Tag: Texas Medical Association (TMA)
The PHE Has Been Extended
The Public Health Emergency (PHE) has been extended for the eight time.
The federal Department of Health and Human Services (HHS) has extended the COVID-19 public health emergency (PHE) for another 90 days, which means many payer flexibilities are likely to continue as well. HHS Secretary Xavier Becerra issued the extension on Jan. 14, two days before the PHE was set to expire. The new extension runs through April 16. It is the eighth extension of the PHE since HHS originally declared the emergency in late January 2020. |
Have You Paid Your Fee for PMP?
If you haven’t paid your fees to keep your electronic health record (EHR) integrated with Texas’ prescription monitoring program (PMP), the state’s PMP vendor may have deactivated your connection, in which case you’ll need to pay to reactivate it.
You have to revalidate your enrollment to stay in Medicaid.
If you are a physician participating in the Texas Medicaid program and saw your required revalidation period for the program extended due to the COVID-19 pandemic, take note:
The End Of That Extension Is Coming on February 28th, 2022.
Texas Prepares to Inplement “GOLD CARD”
HAD YOUR FILL OF BURDENSOME PRIOR AUTHORIZATIONS?
For the Nitty Gritty of how House Bill 3459 is supposed to make your life easier follow this link to the TMA article by Joey Berlin.
When the PHE Expires, What then?
How to Reverify Patients’ Medicaid Eligibility
When the Public Health Emergency Ends
With the federal public health emergency (PHE) slated to expire at the end of 2021, millions of Medicaid patients across the U.S. are at risk of losing their coverage. Texas physicians should prepare by scheduling services as soon as possible for such patients and evaluating the financial impact of potential increases in uncompensated care. They also should expect to reverify patients’ Medicaid eligibility when the PHE expires.
Physicians can reverify patients’ eligibility electronically through the Texas Medicaid & Healthcare Partnership (TMHP) Electronic Data Interchange, TexMedConnect, or the Medicaid Client Portal. They can also call the TMHP Automated Inquiry System at (800) 925-9126.
Biden Vaccine Mandate Plan
Earlier this month, President Joe Biden introduced a six-point plan that mandates COVID-19 vaccines for millions of Americans.
Many details of the plan are still being developed as specific regulations are written, but at least one aspect of the plan is clear: The vaccination mandate for “over 17 million health care workers at Medicare and Medicaid-participating hospitals and other health care settings,” largely does not apply to small physician practices, according to Texas Medical Association analysis
HAVING UHC CLAIMS ISSUES?
If You Are Having UHC OON
Claims Issues,
Please Read This!
POET is working with the TMA regarding UHC OON issues. They have confirmed the following:
If you are billing with a GROUP TIN:
You will not utilize the group NPI# in box 33a – if you do, it will process OON. Only the individual physician’s NPI# should be listed here since your physicians has an individual contract with UHC, not a group contract.
For those claims processing OON, if timely filing limits have not passed you should file corrected claims with the individual NPI in box 33a.
When verifying whether a physician is in or out of network, you should not provide the group NPI#.
This only reflects physicians who are in the POET All Products contract. If you have a direct, POET is unable to direct you in this matter.
Vaccine Documentation Can’t be Required for Medical Treatment
The Texas Health and Human Services Commission (HHSC) is notifying practitioners who see Medicaid patients that those patients can’t be required to provide documentation of their COVID-19 vaccination status as a condition of receiving services under Texas Medicaid.
The agency’s Sept. 17 announcement references Gov. Greg Abbott’s Aug. 25 executive order, which bars “[a]ny public or private entity that is receiving or will receive public funds through any means” from requiring COVID-19 vaccination documentation to receive services.
TMA “Ask the Expert” Virtual Series
Today’s “Ask the Expert” subject “How to Delegate to Non-physician Practioners” will be available On-Demand in a couple weeks. The link to access the recording will be www.texmed.org/asktheexpert.
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