Partnering for the People of North Carolina

2018 Alliance sponsor feature article provided courtesy of UnitedHealthcare

From technology and patient needs to payment models and innovative partnerships, trends are converging in a rapid and exciting fashion. We’re all in it together: patients, physicians and care providers, and payers. UnitedHealthcare Community Plan shares your commitment to delivering a superior patient experience and improving health outcomes.

We believe that the best solutions come when we work together with care providers. We share the power to chart a new path, creating a stronger health care system that works better for everyone. And we’re ready to support you with tools and data resources designed to help you serve your patients and allow your practice to thrive.

Our Promise to the people of North Carolina:

Health care is constantly changing in North Carolina and throughout the country, and all stakeholders – individuals, care providers, community partners and federal and state governments – feel the impact. In the face of this changing landscape, the business and social mission of UnitedHealthcare will always remain the same: To help people live healthier lives and to help make the health system work better for everyone.

We have a long history in the great state of North Carolina and are proud of our record improving the health of more than 1.4 million people we are privileged to serve through the delivery of quality, cost-effective health care. We are committed to continuing to serve North Carolinians and working together to move the new Medicaid program forward today and for the future.

UnitedHealthcare has update its After-hours reimbursement policy for commercial plans in North Carolina

Beginning July 1, 2018, UnitedHealthcare will reimburse Primary Providers for CPT Code 99051 “Services provided in the office on evenings, weekends or holidays when Office is normally schedule to be open” when billed with a non-preventative office visit.

  • 99051: Eligible expenses for after-hours health services will be reimbursed at a value determined using the alternate of (‘gap-fill’) Fee Source as CMS does not publish an RVU value for the code.

This policy update will be effective for claims with dates of service July 1, 2018 and after. A national policy update will be implemented later in 2018.

If you have any questions about this policy update please contact Provider Relations at Carolinaprteam@uhc.com and include your practice name, tax ID number and National Provider Identifier to assist us in identifying your assigned Advocate. The reimbursement rate for CPT code 99051 will be available via the fee schedule lookup tool in Link beginning 07/01/2018.

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10th Annual Advocacy Days a Success

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10th Annual Advocacy Days a Success

The NCMGMA Advocacy Days event had a very positive response from the members who were able to attend. Some of the feedback describing the experience:

“Pertinent and timely issues impacting the practice due to legislation passed, Medicaid, and State Health Plan.”

“Excellent. Speakers were great and relative to all that is happening in NC right now. Well worth the time and money. Dinner was delicious!”

“I wanted to learn more about Medicaid and was extremely pleased. I wish I had planned to stay for the Legislative day, next year – I will!”

Attendees learned about the future of many different healthcare issues that will affect our state both now and in the future, including Medicaid Managed care, new legislation impacting our provider networks, and updates on hot healthcare topics currently being debated in Raleigh. In addition to the education sessions, attendees enjoyed the opportunity to engage with peers from other practices; they were able to proactively share challenges and solutions.

Finally, several attendees of the legislative visits also learned a great deal about what actually happens at the legislative level when concerns are raised by the public (when visiting the legislature, that’s US!). Attendees were able to witness and talk to the people who establish the criteria for what is heard by our lawmakers and also HOW it is being heard from different constituencies. They saw the true impact of what it means to make sure your voice is represented.

The Advocacy committee and NCMGMA Board would like to thank all the attendees for participating. Though our positions are sometimes varied, we do many times speak with a singular voice on many of the issues facing our practices. Your active participation in both education and advocating for our practices is invaluable; we thank you for making our organization a success!

June 19th NCMGMA-NCMSF Webinar: NC Legislative Update

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June 19th NCMGMA-NCMSF Webinar:
NC Legislative Update

June 19, 2018 | 12:00 PM – 1:00 PM

Program

Presented by the North Carolina Medical Society Foundation in cooperation with the North Carolina Medical Group Management Association, NCMS Senior VP for Advocacy and Advancement, Chip Baggett, will update attendees on the latest developments at the NC General Assembly, including issues around the budget, Medicaid and the newly introduced HOPE Act.

Speaker

Chip Baggett, JD
Senior VP for Advocacy and Advancement
North Carolina Medical Society (NCMS)
As Senior Vice President for Advocacy and Associate General Counsel at the North Carolina Medical Society (NCMS), Chip Baggett is responsible for state level advocacy efforts (primarily focused on the NC General Assembly) as well as communications and fundraising for the NCMS and NCMS Foundation.

Chip has a long history in organizational advancement and advocacy. He has worked in many facets of health care ranging from a children’s science and health museum to pharmaceutical sales before going to work directly for physicians and PAs as a medical society executive, first at the county level in western North Carolina and then, since 2007, at the NCMS. He consistently is ranked as one of the top lobbyists in the state by his peers. Chip received his law degree and was admitted to the North Carolina bar in 2016.

Registration

This webinar is complimentary but space is limited! After you register, you will receive an emailed confirmation with webinar and phone-in instructions.

Click here to register

Continuing education credit may be granted through your professional organization (MGMA, PAHCOM, AHIMA, etc.). Please self-submit for these organizations.

Questions

For questions or more information please contact the NC Medical Society offices at ncmsfoundation@ncmedsoc.org.

NCMGMA Responds to DHHS’s Call for Public Comments

NCMGMA submitted a response to DHHS’s call for public comments regarding Medicaid expansion, specifically PHP/Provider contracting. Many thanks to the members that assisted with this crafted response, including Dickson Capps, Melissa White, Cameron Cox, III, and Young Moore & Henderson, PA. NCMGMA’s response was submitted to DHHS on Monday, June 11th via email.

Please click here to view the letter that was submitted.

June 1, 2018, is the Deadline to Initiate Connection to NC HealthConnex

Message from Dave Richard, Deputy Secretary for Medical Assistance

On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record (EHR) system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.

Providers who cannot meet the deadline may receive an extension for their connection. To request an extension, providers must:

  1. Complete and sign an NC HIEA Participation Agreement;
  2. Have NC HIEA countersign the agreement; and
  3. Begin the onboarding process to connect to NC HealthConnex.

Providers Who Do Not Initiate Connection to NC HealthConnex by June 1, 2018 
Medicaid will work collaboratively with providers to comply with the June 1, 2018, deadline, and will initiate corrective action, including requiring corrective action plans, to ensure all providers come into compliance. At this time, all providers will continue to be enrolled as Medicaid providers and, as they file claims, will receive reimbursements for services and treatment of Medicaid beneficiaries.

Medicaid appreciates the many providers across the state who have initiated a connection and are making data available through the system. We will continue to work closely with the HIEA to ensure that NC HealthConnex develops to support your priorities and enable all of us to better serve patients and families.

Currently NC HealthConnex houses 4.8 million unique patient records, allowing providers to access their patients’ comprehensive records across multiple providers, and review consolidated lists of items including labs, diagnoses, allergies and medications.

Contact NC HIEA staff at hiea@nc.gov or Medicaid at Renee.McCoy@dhhs.nc.gov with questions.

Make Your Voice Heard in Raleigh: Join us for Advocacy Days in June

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Meet with North Carolina Legislators
Make a Difference in Healthcare in our State

June 6-7, 2018
Holiday Inn Raleigh Downtown
North Carolina State Capitol

This year, join us June 6th and 7th in Raleigh as we host our 10th annual Advocacy Days which we promise to be packed full of information you do not want to miss! There is no shortage of issues at hand in North Carolina and NOW is the time to make our voices heard!

Schedule of Events

Wednesday
June 6, 2018
1:00 pm – 2:00 pm
Medicaid Managed Care Payor Panel: What’s Next for North Carolina?
A diverse panel of payors competing for contracts to administer Medicaid managed care in NC will present information about their programs, next steps, and what providers need to know about the upcoming transition.
• Lisa Farrell, North Carolina Owned Provider Plans (Bio)
• Steve Keene, Carolina Complete Health Network, Inc. (Bio)
• Anita Bachmann, United Healthcare Community Plans (Bio)
• Gregg MacDonald, WellCare (Bio)
2:00 pm – 3:00 pm
BCBSNC, Legislative Affairs Update
Hear directly from Blue Cross about legislative efforts in North Carolina. This will be an excellent opportunity to learn more and ask questions face-to-face about Blue Cross’s plans to address the recent direction from State Treasurer Dale Folwell to cut State Health Plan reimbursement rates by 15%.
• Chris Evans
3:00 pm – 4:00 pm
NCDOI Seniors’ Health Insurance Information Program (SHIIP)
Learn about how SHIIP can help your practice and your patients navigate the complexities of Medicare, Medicare supplements, Medicare Advantage, Medicare Part D, and long-term care insurance. Since the program’s creation in 1986, SHIIP has become a role model for other states and has received two national awards for “innovative” and “exemplary” service.
• Melinda Munden, Communication Specialist
4:00 pm – 5:00 pm
DHHS
Learn what role the DHHS will play in helping to structure the Medicaid Managed Care plans. Take the opportunity to validate with DHHS some of the information learned in the prior session with the potential Medicaid Managed Care companies.
• Dave Richards, Deputy Secretary for Medical Assistance
Bowtie: Live and Unedited
Always a fan favorite, hear about the many hot topics affecting medical practices in North Carolina. Chip Baggett will provide the group with insight into the current “sausage making” that is happening in downtown Raleigh during the current session.
• Chip Baggett, NCMS
6:00 pm – 9:00 pm
Dinner at Taverna Agora
Sponsored by Medical Mutual
Thursday
June 7, 2018
9:00 am – 12:00 pm
Legislative Visits with NCMGMA and General Assembly Meetings

General Information

Registration
Register and join fellow NCMGMA members in Raleigh on Wednesday, June 6th for a half-day of education sessions and a dinner program sponsored by Medical Mutual. Stay on Thursday, June 7th and meet with our legislators, along with other North Carolina administrators. For members of NCMGMA, the cost is $55 per person. For non-members, the cost is $75 per person. Registration cost covers education and dinner. After May 21st, the cost of registrations increases by $10.

Hotel Accommodations
Reserve your room now at the Holiday Inn Raleigh Downtown. Limited standard rooms available at the discounted rate of $109/night for single/double occupancy plus tax. To reserve your hotel room, please call the hotel directly at 919-832-0501. Reservations will be accepted until rooms are sold out or until Monday, May 21st. Self-parking is available for $7.00.

Questions?
If you have any questions about the NCMGMA Advocacy Days, please contact the NCMGMA offices at 800-753-MGMA (6462) or by email at info@ncmgm.org.

NCMGMA Advocacy Days are June 6-7 in Raleigh

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Meet with North Carolina Legislators
Make a Difference in Healthcare in our State

June 6-7, 2018
Holiday Inn Raleigh Downtown
North Carolina State Capitol

This year, join us June 6th and 7th in Raleigh as we host our 10th annual Advocacy Days which we promise to be packed full of information you do not want to miss! There is no shortage of issues at hand in North Carolina and NOW is the time to make our voices heard!

Schedule of Events

 

Wednesday
June 6, 2018
1:00 pm – 2:00 pm
Medicaid Managed Care Payor Panel: What’s Next for North Carolina?
A diverse panel of payors competing for contracts to administer Medicaid managed care in NC will present information about their programs, next steps, and what providers need to know about the upcoming transition.
• Lisa Farrell, North Carolina Owned Provider Plans (Bio)
• Steve Keene, Carolina Complete Health Network, Inc. (Bio)
• Anita Bachmann, United Healthcare Community Plans (Bio)
• Gregg MacDonald, WellCare (Bio)
2:00 pm – 3:00 pm
BCBSNC, Legislative Affairs Update
Hear directly from Blue Cross about legislative efforts in North Carolina. This will be an excellent opportunity to learn more and ask questions face-to-face about Blue Cross’s plans to address the recent direction from State Treasurer Dale Folwell to cut State Health Plan reimbursement rates by 15%.
• Chris Evans
3:00 pm – 4:00 pm
NCDOI Seniors’ Health Insurance Information Program (SHIIP)
Learn about how SHIIP can help your practice and your patients navigate the complexities of Medicare, Medicare supplements, Medicare Advantage, Medicare Part D, and long-term care insurance. Since the program’s creation in 1986, SHIIP has become a role model for other states and has received two national awards for “innovative” and “exemplary” service.
• Melinda Munden, Communication Specialist
4:00 pm – 5:00 pm
DHHS
Learn what role the DHHS will play in helping to structure the Medicaid Managed Care plans. Take the opportunity to validate with DHHS some of the information learned in the prior session with the potential Medicaid Managed Care companies.
• Dave Richards, Deputy Secretary for Medical Assistance
Bowtie: Live and Unedited
Always a fan favorite, hear about the many hot topics affecting medical practices in North Carolina. Chip Baggett will provide the group with insight into the current “sausage making” that is happening in downtown Raleigh during the current session.
• Chip Baggett, NCMS
6:00 pm – 9:00 pm
Dinner at Taverna Agora
Sponsored by Medical Mutual
Thursday
June 7, 2018
9:00 am – 12:00 pm
Legislative Visits with NCMGMA and General Assembly Meetings

General Information

Registration
Register and join fellow NCMGMA members in Raleigh on Wednesday, June 6th for a half-day of education sessions and a dinner program sponsored by Medical Mutual. Stay on Thursday, June 7th and meet with our legislators, along with other North Carolina administrators. For members of NCMGMA, the cost is $55 per person. For non-members, the cost is $75 per person. Registration cost covers education and dinner. After May 21st, the cost of registrations increases by $10.

Hotel Accommodations
Reserve your room now at the Holiday Inn Raleigh Downtown. Limited standard rooms available at the discounted rate of $109/night for single/double occupancy plus tax. To reserve your hotel room, please call the hotel directly at 919-832-0501. Reservations will be accepted until rooms are sold out or until Monday, May 21st. Self-parking is available for $7.00.

Questions?
If you have any questions about the NCMGMA Advocacy Days, please contact the NCMGMA offices at 800-753-MGMA (6462) or by email at info@ncmgm.org.