Mtg Agenda _ Notes by forrests


									                                                                                                                                    Meeting Notes
                                                Date & Start Time: 06/18/09 10:00                             End Time: 12:00
                                                Meeting Purpose: Combined PAG-TAG Meeting                     Meeting Location: CR 1 A/B

                  HANDOUT/REFERENCE:                                                                    ATTENDEES:
Agenda, IPR Weekly Snapshot, Interim Payment Recovery         Facilitator -    Patricia Negron                     Notes By -   Cheryl Rood
Snapshot, IPR Summary, Claim Status Report, Non-RA            Meeting Attendees: Patricia Negron, Cheryl Rood, Cecile Eisenhart, Paul McDonnell,
Generated Claims Aging Report, June Policy Status Report      Andy MacLean, Rod Redstone, Nancy Barry, Koriene Low, Eileen Cummings,
                                                              Michelle Hatarick, Mary Lou Dyer, Jason Silberstein, Greg Nadeau, Patty Dushuttle
                                                              Stefanie Nadeau, Bart Beattie, Rhonda Obie, Glen Cyr, Dan Washburn, Kevin Glynn

Item         Statement/Owner                                                       Comments/Notes                                                     Action #
 1     Welcome & Introductions
 2     Policy Updates              Patty Dushuttle reviewed the policy status report. Many policies recently adopted and in the APA process are
                                   due to changes needed prior to MIHMS implementation. Common themes for policies that are being reviewed
                                   are budget oriented, rate setting, and HIPAA compliant codes.
                                         In APA Process = 2
                                         Recently Adopted = 1
                                         In Draft/Planning Stages (post MIHMS implementation) = 6
                                         In Planning Stage Longer Term (post MIHMS Implementation) = 41
                                         Emergency Rules for July 1 = 8

                                   Mary Lou Dyer brought up a concern about a letter that went out to members on Targeted Case Management.
                                   She did not feel there was sufficient notice given. Patty explained that there was a short window of time to get
                                   this out and apologized for the short notice. The group would like a copy of this letter.                           1
 3     Customer Service / IPR      Greg Nadeau provided an update on interim payment recapture. Maine Revenue Services have closed some
       Report                      cases and returned some for OMS to continue the collection process. Under the collection risk category we have
                                   collected some dollars and moved others to bad debt. We do not anticipate seeing much more from the formal
                                   reviews. Still pursuing getting the State’s share of money back even though it is considered a bad debt.
                                         Interim payments made to providers were $533 million.
                                         Total of $518.4 million had been recovered (97%).
 4     Operational Updates         Claims staff is still working to reduce suspended claims. Last weeks claims process had over a million more than
                                   usual. RA’s and checks will be late due to the volume.
                                   The following numbers represent suspended claims as of 06/14/09.
                                    Edits Processing Failures – 3,065
                                    Fund Allocation Failures – 9,915
                                    Other Suspended – 37,565
 5     MIHMS                        Training for provider re-enrollment started this past Monday. More than 2,000 people have registered for the
                                        training. Questions received from these trainings will be posted on the website each week. Testing
                                        continues for the portal. Re-enrollments will not begin on the previously announced date, as there is a slight
                                        delay. We are not ready for pilot providers just yet. Contacts will be made when it is time. There is a
                                        volume of emails received on the MIHMS 2010 email address. An additional staff person has been added to
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                                                                                                                                     Meeting Notes
                                                  Date & Start Time: 06/18/09 10:00                            End Time: 12:00
                                                  Meeting Purpose: Combined PAG-TAG Meeting                    Meeting Location: CR 1 A/B

                                        respond to these emails.
                                       Detail System Design (DSD) document is due the first of July. Staff is finishing up with joint application
                                        design meetings.
                                      Staff is working on a list of work around processes that were developed in order to process certain claims.
                                        This will be helpful when announcing upcoming changes for billing guides.
                                      RHC’s, FQHC’s, and Dialysis Centers will move from billing on CMS1500 to UB04.
                                      The State will be implementing DRG payment methodology for hospitals.
                                      Crossovers will be handled by MIHMS.
                                      Anesthesia billing will be using anesthesia codes instead of surgical codes.
                                      Details for a cutover strategy are still in development. There may be a 4 to 8 month run-out for MeCMS.
 6   Other Discussion                 KUDOS to DHHS Staff. Mary Lou Dyer said that DHHS staff has gone above and beyond responding and
                                        dealing with provider issues.
                                      Waiver adjustment provider tax is anticipated to go out in next week’s payment cycle.
 7   Next Scheduled Meeting          Next scheduled TAG and PAG Meeting will be July 23 beginning at 9:00

  Date     Action           Assignee                                            Action                                            Follow up notes
 Added       #
06/18/09   1            Patricia Negron    Send a copy of the TCM letter that was mailed to members to this group.

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