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May 11, 2015 |  view this message as a web page   

In this edition:

The Post-SGR World: MACRA Summary & Implementation Timeline

To help physicians prepare for the post-SGR world, the American Medical Association (AMA) has prepared a section-by-section summary of the recently passed “Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)” and a companion implementation timeline. You can access the documents here:

  • The MACRA Summary is a section-by-section summary of the new law.
  • The Timeline Highlights is a chronological list that shows when some of the major provisions will take effect.

The Federal MACRA Law, H.R.2, was passed by the U.S. House of Representatives on March 26 (by a vote of 392 to 37) and the Senate on April 14 (by a vote of 92 to 8), and signed into law on April 16, 2015. The law permanently repeals the sustainable growth rate (SGR) formula and stabilizes Medicare payments for physician services with positive updates from July 1, 2015, through the end of 2019, and again in 2026 and beyond. It replaces Medicare’s multiple quality reporting programs with a new single “MIPS” program that makes it easier for physicians to earn rewards for providing high-quality, high-value health care, and it supports and rewards physicians for participating in new payment and delivery models to improve the efficiency of care while preserving fee-for-service as an option. In addition, it preserves the current 10-day and 90-day global periods for over 4,000 surgical service codes that Medicare had planned to unbundle.

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Carolinas Chapter—AACE Annual Meeting, Aug. 28-30

Add this event to your calendar.

The Omni Grove Park Inn

The Annual Meeting of the Carolinas Chapter of the American Association of Clinical Endocrinologists is the premier educational and networking event for endocrinologists in the Carolinas.  Start planning now to be part of the CC-AACE 2015 Annual meeting, Aug. 28-30, at the historic Omni Grove Park Inn. For room reservations, call 800-438-5800 and reference CC-AACE.

Your participation and vendor support are critical to our annual meeting’s ongoing success. Here's what you can do to help:

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Job Opportunity in Wilmington

Join a vibrant multi-specialty group committed to collaborative quality care. Wilmington Health Endocrinology consists of five physicians and two advance practitioners. We offer support services in diabetes education and management and physician-monitored weight loss. Position includes inpatient and outpatient responsibilities. Experience in thyroid U/S certified (ECNU) as well as the ability to perform your own U/S and biopsies a plus! And you’ll live where others vacation—beautiful Wilmington, NC.

For more information contact Alysa Bostick, Provider Relations at abostick@wilmingtonhealth.com or 910-520-3818.

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Upcoming ICD-10 & Clinical Documentation Workshops from the SC Office of Rural Health

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NC: Medicaid Reform Update

As you’ve likely gathered from recent coverage and discussion, Medicaid reform continues to be a BIG issue of debate at the N.C. General Assembly. And, the wide divide between the competing proposals does not seem to be narrowing.

To give you an idea of how expansive the issue has grown, a recent article in the Winston-Salem Journal notes all the various bills impacting Medicaid that have been introduced thus far. Debate on any of these of these measures has yet to be placed on the calendar, so it is still too soon to tell how the discussion will play out.

The North Carolina Medical Society (NCMS) continues to provide leadership on this issue in partnership with a coalition of specialties. In an op-ed published by The News & Observer on April 15, NCMS CEO Robert Selligson's "Why managed care is not the answer for North Carolina" presents the facts about how the move to managed care has worked in other states, why a provider-led solution is the only real opportunity for true reform, and what the NCMS is doing to present legislators with a homegrown solution.

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NC: Proposed Legislation Threatens Physician-Patient Communication Regarding Firearm Safety
Reprinted with permission from the North Carolina Medical Society

New Regulation of the Practice of Medicine!

A bill pending consideration by the North Carolina House Appropriations Committee, HB 562, Second Amendment Affirmation Act, includes two unprecedented provisions in Section 15 of the bill.

The first provision would prohibit a physician from asking a patient about lawful gun ownership in any written form. While technically a physician could still verbally discuss lawful gun ownership with a patient, this unprecedented prohibition would constitute a dangerous new level of government intervention in the doctor-patient relationship. This intrusion into physician communication with the patient eliminates an important risk-evaluation tool for the physician.

Second, should a physician discuss with a patient the risks of guns in the home where children reside, Section 15 would prohibit a physician from sharing any information about that inquiry and the patient response with a government official or agency.

  1. This would prohibit the physician from complying with a lawful subpoena for medical records, should the physician have recorded any information about gun ownership in the record. If disclosed, the doctor could face a penalty from the NC Medical Board of up to $500.00 per violation.
  2. It would also prohibit sharing with law enforcement a patient's communication with the doctor indicating that the patient intended to commit suicide with a gun lawfully owned.
  3. Finally, this would make the sharing of medical records unlawful for those patients—including mental health patients—with Medicaid, Medicare or State Employee Healthcare insurance plans, if those records include any information about lawful gun ownership.

Please contact members of the N.C. House Appropriations Committee to make your voice heard. Contact your representatives and tell them to stay out of the physician-patient relationship and vote to remove Section 15 from HB562

Take Action Now - Email Your Representatives

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NC: Physicians Mobilize to Maintain Health Care Quality in NC

The Carolinas Chapter-AACE, in partnership with the North Carolina Coalition to Protect Patients, urges you to TAKE ACTION TODAY in response to recently introduced legislation that would remove the physician supervision requirements for many non-physician practitioners. Multiple bills filed at the North Carolina General Assembly this session would do just that.

Among the most aggressive of these proposals is one introduced by Senator Ralph Hise, SB 695, Modernize Nursing Practice Act, which enhances the already broad authority of the North Carolina Board of Nursing. SB 695 proposes to include adding advanced practice registered nurse (APRN) licensure for nurse practitioners, certified nurse midwives and clinical nurse specialists. Here’s a snapshot of the bill text:

The section highlighted above, "Collaborating with other health care providers," equates to independent practice! The value of physician supervision and the contributions to patient safety made by physicians are being questioned. Please contact your legislator and tell them the important role of physician supervision in protecting patients in our healthcare system.

Take Action Now >>

When it comes to protecting North Carolina patients, there’s no sense arguing over who can provide the highest quality of care. The best solution is for healthcare professionals to continue working together under the leadership and supervision of a trained physician. That’s why more than a dozen physician specialty societies have formed the North Carolina Coalition to Protect Patients.


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AACE Advocacy News for the Carolinas

Contact Federal Lawmakers to Co-Sponsor Diabetes Commission Bill

The National Diabetes Clinical Care Commission Act (H.R. 1192/S. 586), has been re-introduced in the 114th Congress by Representative Pete Olson (R-22nd-TX) and Representative Dave Loebsack (D-2-IA) in the House and Senator Jeanne Shaheen (D-NH) and Senator Susan Collins (R-ME), the Co-chairs of the Senate Diabetes Caucus, in the Senate. Carolinas-AACE Chapter members know that passage of this legislation is a high priority for AACE.

Members of the Carolinas Chapter-AACE are urged to go to the AACE Legislative Action Center to send an email to their federal lawmakers requesting co-sponsorship of H.R. 1192 and S. 586. AACE specifically requests that chapter members reach out to the offices of Senator Richard Burr (R-NC), Senator Thom Tillis (R-NC), Senator Lindsey Graham (R-SC) and Senator Tim Scott (R-SC) to request co-sponsorship of S. 586. The support of these senators representing the Carolinas Chapter will be critically important to move the legislation through the Senate in the 114th Congress.

AACE was joined by 45 national groups representing physicians, allied health professionals, patients, community health organizations and industry in sending a letter of support for the legislation to the House and Senate bill sponsors. AACE is proud that the entire diabetes community has again come together to support the legislation, including the American Diabetes Association, American Association of Diabetes Educators, Endocrine Society, JDRF, Pediatric Endocrine Society, and the Diabetes Advocacy Alliance. The re-introduced legislation also highlights the chronic diseases and conditions that are often complications of diabetes. Groups that have also recognized the value of this initiative and have endorsed the legislation include the American Academy of Family Physicians, American Podiatric Medical Association, American Society for Metabolic and Bariatric Surgery, American Society of Nephrology and The Obesity Society, among others. Additionally a number of our Corporate-AACE Partnership (CAP) members have endorsed the bill.

H.R. 1192/S. 586 establishes a new commission to evaluate federal diabetes activities and recommend new approaches to improve the quality of diabetes care. The Commission is intended to help the federal government address diabetes in a more effective, fiscally responsible manner by reviewing activities currently spread across more than 35 federal agencies and eliminating duplication, inconsistency, and identifying gaps in current diabetes efforts.

AACE advocacy on the National Diabetes Clinical Care Commission Act has also raised the profile and visibility of AACE on Capitol Hill as the organization representing diabetes experts and promoting a focus on diabetes in federal prevention and wellness activities and in chronic disease management.

Other federal diabetes legislation that AACE is supporting:

  • Protecting Access to Diabetes Supplies Act of 2015 (H.R. 771) – This legislation enforces and strengthens provisions of the National Mail Order Program for Diabetic Testing Supplies that is part of Medicare’s Competitive Bidding Program. Specifically, the bill 1) requires suppliers to maintain and offer an adequate inventory of each of the types of testing supplies included in the supplier’s bid; and 2) prohibits contract suppliers from influencing or incentivizing patients to switch their current brand of glucose monitor and testing supplies to another brand, protecting patient access to preferred diabetes testing systems and supplies. The bill contains a number of other safeguards. Many of these issues were highlighted at the AACE/ACE Glucose Monitoring Consensus Conference in September, 2014.
  • Medicare CGM Access Act of 2015 (H.R. 1497/ S. 804) – Legislation from the 113th Congress was re-introduced that would provide Medicare coverage for continuous glucose monitors (CGMs) to qualified beneficiaries. The current lack of Medicare coverage for CGMs is another issue that was highlighted at the AACE/ACE Glucose Monitoring Consensus Conference.
  • Medicare Diabetes Prevention Act (S. 1131/H.R. 2102) - Introduced on April 29th, this legislation will provide Medicare coverage for qualified beneficiary enrollment in a national diabetes prevention program.

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