June 3, 2015
Statement: Colorado Supreme Court ruling on surgery supervision

The Colorado Supreme Court gave physicians a partial victory on June 1 when the justices ruled on a lawsuit challenging a 2010 decision by then-Gov. Bill Ritter that exempted Colorado's rural hospitals from the federal regulation requiring a physician to supervise a nurse anesthetist delivering anesthesia care during surgery. CMS thanks the AMA Litigation Center for their support in this effort.

The Colorado Medical Society and the Colorado Society of Anesthesiologists brought suit against the governor in 2010 arguing the exemption was contrary to Colorado state law. A Colorado District Court ruled against CMS and CSA in 2011 and the Colorado Court of Appeals upheld the lower court decision in 2012. The Supreme Court decision negates the major portion of the earlier rulings and reinforces CMS's and CSA's standing to challenge the Ritter decision in order to protect patient safety in anesthesia care.

CMS President Tamaan Osbourne-Roberts, MD, made the following statement in response to the ruling:

The Colorado Supreme Court determined that the governor "opting out" of Medicare physician supervision requirements for anesthesia delivered by CRNAs impacts only Medicare reimbursement and is not a determination of Colorado law. Colorado law continues to classify delivery of anesthesia by a CRNA as a delegated medical function subject to physician supervision. Such supervision is consistent with patient expectations and Colorado's application of the Captain of the Ship doctrine which designates legal responsibility for care of patients under anesthesia.

Colorado Medical Society recognizes CRNAs as valuable members of the surgical care team. There is no dispute that nurse anesthetists are highly trained professionals; however, their training is shorter in duration, narrower in scope, and less comprehensive than the medical training of physicians. The Colorado Supreme Court's decision clarifies that the governor's decision is not a legal interpretation of either Colorado's Medical or Nursing Practice Acts. 

CMS member appointed to SIM Advisory Board

CMS member Glenn Madrid, MD, a family physician with Primary Care Partners in Grand Junction, has been selected as one of four appointed members of the SIM Advisory Board. Gov. John Hickenlooper announced in December 2014 that Colorado had been awarded a federal State Innovation Model (SIM) grant. Over the next four years, the state will receive $65 million to create a coordinated, accountable system of care that gives Coloradans access to integrated primary care and behavioral health.

The governor's Office of Boards and Commissions considered dozens of applications for the SIM Advisory Board. Other appointees are Lilly Marks, Vice President for Health Affairs, University of Colorado and Executive Vice Chancellor of the Anschutz Medical Campus; Jeannie Ritter, Mental Health Ambassador and former First Lady of Colorado; and Patrick Gordon, Associate Vice-President, Rocky Mountain Health Plans.

They will join the other five board members appointed through their positions in the administration: Reggie Bicha, Executive Director of the Colorado Department of Human Services; Sue Birch, Executive Director of the Colorado Department of Health Care Policy and Financing; Marguerite Salazar, Colorado Insurance Commissioner; Larry Wolk, MD, Executive Director and Chief Medical Officer for the Colorado Department of Public Health and Environment; and Vatsala Pathy, SIM Director.

The first meeting of the SIM Advisory Board will be held June 15, 2015, at the Colorado Department of Public Health and Environment in Denver. Click here to visit the Colorado SIM website.

DentaQuest launches PCP program to improve Medicaid members' oral health

Colorado Medicaid has contracted with DentaQuest to administer the Colorado Medicaid Dental Program for children and adults. Their main goals are to improve the oral health of Colorado Medicaid members and to increase the use of preventive dental services in children enrolled in the Medicaid Dental Program.

The Outreach Team promotes oral health in the Medicaid population through a variety of education efforts, collaborative community health events, wellness-based programs and prevention-based initiatives. They are currently rolling out the Primary Care Provider (PCP) Integration Program, a way to connect patients with Medicaid dental services.

Through this program, the member's primary care physician will have access to educational materials highlighting the importance of dental care. These materials should be distributed during wellness visits, and serve as a reminder for parents to take their children to their dental provider every six months for a dental exam. They also provide information on accessing a Medicaid dental provider and the toll-free member support line. This program supports the mission of Cavity Free at Three, which allows trained primary care providers to provide, and be reimbursed for, specific oral evaluation and preventive procedures for their patients ages 0-20 years old.

For more information about this program including order information, or any of the member outreach and education programs, please call Outreach and Education Coordinator Nancy Greene at 303-349-3439. For more information about the Colorado Medicaid Dental Program, visit dentaquest.com/colorado.

Healthy Transitions Colorado: Cultivating the Network of Care learning series

Healthy Transitions Colorado presents a multi-month learning series on effective care transitions. The dates of the series are June 26, Oct. 16 and Jan. 15, and each program runs 8 a.m. - 3:30 p.m. A free one-hour kick-off webinar will be held June 19 at 11 a.m. Click here to register for the kick-off webinar.

By participating in the learning series, "Cultivating the Network of Care," health care organizations and communities can learn how to streamline internal processes, enhance communication with community partners, and foster patient and family engagement. The single event fee is $65; $150 for all three programs. Click here for more information.

CPEP presents: "Prescribing Controlled Drugs: Critical Issues and Common Pitfalls" in Denver

CPEP is offering their Prescribing Controlled Drugs: Critical Issues and Common Pitfalls� course in Denver in July. Originally developed by Vanderbilt Center for Professional Health in Nashville, Tenn., this three-day course is intended for participants who have engaged in misprescribing activities and is designed to teach appropriate prescribing practices, facilitate understanding of personal motivations in the patient encounter as understood within the framework of family systems theory, discuss personal responsibilities with patients, and cultivate new skills in substance abuse identification.

CPEP will hold this course twice in 2015. The initial offering will be held July 20-22 at the Hilton Garden Inn on South Colorado Boulevard in Denver. Click here for more information.

Sponsors
Get covered with COPIC

COPIC Insurance Company is Colorado's leading medical liability insurance provider. Three out of four physicians choose COPIC for this critically important coverage. CMS members receive a 10 percent premium discount from COPIC.

For more information, call (720) 858-6000 or visit www.callcopic.com.


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"PQRS/Value-Based Payment Modifier" video presentation posted to YouTube

A video recording of the "PQRS/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015" presentation has been posted to the Centers for Medicare and Medicaid Services MLN Connects� page on YouTube. This presentation is the same as the webinars that were delivered on March 31, 2015 and April 7, 2015. A link to the video can be found here: youtu.be/Ww0oH-FhaYM.

Online CME
The Opioid Crisis: Guidelines and Tools for Improving Chronic Pain Management,
presented by the Colorado School of Public Health and accredited for two credits of CME and approved for COPIC points. This activity examines the best practices and universal precautions for treating chronic pain. Click here for more.
Upcoming events
Denver
CPEP presents: "Prescribing Controlled Drugs: Critical Issues and Common Pitfalls"
July 20-22
Hilton Garden Inn, South Colorado Blvd in Denver
Grand Junction
CMS Annual Meeting
Sept. 18-20, 2015
Beaver Run Resort, Breckenridge
Pinnacol Workers' Compensation Conference
Sept. 24, 2015
Wildlife Experience at CU South Denver, Parker, CO
Registration opens in June. 303-361-4945
To comment on something you read in ASAP or to update your contact information, send an e-mail to [email protected]. Visit us online at www.cms.org.
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