NCMS Morning Rounds 9-23-19

Celebrate the Fall Equinox and enjoy your

NCMS Morning Rounds!

Sept. 23, 2019

NCMS Weekly Legislative Summary

The big health care news out of the NC General Assembly last week was the House Health Committee’s passage of HB655 – NC Health Care for Working Families. This legislation, which the NCMS has supported as a way to increase the number of people eligible for health insurance, was amended in the committee. Read about what this legislation does and its history over this legislative session.

It is unclear what the next stop will be for this bill – perhaps the House Rules Committee, or possibly the House floor. Please contact your elected representatives to let them know how this bill could be beneficial for your patients and your practice.

In other legislative news also noted in an earlier NCMS Morning Rounds, NCMS member Greg Murphy, MD, a Greenville urologist, was sworn in to the US House of Representatives last Tuesday and will now represent North Carolina’s 3rd Congressional District. Congratulations, Dr. Murphy!

Keep up with everything that’s happening at the General Assembly throughout the week on the NCMS Legislative Blog.

Medicaid Provider Directory Updates

The NC Department of Health and Human Services and NC Medicaid recently published updates to several issues involving the Medicaid Managed Care Enrollment Broker’s Provider Directory. Open enrollment for the new managed care plans continues into October and ends Dec. 13 in all regions. Difficulty in finding proper listings has been frustrating to some patients looking to enroll as well as physician practices that had signed on with the managed care health plans.

The latest NC Medicaid fact sheet states that “some of the issues that have been encountered are due to a lack of network maturity. The Health Plans are in the process of building their provider networks across their regions. Other issues are the result of the functions built into the Provider Directory. Because they range in cause and complexity, the timeline to address issues will vary.”

Read the update from NC Medicaid.

NC DHHS has delayed the implementation of Medicaid managed care. Now, the new program is slated to launch statewide on Feb. 1, 2020.

Below is the new timeline. Use this region map for reference:
Ongoing: Open enrollment for beneficiaries in regions 2 and 4 continues.
Oct. 1: Enrollment packets mailed to beneficiaries in regions 1,3,5,6.
Oct. 14: Open Enrollment Begins for beneficiaries in regions 1,3,5,6.
Mid-November: Provider contracts must be signed for inclusion in auto-assignment (watch your NCMS Morning Rounds for more on this.)
Dec. 13: End of open enrollment for ALL REGIONS.
Dec. 16: Auto-assignment to PHPs for ALL REGIONS.
Dec. 19: PHP auto assignment to Primary Care Providers for ALL REGIONs.

Reminder: Friday is the Deadline to Comment on Proposed QPP Rule

Feedback on proposed changes to the Quality Payment Program (QPP) are due to the Centers for Medicare and Medicaid Services (CMS) by this Friday, Sept. 27. The proposals include changes to the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs).

Learn more about the Quality Payment Program. Understand the proposed changes better with these resources:

  • Fact Sheet – Offers an overview of the QPP proposed policies for 2020 (Year 4) and compares these policies to the current 2019 (Year 3) requirements.
    MIPS Value Pathways Webpage – Provides an overview of the proposed MVPs framework, how to comment, and where to find more information.
    MIPS Value Pathways Overview and RFI Fact Sheet – Provides an overview of the proposed MVPs framework and lists the Request for Information (RFI) questions on MVPs.

In the News

Most Providers Don’t Screen for Social Determinants of Health, Modern Healthcare, 9-18-19

Learning Opportunity

Wake AHEC offers the NC Integrated Care Symposium on Nov. 7 in Raleigh. This one-day symposium is designed to enhance integrated care knowledge and build skill sets for those working in primary care settings providing integrated behavioral health services. Speakers include NC Department of Health and Human Services Secretary Mandy Cohen, MD. Learn more and register.

Registration closes Wednesday for NCMS’ LEAD Health Care Conference!

Register today!


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