Provider Outreach and Education Advisory Group (POEAG) Meeting Minutes - January 18, 2023

Attendees

POEAG Members: Bill Noyes; Carla Cespedes; Crissy Hill; Dawn Jorgensen; Jan Palmer; Jeannette Leon; Kim Brummett; Kimberly Hanson; Maria Koehnlein; Maria Raszkowski; Melinda Eberhart; Noel Neile; Pamela Fritz; Paul Kesselman; Ronda Buhrmester; Tugba Koca; Valerie Eriole; Yvette Nugent; Yvonne Weiler; Kimberly Hanson

CMS: Pamela Durbin

Noridian: Amber Mertz; Ashley Decoteau; Brenda Swancy; Cindy White; Colleen Harryman; Conner Dingle; Kate Petersen; Kelsey Slettebak; Kloe Roberts; Melissa Betts; Ruth Reese; Shelly Carlson; Tanya Gillies; Tracy Schutt

POE Advisory Group Mission and Goals

Mission

  • To determine the best methods of providing quality education and training to our supplier community.

Goals

Standing Agenda Items

  • Coronavirus (COVID-19) Public Health Emergency (PHE)
    • Waivers and flexibilities remain in place
    • Extended January 11, 2023
  • Post COVID-19 PHE Guidance
  • Education for Practitioners
    • Continue to seek opportunities

Follow-up from Previous Meeting

General

  • Joint POEAG to develop education for clinicians ordering DMEPOS
    • Four meetings have been held focusing on sleep
      • Great suggestions being worked on
        • Provide education during residency
        • More webinars for providers on DME requirements
        • Update clinician checklist
    • Looking for supplier volunteers for a similar Glucose meeting, willing to recruit practitioners
      • Meetings to start in 2023
  • Collaborative MAC education
    • Knee Orthoses
      • February 2023
    • Oxygen
      • Quarter two
    • Surgical Dressings
      • Quarter three
    • Therapeutic Shoes for Persons with Diabetes
      • Quarter four
  • Hospice and DME education
    • Webinar will be held in April 2023
  • Level 200 webinars
    • Please send scenarios you would like to see included
  • Considering 2023 in-person event
    • Held centrally for JA and JD
    • Several attendees expressed interest
  • Quarterly updates
    • DME highlights from weekly email
    • Hot topics
    • New format
    • Is this beneficial?

DME

  • Philips Respironics Respiratory Products Recall
    • On going
    • Medical director discussions
      • During the PHE, if there is documentation from the treating provider that states the beneficiary’s medical condition has not changed since the previous sleep study and the evaluation by the treating physician is within a year of the DOS for initial issue of a CPAP, then DME MACs will accept this documentation in lieu of a repeat sleep study to meet the timely documentation requirement.
  • Removal of Certificate of Medical Necessity (CMN) and DME Information Form (DIF)
    • January 2023
  • FreeStyle Libre 3 not covered, education for practitioners
    • Reviewing clinician checklist and education for possible updates
  • Education on appealing Comprehensive Error Rate Testing (CERT) denials
    • Working on an article with guidance on appealing denials from other contractors

O&P

  • Therapeutic Shoes for Persons with Diabetes "incident to" guidance
    • Reviewing and updating webinar

New Items

General

  • Ask the contractor teleconference (ACT)
    • Scheduled for 2023
      • February 9, 2023, 2 p.m. CT
      • May 11, 2023, 2 p.m. CT
    • General - all topics
  • Combined JA/JD POEAG quarterly meeting?

DME

  • National Supplier Clearinghouse (NSC) is now National Provider Enrollment (NPE)
    • Effective November 7, 2022
    • East of the Mississippi is NPE East
      • Novitas Solutions
    • West of the Mississippi is NPE West
      • Palmetto GBA
  • Continuous Glucose Monitors (CGM) HCPCS code update
    • Effective January 1, 2023
    • New HCPCS codes
      • A4239 Supply allowance for non-adjunctive, non-implanted CGM, includes all supplies and accessories, 1month supply = 1 unit of service
      • E2103 Non-adjunctive, non-implanted continuous glucose monitor or receiver
    • Deleted HCPCS codes
      • K0553 Supply allowance for therapeutic CGM device
      • K0554 CGM receiver/monitor
  • New Medicare Part B immunosuppressant drug benefit
  • Open to combing Jurisdictions A and D into one POEAG meeting?
    • No objections

Suggestions from POE Advisory Members

  • Things to highlight at NHIA and in education:
    • JZ modifier - Suppliers will have questions on what drugs this will apply to
      • Note that Noridian has not received instruction at this time. Will add any updates available to the NHIA presentation and also future education.
    • New use of KX modifier in the external infusion pump policy
  • Is there a requirement for POEAG members to complete surveys and is there a POEAG-specific survey?
    • No, there is not a requirement nor a POEAG-specific survey, but we appreciate members taking any website and webinar surveys
  • We find quarterly updates useful; we use with staff that might not be on the listservs and internal newsletters to remind staff of upcoming changes
  • Where are the updates on Libre 3?
    • Browse by DMEPOS Category > Glucose Monitors page
    • Added to Clinician's Checklist
  • If you are revalidating enrollment, where do you get the information from?
    • It is dependent on the location of the supplier
    • Noridian website > Browse by Topic > Enrollment
  • Very interested in trying to get something going in vision with practitioners
  • Will there be more education on the 10 new codes added to face-to-face and written order requirement list?
    • Yes, as soon as we receive more information, we will pass it along to suppliers

Upcoming Meeting

Next Meeting: April 19, 2023

 

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