REGION D DME MAC/PSC DMERC Advisory Committee (DAC)
NAME OF ORGANIZATION
The name of this coalition is the Jurisdiction D MAC / PSC Advisory Committee (DAC), hereinafter referred to as the DAC.
MISSION STATEMENT
The DAC shall be the primary communications vehicle between the home medical equipment (HME) industry and Noridian Administrative Services, the Jurisdiction D Durable Medical Equipment Medicare Administrative Contractor (DME MAC) and IntegriGuard, the Jurisdiction D Medicare Program Safeguard Contractor (PSC).
The DAC will accomplish this by establishing strong relationships with the Jurisdiction D MAC and PSC staff as well as CMS staff; meeting with the Jurisdiction D MAC and PSC on a regular basis; providing the communication tools to facilitate thorough and prompt transfer of information to and from the industry representatives and associations; and coordinating the issues within the industry to adequately reflect the opinions of the majority.
PURPOSE
The specific and primary purpose of the DAC is to operate a professional organization within the meaning of Section 23701e of the California Revenue and Taxation Code.
The DAC does not contemplate pecuniary gain or profit to the members thereof and is organized for nonprofit purposes.
Each state within CMS’s Jurisdiction D will be provided with an opportunity to liaison directly with the Jurisdiction D DME MAC and PSC staff. By representing providers within each state, the DAC will be able to address key issues from throughout the Jurisdiction, and consolidate these issues into a format that allows for productive proactive efforts to solve identified areas of concern.
By maintaining an on-going working relationship with the Jurisdiction D DME MAC and PSC, it is hoped that the industry and the DME MAC and PSC representatives will promote more effective communication to better serve Medicare beneficiaries receiving home medical services, home infusion or assistive technology services.
INTENT
The representatives on the DAC shall solicit input from their respective industry representatives and associations on issues including, but not limited to, the following areas:
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Home Medical Equipment
Specific questions (Medicare Part B) will be collected in these areas as related to reimbursement criteria, medical policy issues, and claims processing issues, electronic claims problems and secondary payor function. These questions will be submitted to the Jurisdiction D DME MAC and PSC on a regular basis, and the Jurisdiction D DME MAC and PSC will provide the DAC with answers at our quarterly meetings or sooner, if needed.
The DAC will distribute these questions and their respective answers, as well as any other pertinent information collected, back to the industry representatives and associations.
The DAC will also address legislative and regulatory issues with the Jurisdiction D DME MAC and PSC. CMS representatives will also be listed as permanent invitees to the DAC meetings. It is hoped that CMS's presence will facilitate their oversight of provider/DME MAC/PSC activities in Jurisdiction D and provide a forum to communicate CMS's position on issues.
REPRESENTATION
The DAC will be open to Supplier representation from all states within Jurisdiction D. The representatives must be approved by their respective state. Each state will be allowed one voting representative at the DAC meetings.
Consideration will be given to each "member" for the selection of an "alternate" in the event that member cannot attend a scheduled meeting. Members are expected to provide the DAC with prior notification of the name of the authorized replacement.
Any Jurisdiction D Supplier representative in good standing with Medicare qualifies as a Jurisdiction D DAC member. To participate as a volunteer on a DAC A -Team, regular participation on the A-Team is required to maintain A-Team membership. State Association membership is highly encouraged for all DAC supplier members. Consultants with expertise in DMEPOS who provide professional services to HME suppliers within Jurisdiction D may participate in the DAC. Supplier State Association members within the Medicare DME Jurisdiction D are considered "supplier representatives" and may participate on DAC A Teams.
To become eligible for election to A-Team Leader or Assistant A-Team Leader, a DAC member must be a Jurisdiction D supplier, a State Association member, or an industry consultant with expertise in DMEPOS who provides professional services to HME suppliers within Jurisdiction D.
Vendors and/or manufacturers may be invited to serve in an advisory position to the DAC. 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. Vendor and/or manufacturer representatives must be a Jurisdiction D DAC manufacturer/supporter in good standing, and may participate in the DAC as A-Team members. Vendor and/or manufacturer representatives may not serve as A -Team Leaders, Assistant A-Team Leaders, or on the Jurisdiction D DAC Executive Committee.
National or Regional trade associations representing the HME industry shall be invited to serve as "associate members" of the DAC. Associate members will not have voting rights in the DAC. Associate members may participate on DAC A-Teams but are not eligible to serve as DAC A-Team Leaders, Assistant A-Team Leaders, or on the Executive Committee.
The DME MAC/PSC may be represented by officials from the areas of Provider Relations, Medical Policy, Customer Service, Claims Processing, Fraud and Abuse, Ombudsmen, and other department personnel selected by the DME MAC / PSC at the time of the scheduled
To be eligible for nomination to the DAC Executive Committee, a DAC supplier member must have served as a DAC D State Representative for a minimum of one year, a DAC D A-Team Leader for a minimum of one year, or a DAC D Assistant A- Team Leader for a minimum of two years. In addition, the DAC D member must also be a current member of a state or regional state association in good financial standing within the Jurisdiction D DAC to be eligible for consideration for nomination for the DAC D Executive Committee. Associate members, and manufacturer/vendor representatives are not eligible for nomination to the DAC Executive Committee.
Should a DAC D Executive Committee member have a change in supplier member eligibility status during their service on the committee (i.e., loss of employment, leave of absence, relocation, etc.), and the Executive Committee member intends to continue as an industry supplier in Jurisdiction D, the Executive Committee member will have six months grace period to re-establish DAC D supplier member eligibility. If the Executive Committee member does not intend to continue as an industry supplier in Jurisdiction D or after six months the Executive Committee member is unable to re-qualify to serve as a supplier member on the Executive Committee, that Executive Committee member will be replaced on the committee by special election within 60 days of position vacancy or at the annual election whichever is sooner.
The DAC shall engage an Administrative Services group to handle clerical and accounting functions within the DAC. Fees and terms will be negotiated annually by the Chairman and approved by the Executive Committee.
Each state or state champion will be assessed an annual fee of $ 1,000.00 to cover the operational costs incurred by the DAC.
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Associate members, such as national or regional trade associations will be assessed an annual fee of $ 700.00.
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.