LEGISLATIVE ALERT: SB 187 by Sen. Barrow allowing Nurse Practitioners to practice without a collaborative practice agreement PASSED the House Health and Welfare Committee today by a vote of 7-6. It now moves to the full House for consideration. Please contact your representative to ask them to vote against this measure. You can find out who your representative is by going here: http://www.legis.la.gov/legis/FindMyLegislators.aspx
Progress Reports 2016
In this Edition:
- Gov. Edwards and Dr. Rebekah Gee Begin the Healthy Louisiana Statewide Tour
- DHH Releases State Health Assessment
- Reminder and Recall Messaging
- Availability of Serogroup B Meningococcal (MenB) Vaccine
- Survey Seeks Feedback Of Louisiana’s Health Care Consumers
- CDC’s Zika Virus Guidance for Providers Caring for Pregnant Women and Women of Reproductive Age
- Dr. Vanchiere receives $1.78 Million NIH Grant
- LA AAP Recognizes Passing of Chapter member Andrew Rinker, MD
- Attention all Providers receiving Electronic Remit Transactions (835)
- Important Information Concerning New Medicaid Requirements For Enrolling Ordering, Prescribing and Referring Providers
- MCO Provider Calls Moving to Weekly Format in May
- Bayou Health Informational Bulletins
- Health Plan Advisories
- Happy May Birthdays
- Welcome New Members
- SUDIA Recipe: Banana-Strawberry Licuado
- Tulane Saturday Pediatric Series | 6/11/2016 | New Orleans, LA
- Red River Potpourri | 8/19-21/16 | Shreveport, LA
BATON ROUGE – Today, Governor John Bel Edwards and Dr. Rebekah Gee, Secretary of the Department of Health and Hospitals, began a statewide tour to discuss Medicaid expansion in Louisiana. Gov. Edwards and Dr. Gee also announced that the Bayou Health program is being renamed Healthy Louisiana. The new program seeks to improve the health of those who are currently covered by Medicaid and those who will become eligible for coverage under Medicaid expansion. Gov. Edwards and Dr. Gee also unveiled a new website,www.healthy.la.gov, for enrollment information for qualified individuals.
“Beginning in June, hardworking citizens of Louisiana will be able to sign up for healthcare coverage under Medicaid expansion,” said Gov. Edwards. “On my first full day in office, I began the process of bringing our federal tax dollars back to Louisiana to help our people. Now, more than 300,000 working citizens will have access to healthcare, and more than $180 million in savings will be available to help stabilize our budget, fund healthcare services, and increase funding to the TOPS program. This is one of the easiest decisions I’ve made since taking office, and I am looking forward to seeing the benefits for our state.”
The first stop was held in Baton Rouge at the CareSouth Center, one of the federally qualified health centers in the state that will provide care for many of the people who will be able to acquire health insurance, in many cases for the first time, as a result of the expansion. Gov. Edwards and Dr. Gee will visit several healthcare facilities across Louisiana within the coming weeks to help educate the public about the health benefits of Medicaid expansion for Louisianans as well as the positive impact it will have on the state budget.
“Louisiana continues to rank at or near bottom for all measures of health, but expanding Medicaid is an important step to improve our rankings,” said Dr. Gee. “Research from the Kaiser Family Foundation and from other states that have expanded Medicaid shows those with Medicaid coverage are healthier than people who are uninsured. They are more likely to have access to primary care, they are less likely to delay or go without needed medical care because of costs, and health care coverage virtually eliminates catastrophic medical expenses.”
Important facts to remember:
• Enrollment begins June 1, 2016
• Coverage begins July 1, 2016.
• 300,000- 450,000 people are expected to enroll.
• Registration will be available online starting June 1, at the new website www.healthy.la.gov.
Medicaid expansion is a hallmark of the Edwards administration. In his first official act as governor, Edwardssigned an executive order adopting the expansion and making good on a campaign promise to help provide more access to health care for the uninsured. As a result, critical tax dollars that Louisianans have been paying to cover the cost of health care in other states will finally come home to help citizens here who until now have been unable to afford it.
DHH Releases State Health Assessment
Provides guidance for Louisiana communities to improve health
Friday, April 29, 2016 | Contact: Media & Communications: Phone: 225.342.1532, E-mail: email@example.com
Baton Rouge, La.—The Louisiana Department of Health and Hospitals, in collaboration with hundreds of local governments and community organizations, has released the Louisiana State Health Assessment and State Health Improvement Plan. The State Health Assessment presents an analysis of the health needs and priorities facing every region of the state, detailing the strengths and weaknesses of each community as well as the opportunities and challenges facing them.
More than 2800 stakeholders and other community members representing over 500 organizations from throughout Louisiana, including organizations operating at the federal, state and local levels, participated in the creation of the assessment. These stakeholders will now be able to use the document as a framework under which they can engage their local communities in improving the issues they identified as top local priorities.
“Each community told us and each other what their own priorities are, and that’s what is outlined in the health assessment,” said Beth Scalco, DHH’s interim assistant secretary for the Office of Public Health. “This assessment will serve as a plan to guide them, and each community will have a starting point from which it can begin the work of tackling its own, self-identified health concerns.”
Five statewide priorities were identified: supporting behavioral health, promoting healthy lifestyles, assuring access to healthcare, promoting economic development and building public health infrastructure. For each priority, a series of key objectives was identified.
DHH Secretary Rebekah Gee noted that Medicaid expansion will do much to help improve access to care and the behavioral health of Louisianans.
“Throughout the discussions leading to the publication of this document, access to care and behavioral health were issues identified in every community, and put simply, expanding Medicaid is the single greatest action our state can take to ensure that every working Louisianan has access to both primary and behavioral health care,” Gee said. “Expanding Medicaid will have positive, deep and meaningful impacts in every community in our state, not only by improving access to and the quality of care, but also by creating more jobs, making Louisiana better from both a health and economic perspective.”
A full copy of the health assessment can be found by clicking here.
Reminder and Recall Messaging
Department of Health and Hospitals- Office of Public Health
Stacy Hall, RN MSN, Immunization Program Director | Frank J. Welch, MD, Immunization Program Medical Director
Although immunizations are the most effective defense against vaccine preventable diseases, many children in Louisiana are under-immunized. Barriers to immunization have been well-studied and include anti-vaccination sentiments, difficulty accessing a healthcare provider to provide immunization, public perception of a lack of endorsement by physicians, and, for non-publicly funded vaccines, cost. However, one of the most commonly cited reasons for low coverage are parents being unaware that one or more vaccines are due or overdue.
To address this prevalent issue, reminder-recall (RR) systems have been developed to improve vaccine coverage, both to remind individuals of upcoming immunizations and to recall those for whom immunizations are overdue. Studies show that the use of RR systems can increase vaccine coverage rates by 5-20%.
The benefits of RR interventions may also extend data quality, since such measures may prompt patients to update other personal information, thereby leading to improved accuracy and completeness of the entire patient record. Furthermore, patients who are under-immunized often do not participate in other recommended preventive care activities; immunization-based RR can improve this by providing opportunities for other practice/patient interactions.
Working with our partners (at no cost to providers), the Louisiana Immunization Registry (LINKS) has conducted RR activities using both postcards and phone calls over the last five years. Although sporadic, these RR activities highlighted the need and importance of letting parents know when vaccinations were due/past-due. However, given the sporadic nature of the RR, providers have occasionally been overwhelmed with calls and requests for appointments.
In order to accommodate both the important function of the LINKS registry to inform parents of due/past-due vaccinations and decrease the burden on providers, we will begin to do RR more frequently. This increase in the frequency of RR will decrease the number of children who get calls/postcards each time.
The OPH Reminder Recall will include all age-appropriate vaccinations as recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP). Parents will be informed of all due or overdue immunizations that are recommended, not just those required for school entry in Louisiana. Therefore, if you get a call from a parent, look up the child’s record in LINKS to see what vaccinations are due. Don’t assume that since they have a Universal Certificate which allows them to be enrolled in school that they have all recommended vaccines.
Our current RR schedule will be:
Due and Overdue three times in the first year (6, 8, 13mo)
Due and Overdue at 60-63mo and 63-66mo
Due and Overdue at 133-136mo and 136-139mo
Remember, only those parents whose children are due or past due for a vaccination will receive a postcard or call from the LINKS registry. To decrease the number/volume of calls to your practice, you can do several things. First, ensure that as many methods are in place in your practice to ensure on-time vaccination of all children. Secondly, use the practice-level information available in LINKS for Reminder Recall in your own practice.
Additional information about Reminder Systems and Strategies for Increasing Childhood Vaccination Rates is available at http://www.cdc.gov/vaccines/recs/reminder-sys.htm
Many children in Louisiana are under-immunized, leaving the potential for serious illnesses and outbreaks of disease. We hope you understand and value this vital service to parents that reminds them and engages them in preventive healthcare for their children by ensuring they are aware of due and over-due vaccinations.
Availability of Serogroup B Meningococcal (MenB) Vaccine
The purpose of this memorandum is to announce the availability of Serogroup B Meningococcal (MenB) vaccine for Louisiana VFC providers. With the expansion of the formulary, MenB will be routinely available for all Louisiana VFC providers. Please note there is a 10 dose ordering limitation for this vaccine.
The Advisory Committee on Immunization Practices (ACIP) recommends that decisions to vaccinate adolescents and young adults aged 16 through 23 years of age against serogroup B meningococcal disease should be made at the discretion of the administrating provider. ACIP also recommends use of MenB vaccines among certain groups of individuals aged > 10 years of age who are at increased risk for serogroup B meningococcal disease.The MenB vaccine offered by the Louisiana VFC Program is available for eligible individuals 16 through 18 years of age and children >10 years of age who are at increased risk.
Individuals at increased risk include:
• Individuals with persistent complement component deficiencies;
• Individuals with anatomic or functional asplenia, including sickle cell disease; and
• Individuals identified to be at increased risk because of a serogroup B meningococcal disease outbreak.
Please contact the Immunization Program for special circumstances.
The MenB vaccine should be administered as either a 2-dose series of MenB-4C (Bexsero) or a 3-dose series of MenB-FHbp (Trumenba). The same vaccine brand should always be used for all doses administered, as the two available vaccines are not interchangeable. Please note, the ACIP does not recommend the routine use of Men B vaccines in place of routine adolescent vaccination with quadrivalent meningococcal vaccines.
In LINKS, Bexsero is listed as MENB,OMV (Bexsero), Trumenba is listed as MENB, Recombinant (Trumenba). This policy is a separate document in the Document Center in LINKS.
Please remember to utilize the appropriate VIS statement. Inquiries may be directed to the Immunization Program at 504-838-5300. This Memorandum should be kept for future reference.
Survey Seeks Feedback Of Louisiana’s Health Care Consumers
BATON ROUGE, LA – (May 2, 2016) – The Louisiana Health Care Quality Forum and the Louisiana Department of Health and Hospitals (DHH) are conducting a web-based survey to gauge Louisiana residents’ awareness of health information technology (IT) and patients’ rights to access personal health information.
The survey launched May 1, 2016, and will continue through May 31, 2016. It can be found atwww.makemyhealth.me/survey.
The survey is a key factor in a collaborative effort of the Quality Forum and DHH to promote awareness and use of health IT tools such as electronic health records (EHRs) and patient portals to improve health outcomes and health care decision-making for Louisiana residents. The survey takes less than two minutes to complete and will provide important feedback about health IT education efforts in Louisiana.
About the Louisiana Health Care Quality Forum
The Louisiana Health Care Quality Forum is a private, not-for-profit organization, dedicated to advancing evidence-based, collaborative initiatives to improve the health of Louisiana residents. Its focus areas include quality measurement and analytics, clinical quality improvement, the patient-centered medical home/care coordination model, outreach/education and health information technology (IT). With regard to health IT, the Quality Forum supports health care providers and critical access/rural hospitals as they adopt and meaningfully use electronic health records and serves as the State-Designated Entity to lead the planning and implementation of the state’s health information exchange. For more information, visit www.lhcqf.org.
CDC’s Zika Virus Guidance for Providers Caring for Pregnant Women and Women of Reproductive Age
This is a message from the Louisiana Department of Health and Hospitals Emergency Operations Center (DHH EOC). To remain current on available information about the Zika Virus and Pregnancy, visit the Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/zika/hc-providers/qa-pregnant-women.html
Please distribute this communication to your internal and external partners. By forwarding this information you increase the number of providers who will be prepared and knowledgeable about available Zika resources. Below is a list of available CDC guidance documents and information:
Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016 (March 25, 2016)
UPDATE: Interim Guidance for Health Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure – United States, 2016 (March 25, 2016)
Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak – Puerto Rico, 2016 (March 25, 2016)
COCA Call: Update on Interim Zika Virus Clinical Guidance and Recommendations (Feb. 25, 2016)
UPDATE: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure – United States, 2016 (Feb. 5, 2016)
Interim Guidelines for Pregnant Women During a Zika Virus Outbreak—United States, 2016 (Jan. 22, 2016)
There are also counseling resources and extensive resources for pregnant women available:
Questions and Answers for Healthcare Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure
It is strongly recommended that all OB/GYN providers routinely access the CDC Zika Virus page to obtain updated guidance. In addition, all OB/GYN providers are encouraged to sign up for the Louisiana State Health Alert Network through email request to Jeanne.Haupt@LA.GOV
Providers may sign up for email updates from the CDC here, which contain all updates on the Zika Pregnancy page as well: https://service.govdelivery.com/accounts/USCDC/subscriber/new
Immediately notify the Louisiana Office of Public Health at 504-568-8313 or after hours at 800-256-2748 to discuss a possible exposure, report a suspected case and arrange for laboratory testing.
LA AAP Recognizes Passing of Chapter member Andrew Rinker, MD
Andrew Rinker, M.D., a prominent New Orleans pediatrician, passed away peacefully on March 10, 2016, at his home. He was known as Andy to his family and friends. He devoted his life to his family; the care, development and well-being of children; public service and his passion for fishing. Click here to read the full obituary.
Medicaid/ Bayou Health
In accordance with CAQH/CORE Rule 360 requirements, we are updating the CARC (Claim Adjustment Reason Code) and RARC (Remittance Advice Remark Code) code combinations as of January 1, 2016. The CARC and RARC codes appear in the v5010 835 transaction in CAS Segments and LQ Segments in the Service Payment Information section. The January 2016 versions of the Molina RF-0-77 (LA Medicaid/HIPAA Error Code Crosswalk) and RF-0-77-R (HIPAA/LA Medicaid Error Code Crosswalk) reports display the new code combinations used in the Louisiana Medicaid Program. These crosswalks do not apply to Pharmacy (NCPDP) claims or encounters. These reports are posted on lamedicaid.com under the Forms/Files/User Manuals link. For a complete list of all CARC and RARC codes, go to www.wpc-edi.com and click on link titled Code Lists.
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OVERVIEW: The Affordable Care Act (ACA) requires physicians or other practitioners who order, prescribe, or refer items or services to Medicaid recipients to enroll in the Medicaid Program, even when they do not submit claims to Medicaid. The ACA requirements are designed to ensure items or services for Medicaid recipients originate from appropriately licensed providers who have not been excluded from Medicare or Medicaid.
Individuals who order, prescribe, or refer items or services for Medicaid recipients, but choose not to submit claims to Medicaid, are referred to throughout this notice as “OPR providers.”
Professional and Institutional Billing Providers should begin notifying any individuals who you report on fee-for service claims as an Ordering, Prescribing or Referring provider that they must enroll with Louisiana (LA) Medicaid.
OPR Providers must understand the implications of failing to enroll in Medicaid. If you are an OPR provider, then the individuals and facilities who bill services for Medicaid recipients based on your order, prescription, or referral,will not be paid for those items or services unless you enroll in Medicaid.
Effective with claims using dates of service on or after September 1, 2016, LA Medicaid will deny fee-for-service claims that use Referring providers who are not enrolled as of the date of service. Providers should monitor the Louisiana Medicaid website for future information specific to Ordering providers.
LA Medicaid has established edits for issues with prescribing providers. See below for more information:Prescribing Providers Encouraged to Enroll in Fee-for-Service (FFS) Medicaid – Effective January 19, 2016
ENROLLMENT: Practitioners currently enrolled as participating providers in fee-for-service LA Medicaid are not required to enroll separately as an OPR provider.
Physicians and other eligible practitioners who choose to not bill for Medicaid services may enroll with an abbreviated Ordering, Prescribing, or Referring (OPR) application, found at the following link:
Due to the large number of Practitioners needing to enroll, expect a two-month waiting period to have your application processed. Keep in mind that ‘timely filing’ claim requirements may be impacted while waiting for providers to be enrolled; therefore, applications should be submitted as quickly as possible.
IMPORTANT NOTE: These ACA requirements do not apply to providers listed on Medicare Crossover claims (Institutional or Professional). LA Medicaid will accept and process the Medicare claim with the understanding that Medicare has edited this information as the primary payer of the claim.
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MCO Provider Calls Moving to Weekly Format in May
Friday, April 15, 2016 | Contact: firstname.lastname@example.org
Beginning in May, the daily noon provider calls related to the integration of mental health and substance use services into Bayou Health will shift to a weekly call on Wednesdays only. The Department of Health and Hospitals (DHH) will co-host the calls with the Managed Care Organizations (MCO) through the middle of September 2016. Each week a different MCO will participate in the calls, giving providers the opportunity to make comments or ask the MCOs questions, and DHH the chance to keep providers up to date with announcements. Providers may continue to email questions or concerns to email@example.com if you are unable to resolve your issue with the MCOs. All provider types are welcome to participate on the calls. The call schedule will be as follows:
• May 4, 2016 – Aetna
• May 11, 2016 – Amerigroup
• May 18, 2016 – AmeriHealth Caritas
• May 25, 2016 – Louisiana Healthcare Connections
• June 1, 2016 – United Healthcare Community Plan
• June 8, 2016 – Aetna
• June 15, 2016 – Amerigroup
• June 22, 2016 – AmeriHealth Caritas
• June 29, 2016 – Louisiana Healthcare Connections
• July 6, 2016 – United Healthcare Community Plan
• July 13, 2016 – Aetna
• July 20, 2016 – Amerigroup
• July 27, 2016 – AmeriHealth Caritas
• Aug. 3, 2016 – Louisiana Healthcare Connections
• Aug. 10, 2016 – United Healthcare Community Plan
• Aug. 17, 2016 – Aetna
• Aug. 24, 2016 – Amerigroup
• Aug. 31, 2016 – AmeriHealth Caritas
• Sept. 7, 2016 – Louisiana Healthcare Connections
• Sept. 14, 2016 – United Healthcare Community Plan
All calls will take place from noon until 1 p.m. The call-in information is as follows:
• Call-in #: 1-888-636-3807
• Access Code: 1133472
DHH offers providers numerous avenues for reporting and resolving issues related to Bayou Health. Please refer to Information Bulletin 12-27 posted on www.makingmedicaidbetter.com. This bulletin also includes contact information for each of the MCOs.
For news specifically pertaining to the integration, you can click on the “Behavioral Health” tab onwww.makingmedicaidbetter.com. To automatically receive updates and releases from the Department regarding the integration, subscribe to the “Integrated Health Care” newsletter.
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Bayou Health Informational Bulletins for Providers
Informational Bulletins cover a variety of topics related to Bayou Health, and all are available here.
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Health Plan Advisories
Health Plan Advisories are available at http://new.dhh.louisiana.gov/index.cfm/page/1734
|5/1 Deepa Bhatnagar, MD, FAAP
5/1 Cary A Culbertson, MD, FAAP
5/1 Dennis Ren
5/1 Morgan Jones Sims, MD
5/1 James Kent Treadway Jr., MD, FAAP
5/2 Scott Victor Bracey, MD, FAAP
5/2 Erika Baier Rabalais, MD, FAAP
5/2 Susonne Annette Ursin, MD, FAAP
5/3 Veronica Alexander, MD
5/3 Laura Finley, MD
5/3 Megan Gardner, MD, FAAP
5/3 L’Issa Gates, MD, FAAP
5/3 Dorothy D McCord
5/5 Kate M. Brown, MD, FAAP
5/5 Suzanne Patrice Foster, MD, FAAP
5/6 John Alexander Mata, MD, FAAP
5/7 Judy M. Moreau, DO, FAAP
5/7 Albert Warren Richert Jr., MD, FAAP
5/8 Nicholas Sausen, MD
5/9 Marilyn Jonell Roby, MD, FAAP
5/10 Aiyasawmy Dorairajan, MD
5/10 Karen Kern, MD, FAAP
5/10 Monique Patricia Dibbs Vallee, MD, FAAP
5/10 Alexandra Wright, MD
5/11 Stanley Lawrence Bonis, MD, FAAP
5/11 Giao N Do, MD, FAAP
5/11 Anita Go, MD, FAAP
5/11 Mitra Green, MD, FAAP
5/11 Shipra Sharma, DO
5/12 Lauren Kaczka, DO
5/12 Darlonda Reynaud, MD
5/13 Claire Christman Morgan, MD, FAAP
5/13 Ricardo Sorensen, MD, FAAP
|5/14 Amanpreet Kaur Dulai, MD
5/14 Michele Salassi, MD, FAAP
5/15 Veronica Fabrizio, DO5/17 Terry Lynn Dise, MD, FAAP
5/17 Jennifer Gee Yuen Lee, MD
5/19 Chris John Leumas, MD, FAAP
5/20 Bradley Randall Dowden, MD, FAAP
5/21 Anne-Marie Herbert Ardoin, MD, FAAP
5/21 Juan Manuel Fukuda, MD, FAAP
5/22 Brent Gerard Nick, MD, FAAP
5/23 Cameron Laseter Diaz, MD
5/24 Amanda Lavigne Talbot, MD, FAAP
5/25 Stuart G. Landry, MD, FAAP
5/26 Geeta N. Dalal, MD, FAAP
5/26 Jessica Jang, MD, FAAP
5/26 Anatole Juris Karpovs, MD, FAAP
5/26 Monica Lau, MD
5/27 Liaqat H. Khan, MD, FAAP
5/27 Shree Patel, DO
5/27 Oleitha Wilson-Ruffin, MD, FAAP
5/28 Aviel O Lemus, MD
5/28 Kathryn Tierling, MD
5/30 Jamar Adcock Melton, MD, FAAP
5/30 Cheynita Metoyer, MD
5/31 Grace E Banuchi, MD, FAAP
5/31 Jean-Claude Comeau, MD, FAAP
Please join us in welcoming our newest member to the LA Chapter of the American Academy of Pediatrics. There is strength in numbers and we are so glad you have chosen to add your voice to the more than 700 Louisiana Chapter members who are speaking out on behalf of the Children of Louisiana and the profession of Pediatrics.
Melissa Roy MD FAAP
SUDIA Recipe: Banana-Strawberry Licuado
Cool down with this protein-filled fruit smoothie that features lactose-free milk.
Yield: 4 (8-ounce) servings (32 ounces)
Preparation time: 30 minutes
Source: Makers of LACTAID® Brand Products
1 cup LACTAID low-fat milk
1 cup frozen sliced strawberries
1 large ripe banana, peeled
1/2 cup orange juice
2 tablespoons fresh lime juice
1 cup ice cubes
Slice banana and freeze for 30 minutes.
Combine milk, frozen strawberries, banana, orange juice, lime juice and ice cubes in blender. Blend until smooth and frothy.
For more information and recipes visit www.southeastdairy.org
Tulane Saturday Pediatric Series
Updates on Adolescent Health
Saturday, June 11, 2016
Registration 9:00 am – 10:00 am
Conference 10:00 am – 1:30 pm
Tulane University School of Medicine Department of Pediatrics
and the Tulane University Center for Continuing Education
Ralph’s on the Park
900 City Park Avenue
New Orleans, LA
Topics are scheduled to include:
Update on Contraceptive Methods
Screening and Treatment of Sexually Transmitted Diseases
Adolescent Well Visits
Adolescent Consent and Confidentiality
This activity has been approved for AMA PRA Category 1 Credit™.
Registration Fee is $35
Online registration will be open 5/1/16 at http://tulane.edu/cce/
Red River Potpourri
August 19-21, 2016
Shreveport Convention Center
Registration details will be forthcoming
Call us for more information 337.988.1816
Red River Potpourri is presented by The Louisiana Chapter of the American Academy of Pediatrics
For all the latest updates, go to: www.laaap.org/2016potpourri