Current Bulletin

  • NC DHHS Takes Next Step in NC Medicaid Transformation

    Mandy K. Cohen, MD, MPH – Secretary, NC DHHS

    Last week the NC Department of Health and Human Services (NCDHHS) issued its much anticipated request for proposal (RFP) outlining the requirements for managed care organizations seeking a state contract to serve North Carolina’s Medicaid beneficiaries. Read the RFP.

    This is the next step in a process that began in 2015 with passage of legislation moving the state’s Medicaid program to managed care. Many organizations, including Carolina Complete Health, a partnership between the North Carolina Medical Society (NCMS), the NC Community Health Center Association and Centene Corporation, are expected to submit proposals to the state by the Oct. 12, 2018 deadline. An evaluation committee made up of state employees with expertise in managed care will evaluate the proposals and award four statewide contracts for pre-paid health plans (PHP) in February 2019.  The new managed care system will be phased in regionally beginning in November 2019.

    During a conference call with health care providers on Aug. 9, the day the RFP was issued, NC DHHS Secretary Mandy Cohen, MD, MPH, outlined several key points and answered questions, including that:

    • This RFP, the largest procurement in the department’s history, is the result of much input from the health care community, including more than 1,000 submitted comments on the transition to managed care. [The NCMS has worked closely with NCDHHS since 2015 to help protect members’ interests throughout the process.]
    • Each PHP will be subject to rigorous oversight including ensuring adequate networks and timely payments to providers.
    • The draft rate book, which may be reviewed here, is set by NC DHHS and ensures 100 percent of the current Medicaid fee-for-service rates.
    • Credentialing will be centralized by the state. It is expected that practices will contract with multiple PHPs and participate in multiple networks but physicians and PAs will not have to go through the credentialing process with each PHP they contract with.
    • There will be one pharmacy formulary for the state.

    To learn more about the scope of services each PHP must offer as well as the credentialing process and the draft rate book for the capitated payments for patients visit the state’s Medicaid Transformation webpage.

    As a physician or PA who would like to continue to see Medicaid patients, now is the time to familiarize yourself with what is being asked of the contract contenders in the RFP. The various managed care plans vying for one of the contracts currently are seeking physicians and PAs to join their networks, and Dr. Cohen encouraged practices to have ongoing discussions with each of these organizations.

    For a helpful overview of the state’s move to managed care read NCMS’ Vice President of Legal & Regulatory Affairs and Associate General Counsel, Conor Brockett’s summary of the process thus far.

    Throughout the fall, NC DHHS also is offering training to help you understand the state’s Advanced Medical Home model as the primary vehicle for delivering local care management at the transition to Medicaid managed care takes place. Learn more about the upcoming statewide webinars as well as the regional training forums and register.

     
  • The LEAD Health Care Conference Offers 10+ Hours of CME — Registration is NOW OPEN!

    Join us October 18-19 at the Raleigh Marriott Crabtree Valley for two days of learning, networking and fun on the town, plus a gala event to celebrate our NCMS LEADers — physicians and PAs making a difference in health care and our communities. Plus, the conference has been approved for 10.25 hours of AMA PRA Category 1 Credits™.

    Again this year we will feature the best and brightest — our Leadership College scholars will speak on a variety of timely topics throughout the conference. Modeled on the quick and insightful TEDTalks, you won’t want to miss our MEDTalks. Watch the video if you need further convincing.

    Review the agenda, speakers and fun planned.

    Take advantage of early bird savings and REGISTER TODAY.
     
  • Calling All Students, Residents and Fellows – Enter the NCMS’ 6th Annual Scientific Poster Session

    Share your clinical work and research, network with your peers and vie for great prizes by participating in the North Carolina Medical Society’s (NCMS) 6th Annual Scientific Poster Session at the 2018 LEAD Health Care Conference, Oct. 19 in Raleigh.

    The Poster Session will be divided into two categories:  Clinical Vignette and Clinical Research. Prizes will be awarded to the top three students, residents and fellows (first authors) in both categories. Get the full details and rules by downloading the application (PDF).

    • 1st prize=$200 per student/resident/fellow author in both categories, for a total of six awards
    • 2nd prize=$100 per student/resident/fellow author in both categories, for a total of six awards
    • 3rd prize=$50 per student/resident/fellow author in both categories, for a total of six awards

    The deadline for application and abstract submissions is August 30, 2018. For questions regarding the Poster Session, please contact Nancy Lowe at the NCMS.

     
  • Learn More about Team Building and Leadership with This Month’s Lunch & Learn Webinar

    LUNCH & LEARN WEBINAR: TEAM BUILDING AND LEADERSHIP

    featuring Kristina Natt och Dag, PhD, MA, and Gerri Mattson, MD, FAAP, MSPH

    TUESDAY, AUG. 28 from noon to 1 pm

    Working in teams has been shown to improve organizational effectiveness and increase employee engagement and motivation. But what makes a team successful and how do you, as a leader, build those teams? In health care, a good team means all members understand, believe in and work towards the shared purpose of caring and working for patients, whether as a clinician or non-clinician. Because strong teams do not develop and evolve by themselves, leadership is crucial to their success. In this webinar we will talk about some core team characteristics  and how all teams move through different stages of development. Teams are at their most productive where there is openness and trust, with members working to their own strengths. But how do they get there?

    Register now for this free webinar featuring Dr. Natt och Dag and Dr. Mattson as they help you address the challenges of building health care teams, and the leadership skills necessary for success. Before the webinar, submit the personal and professional challenges you have faced when leading teams so the speakers can tailor this session to better help you.

     
  • NC Court of Appeals Considers Time Limitations on Medical Malpractice Case

    Last Wednesday, the North Carolina Court of Appeals heard oral arguments in Glover v. Charlotte-Mecklenburg Hospital Authority, a case with implications for how long a plaintiff has to file a medical negligence lawsuit.

    The case involves a couple who claim their obstetrician/gynecologist misinterpreted the results of the pregnant woman’s 2011 genetic test as negative for cystic fibrosis, when in fact the test results were positive. The woman delivered a healthy baby in 2011 and continued to visit the same physician until her second child was born in 2015. This child has cystic fibrosis.

    The couple filed suit against the physician, hospital, and other defendants in 2017, alleging ‘wrongful conception and negligent infliction of emotional distress resulting from lack of informed consent.’ They seek reimbursement for the ‘extraordinary expenses’ of raising a child with cystic fibrosis. The lower court dismissed the case because the suit was filed after the four year statute or repose for medical malpractice cases had expired.

    The couple appealed the dismissal, arguing that since the physician continued to care for his patient, there was a ‘continuing course of treatment’ that acted to extend the statute of repose.  The oral arguments before the Court of Appeals centered on whether this ‘continuing course of treatment’ doctrine applies under these facts, and thus, whether the statute of repose bars the Glovers’ claims.

    The North Carolina Medical Society (NCMS) filed a an amicus curiae, or “friend of the court,” brief in this case, arguing the ‘continuing course of treatment doctrine’ should not apply here and that the lower court correctly dismissed the case as untimely. The NCMS brief also notes that North Carolina law prohibits recovery of child-rearing expenses, including extraordinary cost, in a ‘wrongful conception’ claim.

    NCMS staff attended the oral arguments to hear the judges’ questions, which did not betray a leaning one way or the other on whether they will allow this case to proceed. Watch your NCMS Bulletin for the Court’s ruling on this case and its implications for other medical malpractice claims.

     
  • Results of August Snapshot Survey on NCMS Advocacy

    Thank you to everyone who completed the North Carolina Medical Society’s (NCMS) 5-question Snapshot survey this month on the issues that are most important to you as we prepare for the 2019 Legislative Session. And congratulations to the lucky winners of our $100 Amazon gift cards: Labron Chambers MD MBA FASA; Hillary Thomas, DO, MBA; Daniel Zirkman, MD; Nicole D’Andrea, MD, MPH, FACOG; Merritt Seshul, MD, FACS, FAAOA.

    Here’s a quick analysis of the survey results:

    • Scope of practice issues are the most important legislative priority to respondents followed closely by curbing the opioid abuse epidemic. Other legislative issues of importance to members that were not listed specifically , but noted in open responses included: Medicaid reform and Medicaid expansion as well as challenges around sharing health information electronically and electronic health records.
    • In the regulatory realm, working to prevent the 15 percent provider rate cut for the state health plan ranked most important to respondents, with proper implementation of Medicaid reform next in line.
    • More than a third of those responding said they always use the NCMS’ candidate endorsements as their guide in state judicial races. Most found our endorsements valuable as one source to help inform their vote.
    • A healthy proportion (18 percent) of respondents said they were planning to attend a White Coat Wednesday during the upcoming session, although the majority could not make a commitment at this point. The legislative session begins in January. If you would like to learn more about White Coat Wednesday or sign up now, please visit our White Coat Wednesday page.

    Thank you again to those who shared their views through this survey. NCMS staff and leadership rely on this important source of member input for planning and as part of the decision-making process. Our next Snapshot will be emailed to all NCMS members on Wednesday, Sept. 5. You will have 24-hours to respond to the quick 5-question survey on an issue of importance to the medical community. Plus, by participating you are eligible for valuable prizes!

     
  • Review the Slate of Candidates for NCMS Leadership Positions

    The initial slate of candidates for the North Carolina Medical Society (NCMS) Board of Directors, AMA Delegation and the Nominating and Leadership Development Committee was published on July 18. Additional nominations for open positions will be accepted until this Saturday, Aug. 18, 2018.

    The final slate of candidates will be published Sept. 27, 2018. As in the previous two years, all NCMS members in good standing are eligible to cast their votes for the candidates of their choice via electronic ballot starting Oct. 4, 2018.

    This year several of the seats are competitive races, so be an informed voter and watch your Bulletin and email for election updates.

    Please review the biographies and statements for each candidate at our NCMS Election Headquarters page.

    More information about the election process will be provided once the final slate is determined. If you are interested in an open position, contact Evan Simmons for more information: esimmons@ncmedsoc.org; (919) 833-3836 ext. 147.

     
  • NCPHP Board Nominations Accepted Until Aug. 31

    The North Carolina Medical Society (NCMS) appoints five physicians to the Board of Directors of the North Carolina Physicians Health Program (NCPHP). There currently is one vacancy on the NCPHP Board to be filled by an appointee of the NCMS, which is currently accepting applications from physicians interested in serving on the PHP Board of Directors.

    The NCPHP offers an experienced team of experts to assist health care providers with substance use disorders, mental health issues, burnout, communication problems and other issues that may affect their ability to deliver optimal care and services to their patients. NCPHP’s expert evaluation, monitoring and treatment referral programs also provide the basis upon which they advocate for participants to their employers, partners, hospitals, insurance panels and licensing boards. To learn more about the important work of this organization, visit the NCPHP website.

    Physicians interested in an NCPHP Board position should complete the application form and return it to Evan Simmons, esimmons@ncmedsoc.org (preferred), or by US Mail to PHP Board Applications, North Carolina Medical Society, Post Office Box 27167, Raleigh, North Carolina, 27611 by Aug. 31.

     
  • Do You Know a Colleague Who Deserves an Award?

    Each year the North Carolina Medical Society (NCMS) recognizes a physician and a layperson who have made significant contributions to health care. Do you know someone deserving of such an award?

    Now is the time to nominate an outstanding colleague for the E. Harvey Estes, Jr., MD, Physician Community Service Award or the John Huske Anderson Award.  These awards will be presented at the LEAD Health Care Conference on Oct. 19 in Raleigh.

    The E. Harvey Estes, Jr. MD, Physician Community Service Award recognizes the many and varied services rendered by physicians to their communities apart from their practice of medicine.  The recipient must be a physician licensed in North Carolina; must not have received the award previously; and must have compiled an outstanding record of community service, which, apart from his or her specific identification as a physician, reflects well on the medical profession.

    Nominations must be received by Sept. 17, 2018. You may send the completed nomination form by scanning it and emailing it to Evan Simmons, esimmons@ncmedsoc.org, faxing it to her attention at 919-833-2023 or mailing it to her at P.O. Box 27167, Raleigh, NC 27611. If you have questions, please contact Evan via email or by calling 919-833-3836 x147. Download the form here.

    The John Huske Anderson Award is given annually to a layperson whose contributions have had a positive impact on the medical profession and public health. The award honors Mr. Anderson’s service to medicine and the Society, having served as NCMS legal counsel from 1937 until his retirement in 1983. Nominations must be made by an NCMS member.

    The deadline for submissions is Sept. 17, 2018. You may send the completed nomination form by scanning it and emailing it to Evan Simmons, esimmons@ncmedsoc.org, faxing it to her attention at 919-833-2023 or mailing it to her attention at P.O. Box 27167, Raleigh, NC 27611. If you have questions, please contact Evan via email or by calling 919-833-3836 x147. Download the nomination form here.

     
  • AMA’s Campaign School Offers An Insider’s Look at the Political Campaign Process

    The 2018 AMPAC Campaign School will take place Dec. 6-9 at the AMA Office in Washington, DC. The school is targeted to AMA members, their spouses, residents, medical students and medical society staff who want to become more involved in the campaign process.

    Running an effective campaign can be the difference between winning and losing a race. That’s why the AMPAC Campaign School is designed to give you the skills and strategic approach you will need out on the campaign trail. Our team of political experts will teach you everything you need to know to run a successful campaign or be a sought-after volunteer.

    During the two and a half day in-person portion of the program under the direction of our political experts, participants will be broken into campaign staff teams to run a simulated congressional campaign using what they’ve learned from the pre-school workbook activities and videos along with the group sessions on strategy, vote targeting, social media, advertising and more.

    Registration is now open but hurry, deadline to register is Sept. 21.

    For more information on the 2018 Campaign School, e-mail politicaleducation@ama-assn.org or call (202) 789-7455.