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Get To Know Charlotte Meadows

Get To Know Charlotte Meadows

1. While you have been active around Montgomery for quite some time, can you tell us a little bit about yourself? Primary occupation? Interests? Hobbies?

I grew up in Montgomery and graduated from Jeff Davis HS before going to Auburn for college. I married Allen in 1986 who, at the time, was a pediatrician in Mobile. In 1991, we came back to Montgomery and, together, we started his solo practice allergy clinic.

In addition to helping run the office, I’ve been involved with education in Montgomery since the early 2000’s and served on the Montgomery Board of Education from 2006-2012.  I’m also involved with the local Republican Party and Allen and I both have served on the county and state executive committees. Today, I am the current treasurer (and past president) of the Republican Club of Central Alabama.  I enjoy working to get good people elected to office, and have campaigned across Alabama and Florida to support Republican candidates in the last several years.

My hobbies are cooking, reading, taking care of my yard and travel. With Allen’s position as the incoming President of the American college of Allergy, Asthma and Immunology we were privileged to travel to Germany and Nairobi last year in conjunction with allergy training in those areas.

2. What prompted you to consider running for House District 74 this year?

After running unsuccessfully for this seat in the special election in 2013, I still felt like I could help to solve some of the problems in Montgomery from a state level. With my experience in education, and the fact that our number one concern in Montgomery is education, I believe I am the right person for this seat. I have seen firsthand how changes in education policy can change the lives of children and the families that love them. We can’t expect our state to move up in student achievement by doing the same things we’ve always done.  We have to change to focus on what makes a student achieve at higher levels. I am committed to bringing the voices of students and their families to the State House.

3. How will your background help you serve in the legislature and what will be some of your priorities?

My accounting and business administration degrees, as well as my background in medicine and small business, and my experience in education policy will enable me to be up to speed on both the education and general fund budgets, as well as many other committees in the State House.  My work as an education advocate allowed me to spend a lot of time in the State House between 2013 and 2016, including working directly with the Alabama Legislative Reference service, the office that actually researches and writes the legislation that comes before the legislators.  My priorities will always be to first have a balanced budget that prioritizes the needs of Alabama and district 74 over the wants and treats each entity fairly.

I will also work to improve the level of student achievement in Alabama by encouraging better teacher training and specific professional development for teachers and finding ways to keep excellent teachers in the classroom instead of moving up into administration. We also need to have a focus on students being ready for a career when they finish high school; this is accomplished through career pathways in middle/high school, dual enrollment and certification classes.

4. What do you believe are some health-related issues important to your district and/or your constituents?

One of the biggest problems in Alabama and District 74 is that those who need Mental Health services are not able to get it. Because our funding in AL is so low, we have fewer physicians willing to live in Alabama and offer counseling and mental health services. I am very concerned that many people in our prisons and jails are there because they did not get appropriate mental health treatment before they crossed a line.  I am also hearing from constituents about their interest in legalizing medical marijuana.  This would be a topic that I would particularly want to hear from physicians on their thoughts on the issue of using the drug for medical use and how that would impact doctors and their patients.

5. If you could change anything about our state’s health care system, what would it be?

Change the GPCI so that Alabama physician’s get paid on par with Georgia and Florida. Also, Medicaid should be adequately funded.

6. How can the Medical Association – and physicians statewide – help address Alabama’s health challenges?

Advocate more to the legislature – pay attention to the Rotunda and get to know your state representative and state senators. All politics is local and physicians should be leaders in advocating for the change they want to see.  Physicians should be willing to work with legislators on task forces to improve access to mental health care, research marijuana legalization, and participate with MASA in lobbying for the changes they need to continue to practice medicine in Alabama.

7. If there is one thing you could say to physicians in your district before the election, what would it be?

Thank you for your support and make sure you vote in this election and every election. I know it’s difficult for physicians who work 12- and 14-hour days to prioritize voting, but each vote really is critical and the people that represent all of us must be willing to listen as well as work to solve the problems that MD’s face each day.  I will be that person, and I need each voter to go to the polls on Tuesday, June 11th. 

Learn More About Charlotte’s Campaign

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What If No One Was On Call?

What If No One Was On Call?

 In times of illness, injury, and emergency, patients depend on their physicians.  But what if no one was on call?  Public health would be in jeopardy. The same holds true for organized medicine when the legislature is in session.

If the Association had not been on call for its members, numerous inappropriate expansions to the scopes of practice for non-physicians would have passed; lawsuit opportunities against physicians would have increased; and poorly thought out “solutions” to the opioid abuse epidemic could have become law.

Overview of Legislation

Bills & Resolutions Introduced 1,495
Bills & Resolutions Passed 358
Bills & Resolutions Affecting Medicine 199
Amendments Affecting Medicine 60

Moving Medicine Forward

The 2019 Legislative Session is over. For our advocacy efforts to remain successful moving forward, between now and the 2020 Session, the Association will be visiting with physicians and legislators around the state to ensure the views of medicine continue to be heard. Visit our Advocacy Portal to find out how you can get involved.

If no one was on call . . . legislation setting up a process for establishing guidelines for prescription of buprenorphine in nonresidential treatment programs would not have passed. The Association worked alongside the bill’s sponsor, Sen. Larry Stutts, M.D., in supporting this legislation and giving BME the authority to issue regulations on medication assisted treatment. The bill currently awaits the governor’s signature.

If no one was on call . . . the importance of updating statewide immunization registry requirements would not have received the exposure it did. The Association worked with Sen. Tim Melson, M.D. and the Department of Public Health on SB256. The bill was set for final passage in the House, but it unfortunately did not receive a vote on the final day of the session. The Association will support the bill again moving forward.

If no one was on call . . . “truth in advertising” legislation would not have been brought forward. The Association assisted Sen. Tim Melson, M.D. on the legislation to prohibit deceptive or misleading advertising and require all health professionals to take steps to inform patients of their certifications. Although the bill did not receive a vote for final passage, it remains a priority for the Association per a 2018 House of Delegates Resolution.

If no one was on call . . .  the rural physician tax credit would not have been introduced and support for this bill would not have grown. SB374 would have amended the current definition of rural, strengthened the residency requirement, and extended the tax credit from 5 to 6 years. The tax credit is a significant factor in physician retention in Alabama’s rural communities and, while it did not pass, it remains a priority for the Association.

If no one was on call . . . the Board of Medical Scholarship Awards may have been consolidated into some other state agency or seen its funding eliminated. The Association worked with BMSA to request additional funding for this highly successful program, but the increase was ultimately not included in the budget. Like the Rural Physician Tax Credit, the BMSA is a critical tool to placing physicians in rural areas and the Association will continue pushing increased BMSA funding moving forward.

If no one was on call . . . the upgrades that transformed the PDMP into a more user-friendly and valuable tool for physicians may not have continued to be funded. The Association supports maintaining the increased appropriations for the PDMP.

 

Scope Creep – Replacing Education with Legislation

Everyone wants to be a physician, but few are willing to endure medical school, residency, and all the other various education and training requirements to become an M.D. or D.O. Instead of pursuing higher education, non-physicians are pursuing legislative changes as a means to practice medicine. The Association opposes any scope of practice expansions that could endanger quality care for patients.

If no one was on call . . . the physician referral requirement for physical therapy would have been abolished. Patients would not receive a medical diagnosis, potentially receive unnecessary care, and could be delayed in obtaining appropriate care. In conjunction with the Alabama Orthopaedic Society and other allied specialties, the Medical Association convinced members of the Senate Health Committee to uphold the importance of a diagnosis and vote down SB25, 8-2. This bill is expected to return in 2020.

If no one was on call . . . safety standards for anesthesia care would have been significantly lowered. In addition to abolishing physician direction of CRNAs, SB156 could have also led to CRNA prescribing with no physician oversight. In conjunction with the Alabama State Society of Anesthesiologists and other allied specialty societies, the Medical Association convinced legislators not to support the legislation and it failed without receiving a vote. This bill is expected to return in 2020.

If no one was on call . . . optometrists could have begun performing eye surgeries using scalpels and lasers. Moreover, SB114 would have given the Alabama Board of Optometry the sole power to define what is considered to be the practice of optometry simply by regulation. Ultimately, the bill did not receive a vote in committee due to the work of the Alabama Academy of Ophthalmology, other allied specialty societies, and the Medical Association. This bill is expected to return in 2020.

If no one was on call . . . a new state board with unprecedented authority over radiation and medical imaging could have been created.  Among other things, SB165 would have allowed this new board to determine scopes of practice for x-ray operators, radiation therapists, radiographers, radiologist assistants, magnetic resonance technologists, and nuclear medicine technologists (to name a few). This bill could have increased costs for medical practices and dangerously expanded the scopes of practice for non-physicians. While the bill did not receive a vote in committee, it is expected to return in 2020.

If no one was on call . . . all podiatrists would have been granted the ability to perform surgery on the ankle and lower leg. HB310 significantly expanded the scope of practice of podiatrists, who only 10 years ago standardized their residency programs nationwide. This legislation failed to receive a vote in committee, but, similar to the other “scope creep” pieces of legislation, the bill is expected to return in 2020.

If no one was on call . . . physician collaborative practice with nurses could have been abolished. Under the legislation passed this session, nurses are now allowed to apply for a multistate license through a compact. Previous nursing compact legislation, however, had attempted to allow other states’ laws to be substituted for Alabama’s. The Association worked to ensure nothing in this bill alters current collaborative practice agreements.

 

Beating Back the Lawsuit Industry

Plaintiff trial lawyers are constantly seeking new opportunities to sue doctors. Alabama’s medical liability laws have long been recognized for ensuring a stable legal climate and fostering fairness in the courtroom. Yet, year after year, personal injury lawyers seek to undo those laws and allow more frivolous lawsuits to be filed against physicians.

If no one was on call . . . multiple bills dictating standards of care and increasing lawsuits against physicians may have passed. For instance, physicians could have faced lawsuits and criminal penalties if a patient overdosed as a result of an opioid prescription. Also, physicians participating in a state authorized needle exchange program aimed at curbing the spread of disease via IV drug use would not have received proper liability protections. None of the language proposed by plaintiff lawyers passed into law.

If no one was on call . . . plaintiff lawyer-drafted legislation concerning involuntary commitment procedures would have created new lawsuit opportunities against physicians.  These 6 different pieces of legislation amend current law to allow a nurse practitioner or physician assistant to coordinate with a physician in deciding to treat an individual who is unable to consent and without having to first attempt to contact a family member. Before passing, however, the Association successfully added much-needed liability protection for physicians to these bills.

If no one was on call . . . physicians administering chemical castration drugs to certain inmates would not have been shielded from liability. The Association worked with the bill sponsor to add language protecting physicians who administer these drugs to those individuals convicted of sexual offenses against children age 13 and under who opt to take the medication as a condition of parole.

If no one was on call . . . support would not have grown for legislation increasing penalties on attorneys who encourage lawsuits. HB181 would strengthen existing criminal and civil penalties on attorneys who give, offer, or promise valuable consideration to a potential client as an inducement to file a lawsuit. The bill passed committee but never received a final vote.

 

On the Prescribing Front

This session, many bills regarding prescribing practices and prescription drugs were introduced. Some of this legislation was pitched as improving access to quality care, but were actually back-door “scope creep” bills.

If no one was on call . . . Alabama’s existing prescription authorization law would have been repealed, endangering patients and creating hassles and expenses for physicians. Prior to revisions negotiated by the Association, the legislation would have given pharmacists the default ability to substitute drugs and could have allowed the Board of Pharmacy to issue regulations affecting physician prescribing practices. This language was successfully removed by the Association before the bill passed. Physician authority in issuing prescriptions is unchanged.

If no one was on call . . . poorly-written legislation could have passed on biologic substitution, delaying patient and physician notification. The Association negotiated language requiring pharmacists to communicate an authorized substitution within 24 hours to the physician and patient. The notification to physicians must be made via phone or fax or the e-prescribe software used by the physician. The bill that passed was supported by the Medical Association.

If no one was on call . . . legislation opening the door for widespread prosecution of physicians prescribing opioids could have become law. The legislation was successfully amended to adopt the federal standard that all prescribers and pharmacists are currently held to by the DEA. As passed, only someone who issues a prescription knowingly or intentionally for other than a legitimate medical purpose and outside the usual course of his or her practice may be charged.

If no one was on call . . . arbitrary physician requirements for prescribing controlled substances could have been enacted. Working with proponents of the bill, the Association sought to change the bill and default to existing medical regulations governing controlled substance prescribing practices. The legislation, however, did not pass.

 

Other Legislation of Interest

Medical Marijuana . . . having undergone significant changes as it moved through the legislature, this bill now reauthorizes CBD research at UAB via “Carly’s Law” and creates a study commission to make recommendations to the Legislature relating to medical use of cannabis in Alabama. The Commission will be comprised of 15 members and will issue its findings and draft legislation by December 1, 2019.

Abortion . . . this legislation criminalizes the performing of an abortion or attempted abortion, with exceptions for instances where the physical and mental health of the mother is at risk and for treatment of ectopic and cornu implantations. The sole purpose of the bill is to challenge the United States Supreme Court’s prior rulings on abortion laws and a lawsuit has already been filed asking a judge to block its implementation.

Pharmacist/Physician Collaborative Practice . . . this legislation allows pharmacists and physicians to voluntarily enter into agreements for medication management services.  Unlike collaborative practice laws of other states, HB35 does not specify what types of authority or activities a physician may delegate to a pharmacist.  For example, HB35 does not state that ultimate determinations regarding patient care rest with the physician.  Moreover, HB35 does not require pharmacists to input information into patients’ medical records if dosage strength or medication type is changed.  HB35 also does not prohibit pharmacists from prescribing any drugs – including controlled substances – and does not prohibit pharmacists from ordering lab tests.  Despite patient safety and public health concerns raised by the Association, the bill was passed and signed into law.  The Alabama Board of Pharmacy and the Alabama Board of Medical Examiners are now responsible for promulgating rules to enforce the act.

Human Trafficking . . . multiples bills introduced this session would have set new human trafficking training requirements and standards of care for physicians. The failure of a physician to follow these new guidelines could have effectively created liability. In the end, the bills were changed into resolutions calling for education and training which received widespread support.

Gunshot Wound Reporting . . . as introduced, these bills mandated physicians to report all patients receiving treatment for gunshot wounds or acts of violence and contained no language protecting reporting physicians from liability. The Association worked to successfully amend this legislation to limit its scope to only gunshots and provide protection for physicians.

Genetic Counselors . . . these bills would have created an entirely new board authorized to establish regulations for genetic counselors and genetic counseling in Alabama. Working with bill proponents, the Association exempted physicians from regulation under the act and specified that genetic counselors are not authorized to practice medicine. The bill did not pass.

Using Cell Phones While Driving . . . prior to the Association’s successful addition of an amendment, this bill would have outright prohibited the use of cell phones while driving, including physicians responding to an emergency situation. Ultimately, the bill did not pass, even with the Association’s amendment.

General Fund Appropriations . . . in addition to funding for the PDMP mentioned above, the general fund budget contained other appropriations for various health causes. Specifically, $200,000 will be expended for the Addiction Prevention Coalition; $100,000 for the Amyotrophic Lateral Sclerosis (ALS) Association; and $500,000 for the Breast and Cervical Cancer Early Detection Program. Also, the CHIP program received full funding; and there are no scheduled cuts to physician payments in next year’s Medicaid budget.

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Meet Our New Officers

Meet Our New Officers

Aruna Arora, M.D.
President-Elect

Dr. Arora originally planned to follow her father into medicine as a pediatrician after watching him treat his patients and seeing his dedication to the children and their families. She, too, wanted to make a difference in the daily lives of people. But, when she was in medical school, her fascination with the brain and cognitive development changed her mind and her specialty to neurology.

“While taking care of patients with ALS can be challenging at times, there is nothing quite like helping a patient and family understand their own humanity. Helping someone whose life has been dramatically altered appealed to my original goal of helping people in their daily lives. I still remember the first time I performed an EMG on a patient with an initial complaint of a poor golf swing and diagnosed him with ALS. His journey over the next few years to death was humbling,” Dr. Arora said.

This year, Dr. Arora steps into the role of President-Elect on the Association’s Board of Censors with renewed vigor to make a difference for her colleagues in Madison County and beyond. Her desire to give back to her community is a guiding light for her every day.

“Understanding access to care issues or specific health care needs of certain populations can help with the care of individual patients. My membership and interest in the Medical Association is focused on figuring out how we can take a group of like-minded people and develop a coherent strategy that can potentially impact the health care of all Alabamians,” she said.

 

Amanda J. Williams, M.D.
Vice President

Dr. Williams is originally from Tallahassee, Fla. She received her medical doctorate from the University of South Florida and trained at University of Pittsburgh Medical Center’s Western Psychiatric Institute and Clinic, one of the largest and most reputable psychiatry residency programs in the country. There she was the chief resident of inpatient services and completed a one-year fellowship in Community Mental Health. She is now an esteemed board-certified psychiatrist in Montgomery, Ala.

She primarily treats adults with disorders of mood, anxiety, psychosis and personality, along with those struggling with addiction, past trauma, intellectual disabilities, and memory difficulties. She is a strong advocate for individuals suffering from mental illness and absolutely loves helping individuals find genuine wellness.

This is Dr. Williams’ second term on the board, and she is looking forward to lending her experience as a physician to her role as vice president.

“I’m honored and excited to have this opportunity within the Medical Association,” she said. “The practice of medicine faces many challenges right now, and I’m eager to take part in creating solutions in Alabama.”

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Medical Association Successfully Lobbies for PDMP Changes

Medical Association Successfully Lobbies for PDMP Changes

MONTGOMERY — Registered users of the Alabama Prescription Drug Monitoring Program (PDMP) should have noticed a different format earlier this year. The new platform, called NarxCare™, provides enhanced analytics and risk scores with features including prescription information displayed in easy-to-understand graphic representations and allowing the users to obtain prescription information by clicking on the graphics.

Prescribers using the PDMP have often complained accessing the program is cumbersome, time-consuming and complicated, which discourages use of the tool unless it is specifically required by Alabama Board of Medical Examiners rules.

In 2017, Gov. Kay Ivey established the Alabama Opioid Overdose and Addiction Council, which would in part look into options for prevention, treatment, recovery-support and other behavioral health services for substance-use disorders lacking in our state. Leadership from the Medical Association argued a massive upgrade to the PDMP would need to be part of the mission of the Governor’s Opioid Council.

“The Medical Association has been at the forefront of the opioid crisis for many years looking for new ways to identify better options for treatment of patients with substance use disorder and find more intuitive training and tools for our prescribers. The addition of NarxCare is a great first step in streamlining the PDMP and hopefully encouraging more prescribers to use this diagnostic tool in their practice,” said Association Executive Director Mark Jackson.

On Jan. 15, the Alabama Department of Public Health launched the first phase of that upgrade with the NarxCare™ platform to aid prescribers in clinical decision making and provide support to help prevent or manage substance use disorder.

The new format when prescribers search a patient’s history in the PDMP has now changed:

  • There are two short tutorials available to walk PMDP users through the new system. Prescribers are strongly encouraged to view the NarxCare™ tutorials.
  • In the new NarxCare™ format, the patient’s name and information are listed on the upper right of the screen.
  • Each patient will have Narx Scores for narcotics, sedatives and stimulants.
  • An Overdose Risk Score (0-999) is also displayed for the patient. The higher the number, the more at-risk the patient is for an overdose.
  • The prescriptions are displayed as color-coded, interactive blocks on a bar graph. For example, opioid prescriptions are represented by red blocks. Clicking on a block displays the patient’s prescription information.
  • Full prescription information is listed at the bottom of the page in the traditional format seen in Aware.
  • Medication Assisted Therapy (MAT) and CDC resources are available by clicking the Resources tab.

The Narx Report

The Narx Report includes a patient’s NarxScores, Predictive Risk Scores, Red Flags, Rx Graph and PDMP Data, as well as access to Resources and Care Team Communications all in a single, easy-to-use interface.

The NarxScores. Every Narx Report includes type-specific use scores for narcotics, sedatives and stimulants. These scores are based on a complex algorithm factoring in numbers of prescribers, morphine milligram equivalents (MME), pharmacies and overlapping prescriptions. Scores are quantified representations of the data in the PDMP and range from 000-999 with higher scores equating to higher risk and misuse, and the last digit always represents the number of active prescriptions.

The Predictive Risk Scores. These composite risk scores incorporate relevant data (PDMP and non-PDMP) into advanced and customized predictive models to calculate a patient’s risk of a host of outcomes, including overdose and addiction. Non-PDMP data sets may include medical claims data, electronic health records, EMS data and criminal justice data.

The Red Flags. There are multiple customizable PDMP- and non-PDMP based red flags. A red flag(s) may contribute to the risk of unintentional overdose or other adverse events.

The Rx Graph. The Rx Graph is simple, clear and comparative. The interactive display allows you to view all the information you need, analyze data, and click into specific data points to see more detail. You can easily visualize and understand patterns in prescribing and usage behaviors, as well as identify overlapping prescriptions.

The PDMP Data. The PDMP Report is for controlled substance data. The PDMP Report aggregates two years of historical prescription data from providers and pharmacies, including quantities and active prescriptions.

For information about the PDMP or NarxCare™, contact the Alabama Department of Public Health’s Pharmacy Division at (877) 703-9869.

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Association Announces New Online, OnDemand Education Center

Association Announces New Online, OnDemand Education Center

Did you know that as a member of the Medical Association, you have access to our new online, OnDemand Education Center? Featured are seven Alabama Opioid Prescribing courses that meet the Alabama Board of Medical Examiner requirements for holders of an ASCS and are FREE to Medical Association members.

The Medical Association’s new OnDemand Education Center is easily accessed through our website, www.alamedical.org/onlinecme. Simply sign in using your Medical Association username and password and add course(s) to your shopping cart.

“We joined this partnership as a way to bring our members the best educational courses available at the click of a button,” said Executive Director Mark Jackson. “Being a physician is a lifelong learning experience, and we wanted to deliver that opportunity in the easiest, most affordable way possible to Alabama’s physicians and other health care providers. This program was designed for physicians who are busy and have little time to spare but who want to continue expanding their educational prospects to the best of their abilities. Our new online, OnDemand learning experience provides an exciting venue to learn from our own courses in the catalog as well as from others across the country.”

Included in the OnDemand package are the seven Alabama Opioid Prescribing Courses, which meet the CME requirements for the Alabama Board of Medical Examiners:

  • Mitigating Risk When Prescribing Opioids
  • Resist the Opioid Pendulum: Understanding Opioids and Pain and How They Relate to Addiction
  • Use and Misuse of Benzodiazepines
  • Fighting the Opioid Crisis: The Prescription Drug Monitoring Program (PDMP)
  • Basic Principles and Advanced Concepts in Pain Management
  • CDC Guidelines for Prescribing Opioids for Chronic Pain
  • Issues from the Alabama Board of Medical Examiners

OnDemand courses are contributed not only by the Medical Association but also other medical associations and societies across the country. Categories currently include:

Addiction
Alabama Opioid Prescribing
Prescribing
Specialty-specific Topics
Billing and Coding
Ethics
Family Medicine
HIPAA
ICD-10
Internal Medicine
Legal
Medical Staff Leadership
Medico-Legal
Obesity

Opioid Prescribing
Pain Management
Patient Safety
Physician Health
Practice Management
Primary Care
Public Health
Regulatory and Compliance
Risk Management
Substance Abuse
Technology
Tobacco
Women’s Health

Click here to go to the OnDemand Education Center. Log in using your Medical Association username and password. For more information about the new OnDemand Education Center, contact the Education Department at (800) 239-6272.

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Stay Safe During Hurricane Michael

Stay Safe During Hurricane Michael

As Hurricane Michael takes aim at Alabama, all families in affected areas should take health and safety precautions in connection with tropical storm force winds associated with the storm. Listen and follow all health and safety warnings communicated through the news media, and below are some tips to stay safe during the next few days.

Food Safety

Power outages associated with tropical storm force winds can cause concerns about the safety of frozen and refrigerated foods. As a general rule, a full upright or chest freezer will keep foods frozen for about two days without power.

A partially full freezer will keep foods frozen for about one day. This time may be extended by keeping the door shut. A refrigerator will keep foods cool for four to six hours if the door is kept closed as much as possible.

Any thawed foods that have been at room temperature for more than two hours should be discarded. Foods still containing ice crystals can be refrozen, although the quality of the food may decrease. Foods that have thawed to refrigerator temperatures (that is, no more than 40 degrees Fahrenheit) can also be cooked and then refrozen.

Carbon Monoxide

The public should never use generators, grills, camp stoves or other gasoline, propane, natural gas, or charcoal-burning devices inside a home, basement, garage or camper–or even outside near an open window. Keep these devices at least 20 feet away from any door, window or vent and also use a battery-operated or battery back-up carbon monoxide (CO) detector any time you use one of these devices.

CO is an odorless, colorless gas that can cause sudden illness and death if breathed. When power outages occur during emergencies such as hurricanes, people often try to use alternative sources of fuel or electricity for heating, cooling or cooking. CO from these sources can build up in a home, garage or camper and poison the people and animals inside. Look to friends or a community shelter for help. If you must use an alternative source of fuel or electricity, be sure to use it only outside and away from open windows.

Exposure to carbon monoxide can cause loss of consciousness and death. The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain and confusion. People who are sleeping or who have been drinking alcohol can die from CO poisoning before ever having symptoms. Consult a health care professional right away if these symptoms occur.

Important Tips

  • Never use a charcoal grill, hibachi, lantern or portable camping stove inside a home, tent or camper.
  • Never run a generator, pressure washer or any gasoline-powered engine inside a basement, garage or other enclosed structure, even if the doors or windows are open, unless the equipment is professionally installed and vented. Keep vents and flues free of debris, especially if winds are high. Flying debris can block ventilation lines.
  • Always set up a generator at least 20 feet from your home, doors, windows, and vents. Follow the advice linked here:
    a. English:https://www.cdc.gov/co/pdfs/generators.pdf
    b. Spanish:https://www.cdc.gov/co/pdfs/flyers_Spanish.pdf
  • Never run a motor vehicle, generator, pressure washer or any gasoline-powered engine outside an open window or door where exhaust can vent into an enclosed area.
  • Never leave the motor running in a vehicle parked in an enclosed or partially enclosed space, such as a  closed garage.

Animals

Stray animals can pose a danger during a storm. Most animals are disoriented and displaced, so do not corner an animal. Certain animals may carry rabies; therefore, care should be taken to avoid contact with strays. Although rabies is rare, it may be transmitted in Alabama by foxes, bats, raccoons or rarely other animals.  If you are bitten by an animal, seek immediate medical attention as soon as possible. If an animal must be removed, contact your local animal control authorities.

Injury Prevention

The public should follow these safeguards against injury while using a chain saw:

  • Operate, adjust and maintain the saw according to manufacturer’s instructions provided in the manual accompanying the chain saw.
  • Properly sharpen chain saw blades and properly lubricate the blade with bar and chain oil. Additionally, the operator should periodically check and adjust the tension of the chain saw blade to ensure good cutting action.
  • Choose the proper size of chain saw to match the job, and include safety features such as a chain brake, front and rear hand guards, stop switch, chain catcher and spark arrester.
  • Wear the appropriate protective equipment, including hard hat, safety glasses, hearing protection, heavy work gloves, cut-resistant leg wear (chain saw chaps) that extend from the waist to the top of the foot, and boots which cover the ankle.
  • Avoid contact with power lines until the lines are verified as being de-energized.
  • Always cut at waist level or below to ensure that you maintain secure control over the chain saw.
  • Bystanders or coworkers should remain at least two tree lengths (at least 150 feet) away from anyone felling a tree and at least 30 feet from anyone operating a chain saw to remove limbs or cut a fallen tree.
  • If injury occurs, apply direct pressure over site(s) of heavy bleeding; this act may save lives.

For Downed Power Lines

If power lines are lying on the ground or dangling near the ground, do not touch the lines. Notify your utility company as soon as possible that lines have been damaged, or that the power lines are down, but do not attempt to move or repair the power lines.

Avoid driving through standing water if downed power lines are in the water. If a power line falls across your vehicle while you are driving, continue to drive away from the line. If the engine stalls, do not turn off the ignition. Stay in your vehicle and wait for emergency personnel. Do not allow anyone other than emergency personnel to approach your vehicle.

For more information on hurricane safety, please visit www.alabamapublichealth.gov.

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Navigate the New Medicare ID Transition in 9 Steps

Navigate the New Medicare ID Transition in 9 Steps

Due to a legislative mandate in MACRA passed in 2015, Medicare will no longer use social security numbers to identify individuals. Instead, a new randomly generated Medicare Beneficiary Identifier (MBI) will be assigned to all 58 million Medicare recipients. New Medicare ID cards containing the MBI are currently being sent to recipients.

“It is a big change,” said Phillip Allen, billing service manager with MediSYS. “MACRA requires that social security numbers be removed to protect beneficiaries from social security number theft, identity theft, and illegal use of benefits.” Which is why the gender and signature line will not be printed on the new Medicare cards either.

The MBI replaces the Health Insurance Claim Number (HICN) used for Medicare transactions like billing, eligibility status, and claim status. Whereas the HICN started with the 10-digit social security number and ended with a letter or two designating a policy type, the 11-digit MBI will contain both letters and numbers throughout.

The transition to these new cards is a big step for patients as well as providers. “All providers, vendors, and other stakeholders must be ready to accept, receive, and transmit the new MBI  … particularly for the new beneficiaries coming into the program,” said Monica Kay, acting director of the CMS division of program management.

Here are nine steps your practice should take to ease the transition and avoid payment delays:

  • Educate practice staff about the rollout of the new Medicare cards with the new MBIs.
  • Contact practice-management system vendors about what system changes need to be made to accommodate the MBIs.
  • Alert your Medicare patients that they will be receiving new Medicare cards with their new MBIs.
  • Remind Medicare patients to confirm that the Social Security Administration has their correct address on file to ensure that they receive their new Medicare cards.
  • Tell Medicare patients to bring their new Medicare cards to their next appointment after they receive it.
  • Begin using the new MBI in Medicare transactions as soon as it is available for the patient.
  • Monitor eligibility responses for messages that indicate the patient was mailed a new Medicare card.
  • Starting Oct. 1, 2018, monitor remittance advices for messages that provide the patient’s MBI.
  • Sign up for the MBI look-up tool via your regional MAC portal.

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ALBME Names New Executive Director

ALBME Names New Executive Director

Norris Green was recently named executive director of the Alabama Board of Medical Examiners. Green originally joined the ALBME in July 2015 as the associate executive director and was officially named director following the retirement of Larry Dixon in December 2016.

Prior to coming to the ALBME, Green worked for 39 years with the Alabama Legislative Fiscal Office and served as its director for his last four years with the organization.

“Since joining the ALBME, I’ve enjoyed working with our staff members and getting to know Alabama’s physicians who serve as members of the board,” Green said. “We are all working together to shape our state’s health care future. This can be challenging, yet very rewarding work, and I’m excited about continuing to move Alabama forward in our changing health care climate.”

Green has a Bachelor’s degree in Business Administration from Auburn University, a Juris Doctor degree from Jones School of Law, and is a member of the Alabama State Bar. During his career, he received recognition by the National Association for Legislative Fiscal Offices for outstanding contributions to the Alabama Legislature as well as recognition of the fiscal office by the Center on Budget and Policy Priorities as a model legislative agency.

“The Medical Association is excited to work with Norris and continue our strong relationship with the ALBME,” said Association Executive Director Mark Jackson. “His ability to work with complex issues with his experience of the inner workings of state government will be a tremendous asset to our physicians.”

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Alabama Power Warns of Power Scam

Alabama Power Warns of Power Scam

*Editor’s note: After being contacted by several physicians, we contacted Alabama Power for additional information concerning the resurgence of an old scam.

The Medical Association is joining Alabama Power to warn customers about a new wave of an old scam.

In this instance, scammers call from toll-free numbers claiming that the customer’s account is past due and the customer’s service will be discontinued if the customer does not make a payment.

The number features a recording claiming to be Alabama Power; however it is not. Alabama Power does not conduct business in this manner.

If receiving a call, do not rely on caller ID, as thieves alter the number on those devices to appear local, or even display “Alabama Power” or “Customer Service.”

Customers who receive suspicious calls are encouraged to hang up, and report it to law enforcement. The next call should be to your utility company’s billing department to confirm your account status and alert them of the scam.

Over the past few years, scammers targeting both residential and commercial customers have become more sophisticated in their tactics, including:

  • Calling from a local number posing as an Alabama Power technician threatening to disconnect service if a payment was not made immediately with a “money pack” or prepaid card – an untraceable disposable debit card. The scammers ask customers to buy a prepaid card from a local retailer (such as Walmart, CVS or Walgreens).
  • Using a number with “Alabama Power” appearing on the caller ID asking for immediate payment by money pack or prepaid card. The customer is then directed to call a different number with an answering machine that says “This is Alabama Power” and leave the prepaid card information.
  • Going to customers’ homes impersonating Alabama Power employees offering to reduce energy bills by conducting an energy audit. The fake employee offers to immediately credit the account by accepting a cash payment on the spot.
  • Targeting customers in chat rooms posing as employees of companies or organizations that help pay bills for disadvantaged families.
  • Going door to door and posing as clergy telling customers they are assisting people with paying their energy bills and asking for a prepaid card.

Most scams seem obvious after the fact, but scammers are smart and know they do not need to make sense; they just need to scare the intended victim. Their goal is to make the victims believe they are in trouble and that the scammers are the only ones who can help. This type of emotional manipulation is easy when it comes to a vital service such as electricity that customers depend on.

“If someone calls and says your electricity is being turned off unless you make an immediate payment, we urge customers to hang up and call their local authorities,” said Security Manager Scott Stover. “These are crimes that should be reported to law enforcement.”

Stover said after notifying local authorities, a customer’s next call should be to the Alabama Power customer service line to confirm their account status and alert the company of the scam.

“Due to the variety of scams, it is important our customers know the ways in which we conduct business so they can spot a scam and report it to authorities and to us,” Bellamy said.

How to protect yourself

Alabama Power customers should remember:

  • Alabama Power employees will never come to your door and demand an immediate payment.
  • No employee will ever call and ask you for bank information or a credit card number.
  • Any Alabama Power employee who comes to your door for any reason will have company identification that he or she will gladly show. If you have any questions about whether the person works for Alabama Power, call 1-888-430-5787 and do not let the person inside your home until you receive proper verification.
  • Scammers sometimes claim they represent a public agency or government office offering grants that can pay your Alabama Power or other utility bill. Never provide anyone making this claim your credit card information, your Alabama Power Company bill information or account number, or any personal banking information. If someone makes this claim, call Alabama Power or your local police department to report it.

If you ever have any question about the status of your Alabama Power account, do not hesitate to call the company. You can reach Alabama Power Customer Service day or night, seven days a week, at 1-888-430-5787.

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Larry Dixon to Retire as Executive Director of the Alabama Board of Medical Examiners

Larry Dixon to Retire as Executive Director of the Alabama Board of Medical Examiners

MONTGOMERY – After serving as executive director of the Alabama Board of Medical Examiners for more than 35 years, Larry Dixon has announced his retirement at the end of the year.

“We are like family here,” Dixon said. “It has been my privilege to serve Alabama’s physicians and our staff because we are so much like family. We’ve been a part of each other’s lives for so many years, and I’m going to miss that. We’ve done great things together, but I know there are still great things to come.”

Dixon brought his experience with continuing education to the Medical Association of the State of Alabama in 1972 and established the Association’s education department, which has continued to flourish by producing original continuing medical education programs for Alabama’s physicians, as well as nurse practitioners and certified registered nurse practitioners.

“The Medical Association has one of the strongest education departments in the country due largely to the foundation on which it was given when Larry Dixon created it,” said Medical Association Executive Director Mark Jackson. “Since then, he has been the driving force behind the ALBME and making the organization one of the best in the nation year after year. He put his stamp of excellence on both organizations, and we are equally better for it.”

Dixon served four terms on the U.S. Federation of State Medical Boards and was the first president of the Administrators in Medicine, an organization he helped charter. He has also served on committees of both AIM and FSMB. In 2009 he received the Meritorious Service Award from FSMB, and in 2014 FSMB awarded him the Lifetime Achievement Award. He was inducted into the Alabama Healthcare Hall of Fame in 2016, and also earlier this year, the Medical Association honored him by renaming the building that houses the Alabama Board of Medical Examiners to the Dixon-Parker Building.

During the years, Dixon has watched as downtown Montgomery has grown up outside his office window, both figuratively and literally. After serving a term on the Montgomery City Council in 1975 to 1978, he was elected to the Alabama House of Representatives. In 2010 Dixon retired after serving seven terms in the Alabama Legislature – four years in the Alabama House of Representatives before being elected to the Alabama Senate.

His many accomplishments include being a member of the board of directors of the Montgomery Airport Authority; board member of the finance committee and past member of the administrative board of First United Methodist Church; charter member of the Certified Medical Board Executives; member of the advisory committee of the Prescription Drug Monitoring Program; and member of the board of directors of the FSMB Research and Education Foundation.

 

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