Staff Writer Doug Trapp reports on how North Carolina’s Medicaid medical home program has saved nearly $1 billion in state and federal spending over four years. The article includes quotes from NCMS President Robert W. Monteiro, MD, and Community Care of North Carolina President and NCMS member L. Allen Dobson, Jr., MD.

Efficiency a key factor in top practices: MGMA-ACMPE, 1-25-12, Modern Physician

Writer Andis Robeznieks looks at a new report from MGMA-ACMPE (formerly Medical Group Management Association) on what distinguishes better-performing practices.

Florida bill would make doctors, health centers post prices, 1-24-12, South Florida Sun-Sentinel

Writer Bob LaMendola reports on a bill being considered by Florida legislators that would force doctors and some medical centers to post prices in their waiting areas.

Lawmakers hear Rex Hospital complaints, 1-24-12, The News and Observer

Staff Writer Mandy Locke reports on a legislative committee looking into whether the state should own Raleigh’s Rex Hospital.

Titan project would cost millions in health care, report says, 1-24-12, Wilmington Star-News

Writer Kate Elizabeth Queram reports on a study of a proposed cement plant project and its potential impact on health care costs in the Wilmington area.

What We Give Up for Health Care, 1-21-12, The New York Times

An op-ed by Ezekiel J. Emanuel, MD, oncologist and former White House Advisor and a vice provost and professor at the University of Pennsylvania, on why liberals are wrong to ignore costs when it comes to health care reform.

Infection control training mandated at assisted living centers, 1-24-12, The News and Observer

Staff Writer Thomas Goldsmith looks at a new law requiring specific infection control training for assisted living staff members.

NCMS President Robert W. Monteiro, MD, addressed the need to fix the SGR in a letter that was published in the New Bern Sun-Journal on December, 27, 2011. The NCMS and the AMA support a proposal that would leave Medicare physician reimbursement at current levels for two years, giving Congress time to repeal the SGR and develop a plan that would establish a reimbursement structure that meets the actual costs of physician services. Under the SGR, the gap between physician costs and Medicare reimbursement has grown dramatically wider over the past ten years, putting the cost of reforming the SGR at $298 billion at the end of 2011. The AMA projects the costs will grow to $320 billion if Congress fails to act in 2012.

CMS is anticipating that Congress will avert the negative update for the 2012 Medicare Physician Fee Schedule, so it is extending the 2012 Annual Participation Enrollment Period through Tuesday, February 14, 2012. The effective date for any participation status change during the extension, however, remains Sunday, January 1, 2012, and will be in force for the entire year. Palmetto GBA and other Medicare contractors will accept and process any participation elections or withdrawals made during the extended enrollment period that are post-marked on or before Tuesday, February 14, 2012.

CMS Unable To Provide Feedback Report for Electronic Prescribing Program

CMS has advised physicians and other Medicare providers that it cannot provide a 2012 Electronic Prescribing (eRx) Incentive Program payment adjustment feedback report as it had intended. CMS says a high volume of significant hardship requests make it technically unfeasible to do the report. CMS will continue to explore alternatives to notify eligible professions that they are subject to the 2012 eRx payment adjustment.

Eligible professionals are urged to review remittance advices for claims submitted for dates of service on or after Sunday, January 1, 2012. Eligible professionals and group practices that receive the 2012 eRx payment adjustment will see the term “LE” on their remittance advice for all Medicare Part B Services rendered January 1 – December 31, 2012.

The remittance advice will also contain the following Claim Adjustment Reason Code (CARC) and Remittance Advice Remark (RARC):

CARC 237 – Legislated/Regulatory Penalty. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).

RARC N545 – Payment reduced based on status as an unsuccessful e-prescriber per the Electronic Prescribing Rx Incentive Program.

If an eligible professional or group practice receives the payment adjustment in error, the claim will be reprocessed to return the 1.0 percent and the remittance advice for the reprocessed claim will include the following codes and messages:

CARC 237 – (As noted above)

RARC N546 – Payment represents a previous reduction based on the Electronic Prescribing Incentive Program.

For more information on how the 2012 eRx payment adjustment will be assessed and applied, please refer to MLN Matters Article SE1141 for additional information, or visit the eRx Incentive Program webpage at http://www.cms.gov/erxincentive.

Important Changes in Medicare for 2012 that Physicians Need to Know

Medicare cost-sharing for Part B Services will decline in some cases, and for the first time, the Part B deductible will decrease by $22, to $140. Additionally, health care professionals will be paid more to provide certain important services for people covered by Medicare. CMS has increased the payment amount for the initial and annual wellness visit—which has no cost sharing for patients—to account for the introduction of health risk assessment (HRA). CMS wants to balance the comprehensiveness of the HRA with the potential burden on patients and health professional time constraints. CMS will allow for variation in the content of the HRA.

Also, primary care physicians, nurse practitioners, clinical nurse specialists, and physician assistants may be eligible to receive an incentive payment equal to 10 percent of their allowed charges for primary care services under Medicare Part B. This incentive is paid in addition to any physician incentive payments for services furnished in Health Professional Shortage Areas.

North Carolina Physicians Named as Innovation Advisors to CMS

Three North Carolina physicians and a practice group manager have been selected as Innovation Advisors to the Centers for Medicare and Medicaid Services (CMS). The following were selected from more than 900 applications from the Southeast:

Pamela Duncan, MD, Wake Forest Baptist Health, Winston-Salem

Suzanne Landis, MD, Mountain Area Health Education Center (MAHEC), Asheville

Ze’ev Neuwirth, MD, Carolinas Healthcare System, Charlotte

Rod Baird, Geriatric Practice Management, Inc., Asheville

Innovation Advisors will work with the CMS Innovation Center to test new models of health care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States. Funding for this initiative is provided by by the Patient Protection and Affordable Care Act.

A transcript and audio recording of the forum will be posted to the CMS website beginning Friday, January 13, 2012. Participating physicians and ACOs can also refer to the updated information offered by CMS that explains the application process, including how to obtain login credentials for the web tool.

Please note: CMS is now collecting applications for the Advance Payment Model. Applications for the April 1, 2012 start date were available Tuesday, January 3, 2012, and will be collected through Wednesday, February 1, 2012. Applications for the July 1, 2012 start date will be collected between Thursday, March 1, 2012, and Friday, March 30, 2012.

Want to learn more about the Medicare Shared Savings Program? Click here for an overview and to view YouTube slideshow presentations and podcasts about Medicare Shared Savings and the Advanced Payment Model.  Additional links on the webpage include updated information about Medicare ACO quality measures and performance standards as well as steps to submitting a Medicare Shared Savings Program application.

NCMS also provides additional resources toward Accountable Care.

Today Congress approved a mere 2 month patch to the Sustainable Growth Rate (SGR) formula.  Please take a moment to send another e-mail to your Senators and Congressman to let them know that it is time to stop kicking this can down the road. We need a permanent fix.

Take Action! Contact your legislators today.

Review the AMA’s Special Alert on today’s developments below:

This special edition of the Bulletin focuses on the accomplishments achieved on your behalf in the managed care arena by the NCMS and the Physicians Advocacy Institute, a national organization in which the NCMS is actively involved.

Reimbursement issues are the number one frustration among physicians according to our member surveys. As we look back on 2011, the NCMS built a strong track record ensuring that health plans used fair business practices in their dealings with physicians. You’ll see from other stories appearing in this final Bulletin of 2011 that the NCMS devoted significant resources to these efforts.

I also want to highlight our work this year in the public sector. The NCMS was able to minimize the impact of the state’s revenue shortfall on the state Medicaid budget. We also worked successfully to resolve many issues between Palmetto GBA and the physicians and physician assistants who treat Medicare patients.

The NCMS Bulletin routinely reports on these successes throughout the year, and more information can be accessed at our website at http://www.ncmedsoc.org/. Rest assured that in the year ahead the NCMS will continue to work on issues that affect your practice, the delivery of health care in North Carolina, and most importantly, the relationship you have with your patients.

On behalf of the staff and Board of Directors, I wish you a joyful and happy holiday season.

                                                                                     Robert W. Seligson, MBA, MA

                                                                                    EVP, CEO

                                                                                    President, Physicians Advocacy Institute

NCMS Managed Care Activity in 2011

Throughout 2011 the NCMS remained actively engaged with the health plans. We successfully addressed and resolved a variety of managed care issues. We reported these efforts in the Bulletin to keep you informed about how our work would affect your practices. Here is a sampling, of what the NCMS has accomplished:

DOI Sides with Medicine, Blocks Controversial BCBSNC Radiology Policy (12-9-11)

UHC Deploying a Revised Treatment Cost Estimator for Members in 2012 (12-2-11)

IPG Inks Agreement with BCBSNC to Provide Implantable Device Management (12-2-11)

“Heal the Claims Process” and PractEssentials: Resources to Help Cut Practice Costs (11-11-11)

Joint Complaint Filed Over BCBSNC Radiology Services Reimbursement Policy (10-28-11)

PAI Compliance Committee Convenes in Chicago (9-9-11)

Meeting with NCMS Prompts UnitedHealth Group to Revisit Many Details of Premium Designation Program (6-17-11)

Thomas/Love Settlement Agreement Expires; BCBSNC to Permanently Adopt Many Key Settlement Practices (6-3-11)

Blue Cross Blue Shield Launches “Let’s Talk Cost” (4-15-11)

UHC Extends Premium Designation Program Deadlines; Physicians Should Check Designations (3-25-11)

Delay Prompts UnitedHealthcare to Extend Deadline in Premium Designation Program (3-4-11)

Humana: HEDIS Reviews on Humana Medicare Advantage Members Begin in March (2-18-11)

State Health Plan to Seek Reimbursements from Ineligible Members, Not Physicians (1-21-11)

UHC Notifying MDS about Physician Profiling/Tiering Program; Doctors Have Limited Time to Seek Reconsideration of Information (1-14-11)

PAI: Physicians Reap More Than $2 Billon in Benefits from Settlement Successes

The NCMS has been actively involved with the Physicians Advocacy Institute (PAI) since it was formed in 2006 as a result of Multi-District Litigation (MDL) class action settlements against major national for-profit insurers. PAI has worked to guarantee compliance with the settlements and to develop projects and tolls that help guarantee the viability of physicians’ medical practices and the ability of physicians to deliver quality patient care.

Here is a summary of Physician Advocacy Institute activity on behalf of physicians:

Physicians have received more than $2 billion dollars in benefits from the settlement agreements reached with Aetna, CIGNA, Health Net, Humana, Anthem/Wellpoint, and many Blue Cross Blue Shield plans as a result of class action lawsuits brought against these insurers by the NCMS and 18 other state and county medical organizations and physician representatives.

For most physicians, the greatest benefit came from the business changes these insurers were required to implement under the settlement agreements, such as:

• Paying claims promptly;
• Separately recognizing and paying for modifiers 25 and 59;
• Notifying physicians 90 days in advance of any material adverse changes; and
• Limiting the time frame in which insurers could seek recovery of alleged overpayments.

      (Source: Physicians Advocacy Institute)

At the time the settlements were approved by the federal court (US District Court, Miami), the business changes were estimated to be $2 billion to physicians. Because Aetna, CIGNA, Health Net and Humana have committed to retain many of the business changes after the termination of their settlement agreements, this value will only continue to increase over time.

 Compliance Disputes Benefit Physicians

 Hundreds of physicians and several signatory medical societies, including the NCMS, have filed compliance disputes to ensure that insurers hold to their agreements. Since the inception of the compliance process in 2004, compliance disputes have benefited physicians by at least $22 million. The compliance process is overseen by PAI, which was founded in part to enforce the settlement agreements. PAI’s Board is comprised of the CEOs of many of the state and county medical associations which filed the initial lawsuits, including the NCMS. NCMS Executive Vice President, CEO Robert W. Seligson, MBA, MA, has served as an officer of the PAI since its inception, and currently serves as President.

NCMS Intervention in compliance disputes benefited physicians

• An insurer sought recovery of $437,358.12 in alleged overpayments from a North Carolina family physician relating to claims over a four year period in violation of §7.22.  After NCMS filed a compliance dispute on his behalf, the insurer agreed to cease any efforts to collect alleged overpayments beyond the 18 months allowed by its settlement agreement, saving the practice at least $200,000.
• An insurer paid a North Carolina emergency physicians’ practice $125,000 after it filed a compliance dispute alleging that the insurer’s EOB’s sent to patients did not accurately reflect patients’ responsibility for payment, in violation of §7.21.
• An insurer withdrew a contract addendum which did not comply with its settlement agreement and issued a new addendum consistent with the settlement agreement after NCMS filed a compliance dispute showing that the original addendum did not provide physicians with sufficient advance notice of material adverse changes and fee schedule reductions in violation of the settlement agreement.
• After a compliance dispute alleging that an insurer was not paying for the add-on codes for myocardial infusion and CAD mammography in violation of §7.20, North Carolina physicians submitting claims for reprocessing received $363,000.

PAI Claims Data Warehouse Evaluates What Happens to Physicians’ Claims

PAI has developed a business intelligence tool called MDEdge, which is used to analyze 837 claims data from all third party payors and 835 remittance forms from insurers indicating what has been paid. The tool can determine if payments to physicians are correct and if the insurers have applied code edits or made other inappropriate “adjustments” to the physician’s reimbursement. Physicians can learn more about this tool by contacting National Healthcare Exchange Services (NHXS) at: info@mdedge.org or calling 888-466-1472. Click here to access an FAQ about MDEdge.

Click here to read more about how the NCMS has worked for you in addressing managed care payor issues.

For resources and more information about managed care, click here.

If you would like to participate in the survey, please go to: https://ecu.qualtrics.com/SE/?SID=SV_3UTzh903lytFrPm.

Participants are asked if withdrawal of a specific intervention constitutes Physician-Assisted Suicide (PAS), and whether they would feel comfortable with the withdrawal if patient preference is unknown. Demographic questions include age, gender, race, medical school, year of graduation, residency program, and the specialty/sub-specialty of each participant.

The NCMS will publish periodic reminders about the survey and report on the results when the survey ends November 2012.

• G. Hadley Calloway, MD (2 referrals)
• Austin R. Cannon
• Brian R. Forrest, MD
• Nitin Gupta, MD
• Lezah P. McCarthy, MD
• Margaret C. Merrick, MD
• Ashraf Mikhail, MD (3 referrals)
• Michael P. Moulton, MD
• Marion B. Pate, III, MD
• Robert W. Schafermeyer, MD
• Merritt J. Seshul, MD, FACS, FAAOA
• Michael J. Thomas, MD, PhD
• Douglas M. Trate, MD
• Allen Van Dyke, MD
• William T. Walker, Jr., MD
• Frederick H.D. Weidman, III, MD

*New members specifically identified these referring members in their applications to join the NCMS.

Many thanks to all members who have shared the benefits of joining the Medical Society with their peers! We encourage you to continue to spread the word about the importance of joining the NCMS in order to strengthen our voice in Raleigh and beyond.

1. Changing nature of medical practices
2. Increasing administrative burdens on practices
3. Acute shortages of primary care physicians
4. Critical need for physician leadership tools and skills
5. Ensuring patient care is not compromised

Click here to learn more about these issues and how they will affect your practice. 

“Proposed changes to our healthcare system have already significantly impacted physicians and patients,” said Lou Goodman, PhD, President of The Physicians Foundation and chief executive officer of the Texas Medical Association. “We hope the physician watch list helps to address the core issues under the new legislation and offers doctors and the healthcare community guidance on how to deliver the best care possible to patients in 2012.”

NCMS Executive Vice President and CEO Robert W. Seligson serves as Treasurer of the Physicians Foundation.

See related research articles from the Physicians Foundation:

 2011 Roadmap for Physicians to Healthcare Reform

Survey Finds Numerous Problems Facing Primary Care Doctors, Predicts Escalating Shortage Ahead

CMS Symposium-“Empowering Minorities-Promoting Better Health, Better Care, Lower Cost for Medicare Beneficiaries in their Communities,’” will be held on Wednesday, December 14, 2011, through Friday, December 16, 2011, from 7:00 am – 5:00 pm at the Marriott World Center, Orlando, FL. Topics of discussion include empowering minorities, fraud training, Medicare Learning Network, Affordable Care Act, PCIP/CO-OP, Affordable Insurance Exchange, and Medicare 101 Basic Training. Eligible attendees will receive Continuing Education Units (CEUs) for participating in the scheduled fraud training. Early registration is recommended. Attendees can only register for two tracks. Click here to register and to learn more about the event.

NCDA Annual Meeting, will be held on Friday, January 13, 2012, through Sunday, January 15, 2012, at the Washington Duke Inn and Golf Club, Durham. Topics of discussion include FDA sunscreen guidelines, an update on Cutaneous T Cell Lymphoma, hormonal therapy for acne, Lichen Planus, melanoma management, coastal and marine dermatology, meaningful use of EHR technology and AAD updates. Those who attend can receive 11.25 AMA PRA Category 1 Credit(s) ™ or AAD recognized CME credit(s). To register, contact NCDA at (919) 833-3836 to request a brochure; or download the brochure here, or register online. Early bird registration rates end Thursday, December 15.

NC Safe Surgery Conference, sponsored by the NC Center for Hospital Quality and Safety, will be held on Wednesday, January 25, 2012, 8:00 am – 4:30 pm, at the McKimmon Conference and Training Center, Raleigh. The Conference will mark the official launch of a statewide initiative focused on the implementation of the World Health Organization’s (WHO) Surgical Safety Checklist or a modified version of it. Registration deadline is January 11, 2012. Click here to register. For more information, contact Dean Higgins, Project Manager, at dhiggins@ncha.org or 919-677-4212; or Laura Maynard, Director, Collaborative Learning at lmaynard@ncha.org or 919-677-4121.

Codequest Coding College 2012: Learn to Chart and Code Accurately and Effectively Transition to ICD-10, will be offered by the NC Society of Eye Physicians and Surgeons (NCSEPS) on Saturday, February 4, 2012, at the Grandover Resort, Greensboro. Topics of discussion include physician and technician documentation changes, practical applications and examples of ICD-10, exam scenarios, complex surgical cases, and learning how to solve coding quandaries. Attendees can earn six hours of CME, AAPC or JCAHPO credits. Contact NCSEPS at 919-833-3836 or click here to register.

Partners in POLST: Honoring Patient Wishes across Care Settings, which is being held in conjunction with the CCCC Conference, will be on Thursday, February 16, 2012, 8:00 am – 5:15 pm at the Catamaran Resort Hotel & Spa, San Diego, CA. Join end-of-life and palliative care leaders from across the country who are advancing the POLST (Physician Orders for Life-Sustaining Treatment) Paradigm to translate patient wishes into medical orders that are honored in care settings. Attendees will have the chance to learn innovative strategies for implementing POLST. Click here for more information and to register. Early bird registration ends Monday, January 9, 2012. Participation by an endorsed POLST state in the Networking Session from 2:30 pm – 3:30 pm is also being requested. Click here for more information.

Quality Improvement 101 – A Toolbox for Improvement Wave 10, which addresses planning and implementing improvement, will be offered by Charlotte AHEC on Tuesday, February 21, and Wednesday, February 22, 2012 (Workshop 1). This professional development program includes four on-site workshops in February and June which allows participants to build skills and knowledge in quality improvement. By attending participating hospital teams, clinical practices, AHEC regional offices, and other healthcare organizations can accelerate the application of quality improvement methods. The textbook “The Improvement Guide” by Gerald J. Langley et al., (2009), and both breakfast and lunch for each workshop is included in the registration fee. For more information contact Mary Webster at 704-512-6545 or click here to register.

Let us know your questions regarding accountable care, including the how-to’s on implementing this model in your area, by clicking here.

Sen. Forrester entered politics in 1982 when he was elected to the Gaston County Board of Commissioners. He was first elected to the NC Senate in 1991 and served 11 terms, which included numerous leadership positions. At the time of his death, he was Deputy President Pro Tempore and Co-Chair of the Appropriations and Transportation Committees, and Vice-Chairman of Health Care. During his legislative career, he was named Legislator of the Year by four different organizations, including the NC Society of Eye Physicians and Surgeons and the NC Society of Anesthesiologists.

Sen. Forrester earned his medical degree from Wake Forest University (Bowman Gray) and completed his internship at NC Baptist Hospital in Winston-Salem. He received a Masters in Public Health (MPH) from UNC Chapel Hill. He practiced Family Medicine for 46 years in Stanley, NC, before retiring in 2011. He was a Life Member of the NCMS, which he joined in 1963.

A Retired Brigadier General with the NC Air National Guard, Sen. Forrester earned over 2000 flying hours during his military career, which included Flight Surgeon missions during the Vietnam War. Among his many military honors are the Legion of Merit and the Meritorious Service Award.

Senator Forrester was well known for his community and public service, including membership on the state Health Planning Commission, Governor’s Commission on Reduction of Infant Mortality, Advisory Council for Emergency Medical Services, Environmental Review Commission, Governor’s Task Force for Healthy Carolinians and Justus-Warren Heart Disease and Stroke Prevention Task Force. Among his community service awards are the Order of the Long Leaf Pine, American Cancer Society Outstanding Service Award, and the NCMS Community Service Award. He received the AMA’s Pride in Profession Award in 2001.

Sen. Forrester was born in Aberdeen, Scotland in 1937 and graduated from high school in Wilmington, NC in 1954. He is survived by his wife of 51 years, Mary Frances Forrester, three daughters and one son, and eight grandchildren. The family will receive friends from 6:00 pm to 9:00 pm on Saturday at the First Baptist Church in Stanley, NC. Funeral services will be held on Sunday at 3:00 pm at First Baptist Church.

The James S. Forrester, Sr., MD Family Medicine Endowment at Wake Forest University School of Medicine has been established by the family in honor and remembrance of their father’s commitment to public service. The endowment will fund scholarships for medical students who pursue a career in Family Medicine and intend to practice in North Carolina. In lieu of flowers, memorials may be made to Wake Forest School of Medicine for the James S. Forrester, Sr., MD Scholarship in Family Medicine, c/o Office of Development, P.O. Box 571021, Winston-Salem, NC, 27157.

You can register one of three ways:

(1) Contact NCSEPS at 919-833-3836 to request a brochure

(2) Download a brochure

(3) Register securely online 

Rooms are available until December 31, 2011. Call the Grandover Resort at 800-472-6301 and ask for the NCSEPS rate of $163 single or double occupancy, plus tax.

Topics and Speakers include:

Effectively using a Surgical Safety Checklist to Reduce Surgical Complications

William R. Berry, MD, MPH, FACS, Project Director, Safe Surgery 2015: Harvard School of Public Health

SSI Pathogenesis

National and Local Experts

Wound Classification

Jennifer Zinn, MSN, RN, CNS-BC, CNOR, Clinical Nurse Specialist, Operative Services, Cone Health

Vangela Swafford, RN, BSN, Quality Improvement Facilitator, Cone Health

SS Checklist Implementation at Mission Health Systems

Michael LeCroy, MD, Director of Orthopedic Trauma Services and Medical Director of Perioperative Serivces, Mission Health System

There’s No Magic Wizard in the Journey to Zero Surgical Site Infections

Sharon McNamara, RN, MS, CNOR, Performance Improvement Specialist, NC Quality Center

Patsy Davis, RN, BA, CNOR, Education Resource Specialist-Surgical Services, WakeMed Health and Hospitals

Teamwork and Communication in the Operating Room

John S. Webster, MD, MBA, President, Webster Healthcare Consulting, Inc.

Executive Partnerships

Bryan Sexton, PhD, Director, Duke University Health System Patient Safety Training and Research Center

A Patient’s Perspective on VTE

UNC Blood Clot Outreach Program—Clot Connect

NC Safe Surgery Collaborative Overview

Laura Maynard, Director, Collaborative Learning, NC Quality Center

Keith Mankin, MD, FAAP, WakeMed Health and Hospitals/Raleigh Orthopaedic Clinic

The conference will also mark the official launch of a statewide initiative focused on the implementation of the World Health Organization’s (WHO) Surgical Safety Checklist or a modified version of it. The NC Hospital Association is challenging hospitals to commit by October 31, 2011, to using the WHO or modified WHO Checklist, with full implementation by June 30, 2012.

To register, go to: https://www.ncha.org/meetings/registration_index.lasso?e=1159. Registration deadline is January 11, 2012.

At this time, the North Carolina Medical Society (NCMS), the North Carolina Academy of Physician Assistants, and the North Carolina Medical Group Managers collectively urge all PAs and their medical practices to hold their Medicaid enrollment applications until DMA (1) completes rulemaking that establishes its authority to require direct enrollment and (2) fully explains all eventual ramifications that direct enrollment will have for these practitioners and their practices. Until those details are known and until DMA secures the proper authority to continue with this initiative, we feel that the enrollment process presents only risks and no benefits.

We continue to await the opportunity to engage with DMA in further discussions about direct enrollment of non-physician practitioners. Please ask any medical practice personnel who insist on continuing the application process to contact Kristin Freeman (kfreeman@ncmedsoc.org) at the NCMS Member Resource Center, or one of the other above-listed organizations, with any questions.

We will continue to provide updates on this issue as we receive them.

Tuesday, Sept. 27         2:00pm ET

Thursday, Sept. 29       1:00pm ET

Monday, Oct. 3           12:00pm ET

Thursday, Oct. 6           3:00pm ET

Pre-register online at http://event.on24.com/clients/premiere/crackingthecodes2011. Participants will receive confirmation and reminder of event via e-mail.

Living Healthy – How to Implement An Evidence-Based Chronic Disease Self-Management Program, is a webinar that will be offered by Care Share Health Alliance on Wednesday, October 12, 2011, 10:00 am – 11:00 am. This program seeks to enable participants to build self-confidence and assume a major role in maintaining their health and managing their chronic conditions. Space is limited, so reserve your Webinar seat today at https://www1.gotomeeting.com/register/789094104.

North Carolina Health Insurance Institute, hosted by the NC Chapter Healthcare Financial Management Association, will be held October 13-14, 2011, at the Sheraton Hotel at Four Seasons in Greensboro. Registration materials are available at http://www.nchfma.org/.

A special track for Primary Care Physicians is being offered at the American Psychiatric Association’s Fall Institute for Psychiatric Services, October 27-30, 2011, in San Francisco. The special track will be on Friday, October 28 and devoted exclusively to psychiatry’s role with primary care, with more than 20 sessions that include workshops, symposia, lectures, discussion groups and courses. For more information, visit the APA website, http://www.psych.org/.

Lean Healthcare 200: Applying the Fundamentals is two full days of hands-on learning, equipping participants with practical tools and strategies to make significant and sustainable cultural changes within their organizations for the new healthcare environment. Next classes are scheduled for November 8-9, 2011, in Winston-Salem. No prior Lean training or experience is required. The course is limited to 30 attendees, so register today at www.NCQualityCenter.org/educationlean2011.lasso.  For questions and more information, please contact Dean Higgins at dhiggins@ncha.org or 919-677-4212. The NC Lean Healthcare Alliance is associated with the NC Quality Center and NC State University.

SMA Annual Excellence in Clinical Leadership, Cardiovascular Disease…Interdisciplinary Challenges will be offered at the Southern Medical Association Annual Meeting, November 3-5, 2011, in Williamsburg, VA. More information is available at http://www.sma.org/am2011.

The webinar presentation includes an overview of the CQMs, how to report CQMs during attestation, and why CQMs are included in the EHR Incentive Programs. You can view a PDF of the webinar presentation at: https://www.cms.gov/EHRIncentivePrograms/Downloads/CQM_Webinar_Slides.pdf.

A transcript of an hour-long question and answer session that followed the August 30 webinar will be made available online soon, along with a video of the webinar.

For more information about the EHR Incentive Programs, go to: https://www.cms.gov/ehrincentiveprograms/.

A newly formed House Select Committee on Certificate of Need (CON) Process and Related Hospital Issues has been named. It will be chaired by Rep. Fred Steen (R-Rowan) and Rep. John Torbett (R-Gaston). You can find a complete list of the committee here. The committee is scheduled to meet on Wednesday, September 14, 2011 at 10:00 am in Room 544 of the Legislative Office Building in Raleigh.

The committee will take a look at the overall CON process. Additionally, the committee will look at two specifiic issues raised in bills during the 2011 long session:  HB 743 raised questions about the academic medical centers exemption, and HB 812 addressed the county line rule used in making need determinations. The NCMS Legislative Staff will provide updates and more information in the Bulletin and at http://www.ncmedsoc.org/. Questions may be directed to Chip Baggett at cbagget@ncmedsoc.org or call 919-833-3836.

Insurance Bills Included in 2011 Legislative Summary

Eight bills that fall under the Insurance category will be among the dozens of bills that will be reviewed in the soon-to-be released NCMS 2011 Legislative Summary. Insurance-related measures that will be in the summary include:

House Bill 496 – Insurance Co-pays for Chiropractic Services  (NCMS opposed)

Senate Bill 608 – Health Care Sharing Organizations (Passed)

House Bill 709 – Protect and Put NC Back to Work (Senate Bill 544) (Passed)

Senate Bill 517 – Freedom to Negotiate Health Care Rates (NCMS supports)

Senate Bill 774 – Update Electronic Prescription Rules (Not debated)

House Bill 138 – Amend Health Insurance Risk Pool Statutes (NCMS supports)

House Bill 298 – Insurance Amendments A-B (Passed)

Senate Bill 323 – State Health Plan/Appropriations and Transfer II (Passed)

Get Ready for 2012: Primary, Legislative Short Session and Election

Issues of importance to physicians and their patients will be part of the 2012 Election Year. The NCMS 2011 Legislative Summary will provide background to help you better understand many of these issues. Since 2012 is a Presidential Election Year, there will be increased voter interest in issues like health care reform, Medicare and Medicaid, jobs, and economic improvements. Your NCMS Legislative Staff will be working to provide timely information to help you understand these issues, and how you can engage with legislators at the state and national level. This information will be made available through the Bulletin, Member Alerts, Legislative Updates , and the NCMS website, http://www.ncmedsoc.org/. By being informed and involved, you can help us continue our efforts to provide access to quality health care for all North Carolinians.

On Thursday, Governor Perdue declared a state of emergency and President Obama approved federal aid to assist state and local responses to the storm. Forecasts at midday Friday indicated that the center of Irene was expected to make landfall in the vicinity of Cape Lookout around 9:00 am Saturday. Advisories showed Irene had weakened to a Category 2 hurricane, with maximum sustained winds of 105 miles per hour. Forecasters did not expect the storm to strengthen before making landfall. High wind warnings were issued for eastern North Carolina for Saturday, effective from 6:00 am to midnight. Heavy rains capable of producing flash floods were expected, beginning Friday afternoon and continuing through Saturday.

State emergency officials reported that storm shelters were opened in North Hampton, Wilson, Halifax, Nash, Wilson and Johnston Counties. Wake County was on stand-by to open an evacuation shelter, should the shelters in the eastern counties exceed 50 percent capacity. Mandatory evacuations were ordered in several coastal communities.

As many NCMS and ONSMS members will recall from Hurricane Floyd, high winds and floods can quickly displace physicians and their practices. Should you experience an extended storm-related disruption, or you become aware of a physician who has had such an experience, please contact Mike Edwards at the NCMS, medwards@ncmedsoc.org or 919-833-3836, ext. 112.

The NCMS emergency/disaster plan includes:

•  Serving as a key contact point to assist physicians affected by the storm
  • Call: 800-722-1350 or 919-833-3836
• Communication of important information to physicians in private practice and component medical societies in storm-affected areas
• Coordinating and communicating requests for volunteers, equipment, donations and other needs
• Serving as a liaison with the Division of Public Health, State Emergency Management and other agencies in communicating advisories, alerts, updates and other storm-related information important to physicians and component medical societies
• Creating online resources including phone numbers and other information to help physicians during the post-storm recovery

NCMS is prepared to utilize a variety of communication tools to reach physicians, including our Doctor to Doctor blog, NCMS Webpage, Twitter, Facebook, email, fax and phone calls. As past experience has demonstrated, power outages can affect locally available communication, so we will try to provide information using several sources and encourage physicians to periodically check the NCMS website, http://www.ncmedsoc.org/, for updates and other information.

Here are some helpful links for storm-related events:

CDC Hurricane Information for Health Care Professionals: www.bt.cdc.gov/disasters/hurricanes/hcp.asp

American Red Cross Information on Disaster and Emergency Preparedness:

Getting Assistance: http://www.redcross.org/portal/site/en/menuitem.d8aaecf214c576bf971e4cfe43181aa0/?vgnextoid=6cde1a53f1c37110VgnVCM1000003481a10aRCRD&vgnextfmt=default

Preparedness Information:  http://www.redcross.org/portal/site/en/menuitem.d8aaecf214c576bf971e4cfe43181aa0/?vgnextoid=46de1a53f1c37110VgnVCM1000003481a10aRCRD&vgnextfmt=default

NC Division of Emergency Management: http://www.nccrimecontrol.org/Index2.cfm?a=000003,000010

NC Department of Public Health (DHHS): http://publichealth.nc.gov/

NC State Government Hurricane Information: http://www.ncgov.com/NCHurricane.aspx

Hurricane and Health Safety (NC DHHS): http://www.ncdhhs.gov/hurricanes/

Please feel free to share this information with your physician colleagues and staff and know that we are here to help you. 

Robert Seligson, EVP, CEO, NCMS, rseligson@ncmedsoc.org.