Oct. 17, 2018
COMPAC announces 2018 election endorsements
In the next several weeks, ballots for the 2018 general election will arrive in your mailbox.

As you consider your choices this year, COMPAC, the bipartisan political arm of the Colorado Medical Society, has released its full list of endorsed candidates. COMPAC has partnered with your local medical society to educate and vet candidates on the most pressing medical issues ahead of what is shaping up to be a contentious 2019 legislative session.

Two of the most important medical-related acts are sunsetting: the Medical Practice and Professional Review statutes. Already, plaintiff attorneys will seek to make peer review records discoverable in civil litigation and CMS anticipates an equally aggressive effort to expand the value of a lawsuit. Legislators will also consider landmark legislation on the opioid crisis and cost of care.

Click here to watch a brief video about issues that will affect your practice. Click here to read about all of the major issues medicine will be facing in the 2019 legislature.

We leave to your discretion how you choose to vote, but hope you'll consider the recommendations of your physician peers.

COMPAC cannot do this work without your generous support. Consider texting UNITE to 91999 to contribute to COMPAC and the Small Donor Committee (SDC). SDC gives money exclusively to candidates who vote with us on all liability issues. You can also donate online to COMPAC and SDC by visiting www.cms.org/contribute.
Three steps to implement a diabetes prevention strategy for your patients 
The prevalence of type 2 diabetes has been rising over the past 20 years. Based upon statistics on current health trends from the Centers for Disease Control and Prevention, it is estimated that 30 million adult Americans have diabetes, or approximately 10 percent of the adult population. Even more adults are at risk for developing type 2 diabetes; the CDC estimates that currently 84 million adult Americans have prediabetes.

The National Diabetes Prevention Program lifestyle change program is a structured, year-long program that has been proven to help patients delay or prevent type 2 diabetes. Over the past few years, the CDC, American Medical Association, and health care organizations across the nation have worked together to bring National DPP lifestyle change programs to patients.

The AMA encourages physicians to read this article on the three steps that can help you identify patients with prediabetes and refer them to a National Diabetes Prevention Program lifestyle change program, then take a survey. Thank you for your participation.
Member survey results: Health care costs, transparency and payer issues
View an infographic here
A September 2018 statewide membership poll surveyed CMS members on health care costs, transparency and payer issues. Almost three-quarters (73 percent) of respondents describe health care costs today as a crisis or serious problem. Physicians feel they can have an impact on health care costs but see health insurance plans, drug manufacturers and hospitals as the top three influencers.

CMS-member physicians are taking action, reporting that they help patients control high costs by identifying less expensive treatment (77 percent); helping them navigate coverage, co-pays and deductibles (76 percent); and advocating with health plans to get authorization for treatments or medications (75 percent). And they have taken steps to reduce costs and improve quality by having an electronic health record (87 percent), using generics as a first line (60 percent) and integrating behavioral/mental health into primary care practices (45 percent), among other actions.

View an infographic here.
AMA: Approval of nation's largest health care merger does not go far enough to protect patients
The Justice Department approved the $69 billion merger between CVS Health and Aetna on Wednesday, Oct. 10, on the condition that Aetna sells its Medicare Part D prescription unit. The merger is expected to be finalized this year.

The American Medical Association warns the merger does not go far enough to protect patients, consistently arguing that consolidation in health care leaves American consumers with less control over their medical care and prescription drugs.

"The AMA worked tirelessly to oppose this merger and presented a wealth of expert empirical evidence to convince regulators that the merger would harm patients," said AMA President Barbara L. McAneny, MD, in a statement. "We now urge the DOJ and state antitrust enforcers to monitor the post-merger effects of the Aetna acquisition by CVS Health on highly concentrated markets in pharmaceutical benefit management services, health insurance, retail pharmacy and specialty pharmacy."

"Patients are better served by promoting competitive health care markets," she said. "The AMA is committed to ensuring that competition in health care is not compromised. We will continue to examine proposed health care mergers as they arise and take every opportunity to challenge those that are detrimental to the patients we serve."

According to the New York Times, CVS Health, the last major free-standing pharmacy manager, had revenues of about $185 billion last year and provided prescription plans to roughly 94 million customers. Aetna, one of the nation's largest insurers with about $60 billion in revenue last year, covers 22 million people in its health plans.

Last month, the Justice Department approved the takeover of Express Scripts, a major CVS rival, by insurer Cigna. OptumRx, another major pharmacy manager, is owned by UnitedHealth Group. Anthem, which operates for-profit Blue Cross plans in several states, is developing its own in-house pharmacy operation.
CMS president urges clarification of opioid dependence medication form
CMS President Deb Parsons, MD, FACP, wrote Michael Conway, interim commissioner of insurance, to provide comments on language concerning certain opioid dependence treatment drugs as required by House Bill 18-1007.

"The intent of the legislation was to remove any barriers to patients receiving the medications they need to treat opioid dependence," Parsons stated. "We believe that any instructions the carriers give to physicians concerning prior authorization requirements either in their policy and procedure documentation or on their request form need to clearly state that prior authorization is not necessary (1) for drugs approved for the treatment of opioid dependence for the first request within a 12-month period; or (2) if it has been longer than 12 months since the first prescription request was submitted."

Parsons then suggested language to clarify when prior authorization is not required. Read the letter here.
Congress passes new opioid package 
In early October, Congress reached agreement on legislation to address the opioid epidemic. The House and Senate passed H.R. 6, the "SUPPORT for Patients and Communities Act," with overwhelming majorities in both chambers. The legislation touches on almost every aspect of the epidemic, including numerous provisions supported by physicians that will expand access to substance-use disorder (SUD) prevention and treatment programs. The final bill also retained some provisions with which physicians had raised concerns, primarily related to mandates on physicians and duplicative requirements in state and federal programs. The American Medical Association, Colorado Medical Society and component societies will keep you informed as the numerous provisions in H.R. 6 are implemented. Read more here.
Take advantage of buprenorphine training sponsored by ITMatters2
The University of Colorado Department of Family Medicine is collaborating with the Colorado Health Extension System (CHES), and the Implementing Technology and Medication Assisted Treatment and Team Training in Rural Colorado (IT MATTTRs Colorado) project to help address the opioid epidemic affecting the state. This is a response to calls from health care communities for help in diagnosing opioid use disorders (OUD) and supporting patients in medication assisted treatment (MAT) programs. With funding provided by the Office of Behavioral Health, IT MATTTRs is recruiting 450 providers to complete the MAT waiver training to become certified to prescribe medication for the treatment of OUD. In addition, they will provide support through tools, resources and team training to practice staff on implementing MAT programs. Find more information here.
Catch PBS premiere of "ADDICTION" documentary - tonight, Oct. 17 at 8 p.m. MT 
NOVA, the most-watched primetime science series on American television, will air their newest documentary "ADDICTION" on PBS at 8 p.m. tonight, Wednesday, Oct. 17. Viewers will hear firsthand from individuals struggling with substance use disorder and follow the cutting-edge work of doctors and scientists as they investigate why addiction is not a moral failing, but a chronic, treatable medical condition.

See the science behind how addiction affects the brain and how the public at large should address the opioid epidemic, from embracing evidence-based treatments to rethinking public policies. Also learn about how access to drugs like heroin, fentanyl, and prescription medications like OxyContin fueled this epidemic -- the deadliest in U.S. history.

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Annual Comprehensive Lung and Breathing Summit, 11.5 approved CME credits. Meet-and-greet social Thursday night followed by a day and a half of informative, educational and experiential presentations and discussions. Oct. 25-27, 2018 at The Broadmoor Hotel, Colorado Springs.  Register here.

Reserve your room early at the Broadmoor with the exclusive UCHealth negotiated rate of $171 per night; click here.

Contact Tanya Forsyth by phone  (720-848-7866) or email

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Renew your membership today!
The Colorado Medical Society is only as strong as its members
It's that time of year! Renew your membership today and help CMS continue our work advocating for physicians and their patients. Go to  cms.org/renew. Questions? Contact membership@cms.org.
To comment on something you read in ASAP or to update your contact information, send an e-mail to enews_editor@cms.org. Visit us online at www.cms.org.
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