NC Office of Rural Health seeks your feedback on J-1 Visa Waivers.
August 28, 2018 | view this message as a web page


In this edition:

Registration now open!

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NOTICE: J-1 Visa Waiver Stakeholder Meeting

To: North Carolina Otolaryngologists

North Carolina participates in the national J-1 Visa Waiver Program to recruit foreign medical graduates to help meet the state’s access to care challenges. This program was initiated nationally in 1994 to help meet primary care needs and has since expanded to include specialty care. North Carolina has 30 slots allotted annually.

The North Carolina Office of Rural Health (ORH) has the responsibility for administering the J-1 Visa Waiver Program for our state. The ORH has scheduled a Stakeholder Meeting on Thursday, September 13, 2018 to gather feedback and recommendations on how the program may be improved. The session is scheduled for 1:00pm to 4:00pm and will be held at the NC Medical Society headquarters office (222 North Person Street, Raleigh, NC 27601).

The Stakeholder Meeting notice from the ORH provides details on registering and preparation for those who plan to speak at the session. Additional information on the J-1 Visa Waiver Program is available online on the NC DHHS website.

If you plan to attend, please be sure to register in advance. Please also feel free to share this information with interested colleagues.

If you cannot attend and would like to submit comments and suggestions on the J-1 Visa Waiver Program, you may send a letter to:

            Ms. Maggie Sauer
            NC Office of Rural Health
            2009 Mail Service Center
            Raleigh, NC 27699-2009
            Fax: (919) 733-8300

All submissions must arrive by the close of business on Monday, September 17, 2018.

Questions about the session or the program can be directed to Ms. Karen Gliarmis at ORH – (919) 527-6452,

Best Regards,
W. Alan Skipper, CAE
Executive Director
North Carolina Society of Otolaryngology and Head and Neck Surgery
PO Box 27167
Raleigh, NC 27611
Phone: (919) 833-3836
Fax: (919) 833-2023
Email: /

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NC/SC SOHNS Annual Assembly Wrap Up

The NC and SC Societies of Otolaryngology welcomed more than 100 otolaryngologists and allied providers, along with their families, to their 2018 Annual Assembly, held over the weekend of July 20-22, at the Omni Grove Park Inn in Asheville, NC – one of the most attended NC/SC Assemblies ever!

Participants took in exceptional mountain views while enjoying 11 hours of educational programming, networking and social events, and organized recreational opportunities. The meeting program featured Dr. Rick Pillsbury, Otolaryngology Department Chair and Thomas J. Dark Distinguished Professor at the University of North Carolina, and Dr. Greg Murphy, a Greenville urologist and the only physician currently serving in the NC General Assembly.

The meeting also featured a resident paper competition. The Edgar C. Garrabrant, II, MD Award was created in 2003 to pay tribute to a former North Carolina otolaryngologist and outstanding person, Dr. Ed Garrabrant. This award was instituted in his memory to signify the importance the Society places on residency training and on residents’ involvement in this society. The award is presented to the winning resident paper presenter at the Annual Meeting, on those years when the meeting is hosted by the NCSOHNS.

Zainab Farzal, MD (UNC)

The Society is grateful for the residents from Duke, UNC, Wake Forest and MUSC who presented papers. Thank you! Congratulations to UNC's Zainab Farzal, MD on being selected as the 2018 Edgar C. Garrabrant, II, MD Award for her first place paper, "Sex Bias in Otolaryngology Clinical Research: Current Status in the 21st Century."

The meeting also provided members the opportunity to elect officers and directors to the NCSOHNS Board of Directors.

Meet your 2018-2019 NCSOHNS Board of Directors:

Carlton Zdanski, MD
(Chapel Hill)

Richard Alexander, MD

Vice President:
Charles Woodard, MD

Secretary Treasurer:
Christopher Tebbit, MD

Immediate Past President:
W. Cooper Scurry, Jr., MD

Governor to AAOHNS BOG:
Eileen Raynor, MD, FACS

This exceptional meeting would not have been possible without the generous support of sponsors and exhibitors. See below for a complete listing.

Plans are already underway for another excellent NC/SC SOHNS Annual Assembly. We’ll be returning to the Myrtle Beach Marriott Resort and Spa for the 2019 Annual Assembly, August 1-4. Save the date!

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Lawsuit Filed Over Certificate of Need Restrictions

A Winston-Salem surgeon, Dr. Gajendra Singh, has filed a lawsuit against the State of North Carolina challenging the constitutionality of the state’s Certificate of Need (CON) laws, which are among the most restrictive in the country. North Carolina’s CON laws prohibit physicians from opening ambulatory surgery centers and from purchasing diagnostic equipment, thereby contributing to rising healthcare costs, adversely impacting surgical quality and limiting patient access to care.

There have been several attempts over the years at legislative solutions to deregulate the system, which the NCSOHNS has supported, but those measures have yet to gain enough support to make it through the General Assembly. Most recently, Rep. Beverley Boswell (Dare Co.) in June offered an amendment from the House floor calling for a study of CON’s impact on healthcare access. The amendment failed 18-89, highlighting the low level of interest on this issue among House members.

The timeline for how and when this lawsuit will be adjudicated is uncertain.

Media Coverage and Additional Information:

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State Health Plan Takes Aim at Provider Rates

In a meeting on July 18, 2018 with State Treasurer Dale Folwell and key staff of the State Health Plan, NC Medical Society President-Elect Dr. Timothy Reeder (Greenville) encouraged the State to give physicians access to clinical and claims data to help drive down medical costs for the Plan. Citing quality improvements and cost reductions that have been achieved through value-based payment models, Dr. Reeder noted that physicians’ access into patient data is critical to eliminating waste in health care and improving health care quality.

The meeting was held by Treasurer Folwell to allow provider groups an opportunity to share their ideas on how best to reduce the Plan’s medical costs. On May 14, 2018, Treasurer Folwell and the Plan announced their intention to cut provider rates by at least 15 percent in contract negotiations this year with Blue Cross and Blue Shield of NC, the Plan’s third-party administrator. Meeting participants included NCSOHNS Deputy Director Denna Suko, representatives from the NC Medical Society, state specialty societies, and hospitals. You can read the NCMS’s coverage of this meeting and a follow-up letter sent to Treasurer Folwell on the NCMS website.

For the most part, participants urged the Plan to consider value-based incentives that will lead to improvements in patient health, not just cost reductions. Robin Huffman, executive director of the NC Psychiatric Association, noted the importance of treating the whole patient and added that savings can be achieved through behavioral health integration. This sentiment was echoed by several stakeholders. Speaking on behalf of the NC Ob/Gyn Society, Rob Lamme noted the steps that ob/gyns have taken - such as reducing primary cesarean section, improving birth rates through increased access to progesterone therapy, eliminating elective deliveries before 39 weeks, and care coordination for at-risk mothers – which have led to improved health outcomes while also achieving reductions in health care costs. Cody Hand, on behalf of the NC Health Care Association, provided specific examples of patient-centered programs that have led to health improvements and cost reductions. NCMS’s Senior Vice President Chip Baggett reaffirmed the importance of access to clinical and claims data so that physicians can improve health care quality and he emphasized the valuable role that care coordination plays in achieving long-term health improvements.

In response, Treasurer Folwell and the Plan’s executive director Dee Jones indicated that the ideas presented by the provider groups did not produce the immediate savings the Plan needs to be sustainable.

In 2017, the plan spent $2.5 billion providing medical services. The 15 percent cut is expected to generate $300 million in savings per year, for a total savings of $1 billion over the next three years. The Plan provides health care coverage to more than 720,000 teachers, state employees, current and former lawmakers, state university and community college personnel and their dependents, including non-Medicare and Medicare retirees.

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Medicaid Transformation Update

As previously reported, the NC Department of Health and Human Services (DHHS) announced on August 9, 2018, that it has issued a Request for Proposal (RFP) for Medicaid Prepaid Health Plans (PHP) as part of the state’s transition from Medicaid fee-for-service to managed care. In a call with stakeholders, DHHS Secretary Dr. Mandy Cohen noted that this is the largest procurement in DHHS history and she expressed her appreciation for the stakeholders’ collaboration and feedback throughout the process. DHHS has published on its Medicaid Transformation webpage a helpful fact sheet summarizing the key content within the PHP RFP, including program goals and structure.

NC DHHS Medicaid Transformation Webpage

The RFP seeks proposals for standard plans by October 12, 2018. A PHP Evaluation Committee comprised of state employees will be tasked with the selection of four statewide plans and up to 12 regional plans. DHHS will announce the awardees in February 2019. Standard plans will launch in a phased-in approach with select regions going live on November 1, 2019. Full statewide implementation of standard plans is expected on February 1, 2020.

A separate procurement for tailored plans to provide services to beneficiaries with significant behavioral health and/or intellectual/development disability will be conducted at a later date.

This development follows the DHHS’s August 3 announcement that the state has awarded a contract for Medicaid managed care enrollment broker services to MAXIMUS, a government services provider based in Reston, VA, to provide choice counseling, enrollment assistance and education to beneficiaries as they select from a variety of health plans.

Approval of the new program design is required from the Centers for Medicare and Medicaid Services (CMS) before the state’s transition to managed care can be fully implemented. In September 2015, the NC General Assembly directed the transition of Medicaid from a fee-for-service structure to a managed care structure in North Carolina. The state submitted its managed care design plan to CMS in June 2016 in the form of an 1115 waiver. A revised 1115 waiver application was sent in November 2017 and is still under review by CMS. Dr. Cohen did not address the status of the 1115 waiver on the August 9 call with stakeholders.

Conor Brockett, the North Carolina Medical Society’s Vice President of Legal & Regulatory Affairs and Associate General Counsel, offers this quick overview of Medicaid transformation in North Carolina as of July 2018.

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Make a Difference in a Colleague’s Life – Consider a PHP Board Position
Source: NC Medical Society

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. The NCMS 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, (preferred), or by US Mail to PHP Board Applications, North Carolina Medical Society, Post Office Box 27167, Raleigh, North Carolina, 27611 by Aug. 31.

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NCMS LEAD Health Care Conference: Registration Now Open!

The North Carolina Medical Society (NCMS) is pleased to announce its new and not-to-be-missed annual event – the LEAD Health Care Conference. Mark your calendar now for Oct. 18-19, 2018 to be part of this innovative conference focused on Leadership, Education, Advocacy and Discovery – LEAD. The Southern Regional AHEC designates this live activity for a maximum of 10.25 hours of AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This year’s excellent program will feature an update on the state’s Medicaid Transformation presented by NC DHHS Secretary Dr. Mandy Cohen; she is scheduled to speak on Friday morning, October 19, and we encourage you to attend if your schedule permits. For online registration and program details, visit the LEAD Conference website.

abstract submission deadline: Aug. 30

Due to the great success of the previous events, the North Carolina Medical Society (NCMS) is issuing a Call for Scientific Posters for its LEAD Health Care Conference, scheduled for October 18-19, 2018, at the Raleigh Marriott Crabtree Valley. The NCMS’s objective for the poster presentations is to offer medical students, residents and fellows an opportunity to share significant research and clinical work of interest with other fellow clinicians. We encourage all of our up-and-coming physicians to participate in this educational program by submission of a formal application for scientific presentation. The Poster Session will be divided into two categories: Clinical Research and Clinical Vignette.

Prizes will be awarded to the top three students, residents and fellows (first authors) in both categories.

  • 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

Learn more and apply today (PDF).

Applications and abstracts due by August 30, 2018. Questions? Please contact Nancy Lowe, CMP, or (919) 833-3836 ext. 111.

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AAO-HNSF Annual Meeting & OTO Experience, Oct. 7-10 - Registration Now Open!

Registration is now open for the American Academy of Otolaryngology-Head and Neck Surgery Foundation's 2018 Annual Meeting & OTO Experience, scheduled for October 7-10, in Atlanta, GA. This invigorating, thought-provoking, and inspirational event showcases the latest advances in the specialty and exposes you to new research findings, approaches, and treatment options to help you deliver excellent patient care. Visit the AAO-HNSF Annual Meeting website for complete details.

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Welcome New NCSOHNS Members!

The NCSOHNS is delighted to welcome 12 new members since January 1, 2018.

Susan Abernathy, DO / Greeneville, TN
Jeffrey M. Blumberg, MD / Chapel Hill
Nathan H. Calloway, MD / Raleigh
Jeffrey P. Campbell, MD / Lumberton
John D. Clinger, MD / Winston-Salem
Matthew R. Grafenberg, MD / Pinehurst
Eleanor P. Kiell, MD / Winston-Salem
Joshua E. Levine, MD / Charlotte
Hafiz S. Patwa, MD / Winston-Salem
Daniel J. Rocke, MD / Durham
Jefry H. Rosen, MD / Greensboro
Brian D. Thorp, MD / Durham

The NCSOHNS is the state’s only professional association dedicated to representing our specialty and promoting excellence in ear, nose and throat care. With your support and participation, our NCSOHNS is better positioned to present a strong and unified voice on the issues that impact your practice and patients.

For more information, or to join, visit us online at

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Thank You, 2018 Annual Assembly Sponsors and Exhibitors!




Acclarent, Inc
Osiris Therapeutics, Inc.

EXHIBITORS: Arbor Pharma | DePuy Synthes | Entellus Medical | Fuel Medical Group | Hitachi Healthcare Americas Corporation | Hudson Medical LLC | Inspire Medical Systems, Inc. | Integra Lifesciences Corporation | Intersect ENT, Inc. | KLS Martin, LP | Lumenis | Marathon Medical, Inc. | Medicated Topical Sinus Therapy | Medical Mutual | North Carolina Medical Society | Smith & Nephew, Inc. | Stryker | Sun Oncology | Xoran Technologies

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