Tag: Texas Medical Association (TMA)
Nickel and Dimed by Electronic Credit Card Fees?
Chances are that at least one small health care coverage plan is trying to force your medical practice to receive payments through a virtual credit card – one that charges unnecessary fees.
“This is something that’s affecting all practices to some degree.” “The good news is that physicians don’t need to put up with that, and the Texas Medical Association can help.” See “How to respond” from TMA, below.
Feds Clarify HIPAA Enforcement When PHE Ends
New federal guidance clarifies that relaxed HIPAA enforcement will end at the conclusion of the COVID-19 public health emergency (PHE), while offering instruction on how physicians and others covered by HIPAA can continue to use remote communication technologies to provide audio-only telehealth services.
Back at the start of the pandemic, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) said it would not “impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”
In the new guidance, OCR reiterated that this discretion remains in effect only until the HHS secretary determines the PHE no longer exists or when it expires, whichever occurs first. Congress previously granted a five-month extension for other COVID-related waivers following the conclusion of the PHE..
OCR issued the guidance in direct response to a December 2021 presidential executive order intended to help ensure patients can continue to benefit from audio-only telemedicine and telehealth services with protection of their personal health information.
The new guidance elaborates on types of technologies, business associate agreements with vendors, and ensuring HIPAA compliance when using audio-only technologies.
The Texas Medical Association has numerous resources designed to help physicians adopt and effectively use telemedicine. Visit TMA’s telemedicine page for more information.
Click on the blue highlighted text within the article for more information.
OR
Head to the Business End File and view articles on Telemedicine, and Telemedicine Policy, Procedure, and Form Templates
It Has to End Sometime. Doesn’t It?
What Will the End of the PHE Mean for Coverage?
The PHE has been extended 8 times since January 31st. We all have I fingers crossed that this is the last time. But there is a lot of uneasiness regarding the “WHAT IFs” of when it does.
To get some great insight check out this article from TMA.ED
Cigna Delays Record Request Policy
You may have read the article posted May 23rd. Cigna (Commercial) had implemented a new policy that required medical records be sent when a minor procedure is billed with an office visit.
However, Cigna has delayed the Records Request Policy, Staving Off the “Administrative Nightmare” for now.
Cigna has delayed the implementation of a new billing policy after the Texas Medical Association and others in organized medicine pushed back, warning that it would have negative implications for physicians, practice staff, and patients.
2% Medicare Sequester
Back to the ax!
July 1, 2022, CMS will begin sequestering the full 2% off your Medicare payment.
Hospitals Are Required
Per TMA Article Published 5/25/2022
Hospitals are required to let you know when they’ve seen your patient via an admit, discharge, or transfer (ADT) notice. To ensure that happens, physicians are required to make sure their digital contact information in a federal database is up to date.
As part of the same federal rule, physicians are required to update their digital contact information in the National Plan and Provider Enumeration System (NPPES) so hospitals have the information they need to electronically send the ADT notices.
Your digital contact information should not be a standard email address, rather a direct protocol or similar HIPAA-compliant address. The Texas Health Services Authority direct protocol workgroup has developed practical instructions on how to add your digital address to NPPES
For More Information Check out these links:
Interoperability and Patient Access final rule.
PHE Extended Through 7/15/2022
Will the End of the PHE Impact Physicians Practices and Patient Coverage?
You Bet Your Rain Boots it Will!
Federal Judge Ruled in favor of TMA
Published 2/25/2022, Written by Kelsey Hagg, Associate Director Government Affairs MGMA
“In late 2021, the Texas Medical Association filed a lawsuit against the U.S. Department of Health and Human Services (HHS) alleging that the interim final rule establishing the qualifying payment amount (QPA) as the assumed out-of-network rate went against congressional intent and stating that all criteria (including the QPA) considered by the independent dispute resolution (IDR) entity should be weighted equally.
This morning a federal judge in Texas issued a motion for summary judgement ruling in favor of the Texas Medical Association.
The court determined that HHS violated the Administrative Procedures Act (APA) when issuing rulemaking establishing the QPA as the assumed out-of-network rate in the federal IDR process. This ruling means that if the higher courts don’t overturn or pause implementation pending appeals, we expect the IDR process to begin without the portions of the rule that were vacated.
Specifically, we expect the IDR process to begin without the QPA as the established out-of-network amount. Under this ruling, IDR entities do not have to select the payment amount that is closest to the QPA, nor do IDR entities have to describe the credible information that determined the QPA was materially different from the chosen out-of-network rate.
Additionally, we wanted to share information we received from CMS. In a call with the agency, a CMS spokesperson stated that they intend to open the federal IDR portal on Monday, February 28, 2022. However, this information is subject to change and we will keep you posted on any additional information we receive from the agency. Questions for CMS about the federal IDR process can be directed to: [email protected].
Please let us know if you have any additional questions.
Planning to Test for COVID?
You’ll Need a CLIA Waiver or Certification.
The fast-spreading omicron variant has pumped up demand for COVID-19 testing, and that means physician offices need to make sure they have obtained the correct waiver or certification from the U.S. government to administer those tests.
Employee Vaccinations
TMA Ask the Expert: Employee Vaccinations
“The rule does not apply to independent physician practice settings”
Recent Comments