POE AG Meeting Minutes - January 19, 2022 - JA DME

POE Advisory Group Mission and Goals

Attendees

POEAG Members: Kim Brason; Ronda Buhrmester; Melinda Eberhart; Valerie Eriole; Pamela Fritz; Sharee Hummer; Catherine Hamilton; Kimberly Hanson; Crissy Hill; Dawn Jorgensen; Paul Kesselman; Tugba Koca; Maria Koehnlein; Bridget LaScala; Amanda McFaddin; Noel Neil; Yvette Nugent; Jan Palmer; Caryn Plessinger; Kimberlie Rogers-Bowers; Wendy Russalesi; Randy Stevens; Rhonda Turner; Yvonne Weiler

Noridian: Shelly Carlson; Stacy Dahl; Tanya Gillies; Colleen Harryman; Amber Mertz; Ruth Reese; Mary Reineke-Ferguson; Tracy Schutt; Kelsey Slettebak; Brenda Swancy; Cindy White
CMS: Pamela Durbin; Rebecca Russo

Mission

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

Goals

• Develop timely, useful, relevant educational opportunities for our suppliers
• Provide input in the creation, implementation and review of Provider Education and Training
• Determine innovative, cost effective methods of using technology in provider education and training CMS Internet Only Manual (IOM), Publication 100-09, Chapter 6

Standing Agenda Items

• Coronavirus (COVID-19) Public Health Emergency (PHE)
  • Waivers and flexibilities remain in place look for update soon
  • Last extension expired October 2021
  • Effective January 16, 2022, extended another 90 days
• Post COVID-19 PHE Guidance
  • Send questions to DME POEAG email (DMEPOS-POEAG@Noridian.com) and Noridian forwards to CMS
• Sequestration suspension extended to March 31, 2022
  • Effective April 1, 2022 - June 30, 2022, adjustment will resume at 1%
  • Effective July 1, 2022, adjustment will increase to 2%
• Targeted Probe & Educate (TPE)
  • Resumed
• Post-Payment Clinical Review
  • Ended
• Education for Practitioners
  • Continue to seek opportunities
  • PEN education after checklists are updated
    • DME Enteral webinar January 19, 2022, 11 a.m. CT
    • DME Parenteral webinar January 26, 2022, 1 p.m. CT

Follow-up from Previous Meeting

General

• Suggestions for engaging audiences
  • Working on implementing “pop quizzes”

DME

• Level 200 Ventilator Webinar
  • Three scenarios completed, looking for two more
    • Asked for more scenarios for vents
• L200 Respiratory webinars
  • Oxygen placed on hold due the upcoming policy changes
  • PAP May 25, 2022, 1 p.m. CT
  • Nebulizers placed on hold
  • Continue to look for scenarios
• Frequently Asked Questions – Philips Respironics Respiratory Products Recall – Revised
  • Initially published June 25, revised July 16
  • Frequently Asked Questions (FAQ) posted on Noridian website
  • No updates, waiting on further direction
• Noridian is aware of the oxygen decision memo and more education will be forthcoming.
• Joint POEAG to develop education for clinicians ordering DMEPOS
  • In progress
  • Tentatively looking at development by policy
    • CGM and glucose is a suggestion

O&P

• Nothing pending

New Items

General

• Ask the contractor teleconference (ACT)
  • Scheduled for 2022 - February 10, May 11, August 9, and November 10
  • General - all topics
• MLN Connects January 12, 2022
  • CMS released the required face-to-face (F2F) and written order prior to delivery (WOPD) list effective April 13, 2022
    • Seven items in addition to the power mobility devices
  • Additional items added to the required prior authorization list
    • Five orthoses and six power mobility devices
  • MLN Matters Number: SE20007 Revised

Suggestions from POE Advisory Members

What kind of collaborative education is planned with A/B MACs?

Starting in February, an orthotics webinar is being presented to the A/B side, with another one specific to DME separately. Others are planned throughout each quarter on surgical dressings, respiratory, and documentation.

On the Noridian website, is there a separate place these collaborative events are posted instead of only on the Schedule of Events?

The webinars we are presenting to the A/B side are only posted on those websites. There are a couple in the works that will be available to all, and they will be posted to the Schedule of Events.

Regarding the TPE process, Noridian is always good about calling ahead when we are selected. We received a call a couple of months ago letting us know we were selected and that we'll be receiving a letter, but we didn't receive one. What is the timeline we can expect that letter?

We will check with Medical Review. Checking the Noridian Medicare Portal is the best place to watch because it will be posted there.

Whenever training is developed for the WOPD and F2F, can you explain that just because it's on the master list, a WOPD and F2F are not required? It's very confusing how CMS sent out a master list and a required list of items. Others on the call agreed.

Yes, we will ensure our education is clear to suppliers.

The New York podiatry association went all virtual and Noridian has the opportunity to attend. Dr. Kesselman will send an email to Ruth and Cindy.

Follow-up from the last meeting:

• Publication to indicate how the miscellaneous codes are reimbursed because there seemed to be some inconsistency.
  • There is an article that addresses pricing at this link: Pricing
• Can there be clarification published on power tilt being added to manual tilt and space chairs? They are being approved by Advance Determination of Medicare Coverage (ADMC) but there aren't any coverage criteria.
  • Ruth will follow-up and add to next agenda
• Regarding the HCPCS code K1006 Purewick urine collection system, there was an article explaining coding but it was unclear if it was going to be a covered item, and it is not in the Local Coverage Determination (LCD). Is this a covered item?
  • It is not a covered item for DME - PureWick Urine Collection System - Coding and Billing Instructions  

Prior authorization is expanding to include orthotic codes. Are you planning on doing anything prior to the April launch of the expansion? It was recommended to do collaborative education and others on the meeting agreed.

Yes, we are working on education for these specific codes and will look into a collaborative event.

Can CERT error rates be broken down by provider type and by product category?

Yes, the CMS website provides the following document: 2021 Medicare Fee-for-Service Supplemental Improper Payment Data (PDF)

There was a recent Office of Inspector General (OIG) report on hospice and DME, where they looked into medical records instead of just ICD-10 codes. Education around hospice and billing DME would be helpful.

We will look into adding education on this.

Is the DME supplier enrollment fee still waived?

The following MLN education tool provides information: Medicare Provider Enrollment

Upcoming Meeting

Next Meeting: April 20, 2022