Provider Outreach and Education Advisory Group (POE AG) Meeting Minutes - September 10, 2019

Roll Call

Noridian Attendees

Claire Anderson, Kimberly Behrens, Heather Langei-Watters, Beth Sandeen, Annessa Schjeldrup, Julie Schroeder, Tana Williams

POEAG Member Attendance

Welcome new member Candice Williams- Tacoma, Washington
Susan Albaitis, Lisa Beyer, Teresa Cirelli, Dawn Davidson, Mindy Gale, Samantha Karpenko, Amber Krueger

POEAG Mission and Goals

During each meeting, the Mission and Goals are reviewed.

Prior Meeting Minutes

The June 11, 2019 meeting minutes were distributed to POEAG members and published to the website June 26, 2019.

Prior Suggestions and Recommendations

Below are the POEAG meeting recommendations and/or suggestions from the prior event.

Suggestion Date Description Resolution
06/11/19 A provider asked about appropriate criteria for advanced diagnostic images in 2020. Noridian response: CR11268 effective on January 1, 2020 (the start of the AUC program Educational and Operations Testing Period), MACs should accept the Appropriate Use Criteria (AUC) related HCPCS modifiers on claims. Be sure your billing staff is aware of this update. Subsequent change requests (CRs) will follow at a later date that will continue AUC program implementation available references on this topic. View the complete CMS Medicare Learning Network (MLN) Matters (MM)11268.
06/11/19 A provider questioned the Provider Based attestations; they are working w/ different MAC for off-campus departments. Our Education team members have researched available material on this and contacted the Subject Matter Experts from the Provider Enrollment and Part A Audit team members at Noridian. Working together, we hope to expand and improve our current Provider Based Attestation website information.

 

New Agenda Items

Prior to the meeting, Noridian solicited agenda topics from members and evaluated significant program changes to discuss.

  1. New Medicare Card / Medicare Beneficiary Identifier (MBI) Updates
    We are less than 16 weeks away from the end of the transition period to obtain the new MBI number. As of January 1, 2020 Noridian, can longer accept the Health Insurance Claim Number (HICN). Regardless of the date of service, the claim will require the new MBI number starting January 1, 2020.
    • Additional resources available when the Beneficiary is unable to provide a copy of their new insurance card.
      • MBI look-up tool is available through Noridian Medicare Portal (NMP)
      • Remittance advice (RA) will also provide new MBI when a valid HICN is submitted
    • CMS New Medicare Card Open Door Forum: Completed September 11, 2019 2 p.m. ET
  2. Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Patient Driven Payment Model (PDPM)
    Get Ready for Implementation on October 1, 2019. The new PDPM is replacing the Resource Utilization Group, Version IV (RUG-IV) for the SNF PPS. PDPM improves the accuracy and appropriateness of payments by classifying patients into payment groups based on specific, data-driven patient characteristics, while simultaneously reducing administrative burden.
    • Changes to Assessment: Both RUG-IV and PDPM use Minimum Data Set (MDS) 3.0 as basis for patient assessment and classification, but assessment schedule under PDPM is more streamlined and less burdensome on providers. See presentation (starting on slide 52) to find out how your assessments will change
    • Billing for Services: Use Health Insurance Prospective Payment System (HIPPS) code generated from assessments with an assessment reference date on/after October 1, 2019, to bill under PDPM
    • Changes to Payment: Under PDPM, clinically relevant factors and patient characteristics are used to assign patients into case-mix groups across payment components to derive payment. Additionally, PDPM adjusts per diem payments to reflect varying costs throughout the stay
    CMS and Noridian has resources to help prepare:
  3. Provider Enrollment
    • Website Update: Enrollment portion of the Part A website has been updated. To give the provider community an overview of what is needed to enroll, each specialty type has been added to the website. See the Part A Enrollment for Specialties webpage
    • New Report Card Process: The Provider Enrollment education department has started a report card process. We use providers enrollment application submission, development request per application, revalidation request and more to give them a full overview of their enrollment. We then give them pointers on how to improve their application submission and revisit them in six months and show them where they have improved. This data is sent to them via PDF. They also have the option for an e-visit to go over the data in PowerPoint form. Let us know if you have any enrollments that you think would benefit from this. Or if they have any questions, send us an email at PEeducation@noridian.com
  4. Noridian Medicare Portal (NMP) Education
    • Provider enrollment functions available within NMP
      The NMP has added the use of additional self-service tools for Enrollment functions. Users may enter a Tax Identification Number (TIN), Provider Transaction Access Number (PTAN), and National Provider Identifier (NPI) combination and it will list currently processing applications or the completed applications for either Individuals or Organizations within the past six months.
      • Part A: Organizations can only view their organizational applications
      • Part B: Providers can view Group and Rendering applications.
    The "In Process" applications section will display the application status along with any requests for information letters that have been sent to the contact listed on the submitted application. This information/documentation can be quickly uploaded to the application within NMP. The "Completed" applications section will display a listing of recently completed applications where the notification letter can be downloaded. View the Provider Enrollment section of the NMP User Manual.

Upcoming Events

Providers can view trainings and seminars available by visiting the "Education and Outreach/ Schedule of Events" section of our website.

Webinars

Seminars

Arizona Seminars: Noridian A/B In-Person Seminar in Phoenix 10/16 (8:30-4) and Flagstaff- 10/17 (11:30 - 3:30)
Due to limited space, Noridian can allow only two members per facility.

New POEAG Suggestions and Recommendations

During each meeting, all POEAG members are asked to provide suggestions on ways to increase education, improve training methods, or elaborate on topics discussed during the meeting.

  • A provider asked about eligibility in the DDE system? Noridian provided the eligibility feature will be going away in DDE sometime possibility this fall 2019 and providers are encouraged to use the NMP or other eligibility systems of HETS.
  • A provider asked what education will be provided for the upcoming changes in 2020? Noridian provides a What's New in the first Quarter 2020 webinar, watch the website for the latest update and sign up for the listserv for upcoming changes.
  • A provider shared concerns regarding the Provider Based Billing (PBB) address and changes for claim editing surrounding the United States Postal Service address which is inconsistent with PECOS. Noridian shared CMS has postponed this implementation until April 2020. The address assignment made by the USPS is outside the scope of Noridian's guidance. Noridian will promote and provide resources to assist provider in their preparation for this change.

Upcoming Meetings

All meeting times 1-2 p.m. CT

2019

  • December 10

2020

  • March 10
  • June 9
  • September 8
  • December 8

Thank you for attending today's meeting, we look forward to working with all of you again.

 

Last Updated Thu, 23 Jan 2020 10:13:15 +0000