In this edition:

• Notice Regarding BCBSNC Prior Authorization
• Last Call for Abstract Submissions

Notice Regarding BCBSNC Prior Authorization

To: North Carolina Spine Surgeons

For your information, below is a notice issued today from Blue Cross Blue Shield of North Carolina announcing their new prior authorization process for spine surgery and pain management procedures for Medicare Advantage patients.

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January 28, 2016

A New Way of Managing Orthopedic Services for BCBSNC Medicare Advantage Members

Blue Cross and Blue Shield of North Carolina (BCBSNC) has entered into an agreement with OrthoNet LLC., which will begin prior plan approval (PPA) reviews for spine surgery and certain pain management services, including spinal neurostimulators, for BCBSNC Medicare Advantage (Blue Medicare HMOSM and Blue Medicare PPOSM) members beginning April 1, 2016.

About the OrthoNet Program
As a result of a gap identified in outcomes of care expectations for certain spine surgery and pain management procedures, BCBSNC is implementing this new PPA program for our Medicare Advantage members. We will be delegating responsibility for prior authorization of certain spine surgery and pain management procedures (not including trigger point injections) to OrthoNet, LLC for Blue Medicare HMOSM and Blue Medicare PPOSM members as of April 1, 2016.

OrthoNet will be responsible for the prior authorization process and the related clinical determinations. The program is designed to provide a uniform, outcome-based set of criteria for the provision of spine surgery and pain management. There is no impact to network status for providers currently participating in our Medicare Advantage networks. We will provide you with more information about OrthoNet’s services for BCBSNC’s Medicare Advantage members in the coming weeks, as we prepare for this new program to begin in early April 2016.

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W. Alan Skipper, CAE
Executive Director
North Carolina Spine Society

PO Box 27167
Raleigh, NC 27611
Phone: (919) 833-3836
Fax: (919) 833-2023
Email: ncspine@ncmedsoc.org

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Last Call for Abstract Submissions, 2016 NC Spine Society Annual Meeting

The 2016 NC Spine Society Annual Meeting will be held August 12-13 in Cary. The Society invites abstract submissions from members interested in participating in the meeting program. If you have presented to the Society in the past few years, you are encouraged to present a follow-up on your research or long-term study results. Please complete this abstract submission form to submit your entry by February 1.

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2016 NC Spine Society Annual Meeting, Aug. 12-13

Save the date! The 2016 NC Spine Society Annual Meeting will be held August 12-13 at the Umstead Hotel and Spa in Cary.

To secure your hotel accommodations, please call (866) 877-4141 or (919) 447-4000 and reference the NC Spine Society.

The luxurious Umstead Hotel and Spa holds the prestigious AAA Five Diamond Award. The Umstead is situated on twelve wooded acres, just minutes from Raleigh, Durham and Research Triangle Park. The landscape indoors is just as breathtaking as outdoors. The Umstead Hotel and Spa's private art collection was carefully curated, and features the works of renowned local and national artists, including famed glass artist Dale Chihuly. A dedicated art gallery which changes seasonally allows The Umstead to rotate new artists' work into the hotel to complement the permanent collection. The pieces featured in the collection are modern and minimalist, adding to the contemporary, clean design of the hotel.

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