA with additional resources listed.  On March 10, Beacon Health made announcements about billing for covered services delivered telephonically such as video/telephonic counseling (when clinically appropriate) to reduce risk.  Billing will be accepted as of April 1 for dates of service beginning from March 12.  

We understand the complications this outbreak may bring in carrying out the work all of us are doing.   Many employers have already implemented the CDC social distancing protocols and we are learning more about how to navigate these challenges every day.  In order to focus on disease prevention efforts and reduce the spread of the virus, the Right to Know NH RSA 91-A enables sharing of this important information.   According to guidance issued in March 2020 by OSHA on Preparing Workplaces for COVID-19, everyone should engage in frequent and thorough hand washing. You should make sure to have a place available where you can wash your hands. If soap and running water are not immediately available, have readily available alcohol-based hand rubs containing at least 60% alcohol.  To summarize, CDC has identified following these steps to minimize risks to exposure;

1. Have you visited a doctor’s office or medical facility in last 14 days?

2. Have you had any contact with someone who has been diagnosed with Covid-19 in last 14 days

3. In the past 14 days, you have traveled to (or been in close contact with someone who has traveled to) China, Iran, South Korea, Italy, or any other high-risk country as identified by the CDC

4.  If you believe you have been exposed to the coronavirus or if you are experiencing symptoms consistent with COVID-19 (including fever, cough, sore throat, and/or difficulty breathing), contact your health care provider to schedule a test, practice self-quarantining, handwashing, and limiting contact with others.

Review the guidance released by the Centers for Disease Control and Prevention (CDC) on how to protect yourself from the coronavirus

Relying on the expertise of the CDC and our local health officials, we are committed to sharing information as soon as we have it to protect the health and wellbeing of our members, colleagues, and communities. 

Helpful Links and other resources:

• CDC information on managing anxiety and stress during this time
• COVID-19 Guidance for Opioid Treatment Programs from SAMHSA
• Coronavirus (COVID-19): What the CDC Is Recommending to HIV/AIDS Clinicians via TheBodyPro
• Contact your liability insurance carrier for additional information relevant to your practice and work setting

Most kind regards from everyone at NHADACA and NHTIAD

Dear NHADACA / NHTIAD Community,

All NHADACA trainings and events through the end of April will be converted to remote attendance via Zoom or cancelled.  In the next few weeks, we will evaluate doing the same for May and June.  We are working diligently to consult presenters on the applicability of their training to an online format, update the website, notify registrants, and process credits & refunds.  We are doing our best to respond to your health and credentialing needs, and as soon as possible we will also start working from home ourselves.  We will still have access to emails and phone messages, but it may take slightly longer to get back to you (at least initially).  Please check our website for trainings that are cancelled, but remember we are still working on March & April and will update May and June as soon as we can.

Most sincerely yours,

Dianne Pepin Castrucci, MLADC

Effective Immediately, and for a period of 30 days from today, ALL TESTING SERVICES ARE HALTED throughout the United States and Canada.

Within the past 24 hours, the US Centers for Disease Control (CDC) have issued updated guidance on measures to be taken to reduce the spread of the COVID-19 disease.  In particular, the CDC lowered the number of people that should be able to congregate in the same space from 50 to 10 in the United States. 

Given this new guidance, Prometric has determined it is necessary and appropriate to close our test centers in the United States and Canada for a period of 30 days, starting today on March 17.  This dramatic step is necessary in order to comply with this new federal guidance as well as to further protect the health and well-being of the individual test takers and the staff that provide services at each of our testing locations.  We anticipate re-opening our test centers effective April 16, however, please note that the specific date will be dependent on circumstances that are changing daily.

Operations teams are actively reaching out to individuals with testing appointments today and throughout the closure period, in an effort to prevent them from unnecessarily appearing at the testing centers.  We will be taking measures to reschedule those impacted appointments into a new date after the planned re-opening and will be communicating that information to the impacted individuals.  We will work closely with the test takers to find new appointment dates and times that work for their schedules, and we will be waiving any rescheduling fees.

HIPAA Rules During the Coronavirus - COVID-19 - Outbreak

The HIPAA Privacy Rule and OCR guidance clearly explain how Covered Entities and their Business Associates may collaborate and communicate with other Covered Entities and Public Health Authorities during the COVID-19 outbreak, and how to communicate with family, friends and others involved in the patient’s care.

Date: Wednesday April 1, 2020
Time: 10:00 AM PDT | 01:00 PM EDT
Duration: 60 Minutes
Instructor: Maggie Hales

Overview:

A widespread infectious disease outbreak like COVID-19 stresses the health care system.

HIPAA Rules regarding protected health information (PHI) are not suspended, but key provisions in the Privacy Rule manage the permitted and required uses and disclosures of PHI. And, if there is a Presidential Declaration of a Public Health Emergency, the Secretary of the U.S. Department of Health and Human Services can temporarily waive some HIPAA requirements.

The HIPAA Privacy Rule and OCR guidance clearly explain how Covered Entities and their Business Associates may collaborate and communicate with other Covered Entities and Public Health Authorities during the COVID-19 outbreak, and how to communicate with family, friends and others involved in the patient’s care. 

This webinar will explain how Covered Entities and Business Associates can continue to serve their patients and wider communities with patient care, and protect themselves from HIPAA violations, and what are the limited waivers if the President declares a Public Health Emergency. 

Why you should Attend:

You will find out how to follow HIPAA and use and disclose PHI during the COVID-19 outbreak. You will also learn how to coordinate and collaborate with Public Health Authorities, and communicate with persons at risk for contracting the disease; in situations to prevent a serious and imminent threat; and with the media and others not involved in the patient’s care. You will also learn about the limited waivers of HIPAA sanctions and penalties for hospitals in a Presidential Declaration of a Public Health Emergency.

Areas Covered in the Session:

• Brief review of the HIPAA Privacy Rule, HIPAA Authorization and the Minimum Necessary Standard
• How HIPAA Rules apply in a public health emergency like an infectious disease outbreak
• Review of the situations where patient information may be shared without an individual’s Authorization
• Communication with family, friends and others involved in a patient’s care
• Disclosures to prevent a serious and imminent threat
• Disclosures to the media and others not involved in the care of the patient/notification
• How the Minimum Necessary Standard applies
• In the event of a Presidential Declaration, how the limited waiver of HIPAA sanctions and penalties for hospitals apply, including which hospitals may count on the waivers

https://www.globalcompliancepanel.com/webinar/hipaa-rules-during-the-coronavirus--covid19--outbreak-/602224LIVE?channel=mailer&camp=webinar&AdGroup=MAGGIE_HALES_APR01_MAR12_IBM

brought to you by your NHADACA Ethics Committee

The following updates related to the work of the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience (Clinician Well-Being Collaborative). 

Taking Action Against Clinician Burnout Report

The NAM released the consensus report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being, in October 2019. The report calls upon leaders in health care organizations, health professions educational institutions, government, and industry to prioritize major improvements in clinical work and learning environments across all care settings, and for all disciplines to prevent and mitigate clinician burnout and foster professional well-being for the overall health of clinicians, patients, and the nation.

Check out the related products that have been released since October:

● Research Agenda

● Health Care Leadership Brief

● Report Highlights

● Report Recommendations

● Key Messages

● Social Media Toolkit

The NAM Clinician Well-Being Collaborative is committed to elevating the findings, conclusions, and recommendations from the report, as well as translating the report recommendations into action. We look forward to keeping you updated on these endeavors.

Top 10 NAM Perspectives of 2019

1.     In 2019, NAM Perspectives papers were released on a variety of topics, including reducing clinician burnout. Half of the 10 most popular titles of 2019 were products of the NAM Clinician Well-Being Collaborative! Check them out below:
2.     Implementing Optimal Team-Based Care to Reduce Clinician Burnout
3.     Burnout Among Health Care Professionals: A Call to Explore and Address this Underrecognized Threat to Safe, High-Quality Care
4.     Nurse Suicide: Breaking the Silence
5.     Gender-Based Differences in Burnout: Issues Faced by Women Physicians
6.     Burnout and Job and Career Satisfaction in the Physician Assistant Profession: A Review of the Literature

Visit nam.edu/PerspectivesTop10 to access additional information about all of the top 10 papers, as well as a social media kit to share these papers with your colleagues and friends. Read additional publications from the NAM Clinician Well-Being Collaborative.   

Health Policy Institute of Ohio’s Evidence-Based Policy Brief on Clinician Well-Being and Patient Safety

Bernadette Melnyk, Vice President for Health Promotion, University Chief Wellness Officer, and Dean & Professor of the College of Nursing at The Ohio State University, worked on an evidence-based policy brief on clinician well-being and patient safety with the Health Policy Institute of Ohio, which builds upon the work of the NAM Clinician Well-Being Collaborative. They released the brief during a successful state-wide forum at Ohio State with policymakers and health care leaders across the state of Ohio. Additionally, they are launching a state-wide action collaborative to address clinician burnout, and encourage others to form similar state-wide efforts. Access the brief and executive summary.

 

Medicare clients are turned away from substance use disorder treatment or are serviced for free because they can't access therapy with a counselor who is also a Medicare provider. The Medicare system has historically only accepted and reimbursed services of master’s level clinicians who are licensed social workers.   There are a large number of qualified clinical professionals with equal, or additional, qualifications to treat substance use and other co-occurring mental health disorders, that cannot bill Medicare. Medicare reimbursement policies must be modified.  There is a current bill that can solve this problem, but it needs your help to move forward.

The "Medicare for America Act" was sent to the House in May of 2019 and then to the judiciary committee on 5/31/19. It now needs to get out of committee, get drafted to include language allowing MLADCs and LCMHCs to be reimbursed for Medicare, and sent to the Senate.  Call or write your Congressperson.

The Addiction Treatment Access Act does make changes and is in front of the Senate, as of August of 2019. It is currently in the committee on finance. We have to see some movement.  Please call or write your senator.

Ask them to help get these bills pushed through and support them becoming law.  

Congresswoman Annie Kuster https://kuster.house.gov/contact/offices

Congressman Chris Pappas https://pappas.house.gov/contact

Senator Jeanne Shaheen https://www.shaheen.senate.gov/

Senator Maggie Hassan https://www.hassan.senate.gov/contact

Brought to you by your NHADACA Ethics Committee

https://psychcongress.com/article/psychotic-symptoms-some-marijuana-users-challenge-providers?utm_campaign=NCAD%20Enews&utm_source=hs_email&utm_medium=email&utm_content=83223151&_hsenc=p2ANqtz-_m6EkNDJhBJnaDw4TxlT_se67XMuOxYpx0uhPUf_VGKGeqldtGA1fxmcKOlQJbct31gtrHZmsUfNU5RLZrU3QLoedUKA&_hsmi=83223151

Psychotic Symptoms in Some Marijuana Users Challenge Providers

Today's increasingly favored delivery systems for the psychoactive compound in marijuana have heightened the risk of psychotic symptoms among users, according to leaders in the treatment and research communities. An addiction treatment center medical director tells Addiction Professional that in a growing number of cases he encounters, the effects of vaping THC or using marijuana wax have become so pronounced that the individual cannot successfully be helped in a traditional substance use treatment setting.