Some Medicaid and Children’s Health Insurance Program flexibilities put in place during the COVID-19 pandemic, including authority to use telemedicine more broadly, have been extended through March, 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.
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.
Invest in Coverage Expansion, Medicaid Improvements, TMA Tells Senators Legislative Hotline, Feb. 26, 2021
TMA Testimonies and Letters
Improve Access to Care by Improving Medicaid Rates(Written Testimony by TMA, Senate Finance Committee, Feb. 26, 2021)
Texas Must Provide Meaningful Coverage to All Texans(Written Testimony by TMA, Senate Finance Committee, Feb. 26, 2021)
Read more TMA Medicaid/CHIP Testimonies and Letters.
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TMA’s free Reimbursement Review and Resolution Service (formerly known as the Hassle Factor Log) goes to bat for members by helping to resolve issues related to insurance payments. TMA can help resolve issues with your payer network status, prompt-pay, and other reimbursement claims.
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Got Medicaid or CHIP questions? Call or email the Knowledge Center.