A glimpse into the legislative "short session."
North Carolina Orthopaedic Association (NCOA)
March 4, 2016 | view this message as a webpage 

In this edition:



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Primary Elections Will Be Held March 15 & June 7
Early voting is available through March 12.

Vote early. North Carolina will hold its Presidential Preference Primary and other statewide primary elections on March 15, 2016. If you cannot make it to the polls on March 15, early voting is available now through Saturday, March 12. Find an early voting site in your county through the State Board of Elections website.

The primary election for US House of Representatives will be held on June 7, 2016.

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Medicaid Reform Progress, CON and Other Key Legislative Priorities
Four reasons we expect this short session to be an eventful one.

There’s a surprising number of policy items of particular interest to orthopaedists and other physicians that may be brought for consideration in the upcoming 2016 “short session” of the NC General Assembly. When the legislature convenes on April 25, it is likely that details regarding Medicaid reform implementation will top the legislative agenda. Certificate of Need reform, nurses’ scope of practice and step therapy (or “fail first”) pharmaceutical coverage policies are also likely to be considered in 2016. Following this article you will find two opportunities to increase your engagement during a time when your help is needed most. Here is what’s going on in the legislature and why we’re asking for your participation…

The biggest news in Raleigh this week concerns Medicaid reform implementation and whether progress is being made quickly enough to satisfy a legislature that is anxious to transfer financial risk for the program out of the state budget. NC DHHS Secretary Rick Brajer and Dee Jones, chief operating officer at the new Division of Health Benefits – a new NC Medicaid agency created by last year’s Medicaid reform law – presented the details of the state’s CMS waiver application to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice, and responded to legislators’ questions. All appears to be running on schedule, though there is still much work to be done. Jones described the current status as the “end of the beginning.” According to Brajer, the next steps include public hearings and a final report to the legislature before the waiver application is submitted to CMS on June 1. Please tune into today’s Bowtie Briefing for a video update from NCMS Director of Legislative Relations Chip Baggett.

The NCOA and its coalition partners are gaining ground on achieving Certificate of Need (CON) reform. We continue to have the strong support of the Senate leadership, and are now working with a group of influential legislators in the House to map a possible route for CON reform passage in the short session. Our support is also growing outside of the legislative building. Several conservative advocacy groups are now committed to advancing this issue. We are united around the key messages of lower costs, better quality and happier patients that would come with greater access to ambulatory surgery centers.

Step therapy (or “fail first”) pharmaceutical coverage policies will continue to be the focus of a new House Select Committee in the weeks leading up to the 2016 session. A third meeting of the committee is scheduled for March 23. In 2015, a bill was introduced by Rep. David Lewis (R-Harnett) to regulate the practice by requiring insurers to develop evidence-based protocols that include endorsement by an independent panel of experts. The bill was referred to the House Rules Committee. House Speaker Tim Moore (R-Cleveland) appointed a 15-member committee to study step therapy practice in North Carolina. The committee’s findings and recommendations will be presented when the legislature reconvenes for the short session.

Nurses in North Carolina are attempting to pass an unprecedented scope of practice expansion for nurses in North Carolina. On February 9, Christopher Conover, PhD provided legislative testimony recommending the relaxation of supervision requirements for all Advanced Practice Registered Nurses (APRNs) in NC. This recommendation was based on a meta-analysis study paid for by the North Carolina Nurses Association. The study, which was premised on the expectation of a physician shortage, speculated that APRNs are the solution to such a shortage. The conclusion asserted that relaxing supervision would have a three-fold benefit of (1) improving access, (2) improving quality and (3) lowering cost. Please watch for information from the NCOA and the NCMS regarding opportunities to communicate with your legislators about the resources needed to provide care to North Carolina’s citizens.

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Orthopaedic Advocacy Opportunities in Raleigh, May 18 & May 25
Register for one of two dates.

Sign up now to participate in a 2016 Orthopaedic White Coat Wednesday! Orthopaedists from across the state will gather in Raleigh on two Wednesdays in May - May 18 and 25 – to advocate for Certificate of Need reform and other important policy issues impacting orthopaedic practice and patient care. The schedule runs from 7:30 am to 1:00 pm (lunch is provided). Following a legislative briefing at the NC Medical Society, participants will meet with legislators and attend legislative committee hearings at the NC General Assembly. We’ll have you on the road home by 1:00pm (earlier, if necessary).

Complete this online sign up-form to participate on the May 18 and/or the May 25 Orthopaedic White Coat Wednesday. Not available either date? You can also use this form to indicate the date that works best for your schedule.

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Decline in PAC Support Hurts Our Advocacy Efforts
Now is the time to drive home your message on CON reform.

The NCOA has put tremendous effort into bringing key issues, such as CON reform, to the fore, and now is the time to drive our message home. With your prior support, NCOA PAC has helped elect and re-elect candidates who are willing to advance CON reform and other issues in the NC General Assembly. Unfortunately, NCOA PAC receipts this year have not kept pace with the level of support received in previous years, and that’s impeding our ability to ensure the most favorable environment for our policy priorities in Raleigh. Will you contribute today so that we can maintain our momentum during this critical time?

The NCOA thanks the physicians at Raleigh Orthopaedic Clinic and the Raleigh Orthopaedic Clinic PAC for the recent contribution to NCOA PAC.

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Boykin Publishes Article on the Use of Biologics, Regenerative Treatments in Orthopaedic Surgery

Dr. Robert Boykin (Asheville) is co-author of a recently published article examining the use of regenerative treatments to enhance outcomes in orthopedic surgery. The article, “Regenerative Treatments to Enhance Orthopedic Surgical Outcome,” provides a review of the current literature on platelet rich plasma (PRP) and different types of mesenchymal stem cells (MSCs) in orthopaedics. This included the use of regenerative therapy in the treatment of common conditions such as rotator cuff tears, ligament injuries, meniscal tears and chondral (cartilage) injuries. The article was published in the peer-reviewed journal PM&R, the official scientific journal of the American Academy of Physical Medicine and Rehabilitation (AAPM&R).

Share your practice news and accomplishments with us by email at ncoa@ncmedsoc.org.

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Get the Facts on MACRA
Listen to the webinar recording.

If you are still uncertain what MACRA is all about, get the facts by downloading the recording of a recent webinar on MACRA hosted by NCMS Director of Health Policy Jennifer Gasperini and sponsored by the NCMS Foundation and the NC Medical Group Managers Association (NCMGMA). This webinar reviews key elements of the recently passed Medicare Access and Chip Reauthorization Act (MACRA), including how the current Medicare quality reporting programs will be affected by MACRA. Viewers will learn more about CMS' plans for Medicare reform and key timelines to consider in the implementation process.

To learn more about MACRA, NCMS members can visit the Quality Time with the NCMS blog. This blog is updated weekly with pertinent information about quality program changes and key news and deadlines to be aware of.

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Voting for NC Doctor of the Year Award Will Begin Soon
Nominations are now closed.

March 30, National Doctors' Day, is a time to recognize and celebrate the hard work of physicians – all of the many medical specialties make up a remarkable community, coming together as one to help and heal patients. The observance dates back to 1933 and was officially established by Congress in 1990.

In 2015 the North Carolina Medical Society (NCMS) instituted a new, homegrown tradition with North Carolina Doctors' Day. To celebrate the day, NCMS is sponsoring the 2016 North Carolina Doctor of the Year Award, allowing patients and the public to honor our state's physicians who are:

  • Passionate about keeping patients happy and healthy
  • Experts in using life-changing treatments to give patients the best care
  • And making a positive impact in the community

See more at: www.ncdoctorsday.org.

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NCOA 2016 Annual Meeting, Oct. 7-9 @ Pinehurst
Add this event to your calendar.

Start planning now to attend the NCOA 2016 Annual Meeting. Orthopaedic surgeons and PAs, retired members, residents and fellows-in-training will gather at the historic Pinehurst Resort, October 7-9, 2016, for a weekend of medical education, networking and collegiality.

  • Nancy Lowe can give you the scoop on golf opportunities, nlowe@ncmedsoc.org.
  • Call the Pinehurst Resort at 800-487-4653 to reserve a room now!
  • Share the Exhibitor Prospectus with the product and service representatives that call on your practice.

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Comprehensive Hip and Knee Course in Durham, April 29-30
Duke Department of Orthopaedic Surgery invites NCOA members to attend.

You're invited!  The Department of Orthopaedic Surgery at Duke University Medical Center presents the 8th Annual Emily Berend Adult Reconstruction Symposium (EBARS) on April 29-30, at the Mary Duke Biddle Trent Semans Center for Health Education on the Duke Hospital Main Campus. The Symposium features nationally recognized faculty, including the Mayo Clinic’s Robert T. Trousdale, MD. Attendees can earn up to 13.00 AMA PRA Category 1 Credit(s)™ for their participation. Visit the EBARS page online for more information and registration.

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