August 2019, Volume XXXIII, No 5

CAPSULES

New website serves people with hearing loss

People with hearing loss can learn more about assistive technology, communications access, and other issues at a new website (www.mn.gov/deaf-hard-of-hearing) launched recently by the Minnesota Department of Human Services (DHS).

The site is designed for people who are deaf, hard of hearing, deafblind, and late-deafened; people experiencing age-related hearing loss; and people who live, work, and provide services to people with hearing loss. It features captioned videos in American Sign Language, or ASL, and English. Funding comes from a special 2017 legislative appropriation.

The site is organized around the most common issues faced by people with hearing loss, with information on assistive technology, communications access, living with hearing loss resources, and more.

New law requires check of exclusion list

Anyone submitting claims to Medical Assistance–including hospitals–is now required to check the Department of Human Services (DHS) exclusion list “on a monthly basis and document the date and time the exclusion list was checked and the name and title of the person who checked the exclusion list … even if the named individual or entity is not responsible for direct patient care or direct submission of a claim to Medical Assistance.”

If the hospital discovers that an employee or contractor appears on the list, the hospital is to immediately terminate payments to that individual or entity. The hospital must also refund any payment related to either items or services rendered by an individual or entity on the exclusion list dating back to the later of the individual’s or entity’s first appearance on the list or the first payment made to the individual or entity.

Failure to comply with this provision may result in withholding or reduction of Medical Assistance payments, suspension or termination of Medical Assistance participation, and civil monetary penalties of up to $25,000 per individual or entity on the exclusion list.

To view the exclusion lists, visit www.tinyurl.com/mp-exclusion and click on “MHCP Excluded Group Providers” and “MHCP Excluded Individual Providers.”

University of Minnesota launches Gamma Knife Icon technology

University of Minnesota Health (M Health) is the first in the state to treat brain tumor patients with the latest generation advanced radiosurgery technology, the Gamma Knife Icon, which delivers high doses of radiation to a tumor without exposing the surrounding normal brain to significant radiation.

Radiosurgery works by focusing radiation beams from different angles to a small target. While each beam delivers a small radiation dose that is well-tolerated by the brain, the point where the beams converge receives a high dose—sufficient to eradicate tumor cells.

“For this radiosurgery to work, precision of radiation delivery is essential. Being off by a few millimeters can mean the difference between destroying tumor cells and mutilating normal brain” said Clark Chen, MD, Lyle French Chair and Head of the Department of Neurosurgery at the University of Minnesota Medical School. “The Gamma Knife Icon is the sixth generation of Gamma Knife radiosurgery machine. It is capable of targeting treatment areas with accuracy to within 0.15 mm, or the width of two human hairs. This is the most accurate of the Gamma Knife machines to date.”

In contrast to previous generations of Gamma Knife machines that require a metal headframe to be affixed to the patient’s skull, the Icon gives clinicians the choice of using an individualized face mask during radiation delivery. In this way, Icon will improve patient comfort and experience. Because of the new motion tracking technology, treatment can additionally be divided across multiple sessions, a capacity that previous generations of the Gamma Knife machines lack.

Minnesota providers to receive first-ever opioid prescribing reports

More than 16,000 Minnesota health care providers serving Minnesotans on Medicaid and MinnesotaCare will receive reports in coming weeks comparing their opioid prescribing rates to those of their peers as part of a quality improvement effort led by the Department of Human Services (DHS) in collaboration with the medical community.

The first-ever reports in Minnesota aim to create awareness among providers about their individual prescribing behavior—a message shared in a video by one doctor in Greater Minnesota (https://youtu.be/EZlh06WbdIw), who reframed the conversation about pain management and opioids with his patients after learning how his opioid prescribing rates compared to his peers.

Minnesota law requires DHS to share the individualized, anonymous opioid prescribing reports annually and manage a quality improvement program for providers whose reports show they continue to prescribe outside of community standards.

Health care providers who prescribed at least one opioid to a Medicaid or MinnesotaCare enrollee in 2018 will receive their report over the coming weeks. This includes physicians, dentists, physician assistants, and nurse practitioners. The reports assess prescribing behavior based on seven key measures using claims data, excluding data on opioids used to treat opioid use disorder and those prescribed to individuals in inpatient settings, with cancer, or who receive hospice or palliative care services.

Ridgeview and PrairieCare Medical Group enter agreement

Ridgeview Medical Center (Ridgeview)—an independent health care system of hospitals, clinics, and specialty services—and PrairieCare Medical Group (PCMG), one of the region’s largest providers of inpatient and outpatient psychiatric care are partnering to offer new integrated behavioral health services in Waconia. The first partnership of its kind in Minnesota will have PCMG clinicians providing psychiatric services directly within Ridgeview’s Waconia campus through a joint operating agreement overseen by both Ridgeview and PCMG leaders.

According to Todd Archbold, Vice President of Business Development at PCMG, “This formal collaboration will break down barriers that can exist between specialties, and create new efficiencies to allow nearly 1,500 more individuals to receive much needed mental health care in the first year. We are integrating psychiatric services in the general medical care setting, and reducing fragmentation between specialties to improve outcomes for our shared patients.”

Hepatitis A outbreak declared by MDH

The Minnesota Department of Health (MDH) has declared an outbreak of hepatitis A in multiple counties among people who use street drugs (injection or non-injection), are experiencing homelessness or unstable housing, or have been recently incarcerated.

The outbreak includes 23 cases in nine counties: Pine (5), Hennepin (3), Kanabec (3), Mille Lacs (3), St. Louis (3), Washington (3), Chisago (1), Dakota (1) and Kandiyohi (1). Thirteen cases have been hospitalized and all have been discharged.

While initial cases were clustered in east-central Minnesota and had links to each other, more recent cases occurred in counties in other parts of the state. The infection source is not known for some cases, suggesting some community transmission among those in high-risk groups.

In May 2019, Minnesota began seeing an increase in hepatitis A cases. These cases had similar risk factors to national outbreaks of hepatitis A that have been occurring since 2016. Nationally, there have been more than 23,600 cases in 29 states. MDH has been monitoring the national outbreaks and conducting enhanced surveillance of hepatitis A since mid-2018.

MAAA receives national Aging Innovations Award

Metropolitan Area Agency on Aging received a 2019 Aging Innovations Award for the Juniper program from the National Association of Area Agencies on Aging (n4a) on July 29, in New Orleans.

The award is the highest honor presented by n4a to member agencies, going to programs that develop and implement cutting-edge approaches to support older adults, people with disabilities, and their family caregivers.

According to Dawn Simonson, executive director of Metropolitan Area Agency on Aging. “Juniper has delivered health promotion classes to more than 16,000 people in Minnesota through a broad, distributed network that is deeply rooted in local communities. It’s making a difference in people’s lives.”

As part of the Juniper network, Minnesota AAAs have become hubs for community health and wellness. Across the state, they partner with 133 provider organizations and 660 class leaders.

Law on pediatric care coordination takes effect

Minnesota law regarding care coordination at discharge now includes additional provisions on how a hospital provides care coordination for children with complex medical needs. The new law applies to “discharges involving a child with a high-cost medical or chronic condition who needs post-hospital continuing aftercare, including but not limited to home health care services, post-hospital extended care services, or outpatient services for follow-up or ancillary care, or is at risk of recurrent hospitalization or emergency room services due to a medical or chronic condition.”

The law states explicitly that the hospital must ensure that the following conditions are met and arrangements made before discharging any patient described in the paragraph above:

The patient’s primary care provider and either the health carrier or, if the patient is enrolled in Medical Assistance, the managed care organization are notified of the patient’s date of anticipated discharge and provided a description of the patient’s aftercare needs and a copy of the patient’s discharge plan, including any necessary medical information release forms.

The appropriate arrangements for home health care or posthospital extended care services are made and the initial services as indicated on the discharge plan are scheduled.

If the patient is eligible for care coordination services through a health plan or health certified medical home, the appropriate care coordinator has connected with the patient’s family. 

Medicus

Robert Dahlin, DO, has joined St. Luke’s Neurosurgery Associates in Duluth. Dahlin received his medical degree at Touro University Nevada College of Osteopathic Medicine in Henderson, Nevada. He then completed his neurosurgery residency at Riverside University Health System in Riverside, California, and a Spine Fellowship at the University of California–Davis Medical Center in Sacramento. He has a special interest in minimally invasive spine techniques and cervical artificial disc replacement surgery, both as a means to decrease surgical pain, and to improve surgical recovery.

Jennifer J. Garber, MA, has been appointed as UCare’s Associate Vice President of Behavioral Health Services. Garber will lead this newly invigorated department in attainment of UCare’s behavioral health strategic goals for all Medicare, Medicaid, and Individual and Family Plan members. She will drive the organization’s vision to be a leader in ensuring behavioral health equity—especially for members of UCare’s Special Needs Plans. Garber brings more than 29 years of behavioral clinical experience, including 17 years of management experience within health plan behavioral programs. Most recently she was Director of Clinical Operations and Community Initiatives and Government Programs at Optum Health Behavioral Health Solutions with oversight of the Medica Behavioral Health Care Advocacy Center. Garber joined UCare this year and reports to Julia Joseph-Di Caprio, MD. She works with a team of Medical Directors, including a psychiatrist, to better integrate medical, behavioral health, and substance use services for members. Garber also manages UCare’s expanded behavioral health case management and substance use disorder reform to improve treatment delivery. These efforts include peer recovery support, treatment coordination, and comprehensive assessments and withdrawal management. She is licensed as an independent clinical social worker.

Pamela Jordi, MD, has joined the growing practice at Clinic Sofia, an ob-gyn clinic with offices in Edina and Maple Grove. Jordi attended medical school at Creighton University in Omaha, Nebraska, and completed her residency at the University of Nebraska Medical Center. During the third year of residency, Dr. Jordi had her son, gaining an even greater appreciation for a healthy pregnancy, the labor process, and parenthood. Expanding her education and perspective, Dr. Jordi spent a month at the Institute for Latin American Concern in the Dominican Republic, providing health care for women at local hospitals and free clinics. She has also volunteered at free clinics in Omaha and provided education and testing for inmates at the Douglas County Corrections Facility. Dr. Jordi was drawn to Clinic Sofia’s holistic approach to women’s health care.

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If the patient is eligible for care coordination services through a health plan or health certified medical home, the appropriate care coordinator has connected with the patient’s family. 

Medicus

Robert Dahlin, DO, has joined St. Luke’s Neurosurgery Associates in Duluth. Dahlin received his medical degree at Touro University Nevada College of Osteopathic Medicine in Henderson, Nevada. He then completed his neurosurgery residency at Riverside University Health System in Riverside, California, and a Spine Fellowship at the University of California–Davis Medical Center in Sacramento. He has a special interest in minimally invasive spine techniques and cervical artificial disc replacement surgery, both as a means to decrease surgical pain, and to improve surgical recovery.

Jennifer J. Garber, MA, has been appointed as UCare’s Associate Vice President of Behavioral Health Services. Garber will lead this newly invigorated department in attainment of UCare’s behavioral health strategic goals for all Medicare, Medicaid, and Individual and Family Plan members. She will drive the organization’s vision to be a leader in ensuring behavioral health equity—especially for members of UCare’s Special Needs Plans. Garber brings more than 29 years of behavioral clinical experience, including 17 years of management experience within health plan behavioral programs. Most recently she was Director of Clinical Operations and Community Initiatives and Government Programs at Optum Health Behavioral Health Solutions with oversight of the Medica Behavioral Health Care Advocacy Center. Garber joined UCare this year and reports to Julia Joseph-Di Caprio, MD. She works with a team of Medical Directors, including a psychiatrist, to better integrate medical, behavioral health, and substance use services for members. Garber also manages UCare’s expanded behavioral health case management and substance use disorder reform to improve treatment delivery. These efforts include peer recovery support, treatment coordination, and comprehensive assessments and withdrawal management. She is licensed as an independent clinical social worker.

Pamela Jordi, MD, has joined the growing practice at Clinic Sofia, an ob-gyn clinic with offices in Edina and Maple Grove. Jordi attended medical school at Creighton University in Omaha, Nebraska, and completed her residency at the University of Nebraska Medical Center. During the third year of residency, Dr. Jordi had her son, gaining an even greater appreciation for a healthy pregnancy, the labor process, and parenthood. Expanding her education and perspective, Dr. Jordi spent a month at the Institute for Latin American Concern in the Dominican Republic, providing health care for women at local hospitals and free clinics. She has also volunteered at free clinics in Omaha and provided education and testing for inmates at the Douglas County Corrections Facility. Dr. Jordi was drawn to Clinic Sofia’s holistic approach to women’s health care.