The New Year Is Here!

2016-calendar-coverHave you renewed your membership for 2016?  If yes, thank you! If you're not sure about your membership status, please give NCMS Member Services a call at 1-800-722-1350, and we'll be happy to help answer your questions. You may also log into the NCMS website and review your membership status on your personal homepage.
Renew online for your free gift!
Renew your membership online now and receive the 2016 NCMS Member Calendar, which is filled with award-winning photographs taken by your fellow physician, physician assistant and medical student members of the Medical Society.
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Want to know what's ahead for the NCMS in 2016?
Read: What's Ahead for your medical society in 2016?
View: A Video Message from NCMS CEO Bob Seligson
 
 


Audit of ACA Enhanced Payments for Primary Care Coming this Week

In the coming days NC Medicaid will perform an audit of physicians, physician assistants, and nurse practitioners who attested and received enhanced payments under the ACA for certain primary care services provided in 2013 and 2014. The audit is required by federal law and is meant to confirm that those who attested and received the enhanced payment rates were eligible to receive them.
We have received advance details from the Division of Medical Assistance (DMA) and want to share those with you now. Please review the following carefully.

Physicians

A sample of 100 physicians who attested that they qualified to receive the enhanced payments will be randomly selected for audit. For those selected, DMA will independently confirm that the physician was EITHER board certified in one of the applicable specialties/subspecialties OR that at least 60 percent of his/her Medicaid paid CPT codes were the ACA eligible codes for E&M and vaccine/toxoid codes. No work will be required on the part of those selected. In fact, if the audit confirms that an individual physician was eligible, the physician will likely never know he/she was audited.
However, if DMA believes that the physician was ineligible, DMA will contact the physician with a mailed notice that the supplemental portion of his her 2013-2014 Medicaid payments (not the entire claim payment) will be recouped. Furthermore, if a physician is deemed ineligible and also supervises a PA or NP that attested, the supplemental payments to that PA or NP could be recouped as well. DMA's notice will describe how a physician may dispute the findings and pursue an appeal.

PAs and NPs

Because CMS requires a "paper trail" for the attested PAs and NPs, the process DMA has created for these providers is different. This week DMA will mail certified letters to every PA and NP who self-attested for the enhanced payments. The letter will be sent to the address tied to the person's record in NCTracks.
The letter directs the PA or NP to complete and return the enclosed Midlevel Provider Confirmation form within 30 days. The short form requests the name of the PA's or NP's supervising physician, the physician's NPI, and a signed statement that the physician accepts professional responsibility for the services rendered. Completed forms can be mailed (we suggest certified) or faxed (as a last resort – and please call to confirm receipt) to DMA. Review a draft of the DMA letter and Confirmation form.
DMA stresses that the form is only meant to generate documentation for each attested PA and NP. We understand that a PA's or NP's eligibility will only be scrutinized in this audit if DMA finds the supervising physician ineligible in the sample of 100 physicians outlined above.
But it is still essential that PAs and NPs return the requested paperwork within the 30-day timeframe. Please watch for this letter from DMA and handle immediately upon receipt.
Our goal is to inform you as early as possible when issues like this arise.  Please continue to watch the NCMS Bulletin and website for updates.


NCMS Accepting Nominations for NCPHP Board of Directors

The North Carolina Medical Society (NCMS) appoints five physicians to the Board of Directors of the North Carolina Physicians Health Program (PHP). To learn more about the important work of this organization, visit the PHP website.
View the PHP Director Responsibilities (PDF).
There currently is one vacancy on the PHP Board to be filled by an appointee of the NCMS. Through December 31, 2015, the NCMS will be accepting applications from physicians interested in serving on the PHP Board of Directors. Interested physicians should complete the application form and return it to Abbey Ruggiero,  [email protected] (preferred), or by US Mail to PHP Board Applications, North Carolina Medical Society, Post Office Box 27167, Raleigh, North Carolina, 27611 by December 31, 2015.


Dr. Israel, NCMS Calendar Cover Photographer, Claims His Prize

Dr. Israel poses before his winning image, framed and displayed at his practice.
Dr. Israel poses before his winning image, framed and displayed at his practice.

NCMS staff members ventured to Wake Internal Medicine Consultants in Raleigh to present first-time Photo Contest participant Rodger Israel, MD, with his winnings. His striking landscape photograph, "Old Faithful Star Trails,"  took the grand prize in this year's contest and is now featured on the cover of the 2016 NCMS Member Calendar.

Dr. Israel's work is not only displayed on the calendar cover but also featured on the walls of his practice, where many of his photographs are exhibited. A lover of wildlife and landscape photography, Dr. Israel now travels the world seeking new images to add to his growing collection, with many of his stunning works achieved after long hours spent setting up the perfect shot. As he shares, "Landscape photography is all about getting up early, staying out late and patience." Patience indeed paid off in the case of his winning NCMS Photo Contest picture; its unique effect of the swirl of stars was achieved through a one-hour exposure while his camera was aimed at the North Star.
2016-calendar-coverCongratulations to Dr. Israel on his win! We look forward to seeing what he and all of our other talented photographers submit in next year's contest.
Want a copy of your own 2016 calendar? All NCMS membership online renewals will automatically receive a copy, as will all NCMS Life members. Look for it in your mailbox soon!


Make a Difference with the Seasons Greetings Program

wreaths-across-americaAs the holiday season is upon us, the North Carolina Medical Society Foundation (NCMSF) again offers you a way to give the meaningful gift of health and access to a primary care provider to people across the state through purchase of our Season’s Greetings cards. For a tax-deductible contribution of $35 per card, the Foundation will send each person on your holiday list a personalized greeting card informing them of your gift in their honor.
Website-card-optionsThis year, Season’s Greetings has teamed with the NCMS Service Team to support Wreaths Across AmericaTM, so $15 of every card will be used to purchase wreaths that will be laid at the gravesites of our fallen veterans at national cemeteries in Fort Bragg, New Bern, Salisbury, Raleigh and in Historic Oakwood Cemetery Field of Honor. Every fallen hero deserves a wreath.
Your gift will help ensure that thousands of underserved North Carolinians have access to the health care they need, and will show our veterans and their families that we will never forget!
Order your Season's Greetings cards at www.ncmedsoc.org/greetings.
We also invite you to join the NCMS staff on Saturday, Dec. 12 at 10 am at Raleigh National Cemetery to place the donated wreaths. For more information contact Belinda McKoy at [email protected].
More information about Wreaths Across America. If you choose to give directly on this site, please choose “support a local fundraising group” and search for the North Carolina Medical Society!
For more information on the Season's Greetings program, please contact Pam Highsmith or 800-722-1350.


Medicaid Reform Work Begins in Earnest

Following three years of discussion, the North Carolina General Assembly took the initial steps this year to begin reforming the Medicaid program. The North Carolina Medical Society has been engaged on this issue since the beginning of the discussion. We continue to advocate for provider-led models of care and are working to make sure doctors and their patients are not negatively affected by reform strategies that have proven bad for patients and ineffective at saving scarce Medicaid resources.
Since the 2015 session of the General Assembly adjourned in September, the NCMS has been meeting with officials from the McCrory administration to focus attention on your key issues in the Medicaid reform debate. Among them, physician leadership, access to the clinical and claims data necessary to organize efficient health care delivery and proper protections for you and your patients as a precaution against inappropriate pressure from corporations or institutions with ulterior motives.
The NCMS supports the Triple Aim, in which payers and providers share simultaneous goals of cost control, population health improvement and patient experience of care improvement (which includes quality).  Within such systems, NCMS supports opportunities for specialty specific alternative payment models, such as prospective bundles. The NCMS is working to identify physician-formulated alternatives that are consistent with these principles. All of these issues will be among our priorities as we make progress toward reform.
The Secretary of the North Carolina Department of Health and Human Services, (DHHS) is required to report to the NC General Assembly on this issue in March 2016. We are working hard in preparation for that deadline. The General Assembly has allowed 18 months after federal approval of North Carolina’s reform plans to select the provider led entities and managed care organizations that will be responsible for the state’s Medicaid beneficiaries, and to begin enrollment. It is impossible to know how long the federal approval process will take, but many observers expect enrollment to begin as early as January 2018.
We want to hear from you about your needs and priorities with respect to Medicaid reform. Please comment on this blog or contact us directly at [email protected] or 800-722-1350.


ICD-10 is here!

The big day has finally arrived – for better or worse, ICD-10 is here! While the impact of the changeover may not be fully felt for a week or two, we want you to know that the North Carolina Medical Society (NCMS) is here to help provide you with the resources you need to make a successful transition to this new code set.

Please visit our ICD-10 resource page at www.ncmedsoc.org/icd10 for a list of contacts who will be able to help you troubleshoot any problems you experience. If you still need help, contact our Solution Center at 919-833-3836 x142.

Quick contacts:

Centers for Medicare & Medicaid Services (CMS):

NCTracks:

Private payers:

  • BCBS NC - 800-214-4844 – Provider Blue Line; 888-333-8594 – eSolutions Helpdesk
  • United HealthCare - 800-842-8000; [email protected]

Final Bowtie Briefing for 2015

Chip wraps up his inaugural series of legislative briefings and has a guest to share in his send off. Check it out below!


Don't forget to register today for the North Carolina Medical Society Annual Meeting!


What's Your Annual Meeting Personality Type?

2015 NCMS Annual MeetingFind the right Annual Meeting events to suit your personality:

·        The Advocate

·        The Over-Achiever

·        The Fun Seeker

Advocate Personality Traits

Advocates have a desire to affect change and a keen interest in all things legislative and regulatory. Many tend to sport a bow tie or appreciate the fashion statement thereof and regularly watch Chip Baggett's "Bowtie Briefings" videos just to see what color tie he's wearing that week; frustration often ensues when Chip does not wear a bow tie in said videos. They enjoy C-SPAN, emailing their legislators and White Coat Wednesdays.

Good Annual Meeting events for Advocates to attend:

NCMS PAC Breakfast, Saturday, October 24, 8:30-9:30am - If you fit the Advocate profile and you like a hearty breakfast, this event is for you! The session will bring together experts to talk about the latest legislative news and how it will impact health care. Bow ties are not required but NCMS PAC membership is (membership payable at the door).
Legislative Summit, Saturday, October 24, 2:00-4:00pm - This is the place to be if you're interested in hearing the perspectives from several health care leaders about what they feel are the greatest challenges facing the profession of medicine. See if you agree with them and share your opinions. Advocates like sharing opinions.
Recreational suggestions at the Grandover Resort: Make some strategic connections on the golf course and follow it up with martinis at the Colony Bar on site.

Over-Achiever Personality Traits

In school, were you always the first one to raise your hand and volunteer, whether it was to offer the correct answer or to take on more extracurricular activities? Did you think you doomed your future when you received your first "B" on a test? Do you now work such long hours that you barely recognize your family members? You fall into the Over-Achiever category; not surprisingly most attendees of the NCMS Annual Meeting have these traits.

Good Annual Meeting events for Over-Achievers to attend:

With over-achieving often comes difficulty in finding a balance between work and life at home. These two CME sessions at the Annual Meeting can help you achieve the best "you" possible by addressing issues that lead to burnout.
Keys to Resilience: Thriving Through Change, Friday, October 23, 10:30am-12:30pm. Join well-known author and speaker Wayne Sotile, PhD, as he shares practical tools to improve resilience during times of crisis.
Mastering the Art of Behavior Change, Friday, October 23, 1:00pm-2:00pm. Speaker Laura Putnam, MA, will guide attendees on how to master the challenge of behavior change.
Recreational suggestions at the Grandover Resort: Visit the on-site spa and get that massage and facial! Later experience a leisurely meal at the Di Valletta Restaurant. (Please note: in an effort to assist this personality type in better achieving balance, competitive activities such as tennis or frustrating games such as golf are not recommended.)

The Fun Seeker

This individual has mastered the art of work-life balance and easily demonstrates the ability to leave their worries behind and let their hair down. Their Facebook pages, featuring numerous photos of their latest parties or travel adventures, make those who fall into the Over-Achiever category (see above) feel twinges of jealousy due to their own over-worked lives. Fun Seekers can typically find enjoyment in any environment, including Annual Meetings.

Good Annual Meeting events for Fun Seekers to attend:

The NCMS believes that anyone can be a Fun Seeker, and we have a couple of opportunities to bring out this side of your personality.
Cocktail Reception, Friday, October 23, 5:30pm-7:30pm. The event name says it all. We look forward to seeing you there!
Inaugural Reception, Friday October 23, 7:45pm-11:00pm. Come celebrate the inauguration of Docia Hickey, MD, as president of the NCMS. Dancing, additional cocktails (see above), mingling, and more dancing are on the agenda.
Recreational suggestions at the Grandover Resort: If you're a Fun Seeker but receptions aren't up your alley or dancing just not in your repertoire, play a game of tennis or challenge your friends to a game of pool at the Cafe Espresso East.

No matter your personality type, we hope to see you at the 2015 NCMS Annual Meeting, October 23-24, Grandover Resort, Greensboro.

Register now online or download a registration brochure (PDF) for more details.