Provider Outreach and Education Advisory Group (POE-AG) Minutes: December 12, 2019

Palmetto GBA welcomed all POE-AG Members

Name

Company
Carol Aiken Smith Family Clinic
Fran Sorrell Memphis Pathology
Kim-Marie Walker Northside Hospital
Stephanie Smith Southern Wellness
Wallace Elliott

The Ambulance Service

Gail Harrison   AAPHC
Lisa McCord Montgomery Radiology
Melissa Reeves   

Dothan Specialty Clinic

Erin King Simplify
Joyce Lynn Johnson UAHSF
Peggy Palmer

Peggy Palmer

Peter Dedsrsa Erlanger Health System
Philip Horn Medical Compliance Services
Terry Cobb Laurens County EMS
Kristi May Tennessee Orthopedics

Palmetto GBA Associate
Swandra Miller

Goals/Purpose

Our goals are to:

  • Establish and maintain strong relationships with Palmetto GBA staff and the provider community
  • Meet with Palmetto GBA and the provider community on a quarterly basis
  • Provide the communication tools to facilitate thorough and prompt transfer of information to and from each representative
  • Coordinate the issues within the provider community to adequately reflect the concerns of the majority

It is Palmetto GBA’s intent to:

  • Promote an atmosphere that facilitates an exchange of ideas and information to service the best interests of Medicare providers and Palmetto GBA’s Medicare program administration
  • Provide educational forums that address various global provider concerns
  • Allow the provider community an opportunity to communicate with Palmetto GBA’s staff on any areas that may need additional education activities
  • Assist in making the Medicare program more understandable for providers
  • Enhance providers’ understanding of the role and responsibilities of Palmetto GBA as their A/B Medicare Administrative Contractor (MAC)

Old Business
Critical Care: a listing of all of the critical care resources posted to the website was sent to POE-AG members for review. Members will provide feedback on what additional critical care information they would like to see on the website.

Calendar of Events
Upcoming Scheduled Events 2019:

  • There are no more scheduled events for the remainder of the calendar year. Solicitated topics for the 2020 Ask the Contractor (ACT) teleconferences. There were no topic suggestions submitted on the call.

Special Agenda Topics

  • Medicare Beneficiary Identifier (MBI) Deadline
    • Deadline is December 31, 2019
    • Only the MBI will be accepted as of 01/01/20
    • The MBI may be obtained through the beneficiary, eServices, and the remittance advices
    • Feedback was provided from the group concerning MBI issues
      • Members stated that they were having beneficiaries whose MBI was different than what’s on their card. Members will send me examples and I will have the issues researched.
  • Opioid Treatment Programs
    • Starting January 1, 2020, Medicare will pay Opioid Treatment Programs (OTPs) that provide opioid use disorder treatment services to people with Medicare
    • Under the new OTP benefit, Medicare covers FDA approved opioid agonist and antagonist medication-assisted treatment medications, substance abuse counseling, individual and group therapy, toxicology testing, etc.
    • CMS is handling enrollment and additional information can be found on their website.
  • Ground Ambulance Data Collection
    • Selected ground ambulance providers and suppliers will participate in the Medicare ground ambulance data collection beginning January 1, 2020 and continuing through 2024
    • Selected providers must collect information on cost, utilization, revenue and other service characteristics for a 12-month period
    • Failure to submit the required information will result in a 10 percent reduction in payments
    • Additional information can be found on the CMS website.
  • In-person POE-AG meetings (2020)
    • Face-to-face meetings in each Jurisdiction state (along with our normal teleconferences) will take place in 2020
      • February 19, 2020 – Palmetto GBA, Augusta, Ga.
      • May, 20, 2020 – Palmetto GBA, Birmingham, Ala.
      • August 19, 2020 – Tennessee (City TBD)
      • November 18, 2020 – Teleconference Only
    • Palmetto GBA would like for all members to attend in person when the meeting will be held in their state
    • A survey will be sent to gauge in-person member participation

Agenda Items Requested By Members
New PTA/OTA modifiers for 2020: POE will work on developing education for the new modifiers.

Open Discussion

  • POE-AG Membership
    • Palmetto GBA is in the process of membership intake and asked the members to get the word out and encourage others to submit a membership request form
    • The process was explained for those who would no longer like to be a POE-AG member
  • Member requested more specialized TPE education
    • I will compile a listing of all of the TPE education that we have on the website to send to the members for review. We will then look into creating any additional information that needs to be added.

Announcement of Next Meeting Date
February 19, 2020, at Palmetto GBA in Augusta, Ga.