Coming Thursday 8/20: New Political Pulse Episode
Announcing this week’s special guest on the Political Pulse Podcast: Congressman Don Davis!
Congressman Davis has spent his career in service — as an Air Force officer, educator, minister, Mayor of Snow Hill, State Senator, and now a member of Congress representing 22 counties across ENC.
Health care has been a major focus of his work, especially expanding access to affordable care in rural communities.
Tune in Thursday on the NCMS Substack for the full conversation! Make sure to subscribe so you don’t miss it!
Carolinas Society of Endocrinologists 2026 Annual Meeting
Join the Carolinas Society of Endocrinologists (CSE) for its 2026 Annual Meeting, this weekend, August 21–23 in Charleston, SC.
This premier endocrine education event brings together leading experts to share the latest advances in diagnosing, treating, and managing endocrine and metabolic disorders.
Designed for endocrinologists, trainees, and the wider healthcare team, the meeting features cutting-edge scientific sessions, practical clinical insights, and valuable networking opportunities — all set against the historic charm of Charleston. Elevate your practice, connect with colleagues, and stay at the forefront of endocrine care.
NCDHHS Updates Guidance for Fall Respiratory Vaccine Season
The North Carolina Department of Health and Human Services (NCDHHS) has shared several important updates for the upcoming fall respiratory vaccine season. The NC Board of Pharmacy has advised that pharmacists may continue administering routine influenza and COVID-19 vaccines under last year’s ACIP recommendations, which remain in effect.
The Department is also assessing the potential implications of the Aug. 10 Executive Order, which seeks to revise federal childhood vaccine recommendations by narrowing the vaccines routinely recommended for all children and shifting others, including influenza and COVID-19 vaccines, to shared clinical decision-making.
NCDHHS has not yet received formal federal guidance on how the order may affect North Carolina. In the meantime, the Vaccines for Children program is expected to operate as usual, NC Medicaid will cover indicated vaccines for beneficiaries, and pharmacists may administer the newly licensed mRNA influenza vaccine to adults 50 and older.
Additional guidance, seasonal updates and resources for health care professionals are available on NCDHHS’ Seasonal Respiratory Illnesses website.
ENROLL NOW: Free Quality Improvement Support for NC Clinical Practices
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Old North State Medical Society Annual Scientific Conference
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NCMS leaders and staff were pleased to support and attend the 135th Annual Scientific Conference of the Old North State Medical Society this past weekend. The conference brought together physicians and attorneys from across the state in Wilmington, where the NC Association of Black Lawyers held a joint meeting with ONSMS. NCMS President Carl Westcott, MD, and President-Elect Karen L. Smith, MD, FAAFP, were among the distinguished speakers. The lineup also included Willie Underwood, MD, President of the AMA; Cedric Bright, MD, President of ONSMS; Eddie Glaude Jr., PhD, a noted educator, author, and expert on racial and religious identity and politics in the U.S.; and the NCMS Foundation’s Monecia Thomas and Lisa Mwaikambo. |
NCMS Foundation’s Growing Impact Earns Regional Recognition
The North Carolina Medical Society Foundation (NCMSF) was recently recognized by the Triangle Business Journal among the Triangle’s largest foundations. The Foundation ranked #5 in annual giving percentage increase, #20 in dollar increase in giving, #32 in total assets, and #42 in total giving.
This recognition reflects the Foundation’s continued growth and increasing capacity to invest in programs that support physicians, strengthen communities, and improve health across North Carolina. We are grateful to our donors, partners, and supporters whose generosity makes this work possible and helps expand the Foundation’s impact across the state.
NCSEPS President & Surgeon Serves in South Sudan
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NCMS President-Elect Karen Smith, MD Appointed to Health Care Affordability Commission
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BCBSNC E/M Leveling Program
NCMS is closely monitoring the August 15, 2026 implementation of Blue Cross and Blue Shield of North Carolina’s (BCBSNC) Evaluation and Management (E/M) Leveling Program and its potential impact on physicians and practices across the state.
BCBSNC has identified approximately 13% of its network providers for inclusion in the program, including physicians, physician associates (PAs) and nurse practitioners (NPs) across specialties. Letters to impacted providers were sent on July 27, 2026. Currently, the program is limited to office-based services (Place of Service 11) billed under E/M codes 99204, 99205, 99214 and 99215.
Under the program, BCBSNC may take one of three actions on an affected claim: pend the claim for further review, reimburse the service at a lower E/M level, or recoup payment through future reimbursements. When the program is applied, the provider’s payment remittance will include an EXCD code.
While the notification letter states the insurer will be using “an analytic solution to determine whether coding on these claims is aligned with national industry standard,” BCBSNC has indicated the process being used involves human review rather than AI. Providers who disagree with the determination will be directed to follow the health insurer’s standard claims dispute process.
What You Should Know: NCMS recognizes that changes to E/M claims review and reimbursement can create significant administrative and financial implications for physician practices. We encourage those who receive a notification letter to review it carefully, ensure documentation appropriately supports the E/M level billed, monitor remittance notices for EXCD codes, and track any claims that are reduced, pended or subject to recoupment.
NCMS will continue engaging BCBSNC on this issue, gathering feedback from the physician community and seeking additional clarity regarding implementation of the program. If your practice has received a notification letter or experienced a claim adjustment related to the E/M Leveling Program, we want to hear from you.
Please contact Jenni Hines at [email protected] to share your experience. Your feedback will help NCMS better understand the program’s impact on North Carolina physicians and inform our ongoing advocacy and education efforts.
NCMS Rounds: Let’s Talk Downcoding!
Welcome to NCMS Rounds, a new video series focused on your questions, challenges, and issues affecting physicians, PAs and medical practices. Let’s first talk downcoding!
Thank you to those who contributed questions for this episode!
Here’s what you asked:
- What is downcoding?
- What is the legality of downcoding?
- How prevalent is downcoding?
- What is the economic impact on small rural practices?
- What steps can we take to prevent or recognize downcoding within a practice?
- Why are only diagnosis codes becoming the basis for downcoding?
If this segment brought up additional questions or thoughts, we want to hear from you!
Fill out our quick form, drop your thoughts in the comments on our social media post, or reach out to Jenni Hines directly at [email protected].
Bipartisan Bill Aims to Stabilize Medicare Physician Payments
Last week, the bipartisan Doctors Caucus chairs – United States Representatives John Joyce, MD, Greg Murphy, MD, and Kim Schrier, MD – introduced the Patients First Act, HR 9693. A proposal to reform MACRA (Medicare Access and CHIP Reauthorization Act) and the Medicare physician payment system.
The proposed legislation would make several significant changes to Medicare physician payment with the goal of creating a more stable and predictable system. It would tie annual payment updates more closely to inflation, provide additional support for independent and rural physician practices, and launch a five-year pilot program that combines traditional fee-for-service payments with monthly care management payments for primary care practices.
The bill would also replace the current Merit-based Incentive Payment System (MIPS) with a new quality reporting program called the Patient Outcome Improvement National Tabulation System (POINTS). The new program is designed to simplify reporting, reduce administrative burden, and place greater emphasis on patient outcomes while giving physicians a stronger voice in developing quality measures.
Overall, the legislation aims to improve payment stability, reduce paperwork, encourage participation in value-based care, and help ensure Medicare patients continue to have access to high-quality physician care.
