September 30,2020

Marketplace 2021 Open Enrollment runs Sunday, November 1st – Tuesday, December 15th. ClaimAid Patient Advocates are gearing up for the 2021 enrollment season through training and annual certification. We continue to assist patients with special enrollments and will be prepared to assist with re-enrollment and new enrollments for the 2021 season during open enrollment!

IHCP Works Seminar – IHCP has announced that the Annual Provider Seminar has been revamped this year as the IHCP Works Seminar and it will be virtual, October 13-15, 2020.

IHCP Cost Sharing suspension to continue – Fast Track payments, HIP Power Account and other cost sharing such as copays, as well as MEDWorks and CHIP premiums will continue to be suspended throughout the duration of the COVID public emergency.

IHCP claim resubmission and reprocessing BR202037. IHCP announced September 15, 2020, that would be reprocessing claims for PET scans that were denied inappropriately with dates of service from February 7 through August 13, 2020. Additionally,  BR202036 has detailed that claims for inpatient hospital services that paid incorrectly for patients with discharge dates on or after August 1, 2020 will be mass adjusted and the adjusted claims should begin showing up on Remittance Advices beginning October 7, 2020.

IHCP announces revised billing guidance for telemedicine BT2020106. Beginning with claims on or after September 24, 2020, claims for telemedicine must use the POS code that would have been used if care was given in person along with the modifier GT. This will ensure that providers are reimbursed as if the patient was seen in person.

Annual Update for ICD-10 codes is effective October 1, 2020  BT2020104. The annual update of the ICD-10 codes for IHCP programs went into effect October 1, 2020.  IHCP policies have been updated to reflect and diagnosis codes and procedures will be updated accordingly.

Administration Announces Historically Low Medicare Advantage Premiums and New Payment Model. The Centers for Medicare & Medicaid Services (CMS), announced that average 2021 premiums for Medicare Advantage plans are expected to decline 34.2 percent from 2017. More information and the full CMS Press Release can be found in the CMS Newsroom.