Provider Outreach and Education Advisory Group (POE AG) O&P Meeting Minutes - July 24, 2019

POE Advisory Group Mission and Goals

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.

Reminder: We meet on a quarterly basis to discuss educational opportunities that Noridian Education can provide to suppliers through workshops, our website, and our listserv. We aren't able to discuss claim-specific questions or issues you may be seeing with claims. Please direct those questions to our Supplier Contact Center where they can be researched and resolved.

Noridian Attendees: Cindy White, Colleen Harryman, Trina St. Ours

POEAG member Attendees: Eilleen Levis, Lesleigh Sisson, Michelle Wullstein, Patty Donndelinger

Standing Agenda Items

  1. Medicare Beneficiary Identifier (MBI)
    • We (Noridian) made targeted calls to suppliers with low submission rates
    • Members reported they were successful getting MBI through NMP but some beneficiaries are reluctant to provide SSN for look up process
    • Member suggested conducting additional education to O&P suppliers as most patients are new and these suppliers are not submitting monthly rentals where we would provide MBI after claim is submitted with HICN
    • Member reported using new MBI is not bringing back results for same and similar for O&P (within last couple of weeks). We thought issue was resolved and will investigate again
  2. Targeted Probe and Educate (TPE)
    • We eliminated providing charts until we can get data that is comparable from quarter to quarter. Working with MR to get error rates by round for more relevant data
    • Member inquired as to what is a passing percentage? We responded that there are multiple factors that are considered when moving from one round to the next. A percentage will not be communicated
    • Member inquired how many suppliers have been referred to CMS after third round? We cannot release this information.

Follow up information from previous meeting

  1. Training curriculum status
  2. Noridian DME has begun a project with Part B for a collaborative webinar on telemedicine
    • DME on Demand to be posted within next month
  3. Breakout of round 1 vs 2 data for TPE
    • Discussed above under TPE
  4. Exclusion list for RT/LT modifiers
    • Reiterated need to bill on separate lines. Noridian will not be publishing an exclusion list
  5. Training program for O&P suppliers on Competitive Bid
    • We will put together training as we get closer to implementation and provide guidance on claim submission/billing etc.

New Items

  1. Membership reminder
    • There is a requirement for attendance at 3 of 4 POEAG meetings
    • We have been reviewing attendance and members will be receiving email regarding status
    • Goal is to make sure that members are actively involved in education process

Suggestions from POE Advisory Members

  1. TPE – in last couple of months CGS opened some cases on LLP codes. Has there been any discussion about Noridian opening LLP cases too?
    • We responded that determining factors for a TPE are driven by data. It's always a possibility
  2. HCPC for off the shelf products
    • We responded to ensure there is a code in PDAC for brace that is being provided. When code states it includes fitting, they can be used for custom fitting or off the shelf
      • Supplier requested this in training somewhere – supplier hasn't seen it in writing anywhere
        • We will work to make this information more visible and will provide additional education
  3. CPI (Center for Program Integrity) (task force in CMS) – been around two years but not a lot of information about what they do on CMS website. Do we have any plans to update education based on types of reviews they conduct and what suppliers can expect? (CPI requests documentation that gets sent to a contractor to conduct the review. CPI doesn't actually conduct the review). Letter example said that documentation would be sent to Noridian SMRC
    • We will be looking into what can be provided in terms of education on this topic
  4. Member noted that they are seeing CERT audits on replacement sockets, TPE from CGS, SMRC audits and UPIC in last three weeks
  5. Member questions on avenues to report potential fraud?
    • We advised to have beneficiaries call 1-800-Medicare and log it as a "complaint"
    • Our website also has a Fraud and Abuse webpage which provides reporting guidance

Next JD O&P POEAG

  • October 31, 2019

 

Last Updated Wed, 12 Feb 2020 10:06:52 +0000