October 17 NCMGMA-NCMSF Webinar: Legislative Update

NCMGMA-NCMS Webinar Series

October NCMGMA-NCMSF Webinar
Legislative Update

October 17, 2017 | 12:00 PM – 1:00 PM

Program

Spend one hour with Chip Baggett, JD, Senior Vice President and Associate General Counsel at the North Carolina Medical Society as he reviews the legislative developments in 2017 and the impact on the profession of medicine and the care of patients. Chip will discuss key legislation passed in this year’s sessions (STOP Act) and pending legislation in the General Assembly of North Carolina (SB629 and HB36) and at the federal level (CHIP and ACA Repeal and Replace), which would impact our state.

Speaker

Chip Baggett, JD
Senior Vice President and Associate General Counsel
North Carolina Medical Society
Chip has worked for the North Carolina Medical Society since the spring of 2007, and was recently promoted to Senior Vice President and Associate General Counsel. Attorney Baggett is now responsible for state level advocacy efforts as well as communications and advancement for the NCMS and the NCMS Foundation. Chip has a long history in organizational advancement and advocacy. He has led successful corporate and non-profit annual fund campaigns following training at the Indiana School of Fundraising. A graduate of the evening program at the NC Central University School of Law, Chip passed the NC Bar exam in 2016.

Registration

This webinar is complimentary but space is limited so make sure to register early! 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 October 13th Greenville Roadshow Postponed

The Greenville Roadshow, originally scheduled for Friday, October 13, 2017 at the Holiday Inn in Greenville, NC, has been postponed. This event has been rescheduled for January 18, 2018.  Watch for updated information and registration coming soon.

For anyone who is currently registered for this event, we will keep your registration and transfer this to the new date. If the new date does not work with your schedule, there will be an opportunity to request a full refund.

Questions
If you have any questions please contact the NCMGMA offices at 800-753-MGMA (6462) or email us at info@ncmgm.org.

North Carolina’s New “STOP Act” Creates Obligations for Prescribers and Dispensers of Opioids

2018 Alliance sponsor article courtesy of Medical Mutual

Jason Newton, Senior Vice President, Claims and Risk Management, and Associate General Counsel—Medical Mutual

A new opioid control law in North Carolina brings a nearly immediate effect on physicians and health care providers. Signed by Gov. Roy Cooper on June 29, the Strengthen Opioid Abuse Prevention (STOP) Act has major provisions that went into effect just two days later, on July 1.

The legislation applies to providers, prescribers, and their clinical and non-clinical team members, as well as dispensers. The key points for private practice providers who prescribe “target controlled substances” (Schedule II and III opioids and narcotics listed in NC Gen. Stat. § 90-90(1), (2) or 90-91(d)) to patients in North Carolina are as follows:

  1. Consultation Requirements for NPs and PAs. As of July 1, 2017, nurse practitioners and physician assistants must personally consult with their supervising physician if the patient is being treated at a facility that primarily engages in the treatment of pain by prescribing narcotic medications or advertises for any type of pain management services, and the therapeutic use of the prescription will, or is expected to, exceed 30 days. When continually prescribing the targeted controlled substance to the same patient in accordance with the above, the NP/PA must consult with the supervising physician at least once every 90 days to verify that the prescription remains medically appropriate.
  2. CSRS Not Yet Mandatory, but Should Be Used. Though the law does not make controlled substance reporting system (CSRS) use mandatory immediately (and does not provide a date for when it will be), Medical Mutual’s advice is that providers should not put off registering for and using CSRS for North Carolina patients. It is expected that, after confirming technical upgrades to CSRS, the North Carolina Department of Health and Human Services (NC DHHS) and the North Carolina Medical Board (NCMB) will broadcast when mandatory registration must occur, and that this likely will take place in early 2018.
    1. A patient’s data in CSRS for the prior 12 months must be reviewed before an initial prescription to that patient.
    2. For every three-month period of continued prescription, the practitioner must review the patient’s prior twelve-month history in CSRS and document the results in the EHR.
    3. If CSRS cannot be reviewed because of some technological failure, that inability should be documented in the patient’s chart, and the review should occur as soon as the systems problem is fixed.
    4. CSRS review is not mandatory for certain patients, including but not limited to those receiving the prescription as part of cancer treatment, or those in hospice or receiving palliative care.
  3. Clinical and Non-Clinical Delegates May Be Used to Query CSRS for Physicians. Prescribers may continue to use “delegates” to query the North Carolina Controlled Substance Reporting System. Delegates must work under the physician’s direction and supervision, and the delegation must be approved by NC DHHS. To register delegates, the licensee must register a master account first. The easiest way for a physician licensee to register his or her own account is through the NCMB’s website: https://wwwapps.ncmedboard.org/Clients/NCBOM/Private/MDProfileUpdate/MDProfile_Login.aspx. Delegates may include office nurses and non-clinical staff. The master registrant is responsible for each of his or her delegates. Delegate accounts must be updated annually, or they will become inactive.
  4. Limitations on Prescriptions for Acute Pain. As of January 1, 2018, practitioners must not prescribe more than a five-day supply upon initial consultation and treatment of a patient for acute pain, unless the prescription is for post-operative acute pain relief for immediate use following a surgical procedure, in which case the prescription cannot exceed a seven-day supply.
    1. Acute pain is defined as pain, whether resulting from disease, accident, intentional trauma, or other cause, that the practitioner reasonably expects to last for three months or less. It does not include chronic pain or pain being treated as part of cancer care, hospice care, palliative care, or medication-assisted treatment for substance use disorder.
    2. Chronic pain is defined as pain that typically lasts for longer than three months or that lasts beyond the time of normal tissue healing.
  5. Electronic Prescribing Required as of January 1, 2020. As a general rule, practitioners must electronically prescribe all targeted controlled substances.
  6. Hospice and Palliative Care Instructions. Effective July 1, 2017, Hospice and palliative care providers must share information regarding proper disposal of medications with patients and their families.

As a result of the above, Medical Mutual recommends that practitioners take the following steps:

  1. Enroll in CSRS, read the act, and immediately adopt the prescribing limitations in the act.
  2. Choose delegates carefully, ensuring delegates understand that they must only query CSRS upon the licensee’s request for a patient whose prescription options are being considered by the practitioner.
  3. Set up a process to revoke delegates’ access if those employees leave the practice.
  4. Update delegates’ accounts annually to maintain their access.
  5. Personally document (in the patient’s EHR) that CSRS was queried, what the results were (the prescription history should be added to the EHR), what prescribing decisions were made, and why they were made.
  6. Regularly audit their personal controlled substances prescribing history to ensure its accuracy.
  7. Understand that the DHHS likely will flag unusual prescribing habits evidenced by CSRS activity and share them with the NCMB.
  8. Ask for help with CSRS if needed (CSRS questions should be directed to the Division of Mental Health, Developmental Disabilities and Substance Abuse at [919] 733-7011).

The following resources may be helpful for those seeking more information about the new law:

Medical Mutual members can access opioid-specific resources, including a toolkit and CME-eligible webinars, here: https://www.medicalmutualgroup.com/mednotes-blog/opioid-epidemic-resources.

Welcome New Members

Our membership continues to grow! Take a look at the list of healthcare professionals and students who have recently joined NCMGMA (August 29, 2017 through September 26, 2017):

Active

  • Angela Branson-Atkins, Digestive Health Specialists, Winston-Salem, NC
  • Kristin Edwards, Raleigh Orthopaedic, Raleigh, NC
  • Diane McKeel, East Carolina Anesthesia, Greenville, NC
  • James O’Hara, Northwell Health, Bay Shore, NC
  • Steve Peterson, Wilmington Gastroenterology, Wilmington, NC
  • Jessica Phillips, FHPG, LLC dba FirstHealth Physician Group, Pinehurst, NC
  • Kamie Rauf, Charlotte Eye Ear Nose & Throat Associates, Charlotte, NC
  • Alicia Shue, Salisbury Pediatric Associates PA, Salisbury, NC
  • Stephanie Shuler, Charlotte Eye Ear Nose & Throat Associates, Charlotte, NC
  • Kimberly Tew, Cape Fear Podiatry, Fayetteville, NC
  • Jennifer Toney, Kernodle Clinic A Duke PDC Practice, Burlington, NC
  • Joanne Younts, FHPG, LLC dba FirstHealth Physician Group, Pinehurst, NC

Affiliate

  • Eric Backus, MSOC Health, Chapel Hill, NC
  • Latrecia Brown, MSOC Health, Chapel Hill, NC
  • Tamara McNeill, MSOC Health, Chapel Hill, NC

Student

  • Hallie Mull, Gardner Webb University, Hickory, NC

Act Now on Independent Payment Advisory Board Repeal Legislation

Act Now on Independent Payment Advisory Board (IPAB) Repeal Legislation that was Enacted under the Affordable Care Act

Tomorrow, the House Energy and Commerce Committee and Ways and Means Committee, two committees with jurisdiction over Medicare Part B, are holding hearings on H.R. 849, the Protecting Seniors’ Access to Medicare Act of 2017, which would repeal the Independent Payment Advisory Board (IPAB) created under the Affordable Care Act. Under current law, the IPAB will be triggered when the growth rate in Medicare exceeds target growth rates (as reported by CMS’ Office of the Actuary), and will be responsible for recommending to Congress spending reductions in the Medicare program in order to reduce growth below the target growth rate. Although there have been no members appointed to the IPAB, if the IPAB is triggered, the Secretary of HHS is required to stand in place of the board and submit a proposal for reducing Medicare spending. Any proposal, whether from IPAB or HHS, is subject to a “fast track” legislative implementation process with virtually no oversight, leaving little-to-no room for recourse once IPAB-mandated payment cuts are implemented.

It is paramount that members of Congress act now, before future actuary reports trigger the IPAB and activate payment reductions to Medicare providers. Given the timeliness of the House Committee meetings this week, MGMA has created a template message supporting IPAB repeal that can be found by visiting the MGMA Advocacy Center, where you can contact lawmakers and urge them to support this important legislation.

New and Revised Articles Posted to MLN Matters

New Articles

SE17031 – Updates to Medicare’s Cost Report Worksheet S-10 to Capture Uncompensated Care Data
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE17031.pdf

Revised Articles

MM9904 – Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9904.pdf

MM10198 – New Waived Tests
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10198.pdf

October NCMGMA Roadshows Early Registration Extended to 10/2

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Roadshow Early Registration Extended to October 2nd
Administrator and Front Office Tracks Offered!

NCMGMA is hitting the road and coming your way! Join us in Hickory on October 6th with Rich Schlentz and V2V Management Solutions or in Greenville on October 13th with Novant Health’s Sean Keyser and V2V Management Solutions. Both Roadshows will also offer great networking opportunities with other members and NCMGMA Alliance Exhibitors.

Registration includes continental breakfast and lunch. Register additional employees with the same company for just $75.00 each!

Pick the Roadshow that’s Best for You!

We are holding two Roadshow’s this October: one on October 6th in Hickory and one on October 13th in Greenville.  Follow the links below for complete details on each event, including schedule of events, speakers, costs, registration, and hotel accommodations.

Questions

If you have any questions about our October Roadshow, please contact the NCMGMA offices at info@ncmgm.org or by phone at 800-753-MGMA (6462).