SUPPLEMENTAL PUBLIC AGENDA ALABAMA BOARD OF MEDICAL EXAMINERS JULY 15, 2015
I
PUBLIC MINUTES OF JUNE 17, 2015
II ENDORSEMENT
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Name
Medical School
Endorsement
Simon Gedali Abramson * Jose Luis Benitez Michael Joseph Bernell Joseph Stephen Brigance * Amy Tucker Clark Mohamad Moustapha El Khatib Scott David Friedman Kalyan Chakravarthy Gonugunta Anne Marie Guyot Gregory Douglas Homer * Om Prakash Jha * Fatima E. Kasiah Andrew Wallays Long Antonio Macias Kamal Kishore Mandalapu * Alexis Tanishia Mason Mark Timothy McVay * Leanne Catherine Sienko Mihata Malia Setsuyo Myers Ngozi Chidimma Okeke Anthony Obiesie Okobi Jr. Aashay Navin Patel Sandip Thakor Patel Kathleen Halley Pridgen * Deepak Kolagatla Reddy William Francis Rushton Amena Samar * Bishoy Tharwat Samuel Tiziano Maria Scarabelli * Aasim Shaheen Sehbai * Tongii Lashelle Shavers
Univ of Illinois College of Medicine Chicago Universidad Central Del Este (UCE) Univ of Texas Medical School at Galveston University of Louisville School of Medicine UASOM Birmingham American University of Beirut Tulane University School of Medicine Sri Siddhartha Medical College Tumkur Wayne State University School of Medicine Loma Linda University School Of Medicine Medical College University of Calcutta Ross University University of Virginia School of Medicine Biomedical Cen Autonomous U Aguascalientes Guntur Medical College Nagarjuna University UASOM Birmingham Des Moines Univ of Osteo Medical Center Uniformed Services Univ of Health Sciences Univ of Texas Medical School at San Antonio State U of NY Upstate Medical University Warren Alpert Medical School of Brown Univ N H L Municipal Medical College Gujarat Univ University of Miami School of Medicine University of Virginia School of Medicine Des Moines Univ of Osteo Medical Center Georgetown University School of Medicine Deccan College of Medical Sciences University of South Florida College of Medicine U degli Studi di Torino Scuola di Medicina Rawalpindi Medical College Univ of the Punjab University of Louisville School of Medicine
USMLE/FL USMLE/MA USMLE USMLE/IN USMLE/MS NBOME/IN USMLE/LA USMLE/LA NBME/MI USMLE/TX USMLE/IL USMLE/GA USMLE/LA USMLE/NY USMLE/GA USMLE/TN COMLEX/OK USMLE/VA USMLE/NY USMLE/NJ USMLE/NC USMLE/PA USMLE/FL USMLE NBOME/FL USMLE/VA USMLE/GA USMLE USMLE/MI USMLE/WV USMLE/SC
ABME Public Agenda
1
July 15, 2015
32 33 34 35 36
Abimbola Adenike Shofu Aishwarya Rushyal Shyamraj Robert Adam Silver * Kaveh K. Tayebi * Pallavi Dundumalla Reddy
Escuela Lation Americana de Medicina Ross University Hahnemann University School of Medicine Ross University Spartan Health Sciences University
USMLE/TN USMLE NBME/NC USMLE/IN USMLE/KY
Medical School
Endorsement
PROVISIONAL ENDORSEMENT Name No Provisional Endorsement Applicants
RETIRED SENIOR VOLUNTEER PROGRAM LICENSE (RSVP) Name
Facility
Location
Location
Type of Practice
Name
Medical School
Endorsement
Dakota Syleece Acton Jones Ansley Omega Hairrell Baccus Arnelya Patrice Cade Raymond Bryce Hunt Brittany Anne Ruth McArthur Randi Cheree Melton Omeed Moaven
UASOM Birmingham LL/AL UASOM Birmingham LL/AL UASOM Birmingham LL/AL UASOM Birmingham LL/AL Saba University School of Medicine LL/AL Edward Via Col of Osteo Med Carolinas CampusLL/AL Masshad University of Medical Sciences LL/AL
No RSVP Licensure Applicants
SPECIAL PURPOSE LICENSE Name No Special Purpose License Applicants
II LIMITED LICENSE
1 2 3 4 5 6 7
ABME Public Agenda
2
July 15, 2015
IV PHYSICIAN ASSISTANTS / ADVANCED PRACTICE NURSES (2) Cover Sheet P.A. License
1 2 3
Name
School
NCCPA
* Michael Palmer Gina Luckianow Jennifer Sellers
Bethel University Arcadia University UAB
1122669 1062369 1123312
School
NCCAA
Name
School
NCCPA
Jason Largue * Shauna O’Dell
USAM USAM
Registered for Exam Registered for Exam
A.A. License Name No A.A. License applicants
Temporary P.A. License
1 2
Temporary P.A. License to Full License Name
School
NCCPA
No Temporary License to Full License Applicants
P.A. Registration Without additional duties or remote site; Formulary: #2, #21, and #23
P.A. / Physician
Registration / Formulary Requests
(28)
1.
Sheryll Coleman, PA Clement Cotter, M.D.
Registration
(40)
2.
Sheryll Coleman, PA Chad Mathis, M.D.
Registration
ABME Public Agenda
3
Recommendation
July 15, 2015
P.A. / Physician
Registration / Formulary Requests
(53)
3.
Linda Langston, PA Chad Mathis, M.D.
Registration
(67)
4.
Melinda Ledbetter, PA Davis Claassen, M.D.
Registration Birth Control Drugs and Devices
(76)
5.
Cheri Livingston, PA Edgar Finn, M.D.
Registration
(88)
6.
Sally Morriss, PA Clement Cotter, M.D.
Registration
(100)
7.
Sally Morriss, PA Chad Mathis, M.D.
Registration
(114)
8.
Michael Palmer, PA Muhammad Husainy, M.D.
Registration Birth Control Drugs and Devices
(125)
9.
Jamaal Upshaw, PA Jamil Akhtar, M.D.
Registration
(138)
10.
Sara Welch, PA Michael Ledet, M.D.
Registration Birth Control Drugs and Devices
(150)
11.
Tamara Williams, PA Bryan King, M.D.
Registration Birth Control Drugs and Devices
(159)
12.
Wesley Winebrenner, PA Clement Cotter, M.D.
Registration
SA 71
13.
Andrew Goodner, P.A. Thomas Cawthon, M.D.
Registration
SA 81
14.
Jason Largue, P.A. Suzana Sogorovic, M.D.
Registration
SA 91
15.
Gina Luckianow, P.A. Shannon Carroll, M.D.
Registration
SA 104
16.
Shauna O’Dell, P.A. Suzana Sogorovic, M.D.
Registration
SA 114
17.
Kristin Rhodes, P.A. Mark Leberte, M.D.
Registration
Recommendation
Additional duties, remote site, formulary requests P.A. / Physician
Registration / Skill / Remote Site / Formulary
(171)
Registration Remote site Birth Control Drugs and Devices
1.
Teresa Ann Price, PA Tamara McIntosh, M.D.
Recommendation
A.A. Registration No AA registration applicants ABME Public Agenda
4
July 15, 2015
P.A. Miscellaneous Requests / Reports P.A. / Physician
Skill; Formulary; Misc Requests
Recommendation
(185)
1.
Bradley Hill, PA James Worthen, M.D.
Documentation of training: Joint injections: shoulder and knee
(189)
2.
Heather Lockhart-Payne, PA Michael Ridner, M.D.
Documentation of training: Sclerotherapy
(193)
3.
Sarah Robinson, PA Frazier Jones, M.D.
Documentation of training: Joint injections: shoulder and knee
(197)
4.
Jaimee Sandlin, PA Kirk Withrow, M.D.
Flexible fiberoptic laryngoscopy Percutaneous Gastrostomy Tube Removal
(199)
5.
Emily Stewart, PA James Markert, M.A.
Stereotactic Head Frame Removal Protocol
P.A. QACSC Registration
1
P.A.
Physician
Cicley Kyle
Genevieve McLeod, M.D.
PA Limited Purpose Special Permit (207) Cover Sheet Physician / PA / Specialty
LPSP Formulary
Recommendation Approve Deny
(208)
Short Acting Hydrocodone Combinations meds Hydrocodone Cough Preparations
Approve all
ADHD Medications; Short Acting Hydrocodone Combination meds; Oxycodone-Immediate Release meds; Short Acting Tapentadol
Approve all
1.
Saadat Ansari, M.D. Rashida Dossman, PA IM / Pain Management
2. (209)
Glen Gabrielson, M.D. Allison Gabrielson, CRNP FM / Pain Management
APN Miscellaneous Requests / Reports (211) Cover Sheet Skills Request Within Protocol
ABME Public Agenda
5
July 15, 2015
Physician / APN
Skill; Restricted Drug; Misc Requests
(213)
1.
Harry M. Barnes, M.D. Ashley P. Jerkins, CRNP
Antineoplastic Agents
(216)
2.
Timothy D. Bassett, M.D. David C. Bailey, Jr., CRNP
Documentation of Training: Arthrocentesis Joint Injections
(228)
3.
Joseph W. Clark, M.D. Christine A. Cottrell, CRNP
Orthopedic Specialty Protocol
(240)
4.
Wayne P. Cockrell, M.D. Brittany McElhaney, CRNP
Orthopedic Specialty Protocol
(246)
5.
Jennifer A. Cox, M.D. Heidi M. Simpson, CRNP
Antineoplastic Agents
(249)
6.
Charles E. Hall, M.D. Matthew D. Bean, CRNP
Orthopedic Specialty Protocol
(256)
7.
Charles Hoopes, M.D. Raina Brown, CRNP
Mid-Level Critical Care Specialty Protocol
(272)
8.
Warner K. Huh, M.D. Bethany A. Fees, CRNP
Antineoplastic Agents
(275)
9.
Raquel Innis-Shelton, M.D. Mary Bartlett, CRNP
CVL Remove and Replace Over Guide Wire
(279)
10.
Eric Janssen, M.D. Ryan Parton, CRNP
Documentation of Training: Joint Injections: Shoulder and Knee
11.
Traci W. Jester, M.D. Taylor J. Knight, CRNP Megan L. Moseley, CRNP
Anti-Rheumatic Drugs: Non-Biologic DMARDS Biologic DMARDS Non-TNF Inhibitors
12.
Naveen T. Lobo, M.D. Elizabeth Clark, CRNP Rachel S. Kelly, CRNP
Antineoplastic Agents
(298)
13.
Michael T. Miller, M.D. Jaime B. Cannon, CRNP
CVL Remove and Replace Over Guide Wire
(301)
14.
Janaina Nogueira, M.D. Laurel D. Williams, CRNP
Anti-Rheumatic Drugs: Biologic DMARDS
(304)
15.
Peter J. Pons, M.D. Amanda L. McCann, CRNP
Mid-Level Critical Care Specialty Protocol
16.
Grace A. Thomas, M.D. Sheena Hunter, CRNP Tracey L. Lux, CRNP Stephanie McClure, CRNP Joyce Purvis, CRNP
Subdermal Contraceptive Implants Insertion and Removal
(287) (290)
(293) (295)
(312) (316) (319) (322)
ABME Public Agenda
6
Recommendation
July 15, 2015
Skills Requests Outside of Protocol / Miscellaneous Physician / APN
Skill; Restricted Drug; Misc Requests
(325)
1.
James F. Gauthier, M.D.
Exemption to FTE limit for free clinic
(327)
2.
James E. Johnson, M.D.
Request to amend vascular access protocol
(329)
3.
Stephen G. Walsh, M.D. Alegis Care
Remote physician supervision
(335)
4.
Vera Bittner, M.D. UAB Heart Failure Clinic
Exemption to FTE limit
SA 125
5.
Eric McCraney, CRNP Maria Murdock, CRNP
Pri-Med Pain Management CME Modules
SA 147
6.
Gena Kelley, CRNP Robin Hand, CRNP
NetCe Opioid Prescribing CME Modules
SA 207
7.
Shannon Morrison, CRNP
AZ COM Opioid Prescribing CME Module
Recommendation
Collaborative Practice (SA 214) Collaborative Practice Registration (SA 217) Collaborative Practice Registration Modifications (SA 218) Collaborative Practice Covering Physician Applicants APN QACSC Registration (SA 222) CRNP / CNM QACSC Registration Applicants APN Limited Purpose Special Permit (338) Cover Sheet Physician / APN / Specialty
LPSP Formulary
Recommendation Approve Deny
(342)
ADHD medications
Approve all
Short acting Hydrocodone combination meds Oxycodone Immediate release meds
Approve all
1.
William Brooks, M.D. Sheri Lazenby, CRNP Psychiatry / Mental Health
(343)
2.
Steven Buckley, M.D. Elizabeth Schwarze, CRNP Orthopedic Surgery
ABME Public Agenda
7
July 15, 2015
Physician / APN / Specialty
LPSP Formulary
Recommendation Approve Deny
(344)
Short acting Hydrocodone combination meds Hydrocodone Cough Preparations Morphine Sulfate Immediate release Oxycodone Immediate Release meds
Hydrocodone combo meds SA Hydrocodone Cough Prep MSIR Oxycodone IR
3.
Wendell Erdman, M.D. Suporior Campbell, CRNP Hospice / NH & Rehab
Fentanyl long acting Hydromorphone Morphine Sulfate long acting Oxycodone long acting Oxymorphone long acting Tapentadol Extended release
(346)
4.
Michael Lawley, M.D. Elizabeth Schwarze, CRNP
Approve the following with standard long acting language for Hospice patients only: Fentanyl - LA Hydromorphone Morphine Sulfate - LA Oxycodone - LA
Short acting Hydrocodone combination meds Oxycodone Immediate release meds
Approve all
ADHD medications
Approve all
Orthopedic Surgery (347)
5.
Sanjay Malhotra, M.D. Melissa Karrh, CRNP Psychiatry / Mental Health
ABME Public Agenda
8
July 15, 2015
Physician / APN / Specialty
LPSP Formulary
Recommendation Approve Deny
(348)
ADHD medications Shor tacting Hydrocodone combination meds Hydrocodone Cough Preparations Morphine Sulfate Immediat erelease Oxycodone Immediate Release meds Tapentadol
ADHD meds Shortacting Hydrocodone combo meds Hydrocodone Cough Prep MSIR Oxycodone IR Tapentadol
6.
Joshua Miller, D.O. Elizabeth Maxwell, CRNP FM / Home Bound
Fentanyl long acting Hydrocodone ER/LA Morphine Sulfate long acting Tapentadol Extended release
(350)
7.
Teresa Moran, M.D. Ashley Commins, CRNP
Approve the following with standard long acting language for Hospice; homebound; rehab patients only: Fentanyl LA Hydrocodone ER/LA Morphine Sulfate LA Tapentadol ER
ADHD medications
Approve all
Short acting Hydrocodone combination meds Hydrocodone Cough Preparations Oxycodone Immediate release meds
Approve all
Psychiatry / Mental Health (351)
8.
Steven Sharp, M.D. Tamberlynn Baker, CRNP Family Medicine
ABME Public Agenda
9
July 15, 2015
Physician / APN / Specialty
LPSP Formulary
Recommendation Approve Deny
(352)
ADHD medications Short acting Hydrocodone combination meds Hydrocodone Cough Preparations Morphine Sulfate Immediate release Oxycodone Immediate Release meds
ADHD meds Hydrocodone combination meds SA Hydrocodone Cough Preps MSIR Oxycodone IR
9.
Hermant Sinha, M.D. Jennifer Blackerby, CRNP IM / FM
Fentanyl long acting Hydromorphone Morphine Sulfate long acting Oxycodone long acting Oxymorphone long acting
(354)
10.
Terry True, M.D. Elizabeth Livingston, CRNP Family Medicine
(355)
11.
Richard Jones, M.D. Melissa Harrison, CRNP Rheumatology
ADHD medications Short acting Hydrocodone combination meds Hydrocodone Cough Preparations Oxycodone Immediate Release meds
Approve all
ADHD medications Short acting Hydrocodone combination meds Hydrocodone Cough Preparations Oxycodone Immediate Release meds Tapentadol
ADHD meds Hydrocodone combo meds SA Hydrocodone Cough Preps Oxycodone IR Tapentadol
Fentanyl long acting Hydrocodone ER/LA Oxycodone long acting Tapentado Extended release
(359)
12.
Warner Wiggins, M.D. Julie Wiggins, CRNP
Approve the following with standard long acting language for patients being discharged to Nursing home/Rehab only: Fentanyl LA Hydromorphone Morphine Sulfate LA Oxycodone LA Oxymorphone LA
Fentanyl LA Hydrocodone ER/LA Oxycodone LA Tapentadol ER
Requests expansion of LPSP Controlled IIN protocol (See attached letter).
Pediactrics ABME Public Agenda
10
July 15, 2015
Physician / APN / Specialty
LPSP Formulary
(369)
Requests expansion of LPSP Controlled IIN protocol (See attached letter)
13.
Leesah Ellis-Cox, M.D. Sarah Gilreath, CRNP
Recommendation Approve Deny
Psychiatry / Mental Health
Physician Assistant Advisory Committee Physician Assistant Advisory Committee Meeting - July 14, 2015, 5:00 p.m.
V CURRENT BUSINESS (2) (4)
1. 2.
(9)
3.
(32) (47)
4. 5.
(50) 6. (SA 224) 7.
Administrative Rule 540-X-1-.02 Officers of the Board Administrative Rule 540-X-12, Appendix B / Administrative Rule 540-X18, Appendix B Administrative Rule 540-X-17, Guidelines and Standards for the Utilization of Controlled Substances for Weight Reduction Administrative Rule 540-X-19-.03 / 540-X-19 Appendix A and Appendix B Executive Order Number 7 - Alabama Office for Regulatory Oversight of Boards and Commissions Prescribing Education for Physicians Administrative Rule 540-X-1-.04, Executive Director
PERSONNEL No personnel items
VI HEARINGS (2) ABME Hearing Schedule (3) 1. Chad Jamison Gilliam, P.A. Show Cause Hearing, Wednesday, July 15, 2015, 12:30 p.m.
ABME Public Agenda
11
July 15, 2015
