NCMS Morning Rounds 2-19-20

Happy Wednesday!

Here’s your mid-week NCMS Morning Rounds!

 Feb. 19, 2020

Medicaid Offers Telephone Evaluation for Flu-like Symptoms

In response to the higher than normal number of influenza cases and influenza-related complications and deaths, NC Medicaid is offering telephonic evaluation and management (E/M) services to beneficiaries who are actively experiencing flu-like symptoms. The purpose is to decrease the spread of the influenza virus by encouraging ill beneficiaries to stay home and out of doctor offices, urgent cares and emergency departments.

Telephonic E/M services must be rendered by a physician, nurse practitioner or PA actively enrolled in Medicaid and NCTracks. Services are only to be rendered to established patients or legal guardian of an established patient.

Telephonic E/M services are not to be reported if clinical decision making dictates a need to see the beneficiary within 24 hours for an office visit or next available urgent care appointment; the telephone consultation shall be considered a part of the office visit. If the telephone call follows an office visit performed and reported within the past seven calendar days for the same diagnosis, then the telephone services are considered part of the previous office visit and are not separately reported.

Claims for telephonic calls related to flu-like illness will be accepted for dates of service on or after Feb. 1 and denied for dates of service after April 30, which corresponds to the official flu season.

Read more about this including the specific claim codes for these visits.

Opportunity to Help Reduce Low-Value Care In ACOs

The Institute for Accountable Care (IAC) is looking for ACOs interested in reducing the use of low-value care to join an advisory group to help plan a future study or learning collaborative in this area. Common examples of low value care include unneeded imaging, excess use of colonoscopy for cancer screening or PSA testing for prostate cancer. Experts from the ABIM Foundation, which oversees the Choosing Wisely program, and Kaiser Permanente/MacColl Institutes have found that multiple stakeholders need to be engaged to reduce these and other common practices.

IAC is seeking six-to-10 ACOs to participate in the project with four meetings between now and the end of summer. The planning committee will work together to identify important types of low-value care on which to focus, strategies to reduce the use of these services and important learning objectives for the ACO community. Participants will have an opportunity to participate in a survey of high-value culture in their organizations. If you are interested in more information, please reach out to Leslie Valera at

Recognizing NCMS leader Capt. Jim Hill, PA-C

Former NCMS Foundation Board of Trustees Chair and longtime NCMS leader, Capt. Jim Hill, PA-C, was recently profiled in an article by US Acute Care Solutions (USACS). In the article, Hill recounts his experiences – including a particularly harrowing one — as a Marine, and what it was like in the early days practicing as a PA. Next week, Hill will address the organization’s assembly, which brings together USACS directors, executives and clinicians to educate, exchange ideas and connect with other leaders.

Capt. Hill joined the Marine Corps after graduating from college going on to graduate from Duke University’s PA progra in 1976. That program, started in 1965 with the help of another longtime NCMS leader, E. Harvey Estes, Jr., MD, was initiated in part to train military veterans who had experience responding to trauma.

Last year, Duke selected Hill as the 2019 Alumnus of the Year and inducted him into the Duke PA Hall of Fame. At 71, he became the lead mentor for the Duke PA Program Veterans Mentoring Project, where he works to recruit veterans to connect them with older veteran PAs to mentor them throughout the two-year program. He also volunteers at the Charlotte Rescue Mission, where he works with veterans who have become addicted to substances and are working to get their lives back together.

Kudos Capt. Hill on this latest recognition of your service! Read the article.

In the News

One in Four Opioid ODs Involve Kids and Teens, US News & World Report, 2-17-20

Learning Opportunity

The UNC School of Medicine, the UNC Lineberger Comprehensive Cancer Center, UNC Gillings School of Global Public Health, and the UNC Center for Health Equity Research are hosting the Inaugural Paul A. Godley Health Equity Symposium on March 5 at the University of North Carolina, Chapel Hill. The Symposium will bring together faculty, staff, students and the community to highlight and encourage health equity research, promote collaboration and networking and encourage strategic planning and partnerships at the UNC School of Medicine. Learn more and register.


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