In this edition:

• The Post-SGR World: MACRA Summary & Implementation Timeline
• Carolinas Chapter—AACE Annual Meeting, Aug. 28-30
• Job Opportunity in Wilmington
• Upcoming ICD-10 & Clinical Documentation Workshops from the SC Office of Rural Health
• NC: Medicaid Reform Update
• NC: Proposed Legislation Threatens Physician-Patient Communication
• NC: Physicians Mobilize to Maintain Health Care Quality in NC
• AACE Advocacy News for the Carolinas

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.

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

• Share this save-the-date flyer with your endocrinology colleagues.
• Share the Exhibitor Prospectus with the product and service representatives that call on your practice.

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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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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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