In this edition:

• Medicaid Reform Update
• Movement on SUDEP, Marijuana Oil Bills
• BCBSNC to Cut Blue Medicare Payments by 2%
• SCNA Annual Meeting – Invitation to NC Neurologists
• Make Way for ICD-10
• New MACRA Resource from NCMS
• Sunshine Act Payments Data for 2014 Now Available
• DHHS Announces Leadership Changes
• CSRS Redesign Launched
• Federal Legislative Update
• Medical Economics Update

Medicaid Reform Update

The next few weeks will be a critical period for Medicaid reform. This is when the great divide between the N.C. House and Senate’s proposed budgets and Medicaid reform plans will be whittled down by a conference committee comprised of House and Senate lawmakers. We need your help to remind legislators that the provider community is poised to improve the long-term health of North Carolinians and the state’s Medicaid budget woes. Will you commit a morning (up to the lunch hour) on any of the following dates for meetings with legislators in Raleigh?

• Tuesday, July 28
• Wednesday, July 29
• Thursday, July 30
• Tuesday, August 4
• Wednesday, August 5
• Thursday, August 6

Sign up to participate by email to Denna Suko, dsuko@ncmedsoc.org.

For a complete review of the Medicaid reform discussion, see the North Carolina Medical Society’s recent Medicaid Reform Update and this comparison table which outlines and compares major aspects of each Medicaid reform proposal and notes the NCMS’s position in each of the key areas.

Your support and participation can have a BIG impact on the future of health care in our state. Please check your schedule and let us know at your earliest convenience if you can participate in meetings with legislators in the coming weeks. Email dsuko@ncmedsoc.org.

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Movement on SUDEP, Marijuana Oil Bills

• The William C. Lindley, Jr. SUDEP Law, House Bill 814, continues to advance through the legislative process. The bill was passed with overwhelming support by the NC House of Representatives on April 27 with a vote of 116 to 1. It is now making its way through the Senate. The measure was reported favorably out of the Senate Health Care Committee on June 30. The bill was reported favorably out of the Senate Judiciary II Committee on July 16. If enacted, the bill will require the Chief Medical Examiner to establish a medical examiner training program that includes training regarding sudden unexpected death in epilepsy (SUDEP) during medicolegal death investigations.
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• The Legislature has made changes to a 2014 law pertaining to hemp oil extract for the treatment of severe epilepsy in children. House Bill 766, Amend CBD Oil Statute, was approved by the Senate on July 1 with a vote of 47-0, and subsequently approved by the House on July 14 with a vote of 112-2. The measure awaits the governor’s signature. The bill amends the exemption for use or possession of hemp extract and permits its use as an alternative treatment for intractable epilepsy without participating in a pilot study.

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BCBSNC to Cut Blue Medicare Payments by 2%

Blue Cross and Blue Shield of North Carolina (BCBSNC) recently announced that a new round of Medicare payment cuts would be implemented on Aug. 1, 2015. According to a BCBSNC notice, “[We] have determined that this alignment is necessary for providing our members continued access to high quality health care at an affordable price.” A payment cut of 2 percent will be applied to all covered services in the BCBSNC Medicare Advantage (Blue Medicare) plan. Read the notice here.

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SCNA Annual Meeting – Invitation to NC Neurologists

North Carolina Neurologists are invited to attend the 2015 South Carolina Neurological Association Annual Meeting, October 2-3, in Charleston, SC. Featured Presentations Include:

• Mobile Technology
• Stroke Intervention
• CIPD
• Negotiating with Insurers
• Neuropalliative Care
• Advances in Epilepsy Management
• Resident Posters

Meeting Registration and Hotel Reservation details are available online at, http://www.scneuro.org/events.html.

Questions can be directed to info@scneuro.org.

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Make Way for ICD-10

Ready or not, here it comes. Although CMS recently announced contingency plans for the transition to ICD-10, including guidance that allows for flexibility in the claims auditing and quality reporting process during the transition, we are urging providers to do your part to prepare for ICD-10 by the October 1, 2015, compliance date. CMS recently released a new ICD-10 Quick Start Guide to help providers on their way to ICD-10 implementation. This guide outlines 5 steps health care professionals should take to prepare for ICD-10 by October 1 compliance date. You can complete parts of different steps at the same time if that works best for your practice.

• Download the ICD-10 Quick Start Guide.
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• The AAN website also offers a variety of ICD-10 resources.
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• Free primers for clinical documentation, clinical scenarios, and other specialty-specific resources to help with implementation are available on the “Road to 10” website.

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New MACRA Resource from NCMS

The NC Medical Society has developed a new resource for physicians going forward in the post-SGR world. The new webpage on the Medicare Access and CHIP Reauthorization Act (MACRA, aka the SGR repeal legislation) is now up and running. This page explains what physicians need to know about quality reporting going forward. More information will be added as details are made available from CMS closer to implementation. Go to the NCMS’s MACRA webpage.

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Sunshine Act Payments Data for 2014 Now Available

The 11.4 million financial transactions reported to CMS as required by the Sunshine Act totaled a whopping $6 billion. The Open Payments data was published by CMS on June 30. This is the second year of Open Payments data that is now available online. The first year’s data, 2013, was published in September 2014. We encourage all physicians to review the site and to ensure the accuracy of payments associated with them. Visit the Open Payments site.

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DHHS Announces Leadership Changes

The NC Department of Health and Human Services (DHHS) announced on May 21 that Deputy Secretary for Health Services and Medicaid Director Dr. Robin Gary Cummings, would be leaving the department to become Chancellor of the University of North Carolina at Pembroke. His last day at DHHS was June 5. DHH Secretary Dr. Aldona Wos also announced that Mr. Dave Richards will replace Dr. Cummings as Deputy Secretary of Medical Assistance and Dr. Randall Williams, a Raleigh obstetrician/gynecologist, will become the Deputy Secretary of Health Services. Read the DHHS press release.

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CSRS Redesign Launched

To help tackle a growing epidemic of opioid abuse, the state’s Drug Control Unit launched its redesigned Controlled Substances Reporting System (CSRS) on March 17, 2015. The new web-interface is intended to provide prescribers and pharmacists with more intuitive control of the site. It also provides new convenient features like password reset, profile update, and prescribing history. In addition, the new system provides easy to read reports that include new information like MME (morphine milligram equivalents) conversion and method of payment. An online, 9-minute WebEx training video is available to allow prescribers and pharmacists to become familiar with the new interface. Go to the CSRS training video.

The following is a statement from the Drug Control Unit on the CSRS redesign.

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The Drug Control Unit is committed to improving the CSRS system in order for it to become a far more valuable clinical tool for patient care while significantly increasing utilization through the continuum of care.

Background
Housed within the DMH/DD/SAS, the North Carolina Controlled Substances Reporting System (CSRS) monitors the prescribing and dispensing of Schedule II-V controlled substances (CS) information including most commonly used opioid analgesics. The CSRS makes comprehensive patient CS prescription history information available to healthcare providers that prescribe or dispense CS.

Challenges
Data disclosure to providers takes place through the CSRS’s website. The current web-interface creates some challenges for prescribers and dispensers while trying to reset their passwords, accessing their prescribing history and managing their delegate accounts.

Solution
The Drug Control Unit has developed a new web-interface that provides prescribers and pharmacists a more intuitive control of the site. It also provides new convenient features like password reset, profile update and prescribing history. In addition, the new system provides easy to read reports that include new information like MME conversion and method of payment.
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Prescription drug and heroin abuse have risen to epidemic proportions and are a significant public health concern. The U.S. House of Representatives Energy and Commerce Committee, Subcommittee on Oversight and Investigations has opened a series of hearings to understand what steps the states are taking to combat opioid abuse and to explore how state and federal policies can maximize and expand evidence-based practices in their communities. See more on the Energy and Commerce Committee website.

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Federal Legislative Update from the American Academy of Neurology

• The AAN submitted comments to the U.S. Senate Finance Committee in response to its request for input on improving the management of chronic care in Medicare. The Academy’s recommendations will be considered by a new working group on chronic care, which will develop a legislative proposal to improve care coordination and quality for Medicare beneficiaries with chronic conditions. Stay up to date on AAN advocacy by reading the Capitol Hill Report.
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• The Furthering Access to Stroke Telemedicine (FAST) Act (HR 2799), which would expand Medicare reimbursements for telestroke consultations to include urban and suburban areas, was introduced in the House of Representatives in June. A Senate version of this bill (S 1465) was introduced in May. The AAN, working jointly with the American Heart/Stroke Association, has been actively meeting with members of Congress and their staff to advocate for this legislation.

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Medical Economics Update

• The Centers for Medicare & Medicaid Services (CMS) released its 2016 Medicare Physician Fee Schedule proposed rule with several positive developments for neurology. The AAN’s continued efforts to develop a proactive relationship with the agency is highlighted by the CMS proposal to fund Medicare payments for advance care planning codes. The AAN has continuously advocated for this coverage and participated in defining and valuing these codes. Additionally, after several meetings between the AAN and CMS this past year, the agency is now offering an opportunity to increase reimbursement for cognitive care and improve accuracy of payments for care coordination.
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• The 2015 Neurology Compensation and Productivity Report and Customizable Results Dashboard is now available. The report and customizable results dashboard represent data from 1,350 neurologists across the US. Access is free for AAN Members who completed the 2015 Neurology Compensation and Productivity Survey. Members who did not complete the survey and nonmembers can purchase access in The AAN Store.
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• Evaluate your preparedness and listen as Jeffrey R. Buchhalter, MD, FAAN breaks down ICD-10 to help you get ready for a successful transition in his previously recorded AAN Practice Management webinar, ICD-10: Are you Ready?

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