Current Bulletin

  • Did You Miss Monday’s Deadline to Begin Collecting A Full 90-Days of MIPS Data for 2017?

    Monday (Oct. 2) was the last day to begin the 90-day reporting requirement for the first year of the Merit-based Incentive Payment System (MIPS)—one of the two tracks in the Quality Payment Program — since there are only 90 days left in 2017.  By participating, even in a minimal way this first, transition year of MIPS, you may avoid a negative payment adjustment and may actually be eligible for a positive payment adjustment and bonus. Collecting and reporting data for a minimum of 90 consecutive days will make you eligible for the maximum positive payment adjustment if you perform well relative to others.

    If you didn’t make yesterday’s deadline, you can still report on less than 90 days of data – in fact you can begin data collection as late as Dec 31, 2017 and still avoid a negative payment adjustment. However, the more data you collect and submit increases the likelihood of earning a positive payment adjustment.

    Either way, it behooves you to begin collecting 2017 MIPS performance data because one thing is certain: if you are eligible to participate in MIPS but choose not to collect and submit data, you will get a negative 4 percent payment adjustment beginning on Jan. 1, 2019.

    Need Help?

     
  • Flu Vaccine Recommendations and Reminders

    Early reports indicate this flu season could be a bad one, so public health experts are urging everyone to get their flu shot.

    Medicare Part B reimburses health care providers for flu vaccines and their administration without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies. The Centers for Medicare and Medicaid Services (CMS) is encouraging you to remind Medicare patients to reduce their risk for contracting seasonal flu and serious complications by taking advantage of Medicare’s coverage of the annual flu shot. CMS also recommends you and your office staff be immunized. Read CMS’ flu vaccine recommendations as well as payment information.

    For North Carolina Medicaid patients, the NC Department of Health and Human Services has published its influenza vaccine and reimbursement guidelines here.

     
  • NCMS Signs On to Urge Congress to Retain Flexibility in Implementation of MACRA

    The North Carolina Medical Society (NCMS) along with over 100 other state medical and specialty societies joined with the AMA in a letter urging Congress to enact legislation to ensure that the Centers for Medicare and Medicaid Services (CMS) has the flexibility to continue a transitional approach to the implementation of the Quality Payment Program (QPP).  This letter is addressed to the Committee on Energy and Commerce but also went to chairs and ranking members of the House Ways and Means and Senate Finance committees. Read the letter and the recommendations.
     
  • Public Health Alert: Increased Overdoses From Heroin, Fentanyl and Fentanyl Analogues

    The North Carolina Division of Public Health (NC DPH) identified a significant increase in overdoses from heroin, fentanyl, and fentanyl analogues in August 2017. Given this increase as well as the continuing opioid epidemic, NC DPH recently distributed an alert to provide information on this situation and ongoing guidance to clinicians treating patients with opioid overdose and related conditions.

    NC DPH identified an increase of 136 opioid overdose emergency department (ED) visits from July to August 2017. There were 646 opioid overdose ED visits during August 2017, compared to 510 during July 2017. This is the highest count of opioid overdose ED visits compared to previous months in 2017.

    The majority of these August 2017 opioid overdose ED visits were among patients who were white (85 percent), male (64 percent), and between the ages 25 to 34 (42 percent). The highest rates of opioid overdose ED visits occurred in Cabarrus (26.3 per 100,000 residents), Rowan (22.9 per 100,000 residents), and Lincoln (17.2 per 100,000 residents) counties, and 73 percent of the August 2017 opioid overdose ED visits involved heroin. Review the data.

    NC DPH recommends the following actions:

    • Prescribe/dispense naloxone to patients discharged home after an opioid overdose to prevent death from future overdose.
    • Per CDC guidelines, clinicians should also consider offering naloxone for patients with history of overdose, history of substance use disorder, on higher opioid dosages (≥50 MME/day), or with concurrent benzodiazepine use (www.cdc.gov/drugoverdose/prescribing/guideline.html).
    • Educate family and friends that naloxone can be dispensed at participating pharmacies under NC’s standing order for naloxone. Information on participating pharmacies and use of naloxone can be found at www.naloxonesaves.org.
    • Provide information on syringe exchange programs: www.ncdhhs.gov/divisions/public-health/north-carolina-safer-syringe-initiative/syringe-exchange-programs-north. Syringe exchange programs are effective in decreasing the transmission rates of HIV and hepatitis C, as well as connecting users to treatment.
    • Screen patients to determine risk for or presence of opioid use disorder, and connect to treatment services. Information on 24/7 crisis lines can be found at ncdhhs.gov/providers/lme-mco-directory.

    Read the official health alert.

     
  • Vet’s Choice Program Contact Info Update

    The contact information for HealthNet claims for the Veteran Choice program has been updated. The new contact email is: HNFSPROVIDERRELATIONS@healthnet.com or call Customer Service 1-866-606-8198

    For claims questions, go to www.availity.com to check the status.  If you are having issues with the claims then please follow these instructions:

    • If you are using the Express Entry feature, try manually entering the NPI instead.
    • When asked, ‘Is the provider name the same as the organization name?’, answer ‘No.’
    • The NPI is the billing NPI from the submitted claim.
    • The subscriber ID can be the 10-digit number from the Veteran’s card or his/her Social Security Number.
    • The date of service can be the exact date the service(s) were rendered or a date range (30 day maximum).
    • Only complete the required fields that are marked with a red asterisk.

    If you still are having trouble, please contact Availity Client Services 800-282-4548. A fully staffed team will provide technical support, and will immediately open a ticket to triage provider issues.

     
  • In Case You Missed It: BCBSNC Gets State Health Plan Contract

    Last month State Treasurer Dale R. Folwell, CPA, announced that the State Health Plan Board of Trustees had awarded the Third Party Administrator (TPA) medical claims contract for the State Health Plan to Blue Cross Blue Shield of North Carolina (BCBSNC).

    The TPA contract provides the State Health Plan (Plan) with a provider network, health care claims processing and related services. The current TPA contract, also with BCBSNC, expires December 31, 2018. BCBSNC is also able to provide Population Health Management services which has been previously provided under a separate contract by another vendor. The Plan currently spends $3.2 billion a year for member health care, providing coverage to more than 700,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel and their dependents.

    The TPA negotiates contracts with health care providers as well as processes claims that are then paid using taxpayer funds. The BCBSNC proposal kept the potential administrative costs essentially flat.

    BCBSNC was one of four companies bidding for the contract. UnitedHealthcare (UHC), MedCost, and Aetna also submitted proposals.

    The contract will extend for three years to 2021, at which time the Plan will review the performance of BCBSNC and make a decision on issuing another RFP or extending the contract in one-year increments for a total of up to five years.

    Listen to a podcast of the State Treasurer’s announcement.

     
  • Consortium for Physician Resilience and Retention Formulates Work Plan

    NCPRR logoThe NC Consortium for Physician Resilience and Retention (NCPRR) met on Sept. 15, in Raleigh in conjunction with the NCMS Annual Meeting to develop a work plan to begin to raise awareness about the epidemic of physician burnout and to bring personal fulfillment to the practice of medicine.

    Joe Jordan, PhD, CEO of the NC Physicians Health Program (NCPHP) welcomed the participants, who included representatives of six health systems, the NC Medical Board, the NC Medical Society, NC Academy of Physician Assistants, Medical Mutual Insurance Company of NC and other stakeholders. Paul DeChant, MD, who delivered a keynote presentation to Annual Meeting attendees earlier that day visited the NCCPRR gathering and commended its efforts to address the issues of physician resilience and retention and to promote best practices in North Carolina.

    Jason Horay, Health Promotion Coordinator for the NCMS Employee Benefit Plan, gave an overview of Stanford Medicine’s WellMD program as a national model to emulate. That program created the first Chief Wellness Officer position at a U.S. academic medical center, established a medical staff wellness committee, launched the WellMD website and monthly newsletter, the WellConnect resident crisis hotline, and is supporting widespread educational efforts. Through the Stanford Physician Wellness Survey, the program will measure the pervasiveness of burnout and its effects and develop priorities for wellness interventions based on its findings.

    Consortium members divided into work groups to discuss and formulate work plans in three areas:

    • The Education work group endorsed the work done at Stanford and will connect to those resources for use in North Carolina. The work group commended efforts of the NC Medical Board to support licensees and pledged to work more closely with the Board on physician wellness.
    • The Clinical Causes work group seeks to develop a “Confidential Path to Wellness,” comprised of a confidential referral group of qualified coaches, counselors and peers that will help the medical community address their personal needs.
    • The Intervention work group came up with a plan to develop a “Provider Enjoyment Index,” to measure the level of enjoyment a provider has in their clinical practice. The index would measure various factors such as time spent in EHRs after clinic hours, and include data already being collected by other sources.  The ultimate goal would be for physicians and systems to compare overall index scores across the state and share best practices to increase provider satisfaction.

    The Consortium will reconvene after the first of the year to evaluate progress on the work plan.

     
  • Learn How Genuine Caring Can Lead to Happy Workers AND Financial Success

    mj shaarThe NCMS Employee Benefit Plan is hosting a wellness event on Tuesday, Oct. 10, from 11:30 a.m. to 1:30 p.m. at the NCMS Center for Leadership in Medicine, 222 N. Person St., Raleigh. The guest speaker, MJ Shaar, will present on love and how companies rooted in genuine care are today’s best value creators –both socially and financially. Shaar is one of the most sought-after experts applying positive psychology to health promotion. Trained by the National Speakers Association, she is one of the first 50 in the world to obtain a Master in Applied Positive Psychology from the University of Pennsylvania. In recent years, Shaar facilitated sessions for small and Fortune Companies, governmental institutions, wellness and coaching organizations, as well as various universities. She is the co-author of “Smarts and Stamina: The Busy Person’s Guide to Optimal Health and Performance,” and contributes to The Huffington Post and Psychology Today.

    After her presentation, Shaar will lead attendees through a reflection session on how to infuse her message throughout our worksites.

    The NCMS Plan will provide a healthy lunch. Please RSVP TODAY to reserve your spot.

     
  • Wobble for Wellness – Join the Movement!

    Piedmont Health Service's 'Wobblers.'

    Piedmont Health Services’ ‘Wobblers.’

    Piedmont Health Services is inviting all 41 Community Health Centers, as well as, the North Carolina Community Health Center Association (NCCHCA) to participate in a movement, literally!

    North Carolina Medical Society Benefit Plan (NCMS Plan) client, Piedmont Health Services (PHS) is constantly finding new opportunities for employees to engage and lead a healthier lifestyle. The PHS Wellness Team believes being healthy is a choice, and the more opportunities employees have to become healthier, the more likely they will adopt a healthier lifestyle.

    In keeping with its wellness theme of “Mind, Body and Spirit”, on Friday, Aug. 4, PHS officially kicked off its wellness initiative at the Administrative Offices with the “Wobble” line dance.  Members of the administrative team and other staff wobbled in conjunction with the Tom Joyner Morning Show (TJMS). The show plays the wobble at the top of the 8 a.m. hour every Friday. Events like this have many positive results:

    • studies have shown direct health benefits of doing line dances like the “Wobble;”
    • the sense of well-being and camaraderie participants have with one another also positively impacts health; and,
    • TJMS is nationally syndicated in 132 markets across the country and Mr. Joyner gave Piedmont Health several “shout-outs” both before and as the Wobble played. Moreover, he lauded the company for using this opportunity to promote wellness.

    On Friday, Oct. 20, PHS will Wobble once again since it was so much fun! It promoted movement, comradery and inspiration! Please join us. What better way to let your patients know that you care about the health of your staff? And, you may get to hear the name of your community health center shouted out during the TJMS broadcast.

    If you have questions about how PHS has enhanced their culture of wellness by introducing the Wobble, please contact Rosalyn Freeman, Director of Human Resource at Piedmont Health Service at Freemanr@piedmonthealth.org

    Interested in the NCMS Plan or highlighting YOUR personal wellness journey and how Practice Wellness was able to support you and your practice? Contact Jason Horay at Jason.Horay@mmicnc.com

     
  • Volunteer Opportunities — and Fun – With NC MedAssist

    medassistNC MedAssist, a nonprofit pharmacy program providing access to lifesaving prescription medications, patient support, advocacy and related services to poor, vulnerable and uninsured North Carolina residents, has several worthwhile and fun volunteer opportunities.

    First, the Mobile Free Pharmacy provides adults and children who are low-income with free health screenings, education and medicine cabinet staples.  NC MedAssist collaborates with community partners to organize free events.  Participants receive blood pressure and glucose screenings and items such as aspirin, Tylenol and children’s medicine to take home.

    Serving between 800 – 1000 individuals at each event takes many hands, so volunteers are needed to serve as medical consultants, restockers and sorters, personal shoppers and much more.  Mobile Free Pharmacy events are held across the state.  To view a list of events, please visit www.medassist.org/otc-medicine-program.  If you are interested in volunteering, please either sign-up online at www.medassist.org/volunteer or contact Misty Moore at mmoore@medassist.org or 704.350.3597.

    Second, did you know that beer can do a lot of things—including save a life!  Okay—not really, but participating in the Pancakes & Beer 5K can!    Join NC MedAssist for its 4th Annual Pancakes & Beer 5K Run/Walk on Saturday, November 4th at Olde Mecklenburg Brewery.  All proceeds go to provide lifesaving medication to those who cannot afford it.  Sign up and learn more about this great cause here!  Questions, please contact Blythe Chadim at bchadim@medassist.org or 704.350.3568.  Or visit www.runncmedassist.com to learn more!