In This Issue
President's Perspective
Firearms, Freedom of Speech and Kansas
As State Begins KanCare, Problems Arise
KPF Update!
Fluoride Varnish Dental Code Change
Oral Health Month
PCMH Update
CDC Champion Awards

KAAP 2013

Spring Meeting

  

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Kansas Chapter of AAP

  
  
  
  
  
  
  
  
  
  
  
  

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Officers

 

Kathy Ellerbeck, MD, MPH, FAAP

President

 

Robert Wittler, MD, FAAP

President-Elect

 

Frank Banfield, MD, FAAP

Treasurer

 

Dennis Cooley, MD, FAAP

Past President

 

  

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Chris Steege  

Executive Director   

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Mel Hudelson  

Associate Director 

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Heather Williams

Staff Accountant

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Leslie Sherman 

Chapter Coordinator 

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Shanna Peters

Project Coordinator

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 February 2013
President's Perspective

By Kathy Ellerbeck, MD, MPH, FAAP 

 

Greetings. I hope you've already had a chance to read Dr. Cooley's Legislative update. And I hope you have the opportunity to read this entire newsletter. Some highlights:

  

Literacy

  

See the article "TAP-TAM: A Program that Kansas Should be Proud Of". Turn a Page. Touch a Mind.� has become a model for other AAP Chapters as federal and state funding for Reach Out and Read and other literacy projects has been cut. Some of the most compelling data on the importance of early literacy came from research from Kansas. In their book, Meaningful Differences, Betty Hart and Todd Risley found that by age 4, the children of professors had heard 30 million more words than children growing up in poverty.   Their conclusion: parent/child conversation is key to closing the gaps that arise during the early years. In TAP-TAM, we have a sustainable program that helps promote parent/child conversation and early reading.

 

While TAP-TAM continues to thrive - funding for Kansas' early childhood education has been threatened this year. One concern - Governor Brownback initially allocated $9.2 million from the Early Childhood Block Grant for his "Read to Succeed" program which focused on testing reading levels at the end of third grade. Fortunately, the governor subsequently restored funding to the Early Childhood Block Grant in the budget recommendations for FY 2015 and FY 2015. However, there are still threats to the Children Initiative Fund which largely funds early childhood education programs. The CIF money comes from tobacco settlement money and it is not yet clear how much money Kansas will receive. Stay tuned.

 

Dyslexia

 

Depending on definition, 5 - 10% of children will have difficulty learning to read. Early literacy is critically important for kids. During the first through third grade, children learn to read. After that - they must read to learn.   Early detection of reading difficulty needs to be a focus of advocacy for pediatricians as well as educators. Kansas Chapter member Dr. Chad Issinghoff has been a strong advocate for early recognition and treatment of dyslexia, and as mentioned in Dr. Cooley's Legislative Update, the KAAP will again support SB 44 which addresses dyslexia. Reading problems run in families - if your patient is having difficulty with reading, ask for family history of reading disability and advocate for early treatment. Reading to succeed requires investment in early childhood programs and in early recognition and treatment of those children likely to be poor readers.

 

Poverty

 

Nearly a quarter of Kansas children live in poverty. In November, Governor Brownback announced a twelve member task force on child poverty. The KAAP wrote a letter to Dr. Bob Moser, Secretary of KDHE offering to be a resource with regards to poverty and the science of early brain and child development. We also mentioned Dr. Bob Block, Immediate Past President of the AAP, and the talks he's given around the country on the importance of investing in children in order to provide a healthy and productive workforce. Phyllis Gilmore, Secretary of the Kansas Department for Children and Families and a member of the Governor's Task Force subsequently invited Dr. Bob Block to give a presentation to the Task Force on the effects of adverse childhood experience on brain development and child and adult health outcomes.

 

KanCare and Coding

 

Please read Dr. Cooley's article about KanCare. As expected, the transition of 380,000 Medicaid recipients into KanCare has posed some challenges. The Chapter Pediatric Council can help by talking with Medicaid officials, but KAAP needs to know the specific problems you are having with the new KanCare Medicaid system. Call the KanCare Provider Assistance Line to reach the Medicaid program (the number is 1-800-933-6593 and the email address is [email protected]). To voice your concerns to the Chapter, [email protected].  Also, for questions regarding KanCare and each MCO, call the rapid response Q&A session every day at 9 a.m. (1-877-247-8650 conference code 79687456).  They have representatives from each MCO and KanCare on the line to address issues that need immediate attention. 

 

Thanks to Leslie Sherman - we have clarification about coding for fluoride varnish. See her article on Dental Billing Codes for codes that will be reimbursed.

 

NCCI Edits to E/M and Vaccine Administration Codes.  The NCCI edit has adversely impacted billing procedures for immunization administration and well-child services when reported during the same visit. CMS has deferred this decision to the states. Jon Jantz and the Pediatric Council have been advocating for appropriate coding for vaccine administration in Kansas for some months. The Chapter has written a letter to Ms. Kari Bruffett, Kansas Medicaid Director, to request that Kansas deactivate the NCCI edits.

 

Coming Up

 

Our Spring Meeting: Pediatrics: The Changing Forecast will be at the Westin Crown Center in Kansas City on April 19 - 20th. I hope you can come. Sandy Praeger, Kansas Insurance Commissioner will be our Keynote speaker and will give us an update on Insurance Exchange, Healthcare changes in 2014, and Medicaid Expansion.

 
It's not too early to put the KAAP Annual Fall CME meeting on your calendar.  It will be October 3rd and 4th at the Hotel in Old Town in Wichita. 

 

 

 

Firearms, Freedom of Speech and Kansas

Dennis Cooley

 

By Dennis Cooley, MD, FAAP

KAAP Immediate Past President

 

It was just two months ago that we were all shocked by another act of violence in this country. This time the violence resulted in mass murders occurring at Sandy Hook Elementary School in Newtown, Connecticut. This brought to the surface once more the arguments concerning firearms violence and how to best stop it. These arguments are not new, but seemed to take on a new emphasis because of the large number of children killed (20 along with 6 adults) and the fact it occurred in a school. As the rhetoric on this issue has increased, blame is being scattered around like the Kansas topsoil during the Dust Bowl. Finger pointing has taken a new art form. Increased number of calls for restrictions on firearms has been made. This has led to certain groups of people and organizations fearing what they perceive as a loss of their second amendment rights.

 

But this article is not going to center on the second amendment and its interpretation, rather it is about another amendment -the first amendment- and how these arguments over the second amendment are now threatening physicians' rights to free speech.

 

How have the arguments on gun violence affected physicians' first amendment rights?  To answer this question, we need to go back to a law passed in Florida in 2011. With the backing of the NRA, Florida passed a law threatening significant disciplinary actions for a physician that asked about the presence of guns within a child's home and play areas. This law received much publicity and was challenged in the courts. In late June 2012, US District Judge Marcia G. Cooke (Southern District of Florida-Miami) issued a ruling permanently enjoining the Florida law. Not one to give up easily, the state of Florida has appealed the ruling. Numerous national physician organizations including the American Academy of Pediatrics, the American Medical Association, the American Academy of Family Physicians, the American Academy of Child and Adolescent Psychiatry, the American Academy of Orthopedic Surgeons, the American College of Surgeons, the American College of Preventive Medicine, the American College of Obstetricians and Gynecologists, and the American Psychiatric Association have signed on to an amicus brief supporting the lower court's ruling.

 

Click here to read remainder of article

As State Begins KanCare, Problems Arise

 

by Dennis Cooley, MD, FAAP
  

On January 1, 2013 Kansas moved all 380,000 Medicaid recipients into its new Medicaid managed care program KanCare. The State has contracted with three large national managed care organizations to provide services under the new program. Those companies are United Health Care, Amerigroup, and Sunflower State Health Plan. So far state officials have been pleased with the KanCare transition. That doesn't mean everything has gone smoothly though.

 

Everyone has expected that glitches would arise as the state went from 2 MCO providers giving services to mainly pediatric recipients to 3 national MCOs and expanding services to adults and the disabled. Problems have arisen but according to officials involved with the program far fewer than feared.

 

One of the biggest concerns from providers is slow or delayed payments and there has been reports of this but according to KanCare officials it has not been widespread. One of the MCOs had a problem with some of their electronic claims and required paper forms for a few weeks which delayed payments but this has been fixed. Rejection of claims has occurred as providers and their office staff are learning a new system. In order to determine the extent of these problems among pediatricians the Chapter would like to know if you have experienced any significant delay in payments or rejection of claims. Please contact us at the e-mail address below.

 

Then there was the problem of billing for preventative care services and immunization administration codes during the same visit. This was not a fault of the state or the MCOs but rather CMS on the national level. Our Chapter sent out an alert to help members become aware of this and to make the necessary coding changes to receive the appropriate payments. The AAP is trying to rectify this on a national level but so far CMS has punted this over to the individual states. KAAP is writing a letter to the state Medicaid Director asking her to make the necessary changes that will remedy the problem.
 
 TAP-TAM Update

 TAP-TAM Logo 

TAP-TAM:  A Program that Kansas Should be Proud Of 

 

Did you know that Turn a Page. Touch a Mind. � (TAP-TAM), the early literacy program in Kansas, is envied by many throughout the country? With federal and state funding getting cut for early literacy and other early learning programs, many don't know how they are going to continue to offer services to children. Since the beginning, TAP-TAM has been supported by the Kansas Pediatric Foundation's Early Literacy Endowment, and new reading sites have only been brought on that can be supported by the payout from this endowment fund. TAP-TAM was developed so that Kansas children will grow up with books today, tomorrow, and far into the future because literacy will always be an important part of growing up healthy in body and mind. Taking advantage of a child's early years when their brain is growing is imperative for preparing them to succeed.

 

Today, over 300 physicians and other medical providers give a new, developmentally appropriate book to their patients at each well check visit from 6 months to 5 years, and take time to encourage parents to read with their child every day. In 2013 these TAP-TAM participating providers will distribute almost 100,000 books to Kansas kids! These books will have a significant impact by preparing our youngest Kansans to start school ready to learn to read. Children who are read to regularly have a higher vocabulary, a key factor in learning to read on time, and we know that this impact will continue through the Early Literacy Endowment for many generations to come.

 

 Click here to read remainder of article

IMPORTANT: KanCare Medicaid Reimbursement Coding Information for Fluoride Varnish

 

There have been reports of the dental code D1203 being denied. According to the Sunflower Issues Log posted on the KanCare website, the code D1206 (fluoride varnish) has also been denied since it has recently been added to the States 2013 dental manual. DentaQuest, Sunflower's dental provider, is currently updating their system to include this D1206 code and when completed, the previously denied claims will be processed. There haven't been any reports of denials from using the dental code D1208 (fluoride treatment) for fluoride varnish.

 

From the information gathered, both D1206 and D1208 are being accepted for reimbursement for fluoride varnish application.

 

KAAP Celebrates National Oral Health Month!
      

  

CFK is a physician led education training program for physicians and nurses on the importance of oral health and the application process of fluoride varnish for children ages 0-3 years.

 

 

 

Cavity Free Kids provides:

  • Education and training during the lunch hour at your office/clinic.
  • Free toolkits that include 50 fluoride applications and children's toothbrushes
  • Medicaid reimbursement information.
  • Free CME and CNE credit

If you would like to learn more on how to implement the use of fluoride varnish in pediatric patients' visits and get PAID for it, contact Leslie Sherman at [email protected] or visit our website at www.kansasaap.org.  Applications are being accepted.

 

Other important links:

www.oralhealthkansas.org

www.ksdental.org

  
Patient Centered Medical Home Update

 

 By Kerri Weeks, MD, FAAP
  
The Kansas Primary Care Physicians Coalition met in Topeka this January to discuss ongoing work with the Patient Centered Medical Home (PCMH) Initiative. In September, the group held a PCMH Summit to increase understanding about the PCMH healthcare delivery model. Tracks offered topics on 3 levels of PCMH knowledge and engagement. Surveys of the147 attendees revealed overall satisfaction and a request for additional learning opportunities.
  
The next Kansas PCMH Summit is scheduled for November 1st and 2nd to be held in Wichita. Funding for the Kansas PCMH Initiative is provided by the Kansas Health Foundation, United Methodist Health Ministry Fund and the Sunflower Foundation. Additional support has been provided by BCBS of KS. A PCMH is a model of care that strengthens the physician-patient relationship by replacing episodic care with coordinated care and a long-term healing relationship. Eight practices in the PCMH Initiative are using the services of TransforMED, a subsidiary of the American Academy of Family Physicians, to assist them through this transition. The group has walked along side these practices to identify strengths and reduce barriers. In addition, PCMH received a grant from the AAFP Foundation to produce a video project highlighting the perspective of patients and their families on PCMH.
  
Additional resources and information about PCMH can be found at the website http://kafponline.org/kansaspcmh/.
  
2013 Champion Award Materials Are Ready! 

 

The CDC Foundation and CDC are pleased to announce that the nomination materials for the 2013 CDC Childhood Immunization Champion Award are ready!

 

The CDC Childhood Immunization Champion Award is an annual award that recognizes individuals who make a significant contribution toward improving public health through their work in childhood immunization. Each year, up to one CDC Childhood Immunization Champion from each of the 50 states and the District of Columbia is honored.  The deadline for sending nominations to the Kansas Immunization Program is March 1, 2013.

 

Below is a link to the 2013 Nomination Packet. If you would like to nominate someone or what to self-nominate, please click on the link below:

Click here to open the Nomination Packet

  

For more information about the CDC Childhood Immunization Champion Award, please visit: www.cdc.gov/vaccines/champions. If you have any questions please feel free to email [email protected].