NCMS Joins Others In Opposing the VA’s Plan for APRNs

The North Carolina Medical Society (NCMS) has joined with other state and specialty medical societies to “strongly oppose” the Veterans Health Administration’s (VHA) proposed rule that would allow advanced practice registered nurses (APRNs) to practice without the clinical supervision of physicians regardless of state law.
In a joint letter to David J. Shulkin, MD, Under Secretary for Health for the Department of Veterans Affairs, the NCMS and dozens of other societies urged the VHA “to consider policy alternatives that prioritize team-based care rather than independent nursing practice….APRN education and training simply does not provide the same experience, and as such, independent practice is not appropriate.”
Read the entire letter here.


Legislation Touts Meaningful Use Program Flexibility and Hardship Relief

The Electronic Health Record (EHR) Regulatory Relief Act (S. 3173), which recently was introduced by six US Senators including Sen. Richard Burr (R- NC), would provide regulatory flexibility and hardship relief to providers and hospitals operating under the meaningful use program.
The senators’ legislation would shorten the reporting period for eligible physicians and hospitals from 365 days to 90 days, relax the all-or-nothing nature of the current program requirements, and extend the ability for eligible providers and hospitals to apply for a hardship exception from the meaningful use requirements.
In April, the senators wrote to U.S. Department of Health and Human Services Secretary Sylvia Burwell and Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt to request input on a draft bill, and with the feedback they received, developed the version that was introduced today.
“One-size-fits-all regulation is jeopardizing the full potential for electronic health records to improve care for North Carolinians,” said Burr. “I’m pleased to be working with my colleagues to advance common-sense policy that will provide flexibility and better support North Carolina’s hospitals and doctors in what’s most important—providing quality care to North Carolinians.”
Click here for a summary document and here for legislative text.
Burr is among the original members of the Senate’s health IT working group, Re-examining the Strategies Needed to Successfully Adopt Health IT (REBOOT). In 2013, the group released a white paper outlining concerns with current federal health IT policy, including increased health care costs, lack of momentum toward interoperability, potential waste and abuse, patient privacy and long-term sustainability.
The white paper was part of a broader effort to solicit feedback from the administration and foster an ongoing conversation on improving the health IT program with the stakeholder community, including health care providers, technology vendors and others.


AMA Offers Proposed Fee Schedule Rule Summaries

The AMA advocacy staff is preparing formal comments on the rules the Centers for Medicare and Medicaid Services (CMS) released several weeks ago. In the meantime, they have prepared summaries of each of the rules. Read the 2017 Hospital Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) proposed rule summary here, and the Medicare Physician Fee Schedule (MPFS) proposed rule summary here.  Watch the Bulletin for the formal comments, which are due Sept. 6.


Take Note: Health Spending Projected to Grow; Shift More to Government

The Centers for Medicare and Medicaid Services (CMS) recently released its projections for national health spending growth, which it says will average 5.8 percent for 2015-25. This exceeds the expected average growth in gross domestic product by 1.3 percentage points per year, meaning the health care share of the economy is projected to increase over the next 10 years.
The study also finds that the percentage of the US population that is uninsured is expected to be 8 percent in 2025, down from about 11 percent in 2014.
Health Affairs reports the study showed that “projected national health spending growth, though faster than observed in recent history, is slower than in the two decades before the recent recession, in part because of trends such as increasing cost sharing in private health insurance plans and various Medicare payment update provisions. An expected noteworthy shift at the end of the next decade is a change in who ultimately pays for the nation's health care. By 2025, 47 percent of health spending is projected to be sponsored by federal, state, and local governments -- almost 3 percentage points higher than 2014.”
By 2025, the share of health spending by businesses and households is expected to be 3 percentage points lower than it was in 2014.  As Health Affairs sums up: “This expected higher share of spending by governments reflects the full impacts from the Affordable Care Act's coverage expansions, the continued transition of the baby-boom generation into Medicare, and the growing gap between dedicated Medicare financing and program outlays.”


Choosing Wisely Partners Continue Their Work in NC

choosing-wisely@2xThe North Carolina Medical Society (NCMS) is among the groups working with the North Carolina Healthcare Quality Alliance (NCHQA) to reduce the use of medical tests and treatments that the Choosing Wisely campaign has identified as overused. The effort, which began last March, is thanks to a grant from the ABIM Foundation and will enable NCHQA to build a multi-stakeholder alliance to reduce the use of:

  • antibiotics to treat viral infections in adults;
  • DEXA scans to measure bone density in women younger than 65 and men younger than 70;
  • carotid artery stenosis screening in asymptomatic patients; and
  • annual Pap tests for women between the ages of 30 and 65.

Duke Medicine and Cornerstone Health Care will each implement three Choosing Wisely recommendations aimed at reducing targeted tests and treatments by 20 percent over the three years of the grant. In addition, the NCMS, Blue Cross Blue Shield of North Carolina and the State Health Plan for Teachers and State Employees will launch complementary efforts to educate clinicians and consumers in North Carolina about the problem of overuse and the Choosing Wisely campaign.
Duke Medicine is working to reduce (1) use of antibiotics for viral-based illnesses, (2) unnecessary use of DEXA screening for osteoporosis and (3) avoidable carotid artery stenosis screening.
Cornerstone’s Choosing Wisely efforts will focus on (1) use of antibiotics for viral-based illnesses (2) unnecessary DEXA screening and (3) avoidable Pap tests.
Be sure to watch the Bulletin for updates on each organization’s progress in these areas. Join the North Carolina Choosing Wisely campaign today by notifying NCHQA of your interest. Your organization will be added to the statewide partners list, and you will receive relevant articles and new materials as available. Learn more about the North Carolina initiative and the broader Choosing Wisely program here.


Here's What You Need to Know About the NC Controlled Substance Reporting System

As all physicians who prescribe controlled substances know, North Carolina has a system, the Controlled Substance Reporting System (CSRS) that allows pharmacists to report prescription drug activity and physicians to check patient records and history of prescription drug usage before prescribing controlled substances. Here is a short, one-page summary of everything physicians should know about the system, written by North Carolina Medical Society (NCMS) summer intern, Evan Anderson, a rising senior at NC State University. Read the summary here.


Kudos to Leadership College Alumni; Plus, Your Chance to Become Part of This Esteemed Group

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The latest edition of the North Carolina Medical Journal focuses on value-based care in North Carolina. Review the articles here. The contributor list reads like a who’s who of the North Carolina Medical Society (NCMS) Foundation’s Kanof Institute for Physician Leadership (KIPL) alumni, including NCMS Past President Devdutta Sangvai, MD, who wrote on “Pivoting to Value-Based Care in North Carolina.” Other KIPL alumni writing in this issue include Brian J. Caveney, MD, Lisa Shock, PA-C and Eugenie Komives, MD.
If you’re interested in becoming part of this esteemed group of leaders who have completed the leadership development training through KIPL, consider applying to the KIPL Leadership College or, the most recent addition to the Institute’s curriculum, the Health Care Leadership and Management (HCLM) course. Both tracks are now accepting applications. Submit applications for Leadership College by Aug. 1 and those for HCLM by Sept. 1. Learn more about each of these highly regarded programs here.
 


NCMS Plan Member Talks About Practice Wellness Initiatives


Jason Horay, NCMS Plan Health Promotion Coordinator, connected with the President of Allergy Partners, David A. Brown, M.D. at his Asheville office to record their compelling story.  Dr. Brown shared his personal well-being vision, positive approach to living that emphasizes the whole person, and how it impacts his role as a leader of the practice.  Watch this video to learn how much of the Allergy Partner’s practice’s strength and success depends on their employees.
The NCMS Plan is dedicated to improving the health and well-being of our members.  By providing participating practices the resources to educate and inform, we can make a difference in employees’ lives.  A difference beyond a decrease in medical costs that translates into healthy, happy and high performing workplaces.
For more information on the NCMS Plan and how you can get your office to Practice Wellness, click here, or contact Jason Horay at [email protected] or 919.878.7530.


Physician Groups and the Insurance Mega Mergers

The US Department of Justice filed suit last week to block Anthem's proposed purchase of Cigna and Aetna's planned acquisition of Humana. Justice department officials said the two mergers would reduce competition, raise prices for consumers and stifle innovation if the number of large, national insurers were to fall from five to three. Read an article describing the suit in the In the News feature in this Bulletin.
National physician groups like the AMA and Physicians Advocacy Institute (PAI) had opposed the mergers. North Carolina Medical Society (NCMS) CEO Robert Seligson was quoted in USA Today speaking in his capacity as PAI president. Read that article here.


Seligson Speaks to Organization of Medical Association Presidents

bob at osmapNorth Carolina Medical Society (NCMS) CEO Robert Seligson addressed the Organization of State Medical Association Presidents (OSMAP) meeting in Chicago last month speaking about Medicaid reform and the future of the ACA. Seligson gave the North Carolina perspective following a presentation by a senior research fellow from George Mason University titled “An Analysis of Insurer Performance Selling Exchange Plans and the Future of the ACA.”


NCMS Member Featured in MedPage Today Article

Longtime North Carolina Medical Society (NCMS) member Conrad Flick, MD, a Raleigh family physician was featured in an online news outlet MedPage Today article headlined: “Advocating for Change; Championing Independent Practice.” Read the article.


Learning Opportunities

Open Payments – Special Open Door Forum. The Centers for Medicare and Medicaid Services (CMS) is seeking input from Open Payments stakeholders to inform future rulemaking and other enhancements to the program by hosting a Special Open Door Forum on Tuesday, Aug. 2, from 1 to 3:30 p.m. For more information on the Special ODF and to view slides, please visit the Open Payments events page. Feedback and questions about the solicitation in the proposed 2017 Physician Fee Schedule (page 81 FR 46395) or this Special ODF can be sent to: [email protected]. Special Open Door Participation Instructions: Participant Dial-In Number: 1-800-837-1935 Conference ID #: 44678813


The North Carolina Harm Reduction Coalition is presenting an Opioid Summit in Wilmington, this Friday, July 29 from 8 a.m. to 4 p.m. at Wilmington City Hall –Council Chambers, 102 N. 3rd St., Wilmington. To register call 910-341-4608 or email name & agency to [email protected]. Lunch is provided if you sign up. For more information contact Linda Rawley, [email protected]


The North Carolina Harm Reduction Coalition along with the NC Urban Survivors Union are hosting a conference on Integrating Harm Reduction into Existing Service Provisions on Aug. 11, from 9 a.m. to 4 p.m. with an evening social event from 6:30-11 p.m. at Castle McCulloch, 3925 Kivett Dr, Jamestown, NC. Sign up here.  For more information contact Louise Vincent, [email protected].


Thursday, Aug. 4 Williams Mullen law firm will offer a free seminar/webinar on “HIPAA Compliance: The Current Audit and Enforcement Environment” featuring Iliana L. Peters, J.D., LL.M., Senior Advisor for HIPAA Compliance and Enforcement at the HHS Office for Civil Rights along with members of Williams Mullen’s Health Care Practice. You can participate in two ways, by attending the seminar in person at the Williams Mullen’s Richmond Office, 200 South 10th Street, 16th Floor, Richmond, VA, or by webinar. For more information and to register, please click HERE.


The North Carolina Department of Justice is bringing together law enforcement, public health, medical, legal and public policy professionals to discuss how to curb prescription drug and opioid abuse in North Carolina at a conference to be held on August 11 at the McKimmon Center on the North Carolina State University Campus in Raleigh. Register here. For more information contact Natalie Wood, [email protected] or 919-716-6073.


Take a deep dive into value-based health care at the second annual Move-to-Value Summit in Winston-Salem on Aug. 21-23. Learn more and register here.


The North Carolina Healthcare Information and Communications Alliance (NCHICA) 22nd Annual Conference & Exhibition, “The New Healthcare Ecosystem,” is scheduled for Aug. 29-31 at the Omni Grove Park Resort in Asheville. The conference provides an excellent opportunity to learn about the latest developments and best practices in healthcare IT, and network with your peers.


28th Annual Fall Foliage Cancer Conference, “Update on Melanoma and Gastrointestinal Cancers,” will be held Oct. 21-22 at the Grove Park Inn in Asheville. More information and registration available here.


The North Carolina Chapter of the Healthcare Financial Management Association (HFMA) will hold its 2016 Health Insurance Institute on Sept. 22-23, at the Sheraton Hotel, Four Seasons in Greensboro. Learn more and register here.


MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid
 
 
 


M3 Is the Place to Be This September

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Where are you going to be on Sept. 15-18? The inaugural M3 Conference in Greensboro is the place to be for physicians and practice managers this fall. This landmark conference will bring everyone together for three days of education, networking and inspiration with colleagues from across the state. All the information and registration materials are now available on the M3 Conference website.
Download an agenda/registration form for NCMS participants.
Download an agenda/registration form for NCMGMA participants.
Visit often as we continue to add new sessions. Don’t miss this opportunity to merge medicine and management in North Carolina.
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NCMS Launches New Initiative To Provide Special Resources for You

North Carolina Medical Society (NCMS) members are invited to share their stories, offer their ideas and input and access resources through a new physician well-being initiative formally launched this week. A special video message from NCMS CEO Robert Seligson explains what prompted this move to help physicians who are stressed or burned out and may be at a loss for where to turn for support. Watch the video here.
As he states in the video, Seligson would like to hear what would be most helpful to you as you strive to balance the many pressures of practicing medicine today. Email him at [email protected] or complete a feedback form. We have started to compile a list of resources on our new physician well-being webpage, and several sessions at the M3 conference in September will address various aspects of maintaining a balanced, healthy and positive outlook. See the M3 conference schedule.


Legislative Short Session Concludes

This year North Carolina legislators actually kept their promise to wrap-up their work by the July 4 holiday. Several pieces of legislation affecting North Carolina Medical Society (NCMS) members were enacted this short session, including:

  • HB728 Which amended laws and fees pertaining to the North Carolina Medical Board, including increasing licensing fees from $175 per year to $250 per year; limiting service on the Board to no more than two complete 3-year terms in a lifetime; limiting the use of Maintenance of Certification as part of licensing decisions and increasing access to Physicians Health Program (PHP) assessments. The NCMS along with the NCMB and the PHP had been working on this bill for four years to ensure the Board had adequate revenue to operate and to clarify and refine the Board’s processes.
  • Provided funding to enhance the Controlled Substance Reporting System (CSRS) software, and ensuring the platform will be integrated into North Carolina’s Health Information Exchange (HIE) and allowing it to talk to systems in adjoining states. The legislation also included a provision requiring any licensed physician authorized to dispense opioids to register on the CSRS. These items are included as part of the budget bill, HB1030 (beginning on page 89).

To get a complete rundown of the other legislation of note to NCMS members, watch NCMS General Counsel and EVP for Government Affairs and Health Policy Steve Keene’s video review of the session. Also, watch your Bulletin and the NCMS website for release of the 2016 NCMS Legislative Summary for a comprehensive listing of all bills pertaining to physicians and physician assistants introduced during this short session.


Feds Announce New Actions to Combat Opioid Abuse Epidemic

U.S. Health and Human Services (HHS) Secretary Sylvia M. Burwell recently announced several new actions the department is taking to combat the nation’s opioid abuse epidemic, including:

  • Expanding access to buprenorphine, a medication to treat opioid use disorder;
  • Eliminating any potential financial incentive for doctors to prescribe opioids based on patient experience survey questions, and
  • Requiring Indian Health Service prescribers and pharmacists to check state Prescription Drug Monitoring Program (PDMP) databases before prescribing or dispensing opioids for pain.
  • Launching more than a dozen new scientific studies on opioid misuse and pain treatment and soliciting feedback to improve and expand prescriber education and training programs.

Read more about the announcement.


Take a Deep Dive Into Value-Based Health Care at the Move-to-Value Summit

MTV LogoTake a deep dive into value-based health care at the second annual Move-to-Value Summit in Winston-Salem on Aug. 21-23. Hosted by CHESS Health Enablement Solutions at Biotech Place this year's event will provide insights about the latest industry trends, focusing on alternative payment models, the business of value-based health care, the role of prevention in the value model and more.
The Summit is designed to provide attendees with a broad understanding of what it takes to transform a fee-for-service-dependent organization into one rooted in pay-for-value. Organizers have assembled an impressive list of speakers and topics designed to meet you where you are on your journey to value. Keynote speaker, Dr. Robert Nesse, a respected industry expert and former CEO of Mayo Clinic, will get the Summit underway by sharing his vision for the future of health care delivery in America. Learn more and register here.


Reminder: Submit NCMS Board Nominations By Next Wednesday, July 20

As a North Carolina Medical Society (NCMS) member you may nominate an individual to serve as an NCMS officer or board member under the new governance system adopted by the House of Delegates at last year’s Annual Meeting. Please use this nomination form and submit it by July 20 for consideration by the NCMS Nominating and Leadership Development Committee. The Committee has already published the initial slate of nominees for officer and board positions listed below. For questions on the nominating process, contact Abbey Ruggiero or 919-833-3836.
The following slate of nominees was selected by the committee:

  • President-elect: John L. Reynolds, MD
  • Board of Directors, Region 2: Jeffrey W. Runge, MD
  • Board of Directors, At-Large: Brian S. Kuszyk, MD

AMA Delegates:

  • John R. Mangum, MD
  • William E. Bowman, MD
  • Darlyne Menscer, MD

AMA Alternate Delegates:

  • Hadley Callaway, MD
  • Liana Puscas, MD

The committee will reconvene to consider any additional nominees and publish the final slate of candidates on Aug. 28. Under the NCMS’ new governance structure, online voting for the candidates will begin on Sept. 4 and continue until midnight on Sept. 16, the day before the NCMS annual business meeting. Paper ballots also will be available to those who need them.
The new officers, board members and AMA delegates will be announced and installed at the business meeting on Saturday afternoon, Sept. 17 at the Grandover Resort in Greensboro. For more information about attending the business meeting, which is free of cost, as well as the historic Merging Medicine and Management M3 conference taking place at the Grandover from Sept. 15-18, visit the M3 Conference website.


CME Credit -- Yet Another Reason M3 Is the Place to Be

m3-logo265aThe M3 Conference – Merging Medicine and Management – to be held Sept. 15-18 at the Grandover Resort in Greensboro has been approved for 13.75 hours of AMA PRA Category 1 CreditsTM. This historic gathering will bring together North Carolina Medical Society (NCMS) and the NC Medical Group Management Association (NCMGMA) members for engaging and timely educational sessions, networking and socializing with colleagues, the business meetings for both organizations and the chance to learn and celebrate together. Get all the latest details on speakers, the educational tracks and social events at the M3 website.


Nominate A Worthy Colleague for the Estes or Anderson Awards

The North Carolina Medical Society (NCMS) is accepting nominations for the E. Harvey Estes, Jr., MD, Physician Community Service Award.  This award is designed to provide recognition for the many and varied services rendered by physicians to their communities apart from their practice of medicine.  The recipient must be a physician licensed in North Carolina; must not have received the award previously; and must have compiled an outstanding record of community service, which, apart from his or her specific identification as a physician, reflects well on the medical profession.
Nominations must be received by Aug. 1. You may send the completed nomination form by scanning it and emailing it to Abbey Ruggiero, faxing it to her attention at 919-833-2023 or mailing it to her at P.O. Box 27167, Raleigh, NC 27611. If you have questions, please contact Abbey via email or by calling 919-833-3836 x147. Download the form here.


The NCMS also is accepting nominations for the John Huske Anderson Award, given annually to a layperson whose contributions have had a positive impact on the medical profession and public health. The award honors Mr. Anderson’s service to medicine and the Society, having served as NCMS legal counsel from 1937 until his retirement in 1983. Nominations must be made by an NCMS member.
The deadline for submissions is Aug. 1. You may send the completed nomination form by scanning it and emailing it to Abbey Ruggiero, faxing it to her attention at 919-833-2023 or mailing it to her attention at P.O. Box 27167, Raleigh, NC 27611. If you have questions, please contact Abbey via email or by calling 919-833-3836 x147. Download the nomination form here.


What is Your Most Valuable NCMS Benefit?

Answer that single question here, and we’ll publish the responses (anonymously, of course) in the next Bulletin.


West Virginia Flood Relief Efforts Continue

The West Virginia State Medical Association (WVSMA) has raised nearly $29,000 so far to help those affected by the devastating floods that hit their state last month. The WVSMA, through its West Virginia Medical Foundation (WVMF), established a special disaster relief fund to collect donations to support the ongoing relief efforts throughout the state. The WVMF is a 501 C(3) not-for-profit charitable foundation under IRS law.
The recovery efforts for the thousands of West Virginians affected by the floods continue as the need for crisis intervention, mental health services, housing, water, food, clothing and other such services as well as vaccines, first aid supplies, flashlights, batteries and cleaning supplies and equipment remain.
The WVMF Disaster Relief Fund is helping both local and state medical societies from around the nation, as well as pharmaceutical and medical device corporations and other strategic partners from within and outside the state, to make donations to provide basic medical relief and to fill any unexpected gaps in the recovery effort.
All donations to the WVMF Disaster Relief Fund will be tax deductible, and all donations will be used to support flood relief efforts as approved by the WVMF Board of Directors. Checks should be made payable to the:
West Virginia Medical Foundation
Attn: Karen Foy
4307 MacCorkle Ave., SE
Charleston, WV 25304
Please write "WVMF Disaster Relief Fund" on your check. If you would like to make a donation by credit card, please call the WVSMA offices at 304-925-0342.
The WVSMA President, Paula Taylor, MD, and Coy Flowers, MD, the chair of the WVMF Disaster Relief Fund, thank you for your generosity and compassion!


Important Reminder about Billing Requirements for Certain Dual-Eligibles

In conversations with officials at the Centers for Medicare and Medicaid Services, the AMA was alerted to some physicians who are still billing Qualified Medicare Beneficiaries (QMB). Please note that balance billing is prohibited for Medicare beneficiaries enrolled in the QMB program.
The QMB program is a Medicaid program for very low-income dual eligible beneficiaries—e.g., individuals who are enrolled in both Medicare and Medicaid—with Medicare cost-sharing.  Beneficiaries in the QMB program have annual incomes of less than $12,000.  Federal law protects QMBs from any cost-sharing liability and prohibits all original Medicare and Medicare Advantage providers—even those who do not accept Medicaid—from billing QMB individuals for Medicare deductibles, coinsurance or copayments.  All Medicare and Medicaid payments that physicians receive for furnishing services to a QMB individual are considered payment in full.
It is important to note that these billing restrictions apply regardless of whether the state Medicaid agency is liable to pay the full Medicare cost-sharing amounts (federal law allows state Medicaid programs to reduce or negate Medicare cost-sharing reimbursements for QMBs in certain circumstances).
Physicians may be subject to sanctions for failing to follow these billing requirements, and CMS has indicated that they may start conducting more frequent audits to address this practice.
For further information, see MLN Matters, Prohibition on Balance Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program.


2017 Physician Fee Schedule Proposed; Comments Now Accepted

On July 7, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Physician Fee Schedule to updates payment policies, payment rates, and quality provisions for services provided in calendar year 2017. These services include, but are not limited to visits, surgical procedures, diagnostic tests, therapy services, and specified preventive services. In addition to physicians, the fee schedule pays a variety of practitioners and entities, including nurse practitioners, physician assistants, physical therapists, as well as radiation therapy centers and independent diagnostic testing facilities.
Additional policies proposed in the 2017 payment rule include:

  • The annual Physician Fee Schedule
  • Primary care and care coordination
  • Mental and behavioral health
  • Cognitive impairment care assessment and planning
  • Care for patients with mobility-related impairments

Read the proposed rule here.  Comments are due by 5 pm on Sept. 6, 2016
For more information, CMS has provided a Fact Sheet. You also may stay up-to-date via their Blog
Read the full CMS press release, which was issued July 7.


Apply Today for Acclaimed Leadership Development Courses

The Kanof Institute for Physician Leadership’s (KIPL) seminal Leadership College and, the most recent addition to the Institute’s curriculum, the Health Care Leadership and Management (HCLM) course, are now both accepting applications. Submit applications for Leadership College by Aug. 1 and those for HCLM by Sept. 1. Learn more about each of these highly regarded programs here.
Read what KIPL alumni are saying about their experience.


NCMS Joins in Opposing Insurance ‘Mega-Mergers’

Forty-three state and national organizations including the North Carolina Medical Society (NCMS) have signed a letter to the U.S. Department of Justice (DOJ) expressing grave concerns about anti-competitive behavior seen in state reviews of the proposed mega-mergers of Anthem-Cigna and Aetna-Humana. Read the letter here.
The flawed review process in most states has led the 43 signatories to urge the DOJ to carefully review the mergers’ impact on each state and on the country as a whole. The DOJ has the expertise and enforcement power to protect people from the harm these mergers will cause.
The signatories represent a broad range of organizations, including state and national consumer groups, patient advocacy and health justice organizations, as well as state and national medical associations.
Speaking in his capacity as president of the Physicians Advocacy Institute, NCMS CEO Robert Seligson said: "These proposed health insurance company mergers will stifle competition, raise prices and reduce choice for patients in Connecticut and dozens of other states. Given the failure of several state regulators to carefully scrutinize these mega-mergers, it is incumbent on the U.S. Department of Justice to assert its regulatory authority now."
The letter prompted several media reports, including coverage in the International Business Times and the Ct Mirror.


NCMS Signs On To Bill Protecting Peer Reviewed Items from Sunshine Law

The North Carolina Medical Society (NCMS) has signed on to a letter voicing strong support for legislation introduced in the US Senate to ensure that independent sources of clinical information such as peer-reviewed journals, medical textbooks and independent medical education are exempt from reporting under the Physician Payments Sunshine Act.
The letter explains that Congress “specifically intended to exclude such independent sources of clinical information so as to avoid chilling the dissemination of high quality and actionable clinical information that had undergone independent review.” The legislation, the “Protect Continuing Physician Education and Patient Care Act,” would clarify that certain applicable manufacturer transfers of value to support independent medical educational programs and materials are exempt from reporting under the Sunshine Act.
Read the letter here.
 
 
 


Project Access Celebrates 20 Years

Project Access® is celebrating two decades of providing access to comprehensive medical care for low-income uninsured Buncombe County residents. More than 2,500 low-income individuals in Buncombe County receive health care each year through Project Access® thanks to a network of more than 500 physician volunteers along with Mission Hospital, local pharmacies, the Western Carolina Medical Society Interpreter Network Interpreters, mental health providers, community service navigators and generous volunteers. The program is further supported by donations from businesses and individuals in the community. If you would like to contribute, make a donation online.
Congratulations on this milestone anniversary and thank you to all who contribute their time, expertise and money!


Learning Opportunities

TOMORROW, July 14, 4-5 p.m. a webinar presented by Providers Clinical Support System, “Maintaining Balance Among Compassionate Prescribing, Ethical Clinical Strategies, and Societal Obligations.” Effective pain management is a moral and ethical obligation, and an important public health and health care issue. Access to safe and effective care for people suffering from pain is a priority that needs to be balanced in parallel with efforts to curb diversion and misuse of opioid drugs. Register.


“Leading Teams: 10 Military Secrets for Building Effective and Productive Teams” a webinar featuring Mary Kelly, PhD, CDR, US Navy (Retired) will be held Tuesday, July 19 from noon to 1 p.m. The North Carolina Medical Society Foundation and the North Carolina Medical Group Management Association invite you to learn techniques to conquer the obstacles to building effective teams; to communicate clearly at all levels; to work together and be more productive in less time; and to utilize the strengths of colleagues despite cross generational gaps. The military forges cohesive teams and develops leaders, and you can too! Register here.


SAVE THE DATE: The North Carolina Department of Justice is bringing together law enforcement, public health, medical, legal and public policy professionals to discuss how to curb prescription drug and opioid abuse in North Carolina at a conference to be held on August 11 at the McKimmon Center on the North Carolina State University Campus in Raleigh. Register here. For more information contact Natalie Wood, [email protected] or 919-716-6073.


Take a deep dive into value-based health care at the second annual Move-to-Value Summit in Winston-Salem on Aug. 21-23. Learn more and register here.


The North Carolina Healthcare Information and Communications Alliance (NCHICA) 22nd Annual Conference & Exhibition, “The New Healthcare Ecosystem,” is scheduled for Aug. 29-31 at the Omni Grove Park Resort in Asheville. The conference provides an excellent opportunity to learn about the latest developments and best practices in healthcare IT, and network with your peers.


28th Annual Fall Foliage Cancer Conference, “Update on Melanoma and Gastrointestinal Cancers,” will be held Oct. 21-22 at the Grove Park Inn in Asheville. More information and registration available here.


Save the Date: The North Carolina Chapter of the Healthcare Financial Management Association (HFMA) will hold its 2016 Health Insurance Institute on Sept. 22-23, at the Sheraton Hotel, Four Seasons in Greensboro. Online registration will begin on Friday, July 1.


MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid


Initial Slate of NCMS Officers, Board Representatives Announced

The North Carolina Medical Society (NCMS) Nominating and Leadership Development Committee met last weekend to interview candidates and vote for the initial slate of nominees for officer and board positions. The general membership still may nominate individuals for these positions between now and July 20. Please use this nomination form. For questions on the nominating process, contact Abbey Ruggiero or 919-833-3836.
The following slate of nominees was selected by the committee:
President-elect: John L. Reynolds, MD
Board of Directors, Region 2: Jeffrey W. Runge, MD
Board of Directors, At-Large: Brian S. Kuszyk, MD
AMA Delegates:

  • John R. Mangum, MD
  • William E. Bowman, MD
  • Darlyne Menscer, MD

AMA Alternate Delegates:

  • Hadley Callaway, MD
  • Liana Puscas, MD

If you would like the committee to consider other candidates, please complete the nomination form and submit it by July 20. The committee will reconvene to consider additional nominees and publish the final slate of candidates on Aug. 28. Under the NCMS’ new governance structure adopted last fall, online voting for the candidates will begin on Sept. 4 and continue until midnight on Sept. 16, the day before the NCMS annual business meeting. Paper ballots also will be available to those who need them.
The new officers, board members and AMA delegates will be announced and installed at the business meeting on Saturday afternoon, Sept. 17 at the Grandover Resort in Greensboro. For more information about attending the business meeting, which is free of cost, as well as the historic Merging Medicine and Management M3 conference taking place at the Grandover from Sept. 15-18, see the article in this edition of the Bulletin and visit the M3 Conference website.


General Assembly Clears Regulatory Hurdles for Medicare ACOs

This week the General Assembly completed its work on House Bill 287 – Amend Insurance Laws. This bill includes an important provision that exempts Medicare Accountable Care Organizations (ACO) from state insurance laws since they are already overseen by the Centers for Medicare and Medicaid Services (CMS). The exemption is available for participants in the Medicare Shared Savings Program (MSSP), the Next Generation ACO Model and other current and future Medicare ACO programs administered through CMS’s Center for Medicare & Medicaid Innovation. The change comes at a welcome time, too, as more physicians consider forming or joining ACOs in anticipation of Medicare payment reforms under MACRA.
The North Carolina Medical Society (NCMS) spearheaded the legislative effort and worked diligently to ensure the provision was finalized this year. You can review the two-sentence provision on page 20 of HB 287.
State insurance laws have not kept pace with recent innovations in health care delivery and financing, and therefore do not squarely address the latest emergence of risk-sharing providers. This led to uncertainty in how the NC Department of Insurance would view Medicare ACOs from a regulatory perspective. CMS’s Next Gen ACO application raised the stakes even higher by requiring applicant ACOs to demonstrate compliance with state insurance requirements for risk-sharing providers.
This statutory change not only resolves the uncertainty, but also removes a regulatory barrier to our local pursuits of the triple aim and value-based health care. Several members of our ACO Collaborative and MSSP Council helped NCMS tackle this problem, so we thank them for their engagement and assistance in crafting a solution.


Zika Pregnancy Registry Will Enhance Understanding of the Virus

As part of the response to Zika virus infection, the Centers for Disease Control and Prevention (CDC) has created the Zika Pregnancy Registry to ensure complete and accurate case reporting and to develop more comprehensive information on the effects of Zika infections during pregnancy. The North Carolina Division of Public Health currently is working with CDC to enroll all pregnant women with positive or indeterminate Zika virus test results in the Pregnancy Registry.
This memo provides more information on the registry.


NCMS Pushed for Statewide Standing Order for Naloxone

Article by Minali Nigam, 2016 NCMS Foundation Medical Journalism Intern
Last Monday at a press conference at the Guilford County’s Sheriff Office, Governor Pat McCrory signed Senate Bill 724, which allows people in North Carolina to get naloxone at pharmacies without a prescription. Naloxone is a drug that acts as an opioid antagonist and can be used to treat drug overdoses. The bill received unanimous support at every legislative step, working its way through five committees and eight different votes, in both the House and Senate.
North Carolina Medical Society (NCMS) Board member Jeffrey Runge, MD, and NCMS member Joshua Landau, MD, both stood behind the Governor as he signed the bill into law and as NC State Health Director Randall Williams, MD, signed the statewide standing order. Dr. Williams lauded the NCMS’ support of the bill and efforts to curb prescription drug abuse as seen in the weekly Bowtie Briefing video last Friday.
NC Department of Health and Human Services (DHHS) Secretary Richard Brajer noted that last year almost 1,000 people in the state died from drug overdoses. These deaths, he said, could have been “reversible” had naloxone been readily accessible.
In 2013, North Carolina’s Good Samaritan Law allowed emergency responders to carry and use naloxone. Now, with the statewide standing order, Dr. Williams said any licensed pharmacist can dispense the drug to someone who is at risk or knows someone at risk for opioid overdose.
Pharmacists can choose to dispense the intranasal or intramuscular form of naloxone. The intramuscular form is cheaper, but the branded intranasal form called Narcan, is easy to administer. Medicaid will cover all the options listed in the standing order, but otherwise prices will vary depending on the insurance plan.
Without insurance, cost estimates for Narcan range from $150 to $180.
Pharmacies participating in the standing order are encouraged, but not required, to register on the North Carolina Division of Public Health’s educational website for naloxone. CVS and Walgreens have their own standing orders but will be switching over to the statewide standing order in the upcoming months.
“Our immediate issue is trying to save lives.” Governor McCrory said. At the end of the press conference, he reiterated the commitment to stop drug overdoses seen across the State.
For more information, visit www.naloxonesaves.org


Special Conference on Curbing Prescription Drug Abuse in NC

The North Carolina Department of Justice is bringing together law enforcement, public health, medical, legal and public policy professionals to discuss how to curb prescription drug and opioid abuse in North Carolina at a conference to be held on August 11 at the McKimmon Center  on the North Carolina State University Campus in Raleigh. Please save the date. Registration will open in July. For more information contact Natalie Wood, [email protected] or 919-716-6073.


New Report: Opioid Use Among Injured Workers Declines

According to a new Workers’ Compensation Research Institute (WCRI) report released last week, longer-term use of opioids among injured workers decreased in a number of states, including a significant decline in North Carolina.
"There is little quality evidence about the benefits of long-term opioid use for chronic noncancer pain," said Dongchun Wang, the author of the study. "Moreover, research finds that high doses and prolonged use of opioids may lead to addiction, increased disability, work loss, and even death."
The report, Longer-Term Use of Opioids, 3rd Edition, examines the prevalence and trends of longer-term use of opioids in 25 states and how often the services recommended by medical treatment guidelines were used for monitoring and managing chronic opioid therapy. The study looked at longer-term opioid use over a two-year time period ending March 2014 and compared that with longer-term use over the two-year time period ending March 2012.
In North Carolina, there was a steady decline in the prevalence of long-term opioid use over the 3-year period from 9.7 percent in 2010-12 to 8 percent in 2012-14. The researchers attributed this downward trend at least in part to an increase in use and registration for the state’s Controlled Substance Reporting System (CSRS), especially among those who prescribe the most opioids.
To read the full report you may download it here until July 12. After that date, the report may be purchased through the WCRI web site. If you have questions about this report please contact WCRI.


M3 Video Invitation – Don’t Miss This Important Gathering

On Sept. 15-18, physicians, physician assistants and practice managers from throughout the state will gather in Greensboro to merge medicine and management at the first M3 conference. You don’t want to miss it. The conference will feature educational sessions, engaging speakers, legislative updates and the chance to connect with colleagues. The North Carolina Medical Society annual business meeting also will be held during the conference. Learn more about all that is being offered and register here.
Here is Dale Jenkins, CEO of Medical Mutual Insurance Company, explaining why you should plan to attend.


Get Educated on ACOs with Our TAC Toolkit & Earn CME

Over the past several years, the North Carolina Medical Society (NCMS) Foundation and the Toward Accountable Care (TAC) Consortium and Initiative have produced dozens of toolkits to help physicians understand the move to value through accountable care organizations. Now, thanks to the Texas Medical Association, by reading and absorbing the information in the Physicians’ Accountable Care Guide, the seminal toolkit that provides the basis for all the specialty specific guides that followed, you may now earn CME credit.
Simply click here to download the guide and learn how to earn the CME. Be sure to enter ‘NCMS’ in the coupon code space to receive the NCMS member discount.


Nominees Sought For Two NCMS Service Awards

The North Carolina Medical Society (NCMS) is accepting nominations for the E. Harvey Estes, Jr., MD, Physician Community Service Award.  This award is designed to provide recognition for the many and varied services rendered by physicians to their communities apart from their practice of medicine.  The recipient must be a physician licensed in North Carolina; must not have received the award previously; and must have compiled an outstanding record of community service, which, apart from his or her specific identification as a physician, reflects well on the medical profession.
Nominations must be received by August 1. You may send the completed nomination form by scanning it and emailing it to Abbey Ruggiero, faxing it to her attention at 919-833-2023 or mailing it to her at P.O. Box 27167, Raleigh, NC 27611. If you have questions, please contact Abbey via email or by calling 919-833-3836 x147. Download the form here.


The NCMS also is accepting nominations for the John Huske Anderson Award, given annually to a layperson whose contributions have had a positive impact on the medical profession and public health. The award honors Mr. Anderson’s service to medicine and the Society, having served as NCMS legal counsel from 1937 until his retirement in 1983. Nominations must be made by an NCMS member.
The deadline for submissions is August 1. You may send the completed nomination form by scanning it and emailing it to Abbey Ruggiero, faxing it to her attention at 919-833-2023 or mailing it to her attention at P.O. Box 27167, Raleigh, NC 27611. If you have questions, please contact Abbey via email or by calling 919-833-3836 x147. Download the nomination form here.


State Health Plan Drops Humana; Moves to One Medicare Advantage Carrier

The State Health Plan Board of Trustees recently approved moving from two Medicare Advantage carriers (Humana and UnitedHealthcare) to one Medicare Advantage carrier, UnitedHealthcare (UHC), for 2017. The Board felt the move to just UHC is the best value for Plan members at the lowest cost, and will pass some of the savings onto members.
Both Humana plans are still an option for Medicare retirees through the end of 2016. For 2017, those currently in the Humana Medicare Advantage Base and Enhanced plans will be transferred to the UHC Medicare Advantage Base Plan. Those who wish to select the UHC Medicare Advantage Enhanced Plan may do so during Open Enrollment, Oct. 1-31, 2016. Members who are already in a UHC plan, and are satisfied with that plan, may remain in that plan. If they wish to change to a different UHC plan, either Base or Enhanced, or to the Traditional 70/30 PPO plan, they may make that selection during Open Enrollment.
Final premium rates for 2017 have not yet been established and are pending action by the General Assembly on the State’s employer contribution, which is included in the State budget. The Plan expects the Traditional 70/30 Plan and the Medicare Advantage Base Plan to remain premium free for retirees and for the Medicare Advantage Enhanced Plan to be offered at $64 per month for retiree-only coverage. The State Health Plan’s Board of Trustees will likely vote on premium rates in late July or August.
For 2017, the Plan will provide three options for Medicare Retirees:

  • Traditional 70/30 PPO Plan (BCBSNC)
  • Base Medicare Advantage Plan (UHC)
  • Enhanced Medicare Advantage Plan (UHC)

Helping Flood Victims and Our Colleagues in West Virginia

Our colleagues at the West Virginia State Medical Association (WVSMA) have asked for our help in meeting the needs of those affected by the devastating floods that hit their state last week. The WVSMA, through its West Virginia Medical Foundation (WVMF), has established a special disaster relief fund to collect donations to support the ongoing relief efforts throughout the state. The WVMF is a 501 C(3) not-for-profit charitable foundation under IRS law.
The flooding in central and southeastern West Virginia is historic.  The recovery for thousands of West Virginians and dozens of counties and towns across this state is going to be a long, difficult process that requires a multitude of needs. Many of these needs can be anticipated, such as vaccines, first aid supplies, flashlights, batteries, and cleaning supplies and equipment.  However, there will be just as many needs that are not anticipated or will not be fulfilled by governmental agencies or local organizations in the affected communities.  These can include but are not limited to crisis intervention, mental health services, housing, water, food, clothing and other such services.
The WVMF Disaster Relief Fund will enable both local and state medical societies from around the nation, as well as pharmaceutical and medical device corporations and other strategic partners from within and outside the state, to make donations that can be utilized to provide basic medical relief efforts and to fill the gaps unexpectedly discovered in the recovery effort.
All donations to the WVMF Disaster Relief Fund will be tax deductible, and all donations will be used to support flood relief efforts as approved by the WVMF Board of Directors. Checks should be made payable to the:
West Virginia Medical Foundation
Attn: Karen Foy
4307 MacCorkle Ave., SE
Charleston, WV 25304
Please write "WVMF Disaster Relief Fund" on your check. If you would like to make a donation by credit card, please call the WVSMA offices at 304-925-0342.
The WVSMA President, Paula Taylor, MD, and Coy Flowers, MD, the chair of the WVMF Disaster Relief Fund, say thank you in advance for your generosity and compassion!


NCMS Signs On to AMA and Coalition MACRA Comment Letters

The North Carolina Medical Society (NCMS) has signed onto letters from the American Medical Association (AMA) and the Coalition of State Medical Societies to Andy Slavitt, acting administrator for the Centers for Medicare and Medicaid Services (CMS), outlining the areas for improvement in the Medicare Access and CHIP Reauthorization Act (MACRA).
The comment period for this massive piece of legislation ended on Monday, June 27. The final rule is expected this fall. Read the AMA’s letter to Slavitt here, and the Coalition of State Medical Societies’ comments here.


Coalition of State Medical Societies Weighs in On VA’s Scope of Practice Policy

The 10 medical societies that make up the Coalition of State Medical Societies, including the North Carolina Medical Society (NCMS), have sent a letter to the Secretary of the Department of Veterans Affairs Robert McDonald expressing “deep concern” with the VA’s recent announcement of a proposal that would allow advanced practice nurses to practice independently in the VA health system.
“There is absolutely no question about the value of team-based care, not only to our veterans but also to all of our patients,” the letter states. “No member of the team, however, brings the same skill level and depth of training as the physician. Team-based health care must be physician-led; that is the hallmark of quality care.
“By eliminating this key requirement, the proposed rule places the health of those who have served our nation at risk,” the letter continues. “The proposal also supersedes state law, centralizing health care decision-making, eliminating local control of licensing and regulation of physicians and health care providers.”
Read the entire letter.
 


Students Train To Become Physician Leaders; Physicians Hone Their Skills Through NCMS’ Leadership Development Programs

The following article was written by Minali Nigam, the 2016 NCMS Foundation Medical Journalism Intern. Minali is pursuing her master’s degree in communications and is a 1st-year medical student both at the University of North Carolina-Chapel Hill.
Even if you graduated from medical school years ago, it’s not too late to hone your leadership skills. The deadline to apply to the NCMS Foundation’s Leadership College and Health Care Leadership and Management courses is July 15. Learn more and apply here.


“You are people-oriented.”
“You bring a sense of genuine enthusiasm to the team.”
“You get bogged down in details, like a security blanket in a high-pressure climate.”
These were just some of the results from my DISCcert Leadership Report, which identifies strengths, weaknesses, and working styles, among other characteristics.
I was among the 1st- year medical students at UNC-Chapel Hill who had the opportunity to fill out a list of questions, receive a DISCcert report and participate in a feedback session. The goal was to get students to think early on about leadership development so when we’re third years on the wards, we can improve our communication and better integrate into a team-based clinical setting.
Last November, UNC was one of 20 medical schools invited to join the AMA’s “Accelerating Change in Medical Education Consortium.” As a member of the consortium, UNC received funds to train medical students in new ways that would meet the demands of our current health care system. Part of that innovation was to create a leadership curriculum.
“Doctors often view themselves as passive victims to the policies and institutions of administrators and policy makers,” wrote Angela Cai, a 4th-year medical student at UNC. “We have a critical opportunity today to train a new generation of physicians to become proactive advocates for doctors and patients as health care continues its current course of rapid change.”
Cai helped initiate the school’s leadership interest group, which hosted a physician speaker series throughout the year where students could come ask questions and network. The group’s current leaders, Ammu Vijay and Laura Trollinger, worked with faculty from UNC’s business and medical schools, to offer an elective course for second year medical students this coming fall. In “Anatomy of the US Healthcare System,” students will learn about health care, finance, entrepreneurship and reimbursement models.
The leadership curriculum is still being fleshed out, but according Julie Byerley, the Vice Dean for Education, it will focus on inter-professional education and population health. As the number of independent physicians drops, Cai said, it is becoming more important for students to learn not only how to present a patient on rounds, but also how to present information to hospital administration.
“I think of leadership as an ability to provide the highest quality care in and proactively improve the modern health care system,” wrote Cai. “This ability is built on foundations of teamwork, self-awareness, communication and a basic understanding of the health policy and health care as a business.”


NCMS Members Assuming New Leadership Roles

Photo- Drs Melendez Baker and Huff
Dr. Janice Huff (right) will take over as Medical Director of the Community Care Partners of Greater Mecklenburg on the retirement of Dr. John Baker (center). Dr. Karen Melendez (left) is a network psychiatrist with CCPGM.

Longtime North Carolina Medical Society (NCMS) member and Kanof Institute for Physician Leadership CQ’U’ alumna Janice Huff, MD, has been named Medical Director of Community Care Partners of Greater Mecklenburg (CCPGM). Dr. Huff has served as Assistant Medical Director since joining CCPGM in 2012. She is a faculty member of the Family Medicine Residency Program at Carolinas Medical Center in Charlotte and is a clinical instructor in the Department of Family Medicine at the University of North Carolina at Chapel Hill. She also practices at Novant Urgent Care. Congratulations, Dr. Huff!


Senator Phil Berger, the President Pro Tempore of the North Carolina Senate, recently appointed longtime North Carolina Medical Society (NCMS) member William G. Way, Jr., MD, a Raleigh radiologist to the NC Health Information Exchange Authority (HIEA) Advisory Board representing licensed physicians.  The HIEA was created by the General Assembly last fall as part of the Medicaid reform legislation. The authority oversees the operation of the state’s Health Information Exchange, an integral part of ensuring practices can achieve the triple aim of improved patient experience, enhanced quality of care and cost efficiency.
Dr. Way currently is Chief Medical Officer at Wake Radiology. Congratulations, Dr. Way!


Learning Opportunities

SAVE THE DATE: The North Carolina Department of Justice is bringing together law enforcement, public health, medical, legal and public policy professionals to discuss how to curb prescription drug and opioid abuse in North Carolina at a conference to be held on August 11 at the McKimmon Center on the North Carolina State University Campus in Raleigh. Please save the date. Registration will open in July. For more information contact Natalie Wood, [email protected] or 919-716-6073.


The North Carolina Healthcare Information and Communications Alliance (NCHICA) 22nd Annual Conference & Exhibition, “The New Healthcare Ecosystem,” is scheduled for Aug. 29-31 at the Omni Grove Park Resort in Asheville. The conference provides an excellent opportunity to learn about the latest developments and best practices in healthcare IT, and network with your peers.


28th Annual Fall Foliage Cancer Conference, “Update on Melanoma and Gastrointestinal Cancers,” will be held Oct. 21-22 at the Grove Park Inn in Asheville. More information and registration available here.


Save the Date: The North Carolina Chapter of the Healthcare Financial Management Association (HFMA) will hold its 2016 Health Insurance Institute on Sept. 22-23, at the Sheraton Hotel, Four Seasons in Greensboro. Online registration will begin on Friday, July 1.


MAHEC, working with the North Carolina Academy of Family Physicians, The Governor's Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE; www.mahec.net/opioid


Watch seven new MLN Connects videos on the Medicare Quality Reporting Programs, focusing on the requirements you need to meet in 2016.  For those who participated in the webinars held in February, the information in these modules mirrors the information shared on those calls:
Introduction: Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016. Run time: 15 minutes.
Module 1: Medicare Access and CHIP Reauthorization Act (MACRA) Preview. Run time: 6 minutes.
Module 2: 2016 Incentive Payments and 2018 Payment Adjustments. Run time: 9 minutes.
Module 3: 2016 Physician Quality Reporting System (PQRS) Updates. Run time: 20 minutes.
Module 4: 2018 Value-Based Payment Modifier (VM) Policies. Run time: 17 minutes.
Module 5: Physician Compare Updates in 2016. Run time: 6 minutes.
Module 6: Meaningful Use of Certified Electronic Health Record Technology (CEHRT) in 2016. Run time: 16 minutes.
 


NC Zika Pregnancy Registry Now Available

The North Carolina Division of Public Health currently is working with the CDC to enroll all pregnant women with positive or indeterminate Zika virus test results in the Pregnancy Registry. The registry, part of the CDC’s response to the Zika virus infection, will help to ensure complete and accurate case reporting and allow development of more comprehensive information on the effects of Zika infections during pregnancy.
More information on the NC Zika Pregnancy Registry is available here. To learn more about what North Carolina and the CDC are doing to raise awareness and combat the spread of the Zika virus visit the NC Department of Health and Human Services Zika webpage.
 
 
 


Legislative Update: Budget, CON, Naloxone

North Carolina House and Senate conferees continued their negotiations this week on a final budget in hopes of reaching agreement on a spending plan in time to adjourn by the July 4 holiday.
Several issues of note to North Carolina Medical Society (NCMS) members also were raised, namely reform of the state’s Certificate of Need (CON) law and a standing order for the opioid antagonist naloxone.
The Senate Health Care Committee briefly debated House Bill 161, which would eliminate the state’s CON system in five years.   No vote was taken in committee and it remains unclear whether HB 161 will be taken up again this short session. Reform of the CON laws has generated much dialogue within the NCMS community both for and against changing the system. Discussions among various medical specialties represented within the NCMS and the NCMS Board of Directors are ongoing in an attempt to reach consensus on the Society’s stance on CON reform.
Another provision likely to pass before the end of the week would authorize the State Health Director to issue a statewide, standing order for the opioid-antagonist naloxone. There is strong bipartisan support for making this drug readily available to help stem the opioid overdose epidemic plaguing the state and country. The standing order would allow pharmacies to dispense naloxone without a prescription.
State Health Director Randall Williams, MD, told the Senate Health Committee at a hearing in May that estimates show 500 to 1,000 people who died of prescription opioid overdoses last year potentially could have been saved had naloxone been more readily available.
Watch the Bulletin and NCMS website for updates on these issues and other legislative news in the days ahead.