Q. Is CMS suspending most Medicare Fee-For-Service (FFS) medical review during the Public Health Emergency (PHE) period for the COVID-19 pandemic? A. Yes, CMS has suspended most Medicare Fee-For-Service (FFS) medical review during the emergency period due to the COVID-19 pandemic. This includes pre-payment medical reviews conducted by Medicare Administrative Contractors (MACs) under the Targeted […]
March 2020 Scott and White Health Plan is committed to supporting access to care and easing transitions for our members as they receive services from health system providers and facilities during this national emergency. To help support the efforts of caregivers, Scott and White Health Plan is making temporary changes to reduce the administrative burden
Scott & White Suspends Prior Auth Requirements for Home Health Read More »
March 26, 2020 | Austin, Texas | Press Release Governor Greg Abbott today announced that the Texas Health and Human Services Commission (HHSC) has submitted a Section 1135 Medicaid Waiver to the Center for Medicare and Medicaid (CMS). If approved, this would grant Texas flexibility in administering Medicaid while the state continues to respond to COVID-19.
Governor Abbott Announces HHSC Request Of 1135 Medicaid Waiver Read More »
Last update: March 25, 2020, 11:15 p.m. CDT UnitedHealthcare is working to help people access health care to the fullest extent possible as we come together to address this national emergency. We’re adopting measures that will reduce administrative burden for physicians and facilities, helping members more easily access the care they need under their benefit
COVID-19 Prior Authorization and Ongoing Patient Care Updates Read More »
As stated in MLN Matters Number SE20011 (PDF, 132 KB), Medicare Administrative Contractors (MACs) are allowed to extend the auto-cancellation date of Requests for Anticipated Payment (RAPs). Palmetto GBA has extended the auto-cancel timeframe of RAPs by 90 days from the paid date of the RAP, retroactive to March 1, 2020.
Extension of the Auto-Cancellation Date of Requests for Anticipated Payment (RAPs) Read More »
Today, CMS announced it is broadening access to Medicare telehealth services for physicians so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. This expansion benefit is based on a temporary and emergency basis under the 1135 waiver that was issued due to COVID-19.
HOME HEALTH FACE TO FACE – CAN BE TELEHEALTH Read More »
Fee-for-service Medicaid 1915(c) waiver case managers and service coordinators may suspend face to face service coordination visits for the next 30 days. This applies to the following: Community Living Assistance and Support Services Texas Home Living Deaf-Blind with Multiple Disabilities Home and Community-based Services General Revenue service coordinators Community First Choice service coordinators Preadmission Screening
COVID-19: Guidance for FFS Service Coordinators and Case Managers Read More »
This job aid instructs providers on where to enter the 14-digit alpha-numeric unique tracking number (UTN) provided in the PCR notification on the final claim. Electronic Claims For episodes that begin prior to January 1, 2020, the billing remains unchanged. The Treatment Authorization Code will be keyed in positions 1 through 18. The UTN will
Unique Tracking Number (UTN) Location on the Final Claim Read More »
With the transition to the Home Health Patient-Driven Groupings Model (PDGM), CMS will phase-in the inclusion of LUPAs within the Review Choice Demonstration. The below information reflects the implementation timeframe. The dates provided in this article are episode/period start date driven. For episode start dates prior to January 1, 2020, four (4) or fewer visits
Pre-Claim Review (PCR) and Low Utilization Payment Adjustments (LUPAs) Read More »