In this edition:

• LARC Medicaid Reimbursement Update
• Dr. McMahon Drives LARC Uptake to 34%
• Dr. Haywood Brown Advocates for Contraception as an Essential Health Benefit
• ACOG Congressional Leadership Conference, March 11-13
• ACO Guides for Obstetricians and Gynecologists
• Representative Greg Murphy Featured in NC Health News
• NCMB on Opioid Prescribing: Resources for Safe Prescribing Practices
• Cooper Invites Your Input on Opioid Epidemic
• Diagnostic Imaging Cost and Quality Sharing to Begin in December
• CMS Quality Payment Program Webinars

Save the date! 
NC Ob/Gyn Society
and NC Section of ACOG
2018 Annual Meeting
April 20-22 
The Omni Grove Park Inn

For room reservations, call the Omni Grove Park Inn at 1-800-438-5800 and ask for the NC Ob/Gyn Society group rate of $259++/night.

LARC Medicaid Reimbursement Update

Good news! Medicaid administrators at the NC Department of Health and Human Services have informed us that their plan to “unfreeze” rates for long-acting reversible contraceptives (LARC) and other contraceptives was approved by the federal government. This marks an important victory in one of our NC Ob/Gyn Society’s top advocacy goals – removing obstacles to expand access to LARC in North Carolina and follows several meetings with NC Ob/Gyn Society Leaders, Medicaid administrators as well NC DHHS Secretary Mandy Cohen, MD, MPH about this issue.

These changes allow for a new payment methodology which adjusts reimbursement rates as provider costs increase. This means the cost of contraceptives will not go “underwater” again in the future. You can find more about the new payment methodology in the October 2017 Medicaid Provider Bulletin, p. 17.

While the effective date for the new rates is July 1, 2017, they now have to be formally implemented in the NCTracks system. Once the changes are implemented, claims will be reprocessed back to July 1, 2017. In the meantime, providers should feel comfortable knowing that they will be kept whole by Medicaid reimbursement for any contraceptive methods they choose to provide for Medicaid patients.

NC Medicaid staff also reported that a proposal that will create a mechanism to provide reimbursement to hospitals for LARC devices provided in the in-patient setting is now with the federal government.

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Member Profile: Dr. McMahon Drives LARC Uptake to 34% at Her Fayetteville Clinic

Improving women’s lives by reducing the incidence of teen pregnancy is a priority for Dr. Connette McMahon (Fayetteville), an ob/gyn physician and recent graduate of the NC Medical Society’s Leadership College program. Dr. McMahon is frustrated by a high teen pregnancy rate in her area (42.7 per 1000 in Cumberland County, compared to the state and national averages of 30.2 and 22.3 per 1000, respectively) and the low utilization rate (5.5%) of long-acting reversible contraceptives (LARCs) despite the benefits of improved effectiveness, safety and low cost.

For her Leadership College project, Dr. McMahon set out to influence her patients to choose LARCs by addressing the educational barriers that impact the utilization of LARC. Dr. McMahon studied the impact of The CHOICE Project YouTube videos on participants’ birth control decisions. She found that LARCs were chosen more frequently than the birth control pill, 34% to 22%, among 33 women that participated in the intervention. Dr. McMahon presents her findings in this MEDTalks video, “Influencing Patients in Private Practice with the aid of the Choice Project YouTube Videos to Choose Long Acting Reversible Contraception.”

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Maintain Contraception as an Essential Health Benefit

The American Congress of Obstetricians and Gynecologists (ACOG) wants to ensure that women continue to have access to contraception without a co-pay as an essential health benefit as Congress looks to repealing the Affordable Care Act. ACOG President Dr. Haywood Brown (Durham) recently met with U.S. Representative G.K. Butterfield (D-NC-1) in Washington, DC to discuss how contraceptive coverage without a co-pay is necessary to meeting the needs of reproductive-age women.

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ACOG Congressional Leadership Conference, March 11-13

Plan now to attend ACOG’s 2018 Congressional Leadership Conference (CLC) in Washington, DC, March 11-13, 2018. Each year, a delegation of North Carlina ob/gyn physicians participates in this annual advocacy event, which includes two days of training and meetings with Members of Congress during the Capitol Hill Lobby Day. CLC is a critical opportunity to advocate for our specialty and patients. Attendees may also receive over 15 CME credits. Registration will open in December. We hope you will join us in Washington!

2017 CLC Attendees (L-R): Arthur Ollendorff, MD, Katherine Bishop, MD, Clayton Alfonso, MD, Charlotte Gamble, MD, Robin Matthews, MD, Elizabeth Borders, MD, Lydia Jeffries, MD, Alan Skipper, CAE and (not pictured) John Allbert, MD.

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ACO Guides for Obstetricians and Gynecologists

Specialty-specific toolkits, like the “Accountable Care Guide for Obstetricians” and “Accountable Care Guide for Gynecologists” from the NCMS Toward Accountable Care Consortium and Initiative (TAC) can help your practice make the transition from fee-for-service to value-based health care. The toolkit provides strategic guidance for physicians establishing and participating in accountable care organizations (ACOs) and it is part of a series offering guidance on a range of topics related to the legal and financial issues that you need to know about.

NEW! Want CME credit for learning more about ACOs?The Texas Medical Association was so impressed with the NCMS TAC toolkits, they sought and received permission to offer CME credit for reading and absorbing the information in the seminal guide, “The Physicians Accountable Care Toolkit.” If you are an NCMS member, you can access this CME at a discount by simply downloading the guide and entering ‘NCMS’ in the coupon code space to receive the member discount.

All TAC toolkits are available free of charge from the TAC website, www.tac-consortium.org. Additional titles include “Accountable Care Legal Guide,” “The Bundled Payment Guide for Physicians,” “Rural Accountable Care Guide,” and more.

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Representative Greg Murphy Featured in NC Health News

NC Representative Greg Murphy, MD, a Greenville urologist and the only physician serving in the NC General Assembly, credits his years of medical training for imparting the discipline and stamina necessary to be successful as a legislator in Raleigh. And that he is! As a new legislator, Dr. Murphy has been tapped for some very important posts, including a Vice Chair seat on the Appropriations Committee (arguably the most important committee in the House), Chair on the Appropriations Health and Human Services Committee and Chair on the Health Committee.

Dr. Murphy was recently featured by the online news site North Carolina Health News.

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NCMB on Opioid Prescribing: Resources for Safe Prescribing Practices

The Strengthen Opioid Misuse Prevention (STOP) Act of 2017 addresses the opioid epidemic that has had a severe impact in North Carolina. To help physicians navigate the new law and have a positive impact on the opioid epidemic, the North Carolina Medical Board (NCMB) has developed a webpage with resources and information about NCMB programs that encourage appropriate prescribing.

Also of note, the NC Ob/Gyn Society's 2018 Annual Meeting program will include an optional ASAM Treatment of Opioid Use Disorder Course, including four hours of online coursework and four hours of live instruction to be offered at the April meeting. The course covers the highest quality, evidence- based practices for treating patients with opioid use disorder, including all medications and treatments for opioid use disorder, and provides the required education needed to obtain the waiver to prescribe buprenorphine.

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Cooper Invites Your Input on Opioid Epidemic

To better understand all the efforts taking place across our state to address opioid abuse and addiction, Governor Roy Cooper has asked for public feedback. In a request for feedback that was emailed broadly on November 6, the Office of the Governor noted, “Many individuals and organizations have been working on this issue for years, and we appreciate those efforts. We would like to continue to learn about strategies for combatting opioid misuse and addiction in our state.”

Comments can be submitted via email to opioidfeedback@dhhs.nc.gov. Please note that any information sent to this email address may be subject to public records law.

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Source: BCBSNC.com
October 9, 2017

Diagnostic Imaging Cost and Quality Sharing to Begin in December

Beginning December 1, 2017, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will expand its diagnostic imaging management program with AIM Specialty Health^SM (AIM) to inform referring providers and commercially-insured members about imaging costs, quality, and location alternatives available for specified high-tech imaging services. The expansion is designed to help both referring providers and our members better engage in the selection of imaging providers based on members’ individual needs.

In December, AIM will begin providing our members with information to help them make more informed choices about their health care. If a Blue Cross NC commercially-insured member is scheduled to have a specified diagnostic imaging test (computed tomography [CT/CTA] or magnetic resonance imaging [MRI/MRA]), an AIM representative may call the member if a comparable or higher-quality and/or lower-cost alternative site is locally available to them.

During this outreach, members will have an opportunity to reduce their health care expenses by selecting lower-cost providers or locations that report equal or better quality. If the member agrees to AIM’s suggested alternative, the AIM representative will help the member schedule the test. Members may still choose any participating imaging provider, and will not be denied access to services if they do not choose the lower-cost option.

Blue Cross NC originally announced plans to expand our diagnostic imaging management program with AIM in 2016. However, the program expansion has been temporarily on hold since its intended January 2017 start date. We appreciate the assistance of the many imaging providers who completed the quality component of the program using the OptiNet assessment. When the program goes live, these assessments will be used to provide information about imaging locations to our members, and ensure your imaging location appears in AIM’s online directory.

Imaging providers who have not completed the quality assessment can still complete the OptiNet assessment, available online at aimspecialtyhealth.com/goweb. If you have questions or need help completing the survey, please call AIM Customer Service at 1-800-252-2021.

Additional information about this program for Blue Cross NC’s commercially-insured members is available in these Frequently Asked Questions.

View Recordings of Recent Quality Payment Program Webinars on the CMS Website
Recent Quality Payment Program Webinars Now Available on the CMS Website

Were you unable to participate in a recent Quality Payment Program (QPP) webinar? You can now view all recordings, presentations, and transcripts from QPP webinars on the CMS Quality Payment Program Events webpage. Three recent QPP webinars include:

• August 16, 2017: QPP Notice of Proposed Rulemaking (NPRM) Office Hours Session – Provided a detailed overview on the draft provisions from the QPP Year 2 NPRM. CMS has shared the most frequently asked questions from the session with answers on the CMS website.
• August 30, 2017: 2018 Self Nomination Process for Qualified Clinical Data Registries (QCDRs) and Qualified Registries – Offered an overview of the 2018 self-nomination process for organizations that wish to become QCDRs and qualified registries for the Merit-based Incentive Payment System (MIPS) for the 2018 performance period.
• September 8, 2017: Overview of MIPS for Small, Rural, and Underserved Practices – Provided an overview of MIPS, the flexibilities for small practices under MIPS, and the resources offered by Technical Assistance organizations.

To find the latest information, visit the Quality Payment Program website. The Quality Payment Program Service Center can also be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8 a.m.-8 p.m. ET or via email at QPP@cms.hhs.gov.

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