Pediatric Council

The Pediatric Council

The Pediatric Council of the Massachusetts chapter of the American Academy of Pediatrics holds the distinction as the first and innovator pediatric council. Presently, 43 other chapters of the AAP have recognized the value of this sitting committee and have formed their own pediatric councils. Although the needs of each states councils are unique, information sharing between councils has proven to be an effective strategy for information dissemination. Our chapter continues to work with both the public and private insurance entities and includes the department of public health in their discussions. The council continues to educate the industry representatives and the requirements and recommendations for the provision of care for infants, children and adolescents. Our discussions recently have included immunization issues, the Affordable Care Act, access to care, payment reform, and coding issues including preparation for transition to ICD-10.

The Pediatric Council continues to meet on a quarterly basis with MassHealth, Medicaid HMOs, DPH, and all of the major insurers in Massachusetts. The Council views these meetings as an opportunity to advocate for coverage of services for children consistent with AAP guidelines. Additionally, the Council’s deliberations serve as a forum to educate insurers regarding expected trends and evolution of care guidelines for children. The Council continues to address issues related to immunization coverage & payment, healthcare reform, ACOs, ARRA perspectives, mental health screening, P4P, Medical Home, copayment shifting, prescription drug formulary and refill issues. Most recent items include, immunization legislation, coverage of Guardasil for males, Medicaid coverage changes for nebulizers, results of a modifier 33 survey, BORIM CME requirements and ICD-10 issues. Chapter members are invited to participate in a Council meeting to better understand the evolving process.

Chair, Dr. Peter Rappo – rapp5@aol.com