A pair of big wins capped a successful past week for medicine, as the Texas House of Representatives on Friday afternoon signed off on both curbing the impositions of prior authorization and updating the state’s immunization registry.
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As of May 1, hospitals are now REQUIRED to electronically share their admit, discharge, and/or transfer (ADT) notices with the patient’s established primary care physician (pcp), group, or other practitioner identified by the patient.
As part of the same rule, PHYSICIANS ARE REQUIRED to update their digital contact information in the National Plan and Provider Enumeration System so hospitals have the information they need to electronically send the ADT notices.
UnitedHealthcare (UHC) is waiving cost sharing for Medicare Advantage plan members for primary care services through Dec. 31. This applies to in-network and covered out-of-network COVID-19 and non-COVID-19 visits, whether they are conducted in office or via telemedicine.
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A pair of big wins capped a successful past week for medicine, as the Texas House of Representatives on Friday afternoon signed off on both curbing the impositions of prior authorization and updating the state’s immunization registry.
Haters of preauthorization burdens – and if you’re reading this, chances are you’re among them – will celebrate the House’s passage of House Bill 3459 by Rep. Greg Bonnen, MD (R-Friendswood). The bill attacks the plague of prior authorization requirements in two major ways.
First, for certain services, if a physician earns insurer approval on 80% of preauthorization requests for the service in one calendar year, the doctor will be exempt from preauthorization for that service in the next calendar year. HB 3459 would allow physicians to gain those exemptions on an every-other-year cycle
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If you haven’t read anything this year please read this!
Physicians should be aware of a practice by TRPN DirectPay whereby the out-of-state contracting entity sends checks that may be mistaken as an insurance payment, but instead attempt to have physician practices agree to a binding network participation agreement.
Starting April 5, all practices must comply with so-called information-blocking rules that are part of the federal 21st Century Cures Act, which is designed to facilitate widespread access and sharing of health information among patients and physicians. Follow this link to view the TMA article.
21st Century Cures Act: Interoperability and Information Blocking Webinar: Free for TMA members and their clinical staff, this webinar will help you develop plans to prepare your practice to implement the information-blocking rule. The webinar has been accredited for 1.25 AMA PRA Category 1 Credits™
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