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Charlotte AHEC Practice Support
July Newsletter
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 COVID-19 Pediatric Vaccines: Children 5 Years Old – 6 Months
On June 18th and following FDA authorization, the Centers for Disease Control and Prevention (CDC) recommended that all children 6 months through 5 years of age should receive a COVID-19 vaccine.
All children 5 and under should receive a COVID-19 vaccine.
- In general, the vaccines for children 5 and under are not interchangeable, and the same product should be used for all doses in the primary series. See CDC guidance for exceptional situations.
- As with all other age groups, COVID-19 vaccines can be co-administered with other vaccines for children 5 and under.
Moderna's primary series for ages 6 months – 5 years is 2 doses for non-immunocompromised children, and 3 doses for immunocompromised children.
Pfizer's primary series for ages 6 months – 4 years is 3 doses for all children in this age group.
For fact sheets and standing orders, please visit:
Guidance | NC COVID-19 (ncdhhs.gov)
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Managed Care: Tailored Plan
On December 1, 2022, NC Medicaid will have a new type of health plan. It is called the Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plan (Tailored Plan). People who need certain services to address a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI) may qualify for the Tailored Plan that serves their county. Key milestone dates, including the July 16th contracting deadline for beneficiary choice period, can be found in the Provider Playbook.
To find out how this will impact your practice and learn about contracting, check out: Tailored Plan services | NC Medicaid Managed Care (ncmedicaidplans.gov)
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UPDATE: Prior Authorizations End-dated When a Beneficiary Transitions to Managed Care
When a beneficiary enrolled in Medicaid Direct transitions to NC Medicaid Managed Care, NC Medicaid will transfer authorized prior authorizations (PA) that extend beyond the beneficiary’s transition date, to the appropriate Prepaid Health Plan (PHP). This allows the beneficiary to continue services using the same PA while in Managed Care.
If an individual disenrolls from NC Medicaid Managed Care and returns to Medicaid Direct, the PHP will transfer most authorized PAs that extend beyond the beneficiary’s transition date to NCTracks. See Notes below for exceptions to this process.
Effective June 26, 2022, Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment. To read the full announcement please review: UPDATE: Prior Authorizations End-dated When a Beneficiary Transitions to Managed Care | NC Medicaid (ncdhhs.gov)
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 North Carolina Electronic Case Reporting
Electronic case reporting enables health care providers to satisfy mandated reporting requirements for NC DPH and CMS regulatory requirements for the Public Health and Clinical Data Exchange objectives. The eCR provides complete and accurate data, enables the ability to more quicky identify emerging public health trends, improves collaboration and communication with healthcare through the bidirectional data exchange, and reduces response time with automated information. For more information and steps on how to sign up, visit: NC DPH: Syndromic Surveillance Meaningful Use Requirements (ncdhhs.gov).
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Medicare Payments to Decrease Starting July 1
Medicare payments for dates of service on or after July 1 will decrease as full “sequestration” cuts take effect after several months of partial cuts. “Sequestration” refers to across-the-board reductions in certain federal spending mandated by The Budget Control Act of 2011. The sequestration decrease will appear on Medicare remittance advices with claim adjustment code CO 253, "Sequestration – reduction in federal payment," as the reason. Medicare payments to decrease starting July 1 (aafp.org).
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 Charlotte AHEC Highlight: Library Services
Charlotte AHEC has a team of highly qualified and experienced Medical Librarians to help you get connected to the medical research you need. Areas of service include:
- Clinical Alerts
- Document Delivery and Interlibrary Loan
- Literature searches
- Training
To learn more about Library Services, or to make a request, please visit the Library
webpage.
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Administrative Simplification – HIPPA Regulations
The National Standards Group (NSG), on behalf of DHHS, created a new fact sheet highlighting some key provisions in the HIPAA Administrative Simplification regulations, which CMS recently released. These regulations are aimed at streamlining and simplifying health care transactions, i.e., standards/transactions, operating rules, unique identifiers, and code sets. Check out the links below for more information and to access the fact sheet: HIPAA and Administrative Simplification | CMS.
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 New Low-Cost Prescription Drug Option
The newly established Mark Cuban Cost Plus Drug Company may be an option to help you and your patients find affordable medications without using insurance. The pharmacy continues to add medications to their product list and has accumulated over 700 medications as of June 2022. To learn more, visit:
Additionally, the AAFP has tips to help find solutions to reduce prescription drug costs:
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Performance Year 2021 Preliminary Feedback Available
Per CMS, preliminary feedback for the 2021 performance year is now available. To review your preliminary feedback, sign into your QPP account using your HARP credentials. Please note:
- This isn’t your final score. You’ll be able to preview your final score in mid-June while we calculate MIPS payment adjustments
- CMS announce the final score preview period through the QPP listserv and the QPP Small Practices Newsletter.
- CMS anticipates that final performance feedback, including MIPS payment adjustments, will be available in early August.
- As a reminder, the 2021 performance year is the last year that CMS will automatically calculate a group level quality score from Medicare Part B claims measures reported for individual clinicians.
If you have not done so already, please subscribe to the QPP Listserv to stay informed. To subscribe:
- Visit the Quality Payment Program website.
- Scroll to the bottom of the homepage.
- Enter your e-mail address under the heading, “Sign Up for the QPP Listserv”, and click Subscribe.
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 Medical Staffing Struggles During the “Great Resignation”
Practices all over the region continue to experience staff turnover. The article “Don't Leave Me! Strategies for Medical Staff Retention” in the American Academy of Family Physicians highlights strategies that you can utilize now. Additionally, Charlotte AHEC has developed a Hiring Toolkit to help you fill vacancies you may have.
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| Charlotte AHEC - Part of the NC AHEC Program
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