Ohio Board of Pharmacy HME Renewals Begin May 1

HME Advisory Committee Resumes Meetings for Five-Year Rule Review

All Home Medical Equipment Services Provider licenses (HMEL) and registrations (HMER) are set to expire on June 30, 2024, and the State of Ohio Board of Pharmacy has released updated information about the upcoming renewal cycle.  An email notification will be sent to HME service providers on May 1 indicating the license/registration can be renewed.  Renewal applications cannot be submitted before May 1 and are required to be submitted electronically.  Click here for the full notice with details and resources.

OAMES has also learned that the five-member HME Advisory Committee will begin meeting again this year to work on the five-year rule review of OAC 4729:11 Home Medical Equipment Service providers rules.  The first meeting is scheduled for Tuesday, July 23.  OAMES will participate in future meetings, track the progress of the committee’s work, and share rule updates as needed with OAMES members.

HIGLAS Update Provides Clarity on Remittance Advice

Source:  AAHomecare Insider 4/17/24

The industry has long grappled with the challenge of Treasury offsets impacting supplier payments, a concern that has been actively addressed through collaboration with the DME MACs. For years, suppliers received recoupments without clear identification, leaving them in the dark about the source and purpose of these offsets. The issue stemmed from offsets being tied to Tax ID numbers rather than specific NPI, leading to confusion and difficulty in reconciling payments.
 
However, as of this month, CMS has taken significant steps to address this issue by implementing changes to the Healthcare Integrated General Ledger Accounting System (HIGLAS). Starting April 1, the remittance advice will include the PTAN associated with the location responsible for the deduction. These changes involve updating instructions to the Viable Information Processing Systems (ViPS) Medicare System (VMS) regarding the utilization and reporting of Provider Level Adjustment (PLB) codes on the Remittance Advance (RA). The primary goal of these modifications is to establish consistency and uniformity in reporting practices across the board.
 
These changes offer a permanent solution to the challenges faced by suppliers in reconciling Treasury offsets from their Medicare payments by ensuring that offsets are correctly applied to the corresponding NPI and claim. This positive development not only streamlines administrative processes but also provides much-needed clarity and transparency for suppliers.  This welcome change will provide additional documentation for suppliers to help accurately reconcile recoupments to the correct NPI or supplier entity. You can find a DME MAC article on the change here.

New Provider Enrollment Resources Available; Feedback Needed from Suppliers

The DMEPOS industry currently operates with five contractors overseeing provider enrollment matters.

There are two provider enrollment contractors:

• Novitas for the eastern region
• Palmetto GBA for the western region

Two site visit contractors:

• Deloitte for the western region
• Palmetto GBA for the eastern region

Additionally, a new contractor, C-HIT, handles appeals and rebuttals.

These recent changes and additions have introduced challenges for suppliers, including application and revalidation backlogs, as well as concerns with the training of new staff at the contractors. It is imperative for suppliers to keep their Medicare enrollment applications (Form 855S) up to date. The inclusion of C-HIT as the appeals and rebuttals contractor has added complexity to the enrollment process, making it more challenging for suppliers to navigate.

To document and assess the challenges faced by suppliers, the Advisory Council for Enrollment has developed two web-based forms for suppliers to report issues they encounter. Suppliers experiencing difficulties with the provider enrollment contractors are strongly encouraged to utilize these forms for tracking and trending purposes. You can access the forms through the provided links to submit your concerns as needed.

• Form for Site Inspection Issues: SITE INSPECTION TRACKING FORM(Google form)
• Form Appeals and Rebuttals Issues: APPEALS & REBUTTALS TRACKING FORM(Google form)

Industry Webinar “Navigating Critical Medicare Provider Enrollment Updates” Rescheduled for May 23

This industry webinar was previously scheduled and is now set for May 23 at 2-3 pm EDT/1-2 pm CDT. The presentation is open to all industry stakeholders at no charge; however, registration is required. Speakers include provider enrollment advisory council representatives: Ronda Buhrmester, VGM & Associates; Noel Neil, ACU-Serve Corp.; Kelly Grahovac, The van Halem Group and Lisa Wells, Med-South Inc. & Affiliates.  The presentation will cover the recent changes to Medicare provider enrollment requirements that went into effect January 2024, with a focus on protecting your Provider Transaction Access Number (PTAN). Click here to register.

Reminders from Last Week’s OAMES E-bulletin

We had several timely news items in OAMES 4/10/24 e-bulletin that we want to make sure members didn’t miss.  Click here for the full bulletin and check out the following articles and reminders:

• Ohio Department of Medicaid Hosts MyCare Ohio Community Input Sessions for Members and Providers; Non-Institutional Provider session (covers DMEPOS) will be held virtually on June 27, 3:00 - 5:00 pm EDT.  Click here to register. For more information, refer to OAMES ebulletin linked above or visit the ODM MyCare Ohio website.

• CGS Administrators to Host DME Regional Workshops April 23-25 in Cincinnati, Indianapolis and Louisville. Visit their workshops page for more information and to register for the programs.  They've recently added a workshop on May 22 in Tampa, Florida.

• Participate in HomeCare Salary, Staffing and Benefits Survey sponsored by HomeCare trade publication. Click here for the survey. Results will be shared in the May issue of HomeCare.