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How to Avoid Coding Mistakes in Texas Medicaid - 10/15/2021

Ensuring Texas Medicaid dollars are spent for their intended purpose requires the Texas Health and Human Services (HHS) Office of Inspector General (OIG) to work with health care professionals to prevent waste. Accurate medical coding is part of that work. Incorrect codes result in overpayments – which impact taxpayers – and underpayments, which can impact your practice.


20 Everyday HIPAA Tips - 10/13/2021

 The goal of HIPAA is to make sure the protected health information you are responsible for or come into contact with remains confidential, secure, and available when you need it. Here are basic steps every practice can take to help make this happen.  


20 Everyday HIPAA Tips to Help You Stay Compliant - 10/13/2021

The goal of HIPAA is to make sure the protected health information you are responsible for or come into contact with remains confidential, secure, and available when you need it. Here are basic steps every practice can take to help make this happen.


Practice E-Tips on Billing and Collections - 10/12/2021

Practice E-Tips on Billing and Collections


Texas FQHCs Receive Almost $50 Million for Modernization - 10/12/2021

The federal government will distribute nearly $50 million among 66 federally qualified health centers (FQHCs) in Texas as part of a nationwide infusion of funding from the American Rescue Plan Act to modernize those centers and support underserved communities.


How to Reverify Patients’ Medicaid Eligibility When the Public Health Emergency Ends - 10/06/2021

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.


Medicare’s Quality Payment Program Won’t Support Internet Explorer 11 - 09/29/2021

Due to security concerns, Medicare’s Quality Payment Program (QPP) will no longer support the Internet Explorer (IE) 11 browser beginning on Oct. 13, the Centers for Medicare & Medicaid Services (CMS) has announced.


CDC: Lightly Researched THC Compound May Lurk in CBD Products - 09/15/2021

The Centers for Disease Control and Prevention (CDC) is warning physicians, public health departments, and others about insufficiently labeled cannabidiol (CBD) products that may contain a certain compound of THC, or tetrahydrocannabinol, the chemical that creates the psychotropic high for marijuana users.


Texas Safety-Net Programs Tied to 1115 Waiver Get New Life – for One Year - 09/10/2021

A key component of Texas’ safety net for low-income people remains intact – for at least another year – thanks to an agreement between the Texas Health and Human Services Commission (HHSC) and the Centers for Medicare & Medicaid Services (CMS) to extend three federally funded programs that were set to expire.


Update: Enrollment Closes This Week For COVID-19 Antibody Response Survey - 09/10/2021

Texans between the ages of 5 and 80 can sign up to help The University of Texas Health Science Center at Houston (UTHealth) in its ongoing effort to improve science’s understanding of COVID-19 through the Texas Coronavirus Antibody Response Survey (Texas CARES).


SHACs and School Reopening: Webinar Sept. 23 - 09/07/2021

Action For Healthy Kids is hosting a series of webinars on school health advisory councils (SHACs). The councils are volunteer advisory panels physicians can join to help ensure school districts’ health programs reflect local community values.


Medicaid Relaxes Prior Authorization for Hep C Antiviral Drugs - 09/06/2021

For years, Texas Medicaid patients with hepatitis C haven’t had access to overwhelmingly effective, often-curative antiviral therapy unless they had advanced liver disease. In many cases, getting the antiviral drugs at that point was too little, too late.


Billing for Telemedicine During COVID-19 - 09/06/2021

COVID-19 prompted an increased need for telemedicine services to connect physicians with their patients. To quickly meet that need, Texas Medicaid adopted waivers and changed policies to ease technology restrictions and expand the number of Medicaid services available virtually. Reimbursement for telemedicine and telehealth averaged less than $800,000 per month in 2019. By April 2020, Medicaid payment for virtual services jumped to $43 million, and averaged more than $37 million monthly throughout 2020.


Data Driven: Medicaid’s Inspector General Focuses on Fraud Prevention, Not Just Prosecution - 09/06/2021

Since her appointment in 2018, Texas Health and Human Services Inspector General Sylvia Hernandez Kauffman has homed in on using data analytics not only to prosecute fraud, waste, and abuse within the Medicaid program, but also to prevent it from happening in the first place. Texas Medicine spoke to Ms. Kauffman about what appears to be a shift in tone from this department as it also focuses on using the data it collects to educate physicians and other health care professionals on common billing mistakes.


Help Louisiana Medicaid Patients Affected by Hurricane Ida - 09/02/2021

If you’d like to lend medical services to people from Louisiana affected by Hurricane Ida, the Texas Health and Human Services Commission (HHSC) has released information on how Texas physicians can help Louisiana Medicaid recipients.


Practice e-Tips on Claims - 09/01/2021

Appeals Appealing Claims Can Have Appealing Results   Claim Forms Multiple Place-of-Service Codes on a Single 1500 Claim Form   Fees New Laws Require Billing Di


Commentary: This Is Different - 08/31/2021

As physicians we’re used to encountering illness on a daily basis. And 18 months in, COVID-19 illnesses are unfortunately all too familiar.


Practice e-Tips on Reimbursement - 08/28/2021

Billing & Fees Claims Coding & Documentation Collections Copayments & Deductibles Medicaid & Medicare Workers' Comp Billing & Fees Are You Missing Out on Your Money?    Billi


ESRD Calculator - 08/27/2021

ESRD Calculator


Apply by Sept. 1: Start a Vaccine Clinic with TMAF Local Impact Grant - 08/23/2021

As part of the Texas Medical Association’s Vaccines Defend What Matters campaign, the TMA Foundation offers grants of up to $3,500 to fund vaccination activities, educational resources, and community outreach events. The final round of those 2021 Local Impact Grants is now open for applications.


Medicine Strategizes Best Uses for Federal COVID-19 Relief Dollars - 08/23/2021

The Texas Legislature likely will appropriate $15.8 billion from the federal American Rescue Plan Act (ARPA) during a third special session expected to be called in October – funds that physician leaders say could help ease pandemic challenges, such as clinical staff shortages, while also addressing emerging issues, such as research and treatment related to long COVID.


FDA Grants Full Approval to Pfizer COVID-19 Vaccine - 08/23/2021

Pfizer’s COVID-19 vaccine became the first to receive full approval from the Food and Drug Administration (FDA) on Monday following what the agency described as a thorough and rigorous review process.


Situational Data Element - 08/17/2021

Situational data element


Are You Losing Revenue by Undercoding? - 08/17/2021

Becuase of a fear of overcoding, undercoding is prevalent in many practices. This means lost revenue that is rightfully due to the practice. Correct coding can be a significant opportunity for revenue enhancement without additional resource consumption.


TMA Reimbursement Services - 08/13/2021

TMA Payment Advocacy Services