Due to being short staffed for a variety of reasons for the past several months, we are experiencing a backlog of patients waiting to be screened. Please be assured that we are currently addressing the situation. We have just hired a new navigator and anticipate catching up by the beginning of February. In the meantime, if you have any questions or concerns please contact Sharon Lewis at Sharon@mywcms.org or 828-274-2267, ext 305.

Thank you for your patience and understanding.

This project is coming to fruition through a partnership with the Palliative Care Association of Zambia (PCAZ), Four Season Palliative Care and the Peace Corps volunteers of Zambia. The details of this project scheduled for April 15-May 29, 2013 are described in the link below. Medical volunteers are needed for this project (physicians, mid-level providers, nurses and medical social workers). Zambia is a country located in southern Africa. It is one of the poorest nations and lags behind the world in providing basic safe sanitation and ... Keep reading.

WCMS strives to keep you up to date weekly with Vital Signs, but there's more news than can fit into a weekly newsletter. If you want daily updates, check out our Twitter feed and our Facebook page. 

Did you know that WCMS has a webpage devoted to Health Care Reform, which includes articles and presentations on the implications of ACA, how physicians can play a leadership role in accountable care, payment reform, and more? Even better, WCMS is a member of NCMS' Toward Accountable Care Consortium and Initiative for the purpose of providing the medical community with the knowledge and tools needed to understand, participate in, navigate, lead, and succeed in a value-driven health care system. Check out these resources today. 

Today is the opening day of the State Legislative Session. Now that we know who will be in office for the next few years we are deploying our physician liaisons to go out and build relationships with their assigned legislators. Our goal is for our liaisons to serve as the go-to physician for their legislator on healthcare related issues. Click on this link to find out who your physician liaisons are in WNC!  

To:        All North Carolina Health Care Providers
From:    Megan Davies, MD, State Epidemiologist
RE:        Use of Antivirals for Severe Influenza Infections

The Division of Public Health has received reports of severe and even fatal influenza cases in which antiviral medications were delayed or withheld due either to false negative rapid influenza diagnostic test results or to the belief that antivirals are not effective if started more than 48 hours after illness onset. We would like to remind all providers of the following:

As a reminder, antiviral treatment is recommended as early as possible for patients with suspected or confirmed influenza (regardless of vaccination status) who: 

• are hospitalized;
• have severe, complicated, or progressive illness; or
• are at higher risk for complications (e.g. persons with certain chronic medical conditions, persons 65 or older, children younger than 2 years, and pregnant or postpartum women).

Vaccination remains the best way to prevent flu. We encourage providers to continue offering flu vaccine throughout the remainder of the winter and early spring. Additional guidance and information about influenza activity in North Carolina is available at http://www.flu.nc.gov/

The American Taxpayer Relief Act of 2012 was signed into law Jan. 2, 2013. The new law averts the 26.5% Sustainable Growth Rate (SGR) cut for all of 2013 and the 2% sequester for the next two months. It also extends the work Geographic Practice Cost Index (GPCI) floor for a year. Yesterday, the Centers for Medicare and Medicaid Services (CMS) released an announcement regarding updated 2013 Medicare payment amounts, claims processing, and reopening of the participation enrollment period.

Some carriers are not expected to post the new rates on their websites until at least next week and possibly later. The 2013 fee schedule amounts you received from your carrier in November include both the SGR and GPCI reductions, and thus significantly understate the current Medicare fee schedule.

In the meantime, some practices are asking what they should charge. By law, Medicare is required to pay physicians the lesser of the submitted charge or the Medicare approved amount. In addition, most commercial health insurer physician contracts contain language that similarly sets the billed charge as the cap on payment. Thus, physicians who accept assignment should review their retail fee schedules and update them to reflect their current practice costs before they bill Medicare in 2013. Access AMA's "Defensible fee schedule" toolkit to assist you with this effort. The AMA recommends physicians either defer submission of claims for 2013 dates of service until the new 2013 rates are published, or bill their updated retail rates.

In addition, due to relative value changes that will affect some 2013 payment amounts and limiting charges, for unassigned claims practices should probably wait to bill patients directly for cost-sharing amounts until the new 2013 rates are published. 

Hold Insurers Accountable

WCMS is a thriving 900-plus member professional association of the physicians of western North Carolina and a chartered component medical society of the NC Medical Society and the AMA. The WCMS is an organization run by physicians for physicians.