Assignment of Benefits in Technical Corrections Bill

nc-stampSB 582/HB 229 Agency Technical Corrections
Senate Sponsor: Sen. Tamara Barringer
House Sponsor: Rep. Ted Davis
On June 28, 2017 the House Rules and Operations Committee gave a favorable report to the second edition of SB 582.
The second edition of this bill included a provision that would have changed reimbursement contracts and assignment of benefits.
This edition stated that a reimbursement contract between a health care provider and an insurer should require that reimbursement be made directly to the provider for any service covered under the plan.
This edition stated that an insurer would honor a completed assignment of benefits agreement that gives the insured's reimbursement benefits to a provider. This would only apply if there is no reimbursement contract between a provider an an insurer.
Unfortunately, when the bill made it to the House floor later that evening, an amendment to take out this section of the bill passed narrowly with a vote of 61-52.
Most of the opposition to this language was due to the fact that this section was not technical in nature, not on the substance of the section.

Eyeglass Exemption for Medicaid Capitated Health Plan

nc-stampSB 344 - Combine Adult Correction and Juvenile Justice
Primary Sponsor: Sen. Shirley Randleman (R - Stokes)\
An amendment was adopted on June 28, 2017 to add  language to exempt eyeglass fabrication form Medicaid capitated pre-paid health plans.
This bill passed second on June 28, 2017. This bill passed third reading on June 29, 2017.
This bill was placed on the Senate calendar on June 29, 2017.
The Senate concurred on this bill on June 29, 2017.
This bill was sent to Gov. Cooper on June 20, 2017.
This bill was signed by Gov. Cooper on July 25, 2017.

Hospital Construction Guidelines

nc-stampSB 42 – Reduce Cost & Reg. Burden/Hosp. Construction

Primary Sponsors: Sen. Ralph Hise (R – Madison), Sen. Louis Pate (R – Wayne), Sen. Joyce Krawiec (R – Forsyth)

This bill would direct the Medical Care Commission to adopt the recommendation of the American Society of Healthcare Engineering’s Facility Guidelines Institute "Guidelines for Design and Construction of Hospitals and Outpatient Facilities." This bill would update North Carolina’s hospital guidelines to meet these national standards. This bill would only apply to construction of new facilities.


This bill was referred to Senate Health Care Committee on February 9, 2017.

 passed the Senate Health Care Committee on March 8, 2017 and was re-referred to the Committee on Rules and Operations of the Senate.

The bill was reported favorable the Committee on Rules and Operations of the Senate on March 9, 2017. It has been placed on the calendar for March 14, 2017.

This bill passed second and third readings on March 15, 2017. House:

This bill was received by the House on March 20, 2017.

This bill was referred to the House Health Committee, and then the House regulatory Reform Committee on March 21, 2017.

The referral to the House Regulatory Reform Committee was stricken on June 13, 2017.

This bill was withdrawn from the House Health Committee and re-referred to the House Rules and Operations Committee on June 29, 2017.

This bill passed second and third readings on June 29, 2017.

This bill was presented to Gov. Cooper on June 30, 2017.

This bill was signed by Gov. Cooper on July 21, 2017.

Industrial Commission Seeks to Implement Opioid Rules

nc-stampSB 407 - Employee Misclassification Changes 

Primary Sponsors: Sen. Andy Wells (R-Catawba)
This bill would require that the Industrial Commission implement rules related to opioids and pain management. This portion of the bill would become effective on the date it became law.
In addition, the bill would remove that the Industrial Commission study causes of injury and recommend ways to prevent injuries.
This bill was referred to the Senate Rules and Operations Committee on March 29, 2017. It was withdrawn from this committee on April 6, 2017.
This bill was referred to the Senate Finance Committee on April 6, 2017. This bill received a favorable report in the Senate Finance Committee on April 26, 2017.
The bill was placed on the Senate's Supplemental Calendar on April 26, 2017.  The bill passed second and third reading in the Senate on June 26, 2017.
The bill will now move to the House.
This bill was referred to the House Rules, Calendar, and Operations Committee on April 27, 2017.
This bill was withdrawn from the House Rules, Calendar, and Operations Committee and re-referred to the House Judiciary III Committee on June 19, 2017.
A proposed committee substitute received a favorable report on June 28, 2017.
This bill was added to the House Calendar on June 28, 2017.
Rep. Jonathan Jordan (R-Ashe) sent forward an amendment that would remove section 6 of the bill which stated that employees would not be payable if an injury/death resulted from the use of an intoxicant, controlled substance, willful, neglect, or willful disobedience of a safety regulation.
This amendment passed 114-1.
The updated version of the bill passed the House on second reading with a vote of 116-0 on June 28, 2017.
This bill passed the House on third reading with a vote of 104-2 on June 29, 2017.
This bill was sent to the Senate on June 30, 2017.

Legislature Adjourns

The North Carolina legislature adjourned it's long session around 2:00 a.m. this morning. However, the adjournment resolution adds two more sessions this year:

  • August 3 - This session would mainly focus on overriding vetoes from Governor Cooper, but could also include bills that are currently in conference, nominations, and other topics.
  • September 6 - This session could involve appointments, veto overrides, referendums on constitutional amendments, and impeachment proceedings.

This means that many of our legislative battles are not over due to this extension.
The resolution also adds a November 15 deadline for court ordered legislative redistricting.
A short overview of all of our high priority topics for this session will be posted next week. However, the legislative blog is up to date on all the movement of the bills NCMS  tracked this session.

Senate Delays Vote on Health Care Bill; Read the NCMS Position on BCRA

The Senate has decided to postpone its vote on the proposed Better Care Reconciliation Act (BCRA), which will provide more time for the NCMS to communicate its grave concerns to our Senators. To ensure the best outcome in reforming our health care system, a more deliberative approach must be taken. Political expediency will likely create new problems and add to the problems with previous reforms.
As proposed, the BCRA will negatively affect our state’s most vulnerable citizens. Approximately 2.03 million North Carolinians rely on the Medicaid program to cover their health needs. Review a summary of the bill by the AMA.
The BCRA would weaken the health infrastructure in our state. For North Carolina’s rural and urban safety-net hospitals and physician practices, Medicaid funding is a financial lifeline.  Of the 1,348,300 North Carolinians who will lose health coverage under the BCRA, almost half, (47%) are indigent and will lack the resources needed to secure health coverage anywhere else. This puts them, and North Carolina’s health infrastructure, back in the untenable and unsustainable condition that prevailed before 2010.
The bill in its current format would have devastating effects on our citizenry and our health care system. North Carolina has already taken a bold step in reforming its Medicaid program and is pursuing a waiver from CMS with the goal of more budget predictability and substantial savings to the program. These are the Medicaid program goals that Congress and the North Carolina General Assembly have pursued for years. The Medicaid funding cuts in BCRA would seriously undermine the viability of those reforms.
The NCMS continues to provide leadership in developing guides for numerous medical and surgical specialties on how to practice successfully in an accountable care environment. This month, the NCMS launched an educational program for doctors that includes a hands-on tutorial on how to practice under the new MACRA guidelines. The physicians of this state have already shown tremendous leadership and taking great steps  in meeting the needs of our uninsured and underinsured population. The BCRA, in its current form, would only exacerbate the challenges the state and its indigent citizens are facing in obtaining health services when needed. The NCMS will continue to express its grave concerns regarding BCRA and the impact it will have on our state. Stay tuned for updates on this important issue.
Related links:
Bowtie Briefing for June 23, 2017

Gov. Cooper Urges Use of Common Sense Strategies at Local and National Events Addressing the Opioid Epidemic

National Level: Commission on Combating Drug Addiction and the Opioid Crisis

At the first meeting of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis, North Carolina Governor Roy Cooper urged common sense strategies for the federal government to help combat the opioid crisis. In North Carolina, unintentional opioid, heroin and fentanyl related deaths increased 816 percent from 1999 - 2015. Almost 12,000 North Carolinians have died from unintentional opioid overdoses since 1999. View video from the meeting at right:

Cooper stressed that Congress’ current efforts to roll back health care reforms could jeopardize efforts to stem the epidemic by taking away health care and substance abuse treatment from millions of Americans.
“We can’t arrest our way out of the opioid crisis. Too many people are going through a revolving door of emergency rooms into prison, and we must focus on prevention and treatment,” he said. “The opioid crisis is a complex problem, and solving it will require collaboration from law enforcement, doctors, drug makers and even families of users to work together. It costs our economy in work hours lost and it robs families of their health and security. I’m committed to doing whatever it takes to reverse the epidemic that is raging in too many communities across our state.”
The President’s Commission on Combating Drug Addiction and the Opioid Crisis is a bipartisan group chaired by Gov. Chris Christie of New Jersey and includes Gov. Charlie Baker of Massachusetts, former Congressman Patrick Kennedy, and Professor Bertha Madras, PhD.

State Level: Opioid Misuse and Overdose Prevention Summit

The state's Prescription Drug Abuse Advisory Council hosted a two-day Opioid Misuse and Overdose Prevention Summit at NC State University, attended by NCMS staff as well as by health care providers, law enforcement, medical administrators and other groups focused on addressing the opioid epidemic. During this summit, Governor Cooper rolled out North Carolina's Opioid Action Plan, which sets ambitious goals, such as:

  • Coordinating the state’s infrastructure to tackle the opioid crisis.
  • Reducing the oversupply of prescription opioids.
  • Reducing the diversion of prescription drugs and the flow of illicit drugs.
  • Increasing community awareness and prevention.
  • Making naloxone widely available.
  • Expanding treatment and recovery systems of care.
  • Measuring the effectiveness of these strategies based on results.

Read more about the plan here: "Governor Cooper Announces Bold Action Plan to Turn the Tide of the Opioid Epidemic in North Carolina"

NCMS Hosts Meeting to Address Opioid Epidemic

The NCMS hosted a meeting this week to address the opioid prescribing problem and the emerging societal threat posed by synthetic opioids. The group included 41 health care thought leaders from across the state, representing all aspects of health financing, delivery and regulation. “This is a long-running, complicated problem that affects families and individuals from all parts of our society. The medical community is committed to staying engaged in the effort to formulate and implement solutions until we find what works,” said NCMS President Paul Cunningham, MD.
Facilitating the discussion was Joseph Rannazzisi, JD, RPh, who discussed the various emerging synthetic opioids and the challenges of enforcement. From 2005 to 2015, Mr. Rannazzisi served as Deputy Assistant Administrator, Office of Diversion Control, U.S. Drug Enforcement Administration, where he was responsible for overseeing and coordinating major pharmaceutical and chemical diversion investigations; the drafting and promulgating of regulations; establishing drug production quotas; and conducting liaison with the pharmaceutical industry, international governments, state governments, other federal agencies, and local law enforcement agencies. The meeting was made possible by Steven Mange, senior policy counsel for NC Attorney General Josh Stein, working closely with the NC Medical Board and NC Medical Society.

What You Need To Know about the New Medicare Cards Coming in April

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires the removal of Social Security Numbers (SSNs) also known as the SSN-based Health Insurance Claim Number (HICN) from all Medicare cards by April 2019 to help prevent fraud, fight identity theft and protect private information. Come April 2018, your Medicare patients will have a unique, randomly assigned Medicare Beneficiary Identifier (MBI) for transactions like billing, eligibility status and claim status.
To help ease the transition, the Centers for Medicare and Medicaid Services (CMS) is developing a process where you can look up the new MBI through a secure tool at the point of service. Also there will be a 21-month transition period where you will be able to use either the MBI or HICN for billing purposes. So, even though your system will need to be able to accept the new MBI format by April 2018, you can continue to bill and file health care claims using a patient’s HICN during the transition period. We encourage you to work with your billing vendor to make sure your system will be updated by April as your Medicare patients begin to arrive at your office with new cards in hand.
Here are 5 steps you can take today to be ready:

  • Go to the CMS website and sign-up for the weekly MLN Connects® newsletter.
  • Attend CMS’ quarterly calls to get more information.
  • Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
  • Later this fall, CMS will provide posters and brochures about the new cards you can display in your office.
  • Test your system changes and work with your billing office staff to be sure the practice is ready to use the new MBI format.

Registration Now Open for Several Specialty Society Meetings

NC Dermatology Association 2017 Summer Meeting

 July 7-9 | The Omni Homestead Resort | Hot Springs, VA

NC/SC Society of Otolaryngology and Head & Neck Surgery 2017 Assembly

August 3-6 | The Marriott Resort & Spa at Grande Dunes, Myrtle Beach

  • Program & Registration – Registration must be received no later than July 17.
  • Accommodations: Book online or call the Marriott Resort at 800-228-9290 and reference the group code OTOOTOA to receive the group rate of $219++. Guest room reservations must be received by July 7, 2017.

NC Spine Society 2017 Annual Meeting

 August 18-20 | The Ballantyne Hotel, Charlotte, NC

Carolinas Chapter-American Association of Clinical Endocrinologists 2017 Annual Meeting

 August 25-27 | Pinehurst Resort, Village of Pinehurst, NC

  • Online Registration – Early-bird registration discounts end August 1.
  • Download the registration brochure for complete program details.
  • Accommodations: For room reservations, please use the form in the brochure, or call the Pinehurst Resort at (800) 487-4653 and request the Carolinas Chapter-AACE group rate. The hotel cut-off is July 25.