Month: April 2020

From MGMA April 30, 2020 – Changes to telehealth policy:

• Following MGMA advocacy, CMS is increasing payment for audio-only telephone E/M services (CPT codes 99441-99443) such that they are paid at the same rate as similar office and outpatient E/M visits, resulting in increased payments from $14-$41 to $46-$110. CMS believes that the resources required to furnish these services during the PHE are better captured by RVUs associated with level 2-4 established office/outpatient E/M visits. CMS is not increasing payment for CPT codes 98966-98968, which are intended for practitioners that cannot separately bill for E/M. This policy is retroactive to March 1, 2020.
• For telehealth services other than CPT codes 99441-99443 and 98966-98968 (now added to the list of covered telehealth services), Medicare continues to require modalities that have both audio and video capabilities.
• CMS is forgoing its typical rulemaking process to add new services to the list of Medicare services that may be furnished via telehealth. Instead, CMS will add new telehealth services on a sub-regulatory basis to speed up the process of adding codes to the list.

HHS is delivering a second tranche of $20 billion from the Provider Relief Fund to healthcare providers impacted by COVID-19.  See the summary from MGMA.

Providers are able to receive customized news updates from Superior relevant to their specialty, region or Superior products. Follow the link to find out how.

To help you manage the claim submission and reimbursement process with UnitedHealthcare, as well as access the CARES ACT funding available to health care professionals, here’s a summary of resources to address your most common questions and concerns. Use this link to view the list.

See information provided by CMS IP Technologies regarding  –

 The COVID-19 Telehealth Program

The Program will provide immediate support to eligible health care providers responding to the COVID-19 pandemic by fully funding their telecommunications services, information services, and devices necessary to provide critical connected care services until the program’s funds have been expended or the COVID-19 pandemic has ended.​

TMA has a great chart to help answer your telehealth questions. Here is the link…https://www.texmed.org/uploadedFiles/Current/2016_Practice_Help/Health_Information_Technology/Telemedicine/Telemedicine%20Quick%20Reference%20Chart%20for%20Payers.pdf

Texas Medical Board Press Release

FOR IMMEDIATE RELEASE

April 21, 2020

Media contact: Jarrett Schneider, 512-305-7018

Customer service: 512-305-7030 or 800-248-4062

TMB Adopts Emergency Rule to Enforce Gov. Abbott’s Executive Order GA-15

Following Governor Greg Abbott’s issuance of Executive Order GA-15, the Texas Medical Board’s Executive Committee today adopted rules on an emergency basis to enforce the Governor’s Executive Order which continues the postponement of certain surgeries and procedures as outlined in the order.

The adopted rule amends 22 TAC Chapter 190.8 Violation Guidelines, and adds to the definition of “Unprofessional and Dishonorable Conduct” under 22 TAC §190.8(2)(U). The adopted emergency rule goes into effect later today at 11:59 p.m. when GA-15 goes into effect.

The rule adds to the definition to include the following:

(U) a violation of Texas Executive Order GA-15, issued April 17, 2020, which states: “All licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician; provided, however, that this prohibition shall not apply to either of the following:

(i) any procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete the hospital capacity or the personal protective equipment needed to cope with the COVID-19 disaster; or

(ii) any surgery or procedure performed in a licensed health care facility that has certified in writing to the Texas Health and Human Services Commission both:

(1) that it will reserve at least 25% of its hospital capacity for treatment of COVID-19 patients, accounting for the range of clinical severity of COVID-l9 patients; and

(2) that it will not request any personal protective equipment from any public source, whether federal, state, or local, for the duration of the COVID-19 disaster.”

The Executive Committee also withdrew emergency rules related to Executive Order GA-09 effective today at 11:59 p.m.

The Board has published updated FAQs on the TMB website at www.tmb.state.tx.us/page/coronavirus.

For the latest COVID-19 information for health providers and the public, visit the Department of State Health Services (DSHS) COVID-19 web page at dshs.texas.gov/coronavirus/.

APRIL 22,2020 UPDATE FROM TMA : Please see link for further clarification provided by TMA. https://www.texmed.org/uploadedFiles/Current/2016_Public_Health/Infectious_Diseases/Emergency%20rule%20guidance%20-%203.25%20Update.pdf

TMA offers help with Payer’s COVID-19 Policies.  This is open to all Texas physicians now. To View

From MGMA – April 16, 2020

Regulatory alert: HHS CARES Act grant funding Attestation Portal now open
The Attestation Portal for the initial $30 billion general distribution from the Department of Health & Human Services (HHS) is now open. Providers that received a payment from HHS as part of the Provider Relief Fund authorized under the CARES Act must sign an attestation confirming receipt of the funds and agreeing to the terms and conditions within 30 days of receiving payment.
To complete the attestation, billing entities must provide their Taxpayer Identification Number. Should you choose to reject the funds, you must also complete the attestation to indicate this. The Portal will guide you through the attestation process to accept or reject the funds.
Group practices with questions about the grant funds can call the Provider Relief hotline at (866) 569-3522. Please note that the terms and conditions are subject to further clarification by HHS, and MGMA will pass along any additional guidance if it is made available.