NCMS Annual Meeting: Learn How to Be More Resilient
The 161st Annual Meeting and House of Delegates of the North Carolina Medical Society (NCMS) will be held at the Grandover Resort in Greensboro on October 23-24. This year’s theme is ‘Resilience.’ In today’s health care environment, physicians and PAs have to be as competent in dealing with the business of medicine as they are in caring for their patients. This double duty often leads to a work-life imbalance — a feeling of burnout that can affect patient care and relationships with colleagues and family. This year’s meeting is dedicated to addressing these imbalances and teaching attendees ways in which they can modify their behavior to become more resilient in challenging times.
This is the one opportunity in the year in which friends and colleagues from throughout the state gather to socialize, network and educate themselves on the latest developments affecting health care. We hope you and your family will take advantage of the meeting’s events, as well as the opportunities for fun and relaxation available at the Grandover. Find out more and register today.
In the News
DHHS Gets $4.7M, 5-Year Federal Grant To Combat Overdoses, Winston-Salem Journal, 9-8-15
Innovation By Necessity: Medicaid Emerges As Aggressive Laboratory for Delivery System Reform, Modern HealthCare, 9-5-15
Stethoscope Meets Smartphone and the Heart Knows It's Right, The Los Angeles Times, 9-3-15
Fewer Americans Skipping Health Care for Cost Reasons, The Washington Post, 9-1-15
Doctor-led Startups Offer New Career Path, Public Benefit, MedPageToday, 8-31-15
Primary Care Docs Reaping Most From ACOs, Modern HealthCare, 8-29-15
Physician Shortage Report Casts Shadows On Some NC Counties, Triangle Business Journal, 8-28-15
Small-Business Loans for Doctors Prepping for ICD-10, NerdWallet, 8-27-15
So You Had A Bad Day, MedPageToday, 8-26-15
With Cases On the Rise, CDC Advises Providers to Consider Human Plague as a Diagnosis, Modern HealthCare, 8-26-15
Learning Opportunities
Registration is now open for two additional NCTracks instructor-led ICD-10 training courses for providers in September 2015. The next course is Thursday, September 10, from 1 to 4 p.m. Register for these courses in SkillPort, the NCTracks Learning Management System.
The Palmetto Part B Quarterly Update Webcast will be on Thursday, September 10th at 10 am. This webcast offers pertinent updates, changes and reminders to assist the provider community in staying compliant with Medicare rules and regulations. Learn more and register.
Presentation proposals for the 5th Annual National Rx Drug Abuse Summit, to be held March 28-31, 2016, are being accepted through Friday, September 11, 2015. This year, the Call for Presentations (CFP) asks potential speakers to select which of 19 topic areas best fits their proposed presentation instead of from a predetermined Educational Track. After the National Advisory Board reviews these proposals, up to 10 Educational Tracks and additional Pre-Summit Workshop topics will be selected to be offered. To download the Call for Presentations packet click here, or visit the CFP webpage.
Registration is now open for NCHICA’s 21st Annual Conference & Exhibition on September 13-16, 2015 at Pinehurst Resort in Pinehurst, NC. This year’s theme is Transforming Healthcare from Volume to Value. The conference provides an excellent opportunity to learn about the latest developments and best practices in health IT and network with your peers. For further details, click here. The registration fee is $475 NCHICA members/$675 non-members. For further details, click here. Fees will increase after August 13, so please register early! NCHICA has a special group rate at the Pinehurst Resort of $205/night, which is good until August 13, 2015. For further details on how to register at the special rate, click here.
Overview of the 2014 Annual Quality and Resource Use Reports Webcast, Thursday, September 17; 2:30-4pm ET. This webcast will provide an overview of the 2014 Annual QRUR and explains how to interpret and use the information in the report. To learn more visit MLN Connects Event Registration. Space may be limited, register early.
The Triangle Health Innovation Challenge (THInC) is a three-day health care ‘hackathon’ organized by Duke University, the University of North Carolina-Chapel Hill and Wake Forest University to be held on Duke's campus, Sept. 18-20. The event will bring together over 200 students, clinicians, engineers, designers and others from the Triangle area to form teams and tackle issues facing our health care system. Participants will develop, implement, test and pitch solutions to address specific pain points in health care, and compete for prizes up to $4000. Registration is $25 and includes all meals for the weekend. Our goal is to leverage the brightest minds in North Carolina to tackle real health challenges. We hope you join us. Learn more at thincweekend.org. Experienced clinicians, health executives and others are welcome to participate as mentors to help validate and refine ideas. Mentors will be scheduled for 2-hour “office hours” to meet with teams and provide feedback on their problem statement, solution and pitch. Interested mentors contact the organizers at [email protected].
The North Carolina Coalition Against Domestic Violence is having a Screening Training for physicians and their medical teams/staff on Sept. 18, 2015 in the Raleigh/Durham area. Topics will include best practices for intimate partner violence screening in clinical settings. More information and to register.
Free ICD-10 Implementation Training by CMS at the NCMS Center for Leadership in Medicine, Thursday, Sept. 24, 10 a.m. to 2 p.m. Learn more and register.
All health care professionals interested in neuromuscular disorders are invited to attend the Neuromuscular Review Course 2015 sponsored by the University of Kansas Medical Center, Department of Neurology, on October 3, at the Renaissance Hotel North Hills in Raleigh. Learn more and register.
The North Carolina Industrial Commission will hold its 20th Annual North Carolina Workers' Compensation Educational Conference on October 14-16, 2015 at the Raleigh Convention Center. The conference provides a valuable opportunity for professionals to share information on current issues impacting the workers' compensation arena. View the conference brochure, which includes the conference agenda and registration information. For more information, please contact Jeanne Bush or Eric Oxfeld at the International Workers' Compensation Foundation office by telephone at (386) 677-0041, fax at (386) 677-0155, or e-mail at [email protected].
Carolinas Trauma Related Issues and Critical Knowledge Symposium (TRICKS) of Fracture Management, November 14, 2015, 8 am – 2 pm, Hilton Charlotte Center City Hotel, 222 E. 3rd St., Charlotte, NC 28202. For more information, call 704.512.6534 or visit the website.
The Mountain Area Health Education Center (MAHEC) fall course schedule is out. Find out what is being offered July through December 2015 and register today.
Time Is Running Short To Get Medicaid Reform Right
Legislators are still optimistic a Medicaid reform bill will be passed before this extra-long session ends. Two sticking points between the House and Senate seem to have been resolved. First, it is agreed the state will no longer assume the risk for Medicaid and will ‘outsource’ that risk to other entities. Second, both chambers now appear to agree to a hybrid model in which managed care corporations would be competing with provider-led entities, which we have favored, to take on the risk of the Medicaid program.
Now our work begins in earnest. We need to ensure adequate protections for doctors and their patients are in place to avoid the mistakes other states have made when inviting managed care to take on their Medicaid program. The North Carolina Medical Society (NCMS) has been working diligently to educate legislators on how to adequately protect the state, taxpayers and patients.
Several key areas where we have been advocating to amend the legislation include:
- A rate floor for professional services.
- Patient choice of their primary care physician.
- Contracts with providers to include value-based payments supporting performance, quality and outcome measures – and these measures must be clearly defined, risk adjusted and monitored and measured continually.
- The state would maintain a system to ensure oversight, efficiency and provider participation including network adequacy standards and patients’ timely access to services. The state could impose penalties on the managed care organization or provider led entity if those standards are not met.
The federal government currently is considering rules for Medicaid managed care organizations that would address these same issues and more, and we have been urging legislators to be proactive and incorporate protections like these into any North Carolina Medicaid legislation in advance of a federal mandate.
For more details on what the NCMS is asking the legislature to do to protect your practice and your patients’ access to care read Medicaid Reform: NCMS Principles for Reform. To hear the NCMS Director of Legislative Relations Chip Baggett explain what is happening on Medicaid reform at the General Assembly watch his Bowtie Briefing legislative update.
Most importantly, legislators want to hear from you. Tell them North Carolina needs to avoid other states’ mistakes when it comes to privatizing Medicaid by codifying the protections described above. To make it easier, we have composed an email message detailing each area of importance for you to send. Please take action NOW. As a provider on the front lines treating Medicaid patients and a constituent, you offer the most credible and valuable input for legislators.
CMS Releases Medicare ACO Results for 2014
The Centers for Medicare and Medicaid Services (CMS) yesterday released 2014 quality and financial performance results for Medicare Accountable Care Organizations (ACOs). The results for the 353 Medicare Pioneer model and Shared Savings Program (MSSP) ACOs nationwide were mixed. Participants in these programs agree to meet targets for quality and slow health care spending; those that succeed can keep a share of money they save. The report shows 97 of the 353 ACOs nationally earned bonuses totaling $422 million out of $833 million in savings they produced.
North Carolina has 13 MSSP ACOs based in or with service areas in North Carolina that reported 2014 performance data. Seven additional MSSP ACOs launched this year in the state, but were not part of this report.
Of the group reporting 2014 data, two organizations – CaroMont ACO in Gastonia and Cornerstone Health Care in High Point – earned a shared savings check. Two other ACOs in the state did achieve shared savings above the minimum savings rate, but did not receive a check because of failure to meet the quality reporting requirements. Six more successfully reported on quality metrics and saved money but did not exceed their minimum savings rate: WakeMed Key Community Care in the Triangle, Physicians Healthcare Collaborative, the Wilmington Health ACO in Wilmington, Coastal Carolina Health Care in New Bern, Triad HealthCare Network in Greensboro and Carolinas ACO, which serves patients in both North and South Carolina.
Cornerstone’s quality ratings were the highest in the state at 94 percent -- sixth in the nation of the comparable 214 ACOs reporting for the same period. In the state, Coastal Carolina's quality ratings were at 91 percent and Wilmington Health's at 90 percent.
“We respect the big challenge taken up by the North Carolina doctors working in these ACOs,” said Robert E. Schaaf, MD, FACR, president of the North Carolina Medical Society (NCMS). “They are striving day in and day out to deliver on a bold commitment — the best quality health care in the most efficient manner that medical science has to offer. We will continue to support our doctors in this work.”
Other takeaways from the report include that ACOs tend to improve over time: 37 percent of the MSSP ACOs launched in 2012 generated shared savings compared to 27 percent that began in 2013 and 19 percent from 2014.
MSSP ACOs also improved on quality compared to 2013. ACOs reporting the last two years showed improvement in 27 out of the 33 quality measures, particularly in clinician-patient communication, patient ratings of physicians, tobacco screening, blood pressure screening and EHR use.
Get more detail on the results.
The program is still receiving strong interest and CMS plans to announce new and renewing ACOs by the end of the year.
All eyes are on the performance of this model of care to help curb health care spending through better care coordination and population health management.
CMS Acting Administrator Andy Slavitt said in a CMS press release on the results: “These results show that accountable care organizations as a group are on the path towards transforming how care is provided. Many of these ACOs are demonstrating that they can deliver a higher level of coordinated care that leads to healthier people and smarter spending.”
Some took a less positive tone, like the National Association of ACOs, which issued a press release stating: “While the number of ACOs with positive results and the total dollar savings have increased due to the additional 100+ ACOs that were added to the program, the average savings per ACO actually declined by a significant percent.” The organization’s CEO, Clif Gaus, added: “Savings per ACO decreased. This is probably due to the unfair quality penalty which is so stringent that unless an ACO scores perfectly on every quality measure, their savings will be reduced. We expect ACOs to deliver better care for Medicare beneficiaries but the quality benchmark that CMS prescribes is the government example of letting the perfect be the enemy of the good.”
CMS has pursued improvements to the program over the last year finalizing a new rule in June that made significant changes to the program requirements, including allowing for an additional 3-year contract term with no downside risk for current ACO participants, and maintaining the 50 percent sharing rate for those who choose this option among other updates. Read more about the updated rule.
Don't Let This Opportunity Slip Away
2016 is the last year that providers who have not yet attested to meaningful use for Medicaid can attest and get the $21,250 incentive payment.
The Medicaid Electronic Health Record (EHR) Incentive Program provides incentive payments for Medicaid eligible professionals (EPs) who adopt, implement, upgrade, or meaningfully use certified EHR technology in their first year of participation in the program, and successfully demonstrate meaningful use in subsequent years. Learn more.
North Carolina Medical Society Director of Practice Improvement Terri Gonzalez provides consulting support on achieving meaningful use. Contact her via email [email protected] or call her at 919-833-3836 x123.
How to Thrive in a Value-Driven Health Care System
Join us for this inspiring and informative session on Wednesday, September 16 from 11:30 a.m. until 2 p.m. at the the North Carolina Medical Society (NCMS) Center for Leadership in Medicine with nationally renowned health care payment reform expert, Harold D. Miller, and Karen Cannon, MD, a North Carolina physician leader on the front lines of health care delivery redesign. They will provide a vision for health care transformation now and into the future and how to thrive in a value-driven environment. Mr. Miller and Dr. Cannon look forward to an engaging conversation with you as a stakeholder in North Carolina’s health care community.
Register Now
ABOUT HAROLD D. MILLER
Harold D. Miller is a recognized national expert on health care payment and delivery reform. His overview of health care payment systems, Better Ways to Pay for Health Care: A Primer on Healthcare Payment Reform, was published in January 2009 as part of the NRHI Payment Reform Series in conjunction with the Robert Wood Johnson Foundation, and his paper “From Volume to Value: Better Ways to Pay for Health Care” was published in Health Affairs in September 2009. Miller also served as President and CEO of the Network for Regional Healthcare Improvement from 2008 through early 2013, and he continues to serve as the Strategic Initiatives Consultant to NRHI.
ABOUT KAREN CANNON, MD
Dr. Karen Cannon serves as the Chief Medical Operations Officer for CHESS, a physician-managed health care services company based in High Point, NC, that empowers clinicians and health systems to make the transition to value-based medicine. Her role is designed to provide operational support for CHESS clients as they move along their journey to value. Formerly the Clinical Documentation Improvement Officer for CHESS and Cornerstone Health Care, PA, Dr. Cannon led multiple initiatives in clinical documentation and coding, expertise that is crucial for her current role.
ICD-10 Resources Are Available; Now Is the Time to Prepare
The Centers for Medicare & Medicaid Services (CMS) has released a concise guide to ICD-10 resources. The guide focuses on quick references and key steps you can take to get ready for the October 1 transition. Resources include:
- New Clinical Concepts Guides for specialties
- The Road to 10 online tool for physicians and other clinicians
- Brief animated videos
- Infographics
- A Quick Start Guide featuring 5 basic steps
In addition, CMS has released specialty specific ICD-10 guides that highlight ICD-10 concepts for the following specialties:
- Cardiology, which highlights conditions like heart failure, hypertension, heart valve disease, and more.
- Orthopedics, which highlights conditions like fractures, arthritis, shoulder pain, and more.
- Pediatrics, which highlights conditions like asthma, diabetes, bronchitis, and more.
- OB/GYN, which conditions like abdominal pain and ovarian cysts, breast lumps, preeclampsia, and more.
- Internal Medicine, which highlights conditions like chest pain, headache, heart disease, and more.
- Family Practice, which highlights conditions like diabetes, hypertension, asthma, and more.
ICD-10 will be here Oct. 1, so get ready!
DMA Reviewing Medicaid Recredentialing Compliance
From the North Carolina Division of Medical Assistance (DMA)
The Centers for Medicare and Medicaid Services requires that all Medicaid providers are recredentialed, and the DMA is reviewing the status of enrolled providers to ensure compliance with that requirement. It is crucial that all providers who receive a notice promptly respond and begin the recredentialing process.
All Medicaid providers are required to recredential as part of the NCDHHS Provider Administrative Participation Agreement. Recredentialing is not optional. If the recredentialing is not completed, your provider record may be subject to termination. Providers who have received a notice, but have not started the recredentialing process, should not wait for a second notice.
Providers who believe they have mistakenly received a recredentialing notice should immediately notify DMA using the contact information included in the notice. As a reminder, North Carolina session law requires that providers pay a $100 fee for Medicaid recredentialing.
Note: Recredentialing does not apply to any time-limited enrolled providers such as out-of-state (OOS) providers. OOS providers must continue to complete the enrollment process every 365 days.
Leadership Scholars to Present Capstone Projects
The 2015 class of the Kanof Institute for Physician Leadership Leadership College scholars have been honing their skills throughout the past year and will present their projects at the North Carolina Medical Society (NCMS) Annual Meeting, Oct. 23-24 at the Grandover Resort in Greensboro. Register to attend this meeting to reconnect with your colleagues and meet tomorrow’s leaders as they cap their Leadership College experience.
Established in 2003, the NCMS Leadership College Program builds and enhances physician and PA leadership skills and equips graduates to become more influential in motivating and inspiring their peers to be leaders in their medical settings and their communities. Learn more about the Leadership College and other programs of the Kanof Institute.
Volunteer to be a Part of Doctors on Call at WITN's Studios in Greenville!
Wednesday, September 30, from 5-7pm
Share your medical expertise with viewers of WITN-TV in Greenville! Physician volunteers are needed to man the phones and to answer medical questions from the public. Even if you can spare just one hour of your time, your participation would be welcome!
Physicians and residents from all specialties are invited to participate; all volunteers must have a valid NC medical license and be in good standing with the NCMB. North Carolina Medical Society membership is not required, so feel free to share this information with your peers!
The event will take place at WITN's new studio located at 275 E. Arlington Blvd., Greenville, NC 27858. Please plan on arriving at least 10 minutes before your scheduled time slot. If you are unable to make it to Doctors on Call, please try to recruit a replacement for your time slot from among your colleagues.
For questions regarding Doctors on Call or your participation, please contact Tricia Maddrey-Baker (252-758-8833) with the Pitt County Medical Society or Kristen Shipherd with the North Carolina Medical Society (800-722-1350).
Sign up now!
Tax Scam Affected More Than Previously Thought
The Internal Revenue Service revealed last week hackers had gained access to the tax returns of as many as 334,000 people — 220,000 more than previously thought — allowing the hackers to use Social Security numbers, birth dates and street addresses in order to file fraudulent returns and then collecting the refunds.
The North Carolina Medical Society (NCMS) received 74 calls over the last two tax seasons from members who had been affected by this scam, leading the NCMS and other state medical societies to believe doctors were a specifically targeted group. The NCMS worked with the State Attorney General's Office and the FBI to provide members with information on how to report their lost refund and help authorities crack the case.
The IRS said the criminals had hacked into the records of people from all walks of life through a software program call “Get Transcript,” which allowed taxpayers to retrieve returns from previous years. The IRS shut down the “Get Transcript” service in May. The agency will be sending 220,000 letters to those additional people whose records were compromised.
Physician 'Burnout' is a Serious Issue; Help Is Available
The North Carolina Medical Society (NCMS) and the AMA are working to address the problem of physician ‘burnout’ or ‘caregiver fatigue,’ which is estimated to affect 40 percent of US physicians – more than 10 percent more than the general population.
The NCMS has two CME sessions planned at its upcoming Annual Meeting on October 23-24 at the Grandover Resort in Greensboro to help physicians learn to be more resilient and prevent and/or combat burnout. Get the details on the programs and register for the Annual Meeting today.
The AMA’s on-line program, AMA STEPS Forward, which launched last June, is offering two new online modules to help physicians learn their risk factors for burnout and adopt real-life strategies to reignite professional fulfillment and resilience.
- The first module,Improving Physician Resiliency, offers an internal approach to help physicians managed personal and professional stress. Physicians who are resilient are better equipped to manage the stress of relentless change in medical practice and less likely to experience burnout. The module provides simple, evidence-based solutions to help physicians foster resilience against stress and protect against burnout.
- The second module,Preventing Physician Burnout, offers an external approach to help physicians make practice-level changes to improve workflow and reduce barriers to patient care. Increasing physician involvement in efforts to improve their practice environment results in better patient satisfaction, quality outcomes, and overall practice morale and productivity. The module provides assessment tools and targeted intervention strategies that reduce sources of stress and support professional well-being.
The AMA in collaboration with the Medical Group Management Association has issued a practice innovation challenge offering an opportunity for out-of-the-box thinkers to propose solutions that will also help physicians adapt to the changing health care environment. The best solutions will be eligible for one of several $10,000 prizes in addition to having their idea developed into future STEPS Forward modules. Additional details, submission requirements and evaluation criteria are available here.
Albertini Named President of American College of Mohs Surgery
John G. Albertini, MD, Winston-Salem, has been named the President of the American College of Mohs Surgery (ACMS). Dr Albertini is nationally renowned for his expertise in Mohs surgery and advanced reconstructive surgery. ACMS is a prestigious organization of more than 1200 fellowship-trained skin cancer and reconstructive surgeons. Dr. Albertini has presented over 50 local, regional and national lectures and has published over 40 scientific articles and book chapters. He served as President of the North Carolina Dermatologic Association in 2009 and as Assistant Editor of the journal Dermatologic Surgery (2009-2014). Congratulations, Dr. Albertini!
In the News
New Breed of Paramedics Treats Patients Before Emergencies Occur, The Los Angeles Times, 8-25-15
Possible Expansion of Nurse Independence Is Hot Button Issue for VA, Modern Healthcare, 8-24-15
You're Suing Me For What?, MedPageToday, 8-24-15
Why Your Doctor Won't 'Friend' You on Facebook, Kaiser Health News, 8-24-15
Money and Time Needed To Bring More Doctors To VA, Modern HealthCare, 8-20-15
Commentary:Healthcare Providers Need to Embrace Pay for Quality, Modern HealthCare, 8-15-15
Teaching Docs How To Have End of Life Talks, Modern HealthCare, 8-15-15
Questions and Answers About the War Wound 'moral injury,' The Associated Press, 8-15-15
Medicare's Voluntary Bundled Payment Program Grows, But Many Providers Opt Out, ModernHealthCare, 8-13-15
Blog: Why Health Care Officials Need To Keep Up with the Kardashians, Modern HealthCare, 8-13-15
Should We Swallow The Southern-Style Diet Study? MedPageToday, 8-12-15
Meaningful Use of EHRs By Doctors Fell in 2014, Modern HealthCare, 8-12-15
Uninsured Rate Dips Below 10 Percent, Modern HealthCare, 8-12-15
Learning Opportunities
Tonight, Aug. 26, from 7-8 p.m., tune in to an AMA-hosted webinar and hear from leading Veterans Administration officials on new community-based care options, known as the Veterans’ Choice Program, for VA beneficiaries. This webinar will explain how the VA is relying on private practitioners as a short-term solution to delivery problems and workforce shortages. Participants will understand the conditions of participation and learn how to troubleshoot claims processing issues and payment delays. The webinar will also dispel common misconceptions about the Choice Program and the presenters will conclude with an assessment of ongoing policy challenges. Physicians can register for the webinar here.
Medicare Learning Network (MLN) Connects will hold a National Provider Call: Countdown to ICD-10, Thursday, Aug. 27, from 2:30 to 4 p.m. to register, visit MLN Connects Event Registration. Space may be limited, register early. As of Aug. 27, it will be five weeks before ICD-10 implementation on Oct. 1, 2015. Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will offer coding guidance and tips, along with updates from CMS.
Move to Value Summit, the ultimate primer on value-based health care will be held at Biotech Place in Winston-Salem, Aug. 27-28. Hosted by CHESS Health Enablement Solutions and sponsored by Wake Forest Baptist Health and LabCorp, the Move to Value Summit is designed to provide you with a broad and deep understanding of what it takes to transform your fee-for-service-dependent organization to one rooted in pay-for-value. Learn more and register.
On August 31, 2015, the North Carolina Harm Reduction Coalition (NCHRC) and its allies will partner to host a series of events in the state in solidarity with International Overdose Awareness Day. The NCHRC is a statewide nonprofit dedicated to reducing drug overdose deaths through legislative advocacy, broad coalition building with community-based organizations and the distribution of more than 14,000 naloxone kits. Events focused on remembering loved ones lost to drug overdose and discussing solutions to the opioid abuse problem will be held in Asheville, Durham, Fayetteville, Greensboro and Wilmington. Details here.
The Centers for Medicare & Medicaid Services (CMS) will hold a Virtual Office Hours session regarding 2016 PQRS and the 2016 Medicare proposed rule for Physician Fee Schedule (PFS) on Thursday, September 3 from 2 – 3 p.m. This session will allow stakeholders an opportunity to ask a CMS representative questions about the new proposed PQRS requirements for program year 2016. Additionally, the session will include information regarding the deadline for public comments, and the next steps for the 2016 PFS rule. The number of participants is limited. Register now.
Registration is now open for two additional NCTracks instructor-led ICD-10 training courses for providers in September 2015. The courses are on Friday, September 4, from 9 a.m. to noon and Thursday, September 10, from 1 to 4 p.m. and are in addition to those previously announced. Register for these courses in SkillPort, the NCTracks Learning Management System.
Presentation proposals for the 5th Annual National Rx Drug Abuse Summit, to be held March 28-31, 2016, are being accepted through Friday, September 11, 2015. This year, the Call for Presentations (CFP) asks potential speakers to select which of 19 topic areas best fits their proposed presentation instead of from a predetermined Educational Track. After the National Advisory Board reviews these proposals, up to 10 Educational Tracks and additional Pre-Summit Workshop topics will be selected to be offered. To download the Call for Presentations packet click here, or visit the CFP webpage.
The Triangle Health Innovation Challenge (THInC) is a three-day health care ‘hackathon’ organized by Duke University, the University of North Carolina-Chapel Hill and Wake Forest University to be held on on Duke's campus, Sept. 18-20. The event will bring together over 200 students, clinicians, engineers, designers and others from the Triangle area to form teams and tackle issues facing our health care system. Participants will develop, implement, test and pitch solutions to address specific pain points in health care, and compete for prizes up to $4000. Registration is $25 and includes all meals for the weekend. Our goal is to leverage the brightest minds in North Carolina to tackle real health challenges. We hope you join us. Learn more at thincweekend.org. Experienced clinicians, health executives and others are welcome to participate as mentors to help validate and refine ideas. Mentors will be scheduled for 2-hour “office hours” to meet with teams and provide feedback on their problem statement, solution and pitch. Interested mentors contact the organizers at [email protected].
Registration is now open for NCHICA’s 21st Annual Conference & Exhibition on September 13-16, 2015 at Pinehurst Resort in Pinehurst, NC. This year’s theme is Transforming Healthcare from Volume to Value. The conference provides an excellent opportunity to learn about the latest developments and best practices in health IT and network with your peers. For further details, click here. The registration fee is $475 NCHICA members/$675 non-members. For further details, click here. Fees will increase after August 13, so please register early! NCHICA has a special group rate at the Pinehurst Resort of $205/night, which is good until August 13, 2015. For further details on how to register at the special rate, click here.
The North Carolina Coalition Against Domestic Violence is having a Screening Training for physicians and their medical teams/staff on Sept. 18, 2015 in the Raleigh/Durham area. Topics will include best practices for intimate partner violence screening in clinical settings. More information and to register.
The North Carolina Industrial Commission will hold its 20th Annual North Carolina Workers' Compensation Educational Conference on October 14-16, 2015 at the Raleigh Convention Center. The conference provides a valuable opportunity for professionals to share information on current issues impacting the workers' compensation arena. View the conference brochure, which includes the conference agenda and registration information. For more information, please contact Jeanne Bush or Eric Oxfeld at the International Workers' Compensation Foundation office by telephone at (386) 677-0041, fax at (386) 677-0155, or e-mail at [email protected].
Carolinas Trauma Related Issues and Critical Knowledge Symposium (TRICKS) of Fracture Management, November 14, 2015, 8 am – 2 pm, Hilton Charlotte Center City Hotel, 222 E. 3rd St., Charlotte, NC 28202. For more information, call 704.512.6534 or visit the website.
The Mountain Area Health Education Center (MAHEC) fall course schedule is out. Find out what is being offered July through December 2015 and register today.
Medicaid Reform Is Moving Forward At the Legislature
Yesterday, the North Carolina Senate voted 34-10 to approve HB 372, Medicaid Transformation, a Medicaid reform bill calling for a mix of commercial insurers and in-state health care providers. It also would change the fee-for-service system to a per-member monthly allotment to encourage patients and medical providers to control costs. And the bill would create a new cabinet-level Medicaid department, headed by a secretary appointed by the governor and confirmed by the legislature. The bill now goes back to the House, where its future is uncertain. Read the highlights of the bill.
The North Carolina Medical Society (NCMS) continues to advocate aggressively for policies placing physicians and clinical decision-making at the forefront of any Medicaid reform structure. The NCMS worked hard beginning in 2012 to persuade the state to continue carrying the underwriting risk of the Medicaid program and allow doctors to implement value-driven systems of care directly with the state. The General Assembly is determined, however, to shift the underwriting risk of Medicaid to insurance companies. We believe some of the insurers that show an interest in Medicaid will be physician-led, and we strongly support these physician-led efforts.
To help you in conversations with your colleagues or when you contact your elected representatives, which we encourage you to do, the NCMS has identified the essential provisions to be included in any Medicaid reform legislation. These provisions will help protect the way you practice medicine and ensure a viable Medicaid program. Read them here. And, please send your legislator a message.
PAs Gain a Seat on the NC Medical Board
On Tuesday, Gov. Pat McCrory signed into law HB 724, “Amend Composition of NC Medical Board” thus adding a designated seat for a physician assistant (PA) on the Board. The previous version of the law held seats for either a PA or a nurse practitioner; now both professions have designated seats.
The North Carolina Medical Society (NCMS) worked closely with the N.C. Academy of Physician Assistants (NCAPA) to guide the legislation through the General Assembly.
The NCAPA’s President Marc Katz, a Catawba County PA, praised the bill, adding: “As the rising demand for health care services puts additional strain on providers, particularly in rural areas, PAs are an increasingly important part of North Carolina’s team-based healthcare system. PAs have the training, skills and expertise to provide personal, quality medical care to our patients. We are grateful that our state’s leaders have taken this much-needed step to ensure that PAs have a continuous voice on the N.C. Medical Board.”
The NCMS welcomes PAs as an important part of our membership. They are the fastest growing licensee group regulated by the Medical Board, having increased almost 25 percent since 2010. More than 5,000 PAs are now licensed to practice medicine in North Carolina.
Wos Resigns as NC DHHS Secretary
Last Wednesday Dr. Aldona Wos officially resigned as Secretary of the NC Department of Health and Human Services. In a press conference at the Executive Mansion, Gov. McCrory became teary-eyed as he praised Wos’ service in overseeing the largest state agency saying she brought “incredible passion” to the job.
The North Carolina Medical Society (NCMS) has worked closely with Wos and her staff during her more than two years in the position, advocating for our members on issues surrounding the rocky roll out of NCTracks and formulating a sustainable Medicaid reform plan. The Governor and the Department under Wos came to support a physician-led plan, as the NCMS had advocated early on.
“Dr. Wos worked incredibly hard to serve the citizens of North Carolina, and brought true commitment and dedication to the job,” said NCMS CEO Robert W. Seligson. “She made good progress in advancing sensible Medicaid reforms. We appreciate her efforts.”
Rick Brajer, a business executive from Raleigh will replace Wos as the head of the agency on Friday, Wos’ last day on the job. Brajer was CEO of ProNerve in Denver until January. He was president and CEO of the diagnostic company LipoScience in the Triangle. He is a graduate of the Stanford University School of Business.
The ICD-10 Countdown Continues – You Have 49 Days To Get Ready
Just over 5 percent of doctors accepting Medicaid patients in North Carolina say they will NOT be ready for ICD-10 when it launches on October 1, according to the latest survey by NCTracks, the state’s Medicaid claims system. The Department of Health and Human Services calls this “potentially concerning.” Regardless of payer – Medicaid, Medicare or private payers – are you and your office staff ready to start using ICD-10 codes come Oct. 1?
All payers – public and private – have many resources available to help you gear up and make the transition. Click on the links below for more information on what's available.
NCTracks Coding Help
Centers for Medicare and Medicaid Services ICD-10 resources
The Physicians Foundation also is promoting free software to help make the transition. ICD10Charts.com was developed by a medical student, Parth Desai, who saw the need for such a resource while working in his father's medical practice.
If you learn better with a live instructor, NCTracks now is enrolling for September classes – the August sessions are full.
The training course, "ICD 10 System Changes," is taught via remote WebEx, so you can attend from any location with a telephone, computer and Internet connection. Each session is limited to 115 participants, so register NOW on Skillport. Following are the dates and times the class is offered:
- Thursday, September 3 - 9 to 9:45 a.m.
- Tuesday, September 8 - 3 to 3:45 p.m.
- Friday, September 18 - 10. to 10:45 a.m.
- Monday, September 21 - 3 to 3:45 p.m.
For those not able to attend the live instructor-led course, a recorded session is available. It is titled GEN 102 ICD System Changes_Providers and can be found in Skillport in the General Folder under the heading CBTs.
And don’t forget the national Medicare Learning Network (MLN) Connects Provider Call: Countdown to ICD-10, Thursday, Aug. 27, from 2:30 to 4 p.m. to register, visit MLN Connects Event Registration. Space may be limited, register early.
Finally, back in early July , CMS and the AMA released a joint statement about their efforts to help the provider community get ready for ICD-10. This statement included guidance from CMS that allows for flexibility in the claims auditing and quality reporting processes. In response to questions from the health care community, CMS has released “Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities,” which provides answers to the most commonly asked questions about exactly what this ‘flexibility’ means to you and your practice.
Due September 8: NCMS Resolutions for HOD Consideration
The NCMS Annual Meeting will be held October 23-October 24, 2015, at the Grandover Resort, Greensboro, NC. The first session of the House of Delegates is scheduled for Friday, October 23, from 3-5:30pm and the second session for Saturday, October 24, from 10am-1pm. Register here.
In accordance with the NCMS Bylaws, all resolutions to be considered as regular business of the House of Delegates must be submitted at least forty-five (45) days before the first meeting of the House of Delegates -- that is Sept. 8, 2015. Therefore, all resolutions from component medical societies, sections or medical specialty organizations should bear the signature of two officers of the respective organization. Otherwise, the resolution will need to be submitted by an individual delegate. Resolutions are to be sent to the Executive Vice President, CEO no later than Sept. 8, 2015. Send Resolutions via e-mail to Abbey Ruggiero at [email protected].
Any resolution containing an "action" item must contain a fiscal note estimating the amount needed. Please be sure to include the name of the original sponsor of the resolution and any available supporting information. This is for the purpose of clarification should there be any questions about the resolution and for follow-up should the resolution be referred.
Resolutions received after the Sept. 8 deadline will be considered late resolutions and must be approved for consideration by two-thirds of the delegates present at the First Session of the House of Delegates. All late resolutions will be reviewed by the Board of Directors. The Board of Directors will consider the appropriateness of the late resolutions based on time sensitivity and urgency and importance to the goals and objectives of the Medical Society and recommend late resolutions be "Recommended for Acceptance" or "Not Recommended for Acceptance" by the HOD. Late Resolutions should be e-mailed to Abbey Ruggiero at [email protected] no later than 5 pm on Wednesday, Oct. 21.
Before a resolution is submitted, the NCMS Policy Manual should be searched to ensure a policy doesn't already exist. The NCMS Policy Manual also can be accessed on our website under “Publications” on the News tab at the top of the homepage.
For your convenience, view the standards for resolutions and a sample resolution format. Please make every effort to conform your resolution(s) to these standards. Resolutions that do not conform to the new and existing standards will be put into the proper format before the delegate packets are mailed.
Weapons in the Battle Against Opioid Abuse
North Carolina Medical Society (NCMS) President Robert E. Schaaf, MD, FACR, recently had an editorial piece published in the Raleigh News & Observer titled “The Public Health Issue of Our Time: Prescription Drug Abuse.” Read it here.
As this issue becomes increasingly part of public discourse, organized medicine is responding with new educational resources for physicians to help you do your part. Here is an update from the AMA on what is available to you:
The Providers’ Clinical Support System for Opioid Therapies (PCSS-O), a collaborative of national health care organizations that includes the AMA, develops free, evidence-based educational opioid use resources for physicians. Physicians can use the PCSS-O’s online modules and webinars for information they can put to use in their daily practice.
Here are four resources from the PCSS-O, some of which offer continuing medical education credit in the form of AMA PRA Category 1 Credit(s)™:
- Physicians in primary care can be the first line of assistance for patients who misuse opioids. A webinar from noon to 1 p.m. on Sept. 1 will explain how physicians can use the “SBIRT” method—screening, brief intervention and referral to treatment—to reduce misuse.
- Increased use of prescription drug monitoring programs (PDMP) can help physicians identify patients at risk for opioid misuse. A webinar from noon to 1 p.m. on Sept. 2 will give physicians the basics on PDMPs and how to maximize their benefit.
- Physicians who treat patients with low back pain may benefit from a module on whether to use opioids to treat these patients. The module addresses psychosocial contributors to pain and recognizes that opioids are not first-line treatment for low back pain and may not be appropriate for many patients.
- Older adults represent an increasing proportion of individuals who misuse drugs. One module can help physicians make an overall plan for pain assessment and management in older adults.
Physicians interested in medication-assisted treatment also can register for an upcoming webinar from the Providers’ Clinical Support System for Medication Assisted Treatment. The webinar, to be held from 3 to 4 p.m. on Sept. 3, will address the impact substance use has on families and how physicians can engage families to improve the patient’s health.
Why physicians are crucial to stopping the epidemic
The AMA has convened a task force with the American Osteopathic Association, the American Dental Association, and more than 20 state and specialty medical associations to work collaboratively to address the opioid public health epidemic by identifying best practices and implementing them across the country.
The group identified three initial steps physicians can take now to help their patient populations:
- Register and use state-based prescription drug monitoring programs.[This is the topic of Dr. Schaaf’s editorial] Register for and consult these databases to identify patients at risk for opioid misuse and help patients with substance use disorders get appropriate treatment.
- Discuss with patients available treatment options.When caring for patients with pain, understand the best possible course for managing that pain with the tools available.
- Take advantage of educational opportunities. Visit the AMA’s Opioid Abuse Prevention Web pages to access resources to enhance your education, and promote comprehensive, appropriate pain treatment while safeguarding against opioid overdose.
NCMB Reminder on Death Certification Protocols
From the North Carolina Medical Board
Refusals or delays in certifying patient deaths have real consequences, and the North Carolina Medical Board (NCMB) frequently receives phone calls and complaints from patients' families, EMS directors, funeral home personnel and others about refusals and/or unacceptable delays in physician completion of death certificates.
Most often these concerns relate to an unattended death from natural causes. Most of these decedents have an established relationship with a physician, but for a variety of reasons, the identified physician is reluctant to certify the death. For example, the decedent may not have seen the physician for several months, or the physician may have been providing treatment for stable, conditions that posed no apparent immediate threat to the patient's life (hypertension, diabetes, etc.). Or, the physician may simply feel he or she has no exact idea why the patient died.
Regardless of the reason, delaying the completion of a death certificate or refusing to sign a death certificate creates unnecessary complications with funeral arrangements, estate proceedings and other legal and personal matters. This makes an already difficult time for surviving family members and other loved ones even more so.
Please review these Frequently Asked Questions about death certificates and your important role in completing them.
School Year Begins with Medical Student Recruiting Events
On Monday and Tuesday, North Carolina Medical Society (NCMS) medical student recruiting events were held at Duke University and UNC-Chapel Hill medical schools respectively. Both events were well-attended with almost every student in the first year class participating.
At Duke, NCMS Immediate Past President Dev Sangvai, MD gave the opening address, giving an overview of organized medicine and key topics in health policy. Duke chapter leaders Bora Chang, Kyle Freischleng, Trach Cheng and others made comments regarding how to get involved. They also shared their experiences in meetings with the AMA, NCMS and the Durham Orange County Medical Society.
At UNC-Chapel Hill, Wesley Burks, MD, made the keynote address speaking about the changing dynamics in health care and the importance of developing leadership skills. Student leaders Audrey Lan, Hannah Chen, and Betsy Yang were instrumental in planning two fabulous events at UNC.
There also will be ‘lunch-and-learn’ sessions for medical students at the Brody School of Medicine at East Carolina University, and the medical schools at Wake Forest University and Campbell University. In the meantime, if you are a medical student and would like to join the NCMS, click here to visit our membership page and join online. To learn more about how to get involved at the local, state or national level, contact Will Barnett at [email protected].
CDC Issues This Season’s Flu Vaccine Recommendations
The Center for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices has issued its recommendation for the 2015-16 flu vaccine season. Read about them.
In the News
Will Doctors Soon Be Prescribing Video Games for Mental Health?, NPR, 8-10-15
Ebola Survivors Plagued By Chronic Joint Pain, Eye Problems, NEJM Journal Watch, 8-10-15
Uninsured Rate Down Way More In States That Embraced Obamacare, The Huffington Post, 8-10-15
Cost of Obesity Will 'Wipe Out Health Care', MedPage Today, 8-9-15
CMS' Proposed Medicaid Managed-Care Rules Face Resistance, ModernHealthCare, 7-29-15
Learning Opportunities
Palmetto GBA will host the next Part B Ask the Contractor Teleconference: ICD-10 -- Are You Ready? on Aug. 13, 2015, from 10 to 11 a.m. This call is intended for Part B providers and their billing staff billing for services rendered in North Carolina. This call will focus on helping providers prepare for the implementation of mandatory use of ICD-10 codes on Oct. 1 and will not teach providers how to code using ICD-10.
Medicare Learning Network (MLN) Connects will hold a National Provider Call: Countdown to ICD-10, Thursday, Aug. 27, from 2:30 to 4 p.m. to register, visit MLN Connects Event Registration. Space may be limited, register early. As of Aug. 27, it will be five weeks before ICD-10 implementation on Oct. 1, 2015. Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will offer coding guidance and tips, along with updates from CMS.
Move to Value Summit, the ultimate primer on value-based health care will be held at Biotech Place in Winston-Salem, Aug. 27-28. Hosted by CHESS Health Enablement Soutions and sponsored by Wake Forest Baptist Health and LabCorp, the Move to Value Summit is designed to provide you with a broad and deep understanding of what it takes to transform your fee-for-service-dependent organization to one rooted in pay-for-value. Learn more and register.
Registration is now open for NCHICA’s 21st Annual Conference & Exhibition on September 13-16, 2015 at Pinehurst Resort in Pinehurst, NC. This year’s theme is Transforming Healthcare from Volume to Value. The conference provides an excellent opportunity to learn about the latest developments and best practices in health IT and network with your peers. For further details, click here. The registration fee is $475 NCHICA members/$675 non-members. For further details, click here. Fees will increase after August 13, so please register early! NCHICA has a special group rate at the Pinehurst Resort of $205/night, which is good until August 13, 2015. For further details on how to register at the special rate, click here.
The North Carolina Coalition Against Domestic Violence is having a Screening Training for physicians and their medical teams/staff on Sept. 18, 2015 in the Raleigh/Durham area. Topics will include best practices for intimate partner violence screening in clinical settings. More information and to register.
The North Carolina Industrial Commission will hold its 20th Annual North Carolina Workers' Compensation Educational Conference on October 14-16, 2015 at the Raleigh Convention Center. The conference provides a valuable opportunity for professionals to share information on current issues impacting the workers' compensation arena. View the conference brochure, which includes the conference agenda and registration information. For more information, please contact Jeanne Bush or Eric Oxfeld at the International Workers' Compensation Foundation office by telephone at (386) 677-0041, fax at (386) 677-0155, or e-mail at [email protected].
Carolinas Trauma Related Issues and Critical Knowledge Symposium (TRICKS) of Fracture Management, November 14, 2015, 8 am – 2 pm, Hilton Charlotte Center City Hotel, 222 E. 3rd St., Charlotte, NC 28202. For more information, call 704.512.6534 or visit the website.
The Mountain Area Health Education Center (MAHEC) fall course schedule is out. Find out what is being offered July through December 2015 and register today.
Benefits of Tort Reform Legislation Are Now Apparent
Three years after the North Carolina Medical Society (NCMS) was instrumental in pushing for landmark tort reform in North Carolina—including seeing it through an override of then-Governor Bev Perdue's veto—the benefits of the new law are apparent. The North Carolina Administrative Office of the Courts has released the most recent year’s data on the number of malpractice lawsuits, showing many fewer suits being filed. This is yet another example of how the NCMS' advocacy on your behalf has a major impact on how you practice medicine.
The North Carolina Lawyers Weekly recently wrote about the trend in malpractice cases, attributing the decline to the 2011 legislation. Read the article.
100 Legislative Days — With No End in Sight
Today marks the 100th day the North Carolina Legislature has been in session this year with no clear end in sight. The continuing resolution passed at the beginning of July to keep the government running absent a new state budget is set to expire on August 14. With no progress in resolving major differences between the House and Senate on issues like Medicaid reform, that deadline seems more and more unlikely to be met.
Lawmakers are in Raleigh and doctors who are interested in coming to visit them to discuss Medicaid or other issues of importance to your practice are encouraged to arrange a time. Because of the demand, we’ve expanded our White Coat Wednesday program to other days of the week to accommodate your busy schedule. Please visit www.ncmedsoc.org/wcw to learn more about how you can get involved at this key time.
In our effort to keep you apprised of what is going on at the General Assembly, our Director of Legislative Relations Chip Baggett, has been posting his "Bowtie Briefing" videos each Friday reviewing what happened in the past week and looking ahead to what lies ahead. Watch the last two briefings:
- “Medicaid Reform – the key question”
- Last Friday’s briefing on two bills destined for the Governor’s desk -- one on the composition of the North Carolina Medical Board, and the other protecting how you speak to your patients about firearms in the home.
If you’d like to receive "Bowtie Briefings" directly to your inbox each Friday, please let us know by sending your name and preferred email address to [email protected].
ICD-10 Is Going to Happen This Time -- Better Be Ready
In the final weeks before ICD-10 becomes the new coding reality on Oct. 1, the Centers for Medicare and Medicaid Services (CMS) and NCTracks, which processes Medicaid claims for the state, have been flooding the Internet with resources and answers to questions about the transition. Here is a partial compilation of what has been published recently to help you successfully navigate the change. To get the latest delivered directly to your inbox, subscribe to CMS messages and/or NCTracks email updates.
CMS has published Five More Facts About ICD-10, including what to do if you can’t submit ICD-10 claims electronically and what happens if you’re not ready on Oct. 1. Also check out their list of FAQs. If you’re a visual learner, CMS provides a video outlining the myths and common misperceptions about ICD-10. Watch “10 Facts About ICD-10.”
Mark your calendar for the CMS’ national provider call “Countdown to ICD-10” to be held on Thursday, Aug. 27, from 2:30-4 p.m. ET. It’s sure to be popular so register now. The call will open with a national implementation update. Then, Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will be joining us with coding guidance and tips, along with updates from CMS. The target audience includes physicians as well as office staff and coders.
If you haven’t even begun the process, CMS offers a Quick Start Guide, but hurry, time is running short.
For those who file Medicaid claims through NCTracks, the folks there offer the following information:
- The date of service determines whether you use ICD-9 or ICD-10 codes on the claim, regardless of when the claim is submitted. Submit an ICD-9 claim for dates of service before Oct. 1, and an ICD-10 claim for dates of service on and after Oct. 1.
- You can find the answer to many common ICD-10 questions on the ICD-10 Frequently Asked Questions (FAQ) page of the NCTracks Provider Portal.
- Claims with ICD-10 codes will be accepted by NCTracks beginning Oct. 1, 2015, and no sooner, per federal mandate.
- ICD-9 codes and ICD-10 codes cannot be used on the same claim. However, claims with ICD-9 codes and claims with ICD-10 codes can be submitted in the same batch.
- Registration is now open for an instructor-led ICD-10 training course for providers. The same course is being offered on multiple dates in August 2015. This course will be taught via WebEx and can be attended remotely from any location with a telephone, computer and internet connection. The WebEx will be limited to 115 participants. The course will be offered on:
Wednesday, August 12 – 9 to 9:45 a.m.
Friday, August 21 – 2 to 2:45 p.m.
Friday, August 28 – 10 to 10:45 a.m.
Enrollment Instructions:
Providers can register for this course in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The course can be found in the sub-folder labeled ILTs: Remote via WebEx. Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort. The Provider Training page also includes a quick reference regarding Java, which is required for the use of SkillPort.
Understand the Proposed Medicare Physician Fee Schedule
The North Carolina Medical Society’s (NCMS) Director of Health Policy Jennifer Gasperini has thoroughly reviewed the proposed changes to the Medicare Physician Fee Schedule and summarized the major changes on the Quality Time with NCMS webpage. If you’ve already registered on the NCMS website, simply log on. If not, please create an account so you can access Jennifer’s analysis.
More Resources Available for Specialists Interested in ACOs
The latest cohort of Toward Accountable Care (TAC) guides are now available on the TAC website:
- Accountable Care Guide for Hospitalists
- Accountable Care Guide for Internal Medicine
- Accountable Care Guide for Nephrologists
- Accountable Care Guide for Orthopaedists
Funding remains for six additional guides. At this point, we are looking at developing accountable care guides for: rheumatology, pulmonology, dermatology, ophthalmology, rural health providers, and local health directors.
In addition, we are working with the Texas Medical Association to convert the guides to webinars with CME. We will let you know once these new resources are available.
2015 MAC Satisfaction Indicator Survey -- Please Share Your Opinions!
There is still time to share your views on Palmetto GBA, but don't delay since the survey will close soon. The Centers for Medicare and Medicaid Services (CMS) would like your opinion. If you haven't already completed the MAC Satisfaction Indicator (MSI) survey, please take a moment to complete it now. Share your experience with the services we provide. It will take about 10 minutes. The CFI Group is conducting this survey on behalf of the CMS.
Medicare and Medicaid Turn 50 Tomorrow
On July 30, 1965, President Lyndon Johnson signed legislation amending the Social Security Act and establishing Medicare for the elderly and Medicaid for low-income adults, children, pregnant women and people with disabilities. These programs transformed the delivery of health care in the United States.
To commemorate this 50th anniversary, the Centers for Medicare and Medicaid Services (CMS) will share daily facts and posts on Twitter (@cmsgov) and Medicaid.gov, CMS will highlight people and places representing the Medicare and Medicaid programs over the years. CMS will engage in conversations with beneficiaries, providers and health experts. They invite the public to participate by sharing stories of how Medicare and Medicaid have made a difference. Share your story.
Here is some of the media coverage of the milestone:
Medicare and Medicaid Mark A Milestone, The Washington Post, 7-20-15
Medicaid Turns 50 Mired in Controversy, USA Today, 7-15-15
The Kaiser Family Foundation has published this report on the programs at their half century mark, “Medicare and Medicaid at 50.”
Where the NCMB Stands on MOL and CME
The following article is from the North Carolina Medical Board (NCMB)
The topic of how best to ensure the continued competence of medical professionals over the course of their careers remains an area of active and, at time, heated discussion among stakeholders nationally and in North Carolina.
For many years, the NCMB, like other state medical boards, has encouraged ongoing competence among its licensees through requirements that compel physicians and physician assistants to earn a certain number of hours of practice relevant continuing medical education (CME). Over the last several years, however, discussion among leaders in medical regulation has turned toward a different approach that emphasizes continuing education linked to specific areas of practice, assessment of knowledge gaps and measurement of improvement and outcomes. This approach is generally known as maintenance of licensure (MOL).
Although it has no plans to establish an MOL-based program in North Carolina, the NCMB has participated in national conversations regarding MOL in the past and has thoroughly considered the proper place, if any, it has in medical regulation. Many licensees are understandably concerned at the prospect of new, rigorous MOL requirements being adopted in North Carolina, and the NCMB continues to field occasional questions on the Board’s current position on the matter.
This article is offered as clarification of the Board’s current position o MOL and CME.
Maintenance of Licensure
What is maintenance of licensure? As defined by the Federation of State Medical Boards (FSMB), MOL is “a continuous professional development for physicians that supports, as a condition for license renewal, a physician’s commitment to lifelong learning that is relevant to their area of practice and contributes to improved health care.” The FSMB adopted an MOL framework in 2010 to guide state medical boards interested in adopting MOL programs.
What would an MOL program consist of? At the most basic level, MOL programs require licensees to demonstrate their commitment to lifelong learning and continued professional development. States that pursue MOL are free to determine the specific ways for licensees to do this. The FSMB has established an MOL resource center that state medical boards may, but are not required to, access as they make adjustments to their efforts to ensure continued competence among licensees.
Will the NCMB establish MOL requirements for licensees? Establishing MOL, either as a condition of initial licensure or license renewal, is not under consideration in North Carolina. In the years leading up to and shortly after the adoption of the FSMB’s MOL framework, the NCMB studied, considered and discussed whether MOL made sense for North Carolina. In November 2011 the Board voted not to pursue MOL in the state, and the issue has not been reopened since that time.
Current continued competence requirements in NC
North Carolina continues to encourage licensees to maintain their competence through earning CME hours. The Board amended regulations regarding CME in 2012, eliminating the obligation to report Category 2 CME hours while maintaining the requirement for physician licensees to complete a minimum of 60 Category 1 hours relevant to the licensee’s area of practice.
The 2012 CME rule changes established exemptions for certain licensees, including those physicians who are currently engaged in a program of recertification or maintenance of certification (MOC) through an ABMS, AOA or RCPSC specialty board. These licensees are exempt from reporting CME to the NCMB for the three year cycle in which they are involved in recertification/MOC. Physicians who have been “grandfathered” or awarded lifetime certification by an ABMS, AOA or RCPSC specialty board do not qualify for the exemption and will be required to report CME.
This exemption was created to reduce the administrative burden on physicians who choose to participate in a recognized MOC program. At no time has the Board contemplated requiring participation in a MOC program as a condition of licensure.
Consider Applying to Our Pilot Health Care Leadership and Management Program
The Kanof Institute for Physician Leadership has begun accepting applications for the pilot of its new Health Care Leadership and Management program. The program launches at the end of August and is designed to minimize the number of days out of the office. It is a pilot so there is no tuition, although there will be hotel and travel expenses. The only requirement is North Carolina Medical Society membership. (Join here.) If you or one of your colleagues is interested, please contact Erin Grover or call 919-833-3836 x134.
Now Accepting Resolutions for HOD Consideration
In accordance with the North Carolina Medical Society (NCMS) Bylaws, all resolutions to be considered by the House of Delegates at its Annual Meeting on October 23-24, 2015 must be submitted at least forty-five (45) days before the first meeting of the House of Delegates. The deadline for submission of resolutions this year is September 8, 2015.
All resolutions from component medical societies, sections or medical specialty organizations must bear the signature of two officers of each respective organization. Otherwise, the resolution will need to be submitted by an individual delegate. Resolutions arriving after the deadline will be considered late resolutions, and in order to be considered the business of the House will have to be presented by a delegate at the first session of the House of Delegates for approval by two-thirds of the delegates present at the meeting of the House of Delegates and meet the criteria for late resolutions (i.e., urgency and importance to the goals and objectives of the NCMS). Late resolutions should be submitted no later than 5 p.m. on Wednesday, October 22.
All resolutions should be mailed to Robert W. Seligson, EVP/CEO, NCMS, PO Box 27167, Raleigh, NC 27611 and submitted electronically to Abbey Ruggiero at [email protected]. For more information, contact Abbey via email at [email protected].
Weigh-in Today With Your Thoughts on Obesity As a Disease
Robert Carels, Ph.D., MBA, a professor and the Director of Clinical Training for the Clinical Health concentration of the Health Psychology doctoral program in the Psychology Department at East Carolina University, seeks the opinions of those medical professionals who treat obese patients on the American Medical Association’s recent decision to label obesity a disease. The survey will take approximately 5-10 minutes to complete and has been approved by ECU’s IRB. Your responses are completely anonymous.
Take the survey.
In the News
Another Health Care Data Breach, USA Today, 7-25-15
What the Anthem-Cigna Merger Means for North Carolina Policies, Triangle Business Journal, 7-24-15
VA Has 41,500 Unfilled Medical Jobs Forcing Vets Into Costly Private Care, USA Today, 7-23-15
Good News, Bad News In Medicare Trustees Report, Kaiser Health News, 7-23-15
Senate Panel Will Push HHS To Delay Stage 3 MU Rules, ModernHealthCare, 7-23-15
Got Scribes? Study Says They Could Make ED Testing More Exact, ModernHealthCare, 7-22-15
Blog: Can Medical Devices Be Hacked Like Remote Controlled Cars?, ModernHealthCare, 7-22-15
Giving Doctors Grades, The New York Times, 7-21-15
North Carolina Health Systems Consider Starting Insurance Plans, ModernHealthCare, 7-21-15
The ProPublica Report Card: A Step In the Right Direction, An Ounce of Evidence (health policy blog of Harvard physician, Ashish Jha), 7-20-15.
A Revolution in How Doctors Are Getting Paid Isn't Really Changing How Doctors Are Paid, The Washington Post, 7-20-15
Medicare and Medicaid Mark A Milestone, The Washington Post, 7-20-15
Vaccinemakers Have Fingers Crossed for This Flu Season, ModernHealthCare, 7-16-15
Re-Emergence of Ebola in Liberia Remains a Mystery, USA Today, 7-16-15
Report: ACA Plans Have a Third Fewer Providers Than Employer Based Plans, The Washington Post, 7-15-15
Medicaid Turns 50 Mired in Controversy, USA Today, 7-15-15
Learning Opportunities
Palmetto GBA will host the next Part B Ask the Contractor Teleconference: ICD-10 -- Are You Ready? on Aug. 13, 2015, from 10 to 11 a.m. This call is intended for Part B providers and their billing staff billing for services rendered in North Carolina. This call will focus on helping providers prepare for the implementation of mandatory use of ICD-10 codes on Oct. 1 and will not teach providers how to code using ICD-10.
Medicare Learning Network (MLN) Connects will hold a National Provider Call: Countdown to ICD-10, Thursday, Aug. 27, from 2:30 to 4 p.m. to register, visit MLN Connects Event Registration. Space may be limited, register early. As of Aug. 27, it will be five weeks before ICD-10 implementation on Oct. 1, 2015. Sue Bowman from the American Health Information Management Association (AHIMA) and Nelly Leon-Chisen from the American Hospital Association (AHA) will offer coding guidance and tips, along with updates from CMS.
Move to Value Summit, the ultimate primer on value-based health care will be held at Biotech Place in Winston-Salem, Aug. 27-28. Hosted by CHESS Health Enablement Soutions and sponsored by Wake Forest Baptist Health and LabCorp, the Move to Value Summit is designed to provide you with a broad and deep understanding of what it takes to transform your fee-for-service-dependent organization to one rooted in pay-for-value. Learn more and register.
Registration is now open for NCHICA’s 21st Annual Conference & Exhibition on September 13-16, 2015 at Pinehurst Resort in Pinehurst, NC. This year’s theme is Transforming Healthcare from Volume to Value. The conference provides an excellent opportunity to learn about the latest developments and best practices in health IT and network with your peers. For further details, click here. The registration fee is $475 NCHICA members/$675 non-members. For further details, click here. Fees will increase after August 13, so please register early! NCHICA has a special group rate at the Pinehurst Resort of $205/night, which is good until August 13, 2015. For further details on how to register at the special rate, click here.
The North Carolina Coalition Against Domestic Violence is having a Screening Training for physicians and their medical teams/staff on Sept. 18, 2015 in the Raleigh/Durham area. Topics will include best practices for intimate partner violence screening in clinical settings. More information and to register.
The North Carolina Industrial Commission will hold its 20th Annual North Carolina Workers' Compensation Educational Conference on October 14-16, 2015 at the Raleigh Convention Center. The conference provides a valuable opportunity for professionals to share information on current issues impacting the workers' compensation arena. View the conference brochure, which includes the conference agenda and registration information. For more information, please contact Jeanne Bush or Eric Oxfeld at the International Workers' Compensation Foundation office by telephone at (386) 677-0041, fax at (386) 677-0155, or e-mail at [email protected].
Carolinas Trauma Related Issues and Critical Knowledge Symposium (TRICKS) of Fracture Management, November 14, 2015, 8 am – 2 pm, Hilton Charlotte Center City Hotel, 222 E. 3rd St., Charlotte, NC 28202. For more information, call 704.512.6534 or visit the website.
The Mountain Area Health Education Center (MAHEC) fall course schedule is out. Find out what is being offered July through December 2015 and register today.
HEALTH ALERT: 18 Cases of Illness Due to Heroin Mixed with Clenbuterol
The North Carolina Division of Public Health (NC DPH) currently is investigating 18 cases of illness potentially due to use of heroin mixed with clenbuterol. Reported cases are from four counties (Durham, Lee, Orange, and Wake). The source of the clenbuterol-contaminated heroin is suspected to be in Durham County.
Clenbuterol is a potent beta-agonist not approved for human use in the United States. In the current outbreak, cases have reported symptoms atypical for heroin use, including a rapid onset of heart palpitations, dizziness, anxiety, vomiting, fainting, hypotension, shock and severe muscle cramping.
NC DPH and the Carolinas Poison Center offer this guidance for clinicians.
Submit Your Resolutions for Annual Meeting Now
In accordance with the North Carolina Medical Society (NCMS) Bylaws, all resolutions to be considered by the House of Delegates at its Annual Meeting on October 23-24, 2015 must be submitted at least forty-five (45) days before the first meeting of the House of Delegates. The deadline for submission of resolutions this year is September 8, 2015.
All resolutions from component medical societies, sections or medical specialty organizations must bear the signature of two officers of each respective organization. Otherwise, the resolution will need to be submitted by an individual delegate. Resolutions arriving after the deadline will be considered late resolutions, and in order to be considered the business of the House will have to be presented by a delegate at the first session of the House of Delegates for approval by two-thirds of the delegates present at the meeting of the House of Delegates and meet the criteria for late resolutions (i.e., urgency and importance to the goals and objectives of the NCMS). Late resolutions should be submitted no later than 5 p.m. on Wednesday, October 22.
All resolutions should be mailed to Robert W. Seligson, EVP/CEO, NCMS, PO Box 27167, Raleigh, NC 27611 and submitted electronically to Abbey Ruggiero at [email protected]. For more information, contact Abbey via email at [email protected].
Comparing the Medicaid Reform Bills and Where the NCMS Stands
With the General Assembly back in session after the July 4th break, Medicaid reform will once again be a hot topic of debate.
The comparison table below addresses the current House and Senate proposals for reforming North Carolina’s Medicaid program. This table outlines and compares major aspects of each Medicaid reform proposal and notes the North Carolina Medical Society’s position in each of these key areas.
View table.
Implementation of MACRA Has Started
Last week, the Centers for Medicare and Medicaid Services (CMS) released the first proposed update to the physician payment schedule since the repeal of the Sustainable Growth Rate through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The proposal includes a number of provisions focused on person-centered care, and continues to transform the Medicare program to a system based on quality and healthy outcomes.
In the proposed CY 2016 Physician Fee Schedule rule, CMS is also seeking comment from the public on implementation of certain provisions of the MACRA, including the new Merit-based Incentive payment system (MIPS).
The proposed rule includes updates to payment policies, proposals to implement statutory adjustments to physician payments based on misvalued codes, updates to the Physician Quality Reporting System, which measures the quality performance of physicians participating in Medicare, and updates to the Physician Value-Based Payment Modifier, which ties a portion of physician payments to performance on measures of quality and cost. CMS also is seeking comment on the potential expansion of the Comprehensive Primary Care Initiative, a CMS Innovation Center initiative designed to improve the coordination of care for Medicare beneficiaries.
The proposed rule also seeks comment on a proposal that supports patient- and family-centered care for seniors and other Medicare beneficiaries by enabling them to discuss advance care planning with their providers. The proposal follows the American Medical Association’s recommendation to make advance care planning services a separately payable service under Medicare.
The release of the rule triggers a 60-day comment period, during which time CMS welcomes the input of stakeholders and the public. A final rule will be published this fall. A fact sheet on the proposed rule. More information and the rule itself.
This is just the first in a series of opportunities to give feedback on the implementation of MACRA.
North Carolina Medical Society (NCMS) members have access to up-to-date information on a variety of quality of care initiatives on the “Quality Time With NCMS” webpage. [If you have not registered on our website, please do so to gain access to this page and its valuable resources and analysis. Simply click on the login button at the top right of the homepage.]
NCMS Helps Injured Workers Get The Medical Care They Need
Only two weeks have passed since the updated workers’ comp medical fee schedule took effect on July 1, 2015, so it’s too early to assess the impact the new fees will have on access to care for injured workers. The prognosis is good, however. The new fees likely will remove hesitation doctors may have had in the past when faced with fees that were set circa 1995. The North Carolina Medical Society (NCMS) was instrumental in modernizing this fee schedule and raising North Carolina's ranking among other states with workers’ comp medical fee schedules. In this letter to members, NCMS President Robert E. Schaaf, MD, FACR, describes how your Medical Society achieved this long-sought change and its potential impact on your practice. Read Dr. Schaaf’s letter to the NCMS membership.
DMA Details Changes to Payment of Crossover Claims
The North Carolina Division of Medical Assistance (DMA) today sent a letter to providers detailing changes to the payment of crossover claims for Qualified Medicare Beneficiaries (QMB). The North Carolina Medical Society (NCMS) is working to analyze what this means to you. Watch the Bulletin for details.
Read DMA's letter.
Resources Update: Just 77 Days Until ICD-10 Becomes a Reality
The Centers for Medicare and Medicaid Services (CMS) recently announced they will allow for flexibility in the claims auditing and quality reporting process, as the medical community gains experience using the new ICD-10 code set starting Oct. 1, 2015. The American Medical Association (AMA) had been calling for measures to mitigate the impact of the ICD-10 transition by implementing a transition period. During this ‘grace period’ physicians would not be penalized for coding errors and system malfunctions.
With CMS’ willingness to be flexible in the transition, CMS and AMA now are working together to make sure physicians and other providers are ready by educating providers through webinars, on-site training, educational articles, and national provider calls.
Free help from CMS includes the “Road to 10,” aimed specifically at smaller physician practices with primers for clinical documentation, clinical scenarios, and other specialty-specific resources to help with implementation. CMS has also released provider training videos that offer helpful ICD-10 implementation tips. See the ICD-10 website for more information.
The AMA also has a broad range of materials available to help physicians prepare for the Oct. 1 deadline. To learn more and stay apprised on developments, visit AMA Wire.
Here is more information on CMS’ ICD-10 resources as well as FAQs. And don’t forget CMS’ National Provider call, “Countdown to ICD-10” on Thursday, August 27, from 2:30 to 4 p.m. To Register: Visit MLN Connects Event Registration. Space may be limited, register early.
Palmetto GBA will host Part B Ask the Contractor Teleconference: ICD-10 - Are You Ready? on Aug. 13, 2015, from 10 to 11 a.m. This call is intended for Part B providers and their billing staff billing for services rendered in Virginia, West Virginia, North Carolina and South Carolina. This ACT call will focus on helping providers prepare for the implementation of mandatory use of ICD-10 codes on October 1, 2015. This call will not teach providers how to code using ICD-10.
The Physicians Foundation is promoting a free resource designed to help your practice make the transition. ICD10Charts.com was developed by a medical student who saw the need for such a resource while working in his father's medical practice.
ICD-10 Charts is a collection of innovative ICD-10 training resources that can help streamline your entire ICD-10 implementation process and save your practice a considerable amount of time and money during this transition. Desai has refined the software even more recently, making ICD-10Charts a most valuable tool to help you prepare. Watch a short informational video detailing how the site works.
In North Carolina, the Industrial Commission just posted their ICD-10 guidance as it relates to workers’ compensation claims:
“Beginning October 1, 2015, pursuant to N.C. Gen. Stat. § 97-26(g1) and in alignment with federal regulations, the applicable administrative standard for diagnosis code sets for medical billing and reporting in North Carolina workers’ compensation cases will transition to the International Classification of Diseases, 10th Edition, Clinical Modification and Procedure Coding System (ICD-10), from the 9th Edition (ICD-9).”
Read the full notice.
NCTracks continues to offer assistance to Medicaid providers in preparation for the transition to ICD-10. Here are some of their recent posts:
- Have a question about ICD-10 and NCTracks? Email [email protected]
- Take a walk on the NCTracks ICD-10 Crosswalk here.
- CPT codes aren't changing during the transition to ICD-10. Do you know the difference? One picture helps.
- Quick Start: A resource for any health care provider who needs help with ICD-10.
Watch for Info on NCMS By-Laws Updates
Soon we will post the proposed updates to the North Carolina Medical Society’s (NCMS) by-laws regarding the House of Delegates. Watch your email for when the proposed changes will be posted on our website for your review and comment.
Asheville Mix and Mingle Brings Together NCMS Members, Leadership
Last weekend, Asheville area physicians and physician assistants came together at the Highland Brewing Company to ‘mix and mingle’ and casually converse with North Carolina Medical Society (NCMS) Board members. The gathering is the latest in a series of NCMS events across the state aimed at bringing NCMS members together with the organization’s leadership to discuss issues of concern as well as to socialize and have a good time.
Thank you to the Western Carolina Medical Society for helping promote the Mixer to its members.
Watch the Bulletin for announcements about a ‘mix and mingle’ in your area.
