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Welcome to AHIA’s Compliance Corner!

We will be posting little known facts that you may or may not have known. We will do our best to keep you up to date on changes in our industry and how it effects you as an agent. If you have any specific questions, concerns or wish to report a compliance issue you may send it anonymously below:


We will do our best to address your issue.

Compliance Hotline

210-519-0036


(9-17-2023)
CMS ACA Final Rule 2024 and AHIA-ACA-Consumer-Authorization-Form

Click to download "CMS ACA Final Rule 2024".

Click to download "AHIA ACA Consumer Authorization Form".


(6-20-2023)
CMS ACA AHIA Consent Form

Please click button to view and download.


(3-27-2023)
Blue Cross Blue Shield of Texas ALERT to Users of Blue Access for Produceers

If You Share Your BAPSM Account with Others, Read This

Security upgrade coming soon: When Blue Cross and Blue Shield of Texas launches multifactor authentication (MFA) for Blue Access for ProducersSM (BAP), we will send a one-time passcode via the email listed in your BAP profile, which you then enter to complete the log-in process.

BE AWARE: Some agencies share one BAP login among several colleagues. This will not work after we launch MFA. If multiple people share one BAP account, all of them may not be able to access the email to retrieve the passcode. Even if a group of people share the email account, they may not be able to accurately match the passcode to the person logging in. In these cases, it’s likely the BAP account will get locked due to failed login attempts.

Make changes now. Instead of multiple people sharing one username and password, do one or both of the following:

  1. The producer or agency that owns the username (the 9-digit producer ID number) can add each team member as a delegate. For details, see Managing Delegates in Blue Access for Producers.
  2. If a member of the team is another producer with their own 9-digit producer ID number, that producer can register for BAP.

For more details on BAP MFA, check out our FAQs.

(3-1-2023)
Compliance Request - Scan Health Plan FDR Attestation

Appendix A – Report an Issue to SCAN Health Plan

FDRs, their employees and first tier, downstream and related entities must report compliance concerns and suspected or actual violations related to the Medicare program to SCAN Health Plan.

SCAN Health Plan will maintain confidentiality of all reports to the greatest extent possible. There are several ways to report potential compliance issues and/or Fraud, Waste and Abuse – to SCAN, to Ethicspoint, and independent organization or to the Office of Inspector General (OIG).

To report a compliance issue, you may contact SCAN in one of these ways:

(1-11-2023)
CMS Update

The Centers for Medicare & Medicaid Services (CMS) released the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs serve as key connectors to care for more millions of Americans.

Medicare

As of September 2022, 65,103,807 people are enrolled in Medicare. This is an increase of 160,823 since the last report. 34,984,295 are enrolled in Original Medicare. 30,119,512 are enrolled in Medicare Advantage or other health plans. This includes enrollment in Medicare Advantage plans with and without prescription drug coverage. 50,574,579 are enrolled in Medicare Part D. This includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage. Over 12 million individuals are dually eligible for Medicare and Medicaid, so are counted in the enrollment figures for both programs. Detailed enrollment data can be viewed here: https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment

Medicaid and Children’s Health Insurance Program (CHIP) As of September 2022, 90,933,769 people are enrolled in Medicaid and CHIP. This is an increase of 383,357 since the last report. 83,901,601 are enrolled in Medicaid, 7,032,168 are enrolled in CHIP. For more information on Medicaid/CHIP enrollment, including enrollment trends, visit https://www.medicaid.gov/medicaid/program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot/index.html

Every day, CMS ensures that people across the U.S. have coverage that works. See the latest coverage totals across all CMS programs at https://www.cms.gov/pillar/expand-access. This information is updated on a monthly basis. Enrollment data for CMS programs are compiled on different timelines owing to the unique nature of each program.