In this edition:

• Dr. Christine Dean Wins NCNS Membership Raffle
• Neurologists Meet with U.S. Rep. Foxx in Hickory
• Meeting Professionals Recognize NCNS's Nancy Lowe for Excellence
• Medicaid Reform Update
• Physicians Mobilize to Maintain Health Care Quality in NC
• Proposed Legislation Threatens Physician-Patient Communication Regarding Firearm Safety
• Recently Update Workers’ Compensation Fee Schedule Takes Effect July 1
• NCNS Members Attend AAN’s Neurology on the Hill
• NCNS 2016 Annual Meeting, Feb. 19-21
• Traumatic Brain Injury Featured in April 2015 NCMJ

Dr. Christine Dean Wins NCNS Membership Raffle

Congratulations to Dr. J. Christine Dean (Winston-Salem) for winning this year's Renew to Win membership promotion! Dr. Dean's name was pulled from among 86 NCNS members included in the random drawing for the prize. She’s taking home a sweet Harman Kardon Esquire Mini Bluetooth portable speaker. Dr. Dean is the co-founder and Director of Epilepsy Institute of North Carolina. Dr. Dean has been a member of the NCNS since 2000 and she is also a member of the American Board of Psychiatry and Neurology, the Academy of Neurology, the American Medical Association and the North Carolina Medical Society.

Dr. William G. Ferrell (Raleigh), NCNS President, drew the winning name on May 20 at his Raleigh office. If your membership has expired, please take a moment to renew your NCNS membership today.

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Neurologists Meet with U.S. Rep. Foxx in Hickory

Physicians, mid-level providers and office staff from Neurology Associates, P.A. (Hickory) met with U.S. Representative Virginia Foxx on May 7, 2015, to discuss the federal legislative issues that impact physicians in North Carolina. The meeting agenda included issues related to Affordable Care Act implementation, struggles with insurance companies and Medicare, and the American Association of Neuromuscular and Electrodiagnostic Medicine’s intent to pursue a Medicare National Coverage Determination for lab accreditation.

Front row left to right: Connie Maloney, Front Office Manager, Jessica Cain, PA-C, Rep. Virginia Foxx, Roger Austin, PA-C, Amanda Huffman, Office Manager.
Back row left to right: David Skaff, Practice Administrator, Tiffany Wightman, PA-C, Robert Yapundich, MD, Dale Menard, MD, Caroll Koscheski, MD.

In-person constituent meetings are the most effective way to address complex policy issues with your elected officials.

If you would like assistance organizing local meetings with your elected officials, please contact Denna at dsuko@ncmedsoc.org or call us at 919-833-3836. 

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Meeting Professionals Recognize NCNS's Nancy Lowe for Excellence

The NCNS congratulates Associate Director for Meeting & Education Services Nancy Lowe, CMP for being recognized with the Hall of Fame Award on Monday, May 18, by the Meeting Professionals International - Carolinas Chapter (MPI-CC). The chapter Hall of Fame Award recognizes and rewards members who exemplify excellence and enduring service to MPI.

Nancy Lowe, CMP, received the Hall of Fame Award at the MPI-CC Annual Awards Banquet on May 18.

Nancy has demonstrated those qualities (and more!) throughout her nearly 25 years of active membership. She has served in many leadership positions, including MPI-CC Board of Directors (1992-94) and chair positions on the Meeting Planning Committee and Public Relations Committee, among other committee posts. Nancy has made significant contributions to the meeting planning industry as a panelist and guest speaker, and she has contributed articles to industry publications. Nancy also is an active member of Association Executives of North Carolina and makes regular contributions of her time, talent and treasure to charitable organizations. Congratulations, Nancy!

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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 had been introduced as of the end of March. Adding to the mix, a reform proposal from the N.C. Medical Society (NCMS) and N.C. Hospital Association was presented to legislators late last week. 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 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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Physicians Mobilize to Maintain Health Care Quality in NC

The NCNS, 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 the NCNS and nearly a dozen physician specialty societies have formed the North Carolina Coalition to Protect Patients.

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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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Recently Update Workers’ Compensation Fee Schedule Takes Effect July 1

A neurology practice might expect an 18% increase in its overall workers’ compensation revenue when a new fee schedules takes effect on July 1, 2015. Please be sure that your billing staff is prepared to implement the new rates.

The N.C. Rules Review Commission in February 2015 approved administrative rules which provide the fee schedule update. The update was proposed by the N.C. Industrial Commission in November 2014 following many years of advocacy by the NCMS on this issue along with many specialties’ efforts, including neurology, and a lot of work by NCMS Associate General Counsel Conor Brockett, who guided the successful strategy to completion. Neurologist Robert A. Yapundich, MD (Hickory) was a member of the NCMS Task Force working on this issue. One of the forces that propelled this action is the difficulty that workers currently experience when seeking care resulting from on-the-job injuries.

Here are some key services in which neurologists will see increases:

• E&M services will be paid at 140 percent of Medicare. (CPT 99214: currently $103.13, updated $144.59)
• Physical medicine services will be paid at 140 percent of Medicare. (CPT 97750: currently $31.66, updated $45.11)
• Neurology codes will be paid at 153 percent of Medicare. (CPT 95831: currently $31.58, updated $39.98)

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NCNS Members Attend AAN’s Neurology on the Hill

Seven North Carolina neurologists attended the American Academy of Neurology (AAN) Neurology on the Hill event, March 2-3, 2015, to discuss issues impacting physicians with policy-makers. Legislative issues discussed included repealing the sustainable growth rate (SGR) payment formula, funding for the BRAIN Initiative at NIH, and support for the Saving Lives, Saving Costs Act.

• SGR: For more than a decade, physicians worked to repeal the SGR. That goal was achieved on April 16 when the Federal MACRA Act (HR 2) was signed into law.
• BRAIN Initiative at NIH: Participants advocated for a $135 million appropriation in the Federal FY2016 budget for the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative which aims to increase the development and application of new technologies and ultimately improve comprehensive understanding of the brain in action.
• Saving Lives, Saving Costs Act: Neurologists encouraged members of Congress to support legislation that will give providers facing a medical malpractice claim the option of a “safe harbor.”

Issues summaries from the 2015 Neurology on the Hill are available on the AAN website.

The North Carolina delegation to this year's Neurology on the Hill:

• Jane Boggs, MD
• Philip A. Davenport, MD
• Ashley P. Ghiaseddin, MD
• Ihtsham Haq, MD
• Chen Lin, MD
• Leonardo Morantes, MD
• Gaurang M. Palikh, MD
• W. Alan Skipper, CAE

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NCNS members at Neurology on the Hill with Sen. Richard Burr.

NCNS 2016 Annual Meeting, Feb. 19-21

Add this event to your calendar.

For quality, convenience and affordability, look no further than the NCNS Annual Meeting! Start planning now to join us at the Grandover Resort and Conference Center, Feb. 19-21, for the NCNS 2016 Annual Meeting. For room reservations, call the Grandover at 1-800-472-6301.

NCNS members enjoy a discounted registration rate. Not a member? Download the membership application, or call NCNS at 919-833-3836 for additional information.

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Traumatic Brain Injury Featured in April 2015 NCMJ

In an effort to provide ongoing educational update on this important topic, the North Carolina Medical Journal (NCMJ) dedicated its April 2015 edition to TBI in North Carolina. The edition includes two original articles; “Impact of North Carolinas Motorcycle Helmet Law on Hospital Admissions and Charges for Care of Traumatic Brain Injury” and “A Model of Care for the Uninsured Population in Southeastern North Carolina.” It also includes an Issue Brief which details the “state of the state” for TBI issues and challenges in North Carolina, and ten articles with TBI topics that range from sports-related concussions to TBI among war veterans and prehospital care, among others. You can read this issue online.

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