Orlando Medical News October 2019

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Florida Medical Marijuana: 89 Physicians Certified, 94,850 Patients

Patient/prescriber ratio not indicative of “pill mill” By MICHAEL C. PATTERSON

According to a new state draft report on Medical Marijuana (MMJ), Florida had 168,810 patient “certifications” for MMJ between October 1, 2018 and March 31, 2019. More than half of the certifications came from 89 Physicians. The report has alarmed members of a special panel of MDs setup by the State of Florida charged with keeping tabs on the ordering patterns of physicians who can authorize patients to take MMJ. Sarvam TerKonda, MD, of Jacksonville and member of the joint panel, said after review-

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ing the report, “To me, I look at this data and say this is just another form of a pill mill.” The panel, created in state law, is responsible for reviewing the data for patterns and annually submitting a report with recommendations to the legislature. The concern stems from 89 Physicians (7 percent of the physicians who are eligible to write MMJ certifications) are writing 56 percent - 94,850 - of the certifications. Chronic non-malignant pain was the number one qualifying condition (34 percent) followed by “medical conditions of the same kind or class,” and PTSD (26 percent). There are some people, including phy-

sicians, who are not familiar with the MMJ industry that will immediately assume fraud or “pill mill” activity is going on by reviewing this data. However, as someone who studies the United States and global medical cannabis industries, there are legitimate reasons why a few Florida physicians are certifying a large number of patients. Marijuana is still illegal federally. Physicians are worried about the legality of cannabis and potentially losing their DEA license to prescribe FDA approved medications. Those concerns were real a few years

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ago, but with medical cannabis legal now in 34 states, there has not been one reported case of a United States Physician losing their DEA license to prescribe FDA medications due to recommending or “certifying” a patient for MMJ. Furthermore, medical practices receive the bulk of their funding from federal insurance programs (Medicare and Medicaid). Therefore, most medical practices refuse to allow their physicians to write MMJ certifications for fear of losing their federal insurance funds. (CONTINUED ON PAGE 5)

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Clinically Integrated Networks Can Be a “Win-Win” By MICHAEL R. LOWE AND BRIAN C. EVANDER

At its core, a Clinically Integrative Network (CIN) is a collective of health care organizations in a local or geographic region in which providers share access to electronic health record systems. It is a health network working together, using proven protocols and measures, to improve patient care, decrease cost and demonstrate value to the market. This network of systems allows practices to track shared patient populations in order to improve patient engagement and deliver the best care at the lowest cost. The main goals of a CIN are to increase efficiency and provide better care. The Depart-

ment of Justice (DOJ) and the Federal Trade Commission (FTC) define clinical integration as an active and ongoing program to evaluate and modify practice patterns by CIN participants to create a high degree of interdependence and cooperation among physicians to control costs and ensure quality patient care. In its article, The 7 Components of a Clinical Integration Network, Becker’s Hospital Review defines CINs as individual providers and health systems that are collaborating strategically to do three things: 1) improve patient care, 2) decrease the cost of care and 3) demonstrate their value to the rapidly changing market.

•• •• • •

As care delivery methods and compensation evolve, clinical integration and CINs are being leveraged to deal with market changes, both anticipated and realized. And while changes in the market are one big reason for (CONTINUED ON PAGE 2)

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