Happy Monday! Enjoy your NCMS Morning Rounds.

August 9, 2021

NCMS Legislative Update

Last week, in a unanimous vote, HB96, Pharmacist Approved Public Health Needs, moved through Senate Rules and on the Senate floor. The bill hasn’t changed since we saw it last in Senate Health Committee, where there were two big amendments that included one important provision: a requirement for emergency use authorized vaccines to require parental consent for your patients under 18. This bill is going back to the House for a concurrence vote. We’ll update you when this vote occurs and its outcome.

Parts of the House budget were released last week. Each subcommittee met last Thursday to give an overview of their budget. We paid close attention to the Health Appropriations Committee. There were no amendments to the Health Appropriations budget as currently written; however, there may be some as the process continues. Stay tuned to the NCMS Morning Rounds and our Legislative blog for a summary that will outline the entire budget. Until then, you can find House Budget Information from the House Health Appropriations Committee here.

We saw funding for the East Carolina University Telepsychiatry Program that we’ve been supportive of, included in our legislative priority list, as well as funding for health departments. These are two big wins we’ve seen in the House budget so far.

There are several things that were included in the Senate budget that aren’t included in the House budget. One is the surprise billing language we’ve mentioned previously. We are thrilled this policy provision was excluded from the House budget.

We’re likely to see a vote on this next week, so stay tuned.

Don’t Miss this Opportunity to Learn and Grow with Leadership College

The NCMS Foundation’s Kanof Institute for Physician Leadership (KIPL) is now accepting applications for its 2022 class of Leadership College scholars. This highly thought of program offers a comprehensive look at leadership development, bringing together a diversity of colleagues from a wide variety of specialties, practice models and geographic location within NC. Leadership College is unique because it also offers participants access to the NCMS’ special position in the state’s health care community with opportunities for a firsthand look at our advocacy efforts and our many other innovative initiatives.

Listen to 2019 graduate Quincy Jones, PA, talk about her experience with Leadership College.

If you would like to learn more, please submit a Leadership College interest form here or email Aubrey Cuthbertson at [email protected].

Learn more about the Kanof Institute for Physician Leadership and all its programs here.

Confirming Medicaid Coverage for Beneficiaries

NC Medicaid has received reports of confusion in the field by clinicians and pharmacies when members do not present an ID card or when presented with a Medicaid member ID card that differs from the data shown in the NCTracks system. To mitigate any confusion associated with newly issued Medicaid Managed Care member ID cards, clinicians and pharmacies should always use NCTracks Recipient Eligibility Verification/Response to confirm eligibility and not rely solely on the information shown on a Member ID Card. Follow the steps in this Medicaid bulletin when an NC Medicaid or NC Health Choice member presents at your office.

In the News

FDA Accelerates Full Approval of Pfizer-BioNTech Vaccine as Delta Variant Surges, Time, 8-4-21

Learning Opportunity

Back Porch Chat: Medicaid Managed Care Hot Topics, Thursday, August 19 | 5:30-7 PM

Hosted by Shannon Dowler, MD, Chief Medical Officer of the NC Division of Health Benefits, this 90-minute session welcomes each of the Chief Medical Officers of North Carolina’s five Medicaid Managed Care plans to bring you late breaking information and guidance on NC Medicaid’s transition to Managed Care. Topics covered will include:

  • Updates on Hot Topics
  • Data Overview for Call Center & NEMT
  • Common Claim Issues
  • Common Reasons for Prior Authorization Denials
  • Q & A

Do you have a question you would like Dr. Dowler or the PHP CMOs to answer during the webinar? Please access this link to enter your questions. We look forward to hearing from you!

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!