NCMS Launches NC Doctors’ Day Campaign
The North Carolina Medical Society (NCMS) is excited to launch a public awareness campaign in celebration of YOU – our physician members. On March 30, National Doctors’ Day – the NCMS is sponsoring a new homegrown tradition by celebrating North Carolina Doctors’ Day. The heart of this event is the opportunity for grateful patients and members of the public to nominate and vote for the 2015 North Carolina Doctor of the Year Award.
We are working with partners from across the state and our goal is to have physicians, both members and non-members, be nominated for this award. As your professional association, we know that the greatest gift you can receive is the gratitude and thanks of your patients and this award and the social media campaign surrounding it are our way of helping patients and the general public show you some love!
If you know a doctor colleague who is passionate about keeping patients healthy and dedicated to making a positive impact in our state, speak up! Nominations for the NC Doctor of the Year award are now open. Feel free to share the link to our NC Doctors’ Day website with your staff and patients.
Who among your peers is the most exceptional? Let your patients tell us!
If you’re not already an NCMS follower on Facebook and Twitter – now’s a great time to start. You just might see your name highlighted!
Nominate A Doctor Now!
Leadership College Class of 2015 Underway
The 15 members of the North Carolina Medical Society (NCMS) Foundation Leadership College Class of 2015 are well into their studies for the year long program. This year’s class represents a cross section of specialties and participants are from across the state. See who is in this year’s class.
The Leadership College enhances and develops physician and PA leadership abilities and effectiveness. Through understanding the broader context and the individual’s role within the health care landscape, NCMS members gain perspective on critical leadership and management issues as well as learn techniques and acquire the necessary tools for immediate application in the daily work setting.
Learn from physician faculty, content experts and peers. Through highly interactive sessions and completion of a project, scholars put knowledge into action. If you are interested in learning more about our Leadership College program, visit our website. Questions may be directed to Tina Natt och Dag, Director, Kanof Institute for Physician Leadership or call her at 919-833-3836 x158.
Is CQ'U' Right for You?
Are you prepared to be paid based on the ‘quality’ of services you provide your patients? Do you even know what that means? If you’re unsure, and perhaps perplexed, anxious, frustrated or even a little angry about the changes taking place in our health care system, you’re not alone. That is why the North Carolina Medical Society (NCMS) Foundation in conjunction with the North Carolina Quality Center has developed CQ’U’ (short for Clinical Quality University). CQ’U’ will help you understand exactly what this ‘move to quality’ means, and give you the necessary tools to lead and succeed in this new environment.
Last week, the Centers for Medicare and Medicaid Services (CMS) set new timelines and goals to move more aggressively toward a physician payment system based on the quality of services provided to patients, not the quantity. This announcement provides even more evidence of the historic changes already underway and gaining momentum in our country.
CQ’U’ 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.
Applications are now being accepted for CQ’U’ class of 2015. Learn more about this project-based learning model today.
Problem Solved! CME FAQ
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 a list of CME events?
A: Please visit the NCMS Online Calendar of Events. You can also contact your local AHEC. All of the NC AHEC's are accredited providers, and most list their activities on their websites.
Have An Opinion on Virtual Credit Card Payments? Take This Short Survey
Over the last couple years, the issue of virtual card payments continues to come up due to the tactics some payers have used to pressure practices into accepting virtual credit cards for payment and the additional fees that result.
The North Carolina Medical Society (NCMS) has worked to raise awareness among medical practice staff, and advocate within the health IT industry for better regulation of virtual cards. The short survey below will help stakeholders better understand the various perspectives on the issue. Please take a moment to voice your viewpoint.
The survey was developed by the Workgroup for Electronic Data Interchange, or WEDI. It is a national entity composed of all stakeholders – providers, payers, clearinghouses, EMR vendors, banks, etc.
Complete the survey by visiting https://www.surveymonkey.com/s/virtualpaymentcard. The survey will close February 12.
CCME Elects New Chairman
The Carolinas Center for Medical Excellence (CCME) Board of Directors elected John B. Smith, MD, as its new chairman at their most recent board meeting.
Dr. Smith is a family practitioner and North Carolina Medical Society (NCMS) member active in pediatrics, adult medicine and geriatrics. Educated at NC State University, UNC, and Bowman Gray School of Medicine, Dr. Smith joined Clinton Medical Clinic in 1980. He is a certified medical director of two local nursing homes and a hospital skilled care unit. Dr. Smith has previously held the position of CCME board president from November 2007 to October 2011.
Dr. Smith has also served as president of Sampson County Medical Society; member of Sampson County Board of Health; and medical staff president of Sampson Regional Medical Center. He was named North Carolina Family Physician of the Year in 2000 by the North Carolina Academy of Family Physicians.
CCME is an independent, nonprofit provider of quality improvement services in health care settings. For over 30 years, CCME has served as a Quality Improvement Organization, as designated by the national Centers for Medicare & Medicaid Services. CCME also provides services related to the Medicaid populations.
In the News
Obama's 2016 Budget Cuts Medicare But Eliminates Sequestration, ModernHealthCare, 2-2-15
Culturally Sensitive Palliative Care Represents New Approach, The Associated Press, 2-1-15
How Doctors Can Win the Vaccine Debate With Patients, MedPageToday, 2-1-15
Amid Measles Outbreak, Anti-Vaccine Doctor Revels in His Notoriety, The Washington Post, 1-30-15
Paying Docs to Manage Care Shows Promise -- But the Pay is About to Drop, ModernHealthCare, 1-29-15
Where Health Care Is Now On the March to Value-Based Pay, ModernHealthCare, 1-28-15
Medicare's Payment Reform Push Draws Praise, Fears, ModernHealthCare, 1-26-15
CDC Reminds Providers To Check Patients MMR Vaccine Status, NEJM Journal Watch, 1-26-15
Senator 'Astounded' That Nonprofit Hospitals Sue Poorest Patients, NPR/ProPublica, 1-22-15
Predictable Fault Lines Emerge As Perennial Doc-Fix Debate Begins, ModernHealthCare, 1-21-15
ACOs Make Progress In Using Big Data to Improve Care, ModernHealthCare, 1-17-15
Learning Opportunities
Electronic Health Record Certification, Feb. 9-May31. Offered online through Richmond Community College in Hamlet, NC. This course will prepare students to sit for the Electronic Health Records Certification Exam and earn the credential offered through the National Healthcareer Association. For more information contact Lauren Holland, or call (910)410-1848.
Feb. 18, noon-1 p.m., Webinar on Meaningful Use & HIPAA: Meaningful Use in 2015 including HIPAA requirements for Meaningful Use Stage 1 or 2, featuring Karen McKeithen Schaede, J.D. North Carolina Medical Society Foundation, in cooperation with the North Carolina Medical Group Managers, will discuss what you need to know to attest for Meaningful Use in 2015. This webinar is free but you must register to attend. Space is limited so register early.
NCTracks Training for February include:
Wednesday, Feb. 18 – 9 - 11 a.m. - Recipient Eligibility
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.
Want to learn more about improving quality in your practice?
Recently, the Centers for Medicare and Medicaid Services (CMS) set new timelines and goals to move more aggressively toward a physician payment system based on the quality of services provided to patients, not the quantity. This announcement provides even more evidence of the historic changes already underway and gaining momentum in our country.
The NCMS Foundation has partnered with the NC Quality Center to develop NCMS CQU (Clinical Quality University), which works with health care teams to arm them with the skills they will need to progress in this new health care environment. CQU 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 distance coaching. Teams of three will work together to complete a quality-based project to implement in their work place during this year-long educational track.
For more information or to begin the application process, vist www.ncmedsoc.org/cqu. The deadline for CQU applications for the spring session is February 28, 2015.
NCTracks Ready to Reprocess Claims for Enhanced Payments under the ACA
From NCTracks:
The Affordable Care Act (ACA) requires the state’s Medicaid program pay at the Medicare rate for certain primary care services and to reimburse 100 percent Medicare Cost Share for services paid in calendar years 2013 and 2014 to attested providers. In September 2013, NCTracks began making the ACA enhanced rate payments to providers who attested and were verified by the state for qualified services billed from that point forward.
In September 2014, the Centers for Medicare and Medicaid Services (CMS) approved a North Carolina State Plan Amendment, which changed the allowable attestation date from June 30, 2013, to June 30, 2014, for retroactive ACA payment eligibility back to January 1, 2013. (Providers who attested after June 30, 2014, are eligible for enhanced ACA payment for services rendered after their attestation date.)
NCTracks has since been updated to include information regarding providers who attested at a later date, as well as changes in rates effective January 1, 2014. (ACA eligible claims with a date of service on or after January 1, 2014, that adjudicated on or before March 7, 2014 at 10:00 a.m. paid with the old rates.) Now that these changes are complete, retroactive reimbursement is starting. No action is required on the part of attested providers to receive retroactive reimbursement.
Beginning on January 17, 2015, NCTracks will start the reprocessing of paid physician claims for enhanced ACA payments of eligible services. The reprocessing will include physician claims processed and paid with dates of service from January 1, 2013, through December 31, 2014, that did not already receive enhanced ACA payment.
The claim reprocessing will likely take several checkwrites and should be completed by mid-February. The claims will be reprocessed as Adjustments and will be reported on the providers Remittance Advice (RA). On the paper RAs only, the reprocessed claims will be listed in a separate section of the RA and the claims will be reported with an EOB code of 06040 - "CLAIM REPROCESSED FOR ACA ADJUSTED PAYMENT."
The 835 transactions will include the reprocessed claims along with other claims submitted for the checkwrite. (There is no separate 835.)
This is the second reprocessing effort, and we do not anticipate additional reprocessing of previously paid claims for enhanced ACA payments. Individual reprocessing, if needed, will be addressed on a case by case basis. New claims for eligible services from 2014 rendered by attested providers will be reimbursed appropriately.
If providers have any questions about the reprocessed claims, please contact the NCTracks Call Center at 1-800-688-6696 or [email protected].
Prevention Partners Issues On-Line Report Card On NC's Health
A new, comprehensive look at North Carolina’s health as measured by tobacco use, nutrition, physical activity and obesity gives the state mediocre to dismal grades. The Prevention Partners “2015 NC Prevention Report Card,” however, shows “encouraging momentum around understanding the impact of poor health as an economic issue and the role that employers can play,” writes Meg Molloy, Prevention Partners President and CEO. “This report card offers a wake-up call, pointing all of us to what we can do to fill prevention gaps and build health across North Carolina.”
The Report Card is in an easy to use visual and interactive format with links to sources and resources.
February 15 Deadline Looms for Insurance Marketplace Enrollment
The deadline to sign up for health insurance coverage through the Affordable Care Act’s Insurance Marketplace is Feb. 15. As of Jan. 9, more than 434,000 people in North Carolina have signed up for health insurance coverage, the U.S. Department of Health & Human Services (HHS) reports. That total reflects those who enrolled in 2014 and reenrolled this year as well as new enrollees who were not insured last year through the federal insurance marketplace.
To help patients who may be looking for insurance coverage keep in mind these facts provided by HHS:
- Open Enrollment runs through February 15, 2015. Visit HealthCare.gov to sign up. After the Feb. 15 deadline, people can enroll only under special circumstances, such as the loss of a job or marriage.
- Nationally this year, there are 25 percent more health insurance issuers competing in the Marketplace for enrollees.
- Financial help is available. Eight out of 10 people can find coverage for $100 or less a month with tax credits through the Marketplace. And 87 percent of people who selected 2015 plans through HealthCare.gov in the first month of Open Enrollment got financial assistance to help lower the cost of premiums.
- Last year’s technological glitches have been fixed. HHS has been working to make the consumer experience at HealthCare.gov simpler, faster, and more intuitive.
Last year more than 357,000 enrolled in the state, and 91 percent qualified for federal subsidies. North Carolina had the nation’s fifth-highest enrollment total in 2014. Nationwide as much as 20 percent of initial enrollees don’t make a payment and remain uninsured.
Pulse Check -- Have You Seen Your QRUR?
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Problem Solved!
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 Battle 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 does my practice obtain DNR (Do Not Resuscitate) and MOST (Medical Orders for Scope of Treatment) forms?
A: The DNR and MOST forms are available through the Office of Emergency Medical Services, North Carolina Department of Health and Human Services.
NC Health Department Alert on Simulated Saline
The United States Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) currently are investigating multiple instances of simulated intravenous (IV) saline products being administered to patients. These products are not sterile and should not be injected in humans or animals.
Wallcur’s simulated IV saline solution, Practi-0.9 percent sodium chloride solution, was shipped to medical clinics, surgical centers, and urgent care facilities in numerous states, including North Carolina. In some instances, this product was administered to patients. Adverse events have been associated with these incidents, including multiple hospitalizations.
Wallcur initiated a voluntary recall of Practi-0.9 percent sodium chloride solutions on January 7, 2015. NC DPH has contacted all facilities identified as having received these products.
Read the Health Alert, which outlines what clinicians can do to ensure simulated saline is not administered to patients and what to do if you suspect it has been.
In the News
Sure You Can Track Your Health Data, But Can Your Doctor Use It?, NPR, 1-19-15
When the Fever Breaks, The New Yorker, 1-19-15
Even Advanced ACOs Struggle To Expand Model Beyond Medicare, ModernHealthCare, 1-16-15
Booking a Trip to the ER on Your Smartphone? It's a Breeze, The Associated Press, 1-15-15
NCSU Partners With CCNC to Reduce Medicaid Spending, Triangle Business Journal, 1-13-15
Supreme Court Battle Brewing Over Medicaid Fees, Kaiser Health News, 1-12-15
How Americans' Refusal to Talk About Death Hurts the Elderly, Vox, 1-11-15
Perspective: Boarded to Death -- Why MOC is Bad for Doctors and Patients, The New England Journal of Medicine, 1-8-15
New Antibiotic Stirs Hope Against Resistant Bacteria, The New York Times, 1-7-15
UNC Health Care's Doug Strong Leaves To Become CEO of Orlando Health, Triangle Business Journal, 1-7-15
Challenge to Obamacare's IPAB Could Get Supreme Court Hearing, ModernHealthCare, 1-7-15
McCrory: Obama Open to Medicaid Waiver, The Raleigh News & Observer, 1-6-15
Flu Numbers Reach Epidemic Proportions
Latest Flu Information From NCDHHS:
Influenza activity has been widespread in North Carolina since late November. So far, the predominant virus circulating in North Carolina has been the influenza A (H3N2) virus. This strain is associated with more severe illness and mortality among the elderly.
Approximately two-thirds of H3N2 viruses characterized by CDC so far this season have not been well matched to the vaccine, meaning that vaccine effectiveness against these viruses may be reduced.
Historically, flu activity peaks in North Carolina around late January or February. However, during the past three seasons, and including this current season, we have seen earlier rises in flu activity.
Important factors to note about this season’s intensity are:
- Flu activity has been higher this season than in recent years. Although activity seems to have peaked, flu will still be circulating at high levels in North Carolina over the next several weeks.
- We have seen high numbers of deaths among the elderly and outbreaks in long-term care facilities reported this season. This is expected during seasons like this one in which H3N2 is the predominant strain.
For more details on the flu outbreak, visit www.flu.nc.gov/data.
Read the updated guidelines for prevention and treatment.
CMS Announces Deadlines to Report 2014 PQRS Data
Time is running out to avoid penalties in the Medicare PQRS program. What you report will determine your 2016 penalty status. To avoid the 2016 penalty, an eligible provider (EP) must report 3 PQRS measures in calendar year 2014. There may still be time to avoid this penalty by reporting quality data through a CMS qualified registry or EHR. More information on the PQRS requirements and reporting options are available on the CMS website. The deadlines for reporting 2014 quality data are as follows, as reported by CMS:
| Reporting Method | Submission Period | Submission Deadline Time(All Times are Eastern) |
| EHR Direct or Data Submission Vendor that is certified EHR technology (CEHRT) | 1/1/15 - 2/28/15 | 8:00 p.m. |
| Qualified clinical data registries (QCDRs) (using QRDA III format) reporting for PQRS and the clinical quality measure (CQM) component of meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program | 1/1/15 - 2/28/15 | 8:00 p.m. |
| Group practice reporting option (GPRO) Web Interface | 1/26/15 - 3/20/15 | 8:00 p.m. |
| Qualified registries | 1/1/15 - 3/31/15 | 8:00 p.m. |
| QCDRs (using XML format) reporting for PQRS only | 1/1/15 - 3/31/15 | 8:00 p.m. |
| Maintenance of Certification Organizations (MOCs) | 1/1/15 - 3/31/15 | 8:00 p.m. |
In addition to the PQRS penalty, a Value-Based Payment Modifier (Value Modifier) will apply starting in 2016 to physician group practices of 10 or more eligible professionals (EPs). This Value Modifier will adjust Medicare physician payments based on a quality and cost assessment completed by CMS, relying on PQRS for quality data analysis. Therefore, physicians in practices of 10 or more EPs must meet 2014 PQRS criteria or face penalties in both the PQRS and Value Modifier programs in 2016.
To learn more about how you can act now to avoid these penalties, attend the upcoming NCMS-hosted Webinar on January 21 explaining how it is not too late to send in the data for 2014 and avoid the 2016 penalties. Watch the NCMS website and the Bulletin for details.
For questions, please contact North Carolina Medical Society (NCMS) Director of Health Policy, Jennifer Gasperini, 919-833-3836 X152 or the NCMS Director of Practice Improvement Terri Gonzalez, 919-833-3836 X123, or visit our Marketplace page to view an NCMS-approved vendor list.
CMS Accepting Suggestions for PQRS Measures
The Centers for Medicare & Medicaid Services (CMS) currently is accepting quality measure suggestions for potential inclusion in the Physician Quality Reporting System (PQRS) for future rule-making years. These measures are used not only for the purposes of the PQRS program, but additional value-based initiatives such as the Medicare Shared Savings Program and Value-Based Payment Modifier (VBPM). Having a deep understanding of these measures will be increasingly important, particularly as CMS continues to phase-in implementation of the VBPM to all physicians starting in 2017. To learn more about the call for measures, visit the CMS website.
Former NCMS Executive Director, William N. Hilliard, Passes Away
William N. Hilliard, who spent 33 years at the North Carolina Medical Society (NCMS), retiring as Executive Director in 1984, passed away on Dec. 26, 2014 in Raleigh. Mr. Hilliard began his lengthy career at the NCMS after spending six years as a news editor at radio station WPTF in Raleigh. He was the first recipient of the NCMS’ John Huske Anderson Award, presented to a layman whose “contribution has had a positive impact on the medical profession and the public health.” After retiring from the NCMS, he founded Hilliard Association Management, Inc., where he remained active until his final retirement in 2005 at the age of 85. He served clients including the NC Society of Anesthesiologists and the NC Society of Internal Medicine.
“Mr. Hilliard provided great leadership, guidance and support toNorth Carolina physicians for many years,” said current NCMS CEO Robert Seligson. “His legacy as a strong leader and statesman will be lasting because of the tremendous impact he had on the medical profession in North Carolina.”
We extend our sympathies to Mr. Hilliard’s family.
Watch Your Email for Member Survey on Governance As HOD Recommendation Work Continues
At the 2014 North Carolina Medical Society (NCMS) House of Delegates, proposed amendments to the NCMS Constitution and Bylaws were passed to re-engineer the NCMS governance structure. The goal of the proposed amendments is to establish a policymaking process within the NCMS that is more accessible and efficient. One option to be considered is to develop a mechanism for NCMS members to bring issues to the Board of Directors for discussion and action on a timely basis, rather than waiting for the House of Delegates to meet annually.
Following the House of Delegates meeting, NCMS President Robert Schaaf, MD appointed a Bylaws Modernization Task Force. As part of their work, all members will be contacted by email this week to respond to an online survey. The NCMS has contracted with McLaughlin & Associates, a national public opinion firm, to conduct an Internet survey of all NCMS members. This survey will assist in determining how best the NCMS can represent its members.
The survey will launch on Friday, January 9. It will be administered by McLaughlinOnline.com, an Internet polling service fully owned and operated by McLaughlin & Associates, and powered by Qualtrics, an online data collection engine.
Please take a few minutes to complete the survey to give the NCMS leadership valuable information about your expectations for member representation and how you prefer to engage with us and other professional organizations. The survey will only take a few minutes of your time, which will be invaluable to the NCMS and its leadership. Thank you in advance for your participation in this survey.
North Carolina Home to Seven New Medicare ACOs in 2015
Just before the new year dawned, the Centers for Medicare & Medicaid Services (CMS) announced 89 new Medicare Shared Savings Plan (MSSP) Accountable Care Organizations (ACO) bringing the nationwide total of MSSP ACOs to 405. Of the new ACOs announced, seven have service areas in North Carolina.
1) Cape Fear Valley ACO
2) Carolina Medical Home Network ACO (NC FQHCs)
3) Coastal Plains Network (Vidant)
4) CHESS (Cornerstone, Wake Forest Baptist)
5) Mission Health Partners
6) PACN (Pinehurst Accountable Care Network)
7) Pioneer Health Alliance (service area includes Georgia, Kentucky, Mississippi, North Carolina, Tennessee, Virginia)
To learn more about accountable care efforts in North Carolina or to download educational toolkits on the subject, visit the TAC Consortium website: www.tac-consortium.org.
Applications for CQ ‘U’ Now Being Accepted
As a North Carolina Medical Society (NCMS) member you are eligible to participate in the Clinical Quality track of the Kanof Institute for Physician Leadership or CQ ‘U.’ Enrollment is now open – the deadline is Feb. 28, 2015 for the spring session. Learn more about this unique opportunity and apply today. Please direct questions to Erin Grover, 919-833-3836 X134.
Will The SGR Be Repealed in 2015? Stay Tuned…
Last year, the 113th Congress came closer than any previous Congress to repealing the Sustainable Growth Rate and presenting viable payment reforms. After a year of work, the relevant congressional committees had unanimous support for an SGR repeal bill that not only repealed the SGR and provided for a period of positive updates but also set the stage for a new generation of physician payment arrangements that promote quality and value while maintaining a viable fee-for-service system. This was a significant accomplishment made possible by strong advocates within the Congress and a united front by organized medicine.
Unfortunately, this bipartisan, bicameral agreement failed to become law due to Congress’ persistent inability to agree on whether or how to offset additional costs to the current fictional budget baseline. In March, Congress forced through a 17th SGR patch bill despite significant opposition. Despite declarations from leaders on both sides of the aisle that work would proceed, there is no evidence that any serious efforts were made to resolve the budget issue.
There are only 37 days that the new Congress will be in session before the current SGR patch expires on April 1. Fortunately, the 113th Congress left a blueprint for reform. The AMA hopes legislators will build on the progress made last year so that medicine can focus on addressing other important health care policy issues.
Watch the Bulletin in the coming weeks for updates and talking points to let your representatives know this matter needs to be resolved for doctors and their patients.
Participating in the Medicare EHR Incentive Program? Prepare for Attestation
The Centers for Medicare & Medicaid Services (CMS) reminds you that if you are an eligible professional participating in the Medicare EHR Incentive Program, you have until February 28, 2015 to attest to demonstrating meaningful use of the data collected during your EHR reporting period for the 2014 calendar year. If you are participating in the Medicaid EHR Incentive Program, please refer to the North Carolina deadlines for attestation information.
The CMS Attestation System is open and fully operational, and includes the 2014 Certified EHR Technology (CEHRT) Flexibility Rule options. Medicare eligible professionals can attest any time to 2014 data until 11:59 p.m. ET on February 28, 2015.
More details and helpful resources. North Carolina Medical Society (NCMS) Director of Practice Improvement, Terri Gonzalez, also is available to answer questions, 919-833-3836 x123.
Flu Treatment and Prevention Key As Cases Reach Epidemic Proportions
With nine flu-related deaths last week alone and an increasing number of cases presenting in doctors' offices and emergency departments statewide, State Epidemiologist Megan Davies, MD, issued an update for all clinicians to reinforce important prevention and control measures for the remainder of the season. Flu activity has been early (for the third consecutive season) and more intense than usual, as measured by visits to emergency rooms and providers in the Influenza-Like Illness Network.
Read the updated guidelines for prevention and treatment.
We Know the Troubles You’ve Seen
In June 2013, NCMS already knew the transition from HP’s legacy Medicaid claims system to CSC’s NCTracks would present challenges for physicians across the state. So in advance of the July 1 go-live date, NCMS launched its NCTracks Trouble Log, a straightforward web-based form designed to allow medical practices to report their problems to us with ease.
We didn’t realize at the time how critical this tool would become over the next six months, especially. In the troubled early days of NCTracks, our Trouble Log was flooded with responses, ranging from incredibly detailed accounts of system failures to desperate pleas for help. Physician practices, hospital systems, dentists, chiropractors and other provider types used the Trouble Log to share their experiences.
This data allowed NCMS to identify common problems with the system and report those to CSC and NCDHHS for resolution. It also allowed us to escalate urgent problems immediately and ensure that medical practices in dire need received immediate attention. To date the Log received 200 separate complaints involving thousands of doctors and patients.
Having served its purpose (and then some!) we are decommissioning the Trouble Log and removing it from our website, a year-and-a-half after its launch. Our NCTracks advocacy efforts, of course, will continue, as there are still many folks out there experiencing problems and many system improvements that CSC has forthcoming. Please continue to notify us about difficulties you encounter by emailing or calling Belinda McKoy, NCMS Solution Center Coordinator, 919-833-3836 X142.
ICD-10 News You Can Use
Volunteer for ICD-10 End-to-End Testing in April -- Forms Due Jan. 9
During the week of April 26 through May 1, 2015, a second sample group of providers will have the opportunity to participate in ICD-10 end-to-end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The goal of end-to-end testing is to demonstrate that:
- Providers and submitters are able to successfully submit claims containing ICD-10 codes to the Medicare Fee-For Service (FFS) claims systems
- Centers for Medicare & Medicaid Services (CMS) software changes made to support ICD-10 result in appropriately adjudicated claims
- Accurate remittance advices are produced
Approximately 850 volunteer submitters will be selected to participate in the April end-to-end testing. This nationwide sample will yield meaningful results, since CMS intends to select volunteers representing a broad cross-section of provider, claim, and submitter types, including claims clearinghouses that submit claims for large numbers of providers. Note: testers who are participating in the January testing are able to test again in April and July without re-applying.
Details on how to apply.
Results from November ICD-10 Acknowledgement Testing Week
CMS conducted another successful acknowledgement testing week last month. More than 500 large and small physician practices, suppliers, billing companies, and clearinghouses participated in the testing week last month. Acceptance rates improved throughout the week with Friday’s acceptance rate for test claims at 87 percent. Nationally, CMS accepted 76 percent of total test claims. Testing did not identify any issues with the Medicare FFS claims systems. This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing.
Mark your calendar for upcoming acknowledgement testing weeks on March 2-6, 2015 and June 1-5, 2015. In addition to the special testing weeks, providers are welcome to submit acknowledgement test claims anytime up to the October 1, 2015 implementation date. Contact your Medicare Administrative Contractor for more information.
NCTracks ICD-10 Trading Partner-Provider Testing
In the spring of 2015, NC Tracks will begin working with select Trading Partners and Providers in testing ICD-10 with NCTracks. Trading partners or providers interested in participating in ICD-10 testing should email [email protected]. Trading partners and providers will be selected to participate in testing that represent a broad cross-section of provider types. The State expects to complete the selection of trading partners and providers and notify them by mid-February 2015. Selected participants will receive an orientation and instructions regarding the testing.
North Carolina Drug Card Helps with Rising Costs of Generic Drug Prices
According to a recent article in The Chicago Tribune, the price of generic medication is getting less affordable each year. The latest numbers from Catamaran, which provides pharmacy benefit management services, show consumers and insurers paid an average of $13.14 per prescription for the 50 most popular generics in 2010. In 2014, they paid $62.10, a 373 percent increase.
Physicians can help by educating their patients about the North Carolina Drug Card, which is a free statewide prescription assistance program. The North Carolina Drug Card can be used for savings of up to 75 percent on prescription medications at more than 56,000 pharmacies nationwide. The card discounts both brand and generic prescription medications for individuals without prescription coverage. Those who have prescription drug coverage may still qualify and receive discounts on medications not covered by their insurance plan. There’s no application to complete, no membership restrictions, no income requirement, and no age limitations.
Patients may visit www.northcarolinadrugcard.com to print a free North Carolina Drug Card, search for participating pharmacies and compare medication pricing. Physicians may request a supply of custom cards mailed directly to their office at no cost by contacting the program’s development director, Milton Perkins, at [email protected] or 704-785-5533.
NCMS CEO Part of Business NC Economic Forecast Roundtable
In advance of the New Year, North Carolina Medical Society (NCMS) CEO Robert W. Seligson, participated in the Business North Carolina Economic Forecast 2015 Round Table discussion held Monday, Dec. 15, at the Campbell University Law School. Seligson was joined by leaders in other industries including John Loyack of the newly formed NC Economic Development Partnership, Richard Reich from the NC Department of Agriculture and Consumer Services, Tony Smith of the NC Association of Realtors and Rep. David Lewis.
Business North Carolina publisher, Ben Kinney, served as moderator for the discussion, which addressed questions for each sector on the direction for the state’s economy in the coming year, how companies should prepare, economic concerns and opportunities in the coming months as well as questions on health care legislation and workforce outlook.
The Dean and professors from Campbell University’s Lundy Fetterman School of Business, co-sponsor of the event, also participated in the lively discussion. Edited excerpts from the conversation will be published in the February 2015 issue of Business North Carolina.
NCMS Director of Rural Health Initiatives Speaks at Recruitment and Retention Summit
The North Carolina Medical Society (NCMS) Director of Rural Health Initiatives Franklin Walker was among the participating faculty at the Physician Recruitment and Retention Summit, Dec. 9-10, 2014, in Philadelphia. He spoke about the NCMS Foundation’s Community Practitioner Program, which celebrated its 25th anniversary last year, and presented a video of current CPP participants talking about their part in the program. He also demonstrated the FutureDocs forecasting tool developed at the University of North Carolina, Chapel Hill with the support of The Physicians Foundation and the help of the NCMS Foundation.
The summit brought together various recruitment and business development executives to discuss how to build a retention program that meets the needs of a community and how to bring in the best and brightest physicians.
Linda Carter Retires After 42 Years of Service to the NCMS
On Dec. 16, a who’s who of North Carolina Medical Society (NCMS) past and present leadership and staff gathered at the NC State Club to celebrate and honor Linda Carter on her retirement after 42 years of service to the NCMS as Executive Assistant to the CEO. The luncheon included an appearance by the NC State mascots, a video produced by NCMS CEO Bob Seligson tracing Linda’s life from growing up on the family farm outside of Rocky Mount through her years at the NCMS as well as speeches remembering Linda’s commitment to the society and its members. She was presented with the NCMS’ John Huske Anderson Award and the state honored her with the Order of the Long Leaf Pine.
Being the Christmas season, Santa was on hand to give Linda her retirement gift. Her many NCMS friends contributed to a $30,000+ check to take nine years off Linda’s mortgage. A surprised and tearful Linda expressed her gratitude at the conclusion of the party.
In the News
Success of Kentucky's Health Plan Comes With New Obstacles, The New York Times, 12-29-14
Parade of Pathogens in 2014, MedPage Today, 12-28-14
89 ACOs Will Join Medicare Shared Savings Program in January, ModernHealthCare, 12-22-14
Over 250,000 Providers Face Medicare Penalties for Failing to Meet EHR Goals, NEJM Journal Watch, 12-22-14
Charlotte Patients Take Control of Their Medical Records, Doctor Visits with Virtual Care, The Charlotte Observer, 12-20-14
Durham Startup TouchCare's Telemedicine Service Gains Key Backer, Raleigh News & Observer, 12-20-14
Antibiotic Overuse Targeted By Hospitals, ModernHealthCare, 12-20-14
Patients and Health Care Teams Forging Effective Partnerships, Institute of Medicine Discussion Paper, 12-17-14
CDC's Most Challenging Public Health Threats of 2014, NEJM Journal Watch, 12-17-14
Memo to Staff: Time to Lose a Few Pounds, The Wall Street Journal, 12-16-14
Year End Rush on Doctors' Offices Intensifies, The Charlotte Observer, 12-16-14
How the Obesity Epidemic Drains Medicare and Medicaid, The Fiscal Times, 12-15-14
ECU Notes: Brody Grads Staying, The Daily Reflector, 12-14-14
Rx for Reform: NC Pharmacists Try to Boost Health and Cut Costs, The Charlotte Observer, 12-13-14
Opinion: Don't Homogenize Health Care, The New York Times, 12-10-14
Report Examines US's Addiction to Opioid Painkillers, NEJM Journal Watch, 12-10-14
Learning Opportunities
CCNC Project Lazarus Training, A Guide to Rational Opioid Prescribing for Chronic Pain will assist prescribers of pain medications to understand and treat chronic pain and safer opioid prescribing. The seminar will include a complimentary dinner and dialogue with other concerned professionals. Find the place and date that works for you and register below:
Each of these will offer 3 prescribed credits of AMA Category 1.
NC Dermatology Association Annual Meeting, Jan. 23-25, Grandover Resort, Greensboro, NC. The meeting has been approved for 11.75 hours of AMA PRA Category 1 Credit and 11.75 hours of AAD Category 1 Credit. Get the details and register today.
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.
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.
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.