Some Medicaid and Children’s Health Insurance Program (CHIP) flexibilities put in place during the COVID-19 pandemic have been extended into January, state health officials announced.
Confused by Each Payer’s COVID-19 Policies? TMA is Here to Help
Medicaid Disaster Response Toolkit
Medicaid and CHIP Coverage and Payment Related to COVID-19 (CMS, March 5, 2020)
Medicaid Claims for Telephone (Audio Only) Medical Services (TMHP, March 20, 2020)
Federal Register: Medicare and Medicaid Programs: Policy and Regulatory Revisions (HHS, March 24, 2020)
Go to the TMA COVID-19 Resource Center
As you’re no doubt aware, telemedicine has made it possible for many physicians to continue seeing patients while reducing the risk of spread during the COVID-19 pandemic.
Temporary changes to state and federal rules, particularly regarding payment for services, have helped push up the new demand for and use of telemedicine.
Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.
In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).
Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide. Stay tuned for more detail.
Updated July 27, 2020
The Centers for Medicare & Medicaid Services (CMS) on March 30 approved Texas’ request to waive certain Medicaid regulatory requirements to help physicians and other health care professionals more effectively respond to the COVID-19 pandemic.
Two recent studies suggest expanding Medicaid will not only save Texas money, but add to the Lone Star State’s coffers.With another opportunity for the Texas Legislature to debate Medicaid expansion on the horizon, the Texas Medical Association sees the Episcopal Health Foundation reports as evidence to support efforts to expand meaningful coverage for the state’s poor and vulnerable populations.
Leaders of the Texas Medical Association and four large primary care specialty societies on Wednesday painted for senior Medicaid officials the bleak fiscal picture of many physician practices, and requested immediate financial assistance.
Texas will again receive matching federal funds for women’s health services through a Medicaid 1115 waiver Gov. Greg Abbott announced Wednesday.
Federal lawmakers must pass a bill that would allow states to provide 12 months postpartum coverage to mothers who lose Medicaid coverage two months after giving birth, and would provide a bump in Medicaid matching dollars for those states, medicine and others said in a letter this week.
The combination of the country’s highest uninsured rate and a stressed Medicaid program threaten not only the health of millions of Texans, but also the health of the economy, Texas Medical Association President Doug Curran, MD, says.
Moms and Babies Need Comprehensive Health Care Coverage (Written Comments on Interim Charge 1, House Public Health Committee, Oct. 16, 2020)
Let's Work Together to Strengthen Rural Health (Written Comments on Interim Charge 1, House Committee on Public Health, Oct. 16, 2020)
Renew and Strengthen Texas' Medicaid 1115 Waivers (Written Comments on Interim Charge 2, Article II: Review how Texas is preparing for state and federal budgetary changes that impact the state's health programs, including: the Family First Prevention Services Act; the next phase of the 1115 Healthcare Transformation and Quality Improvement Program Waiver; Texas’ Targeted Opioid Response Grant; the Centers for Medicare and Medicaid Services proposed Medicaid Fiscal Accountability rule, and the Healthy Texas Women Section 1115 Demonstration Waiver. Interim - Sept. 30, 2020)
Support Early Childhood Brain Development with an Enhanced ECI Program(Written comments on the Charge No. 5 request for information: Examine state investments in the health and brain development of babies and toddlers, including Early Childhood Intervention and other early childhood programs for children in the first three years. Evaluate opportunities to boost child outcomes and achieve longer-term savings today on the vital importance of the ECI program for some of Texas’ most at-risk and vulnerable infants and toddlers. A Child’s. Interim - Sept. 30, 2020)
Make Medicaid Managed Care More Efficient (Testimony on House Bill 4178 by Doug Curran, MD, April 9, 2019)
Read more TMA Medicaid testimonies.
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