September 11, 2009 - Volume 60 Issue 42

NCMS Bulletin

Payer Issues

Proposed Medicaid Rate Cuts Are Coming

Since the adjournment of the 2009 Legislative Session, the NC Department of Health and Human Services (DHHS) has been busy developing policy to achieve the target savings reductions outlined in the new budget. The $76 million dollar reduction to Medicaid provider services is of special concern to physicians. If applied evenly to all specialties, it would result in roughly a three percent across the board cut, but the NC General Assembly gave DHHS the authority to develop how this cut would be implemented to insure minimal disruption to primary care delivery in Medicaid. A plan for achieving the savings is expected to be developed within the next week or so. NCMS has learned that one possible plan would be to cut all non-primary care specialists participating in Medicaid by nearly 4% while holding the cut to primary care physicians to just over 1%. A cut framed in this manner could jeopardize an already tenuous relationship between Medicaid and non-primary care physician specialists. Your legislative team at NCMS continues to work closely with staff from the Department of Medical Assistance (DMA) to ensure that the Medicaid program incentivizes primary care delivery while not threatening the participation of specialists that are equally valued partners in the delivery of cost effective and appropriate care to Medicaid patients. It is imperative that physicians contact the DMA regarding the impact of these changes on access to medical services for Medicaid patients. Comments should be directed to Dr. Craigan Gray, Medical Director for DMA at craigan.gray@dhhs.nc.gov or 919-855-4100.

Public Health

Signs that H1N1 Cases Are Rising in NC

State Influenza Surveillance Coordinator Torrey McLean reported on Thursday that “it appears that Pandemic A (H1N1) influenza is rising sharply both in North Carolina and throughout the entire southeast.” Virtually all confirmed influenza activity within the latest reporting cycle continues to be the Pandemic A (H1N1) virus. The latest report comes as the state prepares for the start of the new flu reporting season on September 28, 2009. Influenza activity began to increase sharply the first week of September, according to the state’s sentinel sites and participating hospital emergency departments. That coincided with the start of the new school year across the state. You can read the latest NC Weekly Influenza Surveillance Summary (#43) at www.epi.state.nc.us/epi/gcdc/flu.html.

CMS, CDC, HHS and AMA Seek to Help Physicians Prepare for H1N1

Two upcoming events are designed to give physicians and their practices information and guidance on the Pandemic A (H1N1) virus:

The Centers for Medicare and Medicaid Services (CMS) is convening a call for the physician community on Monday, September 14th to share information on H1N1. Questions may be submitted in advance via e-mail. Details of the call are as follows:

Information Sharing from HHS on H1N1
Call: 1-800-837-1935; Conference ID: 2H1N1
Date: September 14, 2009
Time: 1:30 -3:00 pm, Eastern DS Time
Please submit questions in advance at H1N1.listening@hhs.gov.
The AMA, in cooperation with the CDC and US HHS, will host a webinar, Physicians: Prepare for the 2009 H1N1 Flu, on Tuesday, September 22 at 7:00 p.m. CST. The webinar will cover recommendations for physicians from the Advisory Committee on Immunization Practice and basic epidemiology of the 2009 H1N1 flu virus. The webinar is open free of charge to 1,000 individuals. Register early to reserve your spot.

CDC Offers Influenza Response Guidance for Child Care Programs

The CDC has prepared a communication toolkit on influenza response for child care programs. See the CDC’s Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009-2010 Influenza Season, at: http://www.flu.gov/professional/school/childtoolkit.html.

NIAID Launches 2009 H1N1 Influenza Vaccine Trials in Pregnant Women

The first trial testing a candidate 2009 H1N1 influenza vaccine in pregnant women is launching this week, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, announced Thursday. For more information about NIAID-sponsored clinical trials in pregnant women, see Questions and Answers: Trial of Candidate 2009 H1N1 Influenza Vaccine in Pregnant Women. More details about this trial are available at http://www.nih.gov/news/health/sep2009/niaid-09.htm.

Health Reform

AMA Vows to Stay Engaged in Health Care Reform Process

AMA President J. James Rohack, MD, says the AMA will stay “constructively engaged in the legislative process” as Congress responds to President Obama’s call to end the “bickering” and to take action on health care reform. Dr. Rohack’s response was issued shortly after the President spoke to a joint session of Congress Wednesday night urging lawmakers to enact health care system reform legislation before the end of the year.

Read Dr. Rohack’s response at: http://www.ama-assn.org/ama/pub/health-system-reform/obama-health-reform-address.shtml.

Read President Obama’s speech at:
http://www.whitehouse.gov/the_press_office/Remarks-by-the-President-to-a-Joint-Session-of-Congress-on-Health-Care/.

During the President’s speech, the NCMS posted commentary on the Doctor to Doctor Blog, which is available at www.ncmedsoc.org/blog.

Report Addresses 'Serious Oversights' in National Health Care Debate

Hours before the President delivered his latest address on health care reform, the Physicians Advocacy Institute (PAI) released a report entitled Physicians and their Practices under Health Care Reform, prepared by a team of noted physicians and economists headed by Richard “Buz” Cooper, MD, Professor of Medicine and Senior Fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania. Copies of the report were sent to the President and Congress.

“This report highlights several important concerns that that have been left out of the health care discussion,” PAI Treasurer and NCMS EVP, CEO Robert Seligson said. “In order to pass meaningful health care system reform legislation, we must address the growing problem of physician shortages, how physicians’ practices will be affected in a reformed health care system, and the impact of poverty and other social determinants on access, quality and cost of care.” Physicians are urged to read the report at www.physiciansfoundation.org or at www.ncmedsoc.org, where you can also view physicians’ comments about health care system reform on the Doctor to Doctor blog.

NCMS Staff On-the-Road to Address Health Care System Reform

Robert Seligson, EVP and CEO, spoke on health system reform on “The Big Talker FM” radio station (93.7 and 106.3 FM, Wilmington), with Philip Brown, MD, on Tuesday night. Seligson talked about the essentials that need to be included in health system reform and addressed a series of questions from callers.

Steve Keene, General Counsel and Deputy EVP, participated in a health care reform panel discussion sponsored by the medical staff of the New Hanover Regional Medical Center in Wilmington on Tuesday. Other panelists included Garland Scott of United HealthCare and Allen Feezor, Deputy Secretary of the NC Department of Health and Human Services (DHHS). The panel discussion was preceded by a conference call with Congressman Mike McIntyre (D, District 7) on pending health reform legislation.

Chip Baggett, Director of Legislative Relations, met with members of the Nash County Medical Society Tuesday to discuss national health care reform legislation, particularly HR 3200 and the NCMS position on that bill. Of special concern was the potential for rationing of health care. The group also reviewed legislative action from the 2009 Session of the NC General Assembly.

NCMS Guiding Principles for Health Care System Reform and other resources can be found at www.ncmedsoc.org.

News Highlights

NC Physician Assistant Receives National Recognition

The American Academy of Physician Assistants (AAPA) awarded its 2009 Outstanding PA of the Year Award to Robin Hunter Buskey, MPAS, PA-C, this summer at the AAPA’s annual conference in San Diego. Buskey serves as a senior clinical PA at the Butner Federal Correction Complex (FCC) in Butner, while on active duty as a Health Service Officer with the U.S. Public Health Service. In addition to her work, Buskey serves as the first PA elected to the Board of Directors for the Federation of State Medical Boards and as a member of the Institute of Medicine. In the past, Buskey served for six years on the North Carolina Medical Board and for nine years on the New York Board for Professional Medical Conduct, making her one of only two non-physician members nationwide who served on more than one state medical board.

NCMS Member Partner Offers Solution for Virtual Office Visits

More and more insurance companies are reimbursing for Virtual Office Visits, also called eVisits, based on the enormous value of increased practice efficiencies and convenience for patients. Most recently, Blue Cross Blue Shield of North Carolina announced they are reimbursing for eVisits as of June 1 of this year. NCMS Member Partner Medfusion is offering North Carolina physicians their Virtual Office Visit (VOV) solution for just $35 per doctor per month. Since the average reimbursement from payers is between $28 and $38 per online visit, practices need only to conduct one VOV per month to pay for the solution, with any additional visits generating added revenue to the practice. For details, go to http://www.medfusion.net/ncevisit/.

'Medical Staff Boot Camp' CME Offered at 2009 NCMS Annual Meeting

You can earn CME credit when you attend the Medical Staff Boot Camp, Saturday, October 31, 3:00 p.m. – 5:00 p.m., during the 2009 NCMS Annual Meeting in Raleigh, October 30 – November 1, 2009. This CME activity is a balanced survey and analysis of the rights, duties, and prerogatives of the organized medical staff at North Carolina hospitals. Topics include staff rights and duties under state law, Joint Commission’s standards, Medicare conditions of participation, the Health Care Quality Improvement Act, and case law. In addition, the program will cover organizational and operational issues and the balance of powers between organized staff, the hospital’s governing body, its administration and individual physicians. (Approved for 2 hours AMA PRA Category 1 Credits™). Also available is Dispelling the Horrors of HIT, Saturday, October 31, 3:00 p.m. – 5:00 p.m., which is approved for 2 hours AMA PRA Category 1 Credits™.

Sign up for either of these sessions through the online registration form or download a brochure (PDF - 16 pages) for more information.

Nominate an Outstanding Physician Leader for the Harris Award

The Carolinas Center for Medical Excellence (CCME) is currently accepting nominations for the 2009 Harris Memorial Award in honor of the life and memory of its founding member T. Reginald Harris, MD. Presented in conjunction with the Annual Meeting of the North Carolina Medical Society, a plaque and $2,500 monetary prize are given to a North Carolina physician for outstanding achievements in the areas of health care quality and service to the medical community. Please download and complete the nomination form at www.thecarolinascenter.org. Nominations are due Friday, September 18, 2009. For more information, contact Melinda Postal, CCME director of communications, at 800-922-3089, ext. 3203, or mpostal@thecarolinascenter.org.

Last Call for Resolutions for the 2009 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 Monday, September 14, 2009. All resolutions should be mailed to Robert W. Seligson, EVP/CEO, NCMS, PO Box 27167, Raleigh, NC 27611 or submitted electronically to lcarter@ncmedsoc.org. For more information and sample resolutions, click here. The NCMS Houses of Delegates will meet Saturday, October 31 (Session 1) and Sunday, November 1 (Session 2) at the NCMS Annual Meeting.

Your PAC Has a New Look and New Name, NCMS PAC

The NCMS PAC, formerly MEDPAC, is gearing up for the 2010 election year by making plans to expand on its fundraising and grassroots successes from the last election. We will need your help to get this job done. Combined with the NCMS’s advocacy efforts, the NCMS PAC facilitates future legislative victories which protect your practice and patients. The NCMS PAC 2009 membership year ends September 30th so please visit www.ncmedsoc.org/pac or call 1-800-722-1350 to make your contribution today.

Entries for 2009 NCMS Photo Contest Due by September 15

NCMS is compiling a 2010 calendar for members, and we want our members to have a hand in designing it. Submit your favorite scenic shots (up to three) for a chance to be included in the calendar. The top twelve images will be selected by a jury of NCMS staff members. These images will then be on display at the 2009 NCMS Annual Meeting, where attendees will vote to decide the first place winner. The prize winning photo will be featured on the calendar’s cover, and the photographer will receive free NCMS membership for 2010 (a value of up to $418!). All who enter an image for review will receive an NCMS gift bag, and all submissions will also be placed in a gallery on NCMS Online after the NCMS Annual Meeting. The top twelve will receive an NCMS gift pack and photo credits within the calendar as well as the honor of having their work viewed by 12,000 NCMS members.

To submit your work, send up to three high-resolution images on CD or 8 x 10 prints to NCMS, Attn: Kristen Shipherd, PO Box 27167, Raleigh, NC 27611, or e-mail a high-resolution image to kshipherd@ncmedsoc.org. Please label your work with a title for the shot you are submitting and any description you would like to add to further explain the piece. Deadline for submissions is Tuesday, September 15, 2009.

September is 'Women in Medicine' Month

In September, the NCMS Foundation celebrates Women in Medicine Month by recognizing the many ways in which women contribute to the medical profession. Do you know someone who deserves to be recognized as a mentor, role model, or leader in their profession or in their communities? For a tax-deductible contribution of $35 per honoree (or $100 for three), the Foundation will send a personalized card from you to the physician you wish to honor. Your gift will help increase access to quality health care for all North Carolinians by supporting the Foundation operations and programs. Honorees will also be recognized on the NCMS and the Foundation websites. Download a gift form (PDF), and say thank you to a special physician today! For more information about the Foundation, please visit www.ncmsfoundation.org.

Events-Resources-Training

END OF LIFE CARE DECISIONS: ADVANCE DIRECTIVES CHANGES AND THE NEW MOST (MEDICAL ORDERS FOR SCOPE OF TREATMENT) FORM conference will be held Friday, September 18, 2009, 9:00 a.m. – 4:30 p.m., at the UNC Charlotte/McKnight Auditorium/Cone Center in Charlotte. The fee is $65.00 if you register before September 13. There’s a $5.00 discount for registering online. Breakfast and lunch will be provided, along with Resource notebooks. Registration and details are available at www.charlotteahec.org.

NORTH CAROLINA MEDICAL GROUP MANAGERS (NCMGM) FALL CONFERENCE, Weathering the Season of Change, will be held in Pinehurst, September 16-18, 2009. For more information and to register, go to http://www.ncmgm.org/events.cfm?event_id=M4705FallConference2009Attendee20090916.

NCHICA'S 15TH ANNUAL CONFERENCE & EXHIBITION, to be held on September 20-23, 2009 at the Grove Park Inn in Asheville, NC. For further details, visit http://www.nchica.org/Activities/09/agenda.htm.