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November 14, 2023

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Important Updates

Medicaid Provider Revalidation Deadline Extended to December 31st*

The deadline date to revalidate your enrollment has been extended to December 31, 2023.

 

Federal regulations require State Medicaid Agencies to revalidate the enrollment of all providers, regardless of provider type, at least every five years. The revalidation process requires an enrolled provider to confirm the accuracy of its enrollment information and to make corrections where appropriate. Providers that have not complied with federal regulations are required to complete the revalidation process by December 31, 2023. The deadline date has been extended to allow additional time to complete the revalidation process.

 

The Department has identified several providers that have not revalidated their enrollment in accordance with federal regulations. A complete listing of the providers who have not submitted a revalidation application can be found online on the GAMMIS website at www.mmis.georgia.gov. Once you reach the landing page, select the “Provider Information” tab at the top of the page. Then select “Reports for Public Access.” Select the report titled “Provider Revalidation Past Due by Provider Type.”  Providers who are listed on this report will be suspended if they do not revalidate their enrollment by December 31, 2023.   

 

Effective January 1, 2024, DCH will suspend the enrollment of those providers who have failed to revalidate their enrollment.  As a result, suspended providers will not be able to participate in the Georgia Medicaid/PeachCare for Kids programs. The suspension will apply to providers serving Traditional Fee-for-Service Medicaid members, PeachCare for Kids members, and the Georgia Families and Georgia Families 360 managed care programs which are administered by Amerigroup, CareSource, and Peach State Health Plan. Claims with dates of service on or after January 1, 2024 will not be paid. 

 

Upon successfully completing the revalidation process, your suspension will be lifted. However, your effective date will be the date that you submit your revalidation application. Retro-enrollment is NOT applicable in this instance. Should you fail to revalidate your enrollment within thirty (30) days of receipt of the suspension letter, you will receive a notice of termination from DCH. The notice of termination will outline your appeal rights.

 

The Frequently Asked Questions (FAQs) regarding revalidation can be found on GAMMIS at www.mmis.georgia.gov. Click on the Provider Information tab at the top of the screen. Select FAQ from the drop-down menu. Providers may also contact Gainwell Technologies for assistance at 800-766-4456.

Children's Nirsevimab Update

Demand for nirsevimab (Beyfortus®), the monoclonal antibody injection to protect infants from RSV, has been high this season and there is limited availability nationally. Like many others throughout the United States, Children’s Healthcare of Atlanta has a limited supply of nirsevimab. Based on guidance from CDC, Children’s is prioritizing our limited supply of nirsevimab to infants and children who are hospitalized at Children’s or who are established Children’s outpatients currently receiving care for complex medical conditions. We are unable to accept appointments to provide nirsevimab outside of these settings. 

 

We understand that this has been a notable RSV season to date and we share the goal of wanting to protect all infants and children from severe illness. We anticipate that supplies of nirsevimab for children weighing 5 kilograms or more will remain limited for the rest of the 2023-2024 RSV season and hope for wider availability for next year.

 

Please encourage the pregnant parents of children in your practice to receive an RSV vaccine between 32-36 weeks of gestation to protect them and their neonates against RSV disease.

 

We will continue to provide updates via email and our physician newsletters. As always, thank you for all the ways you care for kids in our communities.

 

Sincerely,

 

Jim Fortenberry, MD, MCCM,

FAAP, FELSO

Chief Medical Officer 


Andi L. Shane, MD, MPH, MSc 

Division Chief, Infectious Diseases

TCCN Pediatric Coding Seminar- November 16th

On November 16th at 10am we will host our annual pediatric coding seminar for your office staff. 


The materials will be sent out prior to the meeting, which will be recorded.


Speaker:


Mary Suhr

Director

Revenue Cycle Consulting with Revenue Cycle Coding Strategies

Register Now

Children's Professional Staff Town Hall Meeting November 1st- Recording Available

If you missed the Professional Staff Town Hall meeting on November 1, listen to the recording (password: xSsHuPA8). 


Here are the time stamps for the topics that were covered during the meeting: 

  • Surge and Capacity Update: 2:10
  • Infectious Diseases Update: 19:12
  • Nirsevimab Update: 25:48
  • AMBH Update: 41:25
  • Quality and Patient Safety Update (PIVIE Outcomes): 51:57

Update on Mental Health Parity Act

The 2008 Mental Health Parity and Addiction Equity Act (federal) and the 2022 Mental Health Parity Act (state) require that health insurance plans not impose more restrictive benefit limitations on mental health and substance use disorder benefits than on medical and surgical benefits. 


A recent update to Georgia AAP Board members stated: “Insurance plans not covering mental health services: Commissioner Tanner (and Reps. Oliver and Jones too) reported that the Insurance Commissioner has received no complaints about this happening. So members are encouraged to report instances in which you see a private insurance company not observing mental health parity in their coverages. You can do so via the Insurance Commissioner’s website, or report it to the Rick at the Chapter office. ” 


The Insurance Commissioner’s website is https://oci.georgia.gov/insurance-resources/complaints-fraud. DCH’s mental health parity portal is at https://dch.georgia.gov/how-do-i/mental-health-parity-information. Rick Ward at the Georgia Chapter of AAP can be reached at rward@gaaap.org

Quality Programs

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

Join us on November 29 at 12:30 pm as we continue our 3-part virtual series 'Antibiotic Stewardship: Why it's Important for Your Practice and Patients'.


Webinar #3: November 29, 12:30-1:30

  • Antibiotic Dosing: Maximize antibiotic adherence, limit wastage, and promote antibiotic stewardship


If you missed it, click here to watch previous webinars: 


Webinar #1: How to Access and Use the Website


Webinar #2: Prescribing Guide

Register Now

November Issue of Quality Steps

Click here to view the latest issue!

Value Added Services

For questions regarding TCCN Value Added Services, please reach out to

Barbara Douglas, TCCN Associate Director of Programs at Barbara.douglas@tccn-choa.org.

Flu Delivery for the 2023-2024 Season

Resources available for practices who participate in the TCCN GSK Program: 




Please reach out to Barbara Douglas at barbara.douglas@tccn-choa.org or your GSK Rep if you have any questions.

Welch Allyn Spot Vision Screener Program

TCCN and McKesson are pleased to announce a special buying program for the Welch Allyn SPOT Vision Screener. This program is only available to TCCN Members through McKesson. Please see the brochure here for additional information.

New Medical Supplies Program - McKesson

The TCCN Value Added Services Team is excited to announce a new Medical Supplies Purchasing Program with McKesson! TCCN and McKesson have entered into a multi-faceted program for all TCCN Community practices! Click here for more program details

Community and Education

Pediatric Mental Health Training from the REACH Institute- Upcoming Dates for January and February 2024

Free virtual training for TCCN primary care physicians in 2024!


This is an excellent opportunity for TCCN members to get free training in pediatric mental health. An Atlanta donor has granted the REACH Institute an opportunity to allow free training for the Patient-Centered Mental Health in Pediatric Primary Care (PPP) program,


The PPP Program trains clinicians to diagnose and treat pediatric mental health conditions including ADHD, anxiety, depression and other common disorders seen in everyday practice.


Upcoming dates for this training in 2024 are:

  • January 19-21, 2024
  • February 2-4, 2024


For More Information About the Program Click Here.


Participants will earn a maximum of 29.75 AMA PRA Category 1 CreditsTM for completing this program.


Click Here to Submit an Online Application for the Program


Required CME for Physicians - Sexual Misconduct

HB458 was passed into Law in 2021 and was effective January 1, 2022 and requires that each physician complete a 2 hour course in “professional boundaries and sexual misconduct in medical practice” before renewing their GA medical license (this is a one-time requirement).  

 

TCCN’s Malpractice Carrier, Curi, has two 1 hour CME courses on “Sexual Misconduct” that fulfills the new GA license requirement for HB458. Please see instructions below on how to access.

 

Instructions:

  • Login in to your Curi account at www.curi.com
  • Click on your initials at the far top right of your screen. (Your initials will appear with a yellow circle around them)
  • Select CME webinars
  • There you will find two new CME activities- Patient Harassment and Sexual Harassment


If you are not part of TCCN’s Malpractice Program with Curi, please reach out to your malpractice carrier as they may have a class available as well. 

In Case You Missed It (please use the links below to review)


TCCN Requirements


TCCN Resources


Community Updates

Questions?

We are here for you. Please reach out to your TCCN Provider Relations Representative contact@tccn-choa.org with any questions.