June 30th, 2023


View as Webpage

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!


Important Updates

APB MOC Part 4 Program Opportunity- Depression Screening***


Kids Health First is excited to announce that we will be offering a free American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Program for our providers! Kids Health First is an ABP Portfolio site and has designed a MOC program that will help the providers and patients in our metro Atlanta area. 


Please note that while we do not anticipate any problems, we do not yet have approval from the Board of Pediatrics. We have submitted the MOC application for Part 4 credit and we are awaiting approval. The program will begin in late July and will extend through the end of the year. If you need your points in 2023 and have completed the program, they will be rewarded before the end of the year. Please see the attached flyer 


In a partnership with TCCN, The Kids Health First Quality Utilization Management Committee is looking to define the scope of the behavioral health crisis in our network and to be part of the data driven solution. As a TCCN minimum requirement, you are already screening for depression at adolescent visits. The MOC program will focus on the results of the screen and assess if follow up is received in an appropriate time frame. We all understand that resources for behavioral and mental health are not adequate. It is our goal to determine the rate of positive screens and with your help, demonstrate the need for more services. 


This is a fantastic opportunity to receive MOC Part 4 points, that can be carried over to next year, as well as an opportunity to impact change. Please see the attached flyer and send an email to MOC@khfirst.com to register. 


The registration deadline is July 19th. 


We strongly encourage all providers in your practice to participate since the MOC will require coding updates to your EMR.  

Pregnant Workers Fairness Act (PWFA)***


The PWFA law went into effect on June 27, 2023. The law applies to any business with 15 workers (bodies- not FTE). Attached is an updated fact sheet from vxtra that gives examples of reasonable accommodations.


NEW AAP Oral Health Risk Assessment in Spanish & English***


The AAP Oral Health Risk Assessment tool has been updated to streamline and support this essential component of the well-child visit.


The tool is now accompanied by an intake form to collect pertinent patient information from parents/caregivers. An updated self-management goal sheet supports shared decision-making on preventing cavities and maintaining healthy teeth at home. 


Find all the new tools here.


The Oral Health Risk Assessment tool is just one of many AAP resources to help you successfully integrate oral health promotion and disease prevention into practice.

KHF Question of the Day Results***



Survey Results: Credit Card Processing Fees


Question: Are you charging a credit card processing fee with each transaction or some sort of other flat fee?


0 of 30 respondents said yes they charge a processing fee.

30 of 30 respondents said they do not charge a processing fee.



Survey Results: Fever in Infants


Question: What is your office policy regarding infants between 4-8 weeks old whose parent calls the office to say they have a fever? 



We surveyed! You answered! Previous Surveys are below!



Law Alert: Georgia Expands Voting Leave



Vxtra has provided the following update for our members,


Starting July 1, 2023, Georgia’s voting leave law—which applies to employers of all sizes—will be expanded to allow employees to take time off to vote on the day of an election or on any in-person early voting day. Employers will also need to provide voting leave regardless of an employee’s work schedule. (Previously, employers only had to provide leave if an employee didn’t have two hours to vote before or after work while the polls were open.)



Time off to vote can be limited to two hours and be unpaid, though exempt employees can’t have their pay reduced for the absence. Voting leave must be made available for any municipal, county, state, or federal election, including primaries.


Action Items


Update your voting leave policy and ensure that managers are made aware of the change and are providing appropriate time off to vote.

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.

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.

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.

 

  • 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.
  • 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.
  • 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. 
  • DHS has also created a website that will post currents news and information about Medicaid. Go to https://staycovered.ga.gov/ to stay informed.
  • 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.

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.

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

End of Public Health Emergency (PHE) Resources



Reminders

Repeal of COVID-19 Staff Vaccination Mandate


PPMA STAT Poll Results- Over 18 Years of Age Lab Reporting


PPMA Chat Session Notes- June 14th


FLSA Protections to Pump at Work



PPMA STAT Poll Results- Masks


HHS Office for Civil Rights Reaches Agreement with Health Care Provider in New Jersey That Disclosed Patient Information in Response to Negative Online Reviews


US Surgeon General Issues Advisory Warning on social media's impact on the developing brain.



FDA Simplifies Recommendations for Bi-valent mRNA COVID-19 Vaccines

The "AAP's Bold Stance on the Value of Pediatrics" 

From Chip Hart: 2023 Telemedicine Requirement Grid


Developed by Jan Blanchard.  Click on the link to download the pdf.

Quality Programs

TCCN Antibiotic Stewardship Webinar: Why It's Important For Your Practice and Patients***



Join us on August 16 at 12:30 pm as we continue our 3-part virtual series 'Antibiotic Stewardship: Why it's Important for Your Practice and Patients'.


This lunchtime series presents 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.


Webinar #2: August 16, 12:30-1:30

  • Prescribing Guide


Please be sure to register in advance to receive the meeting link. Same-day registrations may experience issues with logging on.


If you missed it, click here to watch

Webinar #1: How to Access and Use the Website


Save the dates for upcoming webinars:


Webinar #3: November 1: Antibiotic Dosing


Register Now!

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: 





Community Education

Children's Physician Outreach Webinar Series: Common Hematology/Oncology Disorders***


Topic:

Physician Outreach Webinar Series: Common Hematology/Oncology Disorders

 

Date:

July 11th, 2023 from 12:00-1:00pm

 

Speaker:

Dr. Karen Wasilewski

 

Description:


Registration Link: 

https://zoom.us/webinar/register/WN_cOhwBaHQQD6TqQwhzbJIZA


Join us for the monthly webinar series hosted by Children's Physician Outreach and the Physician Education department. This month, Karen Wasilewski will be discussing the most common pediatric hematology/oncology disorders.


Children’s Healthcare of Atlanta is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.


Children's designates this internet live activity for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.


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.

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. 
Register Here for Medicaid Office Hours

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.

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.

TCCN Payor Updates

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.


Reminders:


Anthem Reimbursement policy update: Modifiers 25 and 57 - Professional


Anthem Notification regarding reimbursement changes to COVID-19 laboratory services codes (MAC)


Additional Anthem Resources:

Click to review Claims Resolution instructions, alerts, and updates

Click Here to Subscribe to Anthem's Provider News


To find the latest Provider News, visit the Anthem Provider News home page.



KHF Payor Updates

Humana


Updated Provider Manual effective March 1, 2023


Introducing an online community resource directory


https://humana.findhelp.com/


Addressing health-related social needs can be important to your patient’s health. That’s why Humana Community Navigator, powered by findhelp, offers an online directory of community resources with more than 500,000 social service programs across the United States.

CareSource Updates


CareSource 2023 Pharmacy Network Change


CareSource published new modifier policies effective January 1, 2023. 


Please see the links below for specific details.


Modifier 25 New Policy


Modifier 59 New Policy

United Healthcare


Get ready to submit electronically in 2023

Reconsiderations, appeals and claims moving to digital submissions only

Cigna Updates


Modifier 25 Reimbursement Update


Effective 5/22/2023, Cigna will delay the implementation requiring the submission of documentation to support the use of modifier 25 when billed with E&M CPT’s 99212–99215 and a minor procedure. Review the updated Cigna policy here.



Additional Virtual Care Services Now Permanently Reimbursable

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?


  1. Please review https://staycovered.ga.gov/ for the latest PHE Unwinding information.
  2. Proactively encourage and remind Medicaid patients to update their personal information on the Gateway website: https://gateway.ga.gov/access/
  3. 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. 


In Case You Missed It

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



Georgia DPH: Meningococcal Conjugate Vaccine Requirement



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.
  • Q & A for parents on recall of Abbott formula and re-opening of plant. 

Communications


TCCN Roundup:


The TCCN Roundup is designed to be a twice weekly information hub for all things TCCN. 

  • 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

 

Resources