NCMS Political Pulse Video for August 21, 2020
Watch this week's video to learn about the NCMS' $50 million request to the legislature to help mitigate the pandemic's impact on your practice. Also, get the latest on the House Select Committee on COVID-19's meeting this week. And, with the elections less than 75 days away, now is the time to make sure you have donated to the NCMS PAC. Make your contribution here.
NCMS Morning Rounds 8-20-20
It's Thursday! Enjoy your NCMS Morning Rounds.
August 20, 2020
This National Survey Asks About Your Wellbeing During Pandemic
NCMS partner organization, The Physicians Foundation, is asking physicians nationwide to take just three minutes to complete its survey on physician wellbeing during the COVID-19 pandemic. Results will be shared with policymakers, legislators, the public, the media and you to ensure physicians’ voices are heard. If you include your email you will be entered in a drawing for one of four $500 Amazon gift cards. TAKE THE SURVEY.
This is the second in a series of surveys by The Physicians Foundation aimed at gauging the impact of COVID-19. The results of the first survey examining how the pandemic has affected physician practices and patients were released earlier this week. See the results of the first survey.
The third and final survey in the series will explore COVID-19’s impact on the health care system. Watch your NCMS Morning Rounds for that survey in the coming weeks. THANK YOU for participating in these important information gathering efforts to assess the current situation and your needs.
NC Medicaid To Cover COVID Test for Uninsured
Effective Sept. 1, NC Medicaid will begin reimbursing COVID-19 testing costs for uninsured individuals who enroll in the NC Medicaid Optional COVID-19 Testing (MCV) program. This option was made available to all states through Section 6004(a)(3) of the Families First Coronavirus Response Act (FFCRA).
To be eligible for this program, the person must
• Live in North Carolina;
• Be a U.S. citizen or U.S. national or have eligible immigration status;
• Not be covered by Medicaid, Medicare or other health insurance.
Individuals will be able to apply online for the MCV program beginning in September. For those without access to the Internet, NC Medicaid encourages COVID-19 testing site providers and other Medicaid-enrolled providers who perform testing to download paper applications, available in English and Spanish, and collect them for mailing to the Medicaid address on the form. Paper applications are estimated to take 2 to 6 weeks for processing.
And in Other Medicaid News…
As of Aug. 15, NC Medicaid will cover bilateral salpingectomy (58661 and 58700) for tubal sterilization both for laparoscopic tubals and at cesarean delivery.
“This is excellent news for the women of North Carolina,” said Amy Bryant, MD, MSCR of the University of North Carolina School of Medicine’s Department of Obstetrics and Gynecology and a leader of the NC Ob-Gyn Society (NCOGS). “Bilateral salpingectomy not only provides improved protection from future ovarian cancer, it also very likely provides the best possible contraception for women who are done with childbearing.”
The NCOGS had advocated for this coverage in the past.
Learn more in this NC Medicaid Bulletin.
In the News
Seven Months Later What We Know About COVID-19 – and the Pressing Questions That Remain, STAT, 8-17-20
Learning Opportunity
Physician author Damon Tweedy, MD, Associate Professor of Psychiatry at Duke University School of Medicine is offering a Health Humanities Grand Rounds, “Reflections on Race and Medicine in the Year of COVID-19 and Nationwide Protests” on Tuesday, Sept. 1 at 4 p.m. In his talk, Dr. Tweedy will explore the dilemma of race within the medical school and hospital setting, highlighting the challenges faced by black patients and black doctors while reviewing recent developments and reforms in the field. 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!
NCMS Offers Access to PPE
To address the needs of the medical practices we serve statewide, the NCMS has developed a mechanism to procure personal protective equipment (PPE) through group purchasing. This two-pronged effort offers you a chance to place an online order through a joint group purchasing arrangement with the Charleston County (South Carolina) Medical Society and other state and local medical societies to access needed PPE materials. The easy ordering process is detailed on this webpage.
Thresholds for the amount of PPE must be met before the orders can be placed, so this is not an immediate fix for your PPE needs. However, please think ahead to your longer term needs as the volume of in-person patient visits may begin to increase as stay-at-home orders and other restrictions are lifted in the coming weeks and months.
As your state medical society, we are pleased to offer you this option to protect your health and that of your patients as together we respond to the COVID-19 pandemic.
View your ordering options now.
NCMS Morning Rounds 8-17-20
It's a new week and time for your NCMS Morning Rounds!
August 17, 2020
NCMS members should have received a special email with the latest issue of the NCMS Bulletin Magazine on Friday afternoon. This issue profiles several of your physician, PA and medical student colleagues and their individual journeys to become health care leaders. We hope you enjoy reading it! Read the Summer 2020 NCMS Bulletin here.
NCMS Legislative Update
The NC General Assembly appropriated funds to help ensure health care providers in a variety of settings have the necessary personal protective equipment to care for patients during the current pandemic. Your NCMS received $5 million to ensure independent medical practices had the PPE they need. Last week, the NCMS launched its free PPE distribution to such practices. Learn more and find out if you are eligible to receive this crucial equipment here.
Also, last week the Joint Legislative Oversight Committees for Health and Human Services and for Medicaid met to hear from officials on the state’s response to the pandemic as well as the timeline for the transition to Medicaid managed care. Review summaries of both of these committee meetings on our legislative blog, where you can also see charts showing how COVID-19 relief funds have been spent in the state, a timeline for Medicaid transformation (the go-live date is July 1, 2021) and projections on increases in those qualifying for Medicaid benefits due to the economic impact of the pandemic.
Legislators complimented the North Carolina medical community for having one of the highest rates of physician participation in the state’s Medicaid program.
We’d also like to offer kudos to longtime NCMS member David Hill, MD, FAAP, a Goldsboro pediatrician, who spoke to the committee on COVID-19’s impact on children, expressing his concern that children continue to receive the recommended immunizations during the pandemic. His presentation is available here on our blog.
The Durham Orange County Medical Society meeting last Wednesday was a huge success with over 40 people participating in a virtual ‘Town Hall’ forum with the majority of the area’s state legislative delegation. The discussion with legislators was lively and informative. If your practice or county or specialty society would like to hold a similar town hall forum, now is a great time as we approach the November election and legislators want to hear what is on their constituents’ minds. If you would like to arrange such a forum, please contact NCMS Director of Legislative Relations Sue Ann Forrest, MPA.
NCMS Member Book Club Starts THIS THURSDAY!
This is a reminder to sign up for the NCMS Book Club before this Thursday, Aug. 20. In this online community, Society Members will connect with each other to read and discuss books on a range of topics, as well as member-submitted recommendations.
There is no cost to participate if you are a member* of the Medical Society – you just have to get a copy of the book to enjoy. We will be kicking off on Aug. 20 with the book Just Mercy by Bryan Stevenson and we’re looking forward to some great conversations with our members! Sign up here.
*If you would like to become a member of NCMS to be eligible to join our book club click here.
**If you are not eligible to be a member of the NCMS but would still like to join the Book Club, please contact Ashley Newton or Danielle Snyder for further information.
Join the ‘Mask Up’ Social Media Campaign
In an effort to help mitigate the spread of the COVID-19 virus, the NCMS has joined the AMA in launching a public health campaign called #MaskUp. This social media effort is focused on specifically encouraging the public to wear masks. The scientific information included also debunks myths and misconceptions around mask usage and equips physicians with simple tools to help patients understand their risks for transmission.
We invite you to join us by using your social media networks to spread the #MaskUp message. The AMA has created a toolkit with ready to use posts and graphics. Access the toolkit here.
By signing up through this ‘participation pledge’ the AMA will periodically send updated communications with key messages and new graphics.
In the News
Election Day is Coming. Should Your Doctor Encourage You to Vote?, The Advisory Board Forum, 8-12-20
Learning Opportunity
A webinar on National COVID-19 Vaccine Trials will be held Tuesday, Aug. 18 from noon to 1:30 p.m. Discussion will focus on a few of the leading COVID-19 vaccine trials, the progress that has been made and next steps in the COVID-19 vaccine trial process as well as exploring the safety and efficacy of the COVID-19 vaccine trial process. Learn more and register.
NCMS Morning Rounds 8-14-20
Happy Friday! Enjoy your NCMS Morning Rounds!
August 14, 2020
Get Ready for the NCMS Election!
Voting for NCMS leadership begins on Oct. 1 and to insure you are able to cast your ballot we ask you to please make sure you have paid your 2020 membership dues and we have your most recent email address on file. Voting to fill positions on the NCMS Board of Directors, AMA delegation and Nominating and Leadership Development Committee is electronic via email. For those without email access, we will mail a paper ballot.
You can easily renew your membership here. If you need to update your email address, please send it to our membership services department here.
The electronic ‘polls’ will open on Oct. 1 and you will receive a secure ballot via email to complete by Oct. 15 when the balloting will end and those elected will be announced at the NCMS Annual Business Meeting.
The NCMS’ Nominating and Leadership Development Committee put forth the following slate of candidates:
Board of Directors
President Elect: Mike Utecht, MD
Secretary Treasurer: John Meier, IV, MD
Region 3 Representative: Karen Smith, MD
Region 4 Representative: Rachel Keever, MD
At-Large Member: Eileen Raynor, MD
At-Large Member: Bryant Murphy, MD
American Medical Association Delegation
Delegate: Hadley Callaway, MD
Delegate: William Bowman, MD
Delegate: Darlyne Menscer, MD
Delegate: Liana Puscas, MD
Alternate Delegate: Rebecca Hayes, MD
Nominating & Leadership Development Committee
Region 1: Chris Grubb, MD
Region 1: Jugta Kahai, MD
Region 2: Justin Hurie, MD
Region 4: Gregory Evans, MD
According to the NCMS Bylaws, component societies, specialty societies, and sections may submit additional nominations for these positions by the end of the day today, Aug. 14, 2020. Please use this form to submit nominations. For questions on the nominating process, contact Evan Simmons. The final slate of candidates will be published by Sept. 24.
Governor Extends Immunization Requirement Deadline for School, Day Care
Earlier this week Governor Roy Cooper issues an Executive Order extending, but not waiving, the proof of immunization deadline for schools and child-care facilities. The extension is in recognition of difficulties some families may face due to the COVID-19 pandemic in getting in to see their doctor to receive the required vaccines and health assessments.
Typically, proof of required immunizations and health assessments are required within 30 days of the first date of school attendance. After that, children are excluded from school until the family provides documentation of the requirements. This year, the 30-day "grace period" for all students will begin on Oct. 1. The requirements apply to children who are home-schooled, attend school in-person or by remote learning.
The requirements are listed on the NC Department of Health and Human Services (NCDHHS) website according to school or grade level, as well as the requirements for young children who attend child care facilities. NCDHHS’ Immunization Branch offers comprehensive guidance on immunization recommendations, as well as advice for families on navigating access issues during COVID-19.
The Vaccines for Children (VFC) program offers free vaccines to families who cannot afford to pay for their children’s vaccines (through 19 years of age), and federal law requires most private insurance plans including Medicaid to cover recommended preventive services such as vaccinations at no out-of-pocket cost.
NCDHHS Secretary Mandy Cohen, MD, MPH stressed the importance of meeting the requirements.
“With kids headed back to school and flu season right around the corner, it’s more important than ever this year for all North Carolinians to get their recommended immunizations," she said. "Childhood immunizations keep kids safe and protect public health by lowering the likelihood of an outbreak of a vaccine-preventable disease like measles."
The Executive Order and a State Health Director Memo issued by State Health Director Elizabeth Tilson, MD, MPH will extend, but not waive, North Carolina’s current proof-of-immunization requirement deadlines for students enrolled in public, private or religious educational institutions, including child care facilities and K-12 schools as well as colleges and universities. The Executive Order also extends the deadline for each child entering a North Carolina public school for the first time to submit a school health assessment.
Accelerate for Value Deadline TODAY + Federal Relief Fund Deadline
Today, Friday, Aug. 14, is the deadline for primary care practices that want to join the Blue Cross and Blue Shield NC’s Accelerate to Value program.
Independent practices that join the program will receive approximately $48 per attributed life in 2020 (all Blue Cross NC commercial products with the exception of the State Health Plan and Blue Cross NC MA are included). Practices approved for participation will receive these funds (likely in late August- early September) and will not have to pay any of this payment back as long as they remain independent through 2022.
Those independent primary care practices that choose to remain in the Accelerate to Value Program beyond 2020 must sign up with a Blue Premier ACO by Dec. 31 and will continue in the Accelerate to Value Program receiving additional payments to “true up” revenue in 2021, assuming COVID-19 continues to impact patient volume.
Reminder: Two weeks from now, Friday, Aug. 28, is the deadline for federal relief for those practices that bill Medicare, Medicaid or CHIP and have experienced lost revenue due to the COVID-19 pandemic and to reimburse claims for testing and treatment of uninsured patients diagnosed with the coronavirus. The funding can be up to 2 percent of patient revenue. You can apply for this funding even if you received a previous disbursement.
In the News
CDC Issues Dire Warning for the Fall If Coronavirus Measures Are Not Followed, CNN, 8-13-20
Learning Opportunity
Mark your calendar for next Friday, Aug. 21, Kanof Institute for Physician Leadership Power Hour from 1 to 2 p.m. when we will continue our ongoing discussion around racism in the United States and what we can do as individuals, as a health care community and as a medical society to address racial injustice and health inequities. Join your colleagues and our guests, who are focused on change at all levels to address health inequities and disparities, as we grapple with these issues. Learn more and register here.
The KIPL Power Hour aims to provide a forum for ongoing conversation, collaboration and community. Tune in to Power Hour weekly to hear from different experts, decision makers and influencers on a variety of topics. The format is informal and conversational and sessions are easy to access through Zoom. Power Hours will be recorded and made available to you through your NCMS Morning Rounds and on the KIPL webpage.
NCMS Morning Rounds 8-13-20
Enjoy Thursday's NCMS Morning Rounds!
August 13, 2020
NCMS Is Pleased to Offer FREE PPE
The NCMS heard your calls for crucial personal protective equipment (PPE) during this pandemic and mobilized to secure a $5 million grant from the NC General Assembly to provide FREE PPE to independent practices across North Carolina. Thanks to your conversations with legislators, the efforts of the NCMS advocacy team and our existing purchasing ability via ActionPPE, we are ready to begin distribution of this valuable resource to ensure you can effectively and safely care for your patients.
To be eligible for FREE PPE provided by the NCMS via the $5 million appropriation from the NC General Assembly, each practice must certify that they meet all the following criteria:
• Your practice is organized in accordance with North Carolina General Statutes Chapter 55B and registered with the North Carolina Medical Board as a professional corporation or professional limited liability company with the purpose of practicing medicine.
• Your practice currently provides or contracts for professional medical services.
• Your practice is not owned, managed, or otherwise controlled by an entity defined in G.S. 131E-76(13).
• Your practice is not managed by a practice management company unless the practice management company is majority owned by North Carolina licensed physicians.
You can complete the confirmation form here.
Once the confirmation form is completed, PPE will be shipped to each office location you provide. Learn more about the available PPE and how it will be shipped at the NCMS Free PPE webpage.
The goal of this distribution effort is to ensure that 100 percent of independent practices in North Carolina have the PPE needed for today, but also PPE reserves for an uncertain future. Please continue to order PPE supplies as you normally would and consider this free PPE as stockpile when possible.
The NCMS also offers a variety of PPE through our ActionPPE group purchasing arrangement. Learn more about this purchasing option here.
If your practice is in critical need or have other questions, please contact Jennifer Crowley or Kathy Scott.
Updates on Launch of Medicaid Managed Care
The NC General Assembly’s Joint Legislative Oversight Committee on Medicaid and NC Health Choice met Tuesday to hear from state health officials on, among other topics, the anticipated launch of Medicaid managed care on July 1, 2021. This new ‘go-live’ date for the state’s move to Medicaid managed care was mandated in SB808 – Medicaid Funding Act, passed during the most recent legislative session.
NC Department of Health and Human Services staff told legislators open enrollment for Medicaid beneficiaries will begin on March 15. The program will launch statewide July 1, 2021, officials said, rather than a phased roll out by region, and is anticipated to cover between 1.6 million and 1.8 million North Carolinians.
Medicaid beneficiaries will be able to choose from among the five health plans awarded state contracts to provide Medicaid services:
• AmeriHealth Caritas (statewide)
• Healthy Blue (statewide)
• United HealthCare (statewide)
• WellCare (statewide)
• Carolina Complete Health (regions 3, 4, 5 – see a map of the regions here)
While the health plans are working to ensure they are ready to enroll and serve patients, the state is working to formulate the per-patient reimbursement rates for providers and submit them to the Centers for Medicare and Medicaid Services (CMS) for approval by November.
Read a complete summary of this committee meeting on our legislative blog here as well as a summary of the Joint Legislative Oversight Committee on Health and Human Services – COVID-19, during which NC DHHS Secretary Mandy Cohen, MD, MPH spoke with legislators.
Getting Ready for Medicaid ‘Go-Live’
Carolina Complete Health Network (CCHN) has announced the immediate availability of three innovation grants for contracted AMH Tier 2 practices interested in considering attesting to Tier 3 before the anticipated go-live of the state’s Medicaid transformation to managed care.
The project will assess each selected practice’s current state, identify any gaps in achieving Tier 3 readiness and collaborate with the practice to address those gaps before the July 1, 2021 go-live date.
CCHN is pleased to be able to fund the project. The only cost to participating practices is staff time and availability. This innovation project brings together CCHN’s Enhanced Provider Engagement services and Emtiro Health’s robust AMH consulting services.
In the News
We Need New Antimicrobials to Prevent the Next Infectious Disease Crisis, STAT, 8-12-20
Learning Opportunity
The Health Equity Summit will be held Wednesday, Aug. 19 from 2 to 5 p.m. This meeting is designed to bring together a diverse group of leaders, innovators and health equity champions from across the country to connect, amplify and accelerate conversations around health equity strategies, solutions and cross sector collaboration for a healthier tomorrow. University of North Carolina Center for Health Equity Research Director Giselle Corbie-Smith, MD, will be a featured speaker. 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!
NCMS Morning Rounds 8-12-20
Halfway through the week. Enjoy your NCMS Morning Rounds!
August 12, 2020
NCMS Urges Congressional Action on Surprise Billing
NCMS Executive Vice President and CEO Robert W. Seligson, MBA, MA sent a letter this week to each member of the NC Congressional delegation urging them to continue efforts toward a proposal that effectively addresses the harm caused by surprise medical bills, holds patients harmless, provides fair compensation for services rendered and protects access to care. Read the letter.
Surprise medical billing is a widespread and costly problem in the United States, and the need to address it has been highlighted during the current pandemic. Research shows that 41 percent of insured adults nationwide were surprised by a medical bill in the past two years alone, and that two thirds of adults worry about their ability to afford an unexpected medical bill.
The U.S. Department of Health and Human Services (HHS) recently released a report on surprise billing calling for Congressional action. Read the report from HHS Secretary Alex Azar.
The NCMS has long advocated for reforms to protect patients from surprise bills, and in November 2019, the NCMS Board of Directors adopted a policy framework to guide our advocacy. The NCMS seeks a solution that addresses the issue proactively by shifting the focus from reacting to the surprise bill after the fact, to preventing it in the first place. This could be accomplished by identifying the areas where surprise billing is most likely to occur and negotiating charges before they are billed, perhaps by requiring them to be arbitrated in advance of services being rendered. Learn more about the NCMS’ proactive approach to this issue.
Earlier this year, NCMS President Palmer Edwards, MD, DFAPA, and other NCMS leaders traveled to Washington, D.C. to lobby the NC Congressional Delegation on this issue.
Celebrating Our Community Health Centers!
This week is National Health Center Week (Aug. 9 – 15), a time to celebrate and raise awareness about the mission and accomplishments of health centers over the past five decades and particularly during the current pandemic.
North Carolina has 42 Community Health Centers with over 270 sites across the state, providing innovative ways to provide preventative and primary care to more than 600,000 patients, many of whom are part of underserved communities.
Each day of this week focuses on a different aspect of Community Health Center’s work. Learn more about each topic and how you can help in your community here.
Sunday: Public Health in Housing Day
Monday: Health care for the Homeless Day
Tuesday: Agricultural Worker Health Day
Wednesday: Patient Appreciation Day
Thursday: Stakeholder Appreciation Day
Friday: Health Center Staff Appreciation Day
Saturday: Children’s Health Day
Your Vote by Mail Questions Answered
With the November election just 88 days away, and with the current pandemic making physical distancing important, the NC State Board of Elections wants to be sure you have answers to your questions about voting by mail as an option this year.
This comprehensive list of FAQs outlines everything you need to know about how to vote by mail and avoid potentially crowded polling places. The document includes links to requesting a mail in ballot and how to cast your vote.
Access this useful document now.
In the News
Which Masks Best Stop the Spread of COVID-19? Duke Researchers Tested Them to Find Out, Raleigh News & Observer, 8-10-20
Learning Opportunity
As part of the State's continuing efforts to ensure providers have the information they need, State Health Director and Chief Medical Officer Betsey Tilson, MD, MPH, and State Epidemiologist Zack Moore, MD, MPH, will provide brief updates on the State's COVID-19 response and will respond to questions this Friday, Aug. 14, from 12:30 to1:30 p.m.
Please send questions in advance to [email protected].
To participate in this Zoom call, connect through this link or dial in at 1-646-558-8656 and enter meeting code 705979628#
Joint Legislative Oversight Health and Human Services - COVID-19
The Joint Legislative Oversight Health and Human Services Committee met on August 11, 2020 at 10:00am.
COVID-19 Opening Remarks from the Secretary
Dr. Mandy Cohen, MD, MPH, informed the Committee that the State took early and aggressive action to slow the spread of the virus.
She emphasized that the public must continue to practice the 3 Ws, wear a mask, wash your hands, and wait six feet apart. The state's strategies include prevention, testing/tracing, and isolation/quarantine.
The current 3 key prevention strategies that the Department is focusing on currently include the following:
- Promote public messaging
- Provide personal protectice equipment
- Issue guidance and support
To date, DHHS has distributed 3.5 million cloth masks and 4.5 million procedure masks, and additional PPE supplies across the state.
There are approximately 30,000 daily tests completed daily and turnaround times have improved to a 3 day average.
DHHS currently has over 1,800 staff members to support contact tracing efforts.
To date, DHHS has recieved $345,340,000 in Coronavirus Relief Funds from the Us Treasury appropriated through the General Assembly. All funding allocated from this source must be used by 12/30/2020.
Other CARES Act funding recieved, mostly through grants, totals $508, 230,785. These funds have longer liquidation periods ranging from 12-36 months.
Funding initiatives to support child welfare, nutrition, child care, older adults, housing, and mental health were highlighted.
DHHS has worked with emergency management to distribute $180 million to distribute PPE to health care workers, long term facilities, childcare centers, court facilities, and schools.
DHHS is investing federal funds to strengthen our public health infrastructure to continue to meet the demands of the pandemic.
- $26.9 million - modernize public health survelliance systems
- $14.8 million - surge staffinf for temporary employees and consultants
- $1 million - support scientific research to learn the impact of COVID-19
NCMS Member, Dr. David Hill, MD, FAAP, provided an update to the Committee about the impact COVID-19 is having on children.
Dr. Hill informed the committee that science constantly improvies on itself which is a strength, but can also cause confusion as better information comes to light.
He added that children ages 0-18 account for approcimately 9% of all US COVID-19 cases. An aysmptomatic infection is commen in children.
He stated hospitalization rates are 95% lower for kids than adults, but 1/3 of hospitalized kids end up in intensive care units.
He added minority children and muti-generational households have a higher risk factor. We can all reduce the spread by using face masks, social distancing, and hand washing.
Children continuing to receive their scheduled vaccinations is a major concern for pediatricians.
Joint Legislative Oversight Committee - NC Medicaid
The Joint Legislative Oversight Committee met on August 11, 2020 at 1:30pm.
The Committee heard reports about Medicaid Transformation, Medicaid enrollment, and Medicaid budgeting.
Dr. Mandy Cohen, MD, MPH, provided overview remarks to the Committee. She noted that increasing access to affordable insurance is an important way for the state to fight COVID-19.
Dr. Cohen presented data from the Kaiser Family Foundation that concludes 13% of North Caroinians were uninsured in 2018.
She added that while the Families First Coronavirus Response Act allows states to pay for COVID-19 testing for the uninsured, it does not pay for treatment.
She remains hopeful that federal legislation will be passed. If there is federal funding, the NCGA would need to convene to distribute the funds.
There are 1.6-1.8 billion Medicaid beneficiaries will enroll in standard plans.
The beneficiaries will be able to choose from 5 prepaid health plans:
- AmeriHealth Caritas
- Healthy Blue
- United HealthCare
- WellCare
- Carolina Complete Health (regions 3, 4, 5)
One added challenge in transitioning to managed care is the uncertainty in provider's prioritizing contracting due to COVID-19.
DHHS is currently working with the Eastern Band of Cherokee Indians to develop a tribal option to go live in region 1.
Enrollment in Medicaid and NC Health Choice is expected to grow. However, the Department was clear that the pandemic will be a major factor in enrollment.
The Medicaid average memberhsip is expected to grow 8% through 2021.
For fiscal year 2019-2020 appropriations expenditure for Medicaid and NC Health Choice was $116 million of 3% less than budgeted.
The main drivers of growth for the 2019-2020 fiscal year were COVID-19 rates and policy. The main areas of savings were the lower claims volume from social distancing, the Families First Act FMAP bonus, and accelerated hospital supplemental payments.
NCMS Morning Rounds 8-11-20
It's Tuesday and time for your NCMS Morning Rounds!
August 11, 2020
Survey Tracks NC Practices’ Continuing COVID-19 Journey
Sixteen weeks ago the NCMS along with the NC Medical Group Management Association (NCMGMA) and Curi began surveying NC medical practices on the impact of the COVID-19 pandemic. This summary of the data collected since March give a snapshot of the changing landscape and the continuing challenges NC practices have experienced over the past four months. Review the data summary report.
Survey data shows that ‘patient volume,’ ‘financial concerns’ and ‘personal protective equipment (PPE) access’ consistently were the top three concerns for responding practices. In recent weeks, two concerns, not previously in the top three, have been rising: ‘staffing’ increased from 5 percent (week of June 22) to 15 percent (week of July 20th) and ‘Access to COVID Testing’ increased from 4 percent (week of June 22) to 10 percent (week of July 20th).
THANK YOU to those who have been responding to the surveys regularly to help track this valuable information to help us respond to your practice needs and to share with key policymakers and legislators.
We continue to send the survey every other week and encourage you to complete it. In addition to the regular, recurring questions, several surveys included additional questions focused on particular areas of concern. See the analysis of those ‘deep dive’ survey results below.
• Financial Summary Report
• Telehealth Report
• Practice Reopening Report
• Practice Well-being Report
Updated PPP Loan Forgiveness FAQs
The Small Business Administration (SBA) last week updated its Frequently Asked Question (FAQ) page with guidance to address borrower and lender questions concerning forgiveness of Paycheck Protection Program (PPP) loans. Access the FAQ document here.
The PPP was a loan program designed to provide a direct incentive for small businesses to keep their workers on the payroll during the shutdowns caused by the COVID-19 pandemic. The SBA will forgive loans if all employee retention criteria are met, and the funds are used for eligible expenses. Click here to read more about the PPP and loan forgiveness.
NC Medicaid Offers Updates; Tips on Improving Immunization Rates
The NC Department of Health and Human Services staff and NC Medicaid Chief Medical Officer Shannon Dowler, MD, will be available Thursday, Aug. 13 from 5:30 to 6:30 p.m. to offer timely updates on topics including the extension of rate changes to Sept. 30 and temporary policies to the end of the year as well the process and timeline for making some of the policies permanent. The webinar will also cover the latest on the state’s move to managed care and an overview of telehealth data.
The other part of the session will be spent discussing ways to improve well-child visits and immunization rates as the school year is set to begin, albeit with remote learning in many areas. Learn more about the state’s innovative ways to get children in for recommended care during the COVID-19 pandemic here.
Tune into this important and informative webinar by clicking here or dialing in at 312-626-6799 and entering webinar ID: 848 964 708.
In the News
COVID-19 May Never Go Away – With or Without a Vaccine, NPR, 8-9-20
Learning Opportunity
Everyone has implicit biases, but it is important to become mindful of how they can show up and impact our work with others. ‘How Implicit Bias Affects Our Work: Engagement with Communities’ is a webinar series, hosted by the Pacific Southwest Mental Health Technology Transfer Center and will explore the dynamics of implicit bias and its impact on decision-making. The first session is scheduled for Thursday, Aug. 27 at 6 p.m. Learn more and register here.
NCMS Morning Rounds 8-10-20
Welcome to a fresh, new week! Enjoy your NCMS Morning Rounds!August 10, 2020 NCMS Legislative UpdateBe sure to join the Durham Orange County Medical Society this Wednesday, Aug. 12 from 6:30 to 8:30 p.m. as it hosts NCMS Director of Legislative Relations Sue Ann Forrest, MPA, and several NC legislators representing the area to discuss current health care issues of importance to you and your practice. The Zoom meeting is open to those outside of Durham and Orange counties, who may be interested in hearing from the legislators, several of whom serve on the NC House Health Committee. Learn more and register here. Legislators invited to participate include: Rep. Graig Meyer (D-Orange), Rep. Verla Insko (D-Orange), Sen. Valerie Foushee (D-Orange), Sen. Mike Woodard (D-Durham), Rep. Vernetta Alston (D-Durham), Sen. Natalie Murdock (D-Durham). This legislative forum is just one example of how the NCMS advocacy team stands ready to partner with you, your practice, health care organization or county medical society to offer valuable information and insights to help you effectively advocate on behalf of your profession. If you would like to learn how we can provide training, tools and resources to help, please contact Sue Ann Forrest at [email protected]. In addition to educating yourself on the issues, candidates and your options for voting in the rapidly approaching election, giving to the NCMS PAC is another important step to take in making sure health care issues are addressed by elected officials. If you haven’t already made your contribution, please do so today. Donate now. NCMS Handy Guide to Telehealth Policies UPDATEDThe NCMS’ popular and extremely useful guide to payer telehealth policies for all NC commercial payers and Medicare Advantage has been updated. You can access the updated grid here. This one-stop resource allows you to quickly reference the multitude of policies and new deadlines for telehealth coverage as the pandemic continues. This valuable guide is always available on the NCMS COVID-19 webpage under Telehealth. Visit the NCMS COVID-19 webpage. Truth Initiative® Presents “Black Lives Black Lungs”'Black Lives Black Lungs’ is a short documentary that explores the history, marketing tactics and impact of the tobacco industry targeting African-Americans with menthol tobacco products. Watch the 15 minute short film here. Learn more about this documentary and the Truth Initiative here. In the NewsThe Best (and Worst) States for Health Care, According to Wallet Hub, The Advisory Board Forum, 8-4-20 [Spoiler alert: NC doesn't do so well in this ranking.] Learning OpportunityAugust is National Immunization Awareness Month and a good time to focus on helping to ensure that children and adults receive all recommended vaccinations. A webinar titled ‘Vaccine Hesitancy Confidence’ will be offered on Thursday, Aug. 13 from 10 to 11 a.m. Sponsored by Pfizer, the session will feature Amy Pisani, Executive Director of Vaccinate Your Family and a leading authority in vaccine advocacy. She will discuss existing best practices and strategies for vaccination confidence in a COVID-19 environment. Learn more and tune in here. The meeting access code is 1610345609. The meeting password is Pfizer123. AND This month’s NCMS Foundation and NC Medical Group Management Association Lunch & Learn webinar will feature the NCMS’ Pam Highsmith, MEd, CFRE and Frank Snyder on the topic ‘You Asked, We Delivered: FREE and other PPE Solutions.’ The NCMS received an appropriation from the North Carolina General Assembly to purchase and distribute PPE to independent practices in NC. Join the webinar on Tuesday, Aug. 18 from noon to 1 p.m. to learn how your practice can receive this FREE PPE. Not an independent practice? This webinar will also provide information on group purchasing and resources available through other professional associations. Please come prepared with tips and resources to share with the group and with your continuing challenges regarding PPE. Together is the only way we’ll find solutions! 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!
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NCMS Political Pulse for Aug. 7, 2020
Find out about an opportunity through the Durham Orange County Medical Society to hear a virtual discussion with NC legislators on issues of importance to all physicians and PAs; learn how the NCMS advocacy team can provide you with the tools and resources to be successful advocates for your profession and a reminder of the importance of donating to the NCMS PAC as the election nears.
NCMS Morning Rounds 8-7-20
Finally Friday and here's your NCMS Morning Rounds!
August 7, 2020
NC Medicaid Extends COVID-19 Provisions
With the recent extension of the federal Declaration of Emergency through Oct. 25, 2020, NC Medicaid has extended its COVID-19 related temporary Clinical Coverage Policy provisions to Dec. 31, 2020. NC Medicaid has also determined it is both necessary and feasible to continue temporary enhanced rates related to COVID-19 through Sept. 30, 2020. In the fall, NC Medicaid will reassess both needs and available funding.
Learn more in this special Medicaid Bulletin. Review the relevant Medicaid fee schedules here.
Additionally, public comments are being accepted on proposed Medicaid and North Carolina Health Choice policies to adopt permanent changes based on certain temporary modifications. The comment period closes for two telehealth policy proposals on Aug. 15. Other comment periods extend into September. All stakeholders are encouraged to provide feedback. Review all the proposals here.
There’s an App for – Physician Wellness!
The University of North Carolina School of Medicine and UNC Health have launched the Heroes Health Initiative to help support the mental health of first responders and health care workers during the COVID-19 global pandemic. The app is available through the App Store/Google Play Store and is free to first responders, health care workers and their organizations. Learn what it offers and how to download it here.
For individual health care workers, the Heroes Health app delivers short mental health self-assessments each week and displays symptom summary reports to help individuals better understand the state of their own mental health and changes over time. The app also provides links to immediate support and mental health resources, emphasizing free and low-cost services.
The app can also help organizations by providing anonymous group-level summaries and trends in the mental health of workers in the organization. The summaries can be shared with unit and organizational leaders each week, to help them identify times/organizational areas that would benefit from additional support.
Heroes Health Initiative was founded by UNC School of Medicine physician Samuel McLean, MD, research vice-chair in the Department of Anesthesiology and an attending physician in the Department of Emergency Medicine. As a practicing emergency physician and COVID-19 unit worker, and a COVID-19 survivor who contracted COVID-19 and infected two of his family members, McLean understands firsthand the great challenges COVID workers face.
Read more about Dr. McLean and the Heroes Health Initiative here.
Seeking Input on Vibrio Infections
If you are an infectious disease specialist, work in an emergency department or in a coastal area where people eat a lot of shellfish or may be impacted by flooding from hurricanes, the Columbia Journalism Investigation team is seeking to understand your experience in dealing with Vibrio infections.
The project is a joint undertaking by Columbia Journalism Investigations, The Center for Public Integrity, Mother Jones and McClatchy newspapers in North and South Carolina. The team is seeking input from medical professionals nationwide to identify successes and challenges in fighting Vibrio infections in their communities.
If you have encountered such infections and would like to participate, please answer this brief list of questions. Your answers will help the team assess what you currently have and what you need to effectively battle this growing health risk.
Your answers will not be published without your permission. All personal information is confidential.
In the News
What You Need to Know About Trump’s Telehealth and Rural Health Executive Order, The Advisory Board Forum, 8-4-20
Learning Opportunity
DON’T FORGET TODAY’S POWER HOUR at 1 p.m. when we will discuss access to health care during COVID-19 for LGBTQ+ patients. Get a variety of perspectives on this topic from our distinguished guests including: Carly Kelley, MD, an endocrinologist and co-director of Duke's Adult Gender Medicine Clinic; Holly Christopher Lewis, MD, PhD, general surgery resident at Duke University Medical Center; Jugta Kahai, MD, a pediatrician with Columbus Regional Health Care System and Dane R. Whicker, PhD, Director of Gender and Sexual Diversity Initiatives as Duke's School of Medicine. Register here for this Zoom session.
NCMS Morning Rounds 8-6-20
Happy Thursday! Enjoy your NCMS Morning RoundsAugust 6, 2020 Was your practice impacted by Hurricane Isaias? Please reply to this email to let us know if we can help. The NCMS is there for you in a crisis – whether it’s through procuring personal protective equipment (PPE) during the current pandemic or helping practices rebuild after Hurricane Florence. We want to help ensure you can continue caring for your community. CMS Releases New Fee and Quality Payment Program ProposalsThe Centers for Medicare and Medicaid Services (CMS) recently released the proposed 2021 Medicare physician fee schedule (PFS) rule, which includes proposed changes to the Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2021. Included in the 1,300+ page proposed rule is the 2021 Medicare payment rates for physician services and the MIPS reporting requirements for 2021. You can read the proposed rule here. For a summary of what is contained in the proposal, here are the Physician Fee Schedule Fact Sheet and Quality Payment Program Fact Sheet. The final rule is expected by November 2020. For some initial perspective on the proposal, the AMA has a brief summary of key issues, perhaps most notably that adjustments to the evaluation and management coding and payment policies, plus other changes, will produce an 11 percent cut in the fee schedule conversion factor to maintain budget neutrality. Read the AMA’s summary here. And, here is the press release put out by the AMA. To learn more about this proposal CMS is offering a webinar on Wednesday, Aug. 12 at 2 to 3:30 p.m. to give an overview and answer questions as time permits. Register here. Seeking Practices for STUN CampaignNC AHEC is recruiting family medicine and internal medicine practices to participate in the Stop Unhealthy Alcohol Use Now (STUN) campaign in North Carolina. The initiative will help practices implement evidence-based interventions such as screening for unhealthy alcohol use; brief interventions for adult patients who drink too much; and medication-assisted therapy for patients with an alcohol use disorder. This activity is funded by the Agency for Healthcare Research and Quality’s Patient-Centered Outcomes Research (PCOR) initiative and in partnership with the University of North Carolina Sheps Center. Excessive alcohol use, which affects almost a third of adults in the US, is the nation’s third leading cause of preventable death. It is a major risk factor for many health, social and economic problems. In addition, the problem has worsened and contributed to the extended COVID-19 pandemic. Learn more about the STUN campaign in this flyer. NC AHEC is also offering a Lunch & Learn webinar on Aug. 12 from noon to 12:30 p.m. on helping patients with unhealthy alcohol use. Learn more and register for the webinar here. If you have questions, please email NC AHEC at [email protected]. Highlighting Step Therapy VictoryNCMS member and President of the NC Neurology Society Guarang Palikh, MD, FAAN, was interviewed for a television report on the recent step therapy reform passed by the NC General Assembly The NCMS has advocated strongly on this issue and is pleased to celebrate this legislative victory to help you care for your patients. Thank you, Dr. Palikh for taking the time to talk to the media about step therapy. In the NewsTelemedicine is Booming – But Many People Still Face Huge Barriers to Virtual Care, STAT, 8-5-20 Learning OpportunityThe National Academy of Medicine (NAM) is offering a public workshop on Equitable Allocation of Vaccines Against COVID-19 on Friday, Aug. 7 from 3:15 to 6:15 p.m. This free workshop is part of a fast-track study that will help policymakers plan for equitable allocation of a limited initial supply of vaccine against COVID-19. Topics will include (subject to change): REMEMBER this week’s Kanof Institute for Physician Leadership Power Hour, Friday, Aug. 7 from 1 to 2 p.m. The topic is LGBTQ+ and access to health care during COVID-19. Learn more and register today.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
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NCMS Morning Rounds 8-5-20
Halfway through the week already and time for your NCMS Morning Rounds
August 5, 2020
Hurricane Relief: Please reply to this email to let us know if your practice was impacted by Hurricane Isaias. The NCMS is here to help in a crisis. We provided approximately $500,000 in assistance to practices in eastern North Carolina to help rebuild in the aftermath of Hurricane Florence. We want to help ensure you can continue caring for your community!
Executive Order on Improving Rural Health and Telehealth Access
On Monday, President Trump issued an Executive Order on 'Improving Rural Health and Telehealth Access,' focusing on ways to finance rural health care and proposing a permanent extension for some telehealth policies. Key provisions from the Executive Order include:
- Within 30 days, the US Department of Health and Human Services (HHS) will launch a new payment model to give rural health care providers flexibilities from existing Medicare rules, establish predictable financial payments and encourage the movement into high-quality, value-based care.
• Within 30 days, HHS, along with other appropriate departments and agencies, will “develop and implement a strategy to improve rural health by improving the physical and communications health care infrastructure available to rural Americans.”
• Within 30 days, HHS will submit a report on existing and upcoming policy initiatives that aim to:
o Increase rural access to health care by eliminating regulatory burdens that limit availability of providers;
o Prevent disease and mortality by developing rural-specific efforts to drive outcomes;
o Reduce mortality and morbidity;
o Improve mental health in rural communities.
• Within 60 days, HHS will review certain flexibilities implemented during the current public health emergency and propose extensions as appropriate. Specific flexibilities to be reviewed include:
o the additional telehealth services offered to Medicare beneficiaries; and
o the services, reporting, staffing and supervision flexibilities offered to Medicare providers in rural areas.
The Executive Order is consistent with Federal Communications Commission (FCC) initiatives to expand broadband access to rural providers, and the recent HEALS Act coronavirus legislation, which calls for an extension of telehealth flexibilities until the end of the public health emergency or December 2021.
A recent analysis by the Centers for Medicare and Medicaid Services (CMS) showed a weekly jump in virtual visits for CMS beneficiaries, from approximately 14,000 pre-public health emergency to almost 1.7 million in the last week of April. Additionally, a recent report by HHS shows that nearly half (43.5 percent) of Medicare fee-for-service primary care visits were provided through telehealth in April, compared with far less than one percent (0.1 percent) in February before the current pandemic. Importantly, the report finds that telehealth visits continued to be frequent even after in-person primary care visits resumed in May, indicating that the expansion of telehealth services is likely to be a more permanent feature of the health care delivery system.
While the report did not analyze specialist visits, other studies mentioned in the report have also shown dramatic increases in telehealth use during the pandemic among specialists such as psychiatry, gastroenterology and neurology to name a few. While in-person patient-provider interactions will remain necessary and preferred, this pandemic has accelerated openness to telehealth in ways previously unseen – from policymakers to providers and patients alike.
Read HHS’ report on telehealth use among Medicare beneficiaries here.
Provider Relief Fund Distribution Deadline Extended Again
The US Department of Health and Human Services (HHS) has announced an application deadline extension for the Provider Relief Fund Phase 2 general distribution to Medicaid, Medicaid managed care and Children's Health Insurance Program (CHIP) providers. Those Medicare providers who experienced challenges in the Phase 1 Medicare General Distribution application period will also have a second opportunity to receive funding. The new deadline to apply is Friday, August 28. Read the announcement.
HHS originally extended the July 20 deadline to Aug. 3, but based on feedback from those eligible to apply for the program, HHS again extended the deadline. Learn more about the Relief Fund and how to apply here.
NCMS Employee Benefit Plan Serves You
Are you aware of one of your most significant benefits as an NCMS member -- access to the NCMS Employee Benefit Plan (NCMS Plan)? This program was created exclusively for Society members and is available through the Curi Agency, LLC.
The NCMS Plan is known for superior customer service, health promotion programming and flexibility, including the following features:
• Wellness programs for clinicians and their teams
• Special eligibility classes for retirees, surviving spouses, and domestic partners
• Option to offer two plans regardless of practice size
• Option to offer three plans for practices with more than 50 enrolled employees
• Guaranteed coverage for all qualifying practices
• No surcharge for practices
• Practices are not excluded based on size.
For more information, call Curi today at (800) 822-6561, and let them know you are a NCMS Member, or visit www.ncmsplan.com.
In the News
Debate Begins for Who’s First In Line for COVID Vaccine, The Associated Press, 8-2-20
Learning Opportunity
Join us this Friday, Aug. 7 at 1 p.m. for this week's Power Hour when we welcome a panel of experts to discuss access to health care during COVID-19 for LGBTQ+ patients. Get a variety of perspectives on this topic from our panelists including: Carly Kelley, MD, an endocrinologist and co-director of Duke's Adult Gender Medicine Clinic; Holly Christopher Lewis, MD, PhD, general surgery resident at Duke University Medical Center; Jugta Kahai, MD, a pediatrician with Columbus Regional Health Care System and Dane R. Whicker, PhD, Director of Gender and Sexual Diversity Initiatives as Duke's School of Medicine. Register here for this Zoom session.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Morning Rounds 8-4-20
It's Tuesday and time for your NCMS Morning Rounds
August 4, 2020
NCDHHS Updates Antigen Testing Guidance
The NC Department of Health and Human Services (NCDHHS) State Epidemiologist Zack Moore, MD, MPH, issued updated guidance on antigen tests for COVID-19 on Friday. The new guidance is in response to the need for rapid results, supply chain challenges and molecular testing capacity issues, Dr. Moore noted in his memo to clinicians and laboratories.
Antigen tests are designed for rapid diagnosis of active infection by detecting viral proteins on the surface of the virus that causes COVID-19 in clinical specimens. This test works similarly to a rapid flu test and produces results in about 15 minutes. The US Food and Drug Administration (FDA) has authorized two COVID-19 antigen tests, which are generally less sensitive than PCR-based methods.
Due to the lower sensitivity, antigen testing is best when there is a high pre-test probability of infection. Such testing should be considered for:
• Symptomatic individuals in whom COVID-19 is suspected.
• Symptomatic and asymptomatic individuals in correctional facilities, long-term care facilities or other high risk, congregate settings where active cases have been confirmed as part of an active outbreak investigation.
Antigen testing is not appropriate for:
• Asymptomatic individuals not in high risk settings;
• Asymptomatic screening of individuals or populations;
• Screening of health care workers, emergency responders and other essential personnel;
• Population-based surveillance studies.
Apply for NC Medicaid EHR Incentive Program
If you have successfully participated in the Medicaid Electronic Health Record (EHR) Incentive program at least once and have not yet received six payments totaling nearly $64,000, you can return now to apply for the 2020 program year.
Unsure whether you’re eligible? A list of all who have participated at least once, but less than all six years, in the NC Medicaid EHR Incentive Program is available under the “Are You Eligible” tab on the program website. If you are not on the list and still unsure, please email the National Provider Identifier (NPI) at [email protected] to determine your eligibility.
For more details on these and additional program requirements, visit the program website.
Keep in mind, your regional Area Health Education Center (NC AHEC) offers free personalized assistance from a Practice Support Coach as well as technical assistance on meaningful use and the attestation process at no cost to you or your practice. NC AHEC staff can also help select, implement and optimize EHRs to improve the quality of patient care.
Attestation assistance is also available through a detailed attestation guide, an extensive library of answers to Frequently Asked Questions, a series of short webinars explaining different aspects of the attestation process, and a dedicated help desk available via email at [email protected] from 8 a.m. to 4 p.m., Monday through Friday.
Two years remain to participate in the NC Medicaid EHR Incentive Program! For those meeting the eligibility requirements up to six incentive payments can total $63,750 through 2021. Participation years do not need to be consecutive.
Visit the NC Medicaid EHR Incentive Payment System (NC-MIPS) and attest for Program Year 2020 today! Questions? Please email [email protected] .
Invite your Colleagues to Join the NCMS – Membership Campaign Underway
The NCMS has launched a membership campaign to invite as many eligible non-members as possible to membership by the end of the year. Please help by spreading the word about the great work of the NCMS and our special campaign.
For more than 170 years, the NCMS has supported the medical community not just in times of crisis, but always. When COVID-19 hit our state, the NCMS mobilized immediately to provide medical professionals and practices with resources for economic relief; a turnkey, free platform for telemedicine; sources of scarce resources including Personal Protective Equipment (PPE); and support for emotional exhaustion. We’ve provided Governor Cooper and the NC Department of Health and Human Services with data and manpower to address complex policy issues. And we’ve secured state funds for allocating PPE to medical practices.
And now, NCMS is making it as easy as possible for physicians and PAs to join as members. Until the end of the year, the NCMS is offering membership for both the remainder of 2020 and 2021 at the 2020 rate, which is 18 months of membership for $430. Encourage your colleagues to join now at www.ncmedsoc.org/join!
In the News
How the Pandemic Defeated America, The Atlantic, September 2020
Groups Partner to Increase Diversity in Cancer Clinical Trials, Associations NOW, 7-31-20
Learning Opportunity
‘The Death of Expertise and What it Means for Public Health Today,’ on Wednesday, Aug. 19 from 4 to 4:45 p.m. will address the rejection of expertise in the Information Age where people are exposed to more information than ever before and the implications for public health institutions and professionals responding to COVID-19. This webinar will feature Tom Nichols, PhD, Sovietologist, author and professor at the U.S. Naval War College. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Morning Rounds 8-3-20
Happy Monday! Start Your Week Off Right with Today's NCMS Morning Rounds
August 3, 2020
Election Day Coming Soon!
The November 2020 election is now less than 100 days away! Physicians are 9% less likely than the general population to vote. Let’s change that! Take time to make sure your voter registration is up to date. You can check your voter registration information by using the NC State Board of Election voter look up tool. If you would like to request an absentee ballot for this election you must submit this request form.
If you haven’t already, now is the time to make a donation to the NCMS PAC!
DHHS COVID-19 Provider Update
On Friday, July 31, State Health Director Betsey Tilson, MD and State Epidemiologist Zack Moore, MD provided a brief update on the State’s COVID-19 response. Dr. Tilson noted that we are seeing early signs of some stabilization. DHHS has adopted the same surveillance techniques used in flu to be used for COVID-19 moving forward. She added that it is not possible to trace our way out of COVID-19, especially with symptoms not showing until later. Physicians are required to report positive COVID-19 tests to their county health departments. An emphasis was made on continuing to encourage patients to follow the 3 W’s, wear, wait, and wash.
The next update will be held on Friday August, 28th from 12:30-1:30. Questions can be sent in advance to [email protected].
Advocating for Access to Care
Long time NCMS Member, Eleanor Greene, MD, was recently selected to be a Steering Committee Member for the Care4Carolina Coalition. Dr. Greene exemplifies leadership in medicine through her passion for advocating on behalf of patient access. The Care4Carolina Coalition’s goal is to strengthen the economic and social well-being of our state by increasing access to affordable, quality healthcare for all North Carolinians. NCMS has been an active supporter in this coalition’s work including recruiting NCMS Member, Lacey Hobgood, MD, to participate in their most recent virtual panel on COVID-19. NCMS Director of Legislative Relations, Sue Ann Forrest also serves on the Steering Committee. You can sign up to be a supporter of Care4Carolina here.
Two Physician Legislators Join NCMS for a Town Hall
NCMS hosted our first ever Virtual Legislative Town Hall with Rep. Kristin Baker, MD (Cabarrus) and Rep. Perrin Jones, MD (Pitt) moderated by Charlie Monteiro, MD. Some of the topics included COVID-19, prior authorization, telemedicine, social determinants of health and access to care. Dr. Baker emphasized her top legislative priority of passing a budget in order to address the State’s most pressing needs around health care and education. Dr. Jones shared that economic stabilization in rural North Carolina, and health care access in rural areas is a priority he hopes to address. Both Dr. Jones and Dr. Baker emphasized the importance and impact of moving to value in the health care system.
NCMS looks forward to hosting more of these virtual in the future!
News You Can Use
Recent NC Polls show discrepancies: what explains it? – Old North State Politics
Social solidarity and widespread public trust needed to boost vaccine confidence during COVID-19 - Harvard School of Public Health
Face Covering Policy –Springfield Missouri- CDC
Learning Opportunities
Health Care Professionals Series to Address Gaps in Immunizations and Well-Child Care
Join the NC Division of Health Benefits (DHB), NC AHEC, and Community Care of North Carolina for a webinar entitled Keeping Kids Well that will highlight a statewide collaboration aimed at increasing well-child visits and immunization rates.
The webinar will be Thursday, August 13, from 5:30 to 6:30 p.m. Dr. Shannon Dowler, DHB chief medical officer, will provide an update on state policies impacting telehealth, Medicaid Managed Care and the State of Emergency around COVID-19. DHB Quality and Population Health Director Kelly Crosbie will provide an overview of the Keeping Kids Well coalition efforts and representatives of CCNC and NC AHEC will be on hand to describe the support that that the collaboration partners will provide to medical practices across the state.
The webinar will also feature a panel of physicians discussing “best practices” for pediatric clinicians seeking to boost immunization rates and well-child care visits.
Please submit any questions for subject matter experts to prepare for in advance to [email protected] before 5 p.m. on the Wednesday preceding the webinar.
To Join the Webinar: https://zoom.us/j/848964708
Office telephone: (312) 626-6799 or (646) 558-8656
Webinar ID: 848 964 708
iPhone one-tap: +13126266799,,848964708#
Joint Legislative Oversight Committee on Health and Human Services will meet August 11 at 10:00am. Listen here. Watch here.
Joint Legislative Oversight Committee on Medicaid and NC Health Choice will meet August 11 at 1:00pm. Listen here. Watch here.
NCMS Political Pulse for July 24, 2020
NCMS Director of Legislative Relations Sue Ann Forrest, MPA, shares an exciting opportunity to engage with our only two physician legislators in the NC General Assembly -- from the comfort of your home or office.
[Please note: Today's Political Pulse is audio and slides only.]
NCMS Morning Rounds 7-22-20
Welcome to Wednesday and your
NCMS Morning Rounds.
July 22, 2020
It’s Practice Survey Week! The NCMS, NC Medical Group Management Association and Curi have been tracking vital practice information statewide since the beginning of the current pandemic. Your responses to this survey – now being sent every other week – has helped to inform our advocacy and resource development around personal protective equipment, telehealth, finances and wellness. Please take just a moment to share your practice’s information so we can continue to collect meaningful data. Results are shared in your NCMS Morning Rounds. Take the survey.
Join Our Two Physician Legislators for a Town Hall Forum
Did you know that of the 170 NC General Assembly legislators, only two are physicians? Please join us for an NCMS Town Hall Forum with your legislators and NCMS physician colleagues Rep. Perrin Jones, MD (R-Pitt) and Rep. Kristin Baker, MD (R-Cabarrus), to learn more about their health policy perspectives.
The discussion will be held via Zoom on Monday, July 27 from 6 to 7 p.m. and will be moderated by NCMS Past President Robert ‘Charlie’ Monteiro, MD.
Please submit questions or topics you would like the legislators to address to NCMS Director of Legislative Relations Sue Ann Forrest, MPA, at [email protected] prior to the meeting.
IRS Attempts to Clarify Provider Relief Fund Taxation
Last week, the Internal Revenue Services (IRS) provided updated information through this ‘Frequently Asked Questions About Taxation of Provider Relief Funds’ regarding taxation of the CARES Act Provider Relief Funds (PRF) to for-profit organizations.
According to the IRS guidance, these funds are considered gross income and are subject to taxation under section 61 of the Code. These funds are not excluded under the qualified disaster relief payment defined in section 139 of the Code.
Health care providers/organizations that are considered tax-exempt as described in section 501(c) of the Code are typically exempt from federal income taxation under section 501(a). However, these funds could be subject to tax if the funds are used for expenses or lost revenue attributable to an unrelated business.
The NCMS is actively advocating for clarification and correction on the tax implications for health care providers receiving Provider Relief Funds during this public health emergency. Watch your NCMS Morning Rounds for any new information as it becomes available.
New Resource to Help Find Quality Addiction Treatment
A new online platform designed to help those seeking addiction treatment find the facility that would be best suited for them, launched yesterday, Tuesday, July 21 in North Carolina. ATLAS™ includes a consumer-friendly level of care assessment aligned with the ASAM Criteria and provides a directory of addiction treatment facilities across the state with transparent data on the use of evidence-based medical practices and patient experiences.
ATLAS was designed by Shatterproof, a national nonprofit dedicated to reversing the addiction crisis in America, to meet the oftentimes difficult process of finding high-quality addiction treatment.
ATLAS measures addiction treatment facilities' use of best practices through a combination of validated data sources and reports the results of these measures publicly. ATLAS will also continue to collect feedback from patients in a crowdsource fashion and will display this information publicly once a minimum threshold of 20 patients have submitted responses on their experience at a given facility.
North Carolina is one of six states launching the ATLAS platform as part of a pilot project.
Learn more about this platform.
In the News
The Next Generation of Face Masks Could Be See-through and Self-cleaning (and They Might Not Fog Your Glasses), The Advisory Board Forum, 7-16-20
Learning Opportunity
This week’s NCMS Foundation Kanof Institute for Physician Leadership (KIPL) Power Hour will focus on ‘Treating Allergies and Asthma During the COVID-19 Pandemic.’ Please register and tune in this Friday, July 24 from 1 to 2 p.m. for the next in our series of conversations around timely topics of importance. 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!
NCMS Morning Rounds 7-20-20
Happy Monday! Here is your
NCMS Morning Rounds.
July 20, 2020
We regret that due to some unfortunate technical difficulties with our email platform, the NCMS Morning Rounds did not arrive in your email as usual last week and today. We hope the problem has been resolved, but please remember if you do not receive your newsletter via email, you can always view that day's issue on the homepage of our website, where all NCMS Morning Rounds issues are archived.
REMINDER: TODAY is the deadline to complete The Physicians Foundation's 10-question survey on how the pandemic is affecting you and your patients. Your participation is important -- and you will be eligible to receive one of four $500 Amazon gift cards. Please take just a minute to COMPLETE THE SURVEY NOW. Thank you!
NCMS Legislative Cabinet Begins Planning for Next Session
Last Wednesday evening the NCMS’ Legislative Cabinet, the group of NCMS members charged with formulating our advocacy agenda, reviewed the General Assembly’s actions during the recently concluded session and began the planning process for the next legislative session.
Chair Bill Ferrell, MD, asked Cabinet members what they thought should be the broad focus for NCMS advocacy going forward – what can the NCMS do to transform health care in the state that will address the needs of and engage NCMS members in these efforts?
Two overarching objectives that would encompass a variety of specific legislative proposals were mentioned – planning for the next pandemic and addressing health disparities.
Cabinet member and Board of Directors at-large member Eileen Raynor, MD, FACS, FAAP said that framing our legislative priorities around addressing racial health disparities would be an effective way to tie in public health, telehealth and access to insurance among other issues.
“It would be powerful,” she said.
Others thought planning and preparing for a future pandemic – which the group seemed to agree is inevitable – would resonate with NCMS members and legislators as we’re grappling with COVID-19.
The current pandemic has highlighted shortcomings in our health system generally, several members noted, and offers an opportunity to address them. Cabinet members mentioned building a robust telehealth system, a reserve of personal protective equipment (PPE) and access to reliable insurance coverage as issues that would put the state in a better position in any crisis and could also serve to generally improve the health of North Carolinians.
Several Cabinet members remarked on larger scale changes to the health care system that take into account access to care and non-clinical factors like food insecurity and housing that impact health.
“Right now health insurance coverage is limited to ‘what’s wrong with you,’” said Cynthia Gary, PA, MPH, who works in the Johnson County Health Department. She would like to see a priority placed on public health and prevention. She also advocated for de-stigmatizing and paying more attention to mental health. “Mental health exams should be a priority just like physical exams.”
With the NCMS’ mission focused on uniting, serving and representing our members to improve health in NC, Cabinet members seemed to agree that our advocacy efforts need to look beyond strictly health care related policies to achieve our mission.
Some in the meeting shared recent experiences in their own practices in which patients were foregoing COVID-19 testing because they couldn’t afford to miss work if the test came back positive.
“We need [to advocate for] no penalty testing and speedy test results,” said Cabinet member and region 4 Board of Directors representative Rachel Keever, MD, CPE, FACC. “People on the financial edge are not practicing good public health. We need to look at the social issues; incentivize business to address these issues. We need to go outside of health [related legislation] if health is our goal.”
The Cabinet’s discussion will be used as a starting point for developing the NCMS’ legislative agenda, which will continue to be refined over the coming weeks and months. The Cabinet is interested in your input. Please contact NCMS Director of Legislative Relations Sue Ann Forrest, MPA at [email protected] or complete the Board input form with your thoughts on our priorities.
The legislature will be back in Raleigh in September to consider allocation of federal COVID-19 appropriations. The regular legislative long session will begin in early 2021.
COVID-19 Provider Relief Updates and Reminders
Just a reminder that the deadline to apply for the $15 billion in relief funds allocated back in June for those physicians and PAs who accept Medicaid and CHIP patients is TODAY Monday, July 20.
To be eligible for this funding, you must not have received payments from the first $50 billion Provider Relief Fund General Distribution (this also includes physicians who were eligible for the General Distribution but ultimately rejected their payments), and either have directly billed the state Medicaid/CHIP programs for health care-related services between Jan. 1, 2018 and May 31, 2020.
The new distribution requires the use of a new portal and a new application. You will have to set up an Optum ID. Please see the Medicaid Distribution Instructions for additional details. This FAQ page has been updated with clarifying information on the general Relief Fund as well as this targeted allocation.
The Small Business Administration has also released updated FAQ guidance for PPP loan recipients. The updated guidance verifies that loans made on or after June 5 will have a five-year maturity date (compared to the two-year maturity date applicable to loans made prior to this date). These changes are pursuant to PPP loan requirement changes made effective through the Paycheck Protection Program Flexibility Act of 2020.
Our national partner, the Physicians Advocacy Institute offers updated on federal programs and regulatory actions in response to the COVID-19 pandemic on their website. Access this information and resources here.
Deadline Nears for BCBSNC Accelerate to Value Program
Blue Cross and Blue Shield of North Carolina (BCBSNC) Senior Vice President and Chief Medical Officer Rahul Rajkumar, MD, is encouraging independent primary care practices to explore and apply for BCBSNC’s Accelerate to Value Program. The goal of the program is to assist independent primary care practices with financial stability and the steps to a value-based care model through participation in their Blue Premier ACO. The deadline to apply is July 31, 2020.
BCBSNC will be hosting an informational webinar next Friday, July 24 from noon to 1 p.m. Learn more about the webinar and register here. Any questions or concerns about the program you would like to see addressed in the webinar can be sent to this email address, [email protected].
In the News
COVID-19 Causes Unprecedented Drop in Physician Demand, Healthcare Dive, 7-15-20
Learning Opportunity
A live webinar, ‘Next Steps in Telehealth: Rebalancing or Reimagining Care,’ will be held TODAY Monday, July 20 from 12:15 to 1 p.m. For many practices, the goal is to rebalance schedules toward traditional in-person care while continuing virtual visits for patients who need or request these services. But do we have an opportunity not to just reopen our doors but to redesign efficient, reliable care with a new digital front door?
Daniel Kuzmanovich a research director at the Advisory Board, a think tank in Washington DC, will discuss lessons learned from the COVID-19 pandemic and to use those experiences to innovate and reimagine care. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Political Pulse for July 17, 2020
With the latest legislative session behind us, the NCMS' Legislative Cabinet met this week to look ahead to what our future legislative priorities should be. Formulating our priorities now gives us the opportunity to communicate them to candidates running in the November election. Watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA, recounts the Cabinet's discussion and asks for your input as we plan for the future.
NCMS Morning Rounds 7-15-20
Already mid-week and time for your
NCMS Morning Rounds.
July 15, 2020
State Health Officials to Answer Your COVID Questions
State Health Director and Chief Medical Officer Betsey Tilson, MD, MPH and State Epidemiologist Zack Moore, MD, MPH will hold office hours this Friday, July 17 from 12:30 to 1:30 p.m. to answer your questions on the state’s COVID-19 response and provide a brief update.
These weekly calls have helped to keep health care professionals informed about the response to COVID-19 as well as allowed state officials to hear your concerns. You may send your questions in advance to this email address: [email protected].
To participate in the call, the Zoom link is: https://zoom.us/j/705979628
For audio only access dial the following number and code: +16465588656,,705979628#
NCIOM Report on Improving Serious Illness Care in NC
The North Carolina Institute of Medicine (NCIOM) has released a report on 'Improving Serious Illness Care in North Carolina' that provides a roadmap for North Carolina health care professionals, state agencies, advocacy organizations, professional associations and health care payers to support individuals with serious illness, their caregivers, and their communities.
Completed earlier this year, the report is the culmination of the work of a 60-person task force. NCMS Senior Vice President for Health System Innovation and Deputy General Counsel Melanie Phelps, JD, served on the task force, which developed 30 recommendations focused in four key areas:
- Health system and social change to address serious illness care;
• High-quality person-centered care;
• Engagement with patients and families to meet goals of care; and
• Development of the health and human services workforce and infrastructure to support serious illness care.
The July-August issue of the North Carolina Medical Journal delves more deeply into the report including personal stories and policy analysis around serious illness care in North Carolina. Access this issue of the Journal here.
As the COVID-19 pandemic continues, serious illness care is touching a record number of North Carolinians and some of the report’s recommendations call for immediate attention. For instance, task force recommendations concerning access to telehealth services and improving advance care planning take on new urgency.
Arising out of the report, the North Carolina Serious Illness Coalition was formed to implement its recommendations and to develop statewide partnerships to educate and create some needed changes. Learn more about the Coalition, which has a diverse membership of 120 individuals representing over 70 stakeholder organizations. The NCMS is represented on the Coalition’s Executive Committee.
Over the past several months in response to COVID-19, the Coalition has pushed for solutions to help families develop advance directives and living wills, reducing barriers that prevent people from getting these legal documents in place.
Read the NCIOM’s report on ‘Improving Serious Illness Care in North Carolina’ here.
Updated COVID-19 Resources
The NC Department of Health and Human Services (NCDHHS) recently updated a number of its COVID-19 resources to help you track the impact of the virus and provide your patients with the latest guidance including the location of ‘pop-up’ testing sites. These and other resources also are always available on the NCMS’ COVID-19 webpage.
Updated resources include:
- ‘Pop-Up’ testing sites listed by county.
• Ongoing Outbreaks in Congregate Living Facilities by county and facility.
• Risk Factors for Severe Illness
• Demographics of Contact Tracers hired by state (updated every Wednesday by 4 p.m.)
• ‘Why Should I Be Tested’ fact sheet for your non-English speaking patients in four new languages in addition to Spanish.(Burmese, Haitian-Creole, Karen, Swahili)
• The Health Care Guidance for Providers page includes information for pregnant women, standing orders for testing and reporting and other information.
In the News
How Pandemics Wreak Havoc – And Open Minds, The New Yorker, 7-20-20
Learning Opportunity
Reminder: this month’s NCMS Foundation, NC Medical Group Management Association Lunch & Learn Webinar on Tuesday, July 21 from noon to 1 p.m. will focus on ‘Special Olympics North Carolina: Creating inclusive health for people with intellectual disabilities.’
Learn about the health equity challenges people with intellectual disabilities face and how Special Olympics North Carolina is doing its part to help build inclusive, healthy communities. Speakers are Ellen Fahey, MS, and Annie Tane of Special Olympics North Carolina. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Morning Rounds 7-13-20
It's a new week and a fresh
NCMS Morning Rounds.
July 13, 2020
NCMS Legislative Update
Legislators were back in Raleigh briefly last week to take up several proposals in committee and attempt to override vetoes by the Governor. None of those veto override votes, the majority of which centered on the reopening of particular businesses like bowling alleys and wedding venues, were successful. As always, visit our NCMS legislative blog for summaries of all the bills we’ve been tracking that could impact your practice.
One proposal of particular note that made it to the Governor’s desk for his consideration is SB232 – Repeal Death Invest Conf/Masks/Health & Safety. This bill would allow North Carolinians to continue to legally wear face masks for public health purposes. With the advent of the COVID-19 pandemic, the legislature had temporarily suspended until August the 1950s statute that prohibits wearing a face covering in public. This bill also includes a provision to repeal a controversial piece of an already vetoed bill (SB 168 – DHHS & Other Revisions), which related to death investigation records.
The NC House and Senate formally adjourned on Saturday with plans to reconvene on Wednesday, Sept. 2, to solely consider appropriations of federal funds in response to the pandemic and any nominations or appointments. Once they conclude their work in September, the legislative short session will be officially concluded.
Community Health Worker Initiative to Help Underserved
The North Carolina Department of Health and Human Services (NCDHHS) has issued a Request For Proposals for an initiative that will send up to 250 Community Health Workers to historically underserved areas with high COVID-19 caseloads. Starting in August, teams of trained frontline public health professionals will connect North Carolinians affected by COVID-19 with needed services and support.
“This new team of Community Health Workers is a critical workforce focused on assisting people struggling with the complex impacts of this pandemic,” said NCDHHS Secretary Mandy Cohen, MD, MPH.
Community Health Workers will be responsible for connecting North Carolinians to medical and social support resources, including diagnostic testing, primary care, case management, nutrition assistance and mental health services. NCDHHS will contract with one or more state-based organizations to recruit, train and manage Community Health Workers deployed to areas with high COVID-19-related needs. Working in coordination with local health departments, this corps of community health workers will also have access to the state’s NCCARE360 platform to connect individuals with needed non-clinical services like food, housing and transportation.
The Community Health Workers initiative will run through December, with the possibility of renewal. The initiative will serve North Carolina communities identified as having high COVID-19 caseloads and historically marginalized populations.
The Community Health Worker RFP is available for review here.
For another perspective on the state of our public health system, this article highlights how the pandemic has stressed a system already on the brink.
YMCAs Statewide Offer Virtual Health Programs
As we reported earlier this month, the YMCA of the Triangle, an NCMS partner in Our Community Health Initiative (OCHI) and Diabetes Prevention Programs, is offering its evidence-based medical membership programs virtually to help members develop and maintain healthy habits despite the fact that workout facilities at Y’s throughout the state are closed due to the pandemic.
For those who practice outside of the Triangle whose patients could benefit from these programs, the following are the virtual medical membership programs and the Ys where they are now being offered beyond the Triangle.
Diabetes Prevention:
• Avery
• Southeastern
• Cleveland County
• Catawba Valley
• YMCA of Western North Carolina
• Greensboro
• Eastern Carolina YMCA
Healthy Weight and Your Child
• Southeastern
Moving For Better Balance
• Southeastern
LIVESTRONG (a program to help adult cancer survivors build strength and energy levels)
• Greensboro
• Avery
Weight Loss
• Avery
These medical membership programs have proven highly effective in helping patients develop and maintain healthy habits. For more information on how the NCMS is partnering with the YMCAs to offer a seamless way for you to refer patients to these programs and receive reports on their progress, visit our OCHI webpage.
In the News
Schools or Bars? Opening Classrooms May Mean Hard Choices, The Associated Press, 7-10-20
Learning Opportunity
Mark your calendar: The University of North Carolina at Chapel Hill invites you to the 26th National Health Equity Research Webcast that will take place on Friday, Sept. 11 at 2 p.m. on Zoom. This year’s webcast will be a live 90-min. interactive webinar. Registration is FREE and opens today July 13. All participants are required to register for this event. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Morning Rounds 7-10-20
Happy Friday! Here's your
NCMS Morning Rounds.
July 10, 2020
Due to some unfortunate technical difficulties with our email platform earlier this week, you probably received multiple copies of the newsletter in your email. We sincerely apologize for this incident!
Making Sure Physician Voices Are Heard
The NCMS’ national partner, The Physicians Foundation, is asking you to take less than five minutes to complete a 10-question survey on how the coronavirus pandemic is affecting physicians and your patients. The results of this nationwide survey of over 700,000 physicians will be shared with policy makers, legislators, the public and the media. Your participation is important.
By completing the quick survey you’ll also be entered into a drawing for one of four $500 Amazon gift cards.
The North Carolina-specific results will be shared in your NCMS Morning Rounds. Thank you for your participation.
Don’t Forego Leadership Development Due to Pandemic
Thoughtful physician and PA leaders are essential now more than ever and the NCMS Foundation’s Kanof Institute for Physician Leadership (KIPL) has responded by adapting its programs to be valuable learning experiences even when held virtually.
If you’re unsure about the future and accessing these highly acclaimed programs, don’t worry. Our staff experts have rethought the format for the 2021 Leadership College and Health Care Leadership and Management (HCLM) programs to employ innovative and effective virtual educational techniques. You will gain everything you would have if these programs were held in person, even if you are participating from the comfort of your home or office.
Applications are now being accepted for both Leadership College and HCLM for the classes of 2021. Learn more about all that KIPL offers. Apply now for Leadership College and HCLM.
State Offers Communications Tools to Prevent and Protect
To help you get the word out to patients and your community about how to prevent and protect against the coronavirus, the NC Department of Health and Human Services (NCDHHS) has compiled a set of easily accessible communications resources on this webpage.
The materials include graphics and links to information for social media posts and downloadable flyers to distribute to patients. The messages include the importance of wearing a face covering, when to be tested, contact tracing and how to find a nearby testing site.
Using these tools is just another way to spread the public health messages to prevent the spread of COVID-19.
In the News
As COVID Testing Soars, Wait Times for Results Jump to a Week – or More, Kaiser Health News, 7-9-20
Learning Opportunity
DON’T MISS today’s Kanof Institute for Physician Leadership Power Hour from 1 to 2 p.m. will continue our ongoing discussion around racism in the United States and what we can do as individuals and as a health care community to address racial injustice and health inequities. Join your colleagues and our guests, who are focused on change at all levels to address health inequities and disparities, as we grapple with these issues. Register here.
Another learning opportunity: a webinar focused on ‘Racial Disparities in Accessing Evidence-Based OUD Treatment and the Impact of the COVID-19 Pandemic’ will be offered next Thursday, July 16 at 3 p.m.
COVID-19 pandemic and recent events have magnified the existing racial and ethnic disparities in our health care systems, including in opioid use disorder (OUD) treatment. While our understanding of and ability to treat OUD has progressed over the past decade, the benefits of this shift have not been made equally available to all who need it. Black Americans are much less likely than their white counterparts to receive treatment for their opioid use disorder, even though both groups are affected at similar rates, and in 2016, fatal opioid overdoses among Black Americans were nearly double that of the general population. The COVID-19 pandemic is likely to further exacerbate these disparities.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Morning Rounds 7-9-20
Welcome to Thursday and your
NCMS Morning Rounds.
July 9, 2020
NC Medicaid to Continue Enhanced Rates
NC Medicaid Deputy Secretary Dave Richard announced yesterday that it “is both necessary and feasible to continue” the enhanced reimbursement rates that were temporarily put in place due to the ongoing COVID-19 pandemic. While NC Medicaid will continue to evaluate the situation, Richard anticipates the enhanced rates will remain in place through September 2020.
The purpose of the continuation of these rates into the state’s new fiscal year, which began July 1, is to help ensure Medicaid beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to COVID-19, Richard said. Read the announcement here.
The enhanced reimbursement rates include medical home per member per month payments. Review all current Medicaid fee schedules here.
More COVID-19 Testing in Underserved Communities
In an effort to reach those who may not have easy access to a medical practice, the NC Department of Health and Human Services (NCDHHS) announced it will launch 300 free testing sites in underserved communities. This targeted testing initiative seeks to confront historical health disparities by increasing access to no-cost COVID-19 testing for African American, Latinx/Hispanic and American Indian communities across the state, the NCDHHS announcement said. Read the full announcement here.
A disproportionately high percentage of North Carolina’s confirmed cases of COVID-19 have occurred among historically marginalized populations. Mounting evidence shows the members of these populations experience higher rates of COVID-19 mortality and serious complications, NCDHHS Secretary Mandy Cohen, MD, MPH, has said.
Throughout July, the 300 temporary testing sites, which will include both drive-thru and walk-up sites, will increase testing capacity in more than 100 ZIP codes statewide. NCDHHS anticipates providing testing access for 2.2 million African American, Latinx/Hispanic and American Indian individuals.
Communities were selected based on low testing capacity and high African American, Latinx/Hispanic and/or American Indian populations. Higher concentration of elderly populations with multiple chronic conditions and higher rates of construction and seasonal farm work were also factors.
Two vendors have been identified to begin this work, Vidant Health and Orig3n, Inc. These vendors are required to connect individuals with medical homes and provide services with culturally and linguistically appropriate standards, working within existing trusted community partnerships.
Learn more about the state’s testing guidance and where testing sites are located.
Want to Be a Primary Care Champion Fellow?
The Primary Care Champions Fellowship at the Campbell University Jerry M. Wallace School of Osteopathic Medicine is now accepting applications for the 2021 program. The year-long course is designed to help clinical professionals of all disciplines develop exemplary leadership and teaching skills, preparing you for much needed and meaningful service in health professions education. Upon completion of the program, fellows will be confident, service-minded clinical leaders, equipped with skills to manage thriving practices, improve physical wellness and expand learning opportunities in rural areas.
An optional, second year of coursework fulfills requirements for a Master of Health Professions Education (MHPE) degree.
Several NCMS staff members and a Kanof Institute of Physician Leadership (KIPL) alumnus serve as faculty in the first semester of the program, which is run by KIPL.
In the News
Window into Virus Surge: Death, Recovery at Houston Hospital, The Associated Press, 7-8-20
Learning Opportunity
Tomorrow’s Kanof Institute for Physician Leadership Power Hour (Friday, July 10 from 1 to 2 p.m.) will continue our ongoing discussion around racism in the United States and what we can do as individuals, as a health care community and as a medical society to address racial injustice and health inequities. Join your colleagues and our guests, who are focused on change at all levels to address health inequities and disparities, as we grapple with these issues. Register here.
The KIPL Power Hour aims to provide a forum for ongoing conversation, collaboration and community. Tune in to Power Hour weekly to hear from different experts, decision makers and influencers on a variety of topics. The format is informal and conversational and sessions are easy to access through Zoom. Power Hours will be recorded and made available to you through your NCMS Morning Rounds and on the KIPL webpage.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
SB 105 - Clarify Emergency Powers
SB 105 - Clarify Emergency Powers
Summary
This bill would clarify the expiration of a state of emergency and the exercise of certain powers under a state of emergency and to clarify the abatement of statewide imminent hazards.
The bill requires a consensus with within 48 hours of contact, a majority of the Council of State prior to the Governor exercising a power or authority requiring concurrence. The Governor would be required to document the contact and response of each Council of State member.
History
This bill was changed into a new bill from it's original subject matter in the House Rules Committee on June 23, 2020.
This bill passed the House 64-51 on June 24, 2020.
This bill passed the House on third reading on June 25, 2020.
This bill passed the Senate on June 26, 2020.
This bill was vetoed by the Governor on July 2, 2020.
The Senate failed to override the Governor's veto on July 8, 2020.
SB 232 - Repeal Death Invest Conf/Masks/Health & Safety
SB 232 - Repeal Death Invest Conf/Masks/Health & Safety
Summary
This bill would have repealed confidentiality of certain death investigation information in a bill that the governor vetoed.
This bill authorizes individuals to wear masks and face coverings for health purposes.
History
This bill was changed from a bill tracking outcomes of veterans programs to the current language in the House Rules Committee on July 6, 2020.
This bill passed the House with a vote of 102-2 on July 7, 2020.
This bill passed the Senate on July 8, 2020.
This bill will now be sent to Governor Cooper.
HB 806 - Open Exercise and Fitness Facilities
HB 806 - Open Exercise and Fitness Facilities
Summary
This bill would authorize indoor and outdoor exercise fitness facilities, gyms, health clubs, and fitness centers to resume operations.
These facilities would be required to meet certain requirements including the following:
- Limit indoor capacity to 40%
- Employee health questions
- Employee face mask requirements except when leading a class or when outdoors socially distant
- Contactless check-in
- Sanitation stations
- Hand sanitizer availability throughout the establishment
- Routine cleanings
- On premises childcare limited to 50%
- Water fountains limited to filling water bottles only
History
The House failed to override the veto on July 8, 2020.
This bill was vetoed by Governor Cooper on July 2, 2020.
This bill was previously a pool liability bill and was turned into a bill opening exercise facilities on June 25, 2020.
NCMS Morning Rounds 7-8-20
It's Wednesday and time for your
NCMS Morning Rounds.
July 8, 2020
Help in Assessing Risk During the Pandemic
Thanks to our colleagues at the Texas Medical Association (TMA) who developed this helpful chart to aide you and your patients in assessing their risk as they go about daily activities during the pandemic. For those who may be contemplating travel or visiting a bar or restaurant, the graphic puts the risk of acquiring the COVID-19 virus in perspective.
The chart was developed by the physician members of the TMA’s COVID-19 Task Force and Committee on Infectious Diseases. The underlying assumption they used is that regardless of the activity, the participant was taking as many safety precautions as possible (i.e. wearing a mask, washing their hands regularly and maintaining physical distance from others).
Here’s some more food for thought as scientists learn more about how COVID-19 spreads: Recently, over 230 scientists in 32 countries wrote an open letter to the World Health Organization (WHO) asking it to revise its recommendations based on research showing the virus spreads through small, aerosolized particles. The research supporting this claim has been accepted for publication in the journal Clinical Infectious Diseases. WHO has maintained that the virus is primarily spread through large respiratory droplets expelled when someone coughs or sneezes.
Learn more about the research in this article from The New York Times or this ABC News broadcast.
Help Patients Fill Prescriptions with NCMS Drug Card
During these difficult times your patients may be struggling financially. The NCMS Drug Card offers discounts on prescriptions at many pharmacies throughout the state and could relieve some of your patients’ financial burden as they fill their prescriptions.
Here is a one-page flyer to download, print and give to patients with more information about the card.
The free card is easily accessible at northcarolinadrugcard.com.
What Would Be Most Helpful and Informative For You?
Our well-attended NC Population Health Collaborative meeting is scheduled to be held virtually in September and to make it most helpful and informative for you, we need your input.
This quick survey, 4-question survey asks what your top population health concern is at the moment and your opinion on the most effective way to present sessions virtually. Please help us provide the most meaningful use of your time by taking the survey now.
In the News
The COVID-19 Crisis: The Opportunity to Build a Fairer, Healthier Nation, Health Affairs, 6-24-20
Learning Opportunity
This month’s NCMS Foundation, NC Medical Group Management Association Lunch & Learn Webinar on Tuesday, July 21 from noon to 1 p.m. will focus on ‘Special Olympics North Carolina: Creating inclusive health for people with intellectual disabilities.’
Learn about the health equity challenges people with intellectual disabilities face and how Special Olympics North Carolina is doing its part to help build inclusive, healthy communities. Speakers are Ellen Fahey, MS, and Annie Tane of Special Olympics North Carolina. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
SB 168 - DHHS Revisions
* This bill was introduced as a PCS in the House Health Committee on June 24, 2020.
Disability Definition
This bill aligns the developmental disability definition with federal law.
Co-Payment Schedule
This bill would allow the co-payment schedule for behavioral health, intellectual and developmental disabilities, and substance use disorder services to be set without the rule making process.
Involuntary Commitment
This bill would clarify that clinical mental health counselors can perform first examinations for involuntary commitment.
Telehealth
This language would clarify that the use of telehealth to be used to conduct first and second involuntary commitment examinations during the COVID-19 emergency.
Brian Injury Advisory Council
This language would create the Brain Injury Advisory Council within DHHS in conjunction with other stakeholder groups.
Medical Examiners
This language would allow retired physicians previously licensed in NC, paramedics, death investigators, pathologists assistants and dentists to serve as medical examiners.
The bill also allows the chief medical examiner to appoint emergency medical examiners during states of emergency.
The bill clarifies that all information and records regarding a death investigation shall not become public records.
The bill does provide a licensed psychiatrist exemption.
SB 168 - Expand Allowable Medical Uses of CBD Oil
Primary Sponsors: Sen. Floyd McKissick (D-Durham), Sen. Ralph Hise (R-Madison)
Bill Summary
This bill would allow hemp extract to be used to treat autism, multiple sclerosis, Crohn's disease or Mitochondiral disease. Current law only allows the extract to be used to treat epilepsy.
The bill also allows the patient to be under the care of a neurologist or has been examined and is under the care of a physician who has consulted with a neurologist about the patient's condition. Current law only allows the patient to be under the care of a neurologist.
The bill defines a physician as an individual licensed, board certified, and affiliated with one or more hospitals licensed in the state.
The bill requires the documentation of the name, address, and hospital affiliation of any physician with whom the neurologist consults with about the patient's condition in making the recommendation.
Bill Movement
Filed - February 27, 2019
This bill was was referred to the following Senate Committees:
- Health Care - March 20, 2019
- Judiciary - April 3, 2019
- Rules - April 9, 2019
This bill will now move to the Senate floor
The Senate voted not to concur with this bill with a vote of 0-48 on June 25, 2020.
The House adopted the conference report to the bill on June 25, 2020.
The Senate adopted the conference report on June 26, 2020.
The Governor vetoed this bill on July 6, 2020.
SB 599 - Open Skating Rinks/Bowling Alleys
SB 599 - Open Skating Rinks/Bowling Alleys
This bill would authorize skating rinks and bowling alleys to resume operations and modify the capacity of temporary outdoor seating for food and drink establishments.
Outdoor seating for food and drink establishments would limit seating capacity to 50% of the current indoor seating capacity or 100 customers, whichever is less.
This bill would limit minor league baseball stadiums to 10% of spectator capacities.
SB 599 - State and Local Disability Reform
Primary Sponsors: Sen. Chuck Edwards (R-Buncombe), Sen. Andy Wells (R-Catawba), Sen. Rick Horner (R-Nash)
Bill Summary
This bill attempts to modernize the Medical Review Board and to make technical correction.
The bill would change language of how the board could be composed. Current law states that the board must be made up of at least 3 physicians but no more than five physicians. The current bill language would remove the “no more than five physicians” language.
Bill Movement
This bill was filed on April 3, 2019.
This bill was referred to the following Senate committees:
- Pensions, Retirement, Aging - passed May 2, 2019
- Rules - passed May 5, 2019
- Passed Senate Floor on May 7, 2019
House
- This bill was changed into a new bill on House Rules Committee on June 15, 2020 to open bowling alleys and skating rinks.
- This bill passed the House 68-52 on June 16, 2020.
- This bill passed the Senate 32-15 on June 18, 2020.
- The Governor vetoed the bill on July 2, 2020.
- The Senate failed to override the veto on July 8, 2020.
NCMS Morning Rounds 7-6-20
Welcome to another week of summer and your NCMS Morning Rounds.
July 6, 2020
NCMS Legislative Update
Election day is a few months away, but now is the time to educate yourself and make decisions not only on who you want to vote for, but also how you intend to vote this November. The NCMS is here to help.
First, some background on the electorate in our state. There are approximately 7 million registered voters who are relatively evenly distributed by party affiliation with 2.5 million registered as democrats, 2.1 million as republicans and about 2.3 million registered as unaffiliated. The last presidential election in 2016 saw the state’s highest voter turnout in history. Another interesting tidbit – physicians generally are 9 percent less likely than the general population to vote, which is why the NCMS wants to be sure you have all the information you need to cast your vote this year.
A great source is the NC State Board of Elections website, where you will find information including:
• How to register or make changes to your registration if you’ve moved since last you voted. If you have an NC driver’s license or state issued ID, you can now register or make certain changes to your registration online.
• Who is on your ballot. In the coming weeks you will be able to see who your choices are and begin to research who will get your vote. Access who is on your particular ballot through the voter lookup tool.
• How to request an absentee ballot if you want to vote by mail instead of in-person at a polling place. Anyone can request an absentee ballot and, thanks to newly adopted bi-partisan legislation, you only need one person to sign your ballot as a witness and it does not need to be notarized. You need to request the absentee ballot by Oct. 27, that’s a week before the election, and then return the completed ballot to your county Board of Elections by 5 p.m. on Election Day, which is Tuesday, Nov. 3, this year.
Casting your vote is a crucial way to make your voice heard!
Diabetes Prevention Goes Virtual in the Triangle
The YMCA of the Triangle, an NCMS partner in Our Community Health Initiative (OCHI) and Diabetes Prevention Programs, wants to make physicians and PAs aware that its medical membership program now has a virtual option.
Since the pandemic began in March, the Y has created virtual alternatives for each of the evidence-based programs they offer, including the Diabetes Prevention Program.
The virtual classes will begin in July. Visit the YMCA of the Triangle website for specific program dates.
The Y’s Medical Membership programs include:
• LIVESTRONG at the YMCA, to help adult cancer survivors build strength and energy levels
• Moving For Better Balance
• Diabetes Prevention Program
• Weight Loss Program
• Blood Pressure Self-Monitoring Program
• Y Fit Kid – Healthy Weight & Your Child
This flyer has information for you as a referring physician or PA and this brochure gives your patients information about the programs, which we hope will soon expand beyond the triangle to the state’s YMCA network.
The NCMS and the YMCA of the Triangle have partnered to offer a seamless way for you to refer patients to these programs and to receive feedback on their progress. We also are working with the AMA to promote Diabetes Prevention Programs like that offered at the YMCA, all through the OCHI platform. Learn more about our efforts to connect you and your patients with these community programs.
NCMS Business Alliance Member Announces Vaccine News
NCMS Business Alliance member Pfizer Inc. along with its partner BioNTech SE, announced last week some preliminary, yet encouraging, news on developing a COVID-19 vaccine.
The news involves the most advanced of four investigational vaccine candidates from the companies’ COVID-19 vaccine program, Project Lightspeed. The preliminary data demonstrated that the vaccine could be administered in a dose that was well-tolerated and generated dose dependent immunogenicity.
The initial part of the study included 45 healthy adults, ages 18 to 55. The most commonly reported side effect was injection site pain and no serious adverse events were reported. Pfizer and BioNTech will use this information to determine a dose level and select among the multiple vaccine candidates to progress to a large global trial that could involve up to 30,000 healthy participants. This could begin late this month, if the companies receive regulatory approval.
If the ongoing studies are successful and the vaccine candidate receives regulatory approval, the companies expect to manufacture up to 100 million doses by the end of 2020 and potentially more than 1.2 billion doses by the end of 2021.
In the News
Hollowed Out Public Health System Faces More Cuts Amid Virus, Associated Press/Kaiser Health News, 7-1-20
Learning Opportunity
Researchers from RTI will present their findings on how alcohol consumption has changed during the COVID-19 pandemic on Tuesday, July 14 from 2 to 3 p.m. Learn the different ways in which drinking has changed during the pandemic and its implications for public health. 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!
NCMS Political Pulse for July 2, 2020
What better way to celebrate our country's birthday this July 4th, then to get ready to vote in the upcoming election. NCMS Director of Legislative Relations Sue Ann Forrest, MPA reviews some statistics on voting demographics in North Carolina; explains how you can see what your ballot will look like so you can research candidates now and reviews the latest on how to request an absentee ballot and the new guidelines on how to cast your vote by mail in case you prefer not to vote in person this November. Exercise your right to vote!
NCMS Morning Rounds 7-2-20
Happy July 4th! Here is your pre-holiday
NCMS Morning Rounds.
July 2, 2020
The NCMS offices will be closed tomorrow, July 3, in honor of the July 4 holiday. Your NCMS Morning Rounds will return on Monday, July 6.
Enjoy your holiday and be safe and well!
Survey Confirms Many of You Are Stressed; Overwhelmed
The results of the recent joint survey of NCMS, NC Medical Group Management Association and Curi member practices confirms what we’ve been hearing anecdotally – many, in fact 78 percent of those responding to the survey, are stressed out these days. Financial concerns and uncertainty about the future are the top stressors, according to the survey results. Forty-five percent of clinical staff seems overwhelmed and exhausted.
The practice survey, sent regularly to practices throughout the state since the beginning of the pandemic, looked more deeply at well-being among clinical and non-clinical staff during this turbulent time the week of June 1. See the full report on the well-being survey results here.
Thank you to those who continue to complete the practice survey, now sent to member practices every other week. The data gathered through these surveys provides valuable insight into how health care organizations are responding to the pandemic. If you are not currently receiving the survey, please email [email protected] and ask to be added to the Urgent Practice Data Survey list.
Previous surveys have taken a closer look at areas of concern including finances, telehealth and practice reopening. Review the reports in these areas below.
- Click here to access the Summary Report This details how practices were faring from the end of March through most of April.
- Click here to access the Trends Report.
- Click here to access the Financial Summary Report.
- Click here to access the Telehealth Report.
- Click here to access the Practice Reopening Report.
Watch your email for the next practice survey on Monday. Thank you for your input!
Federal COVID-19 Public Health Emergency to Be Extended
The US Department of Health and Human Services (HHS) indicated this week through a tweet from HHS Assistant Secretary of Public Affairs Michael Caputo that it intends to extend the COVID-19 public health emergency for another 90 days come July 25, when it is currently set to expire. This would mean several payment policies and regulatory adjustments would be extended.
The emergency declaration has already been extended once – on April 21. This allows HHS to waive or modify certain Medicare, Medicaid, Children’s Health Insurance Program (CHIP) and Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule requirements. It also allows requires insurers cover COVID-19 testing without cost-sharing and waives certain telehealth restrictions.
Learn the details about what the declaration may mean for your practice.
Keep in mind some of the regulatory changes implemented due to the pandemic, however, depend on continuation of the national emergency declaration, including Medicaid waivers that allow bypassing some prior authorization requirements.
NCDHHS Seeks Input on Traumatic Brain Injury Program
The Traumatic Brain Injury (TBI) program at the NC Department of Health and Human Services (NCDHHS), Division of Mental Health, Developmental Disabilities and Substance Abuse Services is considering offering two separate webinar training opportunities with national experts in the field of Brain Injury (BI) during fiscal year 2020-21. To help determine statewide interest among professionals in a variety of settings, the Department is asking you to take a few minutes to complete this short, anonymous survey.
Please email [email protected] with any questions.
In the News
US Withdrawal from WHO Threatens to Leave It ‘Flying Blind’ on Flu Vaccines, STAT, 6-29-20
Learning Opportunity
Be sure to mark your calendar and register now for NEXT week’s Power Hour, July 10 from 1 to 2 p.m. when our guests will discuss race and health equity. Watch for details in the coming days.
In the meantime, the long weekend is a perfect opportunity to catch up on previous Power Hours you may have missed. Learn how Italian physicians have responded to COVID-19 or how your colleagues are dealing with stress during this very stressful time or get a broader perspective on telehealth. Since the beginning of the pandemic the NCMS Foundation’s Kanof Institute for Physician Leadership (KIPL) has offered weekly Power Hours to address some of the pressing issues facing you -- our members.
All of the webinars are archived on our NCMS website and available anytime. Access them now.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Morning Rounds 6-30-20
Hello Tuesday! Here is today's
NCMS Morning Rounds.
June 30, 2020
NCMS Asks Governor to Protect Maternal, Infant Health
The NCMS joined several medical specialty societies and state and other agencies to oppose HB918--Expedite Permanency/DHHS Report/SNAP/TANF in calling on Governor Roy Cooper to veto this legislation that was sent to his desk last week after a 59-53 vote in the NC House.
The NCMS opposes this legislation because it discourages women with substance abuse disorder from seeking medical care, including prenatal care and treatment for the disorder. HB 918 also penalizes pregnant women with substance abuse disorder without increasing access to treatment.
Our letter to Governor Cooper cites several national organizations’ findings that show penalizing or punishing pregnant, postpartum or parenting women for substance abuse dissuades them from seeking vital prenatal care and treatment. Studies have shown non-punitive public health approaches to care and treatment result in better outcomes for both mothers and their children.
Flexibility Offered for CMS’ Merit-Based Incentive Payment System
Last week the Centers for Medicare and Medicaid Services (CMS) announced that physicians will have the option of opting out completely or partially from its Merit-based Incentive Payment System (MIPS) for the 2020 performance year in recognition of the impact of COVID-19.
Individual clinicians and group practices have until Dec. 31, 2020 to complete the hardship application. Options include opting-out of one or more MIPS performance categories due to the COVID-19 public health emergency or opting-out of all four performance categories and being held harmless from a 2022 payment adjustment.
“We believe this approach maintains a balance of encouraging participation in the Quality Payment Program while still allowing those clinicians that are significantly impacted by the public health emergency to have relief from program participation through the extreme and uncontrollable circumstances policy,” CMS stated in its announcement.
CMS also said it was continuing to monitor the impact of the COVID-19 on Shared Savings Program quality reporting for the 2020 performance year
Learn more about these new flexibilities for MIPS.
Health Care Leadership and Management – Virtually
The Kanof Institute for Physician Leadership (KIPL) Health Care Leadership and Management (HCLM) class of 2020 met over the weekend to continuing their training and to check in on the progress of their projects. The program brought the scholars and HCLM faculty together virtually to continue their studies and interact.
The agenda included learning about negotiation skills with Roger Mayer, Ph.D., a Professor of Management, Innovation & Entrepreneurship at North Carolina State University; digging deeper into the participants’ leadership profiles; discussing how a person’s ‘inner game’ shapes their ‘outer game;’ shifting thinking patterns from subject to object (i.e. having a thought rather than the thought having me) and looking at reactive tendencies and how these get in the way of effective leadership. The weekend sessions also included how a practice’s financials apply to value transformation and innovation and finally, KIPL alumnus and NCMS Board of Directors member Michael Utecht, MD, FACEP shared an update on his project, which involves working with the Klarrio Group.
Applications are still being accepted for KIPL’s 2021 HCLM classes and for Leadership College. Learn more about these valuable leadership development opportunities and how the NCMS Foundation can help you join a new generation of health care leaders.
In the News
Primary Care Practice Finances in the United States Amid the COVID-19 Pandemic, Health Affairs, September 2020
Learning Opportunity
The Region IV Public Health Training Center is offering a webinar focused on ‘Health Equity in Young Children,’ on Tuesday, July 7 at noon. Disparities in health outcomes begin early in life, and are often the result of social and economic inequities. Many of the health problems children experience are the result of preventable health disparities. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NCMS Political Pulse for June 26, 2020
The NC General Assembly has reached the end of its session -- sort of. Legislators finished the bulk of their work, but will remain in a skeletal session until July 11 in order to quickly reconvene to override any potential vetoes by the Governor. Watch as NCMS Director of Legislative Relations Sue Ann Forrest, MPA, details some key legislation that passed and looks ahead to what is next.
NCMS Morning Rounds 6-26-20
TGIF! Enjoy your
NCMS Morning Rounds.
June 26, 2020
NCDHHS Offers Toolkit to ‘Prevent and Protect’
In the wake of Governor Roy Cooper’s announcement this week making face coverings mandatory to help stem the transmission of the coronavirus, the NC Department of Health and Human Services (NCDHHS) is offering a ‘prevent and protect’ toolkit with resources to help you get the word out to patients about wearing face coverings as well as washing their hands and physically distancing from others.
“Scientific research shows that preventative measures such as hand washing and wearing cloth coverings over the nose and mouth are effective ways to protect ourselves, our loved ones and our communities by lowering risk of exposure to COVID-19,” said Deputy Secretary Dave Richard, NC Medicaid. “Growing evidence shows that cloth face coverings, when worn consistently, can decrease the spread of COVID-19, especially among people who are not yet showing symptoms of the virus.”
This Prevent and Protect Media Toolkit includes:
• Posters for your practice to print and hang in common areas that remind people to wear cloth coverings over their nose and mouth
• Social media graphics answering basic questions about wearing coverings over the mouth and nose.
• Customizable flyers about the 3W’s -- wash your hands, wear a face covering and wait 6 feet apart.
All materials are available in English and Spanish.
You can find more information about the new cloth covering Executive Order in this press release and answers to frequently asked questions in this Guidance and FAQS.
Getting Ready for the November Election
To help ensure EVERYONE is able to exercise their right to vote in the upcoming election, here are a few reminders of the absentee voting procedure you can follow this year if you are at all uncertain about voting in person come November.
- Any North Carolina registered voter may request and receive a mail-in absentee ballot for the November 2020. If you are not yet registered to vote, you may register online here.
• No special circumstance or reason is needed to receive and vote a mail-in absentee ballot.
• You may complete an absentee ballot request form here. It needs to be received at your county board of elections by 5 p.m. on Tuesday, Oct. 27 – that’s the Tuesday before Election Day.
• Once you receive your absentee ballot, you can mark your ballot in the presence of one witness (usually this requires two witnesses, but the requirement has been changed to one witness for the November 2020 election). The witness must sign the Witness Certification on the ballot envelope.
• The completed ballot with witness certification signature must be returned to the county board of elections no later than 5 p.m. on Election Day.
Learn more about this process at the NC Board of Elections website Absentee Voting Information page.
REMINDER: July 1 Deadline to Apply for Medical Board Seats
The Review Panel for the NC Medical Board, which operates independently of the Medical Board, is seeking physician applicants for three seats on the Board, for three-year terms beginning Nov. 1. In accordance with state law, one of the available seats must be filled by a physician who is a member of the Old North State Medical Society. Two of the physician board members currently serving are eligible for reappointment; one incumbent physician board member is not eligible for reappointment.
The Review Panel will consider only physicians who hold active, unrestricted NC professional licenses, and have practiced in the state for at least five years. Applicants must currently be practicing clinical medicine at least 20 hours per week and plan to continue at least that level of practice in North Carolina for the duration of their service on the Medical Board. In addition, applicants must have no history of disciplinary action (in any jurisdiction) within the past 10 years. The Review Panel will interview qualified applicants Aug. 22 and 23.
Learn more about what is involved in serving on the Board here.
July 1 is the deadline to apply. Submit your application here.
In the News
How the Split Over Face Masks Sums Up America’s Chaotic Coronavirus Response, The Washington Post, 6-25-20
Learning Opportunity
DON’T FORGET – today is Power Hour day. Tune in from 1 to 2 p.m. to hear from your colleagues across the pond on their countries’ response to COVID-19. Register for this international roundtable here.
The Aspen Ideas Festival is online and free! June 28 to July 1 timely thought leaders including Anthony Fauci, MD and other health care, cultural, business and intellectual leaders will address events shaping our world today, including the Covid-19 pandemic and ongoing protests against systemic racism. The festival speakers will look to what may lay ahead, including opportunities for economic recovery, the future of democracy, and the latest innovations in technology and the arts. See the lineup of speakers and sign up today for updates and reminders.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
HB 1023 - Coronavirus Relief Fund/Additions & Revisions
HB 1023 - Coronavirus Relief Fund/Additions & Revisions
Appropriations
- $75 million appropriation to DPI for school nutrition services in response for COVID-19
- $7.4 million the allocation for NC Association of Free and Charitable Clinics and expands the authorized uses from cost of eligible health services provided during COVID-19
- $7.4 million for the NC Community Health Center Association and expands use of services provided during the COVID-19 emergency
- $3.5 million allocation to DHHS, Division of Social Services to assist foster child care monthly supplemental payments by $100
- $15 million allocation to the Department of Commerce for job retention grants
- $2.6 million for the NC HealthConnex health information exchange
- $3.5 million for a domestic violence prevention program
- $7 million to DPI for PPE in public schools
- $3 million to UNC-P for an advanced analysis project for studying COVID-19 with an emphasis on rural and at risk communities
- $2 million to UNC-P for the Department of Nursing to assist with medical and patient safety for COVID019
- $7 million in grants for hospitals to offset costs due to the COVID-19 pandemic
- $2.5 million to tier 2 counties with populations of less than 150k with a hospital to offset patient care in the COVID-19 pandemic
History
- Senate Appropriations - 6/23/2020
- Senate Floor - 6/24/2020
- House Floor - 6/25/2020
- Presented to the Governor - 6/25/2020
SB 284 - County Cybersecurity/Satellite Broadband Grants
SB 284 - County Cybersecurity/Satellite Broadband Grants
Primary Sponsor: Sen. Ralph Hise (R-Madison)
*This bill was transformed into a new bill via a proposed Committee Substitute on 6/22/2020. This bill was previously a State Auditor compliance and regulation bill.
Summary
This bill would create a pilot program within the Information Technology Innovation Center within the Department of Information Technology to utilize public-private partnerships to provide comprehensive cybersecurity support services in tier 1 and tier 2 counties.
The bill would create a pilot program within DIT to implement a program management enhancement program.
The bill would establish the satellite based Broadband Grant Program in DIT to provide grants to satellite-based broadband providers based on maintaining new, unserved households as subscribers. The bill would have $4 million for all grants.
This bill would create a time limitation for State agency determination for new leases and lease renewals for colocation, installation, and operation of equipment by a broadband provider to expedite lease agreements.
The bill would appropriate $12.5 million to appropriate to the Department of Information Technology for certain projects.
History
This bill passed in House Appropriations on June 22, 2020.
This bill passed the House on June 23, 2020.
The Senate failed to concur with the House changes on June 25, 2020.
SB 113 - Education Omnibus
History
This bill was transformed into the Education Omnibus bill in the House Rules Committee on June 23, 2020.
This bill passed the House on June 24, 2020 with a vote of 116-0.
Summary
School Psychologists
- The bill exempts certain school psychologists who are licensed by the State Board of Education and regularly salaried employees of DPI or a local board of education. Contract school psychologists would not be eligible for this exception and must be licensed by the NC Psychology Board.
- $10 million appropriated from the Coronavirus Relief Fund to the School Psychologists Recruitment and Retention Pilot Program
School Nutrition
- $75 million appropriated from the Coronavirus Relief Funds to DPI for school nutrition services provided by public school units in response to COVID-19.
LME/MCO
- This bill requires DHHS to calculate a solvency range for each LME/MCO.
HB 471 - Exempt Direct Primary Care from DOI Regs.
HB 471 - Exempt Direct Primary Care from DOI Regs.
Summary
This bill would exempt medical direct primary care from regulation by the Department of Insurance.
The bill states that a medical direct primary care agreement is not insurance.
A medical direct primary care agreement would require the following:
- Be in writing
- Be signed by the primary care provider, the provider's agent, and the patient, an adult member of the family, or the patient's legal representative
- Allow either party to terminate the agreement with written notice to the other party
- Specify the periodic fee and period of time for the agreement
- Specify services that are included in the agreement
- Predominantly state in writing that the agreement is not health insurance
History
This bill was passed in the House as a bill requiring DHHS to create a workgroup to examine administrative duplication for mental health providers.
However, this current bill language was originally introduced as a proposed committee substitute in the Senate Health Care Committee on 5/28/2020.
This bill passed in the Senate Rules Committee on June 2, 2020.
This bill was amended on the Senate floor and passed on June 3, 2020.
The bill will now move to the House.
This bill was referred to the House Rules Committee on June 9, 2020.
This bill was calendared to be heard on the House on June 17, 2o20.
This bill was withdrawn from the calendar and re-referred to the House Rules Committee.
The House concurred with this bill on June 25, 2020.
This bill will now be sent to Governor Cooper.
SB 808 - Medicaid Funding Act
Primary Sponsors: Sen. Harry Brown (R-Onslow), Sen. Kathy Harrington (R-Gaston), Sen. Brent Jackson (R-Sampson)
*This bill was introduced as a PCS in the House Appropriations Committee on June 22, 2020 to revise and update the hospital assessments.
*This bill was introduced as a PCS in the House Rules Committee on June 24, 2020 to make compromise changes in order to move the bill.
Summary
Dorothea Dix Relocation Project
- $15 million in nonrecurring funding for the relocation of DHHS in Wake County
Child Welfare Case Management - NC FAST
- $26.4 million in nonrecurring funding for updates and changes to the child welfare case management component of NC FAST.
Behavioral Health and Crisis Service (COVID-19)
- $50 million in nonrecurring funding to the LME/MCOs
Early Childhood Initiatives
- $20 million in nonrecurring funds for early childhood initiatives to assist in mitigating the financial impact due to the COVID-19 pandemic
Additional Coronavirus Relief Funds for Testing, Tracing, Tracking, and Analysis
- $100 million in funding to expand testing for surveillance including hiring more temporary staff for tracing
Medicaid Budget Surplus
- This section disallows DHHS to transfer a Medicaid budget surplus to LME/MCOs
Medicaid Funding
- $1.4 million in nonrecurring funds to be used for the implementation of an electronic visit verification system for personal care services and home health services under the Medicaid program.
- $30,000 in nonrecurring funds shall not revert at the end of the fiscal year but shall remain available and used for Medicaid/NC Health Choice programs rebase in 2020-21
- $84 million in nonrecurring funds for Medicaid and NC Health Choice programs rebase
- $136 million in nonrecurring funds to the Medicaid Contingency Reserve
- $213 million from the General Fund to the Medicaid and NC Health Choice programs rebase
Medicaid Transformation
- Sets a new Medicaid Transformation go live date of July 1, 2021
- $69.4 million transferred to the Medicaid Transformation Fund
- Requires DHHS to maintain a hotline for customer service questions related to transformation
- Allows for a tribal option for Medicaid Transformation
- Creates a Medicaid Contingency Reserve to be used for budget shortfalls
- Includes gross premiums tax for the prepaid health plans
New Payment Models
- Revises the hospital assessment
- Revises supplemental payments
- Repeals past requirement eliminate GME to align with Medicaid Transformation
- Creates hospital uncompensated care fund
This is the summary of the bill language before it was amended in committee on June 10, 2020.
Delay Implementation
- This bill would require Medicaid Transformation implementation by January 1, 2021.
Funds
- This bill would appropriate funds to the operation of the NC Medicaid program. No set amounts are listed in this bill as of 5/19/2020. (*This is consistent with the other Senate appropriation bills.)
Use of Medicaid Transformation Fund
- The bill appropriates a non-recurring amount for Medicaid Transformation needs in the 2020-21 fiscal year. No set amounts are listed in this bill as of 5/19/2020.
- The bill appropriates a non-recurring amount to the Division of Health Benefits as needed for the purpose of paying claims to services billed under fee for service. No set amounts are listed in this bill as of 5/19/2020.
- The bill appropriates nonrecurring funds as needed, and not a lump sum to the Division of Health Benefits for qualifying needs relating to transformation including program design, beneficiary experience, NC FAST upgrades, data management, program integrity, and technical operations.
- The bill requires the Office of State Budget and Management to oversee the funding use and ensure any requested amount does not exceed $140 million.
GME
- The bill repeals the past directive to eliminate GME to align with Medicaid Transformation.
Medicaid Transformation Hotline
- The bill requires DHHS to ensure that the existing DHHS customer service hotline is responsive to questions posed by a Medicaid beneficiary, provider, or the general public.
Tribal Option
- The bill creates a new option for DHHS to contract with an Indian managed care entity or Indian Health care provider to assist in services to federally recognized tribes.
Revise Supplemental Payments
- The bill states that the program shall no longer utilize a limit on the number of eligible medical providers that may be reimbursed the program and instead shall limit the total payments made under the program.
- The bill requires payments to increase reimbursement to the average commercial rate under the State Health Plan and direct that payments increase to the average commercial rate under the managed care system.
- The bill creates a roll out period for creating this new system.
Medicaid Contingency Reserve
- The bill creates a Medicaid reserve to be used for budget shortfalls.
Revise Hospital Assessments
- The bill gives authority to NC DHHS to adjust the hospital assessment payment amounts between October 2020 and December 2020.
- The bill exempts certain types of hospitals from the supplemental assessment and base assessment.
Gross Premiums/Prepaid Health Plans
- The bill states that the tax in this section shall be measured by the gross capitation payments received by the prepaid health plan from DHHS for services provided to enrollees in the Medicaid program.
- The bill states that capitation payments refunded by a prepaid health plan to the State are the only allowable deductions.
- The set tax rate to be applied to gross premiums is 1.9%.
Hospital Uncompensated Care Fund
- The bill creates a special fund consisting of federal adjustment receipts arising from certified public expenditures.
- The funding could be used for payments to institutions for mental diseases and payments to hospitals to reimburse inpatient services, uncompensated care costs, or outpatient services.
History
Filed - 5/19/2020
This bill was passed as a proposed committee substitute in the Senate Appropriations Committee on June 10, 2020.
This bill passed in the Senate Rules Committee on June 15, 2020.
This bill passed the Senate 43-5 on June 17, 2020.
A proposed committee substitute was heard in the House Appropriations on June 22, 2020.
This bill passed on June 23, 2020.
A proposed committee substitute was heard on the House Rules Committee on June 24, 2020.
A clarifying amendment was passed on the House floor on June 25, 2020.
This bill passed the House with a vote of 111-2 on June 25, 2020.
This bill will now be sent to the Senate.
HB 918 - Expedite Permanency/DHHS Report/SNAP/TANF
HB 918 - Expedite Permanency/DHHS Report/SNAP/TANF
Primary Sponsors: Rep. Steve Jarvis (R-Davidson), Rep. Sarah Stevenes (R-Surry), Rep. Greg Murphy (R-Pitt)
Summary
This bill expedites permanency planning hearings for children who have been removed from the home.
This bill creates a presumption that foster parents with whom a child has lived continuously for 9 months are deemed nonrelative kin.
This bill creates an aggravating circumstance for the exposure of unlawful controlled substances in utero or controlled substances in violation of the law in utero.
The bill requires DHHS, Division of Social Services (DSS) to report annually on certain expenditures for the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) Program.
History
Filed 4/16/2019
Passed House Health Committee - 4/22/2019
Passed House Rules Committee - 5/3/2019
Passed House Session 5/6/2019
Passed Senate Health Care 8/21/2019
Passed Senate Rules 6/18/2020
Passed Senate with an amendment on 6/24/2020
Sent to the House for concurrence on 6/24/2020
This bill passed the House with a vote of 59-53.
This bill will be sent to the Governor.
SB 730 - No Patient Left Alone Act
SB 730 - No Patient Left Alone Act
Primary Sponsors: Sen. Warren Daniel (R-Avery), Sen. Jim Perry (R-Wayne), Sen. Joyce Krawiec (R-Forsyth)
Summary
Current Version
This bill states that a hospital shall allow a support person of the patient's choice to be present during the patient's stay, unless the individual's presence infringes on others' rights or safety or is medically contraindicated.
A hospital must have written policies and procedures regarding the visitation rights of patients, including those that may need a reasonable restriction.
A hospital must inform each patient or support person of their visitation rights.
This bill appropriates $10 million from the Coronavirus Relief Fund to the UNC Policy Collaboratory for statewide testing, tracking, and tracing.
Senate Version
This bill provides visitation rights that will not be impacted during declared disasters and public health emergencies. The bill states that a hospital will provide the opportunity for at least one visitor per patient. The visitation would be subject to the guidelines, conditions, and limitations of the normal visitation policy.
Minors would be allowed one parent/guardian to be allowed to visit and be present while the minor patient is receiving hospital care. The bill clarifies that if there is a custody agreement it will control.
The hospital may require a visitor to submit health screenings to prevent the spread of infectious diseases.
The hospital may require visitors to submit health screenings necessary to prevent the spread of infectious diseases.
History
Filed - 5.13.2020
Favorable - Senate Health Committee - 6.11.2020
Favorable - Senate Appropriations - 6.17.2020
Favorable - Senate Rules Committee - 6.18.2020
This bill passed in the Senate on June 19, 2020
Proposed Committee Substitute passed the House Rules Committee on June 24, 2020
This bill passed the House on second reading on June 24, 2020. There was an objection to third reading.
An amendment passed to add an additional $100 million in funding to provide grants for businesses that closed as a result of the COVID-19 pandemic.
Thes Senate voted not to concur with the House changes on June 25, 2020.
NCMS Morning Rounds 6-25-20
Happy Thursday! Enjoy your
NCMS Morning Rounds.
June 25, 2020
Seeking ‘Person on the Street’ Views on Face Coverings
Researchers at the University of North Carolina – Chapel Hill hope to gain insight into why the average person does or does not wear face coverings during the current pandemic. They are seeking North Carolina residents with opinions to share in online focus groups.
Questions include: what makes it hard to wear a face covering? What could be good about wearing a face covering? What could help make it easier to wear one? They are particularly interested in hearing from those who identify as:
- Latino/a/x or Hispanic
• Black or African American
• Living in a rural area
• Young adult (ages 18 – 25)
The online focus group will last 90 minutes and you will receive a $40 online Amazon gift card for your participation.
If any of your patients are interested they can email the researchers at [email protected] or text them at (919) 650-4050. You can publicize this study in your practice by distributing this one-pager in English and Spanish.
Last week the NCMS issued a joint statement with the NC Healthcare Association and the NC Chamber encouraging the public to practice the ‘3 W’s’ of wearing a face covering, washing hands and waiting at least six feet apart to practice physical distancing. As NCMS CEO Robert W. Seligson, MBA, MA says in the statement: “The scientific and medical community consensus is now quite clear that masks both protect the individual wearing it and have collective benefit for the community. The benefits far outweigh the inconvenience. If everyone consistently does these recommended behaviors, we can help avoid further impacting our economy.”
Helping Patients Access Food and Nutrition Services
This week, NCDHHS is launching an improved, mobile-friendly online application for Medicaid and Food and Nutrition Services that will help support social distancing and beneficiary applications from home during the COVID-19 pandemic. North Carolina’s online application portal, ePASS, has been improved with new and updated features that will provide a streamlined user experience with specific enhancements to be more mobile-friendly.
These changes do not impact any previously submitted application. Any questions about existing applications will still be directed to the County DSS offices.
To learn more about the new features of NC FAST’s ePASS upgrade, visit the NC Medicaid/Health Choice webpage or the NCDHHS Food and Nutrition Service webpage.
You also can download and print flyers for your patients outlining how to access these services in English and Spanish.
Campbell Offers Virtual Med School Open House
The Campbell University School of Osteopathic Medicine is holding a virtual open house next Tuesday, June 30 from 1 to 4 p.m. The school’s Masters of Health Professions Education (MHPE) program will be part of the tour. The NCMS Foundation’s Kanof Institute for Physician Leadership staff is heavily involved in the MHPE program curriculum development and as faculty.
Please take this opportunity to learn more about Campbell’s programs and pass the information onto potential students. Register here to attend.
In the News
The Hidden Deaths of the COVID Pandemic, Kaiser Health News, 6-23-20
Learning Opportunity
Be sure to join us for this week’s Power Hour when we will welcome physicians from Europe to discuss their various countries’ response to COVID-19. Physicians from Italy and possibly Sweden will participate in the discussion. Get the international perspective on the pandemic from your colleagues across the Atlantic. Register now and join us Friday at 1 p.m. for the next in our Power Hour series.
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REMINDER: the US Department of Health and Human Services is offering a webcast today, Thursday, June 25 at 2 p.m. on the application process for NC Medicaid providers to receive federal relief through the CARES Act Provider Relief Fund. Those eligible will receive at least 2 percent of reported annual gross revenue from patient care. Practices can apply by July 20, 2020 to receive payments. Sign up for the webcast here. Learn more about your eligibility at the NC Medicaid site.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
HB 594 - Temp Open Gyms/Health Clubs/Fitness Centers
HB 594 - Temp Open Gyms/Health Clubs/Fitness Centers
Primary Sponsor: Sen. Rick Gunn (R-Alamance)
Summary
This bill would authorize indoor or outdoor exercise and fitness facilities, gyms, health clubs, and fitness centers to resume operations while also safeguarding public health to prevent the spread of COVID-19.
The bill would require all gyms to do the following:
- Limit capacity to 50% of the authorized fire capacity.
- Employee requirement to complete a health questionnaire and have their temperature taken. Any employee showing symptoms/fever is not allowed to enter the establishment
- All employees wear face masks, except when actively leading a group fitness class or when outdoors socially distances. All visitors are strongly encouraged to wear masks.
- Contactless check-in, including propping open all entry doors when possible. Markings are on the ground to denote proper social distancing.
- Sanitation spray bottles with disinfectant or wipes available throughout the establishment
- Hang sanitizer station available.
- Employees conduct frequent cleanings.
- Specific requirement for cardiovascular equipment and group fitness classes.
- Water fountains are limited to filling water bottles only.
- Personal hygiene amenity services closed except for toilets.
History
This bill was introduced as a proposed committee substitute, replacing a bill with this fitness center language in the Senate Commerce and Insurance Committee on June 4, 2020.
The bill passed the Senate Rules Committee on June 8, 2020.
This bill was amended on the Senate floor and passed with a vote of 36-13 on June 9, 2020.
The House voted to concur with the Senate changes to the bill on June 10, 2o2o with a vote of 69-50.
This bill was presented to the Governor on June 10, 2020.
The Governor vetoed this bill.
The House failed to override this bill with a vote of 66-55 on June 24, 2020.
NCMS Morning Rounds 6-24-20
It's Wednesday and time for your
NCMS Morning Rounds.
June 24, 2020
Deadline Approaching for Valuable Leadership Opportunity
The world currently is in the grip of a global pandemic and our nation continues to grapple with many other long standing challenges to our health and our health care system. Skilled health care leaders are crucial to finding solutions and moving toward positive change in our workplaces and our communities.
The NCMS Foundation’s Kanof Institute for Physician Leadership (KIPL) offers an award-winning array of leadership development programs to help you gain insight into your unique leadership talents and to empower you to lead at many levels now and in the future.
Currently, the Leadership College and Health Care Leadership and Management (HCLM) programs are accepting applications for class of 2021 scholars. Both programs plan to proceed as usual with in-person sessions in the coming year, but also can be held virtually, if necessary.
Learn more about these valuable opportunities at the KIPL webpage and consider applying for this chance to enhance your understanding of your leadership potential and how to leverage it to the benefit of your larger community.
Joint Survey Offers Valuable Data
Thank you to everyone who continues to respond to the practice survey jointly administered by the NCMS, NC Medical Group Management Association and Curi. Over the past several months this survey has offered a wealth of valuable data on how medical practices throughout the state are coping with various aspects of the pandemic from the financial fallout, to procuring personal protective equipment, to adoption of telehealth, to the emotional impact on staff.
We have moved to a biweekly format to respect your time. Please take just a moment to complete the survey this week. The information you provide gives our organizations and state officials a window into what you are experiencing and allows a more informed response. Results are reported in your NCMS Morning Rounds.
Performance Improvement Group to Disband
The Physician Consortium for Performance Improvement (PCPI) recently announced that it would dissolve as a 501(c)3 organization this summer after its Board of Directors determined the organization is not sustainable for the long term.
Twenty years ago, the American Medical Association (AMA) convened PCPI as a physician-led program to develop performance measures to address a significant gap in the measurement landscape. Over the years, PCPI has developed more than 350 measures, many of which were used in the Physician Quality Reporting System (PQRS) and Meaningful Use, as well as private health plan payment models.
In 2011, PCPI worked with a group of committed volunteer leaders to launch the NQRN®, a national, multi-stakeholder network of clinical registry stewards and others interested in registries. The NQRN has created tools and educational opportunities, and increased the visibility and value of clinical registries as reporting and improvement systems.
In 2015, new Bylaws were adopted that set the course for the PCPI Foundation (PCPI), an independent organization with an expanded membership. This PCPI Foundation’s Board, which includes NCMS’ Senior Vice President for Health System Innovation and Deputy General Counsel Melanie Phelps, JD, and its membership represents a wide array of health care stakeholders including physicians, patients and consumers, health systems, accrediting and licensing entities and employers among others.
In the News
Medicare Data: Blacks Likelier to be Hospitalized for COVID, The Associated Press, 6-23-20
Learning Opportunity
‘Burning Up While Burning Out: Compassion Fatigue Awareness and Burnout Prevention for Practitioners,’ a 90-minute webinar to be held on Thursday, July 9 at 1 p.m., will help you gain awareness of key signs and symptoms of compassion fatigue and burnout while learning how to manage stressors and their consequences. Specific attention will be given to physical, emotional/mental and behavioral symptoms. Awareness training is a key component to the training. Underlying beliefs about compassion fatigue are explored and other general signs and symptoms of burnout are explained. 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!
NCMS Morning Rounds 6-23-20
Enjoy your Tuesday
NCMS Morning Rounds.
June 23, 2020
Learn More About Provider Relief Fund Payments
Last week, the US Department of Health and Human Services (HHS) launched an application portal to distribute $15 billion in CARES Act Provider Relief Fund payments to eligible Medicaid and CHIP physicians and organizations. Read more about this allocation in this June 9 NCMS COVID-19 News Alert.
The payment will be at least 2 percent of reported gross revenue from patient care, and the final amount will be determined based on submitted data, including the number of Medicaid patients served. Eligible physicians and organizations have until July 20, 2020, to submit their application and report other necessary information, such as annual patient revenue data.
Today, June 23 and again on Thursday, June 25 at 2 p.m. HHS is hosting two webcasts for physicians and other health care professionals interested in learning more about the application process. Registration is required.
HHS also posted updated answers to questions about the Provider Relief Fund on its FAQ page. Here are the answers to two common questions:
- Q: Why is there a new Provider Relief Fund Payment Portal?
A: Portal will initially be used for new submissions from Medicaid and Children’s Health Insurance Program (CHIP) providers seeking payments under the Provider Relief Fund starting Wednesday, June 10, 2020. At this time, this portal will serve as the point of entry for providers who have received Medicaid and CHIP payments in 2017, 2018, 2019 or 2020 and who have not already received any payments from the $50 billion Provider Relief Fund General Distribution. - Q: What is the difference between the first Provider Relief Fund Payment Portal and the Enhanced Provider Relief Fund Payment Portal for the Medicaid Targeted Distribution?
A: The first Provider Relief Fund Payment Portal was used for providers who received a General Distribution payment prior to Friday, April 24th. These providers were required to submit financial information in order to receive approximately 2 percent of gross revenues derived from patient care. HHS has developed the new Enhanced Provider Relief Fund Payment Portal for providers who did not receive payments under the previous General Distribution, including those providers who bill Medicaid and CHIP (e.g., pediatricians, long-term care, and behavioral health providers.)
To review the complete list of FAQs visit the CARES Act Provider Relief Fund FAQs page.
Routine Vaccinations for School – An Update
With summer officially here, it’s hard to believe the new school year is just around the corner. The start of the school year is an important time to remind patients to stay on the recommended vaccination schedule. This year also brings a new vaccination requirement for the meningococcal conjugate vaccine.
Based on North Carolina immunization requirements, individuals who are turning 17 years old or entering 12th grade in 2020 now require a booster dose of the meningococcal conjugate vaccine (MenACWY). However, if a patient did not receive their first dose of the meningococcal conjugate vaccine until they were 16 or older, they are exempt from the booster dose at 17 years old.
As you discuss the MenACWY booster dose with your patients, you may also want to review the meningitis B vaccine, which adolescents and young adults ages 16-23 may receive, in order to fully protect your patients from bacterial meningitis. Meningitis B accounts for 70 percent of meningococcal cases among 16-23-year-olds, yet 83 percent of 17-year-olds have not received at least one dose of the MenB vaccine.
Medical and religious exemptions are still allowed for all mandatory vaccines in North Carolina. You can find more information about the latest immunization requirements in North Carolina here.
Here are the full vaccine requirements for those entering 12th grade.
What We Know Now About COVID-19
A lot has changed since NCMS Past President and current Durham Orange County Medical Society Board member Robert ‘Charlie’ Monteiro, MD, spoke on WCHL radio in March about COVID-19. In his latest radio interview, Dr. Monteiro, an internal medicine specialist, updates and educates the public on the changes over the last three months in scientific knowledge about and potential treatments for the coronavirus.
Listen to his 14-minute interview.
In the News
The Promise and the Peril of Virtual Health Care, The New Yorker, 6-22-20
Learning Opportunity
The American Public Health Association and the National Academy of Medicine offers the next in its webinar series is exploring the state of the science surrounding the current outbreak of COVID-19 in the United States and globally, with a focus on the emerging evidence on how to best mitigate its impact. Hear from trusted experts in such fields as public health, infectious disease, risk communication, and crisis standards of care in webinar #10: Learning to Treat COVID-19 — Clinical Trials and Developing Therapeutics during a Pandemic on Wednesday, June 24 from 5-6:30 p.m. Learn more and register.
If you have policies you'd like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!
NC Child Well-Being Transformation Council
NC Child Well-Being Transformation Council
The NC Child Well-Being Transformation Council met on Monday, June 22, 2020.
The Council discussed 18 recommendations including the following:
- Direct DHHS to require coordination between counties no later than 90 after a child's 17th birthday to ensure services are available upon exiting foster care
- Direct DHHS to outline the permanency plan process and require permanency plans to be initiated no later than 90 days after a child's 17th birthday and no later than 15 days prior to a child transitioning out of their 18th birthday
- Require DHHS to develop and implement a plan to keep foster children in community based settings and avoid inappropriate behavioral health placements
- Require DHHS to study requirements of the state's social services system, juvenile justice system, LME/MCO communications, LME?MCO cost savings, and the Medicaid program for foster care youth to identify gaps,
- Direct DHHS to implement a rapid consultation system to provide consultation to counties when making decisions regarding the safety of children using regional staff increasing consistency among counties.
- Direct DHHS to develop trauma informed assessment tools, evaluate costs and benefits of implementing assessment tools, require their usage to be limited to trained clinicians, evaluate the costs of the tools.
- Direct DHHS to do increase the use of the Guardian Assistance Program and the Kinship Care Program
- Require DHHS and NC Association of Regional Councils of Governments to develop a plan to allow Councils of Government to provide physical office space for regional social services staff.
- Require DHHS to report on federal reimbursement on federal programs and strategies to improve use of those programs.
- Direct the Social Services Commission to review DHHS's Division of Social Service's publications, policies and procedures that satisfy the definition of a rule. They must report to the Office of Administrative Hearings, and submit under the rule making process any identified as satisfying the definition of a rule.
- Require DHHS, DPI, DPS, AOC, and DIT to study social services confidentiality laws and request recommendations for revisions to improve collaboration and service delivery.
- Modify state statute to eliminate the following inactive boards and comissions in the children, youth, and family arena.
- Modify state law to continue the Social Services Working Group.
- Implement regional supervision of county DSS.
- Direct DPI and DHHS and LME/MCOs to develop a plan to increase additional in school Medicaid services
- Require the Program Evaluation Division to evaluate the success of the Integrated Care for Kids pilot program in 2024 including: benefits, telehealth, and cost savings.
- Express support to share information between DHHS, DPS, county DSS and LME/MCOs
- Express support for DHHS to prepare comprehensive guidance and training regarding information sharing and confidentiality for all social services programs.
There were three bill drafts presented to make recommendations for study and reform that would accompany the final report issued by the Child Well-Being Transformation Council.
SB 805 - First Responders Worker's Compensation and DHHS Funding
SB 805 - Enhance First Responder's WC and Benefits
Primary Sponsors: Sen. Harry Brown (R-Onslow), Sen. Kathy Harrington (R-Gaston), Sen. Brent Jackson (R-Sampson)
Summary
This bill was transformed into a new bill via a proposed committee substitute to SB 805 to Enhance First Responder's worker's compensation and benefits on June 22, 2020.
Filed Language
This bill appropriates funds from the Coronavirus Relief Fund to be used to offset General Fund appropriations across State government for allowable expenditures.
The bill directs the State Controller to transfer $645,400,000 to the Coronavirus Relief Fund. This funding would be used for allowable expenditures under the CARES Act.
New Language 6/22/2020
This bill was introduced for discussion only in the House Appropriations Committee on June 22, 2020.
This bill creates a presumption that certain cancers are occupational diseases for firefighters employed by local units. This bill expands the list of cancers covered as occupational diseases for firefighters' death benefits. This bill will establish a special separation allowance for state and local firefighters and rescue squad workers.
This bill funds $50 million in nonrecurring funds to DHHS behavioral health and crisis services in response to COVID-19.
History
Filed: 5/19/2020
Committee Substitute Passed Senate Appropriations Committee 6/10/2020
Passed Senate 49-0 on 6/15/2020
Passed House Appropriations Committee 6/16/2020
Passed second reading in the House 119-0 6/17/2020
This bill was re-referred to House Appropriations on 6/18/2020
This bill was heard as a proposed Committee Substitute in House Appropriations on 6/22/20