Tag: Texas Medical Association (TMA)
Prevent Improper Code Bundling
Physicians can take advantage of a new Medicare tool to sort through service codes that can be bundled together for claims payment – and AVOID improper billing.
The CMS recently released the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) lookup tool to promote accurate code-bundling and prevent improper payment of Medicare Part B and Medicaid claims when incorrect code combinations are reported.
Available via Texas’ Medicare contractor Novitas Solutions, the tool is further designed to help physicians identify when certain pairs of codes are subject to automated edits.
AND FOR EVEN MORE TOOLS
CLICK ON ANY OF THE BUTTONS BELOW
Beware of Phony TMB, DEA Agents
The Texas Medical Board (TMB) continues warning physicians to be on alert for scammers involving criminals who pose as officials from TMB or other state and federal agencies.
“In some instances callers may claim to be employees with the Texas Medical Board, DEA, FBI or other law enforcement entity and may even attempt to spoof agency phone numbers or send documents on official-looking letterhead demanding money,” TMB said in its alert. “Please know the TMB would never call and make such requests for sensitive information over the phone or send demand letters for money to reinstate licenses or threaten the arrest of licensees. The TMB does not suspend licenses at the direction of the DEA, FBI or other federal entity. Additionally, the TMB has no authority to issue, cancel, or influence arrest warrants as some scams have indicated.”
According to the DEA notice, the criminals mask their telephone number on caller ID by displaying the DEA Registration Support 800 number. A real DEA employee would not contact a registrant and demand money, or threaten to suspend someone’s registration over the phone, the DEA says. FBI has issued similar fraud alerts.
If you receive such a call from someone claiming to be either a DEA or TMB official, report it using the DEA’s online extortion scam reporting form here.
Prescription Take Back Day Oct. 29
Help put a dent in the prescription drug misuse in Texas and around the country by reminding your patients to dispose of unused medications safely and anonymously on Oct. 29, National Prescription Drug Take Back Day.
Since the first event in 2010, more than 15 million pounds of prescription drugs have been collected across the country – more than 1 million in Texas – according to DEA. Collection sites may include physicians’ practices, community health centers, hospitals, police stations, schools, and other private businesses
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!
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