NCMS Morning Rounds 6-24-19

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June 24, 2019

NCMS Weekly Legislative Round-Up

Last week saw more bills moving through committee and into position for consideration by the full House and/or Senate. Among those proposals was legislation that could affect your practice, including:

  • HB 656/SB 548 Medicaid Changes for Transformation This bill, which made it out of committee and to the Senate floor last week, mainly focuses on technical changes to the state’s Medicaid program transformation to managed care, expected to ‘go-live’ this November. Several provisions do tweak the appeals process for Medicaid patients, however, the bill does not change the intent of Medicaid transformation nor your process for becoming part of the new system.
  • SB 361 – Health Care Expansion Act of 2019 This proposal contains many elements, but last week perhaps the most controversial part – repeal and then reform of the state’s CON laws – was removed. This is the Senate’s attempt to address a variety of health care issues and passed out of the Rules Committee and headed to the Senate floor.
  • HB 325 – Opioid Response Act Preceded by the STOP Act and the HOPE Act, this is considered the third in a series of legislative initiatives – albeit one without a convenient acronym — to address the state’s opioid abuse epidemic. Significant progress has been made in the fight against opioid abuse, and while the NCMS does not see the need for more regulatory legislation, this bill does focus on treatment of opioid use disorder as a disease. The discussion among legislators on treatment aspects has been encouraging, and we believe this bill has been transformed into a positive piece of legislation.
  • HB 474/SB 375 – Death by Distribution At first the NCMS opposed this bill because it would conceivably hold physicians liable for criminal and civil charges if someone to whom you prescribed a controlled substance died due to use of that substance. We were able to change the proposal so a physician following the accepted standard of care would be exempt in such an instance.
  • HB 575/SB 633 Birth Center Licensure Act This proposal, which establishes a licensure process and annual license fees for birth centers, is still active although it was pulled from committee due to time constraints last week.
    House and Senate leadership was hunkered down working on their conference committee budget report last week. The report should be available early this week and is the real indicator that the end of session is just around the corner.

To get all the details on these and other important health care related bills making their way through the NC General Assembly, be sure to check out our NCMS Legislative blog.

NCMS Joins Coalition Calling for Poverty Index Discussion

The NCMS has joined the Coalition of State Medical Societies, which represents 10 state societies in all, to ask the US Office of Management and Budget (OMB) to fully consider the impact of changing the inflation index used to determine federal poverty guidelines.

While the coalition agrees that the index used to adjust the guidelines is outdated, the indices proposed by the OMB would have an adverse impact on those who rely on government services as determined by the poverty guidelines. The agency is receiving comments on the revision to the inflation index, but has said it will not accept comments on the implications of any change.

“As physicians, we are not experts on the various inflation indices, but we do know what is good for our patients,” the coalition states in a letter to Nancy Potok, the OMB’s chief statistician. “Soliciting public comments on potential revisions to the inflation index without simultaneously soliciting comment on the implications of such a change is like taking a patient into surgery without discussing the potential complications beforehand. As such, we strenuously urge OMB to suspend further discussion of adopting a new index until the agency researches and seeks input on the wider, long-term implications such a change would have on communities across the United States.

“We welcome a robust discussion about how to make the federal poverty guidelines better reflect what families and patients need to be productive and healthy members of our communities,” the coalition letter says.

Read the entire letter to learn more.

NC Plastic Surgeons Converge on Capitol Hill

Plastic surgeons from North Carolina joined with their American Society of Plastic Surgeons (ASPS) colleagues from across the nation on Capitol Hill last week. In all, 87 surgeons met with their elected officials. North Carolina plastic surgeons attending included, Mary Ann Contogiannis MD, Greensboro; Lynn Damitz MD, Chief of Plastic Surgery, UNC Chapel Hill; and Gregory Swank MD, Hickory.

The group visited the offices of the US Senators Richard Burr (R) and Thom Tillis (R) as well as US Representatives Mark Meadows (R-District 11); Ted Budd (R-District 13) and G.K. Butterfield (R-District 1). The surgeons discussed legislation including:

  • The Ensuring Lasting Smiles (ELSA) Act (S.560/H.R.1379), which ensures medical coverage for congenital anomalies.
    The Resident Physician Shortage Reduction Act (S.348/H.R.1763), which makes sure there are enough physicians to meet our nation’s medical needs.
    • Accessible Care by Curbing Excessive Lawsuits (ACCESS) Act, which aims to improve the practice of medicine and the quality of patient care. Learn more.
    • Unanticipated Medical Bills and Bans on Balance Billing, also referred to as surprise billing. This is a hot topic on the Hill right now. The NCMS also is supporting legislation to end surprise billing, and on Friday issued an Action Alert to members. Take Action here.

Learn more about the issue at the Physicians Advocacy Institute (PAI) website.

In the News

Map: The Healthiest (and Unhealthiest) States, According to the Commonwealth Fund, The Advisory Board Forum, 6-14-19

Learning Opportunity

Here are some learning opportunities you could possibly do poolside.
The 23 Best Health and Science Books to Read This Summer, recommended by the staff and readers of STAT.


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