Along with many of you, I find it hard to believe that August is upon us. With the summer waning and back-to-school time here, I find myself serving the final quarter of my tenure as NCMS President. It has been a significant year for medicine and for state government, and those topics were priorities at our recent Board of Directors meeting, held July 27, 2013 in Raleigh.

Timothy J. Reeder, MD, Secretary-Treasurer, reported on the Society’s budget and financial position, along with the progress of renovations of the NCMS Headquarters Building.

John Reynolds, MD, Chairman of the Legislative Cabinet, updated the Board on the NC General Assembly’s final actions as related to NCMS priorities. The Medicaid reform debate will continue into the 2014 short session and was subject of much discussion at our meeting. The state budget includes a process to develop a reform plan, including an Advisory Panel of one House member, one Senator and three gubernatorial appointments.

• The budget also includes a 3 percent “withhold,” most of which will not be in the pool for potential payment to providers. For the state to save $1 on physician services, $4 must be cut, because the federal government will not pay its share unless the state participates. As a result $40 million will be withheld, and $9 million will be available for disbursement. The standard for earning the withheld payments is not yet known. Primary care doctors are excluded from the withhold, first recommended by CCNC, until January 1, 2015.
• The Certificate of Need (CON) law was amended to be favorable to hospitals, both in the budget and the budget technical corrections bill. Because the disparities are more pronounced, CON reform pressure is expected to intensify.
• Scope of practice issues were prevalent, including no changes in physician supervision of midwives and decriminalization of lay midwifery. The only scope of practice issue that moved was giving pharmacists an expanded list of immunizations for adults, pursuant to protocols.
• The Controlled Substance Reporting System was strengthened. Pharmacists must report in a slightly shorter timeframe; docs can have a designee to query the CSRS, and immunity for using the system is intact.
• Tax reform did not directly alter taxation of health care services, nor did it alter the tax preferences for hospitals (income tax, sales tax rebates, sales tax exemption are intact).
• There was no legislation enacted to alter medical malpractice reforms passed in 2011. One proposal would have made unfavorable changes to the law governing medical record request in the litigation context, but it was not debated.

In other discussion, Robert Seligson, Executive Vice President, CEO, reported on the progress of NCMS headquarters building renovations. Mr. Seligson highlighted efforts to raise funds to offset the costs of the renovation, which is designed to serve the Society for many years to come. He announced a major gift from the Medical Mutual Insurance Company for $1 million. This gift from Medical Mutual highlights the strong ties our organizations share. I am grateful for their involvement and their continued dedication to serving our profession.

The Board reviewed the schedule for the Annual Meeting, which will take place October 25-26, 2013 at the Raleigh Marriott City Center. An outstanding agenda is taking shape, including a CME session on prescription drug abuse which will be held in collaboration with the NC Medical Board, Boston University School of Medicine, and other state and national partners, entitled “SCOPE of Pain: Safe and Competent Opioid Prescribing Education;” an “Educational Open House” for medical students, new physicians, and interested practice staff; and a member section networking luncheon. Submissions are already committed for the first annual “Poster Session” for medical students/residents sponsored by the Durham-Orange County Medical Society.

For more information and to register for the annual meeting, visit the Annual Meeting page on the NCMS website.

The Board reviewed several policy items that will be sent to the online Reference Committee for consideration when it opens September 19. Watch upcoming issues of the Bulletin for details.

The nominations of Don C. Chaplin, MD and Ronald B May, MD to the NC Commission for Public Health were approved. Congratulations on your appointments and thank you for your service.

On a final note, the NCMS has many Committees comprised of members and consultants that keep the Board educated on pertinent issues and make recommendations on health policy affecting the daily practice of medicine in our state. President-Elect Dev Sangvai, MD will soon vet and appoint Committee members for 2014. Please let Dr. Sangvai or the NCMS know if you are willing to serve. Our Committees are key to our effectiveness and represent another way for you to have a voice in issues affecting you and your patients.