The Region B Council was formed to provide each state within CMS Medicare DME Region (Jurisdiction) B an opportunity to liaison directly with the DME Contractor staff. By representing each state, the Council will address key issues from throughout the Region, and consolidate these issues into a format that allows for productive problem solving and include proactive efforts to solve identified areas of concern.
By maintaining an on-going working relationship with the DME Contractor, the industry and the Contractor representatives shall establish a higher level of trust and credibility with each other that will promote more effective communication to better serve Medicare beneficiaries receiving home medical services (or home-based health services).
Representatives on the Region B Council shall solicit input from their respective States/State Associations on issues.
Concerns and specific questions (Medicare Part B) will be collected that are related to reimbursement criteria, medical policy issues, claims processing issues, electronic claims problems and secondary payer function. These questions will be submitted to the DME Contractor on a quarterly basis, and the Contractor will provide the Council with the answers at our regular meetings.
The Council will distribute these answers, as well as any other pertinent information collected, back to the industry members in each respective state.
The Council will also address legislative and regulatory issues with the DME Contactor and invited guests. CMS representatives from the Chicago Region V office will be permanent invitees to Council meetings. It is hoped that CMS’s presence will facilitate their oversight of provider/contractor activities in Region B and provide a forum to communicate CMS’s position on multiple issues.
The Council will be open to Supplier/Provider representation from the all states within Region (Jurisdiction) B. These representatives are to be appointed by their respective state, and may be either Supplier/Providers, or State Association staff. Each state will be allotted two voting representatives at the Council meetings.
To facilitate the communication and activities of the Council, all meetings are open to guests who have an interest in the HME industry. Consideration will be given to each “member” for the selection of an “alternate” in the event that a member cannot attend a scheduled meeting. “Member” is expected to provide council with prior notification of the name of the authorized replacement.
Vendors, Manufacturers, and Representatives from other Trade Associations may be invited by the Council to serve as a representative on Council. These persons will be selected based upon their level of expertise, current involvement in reimbursement, operations, regulatory, or legislative activity specific to the HME industry, and their ability to fulfill their obligation as a Council member.
National Associations representing the HME industry shall be invited to appoint a member from the Association to sit on the Council. National Associations do not have voting rights.
The DME Contractor may be represented by officials from the areas of Provider Relations, Medical Policy, Customer Service, Claims Processing, Fraud and Abuse, Ombudsmen/Education, and other department personnel selected by the Contractor at the time of the scheduled meeting.
CMS shall be invited to have staff from Chicago Region V office attend as members of the Council.
The Region B Council shall meet on a quarterly basis, with each meeting being scheduled at the end of the previous meeting (Upon agreement of dates and times by a majority of those present).
Each state in the Region shall be permitted selection of up to two supplier/provider representatives to serve on the Council. Each respective state and/or association shall determine the terms and conditions of its provider representatives.
The Council shall bi-annually at the first meeting of the new even year elect an Executive Committee consisting of a Chairman; Vice Chairman; Secretary and Treasurer who shall serve successive terms if elected by Council. There is no limit established by Council members or leadership on the lengths of their terms. The Chairman should be elected from the current Executive Committee. There will be a Past Chairman once a new Chairman has been voted in. At this same time, the Council will review the A-Team Leaders positions.
The Council shall engage an Administrative Services agent to handle clerical and accounting functions within the Council. Fees and terms will be negotiated annually by the Chairman and approved by the Council.
* Each state will be assessed an annual fee to cover the operational costs incurred by the Council.
* Allied members, such as Vendors and Manufacturers will be assessed an annual fee for membership. Allied members are allowed to vote on Council business.
* Guest members who wish emailing privileges will be assessed an annual fee to cover
* National Associations representing the industry will be assessed an annual fee for membership.
* DME Contractor and CMS staff will not be assessed a fee for Council involvement.
* Fees may change depending on the financial needs of the Council by majority vote of the official representatives from each state present at the time.
The Council will pay for meeting rooms, if applicable, and lunch costs for the rostered members of Council and invited Contractor staff. All other guests will be expected to pay for the lunches on site at a fee determined to cover costs.
Meetings of the Council will be scheduled on a quarterly basis. Generally, the Council will conduct a business meeting in the morning followed by lunch. The Council will then meet with the DME Contractor and CMS in the afternoon.
Meeting notices will be sent to all state associations and Council members at least 6-8 weeks prior to the meeting date. A form for gathering questions will also be sent at that time.
Questions for the DME Contractor will be forwarded to the Administrative Services Representative by the requested deadline via email. Questions will be sorted by category, and forwarded to the A-Team leaders for discussion and review. Once finalized by the A-Teams, they will be resent to the Council Administrative Services Representative, who will then forward them to the current contact person at the DME Contractor.
The DME Contractor is asked to provide the Administrative Services Representative with answers to the submitted questions prior to the scheduled meeting. The Administrative Services Representative will then forward the Q&A to all Council members for their review.
The Chairman shall preside over the Council at the regular council meeting, and the Council/DME Contractor meeting. In his/her absence, the Vice-Chairman shall preside over said meetings.
The Council shall submit drafts of meeting minutes from the DME Contractor meeting to the designated DME Contractor Representative for timely approval. Upon approval, the minutes will be distributed to all paid members and guests of the Council.
Extraordinary costs, such as educational programs or trade shows sponsored by the Region B Council must be approved by Council vote, and may be levied as an additional expense to the respective membership of the Council.
All travel and related expenses of Council members are the sole responsibility of that member, unless determined differently by each respective state association.
The Region B Council will share all relative correspondence with the other Regional Council leaders if provided with those persons’ names, addresses, and requested mode of communication.
LIMITATION OF POWERS
Notwithstanding any of the above statements of purpose and powers, this coalition shall not, except to an insubstantial degree, engage in any activities or exercise any powers that are not in furtherance of the specific purposes of the association.