Happy Friday! Here is your

NCMS Morning Rounds.

  March 13, 2020

Keeping up with Covid-19: Latest Info for NC Health Care Professionals

Remember: The most timely and credible information is available at the

NC Department of Health and Human Services Covid-19 website  

Centers for Disease Control and Prevention website.

Updated lab testing guidance

To facilitate greater access to testing for the virus that causes Covid-19, NCDHHS is encouraging providers to submit specimens to LabCorp when ALL of the following conditions are met:

  • Fever
    • Signs/symptoms of lower respiratory illness (e.g., cough, shortness of breath)
    • Negative influenza test (rapid or PCR).

Guidance for testing at LabCorp is available here.

Clinicians should use their judgment to determine which patients are most in need of testing. NCDHHS does not recommend testing of asymptomatic patients for COVID-19.

Read the memo from NCDHHS on testing through LabCorp.

NC Medical Board Adopts Emergency Rules

The NC Medical Board (NCMB) and the NC Rules Review Commission have approved emergency rules allowing a physician or PA who inactivated his or her NC medical license within the past 24 months to quickly obtain a temporary license to support Gov. Roy Cooper’s declaration of a state of emergency due to Covid-19. The license would authorize the physician or PA to practice for 90 days or until the state of emergency in North Carolina is declared over. Read the rules.

Over the next few days, NCMB will develop an online application form to receive temporary license requests from interested physicians and PAs. We expect to have this application ready by sometime next week. NCMB is not currently accepting requests for the new temporary emergency license.

Issuance of temporary authority to practice is subject to the following conditions:
• The applicant must demonstrate that he or she has practiced clinical medicine for at least 80 hours during the most recent 24 months;
• The applicant must have been licensed continuously for at least 10 years prior to making his or her medical license inactive;
• The applicant must have no history of public discipline and must not have inactivated his or her license while under investigation; and
• The applicant must confine his or her practice to areas in which he or she is clinically competent.

Please note that the NCMB adopted the emergency rules to support the Governor’s declaration of a state of emergency, which identifies a need to develop additional medical resources in the state, including additional providers. This is a preparedness step – there’s no indication that there’s a current need for additional medical providers to assist with COVID-19.

NCMB will likely advise inactive physicians and PAs who may be interested in returning to practice to check in with their local public health departments, former employer/practice, local hospital or other health care employer to determine if they are needed.

For the most up-to-date information visit the NCMB website.

Telehealth Advice

To help protect patients and staff from spread of Covid-19 many practices are looking to telehealth technology. NC Medicaid will allow practices to bill for defined telehealth services. Blue Cross and Blue Shield of NC also announced last week that they will cover telehealth services at parity with in-person provider visits starting March 6 and continuing for 30 days when the insurer will reassess the situation and decide whether to continue this policy.

If you are interested in learning more about how to implement telehealth into your practice, Curi, a Medical Mutual Company, offers this quick one-page summary offering guidance on the structure/execution of clinical telehealth services, as well as a number of links to resources and regulatory bodies. Curi Telehealth Overview.

Toolkit for Independent Physicians

Thanks to our friends at Avance Care, who have shared this toolkit for independent practices grappling with their response to Covid-19. The kit includes practical advice and resources to protect staff; recommendations for room decontamination; sample scripts for patients who may demand testing even if it’s not warranted by clinical guidelines and links to other resources.

Access the toolkit.

The latest from CMS for Your Medicare Patients

The Centers for Medicare and Medicaid Services (CMS) has waived certain requirements for Medicare Advantage and Part D Medicare plans to help prevent the spread of COVID-19. These flexibilities include:

  • Waiving cost-sharing for COVID-19 tests
    • Waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth
    • Removing prior authorizations requirements
    • Waiving prescription refill limits
    • Relaxing restrictions on home or mail delivery of prescription drugs
    • Expanding access to certain telehealth services

Learn more here.

To keep up with all the latest on CMS’ response to COVID-19, please visit the Current Emergencies Website.

Results of Sunday Survey # 2 – Insurance Payer Improvements

Thank you to those who responded to our second in a 5-week series of surveys on prioritizing issues for our advocacy efforts. This week’s survey explored what you see as top priority when it comes to improving your interactions with health insurance payers, both public and private.

Reforming the prior authorization process in fee-for-service plans was top priority for nearly 44 percent of survey respondents. The chart below shows the breakdown of the results.

The NCMS Legislative Cabinet will use these surveys, including the comments many of you made in the open response box, as they decide our legislative priorities for the coming legislative session. Be sure to watch your email this Sunday for our Sunday Survey #3, which will focus on public health.

In the News

These are Six of the Main Differences Between Flu and Coronavirus, MIT Technology Review, 3-10-20

Learning Opportunity

NC Academy of Family Physicians and Humana have partnered to produce this video on moving to value-based care. Watch the trailer. Watch the full, 15-minute video.