RALEIGH — This week the NCMS Payer Task Force continues its discussions of recommendations designed to respond to payer requirements that compromise patient care and increase administrative burden.
The Task Force includes representatives from numerous specialty practice areas.
The group has identified the growing burden associated with prior authorization as top priority. Additional issues include step therapy, recoupments, and retroactive denials.
The goal is to recommend advocacy efforts targeting these issues to the NCMS Board of Directors for inclusion in the NCMS’ 2023 advocacy priorities.
The private payouts offering incentives to participants to use their own hired telemedicine physicians outside the medical home creates more problems and compromises not only the medical home model but also the issue of duplicate care and obtaining records to make sure medication history is accurate.
As a participant in first UHC then BCBS NC I have been contacted through the mail with offering a free online and TeleMed care through physicians I’ve never heard of or ever seen before this can be problematic if a patient does not really know all of their history or their medication list where they don’t count say they’re topical or inhaled medications as a true medication.
This also decreases the primary care ability to care for the entire patient and decreases the bottom line profit of the smaller private practices making it much more difficult for them to continue to offer telemedicine and to continue to function as independent entities.