Bowtie Briefing: The Calm after the Crossover Storm
Chip Baggett revels in the post-Crossover calm but shares the importance of remaining ever-vigilant on the issues still facing health care professionals.
Related Links:
US House of Representatives Pass Revised American Health Care Act
Legislative Update: Staying Vigilant after 'Crossover'
Bowtie Briefing: Special Crossover Update
It was Crossover week -- meaning it was a long, hectic week filled with late nights and lots of policy talk down at the General Assembly. In this special report filmed at the Legislative Building, Chip Baggett sums up crossover results and shares some other important announcements.
Bowtie Briefing for April 21, 2017: Crossover's Coming
Get ready for Crossover! Chip Baggett explains how next week's important deadline will impact the legislative landscape. In addition he highlights an insurance bill on which he urges NCMS member action and also a new NCMS task force dedicated to medical team issues.
Tell Your Legislator That You Oppose S629 - Health Care Services Billing Transparency
The NCMS is strongly opposed to SB 629 – Health Care Services Billing Transparency [Primary Sponsors: Sen. Ralph Hise (R – Madison), Sen. Wesley Meredith (R – Cumberland)], which calls for a benchmark fee for any service provided to a patient by an out-of-network provider if an in-network provider is available to meet the patient’s needs without unreasonable delay. This proposal would hinder the ability of any doctor to negotiate a fair contract with a health insurance company.
The bill states an out-of-network provider’s total payment for care or for emergency services is reasonable if it is equal to the benchmark amount. An out-of-network provider would be required to send a bill to the insured individual who is responsible for paying in-network cost sharing, but the patient would have no legal obligation to pay the remaining balance when the benchmark applies.
This bill further states that no provider would be able to bill insured individuals for services at a greater rate than the benchmark amount nor would the insurer be required to make any direct payment to the provider.
The benchmark would be calculated as the smallest amount among the following:
- 100 percent of the current Medicare payment rate;
- Health care provider’s charges;
- Median concentrated rate for the same service in a similar area.
Those providers who fail to comply would be deemed engaging in unfair and deceptive trade practice.
We ask that you send this ACTION ALERT to your legislators asking them to oppose this proposal.
Bowtie Briefing for March 31, 2017: Cohen confirmation, STOP Act developments and more
Chip Baggett highlights several legislative developments this week, including forward movement on the confirmation hearings for DHHS Secretary Mandy Cohen, MD, updates on the opioid STOP Act, and more.
View Senate Health Committee Confirmation Hearing with Mandy Cohen, MD, MPH
View the 3-29-2017 House Health Committee Hearing where the STOP Act revisions were presented.
Karin R. Minter, MD, MPH, Named 2017 NC Doctor of the Year
As part of the NC Doctors’ Day celebration on March 30, Karin R. Minter, MD, MPH, FAAP, was named 2017 NC Doctor of the Year.
Dr. Minter is a pediatrician with Burlington Pediatrics in Burlington, NC, where she has practiced medicine since 2006. She shares, "I always knew I wanted a career in medicine, but the decision of which field to enter was difficult. It comes down to my fundamental belief that all children are good. So I chose to commit myself to children. It’s fulfilling to provide the best, most thoughtful care that I can to young patients and their families. I strive to make it a personal experience." This approach seems to be working for her, as she received the most online votes of the 10 NC Doctor of the Year Award finalists, making her the winner.
The award comes with a $5,000 prize to be used to further a professional or community project of the winner’s choosing. Dr. Minter plans to split the funds among two worthy charities: Alamance County Partnership for Children and Reach Out and Read of Alamance County. As she explains, "They (Reach Out and Read) make such a big impact to promote literacy by distributing books to kids through pediatricians, and they are really deserving."
NC Doctors’ Day, spearheaded by the NCMS, is the homegrown celebration of National Doctors’ Day. Starting in February, patients, colleagues, family and friends nominated doctors who exemplify the best qualities of caring, compassion, clinical expertise and community involvement. Numerous doctors were nominated through the NC Doctors’ Day website (www.ncdoctorsday.org). In mid-March, 10 finalists were selected from among the nominations to participate in an online voting contest. These extraordinary physicians represent various specialties and are from across North Carolina.
The nomination for Dr. Minter caught the finalist selection committee’s attention, with several nominators singing her praises as a clinician, physician leader and a compassionate community advocate. As one supporter shared, “Karin is a devoted, impressively intelligent pediatrician who is passionate about her patients and the health of the community at large. She has a beautiful sense of humor that puts you at ease, and a formidable feistiness that serves her well when needed. Karin is compassionate and goes to all lengths for her patients.”
There were a total of 22,588 online votes cast to determine this year's winner; many thanks to all who took part in this process!
Bowtie Briefing for March 24, 2017
Chip Baggett sums up a busy week at the legislature and shares his thanks on physician, PA and student involvement in advocacy.
NCMS Board of Directors Considers STOP Act
At their regular bi-monthly meeting held Saturday, March 18 in Greenville, the North Carolina Medical Society (NCMS) Board of Directors discussed pending legislation before the General Assembly including the STOP (Strengthen Opioid Misuse Prevention) Act, HB243/S175, aimed at curbing the state’s opioid poisoning epidemic.
Rep. Greg Murphy, MD, (R-Pitt) a sponsor of the STOP Act, co-chair of the House Health Committee and the only physician in the General Assembly met with NCMS Board members over dinner on Friday night before the Board meeting. Watch Dr. Murphy discuss why it is important for physicians to support this legislation.
The Board expressed concern about provisions in the bill including the mandate that physicians or their delegate check the state’s Controlled Substance Reporting System (CSRS) before prescribing a controlled substance; the drugs covered by the mandate; the daily limit for first prescriptions related to acute, post-operative pain and the requirement to use e-prescribing.
NCMS Senior Vice President for Advocacy, Chip Baggett, explained that the STOP Act is the result of broad, bipartisan work by legislators and the State Attorney General’s Office. The multi-faceted effort to curb the opioid abuse epidemic includes holding physicians accountable as prescribers. It is highly likely to be passed by the legislature this session. The NCMS is supporting the STOP ACT and working with legislators to make changes to achieve the bill’s intent while ensuring that its implementation is realistic in practice and not overly burdensome to physicians.
“We are working to make sure that when these new mandates become operational they do not have a huge negative impact on your practice,” he said. “But they will affect your practice.”
Based on feedback from members on how these new policies might play out, the NCMS is working to:
- Clarify what specific drugs and drug schedule(s) would be covered by the mandate. Currently, it appears controlled substances like Adderall and Ritalin are included in the bill language. The NCMS is asking that drugs not currently identified as contributing to the opioid poisoning crisis be excluded from the mandate to query the CSRS before prescribing and certain other bill provisions.
- Refine the language around e-prescribing since small practices may not currently have the necessary e-prescribing technology nor the financial resources to acquire it.
- Ensure the CSRS is functioning properly and is interoperable with other states’ prescription drug monitoring systems before the mandate would take effect.
- Time the mandate to coincide with the connection of the CSRS with the NC Health Information Exchange (HIE). This will enable prescribers to access the most current information in their electronic medical record and the CSRS simultaneously.
The bill has been discussed in the House Health Committee, and will likely be brought up again as the changes are negotiated over the next few weeks.
The NCMS Board will meet next in May in Chapel Hill. If you have a policy matter you’d like them to address, you may submit a Board contact form.
Bowtie Briefing for March 10, 2017
Both federal and state legislative developments are highlighted in this week's Bowtie Briefing. Get Chip's take on the GOP proposed health care plan, as well as the new STOP Act addressing the opioid crisis in NC.