November 20, 2020 ncpharmacists.org
E-News ENews Advancing Pharmacy. Improving Health.
General News
• PHP Provider Manual updates • Key dates for transitioning to Medicaid Managed Care
Medicaid Managed Care Update Published
NC DHHS Submits COVID-19 Vaccination Plan to the CDC
An update was published, November 17th, in the NC Medicaid Bulletin providing information on North Carolina’s transition to Medicaid Managed Care. On July 1, 2021, an estimated 1.6 to 1.8 million Medicaid and NC Health Choice beneficiaries will transition to Medicaid Managed Care. Beneficiaries will be able to choose from five Prepaid Health Plans (PHPs) or the Eastern Band of Cherokee Indians (EBCI) Tribal Option. Some beneficiaries will stay in fee-for-service known as NC Medicaid Direct. This provider update includes:
In October, North Carolina submitted its COVID-19 Vaccination plan to the Centers for Disease Control and Prevention. The goal of the plan is to immunize everyone who is eligible for and wants a COVID-19 immunization. The NC plan reflects five principles that will guide our state’s planning for and distribution of one or more COVID-19 vaccines. The five principles are:
• Links to sign up for one webinar series specifically for Medicaid Managed Care going live on July 1, 2021, and another that focuses on Quality and Performance on clinical criteria • How to ensure provider information displays correctly in NC’s Provider Directory Tool • Provider Ombudsman contact information
1. All North Carolinians have equitable access to vaccines. 2. Vaccine planning and distribution is inclusive; actively engages state and local government, public and private partners; and draws upon the experience and expertise of leaders from historically marginalized populations. 3. Transparent, accurate and frequent public communications is essential to building trust. 4. Data is used to promote equity, track progress and guide decision-making.
5. Appropriate stewardship of resources and continuous evaluation and improvement drive successful implementation.
The full plan as submitted to the CDC can be accessed here, and the table outlining the phases for immunizing prioritized populations can be found on pages 6467 of the plan.
NCAP Gathers NC Evidence of PBM Unfair Business Practices
NCAP is collecting evidence showcasing unfair PBM practices, such as, clawbacks (DIR fees), patient steering, unfair audits, forced mail order, and low or below cost reimbursement. You should be able to do this from your cell phone by taking a picture and uploading it or you can upload a PDF. PLEASE remove any patient identifiers before uploading and include the name of the PBM if able. We know that some PBMs have retaliated against pharmacies that have spoken out against what PBMs are doing; and others of you are hesitant because often network contracts forbid disclosing details. NCAP will keep your information confidential and share only the examples of the types of unfair practices occurring in
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our state. We need this type of information when advocating for change with our NC legislators. Any relevant information you can provide will bring us one step closer to holding PBMs accountable across our state. Click here to access the form for submitting your examples. Please book mark this link and educate key staff on using this link to provide unfair practice evidence upon occurrence. Well-Being Index Shows Grim Results for North Carolina Pharmacists
As healthcare providers, we all know that burnout is real, and 2020 has further illuminated the stress that pharmacists experience. The latest results of the APhA Well-Being Index shows the following for North Carolina. Please see the picture below.
A limitation to these results is that only 292 pharmacists took the assessment. Please consider taking advantage of the APhA online screening tool, developed by the Mayo Clinic, to evaluate your fatigue, depression, burnout, anxiety and stress. It takes less than 5 minutes to answer 9 short questions in this well-being index. It is 100% anonymous, but can help provide a clearer, more collective picture of our profession’s well-being here in NC; and resources are available once you submit your assessment. The Well-Being Index is free and available for pharmacists, pharmacy technicians and student pharmacists.
You do not have to be an APhA member to take the assessment at https://app.mywellbeingindex. org/signup and use the Invitation Code: APhA.
NCAP Elections The NCAP annual election ended just prior to the start of our annual convention. Due to the virtual nature of our Convention, we were not able to hold our typical awards reception, announce the 2021 Board of Directors, and induct the 2021 officers in front of the membership. The NCAP staff extends a warm thank you to all of our volunteer leaders, and we look forward to working with you in 2021. 2021 NCAP Executive Committee
Beth Mills, President
David Phillips, Board Chairperson Matt Kelm, President-elect Paige Brown, Secretary Ryan Mills, Treasurer
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2021 NCAP Board of Directors Officers listed above
Anita Yang, Student Pharmacist Forum Chair
Brianna Berish, New Practitioner Forum Chair Irene Ulrich, Ambulatory Care Practice Academy Chair Anna Armstrong, Community Practice Academy Chair
Janine Bailey, Chronic Care Practice Academy Chair
Angela Livingood, Health System Practice Academy Chair Ouita Gatton, At-Large Director Vinay Patel, At-Large Director
Riley Bowers, At-Large Director Ambulatory Care Practice Academy Election Results
Holly Canupp, Chair-elect
Michelle Chaplin, At-large Leigh Foushee, At-large
Janelle Montgomery, At-large
Chronic Care Practice Academy Election Results
Amber McLendon, Chair-elect Jamie Cronquist, At-large Sierra Thomas, At-large
Community Care Practice Academy Election Results
Trish Mashburn, Chair-elect Anna Baird, At-large
Onyx Flowers-Russell, At-large Katie Trotta, At-large
Health System Practice Academy Election Results Mary-Haston Vest, Chair-elect Tina Hipp, At-large
Kevin Isaacs, At-large
Ashley Pappas, At-large
Catherine Wendt, At-large
Seeking Volunteers for 2021
It’s that time of year again! Interested in serving on an NCAP committee, task force or team. Our members who volunteer to serve each year are essential to the operations of our state’s pharmacy association. At this time we are recruiting for the following initiatives. Click here to access the ‘how to get involved’ webpage. Scroll the end of the page to access the volunteer form. You will need to log-in as a member, but it takes only few minutes to complete the form. Note: whether you are a first-time or a seasoned NCAP volunteer, and even if you have already emailed or spoken with a staff member regarding your interest in serving, please complete the online volunteer form. The online form will help organize all the volunteer requests.
activities for the NCAP Advocacy Fund • Plan and execute NCAP-hosted podcast • Serve on the NCAP Communications Committee • Serve on the NCAP Policy & Advocacy Committee • Serve on the NCAP Membership Committee • Serve on the NCAP Resource Development Committee • Serve on the NCAP Technician Work Force Task Force • Serve on a Vendor/Sponsor Project Team (seeking individuals who interact regularly with pharmaceutical representatives)
New Practitioner News Bring It
2021 Committee, Task Force, and Project Team Needs
We know you’ve got style, attitude and a can-do-spirit! The New Practitioner Forum is looking for you and others like you to join the leadership team for the Forum. It’s not a huge time commitment and we’re not asking for money, but it is a big deal. We need new practitioners to help us shape the future of NCAP. Have we piqued your interest yet? Contact Bri Berish, NPF Chair, at briana.berish@gmail.com.
• Plan 2021 Convention (this group will work January-May) • Plan topics and recruit speakers for E-Learning, on-demand education • Plan topics and recruit speakers for pharmacy technician education • Plan and lead fundraising
Tired of following along? Want to take command of your future? Then you should join in on the Leadership Buzz, which is a new leadership development program, sponsored by the NCAP New Practitioner Forum. Leadership Buzz is for pharmacists in the first 4 years of practice who
Leadership Buzz
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are NCAP members. This development program will use six leadership books, and facilitated discussion to help you build, and refine your leadership skills. Each session will be facilitated by a NC pharmacy leader. Click here for the schedule, a list of the leadership books, and to register. The first 30 registrants will receive a scholarship to cover the cost of the books for the event.
Practice Advancement News
Updated Immunization Toolkit Now Available NCAP frequently gets calls asking about what resources we have for immunization services. One of the number one questions asked is “do you have sample protocols”? NCAP, for a number of years, has had an immunization toolkit available to members. The past few months we have had a team of individuals working on an overhaul and update to our immunization toolkit. The toolkit is relatively comprehensive, newly updated and now available to members at www. ncpharmacists.org. Use your member log-in and access the immunization toolkit under the ‘resources’ tab. We hope that when you have colleagues who ask about immunization resources you will remember to refer them to NCAP. Also if there are other toolkits or resources that you would like to see NCAP provide for members, please contact our Director of Practice Advancement, Cheryl Viracola, at cheryl@ ncpharmacists.org.
NCAP staff extends a special thank you to our Convention Member News Planning Committee, including the Co-Chairs, Matthew Kelm and Dustin Wilson, all of whom Working Advantage were instrumental in developing the programming, securing NCAP has partnered with “Work- the speakers and helping with ing Advantage” to bring you a many of the behind the scenes new, value-added membership logistics. NCAP President, David benefit. Working Advantage is Phillips, had this to say about the the largest and most successful event. “The overall experience as employee and association-based, an attendee was incredible. The setup, utilizing the new LMS and merchant, travel and entertainZoom, was well organized, and ment discount service. We recognize, in the era of COVID, it is although virtual, it still provided difficult to even think travel and an intimate environment that entertainment, but we think you allowed attendees to engage will be pleasantly surprised by all with the speakers. Thank you to the NCAP staff, moderators, and the home-based, and merchantspeakers for such an enjoyable related discounts that Working and valuable experience!” Advantage has to offer. Treat yourself or take advantage of the Winners of Convention Prizes many savings for the upcoming holidays. It is a simple sign-up process and free for NCAP mem- Deb Hewitt bers, but you will need the NCAP $75 Gifts-for-Good gift card member promo code to join. Click here to learn more and to Ritesh Patel sign-up today. $75 Gifts-for-Good gift card
Event News
2020 Annual Convention Our first all-virtual annual convention was very successful. The event ran from October 29th through November 6th, and included 30+ hours of programming. The extended format and flexible hours enabled over 400 registrants to attend the event. Convention registrants now have access to all the recordings, in case you were unable to attend some of the live sessions. The
Bri Berish $75 Gifts-for-Good gift card Kimberly Mason Yeti Cooler
Upcoming Events
Let’s hear it for the Boys Men’s Health Update Dr. Michelle Fritsch
Sunday, November 22 from 6-7 PM Live CE Webinar Click here to register!
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Managing Diabetes in Older Adults Dr. Tasha Woodall Sunday, December 13 from 6-7 PM Live CE Webinar Click here to register! March 2021 Medicaid Managed Care Forum Opportunity to ask questions and hear from the pharmacy directors for Medicaid and the MCOs Date & Time TBD
Partner News Convention Metal Sponsor The North Carolina Senior Medicare Patrol (NCSMP) Program is housed within the Seniors’ Health Insurance Information Program (SHIIP) at the North Carolina Department of Insur-
ance. NCSMP is a preventive educational program whose goal is to reduce Medicare error, fraud, and abuse through statewide coordinated efforts of educational and promotional activities and to encourage reporting of discrepancies by Medicare beneficiaries and caregivers to the NCSMP Program. NCSMP’s purpose is to educate Medicare beneficiaries and caregivers about Medicare benefits in order to understand Medicare Statements such as Medicare Summary Notices, Medicare Part D Prescription Drug Plan (PDP) Explanations of Benefits (EOB) and other related health care statements. Through this knowledge, a person can identify, resolve and/or report possible billing errors, fraud, abuse and waste to NCSMP.
In North Carolina, all NCSMP volunteers are fully trained SHIIP volunteers. Learn how to become a volunteer with SHIIP and NCSMP.
payers’ money is lost annually to billing discrepancies, fraud, abuse and waste in the Medicare program?
• “Fraud and Abuse” in the Medicare program often times are actually billing errors or discrepancies? • The process of reporting suspected fraud abuse and waste is to contact the provider to seek resolution; to contact their Medicare carriers and insurance companies and to file an appeal by following the appeal instructions found on the back of the Medicare Summary Notice? And if your situation is not resolved satisfactorily, you should contact the North Carolina SMP Program at the nationwide toll-free number, 855-408-1212? Opening doors for Independent Pharmacists. Mutual Drug has been assisting pharmacists in declaring their independence for 65 years.
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Did you know that:
• 68 billion dollars of the tax-
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