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NCPeds News Net-October 2017

Sunday, October 29, 2017  
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NCPeds News Net
October 2017

 

Vaccine Administrative Action Update

Good news! The North Carolina Pediatric Society (NCPeds) and the North Carolina Academy of Family Physicians (NCAFP) have won a court action to correct a significant underpayment on approximately half of vaccine administration payments paid by Medicaid to attested providers during the ACA years!

For more than three years NCPeds, our Pediatric Council and NCAFP have been advocating for the NC Division of Medical Assistance (DMA) to correct an underpayment on administrative fees for immunizations provided to Medicaid recipients under the VFC program in 2013 and 2014. After discussions urging NC Medicaid to correct these underpayments proved unsuccessful, NCPeds and NCAFP joined eight private pediatric practices to retain a lawyer and began an official administrative action.

Judge Beecher R. Gray ruled DMA shall reprocess those payments to attested primary care physicians for vaccine administrations billed during 2013 and 2014 with an extra $6.74 per affected vaccine. Furthermore, he ruled the payments must be made within 120 days. The complete ruling is available here. DMA has 30 days to file an appeal.

There are many people to thank for this successful outcome! Our attorney, Joey Ponzi at Brooks Pierce served as a spectacular advocate on our behalf. He successfully argued NCPeds and NCAFP had "standing" as parties to the lawsuit so all primary care could benefit. He did a masterful job handling strategic and tactical court navigation as well as the complex world of Medicaid, coding, VFC Programs and the ACA.

Graham Barden III, MD, FAAP at Coastal Children's Clinic, who identified the underpayment and related issues, and Christoph Diasio, MD, FAAP at Sandhills Pediatrics, together dedicated countless hours to this effort which truly would not have happened without their involvement.

This effort could not have proceeded without generous financial support from eight private pediatric practices who felt strongly enough about this issue to take the risk of funding the initial legal costs:

Blue Sky Pediatrics
Burlington Pediatrics
Cary Pediatric Center
Coastal Children's Clinic
Goldsboro Pediatrics
Haywood Pediatric and Adolescent Medicine Group
KidzCare Pediatrics PC
Sandhills Pediatrics

NCAFP was a tremendous partner in this suit as were the Board, membership and donors of NCPeds. Filing a lawsuit is beyond the scope of NCPeds' usual activities and the Board believed the potential benefit to members outweighed the risks. Without the support of members and donors contributing to our strong fiscal base, NCPeds financial involvement would not have been possible and the repayment may have been limited to only the named practices and family physicians. Your membership dues and donations helped make this possible. None of this would have been possible without each of the many parts working together.

A letter from Drs. Barden and Diasio explaining how members and practices can help NCPeds retire outstanding legal bills can be found here. We have raised donations for half of our legal expenses but want to raise the rest ASAP so we can get back to our primary mission - improving health care for children. Small and large donations are welcome! Please go here to make a donation on our secure online site, or mail a check made payable to the North Carolina Pediatric Society, Inc. to NCPeds, 1100 Wake Forest Road, Suite 200, Raleigh, NC 27604.

 

 

 

 


PL-2 Career Day
O
ctober 4, 2017 Durham

Earlier this month Dozens of PL-2s turned our to learn about CVs, fellowships, and diverse career paths from a physician panel. The residents also made time for advocacy urging Congress to extend CHIP. Many thanks to everyone who helped make the day a success, especially Dr. Kenya McNeal-Trice for organizing the day.

 

Meet our Lawyer
Joseph A. Ponzi

YourMembership Spotlight
How to Donate On-line



The son of pediatrician, (his father is Joseph Ponzi, MD, FAAP of Goldsboro Pediatrics) Joseph "Joey" A. Ponzi knows a thing or two about pediatric health care in North Carolina, and about NCPeds' work.

"NCPeds is a vital advocate for children in North Carolina and the pediatricians who provide their care," shared Joey.

So when NCPeds needed representation for the vaccine administrative action, Joey was a natural choice. "The lawsuit was about compensating primary care physicians throughout North Carolina at a fair rate for the Medicaid services they provide. The express purpose of the Medicaid payment increase under the ACA was to increase the availability of Medicaid services by encouraging primary care physicians to participate in Medicaid, and it was important for DHHS to follow through on that commitment," said Joey.

A native of Goldsboro, Joey received his undergraduate degree from the University of North Carolina at Chapel Hill and his law degree from the University of Virginia School of Law. He is currently a partner with the Brooks Pierce law firm's Greensboro office where he has worked for the past ten years.

Outside of work, Joey enjoys hiking in the North Carolina mountains and spending time with his family. He lives in Greensboro with his wife, Sarah, and their two daughters, Clara (10) and Sofia (8).

 


 

 

Want to support NCPeds but not sure how? Giving is easy!

 

There are many ways people can make tax deductible donations to NCPeds.

 

NCPeds' website offers a secure online giving portal for a safe and efficient donation experience. The donation form allows donors to choose the giving method that is right for their budget, with one-time gift and monthly giving options.

 

Additionally, donors have the opportunity to make donations "in memoriam" or "in honor" of special people or causes. NCPeds notifies the appropriate people of these type of gifts.

 

Tax deductible donations can also be made via the mail. Checks made payable to the NC Pediatric Society, Inc. can be mailed to 1000 Wake Forest Road, Suite 200, Raleigh, NC 27604.

 

Thank you for supporting NCPeds!



 

Dates to Remember

Mark your calendars for these upcoming NCPeds events.

  • Winter Open Forum, Saturday, January 27, 2018 at the Pinehurst Resort in Pinehurst
  • Practice Manager Retreat, Thursday, March 1 - Friday, March 2, 2018 at the Embassy Suites in Concord
  • Spring Open Forum, Saturday, April 21, 2018 at the Great Wolf Lodge in Concord
  • Annual Meeting, Friday, September 14 - Sunday, September 16, 2018 at the Marriott Resort and Spa at Grand Dunes in Myrtle Beach

 

Contact NCPeds
919-839-1156
www.ncpeds.org


 

 


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