August 19, 2022

Ohio Medicaid PNM Pre-Registration Tool is Now "Live"

Next Generation Overview Webinar Slides and Recording Available

The Ohio Department of Medicaid (ODM) has announced that the PNM Pre-Registration tool is now live! As a reminder, ODM, along with DODD and ODA, is implementing a new Provider Network Management (PNM) module on 10/01/22 which replaces the current MITS provider enrollment subsystem and MITS provider portal.  The PNM Pre-Registration tool requires an OH|ID for provider access and is now available from Aug. 15 until Sept. 23.  The agencies have set-up the tool to ease the transition and prevent disruptions to system access for providers ahead of go-live on Oct. 1.

Click here for details about accessing the PNM Pre-Registration tool, creating an OH|ID and other resources.  Additional information:

  • To learn more about the PNM module and Centralized Credentialing, visit the PNM & Centralized Credentialing site.
  • If you have questions about OH|ID, visit the OH|ID Help Center(please note that OH|ID account log in is required to access this site). 
  • To help OAMES members keep up with the many changes coming this fall on Medicaid HME rules projects and the Next Generation program, OAMES will present its OAMES Fall Medicaid Webinar on 9/22/22 with Mark Rogers (Non-Institutional Policy) and Jim Tassie (Deputy Director) from Ohio Medicaid. Watch for registration to open next week.

ODM hosted the Next Generation Ohio Medicaid provider overview webinars throughout July to share information in preparation for the transition to Next Generation program's October 1 Stage 2 launch. The recording and presentation slides are now available – see links below:

ODM Medical Care Advisory Committee Hosts Meeting

Key Topics Covered Include Unwinding PHE and Next Generation Managed Care

Yesterday the Ohio Department of Medicaid’s Medical Care Advisory Committee hosted their quarterly meeting at the ODM office.  Nick Kalogeras, RPh and Kam Yuricich from OAMES participated. 

There was a lengthy discussion of the Mental Health & Addiction Services Workforce Program and efforts underway to address workforce shortages in healthcare.  This is a high priority for Governor DeWine and something he highlighted in his State of State Address earlier this year.  For more information about the initiative, visit www.mha.ohio.gov/about-us/priorities/workforce

MCAC members also received an update on the staggered rollout of the Next Generation Medicaid Managed Care program by Deputy Director Jim Tassie who is presenting during OAMES 9/22/22 Medicaid webinar and 11/01-02/22 Annual Meeting & Exhibition. OhioRISE launched 7/01/22.  The PNM module, centralized credentialing and single pharmacy benefit manager (SPBM) will be implemented 10/01/22.  12/01/22 is the date set to transition to the Next Generation managed care contracts and plans. There were approximately 4,000 participants in ODM's overview webinars last month.  Training for the PNM module started on August 1 and is currently underway.  Providers are urged to follow updates on the Next Generation managed care website here.

Additionally, the MCAC Chair and ODM Deputy Director Patrick Beatty informed the committee that the federal Public Health Emergency will be in effect through at least mid-January since the state agency was not provided the expected 60-day notification from the US Dept of Health and Human Services (HHS) for the current expiration date of October 15. The committee expects to have more details on the PHE and Next Generation program at the next MCAC meeting scheduled 11/17/2022.

Region B Council and CGS Resume In-Person Meetings

Earlier this week, representatives of the Region B Council, industry guests, along with numerous staff from CGS Administrators and CBIC gathered in-person in Nashville for its regular quarterly meeting.  More than 20 attendees were on-site and an additional 70 joined online.  Official meeting minutes are forth coming but several documents were discussed and are available today:

A few noteworthy items are the announcement that Medical Director Dr. Stacey Brennan will be retiring in January and Dr. Sunil Lalla was introduced as her replacement. Dr. Lalla attended Tuesday’s Council meeting and is working with Dr. Brennan on the transition.  Elaine Hensley’s report from the CBIC included no updates on future rounds of the Medicare competitive bidding program.  Regarding the national Public Health Emergency, Dr. Brennan reiterated that the US Dept of Health and Human Services will provide a 60-day notice before the PHE expires.  With the current period renewed 7/15/22 ending mid-October, we are past the 60-day window therefore it’s expected the PHE will be renewed at least one more time taking us to January 2023.  The DME MACs will be present at Medtrade East in October and the next Region B Council meeting is tentatively scheduled on 11/10/22.

CMS Opens NCD Reconsideration for Seat Elevation Systems

Standing Systems to be "Considered at a Later Date" -- Comments due by 9/14/2022

Disability group advocates and mobility stakeholders are energized in the wake of CMS' announcement this week opening the Medicare National Coverage Determination (NCD) for seat elevation systems used with power wheelchairs. While this is excellent news, both AAHomecare, NCART and other advocates have shared disappointment that CMS did not include an update on the NCD status for standing systems used with power wheelchairs, noting that consideration of both seat elevation and standing systems "requires evaluation of two distinct groupings of evidence” and that the "benefit category and coverage of standing systems will be considered at a later date”.

The ITEM Coalition has taken a leadership role in advocating for opening the NCD for power standing and seat elevation systems. AAHomecare and NCART were among the 60 organizations joining a 2020 ITEM-led letter to CMS seeking NCD reconsideration for this technology that concludes: “Power seat elevation and power standing systems have now been available in power wheelchairs for 25 years and are covered by many payers other than the Medicare program.  Now is the time for Medicare—the largest health care payer in the country—to finally cover power seat elevation and standing systems in Group 3 power wheelchairs.”

The comment period will be open through Wednesday, September 14.  We encourage all segments of the HME community, and especially the mobility sector, to submit comments in support of Medicare coverage for power seat elevation technology.  Please refer to AAHomecare’s Seat Elevation/Standing Systems NCD Reconsideration Central for messaging and resources to help develop your comments. Additionally, the ITEM Coalition has developed Rise4Access.org to help the public advocate for coverage – please share these resources with your patients, clinician contacts, and other contacts to help spur a strong response on this issue.  If you have any questions, please contact OAMES executive director Kam Yuricich at kam@oames.org

ACU-Serve Corp. Acquires ECS Billing & Consulting North

Two Veteran Ohio-Based OAMES Members Unite as One!

Announced Wednesday, ACU-Serve Corp. has acquired ECS Billing & Consulting North. ECS was based in Tiffin, Ohio, and founded by Sarah Hanna, a well-known industry veteran who will assume a role as V.P. of Consulting Services at ACU-Serve Corp.

“I am excited about ECS becoming part of the ACU-Serve team. ACU-Serve and ECS share business and client values, keeping client service as our number one priority,” Hanna shared. “This move provides not only our current client base, but all healthcare providers, access to a full suite of services and technology that sets us apart in the healthcare arena and makes ACU-Serve the elite provider of revenue cycle, consulting, and training services.”

The acquisition provides ACU-Serve with over 30 additional U.S.-based employees, advanced consulting services, and strong offshore resources, solidifying ACU-Serve as the largest and most complete HME Revenue Cycle Management Solution Provider in the country.

“Staffing shortages continue to be a crisis across this country and having the opportunity to add more staff to our team in addition to bringing in Sarah Hanna to build out our consulting division is very exciting,” said Jim Knight, CEO of ACU-Serve. “We look forward to continuing to support the HME Industry, various state, regional and national associations even more with our rapidly growing speaker and consultant network.”  For more information on ACU-Serve, please visit acuservecorp.com.

Advocacy Is a Team Sport!  Join the Industry Virtual “Fly-Ins”

We urge all OAMES members to participate in the NCART and AAHomecare’s virtual advocacy events next month.  No excuses to miss these effective online events!  It’s easy, convenient and CRITICAL to advancing the important issues facing CRT and HME providers.  Please sign up now to allow staff of both organizations the time to schedule appointments with Congressional offices and get you the material for pre-meeting events so you’re set for your advocacy conversations.

* September 14 – NCART and NRRTS CRT Congressional Fly-In

Virtual – All day (Sept. 7 – Mandatory Prep Webinar; Sept. 12 – State Delegation Practice)

Details: https://2022-virtual-crt-congressional.constantcontactsites.com/

* September 21 – AAHomecare Washington Legislative Conference

Virtual – 9:00 am – 5:00 pm Eastern (Sept. 14 – Issue Education and Advocacy Training)

Details: https://www.aahomecare.org/events/2/washington-legislati

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