WPTA Medical Assistance Committee Meeting
November 20, 2006

Minutes

Participants:  Lori Dominiczak, Jason Johns, Ange Baeten, Lynn Steffes,

Agenda:
1.  DHFS Audit Issue: Lynn reported that the HealthReach brief has been filed in circuit court.  New Berlin Therapies has decided to settle their case rather than continue to pursue legal action.

2.  PA Issues:  Lynn reported that providers are still experiencing numerous PA returns with specific code denials and changes being the most frequent complaint.  Other complaints heard from hospitals are long review times (up to 3-4 months in some cases), numerous questions asked by reviewers and a very strict use of the MA Reviewer Checklist when adjudicating.  Lori and Ange will follow up with other hospital providers to see what they are experiencing in addition to Lynn’s information.
      
3.  Legislative Update – Jason reported that much is still up in the air as the climate changes in state government.  He will keep us updated as new committee chairs and members are appointed, especially those related to health and MA issues.  Those appointments are expected by January 3, 2007.  He also confirmed that Mark Moody is no longer the Administrator of Medicaid.  It remains to be seen if the new administrator will move forward with the plan initiated by Mark regarding PA reform issues.

4.  Next All-Association Meeting with the Department:  Next meeting has not been determined but WPTA and WOTA are in agreement that one needs to be held soon to address PA issues and movement on the Moody action plans.

5.  Lori shared that the small group working on revised POC language for the Handbook had finished their work.  The new draft language was approved by all.  Lynn shared that her small group, working on evaluations versus screenings, had not made much progress.  She will forward a document to all committee members for review – this is a document shared with us from WOTA.

6.  Update of FAQs on WPTA Website – Lori will review all recently received questions from providers to see if any new FAQs are needed.  So far, most questions have already been addressed in the current set of FAQs or in the therapy handbook.  Members need to be reminded to use those resources.

Submitted by Lori Dominiczak, PT
Chair, Medical Assistance Committee