September 29, 2009

Medicaid Provider Rate Cut Being Implemented Oct.1

NC Medicaid has announced their proposed State Plan Amendments to save over $200 million from medical services and goods over the next two years. In order to achieve $76 million of this savings this year, NC Medicaid will make a 9% cut to all but 89 specific codes used by physicians and other providers caring for Medicaid patients.

The Medicaid codes that have been protected will continue to be paid at 95% of Medicare. The other codes will be slashed to an average of 86.5% of Medicare rates. Hospitals that are not owned by the State of North Carolina will also be impacted with a 6% cut to their DRG.

September 25, 2009

Medicaid Rate Adjustments Debated

The Department for Health and Human Services (DHHS) is moving quickly to make changes to achieve the $76 million in provider rate savings mandated by the NC General Assembly this year. A number of proposals for how to achieve that target are still being discussed. DHHS is considering multiple proposals that would make adjustments based on a physician’s specialty and other proposals that would that would create variable cuts to individual reimbursement codes. Both of these solutions would cause massive divisions within the physician community that could threaten the stability of NC Medicaid.

September 25, 2009

Compliance Dispute Officer Issues Ruling in Oncology/Rheumatology Dispute

In a disappointing ruling, Compliance Dispute Officer Martin Quinn has determined that the pricing policy and associated actions taken by Blue Cross Blue Shield of North Carolina did not violate key provisions in the BCBS Settlement Agreement.

September 25, 2009

Temporary Order Requires NC Physicians to Report Influenza-Related Deaths of Persons 18 and Older

The State Health Director has issued a temporary order requiring North Carolina physicians to report all influenza-associated deaths in persons 18 years of age or older. Influenza deaths in children less than 18 years of age have been legally reportable since 2004. This order is necessary to enhance influenza surveillance during the current pandemic.

September 18, 2009

Surveys Find Doctors Support Health Care Reform But Vary on Public Option and Private Insurance

Recent studies found that doctors have mixed views about reforming the health care system. A survey published by Investors Business Daily (IBD) found that 65% of physicians surveyed oppose the proposed government health care system reform plan. Seventy-two percent (72% ) disagree with whether proposed legislation can cover 47 million more people with better quality at lower cost.

September 18, 2009

Senate Finance Committee Rolls Out Health Care Reform Plan

U.S. Senate Finance Committee Chairman Max Baucus (D-Montana) introduced the America’s Healthy Future Act of 2009 on Wednesday. A press release from the Committee stated that the “landmark health care reform legislation would lower costs and provide quality, affordable health care coverage.”

September 18, 2009

Second Wave of H1N1 Flu Underway in NC

North Carolina has entered the second wave of the Pandemic A (H1N1) flu, and state health officials are offering guidance for clinicians to meet the challenge.

September 2, 2009

NCMS Annual Meeting Offers CME Opportunities

The 2009 NCMS Annual Meeting and House of Delegates (October 30-November 1, Raleigh) will offer attendees the choice of two CME sessions:

Medical Staff Boot Camp: (Saturday, October 31, 3:00pm-5:00pm)
Dispelling the Horrors of HIT: (Saturday, October 31, 3:00pm-5:00pm)