NCMS Morning Rounds 8-13-19

Read on for Tuesday’s

 NCMS Morning Rounds.

Aug. 13, 2019

Take Just 5 Minutes to Address “Surprise” Billing

The NCMS has been weighing in on quickly-moving federal legislation to address “surprise” billing, which refers to bills that patients incur when they access out-of-network emergency care or receive unanticipated out-of-network services at an in-network hospital or facility.

The NCMS has joined with other physician organizations, including the Physicians Advocacy Institute (PAI) to promote a fair, balanced federal solution for “surprise” medical billing, which is best accomplished by H.R. 3502, bipartisan legislation sponsored by Rep. Raul Ruiz, MD (D-CA) and Rep. Phil Roe, MD (R-Tenn.), and modeled after New York’s successful law.

Congress will be in recess through Labor Day, with many members back home in their districts. During that time, it will be critically important that every member of Congress hear from physician and physician assistant constituents with concerns about the insurer rate-setting approach included in the House Energy and Commerce legislation (H.R. 3630) and Senate HELP legislation (S.B.1895). The House Ways and Means Committee plans to take up legislation after the recess, making an eventual conference committee scenario likely.

Congress must hear from you about the grave consequences for patients if the insurer-championed rate-setting approach prevails.

Click here to access a tool that will match you to your members of Congress and enable you to send an email message, post on Twitter or Facebook or call their offices to communicate your strong views about the right approach to solving the surprise billing problem.

Please don’t delay in speaking out to help influence what will undoubtedly be the most important legislation to impact physicians and patients this year. TAKE ACTION NOW!

Medicaid Problem Solving Webinars Begin Today

The NC Department of Health and Human Services (NCDHHS) is working to ensure open lines of communication between physicians and physician assistants and NCDHHS as state’s Medicaid transformation to managed care gets underway.

“We are committed to ensuring you have the tools and resources to transition your business models, and to help your Medicaid patients navigate enrolling in a health plan for the first time and learning how to make managed care work best to get the care they need,” wrote NC Medicaid Deputy Secretary Dave Richard in a message to physicians and physician assistants last week.

Richard outlined three resources available:
• Starting today with NCMS and other stakeholder groups, NCDHHS will hold regularly scheduled interactive webinars “to quickly identify, discuss and solve issues and concerns.” Today’s call with NCMS and other stakeholder group leadership will provide an update on the “progress to launch Medicaid Managed Care, an overview of provider-related issues and how they are being addressed, and other information specific to the provider community.” Watch for email from NCDHHS and your NCMS Morning Rounds for the details on future calls aimed at the physicians and physician assistants on the frontlines of Medicaid transformation.
• A new “Provider Playbook,” which is a written resource including communications and materials provided to your patients, readiness guides for your practice, upcoming educational meetings and managed care fact sheets.
• An overview and list of resources to resolve issues that arise. “Provider Issues and Resolutions Overview” describes the issue, its resolution and next steps.

Open enrollment for Medicaid beneficiaries is already underway in the regions in and around the triangle and triad. Phase 1 of the state’s transition to Medicaid Managed Care is slated to launch on November 1, with other regions in the state scheduled to roll out in February 2020.


Early Check and Fragile X Syndrome

Early Check is a research study underway in North Carolina that offers two additional newborn screening tests for free to those eligible. When babies are born in North Carolina, they get a heel prick to test for certain health conditions as part of the regular newborn screening. Early Check offers additional tests for fragile x syndrome (FXS) and spinal muscular atrophy as part of that one heel prick. Learn more about the Early Check study, which is led by RTI International.

Last month was National Fragile X Awareness Month. Get the latest information about this condition as well as educational resources for patients. Although FXS is a rare health condition, it is the most common inherited intellectual and developmental disability. It causes moderate to severe intellectual challenges and language problems. Children with FXS may also have problems with attention, impulsive actions and anxiety. There is an ongoing need to show that early treatment changes outcomes for FXS and the researchers overseeing Early Check hope the study results will provide evidence to inform decisions about newborn screening for this syndrome.

In the News

He Went to Jail As a Fake Doctor. Now He’s a Real One: The Saga of Adam Litwin, MD, The Los Angeles Times, 8-7-19

Learning Opportunity

The next meeting of the NC Department of Health and Human Services’ Opioid and Prescription Drug Abuse Advisory Coommittee will meet on Friday, Sept. 20, from 8:30 a.m. to 12:30 p.m. at the McKimmon Center in Raleigh. The agenda includes updates on NCCARE360, collegiate recovery programs in the state and a panel on veterans’ services. Learn more and register.


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