Will the NCMS Legislative Cabinet add CON reform to its 2016 Legislative Agenda?
North Carolina Orthopaedic Association (NCOA)
November 20, 2015 | view this message as a webpage 

In this edition:

ALERT: Provider Re-credentialing/Re-verification to be Reinstated by NCTracks

Every Medicaid provider must be re-credentialed. The North Carolina Department of Health and Human Services (NCDHHS) has announced that all Medicaid providers will be notified, either by letter or via their NCTracks secure portal in-box or e-mail, when it is time to re-verify.

NCDHHS has asked the North Carolina Orthopaedic Association (NCOA) and other health care associations to help ensure that all Medicaid providers are aware of this announcement. Additional information is available on the NCTracks website.

All Medicaid providers are required by the Centers for Medicare and Medicaid Services (CMS) to be re-validated (re-credentialed) every five years. The requirement was suspended in North Carolina in 2013 due to a backlog of applications. The process is now being reinstated, and NCDHHS wants all providers to be prepared to complete the re-credentialing process within the 45 days allotted from receipt of your re-credentialing letter or notification.

Payment will be suspended if you fail to complete the process prior to your re-credentialing due date. Providers risk termination of their enrollment in the N.C. Medicaid and Health Choice Programs if they fail to complete the re-credentialing process.

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NCOA President Urges NCMS to Engage on CON Reform Effort

NCOA President Dr. Matthew Olin (Greensboro) was among several physicians who rose to encourage the North Carolina Medical Society (NCMS) to help dismantle barriers to physician-owned operating rooms during the recent NCMS Annual Meeting. The NCMS Legislative Summit drew an audience of more than 50 on Saturday, October 24, in Greensboro. Physicians representing multiple specialties called on the NCMS to help advance Certificate of Need (CON) reform in the 2016 legislative session. The NCMS invited comments and suggestions at the Summit to help shape the NCMS's legislative strategy for 2016. The NCMS Legislative Cabinet will consider its 2016 legislative agenda when it meets in January. The legislature will return to session on April 25, 2016. Physicians can submit comments to the NCMS Board of Directors via this feedback form.

Dr. Olin appealed to the NCMS’s goal of promoting the “triple aim” of better quality, lower costs and greater satisfaction saying, “Many of the changes that we’re experiencing in health care delivery and reimbursement today are being prompted by the move to value. Our new challenge is to provide the best health care in the most cost-effective way while simultaneously elevating patient satisfaction. Expansion of ASCs in North Carolina is in everyone's best interest, especially the patient's.”

Among the physicians in attendance who also asked the NCMS to take a supportive position on CON reform was Dr. Darrell Hester, a Wilmington ophthalmologist. He expressed frustration over CON’s impact on his practice. He noted in particular the "procedure room loophole," which allows hospitals to perform most types of surgeries in procedure rooms without the burdensome requirement of obtaining an additional CON. The NC Urological Association President Dr. David Cook (Winston-Salem) added the urologists’ support for CON reform and urged unified support on this important issue.

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Medicaid Reform Work Begins in Earnest

With three years of work already behind us, this year’s passage of a Medicaid reform plan by the NC General Assembly marks just a mid-point in the effort to address cost-unpredictability of Medicaid in the state budget. Implementation could take up to three years or more, with enrollment beginning as early as January 2018. This sets into motion the even more challenging task of implementing the new design, which allows the state to contract with three statewide managed care companies and up to 10 regional “provider-led entities” (PLEs) comprised of health systems, hospitals and/or physicians. Our number one priority through this process will be to ensure that physicians and patient care are not adversely affected by new policies and regulations.

Transition to the new NC Medicaid has begun in earnest and the first major deadline is quickly approaching. The first of many steps is approval by the Centers for Medicare and Medicaid Services (CMS) of a State Plan Amendment. Rick Brajer, Secretary of the NC Department of Health and Human Services, is required to report to the NC General Assembly on this issue in March 2016. The federal approval process may take anywhere between six to 18 months.

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NCOA Meeting Attendees Braved Stormy Weather and Lived to Tell

The 2015 NCOA Annual Meeting was held October 9-11 in Kiawah Island, S.C. More than 90 physicians braved the heavy downpours which also brought flooding to many parts of the South Carolina coast. Fortunately, the rain and high water did not adversely impact the meeting and all attendees made the trek without incident.

During Saturday’s Awards Banquet, Dr. Matthew Olin (Greensboro) was introduced as NCOA’s new President. Dr. Olin will serve a one year term of office. Dr. Richard Bruch (Durham) was presented with the Honored Surgeon Award and recognized for his many contributions to organized medicine in his local community, at the state level and nationally.

Participants enjoyed 6 hours of educational programming over the course of the weekend-long meeting. Thirty-seven resident and student presenters participated in this year’s Resident Paper Presentation Competition. They were judged on scientific methodology, organization of material, audio/visuals, presentation and clinical relevance. Prizes were awarded to:

  • 1st Place – Mitchell Klement, MD (pictured)
    Duke University Medical School
  • 2nd Place – Marc Angerame, MD
    Carolinas Medical Center
  • 3rd Place – Frank Johannes Plate, MD, PhD
    Wake Forest School of Medicine

The NCOA extends its appreciation to our industry partners for helping to make our 2015 NCOA Annual Meeting successful.

Platinum Sponsors:
Pacira Pharmaceuticals, Inc.
Smith & Nephew Orthopedic, Endo & Wound Care
Think Surgical

Gold Sponsors:
Crosslink / Stryker Orthopaedics
DePuy Synthes

Silver Sponsors:
Sanofi Biosurgery
Southern Medical Surgical
Therapy Partners Consulting
Zimmer Biomet North Carolina

Meeting attendees enjoyed a break in the weather and a family-friendly oyster roast at scenic Mingo Point on Friday evening during the conference.

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Greenville Physician Fills Vacancy in N.C. House

Following the Pitt County Republican Party's nomination of Dr. Gregory Murphy, a Greenville urologist, to replace Rep. Brian Brown in the N.C. House of Representatives, the Governor officially appointed Dr. Murphy on October 19 to finish out the two-year term of office.  Dr. Murphy will be the only physician in either chamber when the General Assembly returns to Raleigh in April 2016. Brown announced earlier this month his immediate resignation to work for U.S. Senator Thom Tillis.

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New NCMS Governance System Makes Board Accountable to YOU

Reprinted with permission from the North Carolina Medical Society

The newly updated North Carolina Medical Society (NCMS) constitution and bylaws, reflecting the House of Delegates recent decisions to make the NCMS Board of Directors directly accountable to the Society’s membership, has been posted on our website for easy reference.

In keeping with this change in governance, following is the schedule of upcoming Board meetings, which will now be held throughout the state to make NCMS leadership meetings more accessible to the membership wherever they practice. Watch the NCMS Bulletin for details on each meeting as the date approaches.

  • Jan. 8-9, 2016 in Raleigh
  • March 18-19, 2016 in Wilmington
  • May 13-14, 2016 in Cary
  • July 15-16, 2016 in Charlotte
  • Sept. 15-18, 2016, NCMS Annual Meeting/M3 Conference in Greensboro
  • Dec. 3, 2016 in Raleigh (tentative)

If you have an issue you’d like to bring to a Board member’s attention in the meantime, please go to the NCMS website to contact the NCMS Board.

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There's an App for That! AAOS Introduces "OrthoGuidelines" App

The AAOS OrthoGuidelines App provides users with a number of options enabling them to effortlessly scan through AAOS evidence-based products, such as clinical practice guidelines and appropriate use criteria. Introduced in March 2015 as a web-based app, OrthoGuidelines is now available as a free native app download on Android and Apple smartphones and tablets.

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2016 NCOA Annual Meeting Save the Date!

The 2016 NCOA Annual Meeting will be held October 7-9 at the Pinehurst Resort. For reservations, call (800) 487-4653. For more information, contact the NCOA at (919) 833-3836 or nlowe@ncmedsoc.org.

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