Note: New Content Noted with Asterisks*** and Highlighted
Dear KHF Providers and Practice Administrators,
We have several updates to share regarding payor updates, programs and upcoming events. There is a lot of information, and we want to make sure we are keeping our membership informed. We recommend reading through this communication in its entirety and please reach out to us with any questions you may have!
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HHS Takes Action to Keep People Covered as States Resume Medicaid, CHIP Renewal***
On June 12, 2023 the U.S. Department of Health and Human Services (HHS) announced new flexibilities to help keep Americans covered as states resume Medicaid and Children’s Health Insurance Program (CHIP) renewals
In a letter to the nation’s governors, Secretary Becerra stated, “Nobody who is eligible for Medicaid or the Children’s Health Insurance Program should lose coverage simply because they changed addresses, didn’t receive a form, or didn’t have enough information about the renewal process,” said HHS Secretary Xavier Becerra. “We encourage states to utilize all available flexibilities to ensure children and families don’t lose coverage. We also urge states to join us in partnering with local governments, community organizations, and schools to reach people eligible for Medicaid and CHIP where they are.”
Click here for more information.
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KHF Survey Request- Program Development
Practice Administrators,
Based on the feedback from a previous survey and our meetings, we have compiled a list of what has been the most requested support for the practices.
The attached survey contains this list and an opportunity for you to share your thoughts on these programs and offer any that are missing. We will use your feedback to develop our program planning. Please take 10 minutes to complete this survey (or longer if you have a lot to say- that’s ok!)
We will share the results and how these items fit into future programs and timetables, probably at an in person meeting where we can discuss in more detail. If you could complete the survey by Friday, 6/16/23 it would be appreciated.
Thank you so much for your participation.
https://www.surveymonkey.com/r/QDL67YZ
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Repeal of COVID-19 Staff Vaccination Mandate
On May 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released its latest final rule repealing the November 5, 2021, COVID-19 vaccination mandate impacting 13 million staff at 76,000 CMS-regulated provider organizations.
The key takeaway is:
Are providers now prohibited from requiring staff to be vaccinated?
According to CMS, the repeal of the mandate “should not be construed as a diminution of CMS support for vaccination or for facilities to require staff vaccination. Moreover, [the repeal] does not prohibit facilities from requiring staff vaccinations, and we encourage health care employers to maintain evidence-based policies regarding staff vaccination for COVID-19 and other communicable diseases for which vaccination is available and recommended. Health systems and health care employers may continue to require that workers stay up to date on COVID-19 vaccinations, consistent with other Federal, State, and local laws.”
You can read more at:
PYA - Repeal of COVID-19 Staff Vaccination Mandate: What You Need to Know (pyapc.com)
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Social Media Posts for Medicaid Re-enrollment
KHF has developed several social media captions that can be shared on your social media platforms.
Click here to view the posts on the KHF intranet, or download the captions here.
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Alert to KHF Practices on Redetermination of Medicaid Eligibility
As the COVID-19 Public Health Emergency ended, states could begin terminating coverage for ineligible Medicaid recipients, who were temporarily covered during the PHE. According to CMS, while some states have begun the redetermination process, most will not begin terminating coverage until June or July.
In a survey conducted by the Kaiser Family Foundation completed in late May, results indicated that 65% of Medicaid recipients are not aware that states could begin terminating coverage. For more information, click here.
To ensure our patients are aware of the possible termination and redetermination process, please share the following information with them.
If your child is on Medicaid or Peach Care for Kids, please review the following information carefully.
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Continuous enrollment in temporary Medicaid was tied to the end of the public health emergency but will end on March 31, 2023. Recent legislation has allowed states to begin un-enrolling patients as early as April 1, 2023.
- Most states will take approximately one year to complete this process of disenrolling individuals. This is referred to as Medicaid Unwinding or Medicaid Redetermination.
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The state of Georgia will begin the Medicaid Redetermination process on April 1, 2023. This includes all children currently on Medicaid and Peach Care for Kids.
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It is extremely important for you to make sure your information is up to date with the Georgia Department of Human Services (DHS) . If you have not created an account in Gateway, please visit https://www.gateway.ga.gov/access/ and create your account.
- Be sure to update all information including the following: (Available in English and Spanish)
- Name
- Phone number
- Job or income
- Number of people in the household
- DHS encourages you to select “email” notifications which is the easiest way for them to reach you.
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DHS has also created a website that will post currents news and information about Medicaid. Go to https://staycovered.ga.gov/ to stay informed.
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Call 877-423-4746 for more information on Medicaid. Please pay attention to any communications you may receive from the Department of Human Services and CMS.
Resources:
https://staycovered.ga.gov/ (In English and Spanish)
http://www.gateway.ga.gov/
Also attached is a communication with wording that you can use to send an update to your patients to alert them of the changes. Click for the Word version and the PDF version.
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HHS Fact Sheet: Telehealth Flexibilities and Resources and the COVID-19 Public Health Emergency
The HHS released a fact sheet outlining key details of what will change and what will stay the same for patients and providers when the COVID-19 public health emergency ends.
Click here to learn more.
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Update: From KHF on HIPAA Compliance Requirement for Telemedicine Vendors
Dear Colleagues,
An important announcement was distributed this week from the HHS Office of Civil Rights describing the end of enforcement discretion regarding HIPAA compliance in the use of telemedicine during the COVID-19 public health emergency. As the PHE ends on May 11, your ability to use non-compliant HIPAA platforms for telemedicine will expire as well, at 11:59 PM on that date.
This gives you a 90-day period during which to ensure all providers in your practice are using a HIPAA compliant platform for telemedicine.
Please see the information below which details this announcement:
HHS Office for Civil Rights Announces the Expiration of COVID-19 Public Health Emergency HIPAA Notifications of Enforcement Discretion
Melanie Fontes Rainer, OCR Director, stated that the “OCR is continuing to support the use of telehealth after the public health emergency by providing a transition period for health care providers to make any changes to their operations that are needed to provide telehealth in a private and secure manner in compliance with the HIPAA Rules.”
The OCR is allowing 90 days for covered health providers to “come into compliance with the HIPAA rules” in regard to the delivery of telemedicine to their patients/families.
This transition period will begin on May 12, 2023, and end at 11:59 PM on August 9, 2023.
The OCR will exercise discretion in enforcement of these rules and will not impose penalties on covered health care providers for noncompliance with the HIPAA Rules when delivery of care “occurs in connection with the good faith provision of telemedicine during the 90-calendar day transition period.”
To learn more, click here.
As a reminder, TCCN has an agreement with Anytime Pediatrics which is a full service HIPPA compliant telemedicine provider. If you have questions and want to learn more about this program, please contact Barbara Douglas at Bdouglas@khfirst.com.
Lori Desoutter, MD
Medical Director
Kids Health First IPA
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End of Public Health Emergency (PHE) Resources
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TCCN Antibiotic Stewardship Webinar: Why It's Important For Your Practice and Patients
Thanks to everyone who joined us last week for the first webinar in our Antibiotic Stewardship series. This lunchtime series introduces the new Georgia Pediatric Antibiotic Stewardship website, gpas-online.org, designed to help you in your busy practices with guidelines and a new antibiogram visualization tool.
If you were not able to attend live, we encourage you to watch a recording via this link.
A copy of the slides may be accessed by this link.
Save the dates for upcoming webinars:
Webinar #2: August 16: Prescribing Guide
Webinar #3: November 1: Antibiotic Dosing
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TCCN Seizure Action Plan Video and Resources
TCCN member group, Children’s Neurology, has been awarded a 1998 Society grant for a quality improvement project aimed to reduce emergency department visits and hospitalizations for patients with breakthrough seizures. Read more here.
TCCN has developed the following video in support of this grant. The video provides an overview of the self-management education and resources provided to patients and families as well as coordination of care documents for providers and how to locate them in accessCHOA. Teaching sheets utilized by the neurology team are also included.
Click Here to View the Seizure Action Plan Video
Resources:
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Children's Pediatrics Zero Suicide Webinar Series
The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), Office of Behavioral Health Prevention and Federal Grants is pleased to announce the Pediatric Zero Suicide Webinar Series, which will target Georgia's pediatric primary care providers and their staff. This webinar series will offer training sessions that will help to uncover and care for the mental health needs of youth as well as support parents and guardians.
For more information and to register please click here.
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Georgia AAP Medicaid Eligibility Redetermination and "Office Hours" Webinars
The Georgia AAP is offering two upcoming resources regarding Medicaid Eligibility Redetermination.
Medicaid "Office Hours"
Thursday, July 6th 8:00 am - 9:00 am
Moderator: April Hartman, MD; Chair
Georgia AAP Medicaid Task Force
New offering for Chapter Members! Join your colleagues for this monthly comprehensive Q & A on all things Georgia Medicaid.
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This webinar, with officials from the Georgia Department of Community Health & the Georgia Medicaid program, will provide information on the redetermination process for Medicaid patients and changes coming due to the recent end of the Public Health Emergency. The webinar audience will be Chapter members & administrative staff; and also our colleagues in the Georgia PCP coalition—OB/Gyn, family medicine and internal medicine. | |
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AAP Online Course Opportunity: Managing Acute and Chronic Pain and Substance Use Disorders in Pediatrics
This course will meet the new government-mandated requirement for all DEA-registered practitioners to complete eight hours of training on the treatment and management of patients with opioid or other substance use disorders prior to applying for or renewing their license.
Pain in pediatric patients is common, under-recognized, and undertreated. Unrelieved acute, chronic, and needle pain in childhood directly results in poorer clinical outcomes, including increased morbidity, degree of anxiety, needle-phobia, health care avoidance, and chronic pain, which may contribute to substance use disorders.
Please click here to learn more.
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Recommended CME for Kids Health First Providers
The DEA recently announced that physicians renewing their DEA license from late June onward will need to demonstrate that they have completed 8 hours of training in opioid prescribing and treatment of opioid use disorder.
This training is mandated by the MATE Act. Physicians who have previously completed similar training to meet Georgia’s licensing requirements can count those courses, but they typically were not enough to fulfill the 8-hour requirement.
KHF has identified a free, online, Pediatric-specific course that satisfies the DEA requirement. This course has been vetted by Dr. Lori Desouter, KHF’s Medical Director.
Please click here to learn more and register for the class.
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Amerigroup Notification Error Update
On May 23, 2023, Children’s was notified that Amerigroup members received notices advising them Scottish Rite Hospital is out-of-network as of May 15, 2023. Amerigroup is the Medicaid CMO that covers all kids in foster care in Georgia as well as many other children across the state.
Amerigroup confirmed that the member notifications were sent in error due to a system issue that has impacted many providers. There should not be any network disruption for Amerigroup policy holders.
Contact managedcare@choa.org if you or your patients experience any authorization issues related to the inaccurate notification.
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Georgia Medicaid
Medicaid Unwinding Toolkit Resources
Beginning April 1, 2023, all Georgia Medicaid and PeachCare for Kids® members will undergo an eligibility review. This process will take approximately 14 months. A member’s date for redetermination may be anytime between April 2023 and March 2024.
For more information, please visit https://staycovered.ga.gov or https://dhs.georgia.gov/medicaid-unwinding.
Additional Resources
AAP unwinding two pager_3.15.23.pdf
Practice_Template_Letter_Unwinding_Medicaid.docx (live.com)
Practice Template Letter Unwinding Medicaid Spanish Copy.docx (live.com)
Microsoft Word - AAP_Georgia.docx
Lactation Consultants – Revised Policy effective 3/15/2023
Medicaid Member Redetermination
DCH has not contacted members in 2 years and will begin member redetermination outreach on February 1, 2023. They must initiate contact with all Medicaid members within 12 months and complete the redetermination within 14 months in accordance with CMS guidelines. Members will be contacted during their renewal month. For example, if a member had a historical renewal in April, they will not be contacted until April. If the member utilizes SNAP/TANF, DCH will align with those programs to only contact the member one time.
How can the provider community help?
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Please review https://staycovered.ga.gov/ for the latest PHE Unwinding information.
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Proactively encourage and remind Medicaid patients to update their personal information on the Gateway website: https://gateway.ga.gov/access/
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Share video, images, and the PHE toolkit that are found on https://staycovered.ga.gov/ with your patients.
Georgia Medicaid Provider Revalidation
Provider revalidation has also been voluntary due to the PHE. However, in 2023 the revalidation will become mandatory. Gainwell is reaching out to providers to assist with the revalidation process. The Revalidation/Recredential application is one application.
For providers with multiple service locations, you will be required to Revalidate each additional service location.
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Kids Health First Who to Call List
Please contact our team with any needs you may have.
TCCN 2-Week Data Submission Requirement
The TCCN BOD requires all practices to submit claims data to the PHM Tool within 14 calendar days of the most recent encounter date.
Replay: Virtual PA Meeting- Active Shooter Training
KHF Updates: https://vimeo.com/819629693/b7d7ab5e02?share=copy
Active Shooter Discussion with Zachary Williams:
Recording is available for replay on the KHF Intranet site.
- Go to the University tab, then webinars to access the video.
2023 Pediatric Coding Update and Managing the Challenge of Surge
Here is the link to view the recording. Passcode: u*1Xuh11
2023 Pediatric Coding Update and Managing the Challenge of Surge Slide Deck
Nov. 17th Pediatric Coding Seminar Recording and Materials
2023 Pediatric Coding Seminar Recording
Slides: Color and Black & White
Free OSHA Training
Here is the link to the OSHA Webinar held on 9/15/22.
Here is the pdf of the deck.
Here is the end of course test.
If you were unable to attend live and you watch the video above and complete the test and would like your certificate of completion, please email Tandric Bowden at tandric.bowden@tccn-choa.org.
KHF Q&A for Parents
Q&A Resources are posted on the KHF Intranet here.
Topics Include:
- Q & A for parents on the end of the Public Health Emergency and the unwinding of Medicaid.
- Q & A for parents about the COVID-19 Bivalent Vaccine Boosters from Pfizer BioNTech and Moderna for children 5 years of age and older.
- Q & A for parents on what to know about monkeypox from Kids Health First.
- Q & A for parents on Covid-19 Booster Vaccines for 5-11 years old.
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Q & A for parents on recall of Abbott formula and re-opening of plant.
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TCCN Roundup:
The TCCN Roundup is designed to be a twice weekly information hub for all things TCCN.
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Please to check out the latest issue
- Please note that the link above only accounts for some TCCN updates. In order to view the full TCCN Newsletter with your contracted payor updates please check your TCCN inbox!
TCCN Quality Steps Newsletter
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