In the News
HHS Takes Strong Steps To Address Opioid-Drug Related Overdose, Death and Dependence, HHS Press Release, 3-26-15
Affordable Care Act Hasn't Overwhelmed Doctors, Study Finds, USA Today, 3-24-15
CDC: Uninsured Drop By 11M Since Passage of Obama's Law, The Associated Press, 3-24-15
VA Says It Will Relax 40 Mile Rule For Private Medical Care, The Associated Press, 3-24-15
American Doctors Are Killing Themselves and No One is Talking About It, The Daily Beast, 3-23-15
One Year Later, Ebola Outbreak Offers Lessons for Next Epidemic, The New York Times, 3-22-15
Health Care Systems Try to Cut Costs By Aiding the Poor and Troubled, The New York Times, 3-22-15
2015 Is Already the Year of the Health Care Hack -- And It's Only Going to Get Worse, The Washington Post, 3-20-15
Learning Opportunities
Behavioral Health and Faith Summit, April 16, 8:30 a.m. to 2:45 p.m., Greensboro College, 815 W. Market St., Greensboro. The goal is to bring those involved in both mental health and faith communities together to share ideas to promote mental wellness. Learn more. Register here.
MAHEC's Spring CE offerings:
February 19th – May 28: “MAHEC Motivational Interviewing for Health Care”
April 30: “Finding Stability: Management to Live Better with Parkinson Disease or Essential Tremor”
May 6-8: “MAHEC Women’s Recovery Conference”
May 8: "Healthcare Express Track"
May 12: “You’re Looking at Me Like I Live Here and I Don’t – A Unique Documentary About Living with Alzheimer’s and Post-Film Panel Discussion”
Save-the-Dates: June 3-6: “Southeast Pain Symposium”
Cleveland Clinic Florida’s 6th Annual Internal Medicine Review Board
Cleveland Clinic Florida would like assist Internal Medicine physicians and residents who are preparing to take their boards. They will be able take their boards with confidence by attending the 6th Annual Internal Medicine Board Review from May 30, 2015 – June 3, 2015 at the DoubleTree by Hilton in Sunrise, Florida. More info.
Workshop on Improving Geriatric Care through Collaboration
Duke Geriatric Education Center presents a three-part workshop on Improving Care Through Interprofessional Collaborative Practice, March 25, April 8 and April 22. 8:30 a.m – noon, Croasdaile Village Retirement Community, Durham. More information and register.
ICD-10 Success Dinner Event by athenahealth
Preparing Your Practice for ICD-10 Success, April 9, 6 p.m., Ritz Carlton, Charlotte, 201 East Trade Street
Few health care initiatives carry as great a potential for financial disruption: The number of ambulatory diagnosis codes will increase about fivefold, threatening your productivity and revenue flow. Please join athenahealth for this exclusive dinner event. More information and register.
Sixth Annual Addiction Medicine Conference, April 10-11, Asheville, Learn more and register.
Save the date -- June 12, 2015, for Go SIMple, an opportunity to learn about the hottest trends in simulation education from experts. The training session will be held at Campbell University College of Osteopathic Medicine in Lillington, NC.
SGR Update
The US Senate did not follow the House of Representatives and pass HB 2 last night leaving the sustainable growth rate (SGR) formula in place, at least for the moment. According to U.S. Sen. Richard Burr, Congress will likely take up the issue when they return from their spring recess on April 13. The current "patch" to forestall the scheduled 21 percent reduction in physician Medicare reimbursement is set to expire on April 1. Sources tell the North Carolina Medical Society (NCMS) that the Centers for Medicare and Medicaid Services (CMS) will hold paper Medicare claims for four weeks and electronic claims for 14 days until Congress either passes HB 2, which would repeal the SGR, or puts another "patch" in place to keep the reductions from taking effect.
Watch your email and the NCMS website for updates.
Congress is 'Half Way' to Repealing the SGR
Earlier today the U.S. House of Representatives passed H.R. 2, the “Medicare Access and CHIP Reauthorization Act,” by a substantial bipartisan margin—392 to 37. This legislation would end the sustainable growth rate (SGR) formula, used to calculate physicians’ Medicare payments, and would institute changes in the Medicare reimbursement structure.
“This bill replaces arbitrary cuts with actual reforms to ensure access to care for seniors and provide long-awaited certainty to the physicians who choose to serve our elderly population,” said U.S. Rep. George Holding, who represents areas around Raleigh and east to Wilson and Goldsboro.
Now attention turns to the Senate, where leadership will decide whether to take up the bill tonight following a lengthy series of planned votes on the budget resolution. It is still possible for H.R. 2 to pass both chambers of Congress before the April recess begins tomorrow morning. But, Senators will need to agree to an expedited process for that to occur.
Please help maintain the tremendous momentum created by the overwhelming House vote, by contacting your Senators and asking them to vote “yes” on H.R. 2 before adjourning for the April recess.
Call your senators using the AMA’s toll-free Grassroots Hotline: 1-800-833-6354. Visit FixMedicareNow to send an urgent message by email or social media.
House members were clearly proud of their bipartisan efforts to end the 17 years of ‘patches’ to extend the SGR.
“Don’t look now, but we’re actually governing,” said U.S. Rep. Renee Ellmers, whose North Carolina district includes areas west and south of Raleigh extending from High Point to Fayetteville, on the floor Thursday.
House Speaker John Boehner and House Minority Leader Nancy Pelosi had worked together to fashion this “historic bipartisan package,” as Pelosi termed it, over the last few months.
Congress needs to get the job done before March 31, when the latest SGR patch expires, and before their two-week spring recess, which starts next Thursday. If the clock runs out without any legislation being passed, doctors will face a 21 percent reduction in Medicare payments come April 1.
Share your thoughts below....
NCMS Library Dedicated in Honor of Medical School Supporters
A special ceremony was held on Friday, March 20, to dedicate the library at the North Carolina Medical Society Center for Leadership in Medicine in honor of all five medical schools in North Carolina—Campbell University School of Osteopathic Medicine; the University of North Carolina School of Medicine; Duke University School of Medicine; the Brody School of Medicine at East Carolina University and the Wake Forest School of Medicine. Each school contributed $25,000 toward the renovation of the NCMS’ headquarters building in downtown Raleigh.
“The role of the state’s medical schools in training those who will lead our profession into the future is crucial. It is one that we at the NCMS truly support,” Dr. Robert Schaaf, FACR, the current NCMS President told the intimate gathering of the society’s leadership and the deans from four of the state’s five medical schools. “This gathering to honor your generous contribution to our headquarters, also marks what we know will be our continuing collaboration, as together we help shape the future of health care in North Carolina.”
The event was particularly significant because the NCMS is the oldest professional society in the state, founded in 1849 when a group of doctors came together to protect patients from those who had no formal scientific training, but were passing themselves off as ‘doctors.’ Since its inception, the NCMS has always advocated for and supported the educational mission of the state’s medical schools.
Dr. Paul Cunningham, Dean of the Brody School of Medicine at ECU, and also a member of the NCMS Board of Directors, addressed the group of assembled dignitaries from his dual perspective as a medical educator and a leader of the state’s professional society.
“During my tenure on the NCMS Board, I see great synergies between our objectives at Brody and the goals and objectives of the Medical Society,” he said. “These are times of great change in our health care system. It is incumbent on both our medical education programs and our professional organizations to lead and shape the change that is underway. This gathering is a testament to our ability to support each other and work together for the greater good.”
The NCMS Center for Leadership in Medicine, located just three blocks from the General Assembly in downtown Raleigh, was completely renovated over the past two years to provide a focal point and gathering place for the state’s physicians and other organizations in the health care community to address the multitude of issues facing the health care system today and in the future.
The shelves of the library dedicated on Friday include volumes dating back to the mid-19th century, tracing the history of the NCMS, which has protected the patients of North Carolina and promoted the profession of medicine for 166 years.
As Dr. Dev Sangvai, NCMS’ Immediate Past President, summed up: “The NCMS and each of the medical education programs in North Carolina have an unprecedented opportunity to come together to lead the profession through an exciting, but daunting time in health care. Through open dialogue and consistent communication, we truly are leadership in medicine.”
To view more images from this event, please visit the NCMS's Facebook page.
National Call to Action: Repeal the SGR
If you want the Medicare Sustainable Growth rate (SGR) to end, today is the day to make your voice heard.
The AMA has organized a National Call to Action Day today, Tuesday, March 24. Please join your colleagues in North Carolina and across the country by calling your US Representatives and Senators and urge them to eliminate the flawed SGR formula.
Last week, lawmakers in both the U.S. House of Representatives and U.S. Senate introduced bills, H.R. 1470 and S. 810, consistent with the policies established in last year's bipartisan, bicameral Medicare payment reform bill. Congressional leaders are working together to finalize the legislation. Both the House and Senate must vote on the proposal this week, before the March 31 expiration date of the current patch, or physicians will be facing a 21 percent Medicare payment cut.
Do your part: Participate in National Call to Action Day
Contact your senators and representatives and urge them to support H.R. 1470 and S. 810 in any of the following ways:
- Call your lawmakers using the AMA's toll-free Physicians Grassroots Hotline at 1-800-833-6354.
- Send an urgent email to your lawmakers reinforcing the need for SGR repeal now.
- Contact legislators directly through their own social media channels, and share your message with your own Facebook friends and Twitter followers.
To bolster your message use these talking points. Visit the Fix Medicare Now website for additional information on effort to repeal SGR and improve Medicare for our nation's seniors.
Read about the provisions of the bipartisan bill at AMA Wire.
NCMS Foundation Seeks Rural Providers for ACO Opportunity
The North Carolina Medical Society (NCMS) Foundation seeks to identify rural providers interested in learning more about developing an Accountable Care Organization (ACO).
The Centers for Medicare & Medicaid Services (CMS) recently announced a new funding opportunity specifically for rural providers. CMS wants to encourage providers to form Medicare Shared Savings Program (MSSP) ACOs in rural areas and areas with low ACO penetration. The ACO Investment Model (AIM) program will provide upfront and monthly funding for eligible ACOs to participate in the MSSP beginning in 2016. The upfront and monthly per member/per month (PMPM) will provide funds to develop the infrastructure needed for population health management.
The MSSP was established to improve the quality of care for Medicare Fee-For-Service beneficiaries by promoting accountability for their care, requiring coordinated care for any service provided under Medicare FFS and encouraging investment in infrastructure and redesigned care processes. MSSP also aims to reduce unnecessary costs. Providers, hospitals and suppliers that either create or participate in an ACO may participate in this program. Those ACOs that lower their rising health care costs and simultaneously put patients first and meet performance standards on quality of care will be rewarded by the MSSP. Click here to learn more about MSSP.
The NCMS Foundation has been working diligently over the past several years to foster development of value-driven health care models and ACOs through its Toward Accountable Care (TAC) Consortium and Initiative and the NC ACO Collaborative as well as at the General Assembly. This rural ACO initiative is the latest effort. Learn more about it here.
CMS Announces Next Generation ACO
The Centers for Medicare & Medicaid Services (CMS) Innovation Center introduced the “Next Generation Accountable Care Organization” model of payment and care delivery on March 10, 2015. This initiative is for ACOs experienced in coordinating care for populations of patients and will allow these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and Medicare Shared Savings Program (MSSP). The goal of the Model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for original Medicare fee-for-service (FFS) beneficiaries. Learn more about the program and how you might participate here.
Is Repeal of the SGR Finally Possible This Year?
With a flurry of editorials and intense lobbying efforts in Washington, DC, hope springs eternal for repeal of the Sustainable Growth Rate (SGR) this year. The latest “patch,” enacted last year to forestall the deep reductions in Medicare reimbursements, will expire on March 30, giving Congress just a few more weeks to repeal the SGR once and for all this year.
Over 750 medical societies, including the North Carolina Medical Society (NCMS) signed on this week to a letter to Speaker John Boehner, urging the repeal. Read that letter here.
Last year, Congress came the closest it ever had to a repeal, with bipartisan, bicameral support. The hope is that the momentum created with that legislation will carry the repeal over the finish line this Congress.
A major concern has been the cost of repealing the SGR, but for many years Congress always stopped the SGR cuts and therefore, the SGR never took effect. SGR savings to the federal government are therefore non-existent and repealing the SGR portion would cost nothing. Of course, Congress should pay for the new payment system and the new bonus payments contained in the proposed legislation, but they don’t need to pay for the SGR repeal itself.
Read more about the bill and what lawmakers like North Carolina US Representative Renee Elmers are saying and feel free to add your voice to those urging the legislators in Washington, DC to repeal.
Bouncing the “Doc Fix,” The Wall Street Journal, 3-16-15
Medicare: Time for Congress to Repeal and Replace the Sustainable Growth Rate Formula, FoxNews, 3-16-15
Funding for National Health Service Corps Set to Expire
Founded in 1972, the National Health Service Corps (NHSC) was designed to bring primary care health workers to the most underserved communities of the country. In exchange for their medical expertise, the Corps helps these professionals alleviate debt accumulated during the course of their education, much like the North Carolina Medical Society (NCMS) Foundation’s Community Practitioner Program, which uses private funds.
In 2010, the Affordable Care Act created a trust fund to support the NHSC for five years. Over the course of the last five years, Congress has cut funding several times, leaving the program completely dependent on the trust fund account, which is set to expire this year. If this happens, North Carolina would lose funding for the positions outlined in the chart below.
CHCs |
NC |
National |
|
Non-Psychiatrist Physician (MD/DO) |
30 |
70 |
2,230 |
Nurse Practitioner |
22 |
41 |
1,762 |
Physician Assistant |
20 |
73 |
1,379 |
Dentist (DDS/DMD) |
37 |
29 |
1,316 |
Licensed Professional Counselor |
0 |
6 |
1,115 |
Licensed Clinical Social Worker |
5 |
8 |
1,047 |
Health Service Psychologist |
1 |
17 |
752 |
Psychiatrist (MD/DO) |
1 |
3 |
247 |
Dental Hygienist |
0 |
7 |
245 |
Nurse Midwife |
0 |
3 |
193 |
Marriage and Family Therapist |
0 |
0 |
172 |
Psychiatric Nurse Specialist |
0 |
0 |
39 |
Total |
116 |
257 |
10,497 |
Learn more about the program and its funding here. This fact sheet also is helpful to understand the NHSC and its mission.
The Association of Clinicians for the Underserved (ACU) launched a campaign in 2013 to save this valuable program from elimination. Learn more about the campaign.
Cast Your Vote for NC Doctor of the Year
Ten finalists for the NC Doctor of the Year Award, were announced on Monday, March 16. Now is the time to cast your vote for the one doctor who you think should receive the NC Doctor of the Year Award from among this distinguished group of physicians who represent a variety of specialties and come from across the state. Read about each finalist and learn about NC Doctors Day at www.ncdoctorsday.org and cast your online vote. Encourage your friends and colleagues to do the same. The person with the most votes will be announced on Doctors Day, March 30. The North Carolina Medical Society (NCMS) is the lead sponsor of NC Doctors Day and will donate $5,000 to the winner to be used toward furthering their professional mission.
The following finalists were selected from a field of over 120 nominations submitted by patients and colleagues in February.
Dr. Ogie Asemota, Pediatrics, Fayetteville
Dr. Alan Carlson, Opthalmalogy, Durham
Dr. Lisa David, Plastic Surgery, Winston-Salem
Dr. Edgardo Diez, Physical and Rehabilitative Medicine, Asheville
Dr. Ben Fischer, Internal Medicine, Raleigh
Dr. Gloria Graham, Dermatology, Morehead City
Dr. Mark Heffington, Family Medicine, New Bern
Dr. Rene Herlong, Pediatric Cardiology, Charlotte
Dr. Joseph Murad, OB-Gyn, Greenville
Dr. Maureen Murphy, Family Medicine, Concord
NC ACO Collaborative Draws Crowd to Raleigh
On Thursday, March 5, members of the NC ACO Collaborative packed the auditorium of the North Carolina Medical Society (NCMS) Center for Leadership in Medicine in Raleigh for the first of its twice- yearly meeting. The gathering brings together ACOs, aspiring ACOs, ACO participants and other interested parties like the representatives from the State Health Plan, the NC Department of Medical Assistance and vendors. The Collaborative has grown in attendance as those associated with this burgeoning model of care seek to share their experiences and look for ways to collaborate and support each other. A sub-group of the Collaborative also has formed for ACOs that are participating in the Medicare Shared Savings Program (MSSP) to address issues particular to that program.
John Meier, MD, and Ray Coppedge, Executive Director, both of Key Physicians in Raleigh, shared information about their ACO and fielded their colleagues’ questions. Melanie Phelps, Deputy General Counsel for the NCMS and Associate Executive Director of the NCMS Foundation and the person who convenes the NC ACO Collaborative, gave a brief overview of the current status of ACOs in North Carolina. Bo Bobbitt, a partner at Smith Anderson law firm in Raleigh, who has spearheaded development of a variety of toolkits for doctors interested in ACOs, provided an update on recent initiatives and announcements by the Centers for Medicare & Medicaid Services (CMS). CMS and national health insurers have accelerated the move toward value-based arrangements and have signaled their commitment to this approach through a variety of new funding opportunities. View the PowerPoint slides.
The next meeting of the ACO Collaborative is tentatively set for Thursday, September 17, at the NCMS Center for Leadership in Medicine in Raleigh. If you are interested in attending, please contact Melanie Phelps or call her at 919-833-3836.
NCMS Hosts Successful NC Medical Group Managers Advocacy Conference
For its 2015 Advocacy Days Conference, the North Carolina Medical Group Managers Association convened this week at the NCMS Center for Leadership in Medicine. The conference was attended by a strong contingent of advocacy-oriented medical practice leaders from across North Carolina. Cam Cox of MSOC Health and NCMGMA’s Advocacy Liaison moderated the event.
Tuesday’s packed agenda opened with a presentation by Chip Baggett, NCMS Director of Legislative Relations, in which Chip highlighted the need for effective messaging on the looming 3% retro-cut in Medicaid. The afternoon also featured appearances by former state senator Eric Mansfield, MD; Becki Gray of the John Locke Foundation; Adam Linker of the NC Health Access Coalition; and Dr. Robin Cummings, Director of North Carolina Medicaid.
Discussions covered a host of different hot topics in health care, including Medicaid reform, Medicaid expansion, the state’s certificate of need program, and scope of practice.
The managers returned Wednesday morning for a briefing by NCMS staff on the day’s legislative calendar, and they then ventured to the General Assembly to meet with legislators and attend committee meetings. This was the first year the event was held entirely at the NCMS facility, and we hope to host again in years to come!
Don’t Miss Meaningful Use Attestation
March 20 is the last day to attest to meaningful use for the Medicare EHR Incentive Program’s 2014 reporting year. This extended deadline does not affect deadlines for the Medicaid EHR Incentive program. Attesting by the deadline will ensure you earn an incentive payment, if applicable, and avoid the Meaningful Use penalty which will be applied in 2016 (based on 2014 performance).
Understanding the criteria for participating in the various Medicare quality programs is of critical importance, as penalties will be applied to those who do meet the prescribed requirements. Visit our new members-only webpage dedicated to quality issues—“Quality Time with the NCMS” at https://www.ncmedsoc.org/quality—to learn more about the criteria, and how to avoid these penalties, which could cost you up to 11% in total of your Medicare reimbursements in future years.
Gain a Better Understanding of the MOST Form With These Online Courses
The North Carolina Medical Society (NCMS) Foundation in conjunction with the North Carolina Partnership for Compassionate Care are sponsoring a two-part E-learn course to help you get a better understanding of the MOST form and how it ties into advance care planning. To learn more about the Partnership and these courses, click here.
- Register for “Understanding MOST: Part 1“ (Why MOST is an essential tool for knowing and honoring patient wishes at the end of life) – $10 registration fee.
- Register for “Understanding MOST: Part 2“ (Completing the MOST form) – $10 registration fee.
Wanted: Nominations for NCMS & AMA Leadership Positions
The Nominating and Leadership Development Committee is seeking nominations from physician members for NCMS leadership positions that will become vacant in 2015. The deadline for receiving all nominations is July 1. If you are interested in serving in the following positions, please submit your nomination form to Devdutta G. Sangvai, MD, Chair of the Nominating and Leadership Development Committee, NCMS, PO Box 27167, Raleigh, NC 27611-7167.
NCMS BOARD OF DIRECTORS:
- Officers
- President-Elect (1-year term)
- Region and At-Large Members (3-year term)
- Region 1 Representative (1) (incumbent eligible for re-election)
- At-Large Member (1) (incumbent eligible for re-election)
OTHER POSITIONS:
- AMA Delegates (3) (2-year term) (incumbents eligible for re-election)
- AMA Alternate Delegate (1) (2-year term) (incumbent eligible for re-election)
The NCMS Board of Directors is seeking nominations for the following positions. If you are interested in serving in these positions, please submit your nomination form and resume to Robert E. Schaaf, MD, President, NCMS, PO Box 27167, Raleigh, NC 27611-7167.
- North Carolina Medical Care Commission (1) (4-year term) (incumbent eligible for re-election)
- North Carolina Commission for Public Health (2) (4-year term) (incumbents eligible for re-election)
NOMINATING AND LEADERSHIP DEVELOPMENT COMMITTEE (6) (2-year term)
The Committee strives to identify, attract, and develop the most competent physician leadership in the Society.
- Region 1 (1) (incumbent not eligible for re-election)
- Region 2 (1)
- Region 3 (2)
- Region 4 (2) (One incumbent not eligible for re-election)
Region 1 includes:
Beaufort, Bertie, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Currituck, Dare, Duplin, Edgecombe, Gates, Greene, Halifax, Hertford, Hyde, Jones, Lenoir, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Tyrrell, Washington, Wayne, Wilson
Region 2 includes:
Alamance, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Franklin, Granville, Guilford, Johnston, Lee, Montgomery, Orange, Person, Randolph, Rockingham, Stokes, Vance, Wake, Warren
Region 3 includes:
Anson, Bladen, Cabarrus, Cleveland, Cumberland, Gaston, Harnett, Hoke, Lincoln, Mecklenburg, Moore, Richmond, Robeson, Sampson Scotland, Stanly, Union
Region 4 includes:
Alleghany, Alexander, Ashe, Avery, Burke, Buncombe, Caldwell, Catawba, Cherokee, Clay, Graham, Haywood, Henderson, Iredell, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rowan, Rutherford, Surry, Swain, Transylvania, Watauga, Wilkes, Yadkin, Yancey
To obtain a nomination form for any of the above positions, please contact Abbey Ruggiero at (800) 722-1350 or by email at [email protected]
In the News
Supreme Court Ruling On Affordable Care Act Could Leave Thousands In North Carolina Without Insurance, The Fayetteville Observer, 3-15-15
Funding, Focus Lacking for Health Care That Gets Results, USA Today, 3-15-15
Wake County EMS Has One Solution to Overcrowded Emergency Rooms, The Raleigh News & Observer, 3-14-15
Progress Is Slow At VA Hospitals In Wake of Crisis, The New York Times, 3-13-15
VA Manager Helped Pick Relative's Property for New Health Center, The Washington Post, 3-13-15
Efforts To Instill Empathy Among Doctors Is Paying Dividends, Kaiser Health News, 3-12-15
Experts Call For Tobacco Free World and Raising Legal Age for Cigarettes, The Los Angeles Times, 3-12-15
Campbell School of Medicine Becomes First in NC To Receive Emergency Medicine Residency Approval, Triangle Business Journal, 3-11-15
Experts: New ACO Model Positive for Physicians, Family Practice News, 3-11-15
The Ugly Civil War In American Medicine, Newsweek, 3-10-15
FDA Heads Into Uncharted Waters of Biosimilar Drugs, Kaiser Health News, 3-10-15
Supreme Court Justices Split in Key Challenge To Obamacare Subsidies, The Washington Post, 3-4-15
Learning Opportunities
NCMS Plan Free Wellness Webinar: Using the Six Principles of Influence to Optimize Employee Health
Tuesday, March 24, 2015 | 12:00-12:45pm
Influencing others, even towards positive behavior change, is often a challenge, which is why it's valuable to understand the psychological principles behind human motivation and behavior. The NCMS Plan is pleased to welcome Patty Purpur de Vries, Director, Stanford Health Promotion Network and Wellness Manager, Stanford Health Care and Stanford Children’s Health, as part of the continued Practice Wellness webinar series designed to assist practice managers with effectively planning, developing, implementing, and measuring a successful wellness program. Register now online.
Meaningful Use Stage 2 Requirements Free Webinar
The North Carolina Medical Society Foundation in cooperation with the North Carolina Medical Group Managers invite you to join them for a webinar overview of Meaningful Use Stage 2 Requirements in 2015 on March 25, from noon to 1 p.m. This webinar is free but you must be registered to attend. Space is limited so register today online.
ICD-10 Classes
The Centers for Medicare and Medicaid Services (CMS) is scheduling introductory ICD-10 classes in Eastern North Carolina designed for physicians, practice managers, billing managers, and others who need help in transitioning from ICD-9 to ICD-10. These are free, in-person classes, not webinars.
- Rocky Mount, Wednesday, March 25, 3-4 p.m. Register for Rocky Mount
- New Bern, Thursday, March 26, 8-10 a.m. Register for New Bern
- Wilmington, Thursday, March 26, 1:30-3:30 p.m., Registration for Wilmington
CMS is actively looking for hospitals or facilities to host an ICD-10 event in the Hickory/Highpoint area on March 25. To host a meeting, you need to have a meeting room with AV equipment that will hold at least 40 people and have free or low-cost parking for guests. If you can offer to host a class, please write Keith Gilliam.
MAHEC's Spring CE offerings:
February 19th – May 28: “MAHEC Motivational Interviewing for Health Care”
March 24: “Practical Matters in Dementia Care”
April 30: “Finding Stability: Management to Live Better with Parkinson Disease or Essential Tremor”
May 6-8: “MAHEC Women’s Recovery Conference”
May 8: "Healthcare Express Track"
May 12: “You’re Looking at Me Like I Live Here and I Don’t – A Unique Documentary About Living with Alzheimer’s and Post-Film Panel Discussion”
Save-the-Dates: June 3-6: “Southeast Pain Symposium”
Workshop on Improving Geriatric Care through Collaboration
Duke Geriatric Education Center presents a three-part workshop on Improving Care Through Interprofessional Collaborative Practice, March 25, April 8 and April 22. 8:30 a.m – noon, Croasdaile Village Retirement Community, Durham. More information and register.
ICD-10 Boot Camp
ICD-10 Boot Camp, NCMGMA's General Code Set Training, March 26 & 27, 2015, 8 am – 5 pm, Women's Educational Center, Greensboro, NC. This intensive 2-day, 16-hour, General Code Set Training is designed specifically for coding staff and intended to give attendees a comprehensive understanding of guidelines and conventions of ICD-10 as well as fundamental knowledge of how to decipher, understand and accurately apply codes in ICD-10. This Training is approved for 16 CEUs through AAPC. Get more information and register.
ICD-10 Success Dinner Event by athenahealth
Preparing Your Practice for ICD-10 Success, April 9, 6 p.m., Ritz Carlton, Charlotte, 201 East Trade Street
Few health care initiatives carry as great a potential for financial disruption: The number of ambulatory diagnosis codes will increase about fivefold, threatening your productivity and revenue flow. Please join athenahealth for this exclusive dinner event. More information and register.
Sixth Annual Addiction Medicine Conference, April 10-11, Asheville, Learn more and register.
Save the date -- June 12, 2015, for Go SIMple, an opportunity to learn about the hottest trends in simulation education from experts. The training session will be held at Campbell University College of Osteopathic Medicine in Lillington, NC.
NCMS Works To Repeal 3 Percent Retroactive Medicaid Reimbursement Cut
The North Carolina Medical Society (NCMS) Government Affairs staff is working with key legislators to repeal the 3 percent retroactive cut to Medicaid reimbursements. In August 2014, the General Assembly mandated a 3 percent cut to physician payments to be effective retroactively to Jan. 1, 2014. The 3 percent reduction in physician payments going forward started on Monday, March 2. The recoup of payments for the last 14 months, however, has not yet been implemented.
In a statement released to the media on Monday, when the NC Department of Health and Human Services began the 3 percent reduction in payments going forward, NCMS President Robert E. Schaaf, MD, FACR, stated: “North Carolina’s physicians are preparing for an unprecedented retroactive payment cut on services already provided to Medicaid patients over the last 14 months….requiring these medical practices to pay back 3 percent of what the state has already paid them…would wreak havoc with the finances of these businesses.”
As part of the effort, hundreds of NCMS members responded thus far to our call to contact their legislators to ask them to repeal this unnecessary and ill-advised retroactive take back of money paid for services provided to the state’s most vulnerable population. Review talking points (PDF) with examples of how medical practices throughout the state would be affected by such a retroactive cut help make the case.
Take action and contact your legislator.
Huge Win On Workers’ Comp Medical Fee Schedule
After years of work by the North Carolina Medical Society’s (NCMS) staff and Workers’ Comp Task Force and negotiations with a wide variety of stakeholders, a new workers’ comp medical fee schedule was unanimously approved by the Rules Review Commission on February 19, 2015. The new schedule will take effect July 1, 2015, and bring North Carolina back on par with our neighboring states and the rest of the nation.
“The new fee schedule means huge progress for our state’s injured workers, the physicians who treat them, and our workers’ compensation system as a whole. The old physician fee schedule – which has not been maintained since its adoption in 1995 – offers physicians some of the worst rates across the country. This has taken a toll on physician participation, making medical care more difficult for workers to find and more expensive for employers,” said NCMS President Robert E. Schaaf, MD, FACR in a statement to the press. “The North Carolina Medical Society has worked tirelessly for many years on behalf of all physicians to secure these fee schedule revisions. We applaud Chairman Heath’s leadership in bringing all of the stakeholders together to locate common ground and for implementing a positive solution.”
The NCMS along with other stakeholders and the state agencies that oversee the workers’ comp program had worked for several years to establish a fee schedule that successfully ensures injured workers can receive the care they need; medical providers are compensated at reasonable rates; and medical costs remain adequately contained. The old fee schedule had grown stale since its adoption in the mid-1990s, and no longer struck the necessary balance. The new schedule successfully balances these interests.
The Industrial Commission issued a press release after the new fee schedule was adopted and several media outlets ran news stories including this article in the Winston-Salem Journal.
Medicaid Recredentialing Period Extended
The NC Division of Medical Assistance (DMA) has changed the length of time required before a provider must recredential in NCTracks, the Medicaid claims processing system, from three years to five years. The North Carolina Medical Society (NCMS) applauded the move, which became effective on February 18, 2015. For several years, the NCMS had been calling for such a change to help ease the administrative burden on those physicians and physician assistants who accept Medicaid patients. This new timeframe also means the $100 recredentialing fee will be due every five years.
NCTracks notified clinicians that if your current due date for recredentialing is 10/1/2015, your new due date will be 10/1/2017. For new providers who enroll in NCTracks, the due date for recredentialing will automatically be set to 5 years. Providers who currently are recredentialing will complete the process already underway and then the due date for their next recredentialing will be set to five years from the approval date. Providers who have received a letter notifying them that recredentialing is due soon, but have not yet started the recredentialing process, should disregard the letter. Your recredentialing due date will be extended for two more years.
DMA is required to recredential physicians and physician groups to ensure their information is up-to-date and accurate.
NCMS President Meets with White House Staff
North Carolina Medical Society (NCMS) President Robert E. Schaaf, MD, FACR and NCMS CEO Robert W. Seligson were in Washington, D.C. last week to discuss policy issues like reforms to the Medicare Recovery Audit Program (RAC), repeal of the Sustainable Growth Rate, meaningful use, implementation of ICD-10 and ensuring that any increases in compliance or reporting burdens on physicians are accompanied by commensurate payment increases and not penalties. They spoke with experts including Tim Gronniger, senior adviser on health care policy for President Obama.
“We had access to staffers who have the ear of the President and key Congressional leadership on these issues,” Seligson said. “We were able to make our case on these important topics to people who can really make a difference in policy debates.”
In addition to the White House visit, Seligson and Schaaf also spent time on Capitol Hill, discussing policy with Kristin Welsh, Deputy Health Policy Director for the US Senate Finance Committee; Brett Baker and Matt Hoffman, staffers for the Subcommittee on Health for the House Ways and Means Committee and Emily Murry, senior policy advisor to the House Majority Leader.
As part of the AMA Advocacy Conference, which brings together the leadership of nine other medical societies in addition to NCMS, Seligson and Schaaf also visited the offices of North Carolina Senator Richard Burr, Representatives David Price and George Holding and Representative Alma Adams.
While repeal of the SGR and meaningful reform of the RAC audit program have yet to be decided, rest assured that NCMS’ positions on these issues have been clearly and forcefully communicated to those who can make a difference in our nation’s capital.
Supreme Court’s Ruling Will Have Repercussions
The US Supreme Court ruled on Feb. 25 that the North Carolina Dental Board illegally suppressed competition when it told non-dentists to stop offering teeth-whitening services at mall kiosks.
The 6-3 decision came in the case of North Carolina Board of Dental Examiners v. Federal Trade Commission. The FTC had deemed the dental board's actions an illegal suppression of competition. It's common for states to establish regulatory boards consisting of members of the profession being regulated.
“Today’s decision by the Supreme Court runs contrary to the time-tested regulatory model used nationwide by states to regulate the learned professions. The decision focuses narrowly on antitrust law, not on the broader and far more important issue of protecting the public through effective regulation of medical practice,” said Stephen Keene, the North Carolina Medical Society’s (NCMS) General Counsel and Deputy Executive Vice President for Government Affairs and Health Policy.
Going forward, state professional regulatory boards like the North Carolina Medical Board may seek out more state supervision or change the makeup of their boards because of the decision. The AMA, which had filed a ‘friend-of-the-court’ brief in support of the Dental Board’s position, said after the Supreme Court’s ruling that it will work with physician groups to reinforce antitrust protections for activities conducted under state authority to protect patients.
“The AMA agrees with Justice Alito, speaking for the three dissenting justices, that today's decision 'will spawn confusion' by creating far-reaching effects on the jurisdiction of states to regulate medicine and protect patient safety,” AMA President Robert Wah said in the AMA’s statement.
Watch future Bulletins for more information on how this decision will play out in North Carolina.
CMS Extends Deadline for Meaningful Use and Some PQRS Measures
The Centers for Medicare and Medicaid Services (CMS) is giving physicians an extra three weeks to attest they have made "Meaningful Use" of electronic health records, the agency announced Wednesday.
"Eligible professionals now have until 11:59 p.m. ET on March 20, 2015, to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year," CMS said in a press release. "CMS extended the deadline to allow providers extra time to submit their meaningful use data. CMS continues to urge providers to begin attesting for 2014 as soon as they can." The original deadline for attestation was Feb. 28.
"Meaningful Use" refers to provisions in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which authorized incentive payments through Medicare and Medicaid to clinicians who use electronic health records (EHRs) in a meaningful way to significantly improve clinical care.
CMS also extended until March 20 the deadline for certain types of data submission for the Physician Quality Reporting System (PQRS) program. That extension applies to "EHR Direct or Data Submission Vendor that is certified EHR technology (CEHRT), [and] Qualified clinical data registries ... reporting for PQRS and the clinical quality measure (CQM) component of meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program," the agency said in a statement Wednesday.
PQRS provides an incentive payment to individual eligible professionals (EPs) and group practices that satisfactorily participate or satisfactorily report data on quality measures for covered Medicare Physician Fee Schedule (PFS) services. Additionally, those who do not meet the 2014 PQRS reporting requirements will be subject to a negative payment adjustment on all Medicare Part B PFS services rendered in 2016.
For questions, please contact the QualityNet Help Desk 1-866-288-8912 or via email at [email protected] from 7 a.m. - 7 p.m. Central Time. Complete information about PQRS is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html
The North Carolina Medical Society (NCMS) also has staff well-versed in attesting for Meaningful Use and the various quality reporting requirements. Contact Terri Gonzalez, Director of Practice Improvement, or Jennifer Gasperini, Director of Health Policy with questions.
Another useful resource is this list of qualified registries for Meaningful Use.
Tanning Bed Legislation Introduced In Honor of Rep. Jim Fulghum
Legislation introduced in the North Carolina General Assembly to prohibit children from using indoor tanning beds has been named after a doctor and legislator who supported the bill before passing away from cancer last year.
The Jim Fulghum Teen Skin Cancer Prevention Act memorializes the former Republican state representative and neurosurgeon from Wake County who was an early and strong supporter of the tanning bed legislation. The proposal, introduced in the both the state House and Senate, prohibits children under 18 from using indoor tanning beds.
“Part of our family’s healing process includes finding ways to continue to support Jim’s work in the legislature and in the community,” wrote Fulghum’s widow, Dr. Mary Susan Fulghum, in a letter sent to legislators this week. “Toward that end, our family has agreed to allow the North Carolina Dermatology Association, the American Cancer Society and other highly-respected groups to memorialize him in legislation to protect children from the threat of skin cancer caused by indoor tanning beds.”
Senators Wesley Meredith (R-Cumberland) and Tommy Tucker (R-Union) and representatives Donny Lambeth (R-Forsyth) and Nelson Dollar (R-Wake) are the lead sponsors of the legislation.
Meredith also has a personal connection to the dangerous effects of melanoma. His first wife, Michelle, passed away as a result of melanoma skin cancer when she was 24 years old. February marked the 25th anniversary of her death.
“I support this legislation because I have seen, up close, how dangerous melanoma can be," Meredith said. “I also support the legislation because, like similar laws restricting access to tobacco and alcohol, I believe children deserve protection from risks they are too young to fully understand and parents need the help these laws provide to keep their children safe.”
The introduction of the tanning bed legislation comes on the heels of the U. S. Surgeon General’s national “Call to Action” on skin cancer last year, which included reducing the harm from indoor tanning as a major goal. According to the report, nearly 5 million people in the U.S. are treated annually for all skin cancers combined, at an annual estimated cost of $8.1 billion. Melanoma is responsible for the most deaths of all skin cancers, with nearly 9,000 Americans dying from it annually. About $3.3 billion of annual skin cancer treatment costs are attributable to melanoma.
A coalition of North Carolinians supports the legislation, including: the American Cancer Society Cancer Action Network, North Carolina Advisory Committee on Cancer Coordination and Control, North Carolina Child Fatality Task Force, North Carolina Dermatology Association, North Carolina Medical Society, North Carolina Oncology Association, North Carolina Pediatric Society and AIM at Melanoma.
In addition, the American Suntanning Association, an industry trade group, and Planet Beach, one of the country’s largest tanning franchises, announced their support for the North Carolina bill last year.
For more information, visit www.preventskincancernc.org, on Facebook at Preventskincancernc.org or on Twitter at @BantheTanNC.
Sangvai Selected As Presidential Leadership Scholar
Devdutta G. Sangvai, MD, MBA, the immediate past president of the North Carolina Medical Society (NCMS), a 2004 alumnus of the NCMS Foundation Leadership College and associate chief medical officer at Duke University Health Systems, has been selected to be a member of the inaugural class of Presidential Leadership Scholars. This unique leadership development initiative draws upon the resources of the U.S. presidential centers of Lyndon B. Johnson, George H.W. Bush, William J. Clinton and George W. Bush. Dr. Sangvai is one of only 60 individuals nationwide to be chosen to participate from among 900 applicants.
These 60 scholars demonstrated their desire and capacity to take their leadership strengths to a higher level in order to help their communities and our country. The program began on Feb. 24, 2015, at Mount Vernon, George Washington’s home, and will span a 6-month period during which the scholars will travel to each participating presidential center to learn from former presidents, key administration officials and leading academics and put into practice varying approaches to leadership, develop a network of peers and exchange ideas with mentors and others who can help them make an impact in their communities.
The program is non-degree bearing, and entails approximately 100 hours of informative sessions and case studies, and covers expansive approaches to leadership theory, drawing upon examples from recent presidents. The curriculum draws from presidential center archives and resources related to leadership moments from each administration. It includes insights from how each president addressed pressing challenges and benefits from the participation of President George W. Bush and President William J. Clinton. It also relies upon in-depth analyses of how leaders across all sectors address similar types of challenges.
“I’m honored and excited to participate in this unique experience,” Sangvai said. “I look forward not only to the content of the courses, but also to learning from my fellow scholars. This is an opportunity of a lifetime. I intend to make the most of it personally and bring back innovative ideas and methods to help improve health care in North Carolina.”
ICD-10 Preparedness: Are You Ready?
NCTracks Survey
The survey of NCTracks users on whether they are ready for ICD-10 implementation this October shows that of the 1,500 who responded the majority have taken steps to prepare, although 35 percent have not yet started the process. The most common reasons giving for not beginning to get ready for this change are: other priorities/competing projects; not enough staff/resources; don’t know enough about it.
In its email report on the survey results, NCTracks said they “hope to see these numbers improve” and plan to send out additional surveys as October gets closer. Other survey results revealed that:
- 33 percent of respondents have not received ICD-10 information from their billing vendor
- 25 percent do not know if their practice management software is compliant
- 36 percent are uncertain if they will be ready for ICD-10 by October 1
CMS Completes Successful ICD-10 Testing
Marilyn Tavenner, administrator for the Centers for Medicare and Medicaid Services (CMS), announced CMS successfully completed a week of end-to-end testing of new ICD-10 coding. Approximately 660 providers and billing companies nationwide submitted nearly 15,000 test claims between January 26 and February 3. Overall, participants were able to successfully submit ICD-10 claims and have them processed through CMS billing systems.
“This successful week of testing continues to put us on course for successful implementation of this important initiative that better reflects modern practice of medicine by Oct. 1, 2015,” Tavenner said.
Tavenner also sought to clarify that everyone must use ICD-9 for services provided before the October 1 deadline and ICD-10 for services provided on or after October 1, 2015. That means ICD-10 can be used only for test purposes before October 1. And, only ICD-10 can be used for doctor’s visits and other services that happen on or after October 1. ICD-9 cannot be used to bill for services provided on or after October 1. This rule applies no matter when the claim is submitted, so claims submitted after October 1, 2015, for services provided before that date must use ICD-9 codes. These rules and others around adopting ICD-10 apply to all health care providers, not just those who accept Medicare or Medicaid.
CMS is offering other testing opportunities if your practice would like to participate.
ICD-10 Resources
Fact sheet on ICD-10.
CMS website cms.gov/ICD-10, offers many resources, including the Road to 10 tool, designed especially for small medical practices.
CMS has released two animated shorts, less than 4 minutes each that explain key ICD-10 concepts:
“Introduction to ICD-10 Coding” gives an overview of ICD-10’s features and explains the benefits of the new code set to patients and to the health care community.
“ICD-10 Coding and Diabetes” uses diabetes as an example to show how the code set captures important clinical details.
CQ’U’ Deadline Extended Until Friday -- Apply Now!
The deadline to apply to participate in the Clinical Quality track (CQU) of the North Carolina Medical Society Foundation’s Kanof Institute for Physician Leadership has been extended until this Friday, March 6. Act now to join this program in order to learn how quality is driving the changes in our health care system and acquire the necessary tools to lead and succeed in this new environment.
As a physician you understand the need to keep abreast of the latest treatment advances in order to help your patients. Shouldn’t your ability to proactively shape your practice environment be just as important to your professional life – and ultimately to the welfare of your patients?
CQU can help ease the discomfort of the changes underway, and position you to take a leadership role in shaping those changes as they affect your practice.
Some facts about the program:
- 12-month program starting in the spring of 2015.
- Sessions consist of a mix of face-to-face learning at the North Carolina Medical Society (NCMS) Center for Leadership in Medicine in Raleigh, NC, as well as webinars and coaching.
- Participate in teams of three members (teams consists of at least one physician and two additional staff members of their choosing). Physicians and PA’s must be NCMS members.
Problem Solved -- More Info on the Controlled Substances Reporting System
If you need an answer or a problem solved regarding your practice, as a North Carolina Medical Society (NCMS) member you have access to our Solution Center Coordinator, Belinda McKoy, who is standing by to help you solve the problem or answer your question. Call (919-833-3836 x142) or email Belinda the next time you need a problem solved.
Here is a common question Belinda receives:
Q: Where can I find more information on the Controlled Substances Reporting System (CSRS)?
A: The official website for the CSRS is through the NC Department of Health and Human Services at: http://www.dhhs.state.nc.us/MHDDSAS/controlledsubstance/index.htm
If You're Near the NCMS On March 26, Consider Donating Blood
In March, the North Carolina Medical Society (NCMS) community service team has invited the Rex Bloodmobile to our headquarters in downtown Raleigh, 222 N. Person Street, and we invite any NCMS members in the area to sign up to donate blood on Thursday, March 26, between 9 a.m. and 1 p.m. Sign up here or contact Erin Grover. All donors will receive “Donate For Life” points, snacks and refreshments! Read more about the Rex Bloodmobile and the importance of donating blood.
UNC Needs You To Help Assess the NC Medicaid Lock-In Program
The University of North Carolina’s Injury Prevention Research Center (IPRC) is conducting an evaluation of the NC Medicaid Lock-In program (MLIP). An assessment of this program is critical to understanding whether this policy is having the desired effect of reducing costs and improving patient care. Findings will have important implications for building an evidence base for other states using MLIPs or similar programs, as well as improvements to the NC program.
UNC IPRC is interested in hearing from providers who have cared for “Locked In” Medicaid patients. You may qualify, if you:
- Are currently a licensed medical provider practicing in NC
- Accept Medicaid billing
- Have patients currently or previously enrolled in the NC MLIP
Providers who complete a brief phone interview will be entered into a drawing to win a $100 gift certificate. There will be 5 winners! Each responding provider will have an equal chance of receiving the gift certificate.
You will be asked to complete a very short interest survey online (link below) and then a brief, 20 minute phone interview at a prearranged time that is convenient for you. These interviews will explore constructs that relate to patient enrollment and changes in patient service utilization or prescriber/dispenser practices.
Read this brief fact sheet for more information about this study. All data will be presented in aggregate and all information shared by you will remain confidential.
If you fit the criteria listed above and are interested in participating in this study, please visit this secure link to sign up.
If you have any questions about this study, please contact Asheley Skinner or 919.843.9941.
Thank you for your time and consideration.
Total Merchant Services Offer NCMS Members Special Benefits
Total Merchant Services (TMS) has been the NCMS’ preferred payment system provider for the last six years, offering North Carolina Medical Society (NCMS) members state-of-the-art, PCI Compliant, Smart Card Ingenico terminals at no cost (a $795 value). Additionally, TMS offers NCMS members many levels of benefits. Here are just a few:
- Through NCMS preferred pricing, TMS will guarantee the lowest rate.
- TMS does not require any monthly, annual or multi-year contract.
- TMS will reimburse NCMS dues $125 annually. This is an annual benefit paid each throughout the life of the practice partnership with TMS.
- There is no cost for the equipment and you are not required to rent or purchase it. TMS processing equipment is high speed or dial up, secure and Smart Card ready.
- Pin Debit Capability to insure the lowest transaction fees.
- Turn-Key installation with Staff Training and excellent customer support.
- $300.00 sign up bonus for Partnering with Total Merchant Services in 2015!
Contact Susan Bobo for a complimentary analysis of your payment processing today, or call her at 919.345.5042.
In the News
Injured Workers Suffer As 'Reforms' Limit Workers' Compensation Benefits, NPR, 3-4-15
US Faces 90,000 Doctor Shortage by 2025, Medical School Association Warns, The Washington Post, 3-3-15
Poll Explores Our Perception of How Factors Large And Small Shape People's Health, NPR, 3-2-15
If Supreme Court Rules Against Obamacare, States Have Few Options, The Los Angeles Times, 3-2-15
Veterans Propose Major Changes In VA Health Care, USA Today, 2-26-15
Supreme Court Is Deciding A Case That Could Derail Obamacare. Here's What You Need To Know, The Washington Post, 2-26-15
Mississippi Emerges as Leader in Telemedicine, Politico, 2-26-15
Anthem Data Breach Will Affect 775K in NC, Raleigh News & Observer, 2-24-15
ECU Medical School Wants More State Funding, Raleigh News & Observer, 2-23-15
Doctors Say Data Fees Are Blocking Health Reform, Politico, 2-23-15
Physician Assistant Positions Climb in Demand and Appeal, North Carolina News Network, 2-21-15
North Carolina Among Top States for ACA Enrollment, The Charlotte Observer, 2-20-15
Learning Opportunities
NCMS Plan Free Wellness Webinar: Using the Six Principles of Influence to Optimize Employee Health
Tuesday, March 24, 2015 | 12:00-12:45pm
Influencing others, even towards positive behavior change, is often a challenge, which is why it's valuable to understand the psychological principles behind human motivation and behavior. The NCMS Plan is pleased to welcome Patty Purpur de Vries, Director, Stanford Health Promotion Network and Wellness Manager, Stanford Health Care and Stanford Children’s Health, as part of the continued Practice Wellness webinar series designed to assist practice managers with effectively planning, developing, implementing, and measuring a successful wellness program. Register now online.
The March MLN Connects™ National Provider Call, which provides an overview of how to report once across various 2015 Medicare Quality Reporting Programs, including the Physician Quality Reporting System (PQRS), Medicare Electronic Health Record (EHR) Incentive Program, Value-Based Modifier (VM), and Medicare Shared Savings Program, will be held on Wednesday, March 18, 2015 from 1:30 – 3 p.m.
This MLN Connects Call is being evaluated by CMS for CME and CEU continuing education credit (CE). Refer to the call detail page for more information.
For additional details and to register, please visit MLN Connects™ Upcoming Calls. Registration will close at 12:00 p.m. Eastern Time on the day of the call or when available space has been filled.
The Centers for Medicare and Medicaid Services (CMS) is scheduling introductory ICD-10 classes in Eastern North Carolina designed for physicians, practice managers, billing managers, and others who need help in transitioning from ICD-9 to ICD-10. These are free, in-person classes, not webinars.
- Rocky Mount, Wednesday, March 25, 3-4 p.m. Registration info to be announced
- New Bern, Thursday, March 26, 8-10 a.m. Register for New Bern
- Wilmington, Thursday, March 26, 1:30-3:30 p.m., Registration for Wilmington
CMS is actively looking for hospitals or facilities to host an ICD-10 event in the Hickory/Highpoint area on March 25. To host a meeting, you need to have a meeting room with AV equipment that will hold at least 40 people and have free or low-cost parking for guests. If you can offer to host a class, please write Keith Gilliam.
MAHEC's Spring CE offerings include:
February 19th – May 28: “MAHEC Motivational Interviewing for Health Care”
March 13-14: “Everything Has Changed: New Prevention & Management Recommendations in Primary Care”
March 24: “Practical Matters in Dementia Care”
April 30: “Finding Stability: Management to Live Better with Parkinson Disease or Essential Tremor”
May 6-8: “MAHEC Women’s Recovery Conference”
May 8: "Healthcare Express Track"
May 12: “You’re Looking at Me Like I Live Here and I Don’t – A Unique Documentary About Living with Alzheimer’s and Post-Film Panel Discussion”
Save-the-Dates: June 3-6: “Southeast Pain Symposium”
Duke Geriatric Education Center presents a three-part workshop on Improving Care Through Interprofessional Collaborative Practice, March 25, April 8 and April 22. 8:30 a.m – noon, Croasdaile Village Retirement Community, Durham. More information and register.
ICD-10 Boot Camp, NCMGMA's General Code Set Training, March 26 & 27, 2015, 8 am – 5 pm, Women's Educational Center, Greensboro, NC. This intensive 2-day, 16-hour, General Code Set Training is designed specifically for coding staff and intended to give attendees a comprehensive understanding of guidelines and conventions of ICD-10 as well as fundamental knowledge of how to decipher, understand and accurately apply codes in ICD-10. This Training is approved for 16 CEUs through AAPC. Get more information and register.
Sixth Annual Addiction Medicine Conference, April 10-11, Asheville, Learn more and register.
Save the date -- June 12, 2015, for Go SIMple, an opportunity to learn about the hottest trends in simulation education from experts. The training session will be held at Campbell University College of Osteopathic Medicine in Lillington, NC.
Take Action
In 2013, the NC General Assembly included a 3% “withhold” for all Medicaid services with the intention of using that money as the foundation of a shared-savings program. After difficulty developing the program, the “withhold” was redrafted as a cut the following year with an effective date of January 1, 2014. That cut has not been implemented due to delays in NCTracks.
Doctors treating Medicaid patients now face a requirement to pay back 3% of everything they have been paid by Medicaid for the last 14 months. Every day that passes increases this financial and administrative burden. We know this money has already been spent on staff salaries, office overhead, and other basic requirements of serving the Medicaid population.
Call or email your representative/senator and tell them how much you will have to send back to Medicaid, and what it will mean to you and your practice. Tell your legislator that you cannot afford a massive recoupment at the same time as you are being asked to transform the entire way we deliver health care to the Medicaid population.
Take Action Now >>
NOTE: Primary care physicians who received enhanced Medicaid payment rates in accordance with the ACA will not be subject to the 3% reduction in 2014. However, those same PCPs will be subject to the reduced rates and a recoupment of payments made for January and February 2015 dates of service.
NCMS Reports From the Legislature
NCMS’ Medicaid Reform Guiding Principles
Medicaid reform is our top priority this session, and dialogue continues at the General Assembly on what would constitute the most sensible approach to reform. The NCMS steadfastly supports accountable care organizations (ACOs) as the foundation of any change. Some legislators still insist that importing managed care corporations is the best option for the state and show a strong reluctance to maintaining “risk” of budget over-runs in the Medicaid program, favoring capitation instead of any shared savings approach. As the debate continues, the NCMS has outlined several guiding principles to help shape meaningful and sustainable change around the ACO approach. For instance:
- While cost reduction is an important goal, the primary goal must be improved quality of care for each Medicaid patient.
- ACOs are modeled on integrated care delivery. They empower physicians to work in teams with other providers to care for individual patients. This allows doctors, and all members of the team, to function at their fullest capacity for the good of their patients. ACOs incentivize everyone to work together.
- Since doctors have the clinical expertise to know what makes sense for their patients, physicians need to be included in the operational governance structure as well as the clinical governance structure. Legislators, government administrators and corporate bureaucrats do not know what makes sense clinically. We want to ensure physicians have a prominent place in improving Medicaid since they know what’s reasonable and how to achieve it clinically.
- Much discussion has revolved around whether—and how—to segment the state into regions to better track and administer a Medicaid program. Our position is that carving out exclusive regions in which certain providers would care for certain Medicaid recipients is counter to the idea of homegrown competition. We say, allow Medicaid ACOs to emerge in the same way Medicare has promoted ACOs nationwide.
- Finally, the linchpin to this whole scenario is data. To be successful, claims data and clinical data need to be side-by-side to make meaningful comparisons. Luckily, the tool to do this already exists in the NC Health Information Exchange (NC HIE). The legislature needs to continue to support the NC HIE.
We ask for your support to keep you, the physician, in the driver’s seat of care delivery in Medicaid by supporting shared savings and ACO reform models as an alternative. We also ask for your feedback. Please send your thoughts to NCMS Solution Center Specialist Belinda McKoy.
Projected State Budget Shortfall This Fiscal Year: $271m
Top state economists told lawmakers on Feb. 12 that they expect North Carolina will face a $271 million budget shortfall this fiscal year, which ends June 30. That represents a modest 1.3 percent deficit that state reserves and/or spending cuts can handle fairly readily. But its cause—lagging personal income tax payments (5.8 percent below budget projections) resulting from sluggish wage growth across North Carolina—is a signal that the state’s economic recovery is not yet as robust as anticipated, the economists told legislators.
However, with the state’s unemployment rate dropping now steadily, wages should start climbing during the next fiscal year, said the economists from the legislature’s Fiscal Research Division and Gov. McCrory’s Office of State Budget and Management. The state’s fiscal situation will be clearer by early May, after April’s final surge of state income tax payments have been recorded, they noted. For now, the disappointing state revenue receipts could make legislators less likely to consider much additional program funding, further significant tax cuts, or new or expanded economic-development tax incentives as they begin their discussions on adjusting the state’s $21 billion budget.
Meanwhile, the state’s revenue trends are positive, predicted to finish at a modest 2.9 percent growth rate for the current fiscal year—just not the 4 percent legislators expected when they adopted the budget last summer. And the budget picture includes some bright spots:
- Sales tax receipts are 2.3 percent ahead of expectations.
- Business taxes, including corporate income and franchise taxes, are up 5.7 percent.
Review the state economists’ revenue and budget presentation.
Governor’s State of the State Address
Governor Pat McCrory delivered his State of the State Speech to the General Assembly on February 4. The Governor did speak about a “partnership with doctors” and making North Carolina “an excellent place for doctors to practice medicine.” Watch the 4-minute segment of his address, which focuses on health care.
Dr. Runge Presents NCMS Guiding Principles on Medicaid Reform to NC MCC
The NCMS was recently invited to present its views on Medicaid reform to the NC Medical Care Commission (MCC). The MCC develops regulations for health facilities and is a conduit for tax-exempt bond financing for non-profit health facilities in this state. NCMS Board member Jeffrey W. Runge, MD, made the presentation (PPT file) and answered questions from the MCC members on February 11, 2015. On February 18, the MCC issued the following statement on Medicaid reform (PDF).
PAI Advocates Reform of Medicare RAC Program
The Physicians Advocacy Institute (PAI) recently sent comments to the chair of the Health subcommittee of the House Ways and Means Committee, outlining critically needed reforms to the Medicare Recovery Audit Contractor (RAC) program. North Carolina Medical Society (NCMS) CEO Robert W. Seligson serves as PAI's President and signed the letter to Rep. Kevin Brady.
Since its inception eight years ago, PAI has focused considerable attention on helping physicians navigate the audit process more effectively, including providing tools to help them avoid common coding and documentation errors, which are often identified in audits. Still, the current RAC audit process is fundamentally flawed. In his letter, Seligson outlines five significant problems as well as policy recommendations and draft legislative language for reform of the program. Read the letter.
NCMS' involvement with PAI offers NCMS members a strong platform to advocate for meaningful reform of federal programs. The mission of PAI is to advance fair and transparent payment policies and contractual practices by payers and others in order to sustain the profession of medicine for the benefit of patients. Visit the PAI website.
Is This Finally the Year To Repeal the SGR?
Once again it’s time to attempt to push Congress to repeal the Sustainable Growth Rate (SGR) formula. Few legislative days remain before the current Medicare physician payment patch expires on March 31, 2015. If Congress does not pass Medicare physician payment reform by its self-imposed deadline, we will be confronting an 18th payment patch.
Over the years, a lack of consensus was an obstacle to reform of this flawed approach; questions were raised about what kind of payment system should replace the sustainable growth rate (SGR) formula. That problem was resolved last Congress, when a bipartisan, bicameral bill was developed and passed by the three committees with jurisdiction over Medicare. The hard work done in the last Congress has not been lost; support for the underlying policies that would be established by these bills remains. The only obstacle remaining for this new Congress to pass H.R. 4015/S. 2000 is reaching agreement on budget offset issues.
President Obama’s 2016 budget released this month, reiterate calls made in previous budgets to eliminate the SGR and calls for "reforming Medicare physician payments in a manner consistent with the reforms included in recent bipartisan, bicameral legislation."
The AMA is asking members of Congress to urge the leadership to engage in a bipartisan, bicameral dialogue so that we can all put the SGR behind us and start down the road to real Medicare reform. Please consider contacting your US representative or senator. The AMA has provided talking points and FAQs to help guide the discussion.
Get Up to Speed on the Open Payments Program
The Centers for Medicare and Medicaid Services (CMS) is providing opportunities for physicians to learn about the Open Payments program in order to understand what information is being reported about your financial relationships with pharmaceutical or health care manufacturing companies.
These relationships can include money for research activities, gifts, speaking fees, meals, or travel. The Social Security Act requires CMS to collect information from applicable manufacturers and group purchasing organizations (GPOs) in order to report information about their financial relationships with physicians and hospitals. Open Payments is the federally run program that collects the information about these financial relationships and ultimately makes it available to the public.
An audio conference originally presented on January 15, is now available on the Events page of the Open Payments website. Listeners are provided with highlights of the recent data refresh, an overview of what’s to be expected for the 2014 program year, and an opportunity to hear the questions and answers recorded during the original presentation. Also, answers to general questions asked about the 2014 reporting year during the Q&A can be found in the 20 minute Open Payments Program Overview and Enhancements – Video Tutorial.
CMS plans to conduct these sessions regularly each month, and will announce upcoming calls at least a week in advance.
For more information, please visit the Open Payments website and sign up for the Open Payments listserv. If you have any questions, you can submit an email to the Help Desk at [email protected].
Live Help Desk support is available by calling 1-855-326-8366, Monday through Friday, from 7:30 a.m. to 6:30 p.m. (CT), excluding Federal holidays. Peak Help Desk call time is between 11:00 a.m. and 2:00 p.m. (CT), although average wait time is usually short even during peak call time.
ICD-10 Updates & Resources
GAO Reports CMS Is Prepared for ICD-10
The U.S. Government Accountability Office (GAO) issued a report last week indicating that the Centers for Medicare and Medicaid Services (CMS) is adequately preparing for ICD-10 implementation to go ahead on October 1, 2015. The report provides an overview of CMS activites related to the ICD-10 transition and indicates that both Medicare and Medicaid agencies have taken the appropriate steps.
Senate Finance Committee Chairman Orrin Hatch (R-Utah) noted, "While additional testing will be needed to ensure its success, the transition to the new system will streamline the management of healthcare records and improve patient care. I will continue to keep a close eye on this issue but see no reason for any delay past the October deadline."
ICD-10 Basics
Basic resources are a great place to start if you are looking for background information on the ICD-10 transition. These resources feature overviews tailored by audience, including small and rural practices, payers, and non-covered entities.
- The ICD-10 Transition: An Introduction
- ICD-10 Basics for Medical Practices
- ICD-10 Basics for Small and Rural Practices
- ICD-10 Basics for Payers
- The ICD-10 Transition: Focus on Non-Covered Entities
Communicating About ICD-10
Communication between health care providers, software vendors, clearinghouses, and billing agents is vital to a successful transition. Learn how to get the conversation started with these resources:
- Talking to Your Vendors About ICD-10: Tips for Medical Practices
- Questions to Ask Your Systems Vendors about ICD-10
- The Role of Clearinghouses in ICD-10
- Talking to Your Customers About ICD-10: Tips for Software Vendors
Road to 10
Available on the Provider Resources page of the CMS website, the "Road to 10" tool is an online resource built with input from providers in small practices. Intended to help small medical practices jumpstart their ICD-10 transition, "Road to 10" includes specialty references and the capability to build tailored action plans.
Medscape Education Modules
CMS has released two videos and an expert column to help providers prepare for ICD-10. These Medscape education modules offer an overview of ICD-10 for small practices. Continuing medical education (CME) and nursing continuing education (CE) credits are available to providers who complete these resources. Anyone with a free Medscape account can receive a certificate of completion. You can find these resources on the Provider Resources page.
Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare and sign up for CMS ICD-10 Industry Email Updates.
At the state level, NCTracks also is available to answer your ICD-10 Questions
From now until ICD-10 goes live in October, you can send your ICD-10 questions and comments to [email protected]. They say you will get an answer personally, and they will track the types of questions they get to share with all NCTracks users.
NCMS' Solution Center also has the answer. Contact the Solution Center Coordinator Belinda McKoy (919-833-3836 x142), and she will get an answer to your ICD-10 question.
Problem Solved: Renewing Your Membership
If you need an answer or a problem solved regarding your practice, as a North Carolina Medical Society (NCMS) member you have access to our Solution Center Coordinator, Belinda McKoy, who is standing by to help you solve the problem or answer your question. Call (919-833-3836 x142) or email Belinda the next time you need a problem solved.
Here is a common question Belinda receives:
Q: How do I renew my membership online?
A: Visit www.ncmedsoc.org/renew. You can renew your NCMS membership and/or your membership within one of the more than 30 county medical societies and 10 specialty societies for which we collect dues. You also may support the NCMS Foundation or the NCMS PAC through sustaining memberships.
It's Official: The NCMS Is the Oldest Professional Society in NC
You may have read or heard other professional associations claim they are the oldest in the state, but the North Carolina Medical Society (NCMS) recently confirmed we are indeed the oldest professional society in North Carolina. The North Carolina Secretary of State's office keeps records on all incorporated nonprofits back to the early 1800s. After researching the question, the Supervisor of Document Compliance, Corporations Division of the NC Department of the Secretary of State, Daniel Crabbe, wrote: "...you will be happy to hear that the North Carolina Medical Society is the oldest professional society in North Carolina. The oldest private nonprofit corporation is Wake Forest University, which was incorporated on 1/13/1834."
Our official date of incorporation, according to state records, is 2/17/1859, although our informal founding date was in 1849, when Edmund Strudwick, MD, was elected the first president of the Medical Society. The hallmark of Dr. Strudwick's presidency was his call for "stiff requirements in general education and moral character for those seeking entrance in to medical schools." The NCMS has been protecting the profession and the patients of North Carolina ever since.
To read more about the NCMS' history, read "150 Years of Leadership: The History of the North Carolina Medical Society's Pioneering Physician Leaders."
NCMS Service Project for March -- Donate Blood
The North Carolina Medical Society (NCMS) staff regularly participates in various community service projects throughout the year. For instance, last December the staff gathered one morning to package 10,000 meals for needy people around the world through Stop Hunger Now. In March, our community service team has invited the Rex Bloodmobile to our headquarters in downtown Raleigh, 222 N. Person Street, and we invite any NCMS members in the area to sign up to donate blood on Thursday, March 26, between 9 a.m. and 1 p.m. Sign up here or contact Erin Grover. All donors will receive “Donate For Life” points, snacks and refreshments! Read more about the Rex Bloodmobile and the importance of donating blood.
In the News
The Black Market for Stolen Health Care Data, NPR, 2-13-15
Experts Warn 2015 Could Be the Year of the Health Care Hack, Reuters, 2-11-15
Lawmakers Oppose Delaying October Rollout for ICD-10, ModernHealthCare, 2-11-15
Buncombe Has NC's Highest Vaccine Exemption Rate, The Asheville Citizen-Times, 2--6-15
Face of Supreme Court Case Hates Obama, Obamacare, Politico, 2-6-15
Why Hackers Are Targeting the Medical Sector, The Washington Post, 2-5-15
Learning Opportunities
NCTracks Training for February include:
Tuesday, Feb. 24 - 9:30 a.m. to 12 p.m. - Prior Approval - Medical (Professional)
Tuesday, Feb. 24 - 1-4 p.m. - Submitting a Professional Claim
These courses will be offered in-person at the CSC facility in Raleigh. They include hands-on training and will be limited to 45 participants in each course. You may register in SkillPort by logging on 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 courses can be found in the sub-folder labeled ILTs: On-site. Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort.
The North Carolina Healthcare Information and Communications Alliance (NCHICA) fifth Thought Leader Forum, on Using Analytics for Population Health Management. Feb. 25 at the Research Triangle Foundation of NC, 12 Davis Dr., Research Triangle Park. The registration fee is $50 NCHICA members/$75 non-members/$25 students. Click here to register. The deadline to register is Feb. 24.
MAHEC's Spring CE offerings include:
February 19th – May 28: “MAHEC Motivational Interviewing for Health Care”
March 13-14: “Everything Has Changed: New Prevention & Management Recommendations in Primary Care”
March 24: “Practical Matters in Dementia Care”
April 30: “Finding Stability: Management to Live Better with Parkinson Disease or Essential Tremor”
May 6-8: “MAHEC Women’s Recovery Conference”
May 8: "Healthcare Express Track"
May 12: “You’re Looking at Me Like I Live Here and I Don’t – A Unique Documentary About Living with Alzheimer’s and Post-Film Panel Discussion”
Save-the-Dates: June 3-6: “Southeast Pain Symposium”
Cleveland Clinic Florida has three cutting-edge medical symposiums coming up in February 2015. They are part of Cleveland Clinic Florida’s week-long Digestive Disease Institute’s Education Week. Visit the website for details.
- 26th Jagelman / 36th Turnbull International Colorectal Disease Symposium, Feb. 10-15, 2015 at the Harbor Beach Marriott Hotel in Fort Lauderdale, FL.
- 4th Annual Gastroenterology & Hepatology Symposium, Feb. 12 – 14, 2015 at the Harbor Beach Marriott Hotel in Fort Lauderdale, FL.
- 14th Annual Surgery of the Foregut Symposium, Feb. 14 – 18, 2015 at the Biltmore Hotel in Coral Gables, FL.
Save March 4, 2015 for North Carolina Pregnancy & Opioid Exposure Project’s conference, “Pregnancy & Opioid Exposure: Improving Outcomes for Women, Infants, and Families” in Greensboro. Learn the current and emerging approaches to best support families at risk for experiencing opioid exposed pregnancies in North Carolina. Medical, behavioral health, justice, child welfare and other professionals working with women of childbearing age, and their infants, are encouraged to attend.
Duke Geriatric Education Center presents a three-part workshop on Improving Care Through Interprofessional Collaborative Practice, March 25, April 8 and April 22. 8:30 a.m – noon, Croasdaile Village Retirement Community, Durham. More information and register.
ICD-10 Boot Camp, NCMGMA's General Code Set Training, March 26 & 27, 2015, 8 am – 5 pm, Women's Educational Center, Greensboro, NC. This intensive 2-day, 16-hour, General Code Set Training is designed specifically for coding staff and intended to give attendees a comprehensive understanding of guidelines and conventions of ICD-10 as well as fundamental knowledge of how to decipher, understand and accurately apply codes in ICD-10. This Training is approved for 16 CEUs through AAPC. Get more information and register.
Sixth Annual Addiction Medicine Conference, April 10-11, Asheville, Learn more and register.
Save the date -- June 12, 2015, for Go SIMple, an opportunity to learn about the hottest trends in simulation education from experts. The training session will be held at Campbell University College of Osteopathic Medicine in Lillington, NC.
Move Toward 'Pay for Quality' Accelerates With HHS Announcement
In an announcement last week, the US Secretary of Health and Human Services Sylvia M. Burwell set the stage for more aggressive adoption of a Medicare reimbursement system centered on paying physicians based on the quality rather than the quantity of care they provide patients.
The program she described will have measurable goals and a timeline. For instance, HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018. HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.
To make these goals scalable beyond Medicare, Secretary Burwell also announced the creation of a Health Care Payment Learning and Action Network. Through this Network, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs. HHS will intensify its work with states and private payers to support adoption of alternative payments models. The Network will hold its first meeting in March 2015.
For decades, while payers marginalized quality as a legitimate concern in health delivery, the physician community aggressively advocated for more emphasis on it. The North Carolina Medical Society (NCMS) has been working diligently for the past several years to help prepare NCMS members for this new reimbursement model through its Toward Accountable Care (TAC) Consortium and Initiative. TAC provides resources such as specialty specific toolkits to help physicians better understand what the move to quality means to them and their patients. Physicians who are knowledgeable about how quality affects payment can also participate more effectively in NCMS advocacy efforts to address shortcomings and make improvements.
The Affordable Care Act created a number of new payment models that move the needle even further toward rewarding quality. These models include ACOs, primary care medical homes, and new models of bundling payments for episodes of care. In these alternative payment models, health care providers are accountable for the quality and cost of the care they deliver to patients. Providers have a financial incentive to coordinate care for their patients – who are therefore less likely to have duplicative or unnecessary x-rays, screenings and tests. In addition, through the widespread use of health information technology, the health care data needed to track these efforts is now available.
In 2011, Medicare made almost no payments to providers through alternative payment models, but today such payments represent approximately 20 percent of Medicare payments. The goals Secretary Burwell outlined represent a 50 percent increase by 2016.
Read a new Perspectives piece in The New England Journal of Medicine from Secretary Burwell.
NCMS Responds To Proposed ACO Program Changes
The North Carolina Medical Society’s (NCMS) ACO Task Force finalized their comments on proposed changes to the Medicare Shared Savings Program (MSSP) and submitted them to the Centers for Medicare & Medicaid Services’ (CMS) on Wednesday. Review the comments here.
Generally, the Task Force found CMS’ proposals to be a positive step to encourage more practices to participate in, and continue to participate in the MSSP, although there were some concerns outlined in the comments. CMS released the draft rule on the MSSP for Accountable Care Organizations (ACOs) on Dec.1, and proposed a number of modifications, including:
- Allowing for an additional 3 year agreement period containing no downside risk but with a lower shared savings payment potentials (40 percent);
- Adding a third track with prospective patient attribution and greater risk and savings potential;
- Updating the Minimum Savings Rate and Minimum Loss Rate for Track 2 to mirror Track 1;
- Changing the beneficiary assignment methodology;
- Clarifying some ambiguities in the rule;
- Improving data sharing and reducing administrative burden.
2015 Legislative Session Begins in Earnest
North Carolina’s 170-member General Assembly kicked off its 2015 legislative session at noon last Wednesday, and soon the first two dozen substantive bills of the year had been filed. The North Carolina Medical Society (NCMS) Government Affairs team will be monitoring and tracking hundreds of bills over the course of the session. Watch the Bulletin and the NCMS website for information on bills of importance to you and your practice. As the session progresses, keep your eyes open for NCMS Email Alerts. Well-timed calls and emails to your senator or representative on crucial issues can have a big impact.
Governor Pat McCrory is scheduled to return tonight, Feb. 4, to deliver his “State of the State” address in what will be a crowded House chamber. Like McCrory, large majorities in both chambers are Republican – 34 of 50 senators, with 16 Democrats; and 74 of 120 representatives, with 45 Democrats and one independent. The Senate has seven freshmen, the House 17. This year’s biennial “long session” is expected to last into the summer, perhaps with a July adjournment.
If you would like to be part of the excitement at the Legislature, consider signing up for a White Coat Wednesday. Throughout the session, the NCMS hosts briefing breakfasts at the NCMS Center for Leadership in Medicine, just down the block from the General Assembly. After becoming familiar with the issues under discussion that day, our Government Affairs staffers will escort you to the Legislative Building where you can visit your representatives to discuss how pending legislation may affect your practice. To learn more, contact Chip Baggett, Director of Legislative Relations or call him at 919-833-3836 x110.
CMS Considers EHR Incentive Program Changes for 2015
From CMS Reports:
Responding to input from health care providers and other stakeholders, the Centers for Medicare & Medicaid Services (CMS) announced last week that it intends to engage in rulemaking to update the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs beginning in 2015. These intended changes would help to reduce the reporting burden on providers, while supporting the long term goals of the program.
The new rule, expected this spring, would address concerns about software implementation, information exchange readiness, and reflect developments in the industry and progress toward program goals achieved since the program began in 2011.
CMS is considering the following changes:
- Shortening the 2015 reporting period to 90 days to address provider concerns about their ability to fully deploy 2014 Edition software
- Realigning hospital reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other quality programs
- Modifying other aspects of the programs to match long-term goals, reduce complexity and lessen providers’ reporting burden
These proposed changes reflect the Department of Health and Human Services’ commitment to creating a health information technology infrastructure that:
- Elevates patient-centered care
- Improves health outcomes
- Supports the providers who care for patients
This rulemaking is separate from the forthcoming Stage 3 proposed rule expected in early March. CMS intends to limit the scope of the Stage 3 proposed rule to the requirements and criteria for meaningful use in 2017 and subsequent years.
For help with EHR and meaningful use, contact the North Carolina Medical Society’s Director of Practice Improvement Terri Gonzalez or at 919-833-3836 x123. For more information about the EHR Incentive Programs, please visit http://www.cms.gov/EHRIncentivePrograms.