September 30, 2022

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

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As you may recall, in most years since the launch of TCCN, our Board of Directors has elected to pay the dues on behalf of all member practices out of the revenue we receive from our contracted payor partners. We are pleased to let you know that we are once again able to pay the dues on your behalf and you will not receive a 2022 invoice for TCCN dues!

In addition, TCCN has received a substantial final shared savings distribution from WellCare for our 2020 performance. We anticipate distributing these funds by the end of the year based on attributable 2020 WellCare member months and BMI coding performance as we did with the previous distribution earlier this year. More details regarding the distribution will be sent in the coming weeks.

Flu cases are on the rise, and we are continuing our push to get as many children vaccinated for flu as possible by October 31st. As part of our asthma recall efforts, we recently shared several resources to help your practice gear up for the upcoming flu season:

• Flu education for families
• CDC Flu recommendations for children and high-risk populations
• Vaccination Guidance During a Pandemic developed by the CDC
• Asthma Care During the COVID-19 Pandemic
• Flu Testing Algorithm
• Flu and COVID-19 Testing Algorithm

In addition, Children's has created a new webpage for parents explaining the importance of getting a flu shot this year in particular and directing them to schedule their child's flu shot with their pediatrician. Please feel free to share this page with your patient families: Why Everyone Needs a Flu Shot—Especially During COVID-19

Children's has sent out the latest edition of MedBytes to members of the Children's Professional Staff. Today's communication includes the following important updates and more:

• Clinical updates: Medication shortages, PNT meeting minutes, Alinity thyroid immunosuppressants, post-infectious disease clinic, virometer
• System updates: AEA, The Big Deal, Diwali Celebrations, Annual Professional Staff Meeting recap, Sibley Heart Center Cardiology name change, refer a provider
• Training and technology: Emory/Children's interface
• Physician wellness: New members, wellness fairs
• Professional development: Open medical director position, Professional Staff Town Hall, upcoming events

Click here to read MedBytes

Thank you to all who were able to attend last week's Children's Annual Professional Staff Meeting! We had a great turnout of more than 100 physicians and a highly successful networking session that we hope to repeat in future years.

We would like to hear about your experience and how we can improve for next time! If you attended, or wanted to attend but were unable, please take a moment to complete this brief feedback survey. (Physicians who did RSVP will receive the same survey from Children's but only need to complete it once.)

TCCN hosted its annual OSHA training webinar on September 15th, but if you were unable to attend the live session, the recording and materials are provided below:

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 attended the meeting live your certificate will be emailed to the email address you posted in the chat.  

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 [email protected]. 

On Thursday, Sept. 15th, Children's sent out a communication co-written by TCCN to all independent primary care physicians regarding the recent surge in patient volumes in both the outpatient and ED settings. This communication includes the following resources:

• Fever patient information sheet
• Suggested return to school/childcare messaging
• Monkeypox guidance
• Flu and COVID-19 vaccination guidance

TCCN will be following up with additional guidance and resources over the coming weeks as we prepare for flu season, so please stay tuned for more updates.

Click here to read the full communication from Children's and TCCN

Posted on GAMMIS in Provider Notices (9/1/2022) “Presentation-Physician Services-September 2022,” (Slides 25-27)

It is time for providers to revalidate their provider profile. 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.

Completion of Amerigroup Value-Based Agreement

The Children’s Care Network is pleased to let our members know that TCCN has recently signed a new value-based contract with Amerigroup. TCCN member providers currently provide services to over 80,000 Amerigroup covered lives. This arrangement will allow for opportunities in shared savings and improvement in quality metrics for the Amerigroup population. Further details on quality initiatives will be forthcoming.

Here are some Frequently Asked Questions based on responses we have received regarding participation in the new Amerigroup agreement:

Do I need to do anything to participate in the Amerigroup value-based agreement?

All TCCN primary care and subspecialty practices who hold an Amerigroup base agreement have been automatically included in the value-based agreement. There is no additional action you need to take or cost for participating in the value-based agreement.

Will this impact my Amerigroup rates?

The value-based agreement will not impact the rates you are currently being paid. TCCN is engaged with Amerigroup to discuss base contracting, and we will share more information later this year.

What do I need to do for my practice to be successful in this value-based agreement?

We have programming developed for the Amerigroup contracted HEDIS measures and will share more information about our plans for interventions in the coming weeks.

MAGMutual Risk Mitigation Report

MAGMutual has developed a Risk Mitigation Report for Pediatrics to highlight trends in losses and what pediatric providers and practices can do to mitigate these risks. Please share with your staff and discuss at your next practice meeting.

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MAGMutual CME Course Opportunity

MAGMutual has released two 1-hour CME courses on “Sexual Misconduct” that fulfills the new GA license requirement for HB458 which became effective January 1, 2022, and requires that each Physician complete a course in “professional boundaries and sexual misconduct in medical practice” before renewing their GA medical license. Please see below for the links to the 2 classes.

• Sexual Misconduct: Strategies to Minimize Risk (Part 1)
• Sexual Misconduct: Strategies to Minimize Risk (Part 2)

If you are not with MAGMutual, then you should reach out to your malpractice carrier and see if they have a similar course. If they do not, then MAG and GPPA have a program as well – please see link below. 

https://gppa.memberclicks.net/hb485   

Link to register for the recording and get CME credit. Non-members cost $100.

Please contact your carrier, legal advisor or the Georgia Composite Medical Board with any questions. TCCN does not monitor all changes to legal requirements and does not provide legal advice.

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

Each year we are pleased to present the William F. Meyers Quality Award on behalf of TCCN at the Children's Annual Professional Staff Meeting. This award is given annually in honor of Dr. William “Billy” Meyers, pediatric gastroenterologist, who embodied the essence of what a good physician should be: caring, knowledgeable, data-driven, empathetic, and dedicated to improving care and the lives of patients.

The award is designed to recognize TCCN physicians who have gone above and beyond to advance TCCN's mission by actively engaging in using quality improvement approaches to improve the health of their patients, advance our knowledge through research and process improvement, and enhance the adoption of evidence-based protocols.

This year's Primary Care recipient is Dr. Jane Wilkov. Dr. Wilkov has practiced at Dekalb Pediatric Center in Decatur for more than 30 years and is a founding member of TCCN. She has been an active member of the TCCN Finance and Contracting Committee since 2014 where she has contributed greatly to vetting pending contracts and determining our contracting strategy. More recently she bolstered TCCN’s COVID-19 vaccination efforts by developing best practices for implementing a primary care vaccine clinic which she shared with TCCN staff to create the COVID-19 Vaccine Toolkit. Her practice served as a primary vaccination site for DeKalb County, administering 12,918 total doses in 2021.

This year's Subspecialist recipient is Dr. Andrew Muir. Dr. Muir is the Division Chief for Endocrinology at Children’s and has practiced pediatric endocrinology for more than 30 years.

He has served on the TCCN Quality Committee since 2014 and played an integral role in the conception of the TCCN quality program by developing a HEDIS-based diabetes metric. He has greatly supported our subspecialty access initiative by aiding in the development of Endocrine Referral and Obesity guidelines launched through TCCN as well as overseeing the merging of CPG Endocrinology at the Egleston and Scottish Rite campuses.

Please join us in congratulating Dr. Wilkov and Dr. Muir and thanking them for their contributions to TCCN and our pediatric care community!

Congratulations and thank you! We have demonstrated significant improvement with our Anthem contracted measure of Appropriate Testing for Children with Pharyngitis. Earlier in the year, we sent our practice scorecards and requested practices to review the scorecard and look for areas of improvement within their office. Thank you for all your hard work on this measure!

Our staff has been working with Anthem over the course of the year. Through our investigation we were able to demonstrate to Anthem that 84% of non-compliant patients, although attributed to a TCCN provider, were not in fact seen by a TCCN provider. Not only did this show that our network providers have been doing a great job with this measure, but it also provided us with valuable perspective on ways that your practices might better communicate with parents and leverage your services to reduce urgent/emergency services and thereby the inappropriate use of antibiotics and spread of sickness.

Click here to read the full communication

Are you unsure how to handle potential child abuse and neglect cases that you encounter in your practice? The team at the Stephanie V Blank Center for Safe and Healthy Children at Children’s is here to help. The Blank Center sees patients referred to them by community providers to conduct full assessments for suspected child physical abuse, sexual abuse, and neglect. To make a patient referral, please click here to complete the patient referral form. If you have questions about making a referral, please call 404-785-3833. If you would like to arrange a presentation for your staff, please contact your physician liaison to make arrangements to have the team from the Blank Center present to your staff.

Siblings of children with autism spectrum disorder (ASD) are more likely to have developmental delays, speech problems, and autism. To help monitor and mitigate those concerns, Marcus Autism Center has created a new clinic specifically to meet the needs of these children. Children ages 6 months to 24 months who are the siblings of children with ASD qualify for this clinic.

Please download the flyer linked here and share this opportunity with any families of children eligible for this clinic. For more information, please contact Stormi White, PsyD and Natalie Brane, CCC-SLP at [email protected] or 404.785.8501.

Children's Safe Sleep Symposium

October 27, 2022 (CME Credit Available)

Children's Healthcare of Atlanta Strong4Life is proud to host Samuel Hanke, MD, from Cincinnati Children’s and President of Charlie’s Kids Foundation, for a Safe Sleep Symposium. The event will be held at the Children's Support Center on Thursday, Oct. 27. Hanke, in addition to Children’s physicians and Terri Miller, MPH, from the Georgia Department of Health, will discuss updated AAP safe sleep recommendations and motivational interviewing practices, and review local data. In-person attendees will have the opportunity to network with colleagues, and enjoy dinner and drinks. In-person registration is limited, so sign up early! There will also be a virtual option.

Click here to view the event flyer

Click here to register

3rd Annual Pediatric Brain Health Symposium

October 22-23, 2022 (MOC Credit Available)

Event Details:

Saturday, October 22, 2022 8:00 AM - 5:00 PM

Sunday October 23, 2022, 8:00 AM - 12:15 PM

Hybrid Event - offered virtually and at Children's Support Center    

Course Description:  

The 3rd Annual Pediatric Brain Health Symposium will provide an overview of epilepsy, headache/concussions, neuromuscular diseases and neurogenetic disorders with actionable recommendations for clinicians to enact in their practice.

Target Audience:

General pediatricians, advanced practice providers, nurses, pediatric neurologists, neuropsychologists, neurosurgeons, residents, and medical students are all invited to attend.

Click here for more details and to register

Enforcement Actions Ensure Patients Receive Timely Access to their Records, at a Reasonable Cost

September 20, 2022: Today, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the resolution of three investigations concerning potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule's patient right of access provision. These cases are part of a collective effort, bringing the total 41 cases, to drive compliance on right of access under the law.

“These three right of access actions send an important message to dental practices of all sizes that are covered by the HIPAA Rules to ensure they are following the law,” said OCR Director Melanie Fontes Rainer. “Patients have a fundamental right under HIPAA to receive their requested medical records, in most cases, within 30 days. I hope that these actions send the message of compliance so that patients do not have to file a complaint with OCR to have their medical records requests fulfilled.”

OCR has taken the following enforcement actions that underscore the importance and necessity of compliance with the HIPAA Rules, including the foundational right of access provision:

• Family Dental Care, P.C. (“FDC”), is a dental practice located in Chicago, Illinois. OCR received a complaint on August 8, 2020, alleging that FDC failed to provide a former patient with timely access to her complete medical records. The former patient requested her entire medical records in May 2020, but received only portions. The former patient filed a complaint with OCR, and during OCR’s investigation, FDC provided her with the remainder of her records in October 2020. Thus, FDC did not provide a complete copy of the records until more than five months after the request was made. OCR's investigation determined that FDC’s failure to provide timely access to the requested medical records was a potential violation of the HIPAA right of access provision. FDC agreed to pay $30,000 and implement a corrective action plan.

• Great Expressions Dental Center of Georgia, P.C. (“GEDC-GA”), is a dental and orthodontics provider with multiple locations throughout the state of Georgia. In November 2020, OCR received a complaint alleging that GEDC-GA would not provide an individual with copies of her medical records because she would not pay GEDC-GA’s $170 copying fee. The individual first requested her records in November 2019, but did not receive them until February 2021, over a year later. OCR's investigation determined that GEDC-GA’s failure to provide timely access to the requested medical records, and its practice of assessing copying fees that were not reasonable and cost-based, were potential violations of the HIPAA right of access provision. GEDC-GA agreed to pay $80,000 and implement a corrective action plan.

• B. Steven L. Hardy, D.D.S., LTD, doing business as Paradise Family Dental (“Paradise”) is a dental practice in Las Vegas, Nevada. On October 26, 2020, OCR received a complaint alleging that Paradise had failed to provide a mother with copies of her and her minor child’s protected health information. The mother submitted multiple record requests between April 11, 2020, and December 4, 2020, but Paradise did not send the records until December 31, 2020, more than eight months after her initial request. OCR's investigation determined that Paradise’s failure to provide timely access to the requested medical records was a potential violation of the HIPAA right of access provision. Paradise agreed to pay $25,000 and implement a corrective action plan.

OCR’s guidance on the right of access is available at https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html.

Individuals who believe their HIPAA rights have been violated have the right to file a complaint with OCR.

Click here to read the communication from HHS

Children's Urgent Care Update

Urgent Care Locations:

• Open 365 days/year
• Monday through Friday: 11am to 9pm
• Saturday and Sunday: 9am to 9pm
• Holidays: 9am to 7pm
• Hamilton Creek Urgent Care opens on July 26, 2022
• Cherokee Urgent Care opens on September 7, 2022

Hours of Operation Change:

So that we may provide the best care for our patients, Children’s will adjust weekend hours at all Urgent Care locations and holiday hours at some locations

• Hamilton Creek will open on July 26th, with new weekend hours of 9 a.m. to 7 p.m.

As of September 1:

• All Urgent Care locations will adjust weekend hours on Saturday and Sunday from 9 a.m. to 9 p.m. to our new hours of 9 a.m. to 7 p.m.
• We are altering the number of open Urgent Care locations on the holidays (New Year’s Day, Martin Luther King Day (MLK), Memorial Day, 4th of July, Labor Day, Thanksgiving and Christmas)
• Children’s at Chamblee-Brookhaven, Hudson Bridge, Forsyth, Town Center and Satellite Boulevard Urgent Care locations will be open on holidays.
• Children’s at Cherokee, Hamilton Creek, and North Point Urgent Care locations will be closed on holidays.

For more on Urgent Care Locations and Scope, refer to July 29th Roundup

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

TCCN Requirements

• June 2022 TCCN State of the Union Recording and Attestation
• Spring 2022 Clinical Quality Forum Recording and Attestation
• Effective August 1st: 2-Week Data Submission Requirement

TCCN Resources

• TCCN COVID-19 Vaccine Toolkit
• TCCN COVID-19 Diagnosis and Isolation Algorithm
• Announcement of New Malpractice Broker
• Endocrinology Referral Guide
• Nephrology Referral Guideline

Community Updates

• Monkeypox Community Practice Tip Sheet and CDC Page for Healthcare Workers
• Bilirubin Level Testing and Phototherapy Vendors
• Formula Shortage Resources
• CDC Health Advisory on Parechovirus

We are here for you. Please reach out to [email protected] with any questions.