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November 18, 2022

Note: New Content Noted with Asterisks** and Highlighted.

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Important Updates

Nov. 17th Pediatric Coding Seminar Recording and Materials**

Thank you to everyone who attended our annual Pediatric Coding Seminar! If you were not able to attend, a link to the recording is provided below along with color and black and white versions of the meeting slides for your records.


2023 Pediatric Coding Seminar Recording

Slides: Color and Black & White

FDA MedWatch: Do Not Use Infant Head Shaping Pillows

The U.S. Food and Drug Administration (FDA) is warning parents, caregivers, and health care providers not to use infant head shaping pillows intended to change an infant’s head shape and/or symmetry or claim to prevent or treat any medical condition. The FDA is not aware of any demonstrated benefit with the use of infant head shaping pillows. These infant head shaping pillows are unapproved medical devices that may create an unsafe sleep environment. The safety communication provides important information about unapproved infant head shaping pillows, including:


  • Background on the potential risk of death or injury in infants.
  • Recommendations for parents, caregivers, and health care providers.
  • FDA actions to increase awareness of this safety concern.
  • Instructions for reporting problems to the FDA and the manufacturer.


Click here to read more

Georgia DPH: Meningococcal Conjugate Vaccine Requirement

The Georgia Department of Public Health has published a letter to all providers regarding administration of the meningococcal conjugate vaccine (MenACWY). Please read the letter here for the full details and contact the Georgia Immunization Program if you have questions.

Access UpToDate through Children's Physician Portal

We have received questions from several practices regarding UpToDate. Physicians credentialed with Children's can access UpToDate through the Children's Physician Portal. You can use this tip sheet for registration instructions.


Please contact the Children's Solution Center at 404-785-6767 if you need help with your network username and password.

Payor Updates

Medicaid/CMO Update

Georgia Medicaid Fall Fair Updates

The department of Community Health (DCH) held a Medicaid Fair on Wednesday, November 2, 2022. All presentation materials from the Medicaid Fair are found here. Here are highlights from the opening session that you may find valuable. 

 

The Public Health Emergency (PHE) is potentially ending January 15, 2023. DCH is initiating the PHE Unwinding and providing updates to providers and members via https://staycovered.ga.gov/. DCH encourages providers to read and publish this website to their patients.

 

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. If you are unsure of your providers revalidation dates, log into www.mmis.gammis.gov Select Providers, then Demographic Maintenance, the Revalidation Date is present. Posted on GAMMIS in Provider Notices (9/1/2022) “Presentation-Physician Services-September 2022,” (Slides 25-27) 



Lactation Consultants

Lactation Consultants may now enroll via the MMIS web portal, www.mmis.georgia.gov, as an individual practitioner for the Medicaid and Peach Care for Kids programs. Lactation Consultants must have a State Lactation License via the Board of Lactation Consultants and be certified via the International Board of Lactation Consultant Examiners (IBCLC). Additionally, Lactation Consultants must be credentialed.

 

The scope of services provided by Lactation Consultants includes the provision of lactation care and services to pregnant and lactating women and children who are breastfeeding. Such services include lactation assessment, implementation of a plan of care, and education and counseling. Lactation services may be rendered in the following settings: hospital, physician practice, and home setting.

 

Providers may bill utilizing one or both of the following codes:

  1. S4443 (Lactation Class)
  2. S4445 (Patient Counseling)

Reimbursement is based upon the posted fee schedule. Lactation consultant services are limited to five (5) sessions unless deemed medically necessary.

Value Added Services 

2023 Group Health Program Renewal (from 10/24 announcement)

TCCN is very pleased to announce that Vxtra Partners was able to keep our health insurance renewal at only 11% which is well below the national average of 16%! They were able to accomplish this while keeping the same carrier, Aetna, and our benefit plan designs the same. All of this was accomplished in a very challenging renewal environment.


The program does include some minor changes to dental, vision and some voluntary benefits offerings that will be moving to Aetna for coverage:


  • Moving dental and vision to Aetna in 2023 from Anthem
  • Moving all voluntary benefits except Voluntary Life to Aetna (Voluntary Life will remain with Anthem)


TCCN engages the services of a very good Broker, Vxtra Partners, who diligently works to advocate on behalf of TCCN members with carriers to bring us the best rates. For 2023, there were several drivers impacting overall rates including, inflation, impact of staffing issues resulting in higher pay, and hospital financials.


Open Enrollment for the 2023 plan year will be held from 11/7/2022 to 11/18/2022.


Click HERE to review the 2023 Plans and Rates


Contribution Schedules / New Hire Waiting Periods

Our rates will be changing for 2023. Therefore, we will need to confirm each practice’s contributions, number of pay periods and waiting periods. Please complete the practice confirmation sheet linked here and email it to vxtrapartners@vxtra.com as soon as possible.


Online Enrollment System

Open enrollment will take place in the online system: Employee Navigator (www.employeenavigator.com)


Things to Note

If your practice is not currently a member of the TCCN Health Insurance Program and you would like to join, please send an email to Barbara.Douglas@tccn-choa.org.


If you have any questions, please reach out to Vxtra Partners, LLC.

You can reach them by phone: (404-937-6906 ext 0) or by email (vxtrapartners@vxtra.com)


Click HERE to read the full announcement

Quality Programs

Quality Steps Newsletter

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Read the September 28th edition of our Quality Steps newsletter!

Community Updates

Behavioral and Mental Health Project ECHO – Anxiety Cohort

January - March 2023 (CME Credit Available)


Utilizing the Project ECHO platform, Children's has been providing Behavioral and Mental Health education in multiple cohorts since March 2021. The 2023 Anxiety Cohort will meet every other Thursday at lunchtime starting January 12th for six sessions and will cover multiple facets of caring for pediatric patients with Anxiety. Upon the conclusion of our Anxiety cohort we will offer additional cohorts throughout the year covering new topics related to Behavioral and Mental Health.


Project ECHO uses the online platform, Zoom, and participation in Project ECHO is free of charge. Participants will have the opportunity to earn CME and MOC Part II credits for their participation.


Registration is open to primary care providers in the state of Georgia only. Active participation is required and participants are expected to present at minimum one case during the series.


Event Details:

All Anxiety Cohort sessions will take place on Thursdays from 12:00pm – 1:00pm


  • January 12th: Anxiety Issues in Young Children: What is it?
  • January 26th: Anxiety Issues in School-Aged Children and Adolescents: What is it?
  • February 9th: Screening for Anxiety Issues: Tools for primary care providers
  • February 23rd: Coping Strategies and Prevention Opportunities
  • March 9th: Psychotherapeutic Interventions and When to Refer Out
  • March 23rd : Medication Management of Anxiety

This series will be limited to 25 participants due to the time constraints of case presentations. There will be an active waitlist so please add your name if the course is full and you will be contacted if you are able to join.


To register for this series, click here

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 contact@tccn-choa.org with any questions.