Current Bulletin

  • Subscribe to CMS’ ‘Patients over Paperwork’ Newsletter

    The Centers for Medicare and Medicaid Services (CMS) is trying to address physicians’ complaints about the massive amounts of paperwork/inputting of information under quality reporting requirements that oftentimes takes time away from patients. As part of the Meaningful Measures initiative announced last year by CMS, the ‘Patients over Paperwork’ monthly newsletter seeks to track what CMS is doing to alleviate the paperwork burden. Read the February Patients over Paperwork newsletter and subscribe. Learn more about Patients over Paperwork, and view past editions of this newsletter. Visit the Simplifying Documentation Requirements webpage for previous updates, and find out how to submit an idea.
  • CDC Report on ED Opioid Overdoses Shows Epidemic Is Getting Worse

    A Centers for Disease Control and Prevention (CDC) report released this week revealed that from 2015 to 2016, opioid overdose deaths increased 27.7 percent nationally, indicating a worsening of the opioid overdose epidemic. The report is based on data from emergency department (ED) syndromic and hospital billing and included data from North Carolina.

    Our state showed a significant increase of 31.1 percent between the third quarter of 2016 and the third quarter of 2017. Overall, the Southwest, West and Midwest regions saw the greatest increases in opioid involved overdoses. Kentucky was the only state to have a decrease. The largest increases were seen in major metropolitan areas.

    Read the report.

  • Federal Updates on Addressing Opioid Abuse Epidemic

    The North Carolina Medical Society (NCMS) is keeping close tabs on the discussions taking place in Washington, D.C. around how best to address the opioid abuse epidemic.

    Last week, Ways and Means Committee Chairman Kevin Brady (R-TX) and Ranking Member Richard Neal (D-MA), along with Health Subcommittee Chairman Peter Roskam (R-IL) and Ranking Member Sander Levin (D-MI), to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma regarding ways to address and prevent opioid abuse in the Medicare Part D program. NCMS leadership meet recently with Rep. Brady to discuss this issue among others. [See Bulletin article on this meeting.]

    The committee’s letter highlights recommendations presented during two Ways and Means Committee hearings related to the opioid epidemic, and the Committee leaders state that the proposals “represent important steps [the] agency can and should take to continue responding to this national emergency.”

    Specific proposals/suggestions cited in the letter include:

    • The Members request more information on CMS’ proposal that “a sponsor may not limit an at-risk beneficiary’s access to coverage of frequently abused drugs to a selected prescriber(s) until at least six months has passed from the date the beneficiary is first identified as a potential at-risk beneficiary.”  They ask CMS to provide information on how it determined 6 months to be an “appropriate” length of time and to consider condensing this timeframe without limiting beneficiary appeal and notice rights
    • The Members encourage CMS to expand its Overutilization Monitoring System to include additional, non-controlled drugs that are susceptible to fraud, waste and abuse, in line with an Office of Inspector General recommendation
    • The leaders encourage CMS to “evaluate [its] current process to determine the best pathway for plans to share reports of abuse and determine what type of additional information from plans, if any, would be the most beneficial to curb opioid misuse.”
    • The Members state their support for “widespread utilization of lock-in programs” in Part D, in line with an OIG recommendation
    • The Members note that CMS has proposed that beneficiaries who are locked-in would no longer be eligible for the special enrollment period (SEP) that they would otherwise be able to use. The Members suggest that there should be an exceptions process for the forfeiture of SEP to protect beneficiary access
    • The Members recommend that CMS ensure that beneficiaries are aware of their right to appeal, as well as the option of automatic escalation, to ensure beneficiaries have quick resolution on coverage issues
    • The Members request more information on CMS’ proposed “four pharmacy test” to determine whether a beneficiary is at risk, including how CMS determined the number and the average number of pharmacies used by beneficiaries
    • The Members urge CMS to “consider pharmacists as part of the Part D plan’s case management for at-risk or potentially at-risk beneficiaries.”

    The letter states that, given the “severity of the crisis” and issues identified by the OIG and Government Accountability Office, the Members request a detailed response by March 23, 2018. Read the letter.

    From the White House

    The White House has created a page dedicated to the opioid crisis, available here, which details the actions taken by the Trump Administration to quickly “answer this growing threat.”  The page includes materials such as the November 2017 report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis; a November 2017 report from the White House Council of Economic Advisors on the “underestimated cost” of the opioid crisis; and the October 2017 Presidential Memorandum for the heads of Executive Departments and Agencies to use “all appropriate emergency authorities” to “combat the drug demand and opioid crisis currently afflicting our country.”

    Additionally, the US Department of Health and Human Services (HHS) has a page that includes data on HHS’ “5-point strategy to combat the opioid crisis,” which details information such as HHS’ efforts to improve opioid-related data and research. It also includes statistics related to the epidemic.

    Free Opioid CME

    In an effort to be sure all providers are able to obtain their required opioid CME’s a free voucher is available for those unable to attend an onsite training. This FREE CME is approved for up to 3 hours of category 1 CME with AAFP, AMA/AAFP Equivalency, and CDE.

  • How to Get a Return on Your Student Loans During Tax Season And All Year Long

    It’s tax season, and hopefully, for you, that means getting some of the hard-earned money you made the year before, back into your pocket – and if you’ve paid interest on student loan debt, you may.

    Each year, when you file your taxes, you can deduct the interest that you paid on student loans the year prior. Depending on how much you earned, how you file your taxes, and how much interest you paid, you can get money back in your pocket at the top of the year. However, the yearly interest deduction cap is $2,500 and you can’t get money back for interest payments of more than $2,500.  Here are some other stipulations:

    • You must have paid interest on student loans during the tax year.
    • You cannot earn more than $80,000 per year ($160,000 if married).
    • You cannot be claimed as a dependent on someone else’s tax return.
    • Your filing status cannot be married filing separately.

    With the income stipulations, you may not qualify for the student loan deduction, so what now? Student loan refinancing can be a great way to save on your student loan debt, especially if you don’t qualify for the student loan interest tax deduction.

    If you refinance your student loans, you may be able to reduce your monthly payments and save all year long not just at tax time.

    This article was provided by Laurel Road, a student loan refinancing company and an approved NCMS benefit partner, and contains links to advertising content.  Learn more about Laurel Road student loan refinancing here.

    Average savings calculated based on single loans refinanced from 9/2013 to 12/2017 where borrowers’ previous rates were disclosed. Assumes same loan terms for previous and refinanced loans, and payments made to maturity with no prepayments. Actual savings for individual loans vary based on loan balance, interest rates, and other factors.

    Laurel Road Bank does not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. Please consult your own tax, legal and accounting advisors before engaging in any transaction.

  • Kudos to NCMS Members on the Move

    Dr. de Guehery

    Congratulations to North Carolina Medical Society (NCMS) life member Lindsey de Guehery, MD, who was recently appointed medical director of the Wilson County Health Department.

    De Guehery, who works at Wilson Pulmonary and Internal Medicine, will oversee the department’s two current nurse practitioners as well as a third who will start April 1 and a nurse midwife. He will also sign off on all policies and procedures, officials said.

    Dr. De Guehery joined the NCMS in 1985 and served on the Legislative Cabinet as well as the NCMS PAC Board for many years.


    Dr. Forrest

    Longtime NCMS member Brian Forrest, MD, was recognized as a “Changemaker” by Medical Economics magazine. The designation is given to a ‘special group of physicians who are working tirelessly to improve the lives of their patients, their own medical practice and the well-being of their community.

    Dr. Forrest, a primary care physician in Apex, was one of only seven physicians nationwide showcased by the publication. He was recognized for founding Access Healthcare, “a practice considered one of the earliest direct primary care (DPC) practices in the U.S. [putting] Forrest on the map as a pioneer of the new practice type.” Read the article.

    Congratulations, Dr. Forrest!


    Kudos to Michael Miltich, MD, who was elected commissioner and Mayor Pro Tem of the town of Cornelius near Charlotte.

    Dr. Miltich

    Miltich, who has been an NCMS member since 1984 and has served on several NCMS committees over the years, will also be the town’s delegate to the Charlotte Regional Transportation Planning Organization. Read the Cornelius Today article for all the details on this hotly contested election. And congratulations to Dr. Miltich!

  • In the News

  • Learning Opportunities

    The Governor’s Institute and the NC Medical Board is offering “Controlled Substance Prescribing: What Every Provider Needs to Know” live training sessions across the state. These free CME panel sessions are designed for controlled substances prescribers to complete up to two hours of the required education in opioid prescribing. A one hour online training is recommended before the live training. Register for 1-hour online training here. Together they fulfill the three hour requirement.  Here are the upcoming sessions:

    March 15, 2018 – Cape Fear Medical Center, Fayetteville (2 hrs)

    April 3, 2018 – 6:00 p.m. Carolinas Medical Center, Concord (2 hrs)

    May 8, 2018 – 6:00 p.m. Carolinas Medical Center, Shelby (2 hrs)


    Save the date for the next meeting of the NC Department of Health and Human Services Opioid and Prescription Drug Abuse Advisory Committee, Friday, March 16, from 9 a.m. to 12:30 p.m. (with 8:30 to 9:00 a.m. reserved for sign-in and networking). The location will be the McKimmon Center, 1101 Gorman St., Raleigh. Register here.


    NCMS Lunch and Learn webinar — Planning Ahead: The Best Way to Address the Risk of Disaster – will be held Tuesday, March 20, from noon to 1 p.m. Disasters that interrupt a practice’s ability to provide care for patients can happen at any time and in any place. Every practice is likely to feel the impact at some point in time and the best way to address the risk of disaster is to plan ahead. Learn more and register for the webinar.


    The National Academy of Medicine presents a webinar on “Improving Care for High-Need Patients: A Conversation with Health Quality Partners” on March 29 from 2-3 p.m. In the United States, care management for this population remains fragmented, uncoordinated, and reactive. How can we best improve the health and care for this group while balancing quality of care and associated costs? Learn more and register.


    The National Rural Accountable Care Consortium (NRACC) will offer Quality Improvement Workshops North Carolina on April 17 in Fayetteville and April 19 in Elkin. During the interactive workshops, participants will learn from Caravan Health experts about best practices to improve the health of their community, increase practice revenue and improve quality scores. For more information please contact


    Registration is now open for the NC Ob/Gyn Society & NC Section of ACOG’s 2018 Annual Meeting,
    April 20-22 at the Omni Grove Park Inn in Asheville
    . Other specialties may be interested in the Hands-on Ultrasound workshop and the Treatment of Opioid Use Disorder course, which provides the required education needed to obtain the waiver to prescribe buprenorphine. Learn more and register.


    The 9th Annual Addiction Medicine Conference will be held April 26-28, in Asheville. The conference will provide clinically practical and up-to-date substance use related training, applicable across general medical as well as addiction specialty practices. Learn more.

    The 2018 Spine Society of Australia 29th Annual Scientific Meeting will be held April 27-29 at the Adelaide Convention Centre, Australia. Learn more and register.


    The National Academy of Medicine will hold a public meeting around the topic of “Establishing Clinician Well-Being as a National Priority” on May 2, 8:00 a.m. to 5:15 p.m. with an art show and reception from 5:15 to 6:30 p.m. in Washington, D.C. A live webcast is available if you are not able to attend in person. Learn more and register.

    MAHEC is offering two courses to help treat patients with opioid use disorders: “Providers’ Clinical Support System: Buprenorphine Office-Based Treatment for Opioid Use Disorders, The “Half and Half” Course,” and “Recovery Within Reach: Building Team Expertise in Office-Based Opioid Treatment (OBOT).” Sessions will be held June 22 and Sept. 28. Learn more and register.


    NCTracks has Computer-Based Training (CBT) courses on a variety of topics available to providers 24 hours a day, 7 days a week, every day of the year. Anyone who is a registered user with NCID access to the NCTracks secure Provider Portal can access and take a self-paced course. A list of courses available can be found here and under Quick Links on the NCTracks Provider Training page of the public Provider Portal.


    MAHEC, working with the North Carolina Academy of Family Physicians, The Governor’s Institute on Substance Abuse and Project Lazarus: A Project of CCNC, is offering A Guide to Rational Opioid Prescribing for Chronic Pain, an online education course. The course is designed for all prescribing health care practitioners who are interested in an overview of the rational prescribing approaches for persons with chronic pain disorders. It will fulfill the North Carolina Medical Board’s requirement of at least one hour of continuing education designed specifically to address prescribing practices for chronic pain management. The course cost is $15 for the first 6 months. Offers 3 hours of AAFP, AMA/AAFP Equivalency, and CDE;

  • NCMS, State Coalition Meet With Congressional Leaders; CMS’ Seema Verma

    NCMS President John L. Reynolds, MD

    North Carolina Medical Society (NCMS) President John L. Reynolds, MD, and NCMS CEO Robert W. Seligson were on Capitol Hill last week meeting with congressional leaders and Centers for Medicare and Medicaid Services (CMS) staff to discuss current issues of importance to NCMS members.

    The discussions touched on issues like Medicare physician payments, fixing the Affordable Care Act, reforms to MACRA, providing regulatory relief and lifting the moratorium on physician-owned hospitals. Read a summary of the talking points on each of these issues. The meetings are an ongoing part of our federal lobbying efforts that also include the 10-member Coalition of State Medical Societies. Watch the Bulletin for updates on progress on each of these issues in the coming months.

    The NCMS representatives spent over an hour with Sen. Richard Burr (R-NC) and with Sen. Thom Tillis’ health care legislative expert, Bill Bode, discussing the above issues. This particular trip also included meetings with Rep. Kevin Brady (R-TX), Chair of the House Ways and Means Committee and Michael Burgess, MD (R-TX), chair of the subcommittee on health of the House Energy and Commerce Committee.

    The group also met with CMS Administrator Seema Verma, who was welcoming and responsive to the Coalition’s messages, and promised to follow-up.

    Dr. Reynolds had the opportunity to attend a private briefing with Kate Goodrich, MD, Director of the Center for Clinical Standards and Quality at CMS.

    “I was pleasantly surprised that Dr. Goodrich is still a part-time practicing physician,” he said. “She was very open to answering questions, accepting suggestions and appears dedicated to quality measurement that is meaningful and beneficial.”

    Seligson returned from Washington, D.C. to meet with Patrick Conway, MD, CEO of Blue Cross Blue Shield of North Carolina.

    “I continue to be impressed with Dr. Conway’s commitment to work with the NCMS on medical and regulatory issue of importance to our members,” Seligson said. “Dr. Conway’s knowledge and skill set are inspiring. I look forward to working with him.”

  • NCMS Foundation’s Leadership Program Wins Again!

    For the second year in a row, a leadership development program of the North Carolina Medical Society (NCMS) Foundation’s Kanof Institute for Physician Leadership received the equivalent of an ‘Oscar’ for being a “Top Leadership Partner.”

    The LEAD2018 Award is considered the top award in the human resource world. Winners represent some of the largest corporations and nonprofit organizations in the world.  Learn more about the LEAD2018 awards.

    “We are proud of our award-winning leadership development programs not just because of recognition like this, but, most importantly, because programs like our Leadership College and Health Care Leadership and Management help our members be most effective in various health care leadership roles throughout the state,” said NCMS CEO Robert W. Seligson.

  • PAI Urges Congress to Scrutinize Rapid Consolidation In Health Care

    In a letter last week to the U.S. House of Representatives Subcommittee on Oversight and Investigations the Physicians Advocacy Institute (PAI) detailed the extent and impact of rapid consolidation that is occurring across the health care marketplace.  PAI expressed support for Congressional scrutiny into the potential concerns about a system dominated by large, powerful entities with enormous market power. The letter warns this trend can lead to higher prices for consumers, anticompetitive marketplace behavior designed to thwart competitors, restrictions on physician decision-making on patient care issues and limitations on patients’ choice in and access to prescription drugs.

    PAI urged review of federal policies that have fueled this trend towards hospital-driven consolidation, as well as relief from outdated policies that restrict physicians from competing on a level-playing field with hospitals and other corporate entities that are moving quickly to dominate various aspects of the health care delivery system.

    “The vital role that physicians play in our health care system – providing high quality, cost-effective care to patients – should not be undermined by the push towards corporatization” said North Carolina Medical Society (NCMS) CEO Robert W. Seligson, who serves as PAI’s President.   “It is important to advance policies that encourage and support greater competition throughout the health care marketplace, including competition by physician-led organizations.”

    Seligson also was quoted in a ModernHealthcare article [registration required to access] on PAI’s letter.

    Read the letter.