This week the NCMS asked members of the North Carolina Congressional Delegation to consider a list of priorities in addressing health care system reform legislation.  In a letter sent to NC Representatives and Senators on Wednesday, the NCMS continued its campaign to get Congress to adderess serious concerns we have identified with legislation now pending before both chambers. The NCMS supports national health system reform but opposes bills currently under consideration in the House and Senate.

President Obama has set a March 18 deadline for passage of a health care plan that draws largely from legislation crafted by the Senate.  An AMA update on health system reform negotiations reveals that the House and Senate are negotiating changes to the Senate-passed health system reform bill that would address concerns House members have with that legislation. Complicating the efforts are the procedural restrictions that would apply to the budget reconciliation bill that Congress intends to use as a legislative vehicle for making those changes.

One of the outstanding issues is the scope and authority of the proposed Independent Payment Advisory Board (IPAB), which the NCMS and the AMA oppose. The IPAB would make recommendations to Congress for reducing the rate of growth in overall Medicare spending if total spending exceeds a new, program-wide expenditure target. The AMA says the new target system is very stringent and does not apply equitably across Medicare provider groups. In addition, the “fast track” authority the bill would grant these recommendations would require a three-fifths vote in both Chambers for Congress to overturn them, a requirement reminiscent of medicine’s experience with Medicare’s sustainable growth rate (SGR).
 
Physicians need to call their Representatives and Senators  to voice support for the NCMS principles of health system reform that would provide adequate access for patients, a sustainable workforce and support improved quality and administrative effectiveness while managing costs. Additional information concerning health system reform is available at http://www.ncmedsoc.org/healthreform.

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The NCMS, AMA and other physician-led organizations are calling for a permanent repeal of the Medicare physician payment formula, SGR (sustainable growth rate), as the White House continues its campaign for passage of a health care reform bill. The NCMS favors a predictable Medicare physician payment system that will allow physicians to plan quality initiatives and health information technology quality improvements. It would also help sustain the health care workforce and guarantee Medicare and TRICARE beneficiaries’ provider access.

A 21.2% cut in Medicare physician payments is scheduled to take effect on April 1, 2010, after Congress enacted a stopgap extension when the cut initially took effect on March 1, 2010. The AMA wants the SGR eliminated and is opposing further extensions of cuts, calling it a band-aid approach that will only add to the cost when a permanent fix is ultimately implemented.

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As physicians consider their participation in the Medicare program, attorneys Kimberly Licata and Steve Shaber, with Poyner Spruill LLP of Raleigh, have prepared a brief guide to help physicians.View To Participate Or Not Participate: That Is the Question Physicians Are Currently Pondering in Light of a Potential 21% Pay Cut under Medicare. The cut in Medicare physician payment fees is scheduled to take effect April 1, 2010, unless Congress intervenes. While there has been some discussion regarding an extension of the March 17 deadline, there is no clear signal that an extension will be granted.

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Special workshops and the screening of the documentary, The Deadliest Disease in America, will be part of a conference that will examine racism in health care delivery on Saturday, March 20, 2010, 9:30 am, at the Duke University School of Nursing Auditorium. The film was produced and directed by Crystal Emery, and the conference is being presented by URU, The Right To Be, Inc. in collaboration with the Duke University School of Medicine.

Following the film, participants can choose one of three workshops:

• Doctor/Patient Communication
• Empowering Community Organizations to Work with Legislators for Change
• What Racism Looks Like in Health Care Delivery and Why You Should Report It

Please RSVP by March 15 at http://www.urutherighttobe.org/register, or call 919-599-4647.

This event is open and co-sponsored by the North Carolina Medical Society; Durham Academy of Medicine, Dentistry and Pharmacy; Durham Committee on the Affairs of Black People; Durham Congregations In Action; and Old North State Medical Society.

To preview a trailer of the film please visit http://www.urutherighttobe.org/, operated by the non-profit, community-based URU The Right to Be, Inc.

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The NCMS is a signatory to a letter that offers comments on the proposed rule for implementing the Medicare and Medicaid electronic health record (EHR) incentive programs.

Addressed to Charlene Frizzera, Acting Administrator, Centers for Medicare and Medicaid Services, and coordinated by the AMA, the multi-page correspondence details a lengthy list of concerns that physician and health care-related organizations have with the proposed rule. Among the many issues discussed are implementation of meaningful use, need for small physician practice representation on the Health IT Policy Committee and reasonable timelines and criteria for Stage 1 implementation, and strong concerns about the use of “numerators and denominators” to determine whether a physician meets the requirements. Read the complete draft letter (35 pages).

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A webinar entitled Are You Ready? New Health Information Technology Funding for Technical Assistance and Infrastructure will focus on Regional Extension Centers (REC) that will be part of health information technology (HIT) development in North Carolina.  The state was recently awarded over $52 million in federal stimulus dollars to improve infrastructure for HIT and to provide technical assistance to health care providers. The webinar will be co-hosted by the North Carolina Medical Society Foundation (NCMSF) and North Carolina Medical Group Managers (NCMGM) and presented on Thursday, March 25, 2010, 12:00 noon – 1:00 pm.

Ann Lefebvre, NC AHEC; Jennifer Anderson, Carolinas Center for Medical Excellence; and Maggie Sauer, NCMSF, will discuss the plans for the REC and technical assistance activities.

For more information and a link to register, go to: http://www.ncmedsoc.org/legacy/pages/meetings_and_events/calendar_detail.jsp?id=660.

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Maggie Sauer, Associate Executive Director, NCMS Foundation, briefed members of the Joint Legislative Health Oversight Study Committee on The Impact of New NC HIT Initiatives in Physician Practices on March 3, 2010.  Her presentation (PDF) examined electronic health record (EHR) adoption, barriers to adoption, new health information technology (HIT) opportunities for NC and steps that will be taken to improve HIT development and EHR adoption.  Joanne Rohde, CEO, Axial Exchange, provided a Primer on HIT to the committee, which is co-chaired by Senator William Purcell, MD, (D-Scotland), and Representative Bob England, MD, (D-Rutherford).

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The North Carolina Obstetrics and Gynecology Society (NCOGS) will hold its Annual Meeting April 23-25, 2010, at the Grandover Resort & Spa in Greensboro. 10.5 CME credits will be offered. Presidential Speaker will be Alfred Abuhamad, MD, of Eastern Virginia Medical School, who will present Obstetrical Care Quality Improvement and Application of 3-D Ultrasound in OB-GYN.

For a list of other topics to be covered, and meeting information and registration, go to: http://www.ncmedsoc.org/non_members/specialties/brochures/2010-OBGYN.pdf.  Questions may be directed to the NCOGS at (919) 833-3836 or nlowe@ncmedsoc.org.

For room reservations, please call the Grandover Resort at (800) 472-6301. Rooms are being held until March 22, 2010.

The North Carolina Osteopathic Association (NCOA) will hold its Annual CME Meeting April 15-18, 2010, at the Renaissance Hotel at North Hills in Raleigh. Up to 29 CME credits will be available through a weekend of classes, lectures and seminars. A downloadable registration form and conference schedule are available at http://ncoma.org/education.php.  Room reservations may be made by calling (919) 571-8773 or visit www.marriott.com/rdurn.