Happy Monday! Enjoy your NCMS Morning Rounds.

August 2, 2021

NCMS Legislative Update

Most legislators were away last week, attending a national meeting that included a number of legislators from across the country there to discuss a variety of concerns, including some health-related issues. We’ve included a link to the Health Related Draft Policies at American Legislative Exchange Council (ALEC), so you can learn more about the discussion on those particular issues that may pop up next legislative session.

Recently, we sent out an action alert to you concerning a congressional action regarding Medicare rate cuts that are almost at 4%. WE NEED YOUR HELP! Please act now by communicating to your senators and your House members about how this unfavorable cut will impact your practice and your patients. Access the NCMS Medicare Cuts Action Alert here.

While legislators were away at the conference, we held meetings with some House members on the budget. We’re expecting the House budget to come out the second week in August.

This week, some committee meetings have already been scheduled. One issue that is up is SB 257. This is the Pharmacy Benefit Manager (PMB) regulation bill that has been well-vetted. It’s been through several committees, both on the House and Senate side. However, legislators are considering additional language to include in this bill that the NCMS is supportive of. This is Copay Accumulator Adjustment language.

Copay Accumulator Adjustment language is important because it ensures that all payments count that are made on the behalf of patients toward their out-of-pocket maximums or their deductibles. Some version of this language has already passed in Georgia, Virginia, and Tennessee. Again, the NCMS is in support of this language. It allows patients to get to those maximums faster.

Most North Carolina health insurers are now implementing “copay accumulator adjustment programs,” which prohibit copay assistance from any third-party, including a church, foundation, GoFundMe, or copay card, from counting toward a patient’s annual deductible or out-of-pocket maximum.

This means any third-party copay assistance will reduce a patient or family’s cost sharing burden, and means that copays are paid twice: once from copay assistance and again from the patient or family. It’s not fair and only pads the pockets of health insurers and PBMs.

We must include protections against copay accumulator adjustment programs in Senate Bill 257, which is currently being considered by the NC General Assembly.

Sign on now to send a message to your North Carolina legislators to ask them to help patients afford lifesaving treatment. Feel free to edit your message with your own story or perspective in your own words.

If you would like to take action on this issue, we have included the Copay Accumulator Adjustment link here.

Teaching Health Center Planning and Development Funding Available

HRSA, through the American Rescue Plan, released two new NOFOs to support primary care residency programs in rural and underserved communities and create new community-based residency programs.

Applications are due by Monday, August 30.

Learn more here.

NC Medicaid Managed Care Hot Topics Webinar Series Changes

Beginning in August 2021, the Hot Topics Webinar Series hosted by Shannon Dowler, MD, Chief Medical Officer of the NC Division of Health Benefits, and the NC AHEC Program will occur once monthly on the third Thursday of every month. First Thursday webinars, including the event planned for Thursday, August 5, will no longer be held.

In August, a hot topics webinar will be offered on Thursday, August 19 and a Virtual Office Hour event on Thursday, August 26. To view all upcoming webinar and Virtual Office Hour events, visit the Medicaid Managed Care hub on the website. Questions? Contact NC AHEC here.

Download your August 2021 (PDF) NCMS Calendar Page!

Print two sheets on standard paper

Print one full page on an 11 x 17 sheet of paper

View the full online version of the 2021 NCMS Calendar here.

In the News

Physicians Who Post COVID-19 Vaccine Misinformation May Lose License, Medical Panel Says, Becker’s Health IT, 7-29-21

Learning Opportunity

Counseling on Access to Lethal Means (CALM) 101, Friday, August 20 from 10-11:30 AM

Reducing access to lethal means, such as firearms and medication, can determine whether a person at risk for suicide lives or dies. CALM training focuses on (1) identifying people who could benefit from lethal means counseling, (2) asking about their access to lethal methods, and (3) working with them and their families to reduce access.

Learn more and register here.

If you have policies you’d like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!