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

Medicare: E-Prescribing Penalty Prevention

October-December

Changes to BCBS Medical Policies
2012

January-March

CMS to Release Comparative Billing Report on Advanced Diagnostic Imaging

April-June

Federal Agency: DEA Registration and Reregistration Fees Increased
Private Payer: UnitedHealthcare Medical Policy Updates 06-1-2012
UnitedHealthcare Medical Policy Updates
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
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

Private Payer: BCBSTX Fee Schedule Update
Medicare: Transition to New Medicare Administrative Contractor (MAC)
Medicare: Deadline to select Medicare participation status for 2013
2013

January-March

Private Payer: Aetna Becomes the Medicare Advantage Plan for the Teacher Retirement System of Texas (TRS)
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
CMS Implementing Ordering/Referring Edit [Delayed Indefinitely])
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: 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
Practice Operations: Closed Formulary for Workers' Compensation Legacy Patients
Federal Agency: Compliance With New HIPAA Rules

October-December

Medicare: Begin Meaningful Use for 2013 EHR Incentive Program
E-Prsecribing: E-Prescribing Deadline for 2013 Incentive
2014

January-March

Federal Agency: Physicians Can Begin to Register on CMS Open Payments Website

April-June

July-September

October-December

2011

HIT

Medicare: E-Prescribing Penalty Prevention

Private Payor

Changes to BCBS Medical Policies
2012

Federal Agency

Federal Agency: DEA Registration and Reregistration Fees Increased
HIPAA 5010 Electronic Transaction Standards CMS Announces Version 5010 Enforcement Discretion Period

HIPAA

HIPAA: New Texas Privacy and Security Laws (HB 300) Take Effect Sept. 1, Resulting in Important Changes to Staff Training on PHI.

Medicare

CMS to Release Comparative Billing Report on Advanced Diagnostic Imaging
Medicare: Letters arriving from Novitas Solutions about Medicare EFT Enrollment
Medicare: Documentation tips for recovery auditor, MAC, CERT, and ZPIC
Medicare: Transition to New Medicare Administrative Contractor (MAC)
Medicare: Deadline to select Medicare participation status for 2013

Private Payer

Private Payer: UnitedHealthcare Medical Policy Updates 06-1-2012
UnitedHealthcare Medical Policy Updates
Private Payer: Cigna Care Designation Reconsideration Requests Due
Private Payer: UnitedHealthcare To Serve as Third-Party Administrator for the State's HealthSelect Plan
Private Payer: BCBSTX Fee Schedule Update
2013

Private Payer: New UHC 2013 Physician Administrative Guide

Collections

Collections: E-Prescribing Penalty Prevention Claims Due

E-Prescribing

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

Federal Agency

Federal Agency: Physician Payments Sunshine Act Data Collection Begins
Federal Agency: Compliance With New HIPAA Rules

HIT

HIT: UnitedHealthcare to Launch Provisor
Medicaid: EHR Incentive Attestation - 2012 Payment Year

Medicare

Medicare: Physician Participation Deadline Extended
Medicare: Claims due for 2012 payment year e-prescribing incentive
Medicare: Medicare EHR Attestation Deadline - 2012 Payment Year
Medicare: Medicare Revalidation Resumes
Medicare: Medicare Revalidation Resumes
Medicare: Medicare Revalidation Resumes
Medicare: Revised and Clarified Place of Service Coding Instructions for Medicare
Medicare: CMS Services Furnished to Medicare Beneficiaries Classified as Unlawfully Present in the US Under Review.
Medicare: Sequester Cuts Medicare Fees by 2 Percent
Medicare: Novitas Requires Certain Forms for Paper Documentation
CMS Implementing Ordering/Referring Edit [Delayed Indefinitely])
Medicare: Begin Meaningful Use for 2013 EHR Incentive Program

Practice Operations

Government: TRICARE Sanction Authority for Third-Party Billing Agents
Practice Operations: Quarterly Update to Correct Coding Initiative Edits
Practice Operations: Franchise Tax
Practice Operations: Closed Formulary for Workers' Compensation Legacy Patients

Private Payer

Private Payer: Aetna Becomes the Medicare Advantage Plan for the Teacher Retirement System of Texas (TRS)
Private Payer: New/Revised UnitedHealthcare Medical Policy, Drug Policy, Coverage Determination Guidelines, and Utilization Review Guidelines
Private Payer: Aetna Accreditation Requirement for In-Office Surgical Pathology
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 Payter

Private Payer: Cigna Updating Clinical Reimbursement Policies
2014

Federal Agency

Federal Agency: Physicians Can Begin to Register on CMS Open Payments Website

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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