Jurisdiction-C Council Pre-Meeting

Jurisdiction-C Council Pre-Meeting

Permobil’s conference room

10/22/2013

I. Council Business

A. Council chair discussion

-Motion made and passed for Andrea Stark to serve as Chair of the council and Laura Williard to serve as vice-chair (Motion made by Pam and second by Don).

-Motion made and passed to limit chair term by 2 consecutive 2 year terms (Motion made by Andrea and second by Pam).

B. Membership List - review and update -Drop FAMES from list because of non-response and entertain Respironics’ interest to join council.

C. Welcome new members – Lee from Walgreens and John from Permobil welcomed.

D. Financial statement - Motion to approve by Don and second by Peggy.

E. Meeting Q&A calendar date review

-Questions will be due sooner than before in order to provide adequate time for MACs to review and coordinate answers. Question/meeting dates have been updated.

-Questions that are omitted will be communicated back to chair and then back to A-Team leader to be communicated back to originator with explanation why.

New meeting dates:

-July 22 & 23, 2014

-Oct 21 & 22, 2014 depending on Medtrade

F. Coordination with Region B and D – informational sheet distributed at meeting

G. Cross-council Question submission – Submission as usual with updated due dates.

H. Next meeting location

-Depending on CGS’s response to meeting at Permobil’s location.

II. My CGS audit remark codes are not better; providers still have to call to obtain information.

III. CIGNA Meeting agenda reviewed

IV. July 2013 final Q&A review -No comments on the July QA

V. October 2013 Q&A reviewed

VI. Audit Errors Top Discussion

-Problem with denials for medical necessity because medical records have "physician order" printed on top. These are part of the medical record.

-Technical vs medical denials, can they be separated? Workgroup created and Andrea leading.

VII. AAHomecare Update

-Face to face - issues with enforcement. AAHC issued a letter to CMS pointing out the delay should be to effective date not enforcement. There is no statutory rule that states rule must start 7/1/13.

-OIG study indicates sleep studies are being paid for too often.

-Audit task force- Working on several items including a bill to put restraints on what and how we can be audited (protections).

VIII. Other

-Abandoned patients- can patient send a letter stating they are abandoned to restart rental?

-Andrea to investigate whether or not JC needs a website. Peggy is getting a quote from Forbin.

-QA should be posted on state association's websites and used to promote submission of questions.