July 25, 2008 - Volume 59 Issue 31
NCMS Bulletin
In This Issue
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Regulatory News
How to Protest NCMB Physician Profiling Rules
The NC Medical Board made some changes to its proposed profiling rules last week, but did little to improve the usefulness of its profiles to the public. In fact, the cornerstone of the Medical Society’s position was not even discussed at the Board’s meeting on July 16. You can see relevant excerpts from the Medical Board meeting at www.YouTube.com. Enter the search term “ncmedsoc.”
The NCMS believes these rules should not take effect before the General Assembly has an opportunity to review them. Under North Carolina law, there is a procedure to ensure such a legislative review can occur. The physician profiling rules approved by the NC Medical Board at their July 16, 2008 meeting will be considered by the Rules Review Commission (RRC) on August 21, 2008. Even if the RRC approves the rules at this meeting, they will not become effective on September 1, 2008, as would normally occur, so long as 10 or more persons file an objection and request for legislative review no later than 5:00pm on August 22, 2008. If ten or more objection letters are received by the RRC, the profiling rules will not take effect until at least late February 2009. After that, the effective date will depend on what the General Assembly does with the issue.
This form letter satisfies the statutory requirements for a letter of objection and request for legislative review. Please fill in the blanks of this form letter and mail to the following address no later than August 15, 2008 (to allow sufficient time for mail delivery) or fax it to the RRC at (919) 733-9415. Note carefully: The RRC does not accept email submissions.
Rules Review Commission
6714 Mail Service Center
Raleigh, NC 27699-6714
If you have any questions, please contact Scarlette Gardner, Esq. at sgardner@ncmedsoc.org.
Legislative Update
Looking at the 2008 Session
The General Assembly officially closed the 2008 Session last Friday after two months of intense debate. 140 bills were passed, though many of those bills were held until the last few days. Here are some highlights from the final hours of session:
2008 Studies Bill
H2431 – Studies Act of 2008 includes a number of health-related studies. The Legislative Research Commission may study the impact of the certificate of need process and its impact on the availability of local health care services. This was taken from H2598, introduced by Rep. Julia Howard (R-Davie) due to some controversy in her district. The Joint Legislative Health Care Oversight Committee may study a number of issues including DNR orders and the appropriateness of a patient signature on DNR orders, the expansion of an electronic health information management network, as well as increasing the fees for copying medical records. DHHS may study issues relating to hearing loss in older adults as well as the feasibility of operating a licensed care home in a public housing facility and other issues related to respite care. Finally, the Institute of Medicine will convene a panel of experts to discuss access to health care issues in North Carolina and bring back recommendations to the NC General Assembly by January 15, 2008.
Sample Tax
The conference report of S1878 – Property Tax Modifications, introduced by Sen. Dan Clodfelter (D-Mecklenburg), was adopted in the final hours. The controversial section did not pertain to the portion of the bill that NCMS was following. The provision exempted prescription drug samples given free to patients from being taxed. The Governor has yet to sign the bill. He has until August 18 to sign or veto the bill before it automatically becomes law.
State Health Plan
The news of the unexpected shortfall and the even greater financial deficit expected by the end of the year drew sharp criticism by legislators. The House and Senate developed separate plans for how the shortfall should be addressed. The House wanted to take money from the general fund budget to offset the State Health Plan deficit. The Senate proposed to raise state employee copays by $5 for primary and specialty care visits. Unfortunately, the differences were too great to be settled before the close of session. There will be much more to come on this issue in the future. Just today, the state auditor has announced plans to further investigate the financial records of the plan.
News Highlights
Invitation from NCMS President Hadley Callaway, MD, to Attend the 2008 NCMS Annual Meeting
Dear Colleague,
I look forward to your participation at the North Carolina Medical Society’s 2008 Annual Meeting, scheduled for October 17-19, 2008, in Charlotte, North Carolina. The NCMS has listened to your feedback about the Annual Meeting and, as a result, the 2008 Annual Meeting will be streamlined to offer many relevant educational sessions, important policy discussions, and networking opportunities — all within a shorter timeframe to better accommodate attendees’ busy schedules.
When planning discussions for this year’s meeting first started, several words seemed to jump to the forefront of our minds: an evolving health care environment; the importance of this year’s elections; a troubling economy; electronic solutions and needs within medical practices; and the North Carolina Medical Society’s own evolution due to ever-changing priorities. We jokingly agreed that this was the year of the “e,” but on greater thought, felt it was an apt message, and Join the E-volution, this year’s theme, was born. This is a pivotal time in our country and our profession, and we have to combine our energies to shape a future course for the benefit of all. The NCMS Annual Meeting provides a perfect avenue to begin these examinations of what policies can be proposed and what tools will be needed to best address the future of medicine.
Find out more information at www.ncmedsoc.org/annualmeeting. I encourage you to “join the e-volution” and renew your commitment to the patients of North Carolina by attending this year’s meeting. I look forward to seeing you in Charlotte. – G. Hadley Callaway, MD
BCBSNC Announces Statewide Physician Prescribing Program
After an initial pilot program, BCBSNC has announced that they will promote a statewide program to encourage physicians to use electronic prescribing—including the electronic interface that shows the patient’s medical history, drug interactions and other information. A new website will facilitate the process. In return for their active participation, BCBSNC will pay a one-time $1000 incentive to both physicians and pharmacies if specific criteria are met. For more information, see: www.bcbsnc.com/providers/eprescribe.
Medicare Physician Fee Schedule Update
CIGNA Government Services has announced that they have now loaded the updated Physician Fee Schedule for July – December 2008 into their claims system, and have updated their website with the updated Physician Fee Schedule. Physician practices holding their claims may now file claims and be paid at the updated amounts. CIGNA Medicare is beginning the adjustment process for claims paid at the previous fee schedule amounts. To access the new fee schedule, visit: http://www.cignagovernmentservices.com/partb/coverage/fees/index.html.
AMA Campaign Promotes Efficiency in Claims Processing
Originally called “Cure for Claims Process,” the AMA’s “Heal the Claims Process” campaign seeks to encourage physician practices to eliminate waste in the claims process. Today, physician practices are spending as much as 14 percent of their total collections to ensure accurate payment for their services. The AMA wants physician practices to reduce that number to one percent by submitting timely and accurate claims the first time.
PractEssentials Program Director Joe LaBella says physicians practices often greatly underestimate the financial impact of an inefficient claims management process. An efficient process will increase cash flow and significantly reduce administrative costs associated with claim denials and re-billing efforts. More importantly an efficient claims management process will alleviate the negative effect on physician-patient relationships that delayed or inappropriate health insurance payments can cause. To improve the claims management in your practice, review the following processes to see if they have been implemented in consistent and accurate manner:
- Registration
- Clinical Documentation
- Patient Check-Out
- Claim Generation
- Denial Management
To access more information and helpful resources related to this process, visit www.ama-assn.org/go/pmc or contact NCMS PractEssentials at 1-800-722-1350.
Revised CON Applications Take Effect September 1
The Certification of Need (CON) Section of the Division of Health Service Regulation, NC DHHS, has revised their CON applications for (1) New Operating Room Projects, New Ambulatory Surgical Facilities and Gastrointestinal Endoscopy Procedure Room Projects, and (2) Acute Care Facilities, Services and Medical Equipment. The new applications MUST be used for all applications submitted on or after September 1, 2008.
For more information on the Revised Certificate of Need Application Form for New Operating Room Projects, New Ambulatory Surgical Facilities and Gastrointestinal Endoscopy Procedure Room Projects, see:
For information about the Revised Certificate of Need Application Form for Acute Care Facilities, Services and Medical Equipment, visit:
Prospective applicants may contact Martha Frisone (martha.frisone@ncmail.net) or Craig Smith (craig.smith@ncmail.net) to request a copy of the appropriate application by email.
Secretary Leavitt to Address Western HIE Town Hall Meeting
Health and Human Services Secretary Michael Leavitt will address the Western Health Information Exchange (HIE) Town Hall Meeting at the Mountain AHEC (MAHEC) auditorium in Asheville, Friday, August 1, 2008. William Mattern, MD, Chair, NCHICA Board of Directors, will moderate the meeting, which will run from 8:30 – 11:00 am, with registration starting at 8:00 am. US Rep. Heath Shuler (D-NC) is scheduled to introduce Secretary Leavitt, who will offer some remarks and participate in a Town Hall discussion of Community Collaboration, Chartered Value Exchanges, and the Governor’s Quality Initiative. For more information on this event, contact Laura Ksycewski with NCHICA, 919-558-9258 ext. 25.
Public Hearings Set for Proposed 2009 State Medical Facilities Plan
Public hearings are currently being held across the state on the proposed 2009 State Medical Facilities Plan (SMFP)
Click here to view the schedule of hearings.
ReMembers...
END OF LIFE CARE DECISIONS is a one-day conference that will help you learn about the new options for End of Life Care decisions in NC. A collection of experts and speakers from around the state will be on hand to discuss advance directive changes and the new Medical Orders for Scope of Treatment (MOST) form, Friday, September 19, 2008 at MAHEC in Asheville. The fee is $59.00. To register, go to www.mahec.net/calendar, using keyword, MOST.
MAXIMIZE YOUR CASH FLOW using ideas and tips from PractEssentials’ Lunchtime Lesson, “How to Thrive Not Just Survive in the New Healthcare Environment,” August 20, 2008, 12:00pm to 1:00pm, featuring Barbara Fulp, who has owned a public accounting firm since 1986. Her practice has included partnering with startup and maturing businesses to ensure their success, consultations with health care entities to maximize revenue and contain costs by assessing the overall efficiency of the practice, as well as other tax, accounting and management services. Register here or contact PractEssentials at (800)722-1350.
Call for Resolutions--2008 Annual Meeting in October
In accordance with the NCMS Bylaws, all resolutions to be considered by the House of Delegates (HOD) at its annual meeting in October must be submitted at least forty-five (45) days before the first meeting of the HOD. The deadline for submission of resolutions is September 4, 2008. All resolutions from component medical societies, sections or medical specialty organizations must bear the signature of two officers of each respective organization. Otherwise, the resolution will need to be submitted by an individual delegate. Resolutions arriving after the deadline will be considered late resolutions. In order to be considered the business of the House, resolutions received after September 4 must be approved for consideration by two-thirds of the delegates present at the First Session. All late resolutions will be reviewed by the Credentials Committee. The Credentials Committee will consider the appropriateness of the late resolutions based on time sensitivity and urgency and importance to the goals and objectives of the Medical Society and recommend that late resolutions be "Recommended for Acceptance" or "Not Recommended for Acceptance" by the HOD. Resolutions should be emailed to Linda Carter, Executive Assistant to Robert W. Seligson, EVP/CEO. For more information, contact Linda Carter or Scarlette Gardner at the headquarters office. For details about the 2008 Annual Meeting, October 17-19, please check www.ncmedsoc.org/annualmeeting.
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