Tag: COVID-19

Originally published on Texas Medical Association’s Website.

The following deadlines and extensions are in effect during the COVID-19 pandemic.

Practices that received funds from the Coronavirus Aid, Relief, and Economic Security (CARES) Act before April 24 have until June 3 to accept the terms and conditions and submit revenue information to receive an additional payment. 

Aetna is moving its provider portal to Availity (from NaviNet) effective May 31. After that date, you’ll lose access to Aetna on NaviNet, including electronic transactions. Aetna also: 

1. Has extended coverage for commercial telemedicine service, including audio-only visits, through Aug. 4; and  
2. Will no longer waive cost sharing for any in-network telemedicine visits for commercial plans starting June 4. 

Blue Cross Blue Shield of Texas has extended access to telemedicine/telehealth services with no cost sharing for all medically necessary, covered services and treatments through June 30. That access was set to expire May 31. 

Cigna will extend certain cost-share waivers, including customer cost-sharing for telemedicine screenings for COVID-19, and other benefits through at least July 31.

Several Medicaid and Children’s Health Insurance Program(CHIP) flexibilities, including paying for Texas Health Steps (THSteps) medical checkups via telemedicine and CHIP copay waivers, will be extended through June 30. Payments had been set to expire May 31.

Medicare’s 2020 Quality Payment Program (QPP) registration window is open for the Merit-Based Incentive Payment System (MIPS) web interface reporting method and Consumer Assessment of Healthcare Providers and Systems survey through June 30.  

Medicare’s 2019 QPP final performance feedback, which includes your overall MIPS score (0-100 point scale) and 2021 Medicare payment adjustment (bonus or cut) worth up to 7%, is expected July 1 via the  QPP portal. Physicians who did not submit any 2019 MIPS data or who filed an application for an exception due to COVID-19 should not receive a 2021 payment cut. 

Find each payer’s effective and expiration dates of waivers on this chart on the Texas Medical Association’s COVID-19 Resource Center.

By Tammy Camp, MD President, Texas Pediatric Society

Usually at this time of year, children seen in a clinic setting respond with a resounding “yes” when asked if they are ready for school to be out. For many this year, the answer is different. Instead, several have said “No, I can’t wait to go back to school – I miss being there.”

These very thoughts are echoed by the pediatricians who see children and adolescents in their offices. We cannot wait to have children and their caregivers back in our offices so that we can address and treat their physical and emotional needs.

During a disaster such as this pandemic, behavioral health issues in children are likely to be exacerbated. We see this being played out in front of us now. Social isolation has led to increased depression; anxiety is intensified by the relentless news cycle and social media coverage.

The safety net for many children is the education system, but it is no longer functioning in this way for them. While reports of child abuse may be down due to children’s decreased contact with systems that normally watch over them, those children presenting with abuse to emergency rooms unfortunately have injuries far more serious and life-threatening.

Of great concern is data released from Texas Health and Human Services demonstrating a 10% decrease in doses administered every public health region of the state in March of 2020 compared to March of 2019. These decreases suggest that following the current crisis, our children could be faced with another: exposure to vaccine preventable diseases.

While all of this may seem discouraging, there is hope. Pediatricians are prepared to walk alongside their patients, helping them traverse these unprecedented challenges. We are not only prepared, but we long to assist children and caregivers in navigating these rough waters.

As Governor Abbott and his Strike Force team begin to reopen our state, Texas pediatricians stand ready to have the children and adolescents for whom they provide care back in their offices. The Texas Medical Board has instituted minimum standards to assist them in doing this safely. Those standards include that both the patient and the physician wear masks when within 6 feet of one another. Additionally, before encounters, patients must be screened for potential symptoms of COVID-19. Further, prior to procedures that are higher risk for aerosolization for COVID-19, the healthcare provider must use N-95 masks and face shields.
These standards are included in addition to what most offices had already implemented to protect their patients. Many offices are concentrating all well child care visits and behavioral health visits to designated morning times, while seeing patients who are ill in the afternoons. Most have implemented telemedicine appointments for visits that can safely be handled in this manner. The offices use increased cleaning measures between patients and at the end of the day.

Still, some offices may choose not to fully reopen, or may only provide limited access. Pediatricians will use their professional judgment to decide if and when they can resume full provision of services as they value the staff of nurses, receptionists and others in their team who assist in providing care and must place a priority on their health.

So now we ask you, the caregivers of our children, to partner with us as we prepare for the return of a “new normal.” We want to meet the emotional needs of your children. We want to provide you with tips for juggling your parenting responsibilities with your new educating duties. We want to ensure that preparticipation histories and physicals are completed so that your child is ready to safely enter extracurricular activities when they are allowed to resume. We also want to protect your child from another health crisis by keeping their immunizations up to date.

While many of our children eagerly anticipate the return of school, complete with the extracurricular activities and in-person reunions with their friends, we also look forward to welcoming you into our offices.