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Members Present:
The General Membership meeting was called to order at 9:00 AM. Introductions of the members present.
Milo
Schmidt: VGM Pat
Vasquez: McKesson Medical-Surgical Ian
McCracken: President and Owner of PRI Esther
Apter: President/CEO MedForce Technologies, Inc. Doug
Stallbaumer: Vice President, MedForce Technologies, Inc.
Joe McKnight motioned that we adjourn the meeting. The motion was seconded, and all members present voted in favor. The meeting was adjourned at 3:35pm. Meeting
minutes were recorded and submitted electronically by:
Members Present: Rick
Graver – Chairperson Charles
Owen – Mobility Sales Rick
graver opened the meeting at 9:04. , Rick asked the members to
be involved in the meeting and ask a lot of questions and interact
with their peers as this what their dues are for and the benefit
of the organization. Rich
asked for introductions of the audience Approval of Minutes from March 23 2007 Minutes Robin motioned and Ray Summerson seconded, on minutes. Motion carried Treasurer’s
report – Robin reviewed the attached report Rich explained
on accounting and the checks that were written. Pat Vasquez and Matt Gregory with McKesson. Matt and Pat reviewed the products and services offered by McKesson. Rich
spoke on HR 621 (Oxygen Protection) HR 1845 (stop competitive
bidding), S1428 and S1484 Rich explained the lobbing that he
has been doing and that NAMPS needs help with Dean Heller’s
office. Please send e-mail or phone 202-225-6155 Leeann Walker
(HLA) to ask for Congressman’s Heller support and co sponsorship
of both House Bills.. Ian McCracken of PRI – How to Value Differences: “We all my have come from different ships, but we’re all in the same boat now”. Dr. King. Doug Stallbaumer – Medforce Technologies. Activities Based Management, Creating Operations Efficiently and Six Sigma. Nevada Medicaid – Diane Schlapkohl– DME fee schedules can be downloaded now from the website. Each time there is a PDR completed, they will make a change in the fee schedule. They will also post this to the web announcement. They will also send a note to the NAMPS office. At the moment there is not a “list serve” for Medicaid, but things will be sent out through the NAMPS office. Diane
reminded everyone to READ THE WEB FOR ANY UDATES TO THESE NOTES!!! Revised Fee Schedule for DME Providers The following changes have been made to the Provider Type (PT) 33 Durable Medical Equipment (DME), Disposable, and Prosthetics Fee Schedule. The schedule is posted on the Rates webpage on the Division of Health Care Financing and Policy website at: http://dhcfp.state.nv.us/RatesUnit.htm. PT 17 and 33: Effective with service dates January 1, 2007, and forward, Nevada Medicaid activated Healthcare Common Procedure Coding System (HCPCS) code E0165 (Commode chair, mobile or stationary, with detachable arms). This change is consistent with the HCPCS 2007 code revision, which changed the definition for this code. PT 33: Effective with service dates June 1, 2007, and forward, code E0995 (Wheelchair accessory, calf rest/pad, each) has been activated. PT 33: Effective with service dates June 1, 2007, and forward, codes A6501 through A6512 (Compression Burn Garments) require prior authorization (PA). PT 12, 20, 21, 24, 25, 31, 33, 34 (claim types 03 and 05), 36, 72, 74 and 77: Effective with service dates June 1, 2007, and forward, code L3330 (Lift, elevation, metal extension (skate)) requires PA due to L-code rate greater than $250. PT 20, 24, 33 and 77: Effective with service dates July 1, 2007, and forward, codes A4230 (Infusion set for external insulin pump, non-needle cannula type) and A4231 (Infusion set for external insulin pump, needle type) have been added for PT 33. PT 33: Correction made to PA type for code L0623. In accordance with policy change effective October 1, 2006, L code rate is less than $250 and, therefore, does not require a PA. PT
33: Correction made to the limitation for code E0443 (Portable
oxygen contents, gaseous). The correct limit is 8 units per month. Web Announcement Prior Authorization for DME Repair/Labor Codes Repair/labor codes for Durable Medical Equipment (DME), orthotics and prosthetics now require a prior authorization (PA) only when 16 units per month are going to be exceeded. A unit equals 15 minutes. Healthcare Common Procedure Coding System (HCPCS) codes affected by this change are: E1340, L4205, L4210, L7510 and L7520. Claims for code E1340 with service dates back to Jan. 1, 2005, that processed at 16 units when a PA was on file to exceed that amount will be recycled to adjudicate at the number of units approved on the PA. Code E1340 refers to repair or nonroutine service for durable medical equipment requiring the skill of a technician, labor component. Your Remittance Advice will report any adjudication due to the recycle. Nevada Medicaid will monitor utilization on an ongoing basis. Jeff
Shaw and Donna Perkins with Nevada Medicaid: Jeff was queried about on pars. Auth errors are being cleaned up. Not as many as before. They will be revamping the web to make things better. Jeff added they will be building a tool that makes sure all the information is in the system so you don’t miss anything on the par. Q - Jeff was asked: “Will there be a point of sale system in the future?” A- We hope so. There are issues but they are working a similar system. Q -What about same and similar? A - Not at the moment, nothing in the works. Q - Will the fee schedules be posted on the First health site? A - No, but there is a link, just click on links. Questions
for Donna Perkins. NPI questions, there are sporadic NPI rejections.
There is a conflict between the Medicare carrier, the clearing
house and Medicaid. They are currently investigating. Rich spoke about taxation department. Although SB 172 and AB 169 died with Senator Raggio removing our Bill from the Senate floor before a vote was taken on it, Rich has been working with our taxation department. A matrix of their own regulations demonstrates that 2005 rules conflict with 1997 rules so that NRS 372.283 indicates mobility equipment is taxable but that in May, 2005 it was voted upon by our Legislators and approved (SB 515) that under the streamline tax document the same item (mobility equipment) is exempted. Rich feels that there is a good chance to have the dept of Taxation look at the ruling to see if NAMPS can convince the state not to charge the patient anymore sales tax on wheelchairs ,canes and walkers. A group of small HME providers in Las Vegas are meeting to explore the development of some entity to allow them to join together with a bid when competitive bidding hits Nevada. Joe spoke about using VGM and other groups to develop LLC’s or other entities to help with bid processes. Rich, Joe, Rick and Bret Tracy all STRONGLY encouraged the membership to GET INVOLVED with their legislators and make them aware that many of us will be out of business if the legislators don’t support our bills in Washington. DAC Update: Joe explained that IntegriGuard will be losing the ADMC and Medical review contract and that CMS is moving these functions back to the MACs. A new medical director is being appointed. This will occur to conclude by October 31st. Dr. Pilley expects new Orthotics policy to be out by end of his term as current Medical Director. Look for DAC notes to be distributed from the NAMPS office. Cheryl Karstensen motioned to close and Ian McCracken Seconded at 2: 26pm
BOARD OF DIRECTORS RICHARD
J. POZESKY - PRESIDENT
(702) 294-6680
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