Feb 28, 2022 | Insurance & Reimbursement
DVHA will be providing an overview on the Vermont Medicaid Medical Record Review (MRR) request letters; the data requested will be used to compare to HEDIS performance measures each year to gauge our members well-being. This training will review the medical record review request, including the type of documentation being requested and the timeframes around the request and will provide information about who should expect to receive these request letters.
If you would like to join this webinar hosted on April 21, 2021, at 11am, please send an email to vtproviderreps@dxc.com, including your name, phone number and email address, by April 12, 2021. If you would like more information on the details of this webinar, please contact your Provider Relations Representative directly.
Feb 28, 2022 | Insurance & Reimbursement
From VPA Insurance Committee:
The short version of the information provided below, is that the extension of the public health emergency (PHE) is expected on the federal level, and I would imagine this would be mirrored on the state level as well. Medicare rules about originating sites have been or are being relaxed post PHE. Vermont Medicaid, BCBSVT, and MVP (at least Vermont’s MVP plans - not sure about the NY ones) already are required to reimburse for telehealth. The biggest change post-PHE is likely to be that the waivers for audio-only telephone and non-HIPAA compliant platforms like Facetime go away. The more detailed list of information and sources follows:
- APA Services telehealth guidance by state: Note that the public health emergency extension information is a bit out of date for Vermont on this one, but gives a helpful overview of state info otherwise. Scroll down for Vermont. See here: https://www.apaservices.org/practice/clinic/covid-19-telehealth-state-summary
- State of Vermont declaration of public health emergency: Set to expire April 15th as of this writing. No clear indication of what further extension the governor may do, but looks like it typically gets extended a month at a time. I suspect would probably continue extending as the federal government is expected to do. Check here for current status information: https://governor.vermont.gov/covid19response
- Federal government or CMS declaration of public health emergency: Was most recently renewed on January 7, 2021, effective January 21, 2021, with a 90- day expiration. Per personal communication with APA Services’ Diane Pedulla, “The PHE is currently in place through April 20th, but the administration has indicated it will renew the PHE at that time, possibly for the rest of the calendar year.” Current emergencies web page: https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergencies-page
- Traditional Medicare (NGS is the carrier in Vermont): Again, per communication with Diane Pedulla, “The Consolidated Appropriations Act of 2021 removes the geographic location and originating site requirements for mental health services furnished via telehealth. These changes become effective once the public health emergency (PHE) ends.”
- Vermont Medicaid telehealth information: Covered even after PHE, but I would expect audio-only telephone or non HIPAA-compliant audio-video platforms to lose their waiver status. See both your Medicaid provider handbook and here: https://dvha.vermont.gov/providers/telehealth
- Vermont insurances - BCBSVT & MVP: VPA’s executive director Lynda Marshall has kindly provided me with the following links to statutes applying to Vermont insurances being required to reimburse for telehealth ( https://legislature.vermont.gov/statutes/section/08/107/04100k ) and provider requirements, e.g., informing the patient ( https://legislature.vermont.gov/statutes/section/18/219/09361)
- Out of state insurances: Please refer to those provider manuals or representatives for information.
Feb 23, 2022 | News
APA recently published a set of decision aids to accompany each of its existing clinical practice guidelines (PTSD in Adults, Obesity and Overweight in Children and Adolescents, and Depression in Children/Adolescents, Adults, and Older Adults). The decision aids are intended to facilitate shared decision-making within evidence-based practice in psychology. It is hoped that the decision aids will serve as a concise and helpful resource for practitioners seeking to integrate APA’s CPGs into their broader evidence-based work.
Feb 23, 2022 | News
As of January 1, 2022, psychologists and other licensed health care providers will be legally required to provide uninsured patients with a “good faith” estimate of costs for services that may be provided. The goal of the act is to prevent patients from receiving bills with any unspecified costs following provision of services. The estimate is to be provided upon scheduling of treatment, or request of an approximation of cost. Currently, APA is developing additional guidance and resources (expected around March 2022) regarding steps psychologists may take in their practice. Click the links below for more information:
https://www.apaservices.org/practice/legal/managed/billing-disclosure-requirements
https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Guidance-Good-Faith-Estimates-FAQ.pdf
