Welcome to your first NCMS Morning Rounds of December.

Dec. 1, 2020

Advisory Group Discusses COVID Vaccine Allocation

Today at 2 p.m. you can listen in on the Centers for Disease Control and Prevention’s (CDC) Advisory Committee On Immunization Practices (ACIP) via webcast as the group discusses allocation of initial supplies of COVID-19 vaccines. Review today’s agenda here.

Both Pfizer and Moderna are seeking FDA emergency authorization for the vaccines they have developed, which require two doses within three to four weeks of each other. While no serious safety concerns have been reported from Pfizer or Moderna’s clinical trials, patients reported side effects that are common with vaccinations, including pain at the injection site, muscle aches, low-grade fever, fatigue or headaches. Both companies recently announced that clinical trials show their vaccines are more than 90 percent effective.

The ACIP group said last week that patients need to be warned about the potential side effects of getting a COVID-19 vaccine so they are not discouraged from getting a second dose.

ACIP is made up of medical and public health experts who develop recommendations on the use of vaccines in the US civilian population. The recommendations stand as public health guidance for safe use of vaccines and related biological products. Before recommending any vaccine, ACIP considers many factors, including the safety and effectiveness of the vaccine.

Listen in on the ACIP’s meeting today beginning at 2 p.m. at this link.

Medicaid Managed Care Plan Provider Manuals Now Available

All five of NC Medicaid’s managed care pre-paid health plans (PHPs) have finalized and the NC Department of Health and Human Services (NCDHHS) has approved their provider manuals, which include the most current and comprehensive information for you and your practice.

PHPs are contractually obligated to maintain the content of the manual to offer providers the tools and resources necessary for the delivery of quality care and services to Medicaid and NC Health Choice beneficiaries. Likewise, providers must use the manual for each contracted PHP as a means of remaining current on PHP policies, which will reflect any changes in state and federal regulations.

The manual for each PHP includes, among many other items:
• Clinical practice standards and utilization management programs;
• Covered services, additional benefits and carved-out services (services that will remain fee for service, or Medicaid Direct;
• Provider responsibilities;
• Primary care provider responsibilities;
• Network requirements, including nondiscrimination, on-call coverage, credentialing, re-credentialing, access requirements, no-reject requirements, notification of changes in address, licensure requirements, insurance requirements, and required availability;
• Telemedicine guidelines.

You may access the Department-approved PHP provider manuals on the Medicaid Health Plan Contacts and Resources webpage.

Statement on Essential Surgeries During a Pandemic

Last week the American College of Surgeons, the American Society of Anesthesiologists, the Association of periOperative Registered Nurses and the American Hospital Association issued a joint statement outlining a roadmap for maintaining essential surgeries during a pandemic.

Prompted by the recent resurgence of the COVID-19 virus across the US, the statement says that many health care facilities are again struggling to meet the needs of patients presenting for essential surgery.

“Now in their ninth month of stretching to treat growing numbers of COVID-19 patients, health care organizations, physicians and nurses must be able to meet the escalating demands for patients hospitalized with COVID-19 and those in need of essential surgical services,” the statement said. “The need for centralized coordinated governmental action to deploy necessary supplies and alleviate the financial burden on physician practices, health care providers and facilities is critical so the health care community can continue to meet the increasing demands for care of COVID-19 patients both in the operating rooms and throughout the facility.”

The statement lays out a series of principles and considerations for health care professionals as they strive to care for patients during a pandemic. Read the entire statement here.

In the News

Thousands of Doctors Offices Buckle Under Financial Stress of COVID, Kaiser Health News, 11-30-20

Learning Opportunity

A series of webinars on the Advanced Medical Home model for Medicaid Managed Care will begin on Thursday, Dec. 10 at 5:30 pm. This series will provide staff and physicians from primary care practices with more information on the Advanced Medical Home model and how to function at the highest AMH Tier possible when Medicaid Managed Care goes live in July 2021. Register for the webinars here.

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