Legislative Update for 01/18/21
January 18, 2021
The General Assembly kicked off the 2021-2022 biennial session on Wednesday, January 13th with opening day speeches, organizing and the approval of the rules that will be used throughout the session. Just like everything else in our world, this day was unlike previous first days as family and friends were not present and the usual celebratory mood was muted. The legislative complex is open to the public, but social distancing rules are in effect and temperature checks are required before entering the building. Masks are not required but were more common among legislators than in the spring and it appears that the leadership of both chambers are highly encouraging members to wear them.
Tonight! Webinar: COVID Vaccine Distribution Plan Update
January 5, 2021
Please join Dr. Betsey Tilson, State Health Director and Chief Medical Officer, and other NC DHHS leaders on Tuesday, January 5, 2021 from 6:00 – 7:00 for an update on North Carolina’s COVID-19 vaccine distribution plan and for a Question & Answer session about that plan. E-mail us for login information.
Review of Current COVID-19 Vaccine Plan for NC
January 5, 2021
Based on new federal recommendations issued by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices, the NC Department of Health and Human Services (NCDHHS) updated and simplified the vaccine prioritization plan at the end of last month.
For the latest information, tune in tonight, Tuesday, Jan. 5, from 6 to 7 p.m. when State Health Director and Chief Medical Officer Betsey Tilson, MD, MPH, offers an update on the vaccine distribution plan. Dr. Tilson also will respond to questions during the session. Click here to join the meeting via Zoom. Or to join by phone call (646) 558-8656 and use webinar ID 131 899 801.
North Carolina’s updated phases include:
• Current Phase – Phase 1a: Health care workers fighting COVID-19 and Long-Term Care staff and residents.
• Phase 1b (to begin in early January): Adults 75 years or older and frontline essential workers.
• Phase 2: Adults at high risk for exposure and at increased risk of severe illness.
• Phase 3: Students.
• Phase 4: Everyone who wants a safe and effective COVID-19 vaccination.
Currently there is not enough vaccine for everyone to be vaccinated at the same time, so NCDHHS will open the next phase of vaccinations (1b) in groups, starting only with persons above the age of 75 in order to best manage vaccine dose availability. To see all the groups for Phases 1b and Phase 2, please review this Infographic of Vaccine Phases.
Watch your NCMS Morning Rounds for information on how North Carolinians over age 75 will access vaccinations beginning in early January. For those who engage this population, please consider sharing NCDHHS’ resources below in both English and Spanish to answer patients’ questions.
All vaccine providers are expected to ensure the vaccine is equitably administered within each group. Longstanding and continuing racial and ethnic injustices in our health care system contribute to lack of trust in vaccines, and NCDHHS is focused on building trust with historically marginalized populations. The Department is partnering with trusted leaders and organizations to provide accurate information about the vaccine.
More detailed information is available at yourspotyourshot.nc.gov and in the resources below:
• Infographic of Vaccine Phases (English / Spanish)
• Deeper Dive: Phase 1a (English / Spanish)
• Deeper Dive: Phase 1b (English / Spanish Coming)
Here are additional vaccine resources to share with your staff and patients.
• Flyer on Vaccines (English / Spanish)
• Presentation COVID-Vaccination 101 (English / Spanish)
• Frequently Asked Questions (English / Spanish)
Update on COVID Vaccine for NC Medical Practices
December 17, 2020
On Tuesday evening, State Health Director Betsey Tilson, MD, MPH and other state officials offered NC physicians and PAs an overview of the state’s plans to administer the COVID-19 vaccine, which began arriving in North Carolina in limited supplies this week. View the slides from the presentation here.
Dr. Tilson began with the caution that the only certainty, at this point, is that there will be glitches. The mantra for the next few months should be ‘Keep Calm and Carry On.’ She thanked those on the call for their flexibility and understanding as the state undertakes the massive work of distributing and administering the COVID-19 vaccine. Dr. Tilson also said she hopes to hold ‘office hours’ next week and in the weeks ahead to answer your questions and give updates on the vaccination rollout.
Here are some key points, based on common questions NCDHHS has received. The points are outlined in detail in the slide deck, which also includes links to more information and resources.
The vaccine is safe:
• Vaccine development and testing was done according to regular protocols, but at ‘warp speed.’ The administrative process was abbreviated, but there was “no cutting corners on safety and efficacy of the vaccine,” Dr. Tilson said in providing background information for you to allay any fears patients may have about the vaccine’s safety.
• The speed with which this vaccine was developed was partly due to the fact that the RNA technology used in the vaccine was already in the works prior to the pandemic, giving vaccine developers a jump start.
• The vaccine contains no live virus and no stem cells. It is composed of a tiny fragment of genetic material in a lipid envelop. There are no preservatives.
Who can get the vaccine:
• Anyone over age 16.
• There is no data from the clinical trials for pregnant or lactating women, but the vaccine may be offered to them with a discussion of the risks and benefits.
• Anyone who has been previously infected with COVID-19 may receive the vaccine.
• The list of vaccine ingredients is included in the slide deck (slide 11) and anyone with a known allergy to any of the ingredients should not receive it. The severe reactions to the vaccine experienced by several people in the United Kingdom are thought to be related to polyethylene glycol, which is an ingredient in the vaccine.
• Slide 23 outlines the prioritization of vaccination. Outpatient primary care clinicians with high risk of exposure to the virus and who have two or more chronic conditions are in group 1b for vaccination. Outpatient clinicians without chronic conditions who are at high or moderate risk of exposure are in group 2. Because the timing and quantity of vaccine shipments is still unknown, it is difficult to say exactly when these groups will be vaccinated.
• The federal government is paying for the vaccine so there is no cost sharing or charge to patients who receive it.
• Public and private insurance will cover the administrative costs. Medicare/Medicaid is reimbursing for administrative costs at $16. 94 for the first dose and $28.39 for the second dose.
• To be considered as a location for vaccine distribution, you must enroll in the COVID-19 Vaccine Management System (CVMS) at this link. Questions about the CVMS may be directed to CVMS-Help@dhhs.nc.gov.
Office Hours w Drs Tilson and Moore – Friday, December 18th, 12:30 – 1:30
December 14, 2020
Dr. Betsey Tilson, State Health Director and Chief Medical Officer, and Dr. Zack Moore, State Epidemiologist, will hold Office Hours to provide updates on the State’s COVID-19 response and to respond to questions next Friday, December 18th, from 12:30 – 1:30.
In addition to the updates and open discussion, DHHS will provide a brief update on the program for reimbursement for COVID-19 related primary care services for individuals.
From the NCMB President: Seeking help during the prolonged stress of COVID
December 11, 2020
Please take a moment and review the recent message from Dr. Jonnalagadda acknowledging what a tremendously stressful time this is for medical professionals and encouraging licensees to make self-care a priority. Read her full message here.
COVID-19 Vaccine: What North Carolina Practices Need to Know
December 11, 2020
Mark your calendar: Next Tuesday, Dec. 15, from 6 to 7 p.m., State Health Director Betsey Tilson, MD, MPH, and other state health experts will hold a Zoom webinar for health professionals on North Carolina’s plan for the COVID-19 vaccine distribution. E-mail us for login information.
Today, Thursday, Dec. 10, the Food and Drug Administration’s (FDA) Vaccines and Related Biological Products Advisory Committee, which is made up of a group of independent medical experts, will meet to discuss the risks and benefits of the Pfizer/BioNTech COVID-19 vaccine. The goal of the daylong meeting is to make a recommendation on whether the FDA should grant Emergency Use Authorization for the vaccine. The FDA does not have to follow the committee’s recommendations, but usually does. Several media outlets have reported that a decision on the vaccine EUA approval will be made within four days of today’s meeting and vaccine distribution would likely take place within the week.
If you would like to learn more about the results of this vaccine’s clinical trials, you can access the FDA Briefing Document here.
A similar meeting for Moderna’s vaccine candidate is scheduled for next Thursday, Dec. 17.
Get Some Answers on the COVID-19 Vaccine
December 8, 2020
The NC Department of Health and Human Services (NCDHHS) is planning a statewide physician update on the COVID-19 vaccine that will be hosted by NC AHEC on Tuesday, Dec. 15 at 6 p.m. Be sure to mark your calendar and watch your NCMS Morning Rounds in the coming days for updates on agenda and registration links.
Distribution of the vaccine will begin with health systems and physician practices likely will be able to register to administer the vaccine later this month.
NCDHHS has provided a list of basic FAQs about the vaccine on its website including some information about proper storage of the various vaccines. Access that information here.
Stakeholder Calls Information: CMS Atlanta: IFC-4, COVID-19 Vaccine Toolkits, and Listening Session Invitation
November 11, 2020
CMS Atlanta is hosting two calls for stakeholders on Thursday, November 12, 2020 to further discuss the new regulations related to COVID-19 issued on October 28, 2020.. We strongly encourage you to review the IFC and toolkits prior to the conversation and look forward to hearing your feedback.
The following IFC resources are also available:
- To see the press release please visit: https://www.cms.gov/newsroom/press-releases/trump-administration-acts-ensure-coverage-life-saving-covid-19-vaccines-therapeutics
- Additional information on this IFC can be found in the fact sheet here: https://www.cms.gov/newsroom/fact-sheets/fourth-covid-19-interim-final-rule-comment-period-ifc-4
- The FAQs on billing for therapeutics can be found here: https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf
- Toolkits The COVID-19 vaccine resources for providers, health plans and State Medicaid programs can be found here: https://www.cms.gov/covidvax
E-mail us for login information.
Launch of NC Medicaid’s Enrollment Website
November 9, 2020
DHHS has announced the launch of NC Medicaid’s enrollment website, www.ncmedicaidplans.gov, in preparation for the launch of Medicaid Managed Care scheduled for July 1, 2021. Medicaid Managed Care open enrollment will begin March 15, 2021, and will continue through May 14, 2021.
The purpose of the enrollment website is to help Medicaid beneficiaries learn more about Medicaid Managed Care. In 2015, the NC General Assembly enacted legislation directing NCDHHS to transition Medicaid and NC Health Choice from a primarily fee-for-service delivery system to managed care. Under managed care, the state contracts with insurance companies, which are paid a predetermined set rate per enrolled person to provide all services.
The enrollment website provides information about who will have to choose a health plan, who will stay in the traditional Medicaid program (NC Medicaid Direct) and who can choose between the two. It will also share the basic medical and behavioral health benefits that are offered. There will be a list of frequently asked questions and answers to help beneficiaries understand the changes.
Most people currently receiving Medicaid benefits will need to enroll in Medicaid Managed Care. Medicaid beneficiaries will be able to choose from five health plans — WellCare, United HealthCare, Healthy Blue, AmeriHealth Caritas and Carolina Complete Health (serving regions 3, 4 and 5). Those who are federally recognized tribal members or qualify for Indian Health Services are exempt from managed care. Those who live in Cherokee, Graham, Haywood, Jackson or Swain counties or in a neighboring county may choose to enroll in the Eastern Band of Cherokee Indians (EBCI) Tribal Option.
A small number of people will not need to choose a Medicaid Managed Care health plan because of the type of health services they need. They will stay enrolled in NC Medicaid Direct. To learn more, beneficiaries can visit the NC Medicaid Direct services page on the enrollment website.
To learn more about North Carolina’s transformation to Medicaid Managed Care, visit the Medicaid Transformation webpage.
Office Hours w Drs Tilson and Moore – Friday, November 6th, 12:30 – 1:30
November 4, 2020
Dr. Betsey Tilson, State Health Director and Chief Medical Officer, and Dr. Zack Moore, State Epidemiologist, will hold Office Hours to provide updates on the State’s COVID-19 response and to respond to questions this Friday, November 6th, from 12:30 – 1:30.
Please plan to participate and inform your members. Please send questions in advance to questionsCOVID19forum@gmail.com.
E-mail us for login information.
Office Hours w Drs Tilson and Moore – Friday, October 25th, 12:30 – 1:30
October 19, 2020
Dr. Betsey Tilson, State Health Director and Chief Medical Officer, and Dr. Zack Moore, State Epidemiologist, will hold Office Hours to provide updates on the State’s COVID-19 response and to respond to questions this Friday, October 23, from 12:30 – 1:30.
In response to feedback during their last Office Hours, they announced that they will hold Office Hours on the first and third Fridays of the month for the remainder of this year.
Financial Recovery Program
October 15, 2020
The North Carolina Medical Society Foundation (NCMSF) is proud to oversee the state-funded Financial Recovery Program (FRP) to assist eligible practices throughout the state that are experiencing economic distress due to the pandemic.
Funding will be based on reimbursement for COVID-19-related expenses incurred between March 1 and Nov. 30, 2020.
Read more information here.
Lunch and Learn Webinar – The Financial Recovery Program
October 12, 2020
The Financial Recovery Program (FRP): How Independent Practices Can Apply to Receive Covid-19 Relief Funds featuring Franklin Walker, MBA, Vice President of Rural Health Systems Innovation, NCMS, and Reynold Yordy, Co-founder of Greenlight Ventures
Tuesday, October 13, 2020 | 12:00 pm to 1:00 pm
Learn more about this newly launched state-funded program, which is overseen by the North Carolina Medical Society Foundation and seeks to distribute grants to independent medical practices that have suffered financially due to the Covid-19 pandemic. Learn what the criteria are for applying and how your practice can benefit from the FRP.
VISIT OUR SITE for details on the FRP’s requirements and eligibility:
Presented by the North Carolina Medical Society Foundation in cooperation with the North Carolina Medical Group Management Association.
This webinar is free but you must be registered to attend. Space is limited so register early!
After you register, you will receive an emailed confirmation with webinar and phone-in instructions.
Financial Recovery Program
October 12, 2020
Today is the official launch of the Financial Recovery Program run through the NCMS Foundation. Here is information on the program. Embedded in the document are links to the FRP webpage, the application portal and the email address for questions. Here are those links for your reference:
FRP webpage: https://www.ncmedsoc.org/financial-recovery-program/
FRP application portal: https://frp.ncmedsoc.org/
Email address for questions: FRPNCMS@ncmedsoc.org
A list of FAQswill be a dded to the webpage shortly. This will be a dynamic document as we get questions and will be updated regularly. If you have any questions about practice eligibility or eligible expenses, please contact Franklin Walker.
Applications for these funds are now being accepted. The timeframe to distribute the money is short (Nov. 30 is the deadline). Please spread the word widely. We want to be sure to get this funding to those who need it!
Office Hours w Drs Tilson and Moore – Friday, October 9th, 12:30 – 1:30
October 5, 2020
Dr. Betsey Tilson, State Health Director and Chief Medical Officer, and Dr. Zack Moore, State Epidemiologist, will hold Office Hours to provide updates on the State’s COVID-19 response and to respond to questions this Friday, October 9th, from 12:30 – 1:30. They will also hold Office Hours on Friday, October 23, from 12:30 – 1:30.
Health Care Professionals Series to Address Medicaid Transformation
September 30, 2020
The next installment of the “Health Care Professionals Webinar Series” will run this Thursday, October 1, from 5:30 p.m. to 6:30 p.m. and will continue on the first Thursday of every month.
This series will focus on Managed Care and be hosted by Dr. Shannon Dowler, Chief Medical Officer, NC Division of Health Benefits and moderated by Hugh Tilson, Director, NC AHEC Program.
Thursday’s topic is Better with Time: Medicaid Transformation State of Things.
This webinar will focus on:
- Managed Care 101: Reminders and Timeline
- Get to Know Your CMOs
- What You Can Do NOW to be Ready LATER
- Medicaid Hot Topic Updates
- Q & A
Research Survey Study: PTSD Symptoms in ED Physicians during COVID-19
September 28, 2020
Duke University, in collaboration with the ACEP Wellness Section, is looking for physicians working in Emergency Departments across the United States to participate a research study entitled “Prevalence & Predictors of PTSD Symptoms among Emergency Physicians in the United States during the COVID-19 outbreak.” Participation in this study is voluntary.
· US Board-Certified/Board-Eligible Emergency Medicine Physician
· Emergency Medicine Resident in the United States
· US Non-EM Physician working in an EM setting
The purpose of this study is provide information about the prevalence of Post-Traumatic Stress Disorder (PTSD) symptoms among Emergency Medicine physicians nationwide in the United States following the COVID-19 pandemic, and to explore other related factors including predictors of these symptoms.
If you agree to participate, you will be asked to complete a survey about your experiences as an Emergency Room physician during the COVID-19 pandemic. This survey may contain questions that are sensitive or upsetting. You may skip any questions that make you uncomfortable or that you do not wish to answer. No information that can identify you will be collected and your name and contact information will not be linked with the survey results. This survey should take you about 10 minutes to complete.
Special Bulletins Update
September 23, 2020
NC Medicaid is committed to ensuring beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to COVID-19. In August, NC Medicaid released SPECIAL BULLETIN COVID-19 #119: NC Medicaid Extends Temporary Clinical Coverage Policy Provisions and Temporary Rate Enhancements, which provided information on extensions of the COVID-19 rate enhancements and Clinical Coverage Policies in response to the extension of the federal Public Health Emergency declaration.
SPECIAL BULLETIN COVID-19 #134: Clarification of COVID-19 Temporary Rate Increases and Clinical Policy Changes clarifies and further updates information provided in Special Bulletin 119.
NCMB Launches MedBoard Matters Podcast
September 21, 2020
NCMB has announced the launch of their podcast, MedBoard Matters. The podcast will highlight important issues in medicine and medical regulation. The goal is to present compelling content in an easy-to-digest and enjoyable format. The very first episode is on suicide prevention awareness. Jean Fisher Brinkley had a great and uplifting conversation about a very heavy topic with Dr. Christine Moutier, Chief Medical Officer for the American Foundation for Suicide Prevention. Dr. Moutier discusses ways to overcome stigma associated with mental health issues in medical professionals and strategies and resources for getting help – as well as what to do if a colleague is in crisis.
The episode has been published in recognition of Physician Suicide Awareness Day, September 17th.
Here is a link to the episode: https://www.buzzsprout.com/1230689/5455090. We hope that folks will subscribe by searching for “MedBoard Matters” on their podcast platform of choice so they can be notified of future episodes.
If NCCEP members have questions they have always wanted to ask the Board, or ideas for specific topics for future episodes on MedBoard Matters, we would love to get feedback! Send suggestions and questions to firstname.lastname@example.org.
NCDHHS-Covered Services Available to Help NC Residents Isolate or Quarantine
September 14, 2020
Please review the fact sheet outlining the new NC DHHS COVID-19 Support Services Program and Community Health Worker Initiative as announced in late August (press releases are available online here and here). This document provides an overview of NCDHHS-covered services and the community health worker program in target counties, including:
- What are the CHW and Support Service programs
- What support services are available at no cost to individuals
- Who is eligible for support services
- How you play a role in connecting residents to support
- Who to contact for more information
We urge you to send this around your organization to ensure our partners have the most updated information and can refer our residents to the support they need to quarantine and isolate safely and effectively.
Firearm Injury Surveillance Through Emergency Rooms (FASTER) Award Recipients Announced
September 11, 2020
North Carolina is participating in the FASTER program. See more information below:
The CDC’s Division of Violence Prevention announces funding to 10 state health departments to gather surveillance data in near-real time on emergency visits for nonfatal firearm injuries. This competitively awarded funding falls under CDC-RFA-CE20-2005, Firearm Injury Surveillance Through Emergency Rooms (FASTER).
CDC awarded a total of $2,224,482 distributed among 10 recipients:
- District of Columbia Department of Health
- Florida Department of Health
- Georgia Department of Health
- New Mexico Department of Health
- North Carolina Department of Health and Human Services
- Oregon Health Authority
- Utah Department of Health
- Virginia Department of Health
- Washington State Department of Health
- West Virginia Department of Health and Human Services
Timely state- and local-level data on ED visits for nonfatal firearm injuries are currently limited. The collection of near-real-time data on ED visits for nonfatal firearm injuries overall and by intent (intentional self-directed, unintentional, and assault-related) at the state and local level could improve state and local practitioners’ ability to identify and respond to emerging public health problems.
The goal of this award is for recipients to improve the timeliness and dissemination of surveillance data of ED visits for nonfatal firearm injuries. Collaboration among states will include sharing data to strengthen syndrome definitions, data collection methods, analysis of surveillance data, and presentation and dissemination of findings.
Additionally, this collaborative award will result in tools and methods that can be used by state and local health departments across the nation to rapidly track and respond to firearm injuries.
Announcement to NC Medicaid Associations
September 3, 2020
NC Medicaid is reimbursing COVID-19 testing costs for individuals without insurance who enroll in the NC Medicaid Optional COVID-19 Testing (MCV) program. This option was made available to all states through Section 6004(a)(3) of the Families First Coronavirus Response Act (FFCRA). Enrolled MCV beneficiaries will also qualify for coverage of COVID-19 tests retroactive to June 1, 2020 provided they were uninsured at the time of the test.
To qualify, individuals must be uninsured, a resident of North Carolina, and meet the citizenship and legal immigration status requirements of the Medicaid program. NC Medicaid is required to verify citizenship and immigration status. Individuals must qualify for MCV at the time the test was obtained.
SPECIAL BULLETIN COVID #128: NC Medicaid Optional COVID-19 Testing Program Online Applications Available and a fact sheet describe the program in more detail. Additionally, a one-page flyer/signage is designed to help raise awareness of this program at testing locations, practices, clinics, health systems, Departments of Social Services and any organization that sees uninsured residents. The fact sheet and flyer are available at: https://medicaid.ncdhhs.gov/about-us/covid-19-guidance-and-resources/providers.