Month: September 2022
TX Resources for Family
Physicians who frequently refer patients to no- and low-cost state services like health insurance and child care will find that easier now that the state has launched familyresources.texas.gov, a website that puts links to those services all in one place.
FBI Warns Healthcare Sector of Surge in Payment Scams
Cybercriminals are stealing multimillion-dollar payouts from healthcare payment processors by compromising user login credentials, the FBI warns the healthcare industry.
In recent incidents, cybercriminals used employees’ publicly available personally identifiable information and deployed social engineering techniques to impersonate care providers and gain access to healthcare portals, payment information and websites, the FBI says.
In April, an unnamed healthcare company with more than 175 medical providers discovered that a threat actor had posed as an employee and changed automated clearinghouse instructions of one of the entities’ payment processing vendors to direct payments to the cybercriminal.
“Cybercriminals are incredibly patient and have been known to spend months or longer learning about individuals and organizations in order to gain access, and then once they have access, further biding their time to gain more knowledge that allows them to increase the severity and magnitude of their crime,” he says.
Indicators of Compromise
The FBI advises entities to watch for any of a number of potential indicators that cybercriminals are attempting to gain access to user accounts.
The indicators include:
- Phishing emails targeting the financial departments of healthcare payment processors;
- Suspected social engineering attempts to obtain access to internal files and payment portals;
- Unwarranted changes in email exchange server configuration and custom rules for specific user accounts;
- Requests within a short time frame for employees to reset passwords and multifactor authentication phone numbers;
- Employees reporting they are locked out of payment processor accounts due to failed password recovery attempts.
Who ya’ gonna call?
HAVING ISSUES WITH MEDICARE CALLS?
Who do you call? A source from MGMA shared this information.
They suggest you file a complaint and email CMS leadership. Because complaints go to “low-level” administrative staff whose entire goal is to close them.
Create a complaint letter detailing your experience. Email it to CMS Administrator Chiquita Brooks-LaSure Administrator and CC to the relevant CMS leadership as follows:
CMS Administrator: Chiquita Brooks-LaSure [email protected]
Deputy Chief Operating Officer: Karen Jackson [email protected]
Director Office of Program Operations & Local Engagement: Nancy O’Connor [email protected]
Deputy Administrator and Director Center for Medicare: Meena Seshamani, M.D., PhD [email protected]
Deputy Administrator & Director Center for Medicare & Medicaid Innovation: Elizabeth Fowler [email protected]
Deputy Administrator and Director Center for Consumer Information & Insurance Oversight: Dr. Ellen Montz [email protected]
Deputy Director: Cheri Rice [email protected]
Upcoming Texas Incentives for Physicians and Professional Services (TIPPS)
REPORTING PERIOD
October 10 – November 6, 2022
Below please find information on the upcoming Texas Incentives for Physicians and Professional Services (TIPPS) reporting period (October 10 – November 6, 2022) for state fiscal year (SFY) 2023 (year [Y] 2.
- HHSC will hold a reporting webinar to provide instruction on the reporting process and template. The Y2 Round 1 reporting webinar will be held on October 13, 2022 at 2:00 PM. Please register using the link below.
- HHSC will notify participating providers when the reporting companion (instructions for using and submitting the template) and reporting template are posted to the reporting portal Bulletin Board by October 10, 2022. HHSC will post a link to the recorded Y2 reporting webinar on the bulletin Board by October 14, 2022.
- Participating providers must report data using the data measurement period of January 1, 2022 – June 30, 2022 (i.e., the first six months of calendar year 2022). All of the calendar year 2022 will be reported during Y2 Round 2 in April/May 2023
A few other links of interest:
Contact the HHSC CPP Quality Team: [email protected]
Contact the Provider Finance Department (PFD): [email protected]
Is it Posssible, Well and Sick Same Day?
Having Trouble Closing Those Gaps?
Check out these two articles from the POET InK files.
How to Code a Well Visit with a Sick Visit.
HEDIS News You Can Use
Seasonal Influenza Vaccines Pricing
The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), as reflected in the published compendia.
In hospital outpatient departments, payment is based on reasonable cost.
Annual Part B deductible and coinsurance amounts don’t apply for the influenza virus vaccinations. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must take assignment on the claim for the vaccine.
Annual Influenza Vaccine season starts on August 1 and ends on July 31 of the following year.
Payment Allowances and Effective Dates by Flu Season
Recent Comments