The legislative study bill passed by the General Assembly last year allows the North Carolina Midwifery Joint Committee (MJC) to present recommendations during the next legislative session regarding the potential licensure of Certified Professional Midwives(CPMs). On Tuesday, March 16, 2010, Melanie Phelps, NCMS Deputy General Counsel, spoke before the MJC to convey NCMS concerns regarding the licensure of these individuals. The NCMS opposes CPM licensure standards that would put patients at risk by allowing relaxed training and education requirements and allow CPMs to practice without physician supervision. The MJC holds monthly public meetings to discuss this issue. The next meeting will be held on Wednesday, April 14, 2010 at noon.
The North Carolina Medical Society continues to lobby the North Carolina Congressional Delegation asking that our Representatives and Senators consider several areas of concern with national health system reform.
In a letter sent to the Delegation on March 8, 2010, the NCMS asked members of the House and Senate to consider the following priorities as they debate any bill that might go to reconciliation:
A permanent repeal of Medicare’s flawed physician payment formula
Meaningful liability reform
Physicians and patients having the right to privately contract without penalties
Increased provider reimbursement to offset Medicaid expansion
Medicare bonus payments for primary care and the expansion of primary care residency positions
Elimination of penalties for physicians who do not successfully participate in the Physician Quality Reporting Initiative (PQRI)
Elimination of the proposed Medicare Independent Payment Advisory Board (IPAB)
Safeguards on Accountable Care Organizations and payment-bundling pilot programs
Limit barriers to new physician-owned hospitals
Please read the letter (PDF) for more details. Contact your Representative and Senators and urge the need for health system reform that will provide adequate access for patients, a sustainable workforce, and support improved quality and administrative effectiveness while managing costs. Your voice is important and needed.
More information about health system reform can be found on the NCMS website, www.ncmedsoc.org/healthreform, where you can access updates and the Doctor-to-Doctor blog, which allows you to comment on issues and read what your colleagues are saying.
The NCMS is advocating these priorities on a daily basis with members of the NC Congressional Delegation. Be watching for this week’s Bulletin for more information about health system reform and other timely issues.
The President signed HR 4691 into law late Tuesday, March 2, which contained a one-month stopgap provision to override the 21% Medicare rate cut called for by the flawed Sustainable Growth Rate (SGR) formula. Under this bill, the Medicare conversion factor update is set at 0% through March 31, 2010. Your NCMS President, Doug Sheets, MD, and Executive Vice President/CEO Bob Seligson have been in Washington, DC this week lobbying for a permanent solution to the perennial SGR problem. Organized medicine supports legislation to permanently replace SGR with a more realistic approach to Medicare payment updates.
After a day-long discussion at Blair House on Thursday, the White House Bipartisan Health Care Summit ended without a decisive compromise on the future of Health System Reform. Preceding the Summit, President Obama released his proposal for Health System Reform which can be viewed here.
Republicans and Democrats at the Summit discussed the President’s proposal and their own bills, specifically focusing discussion on the cost of healthcare to families and to the government, insurance market reform, Medicare, tort reform and the SGR formula.
• If you missed yesterday’s Summit, you can view the entire discussion on C-Span’s website.
• The New York Times also has a moment-by-moment blog of the Summit discussion available on their website.
President Obama has released a legislative proposal for discussion at a bipartisan summit on health care scheduled for Thursday, February 25. You can view the White House plan here. The proposal is absent a public health insurance option, delays taxes on high cost insurance plans until 2018, and includes reforms to reduce waste, fraud and abuse in Medicare. The NCMS is reviewing the plan and will continue to provide updates on this proposal and other national health system reform developments as available on the NCMS Health Reform page.
The health care summit can be viewed via live stream on Thursday at 10:00 AM by visiting whitehouse.gov/live.
The North Carolina Medicaid Program has announced plans to implement a Preferred Drug List (PDL) effective March 15. The General Assembly authorized the creation of a PDL during the 2009 session as a way to manage costs. The list will allow Medicaid to obtain supplemental rebates for certain outpatient drugs (not including HIV/AIDS drugs).
Drugs that have required prior authorization in the past will continue to do so. Additional prior authorization requirements could be implemented with the use of the PDL. However, these changes would be subject to a public comment period.
The North Carolina Medical Board has created a staff position to address licensee’s questions regarding the new online profiling rules required by NC GS 90-5290-53. You can reach Barbara Gartside, Licensee Information Coordinator, by e-mailing li@ncmedboard.org or calling 919-326-1100 or 800-253-9653.
On Wednesday, February 17, 2010 the Midwifery Joint Committee (MJC) met in Raleigh to discuss their ongoing study of the possible licensure of Certified Professional Midwives. Currently CPM’s are not registered or licensed by the State of North Carolina.
John Albert, MD, president of the North Carolina Obstetrical and Gynecological Society, and Haywood Brown, MD, chair of the Department of Obstetrics and Gynecology at DukeUniversity Medical Center, both represented their specialty and offered comments to the committee. The MJC will continue to meet throughout the spring with the goal of presenting draft legislation to the General Assembly in May. The next meeting will be held on March 16, 2010 at 2:00 pm. The NCMS has attended each meeting of the committee and will continue to keep our members informed of the MJC’s study.
The Medicare Improvements for Patients and Providers Act of 2008 requires providers who wish to continue providing advanced imaging services to Medicare patients to obtain accreditation from one of three national organizations by January 1, 2012.
The three accrediting bodies recently designated by CMS are the American College of Radiology (ACR), the Intersocietal Accreditation Commission (IAC), and The Joint Commission (TJC).
The accreditation requirement applies to the technical component of MRI, CT and nuclear medicine paid for under the Medicare Physician Fee Schedule; it does not apply to a provider’s interpretation of the images.
Factors to be covered in the accreditation process include qualifications of physicians and non-physician personnel, safety procedures and accuracy of interpretation.
Thursday, January 28th the Senate passed H.J. Res. 45, a resolution to raise the federal debt limit by $1.9 trillion, bringing the total national debt limit to $14.3 trillion.
Included in this resolution is a provision to reinstate PAYGO rules for new spending, meaning that any new spending or tax cuts would have to be offset by corresponding spending cuts or tax increases.
A limited exemption for the Sustainable Growth Rate (SGR) was made to this PAYGO rule. Up to $82 billion in spending for an SGR fix would not be required to be offset by other revenue or cuts, should this resolution pass. However, an additional $130 billion in offsets would still be required to permanently repeal the SGR.
H.J. Res. 45 will be considered by the House of Representatives next week. It is important to note that this legislation does not implement a new Medicare physician payment policy. It is still up to Congress to enact separate legislation to stop the 21.2% SGR cuts schedule to begin March 1, 2010. The NCMS continues to advocate for legislation that will permanently repeal the SGR before March 1st.
