Any physician in business for more than a few months knows how difficult it is to work on the business. Between keeping pace with caring for patients, insurance company demands, government regulations, and the latest medical technology, there are never enough hours in a day. That's why TMA developed Deadlines for Doctors, a web-based regulatory compliance tool giving you and your staff a big-picture view of upcoming state and federal compliance timelines and key health policy issues that impact Texas physicians.

Click on the compliance date to review background information, regulations, penalties and incentives, and suggested steps to help you meet the compliance date. Questions? Contact the TMA Knowledge Center at (800) 880-7955 or email knowledge@texmed.org.



2011

January-March

April-June

July-September

RAC Audits for Anesthesiologist Overpayments
Federal Agency: Deadline to Opt Out of Medicare
Medicare: E-Prescribing Penalty Prevention
Federal Agency: IRS - Estimated Tax Payment Due

October-December

Medicare: SGR Formula, Debt Commission Standing Committee Recommendations Due
Private Payor: United Healthcare Spinal Ultrasonography Medical Policy
E-Prescribing Hardship Exemption. File now to avoid a 1% Medicare penalty in 2012.
Medicare: SGR Formula, Deadline for Debt Commission Joint Committee Vote
Federal Agency: Deadline to Opt Out of Medicare
Medicare: SGR Formula, Standing Committee Reports Due on Joint Committee Recommendations
Medicare SGR Formula, Debt Commission Deadline for House and Senate Votes; Procedural Protections End
2011 E-Prescribing Incentives. End-of-year reporting deadline to claim a 1-percent bonus.
2011 Physician Quality Reporting System (PQRS) incentive year ends. Report data by March 31, 2012 to claim a 1% Medicare bonus.
Changes to BCBS Medical Policies
Reporting year ends for Medicare EHR incentive program. Register by Feb. 29, 2012 to claim your incentive payment.
2012

January-March

(Delayed) SGR Formula 29.5-Percent Medicare Physician Payment Cut Takes Effect
Federal Agency: HIPAA 5010 Electronic Transaction Standards. Upgrade or You Won't Get Paid!
Federal Agency: Physician Payment Sunshine Act implications for manufacturers and providers
Private Payor: Blue Cross Blue Shield of Texas Announces It Will Accept Billing With National Drug Codes
Medicare: Medicare won’t pay hospice claims when required face-to-face encounters do not occur timely.
IRS - Estimated Tax Payment Due
CMS to Release Comparative Billing Report on Advanced Diagnostic Imaging
BCBSTX Policy on Payment for Claims Using National Drug Codes (NDCs) 2012-03-01
Federal Agency: Deadline to Opt Out of Medicare
Federal Agency: HIPAA 5010 Electronic Transaction Standards CMS Announces Version 5010 Enforcement Discretion Period [Delayed to 6/30/2012]

April-June

IRS - Estimated Tax Payment Due
Federal Agency: DEA Registration and Reregistration Fees Increased
State Agency: Texas Franchise Tax, Reports & Payments
Federal Agency: Deadline to Opt Out of Medicare
Private Payer: UnitedHealthcare Medical Policy Updates 06-1-2012
UnitedHealthcare Medical Policy Updates
Federal Agency: IRS - Estimated Tax Payment Due
E-Prescribing Hardship Exemption. File now to avoid a 1.5% Medicare penalty in 2013.
E-Prescribing Penalties. File 10 e-prescribing claims to avoid a 1.5% Medicare penalty in 2013.
HIPAA 5010 Electronic Transaction Standards CMS Announces Version 5010 Enforcement Discretion Period

July-September

Medicare: Letters arriving from Novitas Solutions about Medicare EFT Enrollment
Private Payer: Cigna Care Designation Reconsideration Requests Due
Medicare: Documentation tips for recovery auditor, MAC, CERT, and ZPIC
Federal Agency: Deadline to Opt Out of Medicare
HIPAA: New Texas Privacy and Security Laws (HB 300) Take Effect Sept. 1, Resulting in Important Changes to Staff Training on PHI.
Private Payer: UnitedHealthcare To Serve as Third-Party Administrator for the State's HealthSelect Plan

October-December

Medicare EHR incentive program. Last chance to achieve 90 days of meaningful use for first-year particpants.
Private Payer: BCBSTX Fee Schedule Update
State Agency: Texas Franchise Tax, Reports & Payments - Extension Due Date
Medicare: Transition to New Medicare Administrative Contractor (MAC)
2012 E-Prescribing Incentives. End-of-year reporting deadline to claim a 1-percent bonus.
Federal Agency: HIPAA Privacy and Security Audits
Medicare: Deadline to select Medicare participation status for 2013
Reporting year ends for Medicaid EHR incentive program. Register by Feb. 29, 2013 to claim your incentive payment.
Reporting year ends for Medicare EHR incentive program. Register by Feb. 29, 2013 to claim your incentive payment.
2013

January-March

Private Payer: Aetna Becomes the Medicare Advantage Plan for the Teacher Retirement System of Texas (TRS)
Political Voice: 83rd Texas Legislature Convenes
Federal Agency: IRS - Estimated Tax Payment Due
E-Prescribing: Hardship Exemption Deadline
Medicare: Physician Participation Deadline Extended
Medicare: Claims due for 2012 payment year e-prescribing incentive
Medicare: Medicare EHR Attestation Deadline - 2012 Payment Year
HIT: UnitedHealthcare to Launch Provisor
Medicare: Medicare Revalidation Resumes
Medicare: Medicare Revalidation Resumes
Medicaid: EHR Incentive Attestation - 2012 Payment Year
Government: TRICARE Sanction Authority for Third-Party Billing Agents
Medicare: Medicare Revalidation Resumes

April-June

Medicare: CMS Services Furnished to Medicare Beneficiaries Classified as Unlawfully Present in the US Under Review.
Medicare: Revised and Clarified Place of Service Coding Instructions for Medicare
Medicare: Sequester Cuts Medicare Fees by 2 Percent
Practice Operations: Quarterly Update to Correct Coding Initiative Edits
Private Payer: Aetna Accreditation Requirement for In-Office Surgical Pathology
Private Payer: New UHC 2013 Physician Administrative Guide
Private Payer: New/Revised UnitedHealthcare Medical Policy, Drug Policy, Coverage Determination Guidelines, and Utilization Review Guidelines
Medicare: Novitas Requires Certain Forms for Paper Documentation
Private Payer: BCBS of Texas Enhancing ClaimsXten Code Auditing Tool
Practice Operations: Franchise Tax
Private Payer: Cigna Updating Clinical Reimbursement Policies
Private Payer: Aetna Clinical Payment, Coding, and Policy Changes
Private Payer: Changes to Aetna Pharmacy Precert, Quantity Limits, and Step-Therapy Programs
E-Prescribing Hardship Exemption. File now to avoid a 2% Medicare penalty in 2014.
E-Prescribing Penalties. File 10 e-prescribing claims to avoid a 2% Medicare penalty in 2014.
E-Prescribing: eRx Incentive Program Deadline to Prevent 2014 Penalty of 2 Percent

July-September

Private Payer: Changes to the Aetna National Precertification List
Private Payer: Cigna Implementing Single Appeal Reviews
Collections: E-Prescribing Penalty Prevention Claims Due
Federal Agency: Physician Payments Sunshine Act Data Collection Begins
Lorcaserin Designated as a Schedule IV Controlled Substance
Private Payer: Cigna Billing Requirements for Qualitative Drug Screens
Private Payer: Cigna Updating Modifier 59 Documentation Requirement List
Blue Cross and Blue Shield of Texas Changing to Daily Electronic Funds Transfers to Providers
Physician Education Loan Repayment Program
Practice Operations: Closed Formulary for Workers' Compensation Legacy Patients
Compliance With New HIPAA Ominbus Rules

October-December

Begin Medicare Meaningful Use for 2013 EHR Incentive Program
Federal Agency: [Delayed] ICD-10 Compliance. Make the transition or your claims won't be paid.
Give Employees Insurance Exchange Notice by Oct. 1
Medicare Enrollment Delays If Overpayment Exists
Deadline to Avoid 2015 Penalty for Individual EPs and GPRO Participants
2013 AIM Clinical Guideline Changes
Updated Humana Provider Manual
Blue Cross and Blue Shield of Texas Updating Fee Schedule
Humana Updating Policies and Code Edits
New OSHA Deadline: Training About Hazardous Materials
2013 E-Prescribing Incentives. End-of-year reporting deadline to claim a 0.5-percent bonus.
EHR Incentive Program Reporting Period Ends for 2013 Payment Year
E-Prescribing Deadline for 2013 Incentive
2014

January-March

Federal Agency: Physicians Can Begin to Register on CMS Open Payments website (Physician Payment Sunshine Act)
HIT: EHR Incentive Program: First Day of the 2014 Reporting Period
Medicare: Redaction of Health Insurance Claim Numbers in Medicare Redetermination Notices
CMS Implementing Ordering/Referring Edit
Medicare: New Waived Tests
eRx Penalty Review Available Until Feb. 28, 2014
PQRS: Submission Deadline for 2013 PQRS Reporting via EHR, Claims, and to Request Informal Review
Submission Deadline for 2013 PQRS Reporting via Covisint PQRS Registry
Quality/Patient Safety: Submission Deadline for 2013 PQRS Reporting Via PQRS Wizard Registry
Medicaid: EHR Incentive Program Attestation Deadline for 2013 Participation
HIT: Medicare EHR Incentive Program Attestation Deadline for 2013 Payment Year Participation

April-June

New Requirement for Performing Medical Exams on Commercial Vehicle Drivers
CMS: Optional Physician and Teaching Hospital CMS Registration Begins

July-September

CMS: Optional Physician and Teaching Hospital CMS Registration - Phase 2
HIT: First-Year Participants: Last Day to Begin the 90-day Reporting Period for the 2014 Medicare EHR Incentive Program
Quality/Patient Safety: PQRS: Submission Deadline for 2013 Claims-Based Reporting
PQRS: Deadline to Register to Participate in GPRO for 2014

October-December

HIT: First-Year Participants: Deadline to Attest to Meaningful Use for the 2014 Medicare EHR Incentive Program
HIT: Upgrade EHR for Meaningful Use Stage 2
2015

January-March

HIT: Medicare EHR Incentive Program Attestation Deadline for 2014 Payment Year Participation

April-June

July-September

October-December

Collections: ICD-10 Implementation Compliance
2013

Collections

Collections: E-Prescribing Penalty Prevention Claims Due

E-Prescribing

E-Prescribing: eRx Incentive Program Deadline to Prevent 2014 Penalty of 2 Percent
E-Prescribing Deadline for 2013 Incentive

Federal Agency

Federal Agency: Physician Payments Sunshine Act Data Collection Begins
New OSHA Deadline: Training About Hazardous Materials

HIT

EHR Incentive Program Reporting Period Ends for 2013 Payment Year

Human Resources

Give Employees Insurance Exchange Notice by Oct. 1

Medicare

Medicare: Medicare Revalidation Resumes
Medicare: Novitas Requires Certain Forms for Paper Documentation
Medicare Enrollment Delays If Overpayment Exists
Begin Medicare Meaningful Use for 2013 EHR Incentive Program

Practice Help

Physician Education Loan Repayment Program

Practice Operations

Practice Operations: Quarterly Update to Correct Coding Initiative Edits
Practice Operations: Franchise Tax

Private Payer

Private Payer: BCBS of Texas Enhancing ClaimsXten Code Auditing Tool
Private Payer: Aetna Clinical Payment, Coding, and Policy Changes
Private Payer: Changes to Aetna Pharmacy Precert, Quantity Limits, and Step-Therapy Programs
Private Payer: Changes to the Aetna National Precertification List
Private Payer: Cigna Implementing Single Appeal Reviews
Private Payer: Cigna Billing Requirements for Qualitative Drug Screens
Private Payer: Cigna Updating Modifier 59 Documentation Requirement List
Blue Cross and Blue Shield of Texas Changing to Daily Electronic Funds Transfers to Providers
Updated Humana Provider Manual
2013 AIM Clinical Guideline Changes
Blue Cross and Blue Shield of Texas Updating Fee Schedule
Humana Updating Policies and Code Edits

Private Payter

Private Payer: Cigna Updating Clinical Reimbursement Policies

Quality/Patient Safety

Deadline to Avoid 2015 Penalty for Individual EPs and GPRO Participants

State Agency

Lorcaserin Designated as a Schedule IV Controlled Substance
2014

CMS

CMS: Optional Physician and Teaching Hospital CMS Registration Begins
CMS: Optional Physician and Teaching Hospital CMS Registration - Phase 2

E-Prescribing

eRx Penalty Review Available Until Feb. 28, 2014

Federal Agency

New Requirement for Performing Medical Exams on Commercial Vehicle Drivers

Federal Agency

Federal Agency: Physicians Can Begin to Register on CMS Open Payments website (Physician Payment Sunshine Act)

HIT

HIT: EHR Incentive Program: First Day of the 2014 Reporting Period
HIT: Medicare EHR Incentive Program Attestation Deadline for 2013 Payment Year Participation
HIT: First-Year Participants: Last Day to Begin the 90-day Reporting Period for the 2014 Medicare EHR Incentive Program
HIT: First-Year Participants: Deadline to Attest to Meaningful Use for the 2014 Medicare EHR Incentive Program
HIT: Upgrade EHR for Meaningful Use Stage 2

Medicaid

Medicaid: EHR Incentive Program Attestation Deadline for 2013 Participation

Medicare

Medicare: Redaction of Health Insurance Claim Numbers in Medicare Redetermination Notices
Medicare: New Waived Tests
CMS Implementing Ordering/Referring Edit

PQRS

PQRS: Deadline to Register to Participate in GPRO for 2014

Quality/Patient Safety

PQRS: Submission Deadline for 2013 PQRS Reporting via EHR, Claims, and to Request Informal Review
Submission Deadline for 2013 PQRS Reporting via Covisint PQRS Registry
Quality/Patient Safety: Submission Deadline for 2013 PQRS Reporting Via PQRS Wizard Registry
Quality/Patient Safety: PQRS: Submission Deadline for 2013 Claims-Based Reporting
2015

Collections

Collections: ICD-10 Implementation Compliance

HIT

HIT: Medicare EHR Incentive Program Attestation Deadline for 2014 Payment Year Participation

The Texas Medical Association designed this tool to provide general information about state and federal health care compliance dates and key health policy issues. This information is not intended to provide advice on any specific legal matter and is not a substitute for the advice of an attorney. When dealing with personal legal or financial matters, please seek advice from retained legal counsel or other certified/licensed industry professional.

While every effort is made to ensure that content is complete, accurate, and timely, TMA cannot guarantee the accuracy and totality of the information contained in this website. Further, TMA assumes no responsibility for accuracy, errors, or omissions and assumes no legal liability or responsibility for loss or damages resulting from the use of this content.

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