Region D DAC/IntegriGuard/EDS/CIGNA
Meeting Minutes
July 12, 2006
Via Teleconference
11:00 am PST
Present:
Region D DAC Executive Committee Members: Chair: Val Taylor; Vice Chair: John Kenney; Secretary: Rick Graver; Treasurer: Reid Bellis; and Past Chair: Rich Pozesky. Administration: Rose Schafhauser.
CIGNA Government Services Region D DMERC: Ellen Edenfield and Barbara Douglas.
DME Medicare Administrative Contractor (MAC) Noridian Administrative Services (NAS): Teresa English and Janet Kirsch.
Program Safeguard Contractor (PSC) IntegriGuard/EDS: Dr. Mark Pilley, Carrie Metzke, Amy Barnes, Carolyn Osborne and Missy Edison.
Region D DAC Participants: see enclosed listing.
Meeting opened at 11:01 am
1. Introductions of all attendees ensued and a reminder of the protocols were read.
2. General Business:
a. Approval of meeting minutes: A motion to approve the March 22, 2006 meeting minutes as written by Wade Hendrickson. Second Sharon Nichelson. Motion carried.
3. Medical Director update: Dr. Mark Pilley:
a. Very active year: Final rule for Power Mobility Devices has been put out with dropping of CMN and inclusion of a face to face within 45 days from the time of the order. In the process of completing draft policy and implement the LCD that will be coming out in the near future. A bulletin article on the documentation requirements and ADMC will also be done. Codes for wheelchairs will also be coming in the future, most likely on 10-01-06.
b. CMN changes: updating the LCD and articles on those items that are affected in the changes in CMNS and DIFs. This may also happen 10-01-06.
c. Nebulizer policy still remains in draft form. The policy is still in review and consideration of the thousands of comments they have received.
d. Transition update: March 1, 2006 the PSC went to EDS/IntegriGuard. Noridian Administrative Services (NAS) will be the claims processor. The DME MAC transition to NAS will be Oct 1, 2006.
i. Questions: Val Taylor asked about the request in the NAS newsletter for members of the Provider Outreach and Educational (POE) Advisory Group, if this is the same as the PCOM?
1. NAS responded that it will stay the same and will move over to them. The previous membership, along with new members, will now be called the POE. Only the DME MACs will have the POE.
4. Medicare Beneficiary Information – Provider Access: Lori Borelli was not on the call.
5. CIGNA Update: Kathy Brock and Doug Frazier were not on the call.
6. New Business:
a. Next meeting at Medtrade: Discussed having the meeting at Medtrade on Tuesday, September 19 th , 8:00am to 10:00 am for the DAC only meeting, and the DAC/DME MAC/PSC meeting from 11:00am to 1:00pm. The DAC office is setting up the room. We will send the dates and times to the respective entities to see if this will work.
b. Equipment Fair: Val Taylor asked both the PSC and the DME MAC if both are still interested in having an Equipment Fair. The PSC is still very interested. Val explained the workings of the Equipment Fair where there would be all the various grouping of items; the HCPCS it represents; and able to ask questions. Each staff member would be able to go through the fair if we held close to the respective offices. It is a separate from Medtrade. The DME MAC will discuss this internally and let us know. They would not want to do the Fair during the transition time.
c. Other New Business: The NSC A-Team did not have questions, but did want clarification on diabetic shoes. Wade Hendrickson discussed if there is an update to report on as to what other healthcare provider can provide diabetic shoes. Has anything changed in this for it was rumored that Dr. Pilley had been looking at defining further.
i. Response from Dr. Pilley: nothing has substantially changed since the previous clarification. There is discussion as to what licensed certified professional means. It is under discussion and consideration and no decisions that have been made. Provide language that they are certified to provide the services. There is discussion on a national basis, but there is no time frame. If there is substantial change, then that would require it to go to a comment and notice period.
1. Question: Wade asked if there was an entity, like an association who developed a program, how does that program get included and who would they get the information to?
2. Response from Dr. Pilley: those policy changes would have to come out for comment, and at that time they can make a request to be included. There is the option now for reconsideration of a LCD. There will ample opportunities to make a request.
a. Question: Wade asked if we have already utilized that time and the request a few years ago. He asked Dr. Pilley to get back to us if this time frame hasn’t already come and gone.
b. Response from Dr. Pilley: it is in current discussion for making changes and he is not familiar with what transpired a few years ago. Send request to him to forward on this question for consideration and he provide response back.
7. A-Team Leaders review of questions: See separate question and answer document.
Meeting concluded at 12:18 PST – (1:18 MST, 2:18 CST, 3:18 EST)
Region D DAC Participants
Barb Stockert
Carlos Reyes
Connie Lind-Fraher
Laura Steelquist
Deanne Birch
Ed Erickson
Evan Call
Gemma English
Joe McKnight
Kimberlie Rogers-Bowers
Laura McIlvane
Leslie Rigg
Mary Turner
Mike Hayden
Pat Spanel
Sha Eppley
Sharon Nichelson
Steve Treinen
Troy Paz
Velma Goertzen
Wade Hendrickson
Yvonne Cordoza
Zena Jacobi