July 17, 2009 - Volume 60 Issue 31

NCMS Bulletin

Health Reform

AMA Trustees Back House Health Reform Bill; NCMS Board Set to Review Health System Reform Measures

The AMA Board of Trustees has voted to support a Democrat-backed health reform bill that was approved by the House Committee on Energy and Commerce on Tuesday. In a letter sent to Committee Chair Senator Henry A Waxman (D-CA) on Thursday, AMA Executive VP, CEO Michael D. Maves, MD, MBA wrote, “I am writing to express our appreciation and support of HR. 3200, the ‘America’s Affordable Health Choices Act of 2009.’ This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform.” The letter was also sent to the House Education and Labor, Energy and Commerce, and Ways and Means Committees asking them to give HR 3200 a favorable recommendation. “AMA Views on House Reform Legislation: H.R. 3200 (PDF), the America’s Affordable Health Choices Act of 2009, ” and the letter to Sen. Waxman can be viewed at www.ncmedsoc.org.

The AMA Trustees action comes as the NCMS Board of Directors prepares to meet on Saturday, July 18, 2009 to discuss a variety of health reform proposals. “The Board will be spending a lot of time reviewing and discussing the various health care reform measures that have emerged in Washington,” said NCMS EVP, CEO Robert W. Seligson. “The NCMS has not endorsed any health reform bill. As our members know, the Board adopted its ‘Guiding Principles for Health System Reform’ in May, and the Board will be using those principles in its assessment of health system reform proposals, including an intense review of HR 3200.” Seligson added that NCMS staff will be in Washington most of the summer advocating on behalf of physicians.

As the White House pushed Congress to act on health care reform legislation, a report by a highly respected and reliable medical affairs analyst revealed that many Congressmen were keeping a close watch on voter opinion polls. A newly released Zogby Poll found 50 percent of those surveyed opposed the House health reform measure that came out of committee on Wednesday. Fifty-nine percent oppose increasing taxes for health care reform. Reform measures gaining the most support include:

Eliminating fraud- 88%
Standardizing administrative forms- 77%
Reducing medical errors- 73%
Reducing unnecessary care- 71%

Looking ahead, the report says the next four weeks will likely see crafting and passing of House and Senate bills, and then letting a conference committee try to work out differences.

Republican House members were quick to criticize the House plan The Republican staff of the Joint Economic Committee issued a diagram showing its interpretation of how the plan will work. You can see it at www.ncmedsoc.org (PDF).

On Thursday, the director of the non-partisan Congressional Budget Office (CBO) said the proposed health reform measures would weaken the economy and expand federal responsibility for health care costs. The comment from CBO director Douglas Elmendorf came during an appearance before the Senate Budget Committee.

Read more about health system reform and access the NCMS Guiding Principles for Health System Reform at www.ncmedsoc.org.

Legislative Update

Legislative Update: House Committee to Consider S958 on Tuesday; S877 Awaits Governor's Signature

S958 – NC Medical Board Disciplinary Procedures (Sen. Martin Nesbitt, D-Buncombe)
After a very positive conversation last week, progress on S958 has been slower this week while the NC Medical Board has been discussing revisions to the bill. The bill is calendared to be heard in House Health Committee next Tuesday at noon. If it receives a favorable report there, it will then go to Judiciary I for further review before the full House has an opportunity to vote on the bill. Watch our updates on www.ncmedsoc.org to see the latest version of the bill as well as scheduled hearing reports.

S877 – Fair Contracting (Sen. Dan Clodfelter, D-Mecklenburg)
Rep. Rick Glazier (D-Cumberland) guided S877 to another unanimous vote in the House this week. Just hours after the bill was ratified, representatives of insurance companies were already hard at work to undo our success from the previous day. On Thursday, another insurance related bill was up for hearing in the Senate Commerce Committee. Sponsors of the bill were informed of an amendment that was to be offered just moments before the bill was to be brought up. Seeing that the amendment would include language that had failed on the House floor the night before by a vote of 103 to 16, the sponsors chose to have the bill pulled. This is just one example of how the battle over an insurer’s ability to make unilateral changes to the fee schedule of a contract is likely to continue well into the future. The NCMS as well as the NC Society of Anesthesiology, the NC Academy of Family Physicians and the NC Hospital Association are poised and ready to oppose changes in other bills that would adversely affect the changes outlined in S877. Please contact your legislator today and thank them for supporting you when they voted for S877.

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Volunteer for Doctor of the Day. The Doctor of the Day provides basic first aid services to legislators and visitors at the Legislative Building. There are several dates available for July. All specialties are eligible, and the Doctor of the Day should have malpractice insurance and active license status with no public disciplinary action by the NC Medical Board. Serving as Doctor of the Day precludes you from lobbying on the day you serve. Contact Jean Lewis at jlewis@ncmedsoc.org or 800-722-1350 to schedule a day or for more information.

Payor Issues

Online Medicaid Enrollment Available Soon

Computer Sciences Corporation (CSC) has announced that starting August 31, 2009, providers will have the option to enroll in Medicaid programs online. This is one of the ongoing activities by DHHS and CSC to upgrade and streamline the Medicaid provider enrollment process. Pilot sessions for the web application are scheduled for August 3 - August 14 at CSC offices in Raleigh. Providers participating in the sessions will have the opportunity to preview the web application and give CSC and the State valuable feedback, comments, and concerns. It is anticipated that pilot sessions will last four to six hours. NCMS has been asked to nominate one or two practices to participate in the pilot. Please contact Lauren Cullipher at the NCMS Resource Center at lcullipher@ncmedsoc.org by July 21, if you are interested in taking part in the pilot program.

Aetna Wins Contract to Manage US DOD TRICARE

The US Department of Defense has awarded the TRICARE managed care support contract for the North Region to Aetna, Inc. Under the five-year administrative services contract, Aetna Government Health Plans will support health care delivery to approximately 2.8 million eligible beneficiaries who are active duty service members, retirees, and family members based in 21 states of TRICARE’s North Region, which includes North Carolina. The contract is effective April 1, 2010. More information is available at www.aetna.com.

News Highlights

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NCMS Calls on NC Senators to Support US Surgeon General Nominee

The NCMS has called on North Carolina Senators Richard Burr (R-Winston-Salem) and Kay Hagan (D-Greensboro) to support President Obama’s nomination of Regina Benjamin, MD, as the next US Surgeon General. “We believe Dr. Benjamin will serve diligently as an advocate for the nation’s patients and for health care reform that will offer high quality, affordable care for every man, woman and child in our great nation,” said NCMS President Albert J. Osbahr, MD, and AMA Delegation Chair John R. Mangum, MD, in a letter to the senators. The letter cited Dr. Benjamin’s professionalism and strong leadership, along with her selfless devotion and care for her patients. A Family Physician, Dr. Benjamin stepped into the national spotlight when she led efforts to rebuild a rural health clinic in Alabama in the wake of Hurricane Katrina. She has chaired the AMA’s Council on Ethical and Judicial Affairs, served as a member of the AMA Board of Trustees, and was the first African-American woman to serve as President of the Alabama Medical Association.

New Data Say Uninsured Account for Nearly One-Fifth of ER Visits

Federal HHS Secretary Kathleen Sebelius released new data Wednesday from the Nationwide Emergency Department Sample—the largest all-payer emergency department database in the US. The data indicates that uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006. The database is managed by the Agency for Healthcare Research and Quality (AHRQ) and contains 26 million records from emergency department visits from approximately 1,000 community hospitals nationwide. The Sample is designed to help public health experts, policymakers, health care administrators, researchers and others find the data they need to answer questions about care that occurs in US hospital emergency departments. More information is available at www.hhs.gov.

CDC to MDs: Develop a Response Plan for Novel H1N1 Flu

The CDC is urging medical offices and outpatient facilities to develop action plans for novel H1N1 influenza in order to have a “sustainable community health care response for a likely recurrence of novel H1N1 flu in the fall.” A ten-step planning guide is available at http://www.cdc.gov/h1n1flu/10steps.htm.

The NC Division of Public Health (NCDPH/DHHS) reported on July 15 that there were 84 new confirmed cases of influenza A (H1N1) in the state during the previous seven days, bringing the total number of cases to 395 in 57 counties. Four deaths in NC are linked to H1N1: 2 in Guilford, 1 in Carteret, and 1 in Wilson County. More H1N1-related information and links can be found at www.ncmedsoc.org.

NC DHHS Issues Safe Surrender Reminder

The NC Department of Health and Human Services (DHHS) is seeking to remind physicians and the public about North Carolina’s Safe Surrender Law, which provides an option to keep babies safe. In 2001, the NC General Assembly passed a law making it legal for a parent to surrender a newborn to a responsible adult without fear of criminal prosecution. The law was designed to help prevent a postpartum woman who is distraught from endangering her baby. Examples of responsible adults include emergency medical workers, hospital workers, social workers and law enforcement officers. As the law is written, any responsible adult can receive a newborn under the age of seven days. They then must protect the infant and immediately notify law enforcement or their county social services department. For more information about Safe Surrender in North Carolina, go to www.safesurrender.net or call 1-800-FOR-BABY.

Durham Bulls Recognize Team Physician

The Durham Bulls minor league baseball team recently honored Richard F. Bruch, MD, for his service as the Bulls team physician for 29 years. “Dr. Bruch has done more than help players heal and get them back on the field. His love of the game and his honesty have also enabled him to form lasting relationships with players and staff,” according to a news release posted on the Bulls website. Dr Bruch’s career with the Bulls started in 1980 when he stopped by the ballpark to ask Miles Wolff, the team owner at the time, about being the orthopedic surgeon for them. Wolf agreed, and Dr. Bruch became the team physician a few years later. Dr. Bruch serves as President of the Board of Trustees of the NCMS Foundation and is a Past President of the NCMS. Read more about Dr. Bruch’s career with the Bulls at http://durhambulls.com/team/press_release.html?id=1005.

Drug Safety Institute Opens in RTP

The Hamner-UNC Institute for Drug Safety Sciences celebrated its Grand Opening on June 11, 2009 at the Institute’s campus in Research Triangle Park. Janet Woodcock, MD, Director of the FDA Center for Drug Evaluation and Research (CDER), delivered the keynote address. The Institute is led by Paul Watkins, MD, one of the leading experts in drug-induced liver injury, and will focus on innovative research and training programs as well as technologies to improve the safety of new drugs. Learn more about the Institute and read its newsletter, At The Hamner, by visiting www.thehamner.org.

2010 NCMS Leadership College Nomination Period is Closing

The nomination period for the 2010 NCMS Leadership College is closing on July 24, 2009. Only a limited number of nominees are selected to participate in the prestigious Leadership College, conducted in partnership with the NCMS Foundation. The official nomination form, which must be completed by both the nominee and the nominating organization, and additional information on the program can be found at www.ncmsleadershipcollege.org. Completed nomination forms for consideration in the 2010 class must be received by July 24, 2009. The 2010 Leadership College scholars class will be announced in mid-August. Questions may be directed to Richard W. Skinner, Associate Director, NCMS Member Services, rskinner@ncmedsoc.org, 919-833-3836 or 800-722-1350.

Call for Resolutions: NCMS House of Delegates

In accordance with the NCMS Bylaws, all resolutions to be considered by the House of Delegates at its annual meeting in October must be submitted at least forty-five (45) days before the first meeting of the House of Delegates. The deadline for submission of resolutions is September 14, 2009.

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, and in order to be considered the business of the House will have to be presented by a delegate at the first session of the House of Delegates for approval by two-thirds of the delegates present at the meeting of the House of Delegates and meet the criteria for late resolutions (i.e., urgency and importance to the goals and objectives of the NCMS).

All resolutions should be mailed to Robert W. Seligson, EVP/CEO, NCMS, PO Box 27167, Raleigh, NC 27611 and submitted electronically to lcarter@ncmedsoc.org. For more information, contact Linda Carter or Mike Edwards at the headquarters office.

Put It on Your Calendar: 2009 Annual Meeting, October 30-November 1

There’s a touch of Halloween in this year’s theme for the 2009 NCMS Annual Meeting, Succeeding in Frightening Times. Mark the date, October 30-November 1, 2009, at the Raleigh Marriott City Center Hotel, Raleigh. More details coming in the Bulletin and at www.ncmedsoc.org/annualmeeting.

Events-Resources-Training

RECOVERY AUDIT CONTRACTOR (RAC) PHYSICIAN PRACTICE ORIENTATION SESSION is scheduled for Wednesday, August 5, 2009, 1:30 pm – 4:30 pm, at the Embassy Suites in Cary. CMS will introduce Connolly Consulting to North Carolina physician practices, describe RAC processes and procedures, discuss the process to address RAC audits and explain what to expect when the program becomes operational. CMS will not discuss the RAC demonstration projects, the appeals process or the 935 recoupment process at this session. All physicians and practice administrators are welcome to attend. A meeting oriented toward hospitals will be held that morning, with separate registration, through NCHA, required for that meeting. There is no registration fee for physicians and their office staff. All others will pay a $25 fee when they register the date of the meeting. Preregistration is required for all attendees to ensure adequate space. To register for the free session, email lcullipher@ncmedsoc.org. For more information about RAC implementation, see http://www.cms.hhs.gov/RAC/.

THE STATE HEALTH COORDINATING COUNCIL (SHCC) is holding public hearings for the proposed 2010 North Carolina State Medical Facilities Plan, July 15 – July 31. Each hearing will run from 1:30 – 2:30 pm, at the following locations:

July 21: Wilmington, Coastal AHEC, New Hanover Regional
July 24: Asheville, Mountain AHEC Education Center
July 28: Charlotte, Carolinas College of Health Sciences
July 31: Raleigh, McKimmon Center, NCSU

To view the proposed plan and for more information about the hearings, go to http://www.dhhs.state.nc.us/dhsr/mfp/publichearing.html.

LAST CHANCE TO REGISTER FOR THE NCMS SPORTS MEDICINE SYMPOSIUM - Physicians interested or involved in sports medicine are encouraged to join their colleagues July 24-26 at Wrightsville Beach. 8 AMA PRA Category 1 Credit(s)™ available. To register, contact Roni Baker, rbaker@ncmedsoc.org at the NCMS or download a brochure from the website: http://www.ncmedsoc.org/non_members/specialties/2009-sports-med-brochure.pdf.