COVID-19 Coverage and Billing - Public Health Emergency Set to End
As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.
Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:
If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:
Commercial: 866.895.5828
Medicare Advantage: 800.455.9776
Latest on COVID-19: Testing & Vaccines
IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.
Updated August 9, 2023
For IU Health Medicare Advantage only: IU Health Plans reports notice of MOVEit data security incident involving its vendor, TMG Health.
IU Health Plans announced today that its claims processing vendor, TMG Health, Inc. (TMG), discovered a security incident involving TMG’s use of a third-party service, MOVEit Transfer, which recently reported a security vulnerability.
It is noteworthy that IU Health Plans is among more than 500 companies affected by the MOVEit security incident. In response to this situation, we want to assure all our members that safeguarding data privacy remains our top priority.
This security incident impacted IU Health Plans Medicare Advantage members only. Other IU Health Plans products lines (including IU Health Plans fully insured commercial products and the IU Health Team Member Plan) were not impacted.
On June 22, 2023, IU Health Plans was notified of the security incident by TMG who immediately initiated an investigation confirming downloads had been made by an unauthorized party between May 30, 2023 and June 2, 2023. The downloaded data included IU Health Plans Medicare Advantage member names, member identification numbers, and effective dates of plans, and in limited circumstances, banking account and routing numbers.
IU Health Plans began notifying affected Medicare Advantage members on Aug. 4, 2023. All IU Health Plans Medicare Advantage members impacted are being provided free credit monitoring by TMG. Additionally, TMG deployed the requisite security measures to ensure its systems are updated to block these activities from occurring in the future.
Moving forward
In the dynamic field of digital advancements, the challenge of preventing unauthorized access to data is an ongoing and pressing concern for all healthcare organizations, and IU Health Plans is no exception. IU Health Plans has taken steps to collaborate closely with our vendor, TMG. Together, we are strengthening our systems to prevent unauthorized activities, and continuing to set up strong defenses to stop any potential breaches in the future.
Since June 2, 2023, there has been no observed unauthorized activity, signifying a successful containment of the breach.
If you have any questions, please call toll-free 1-888-727-2311 or visit the TMG website at https://response.idx.us/notice-info. A list of frequently asked questions is also available online at https://response.idx.us/notice-info.
IU Health posted a notice about the incident on its website at: https://iuhealth.org/for-media/press-releases.
August 31, 2023
IU Health Plans reports security incident by third-party vendor’s law firm
IU Health Plans announced today that the law firm of its network vision manager, EyeMed, recently experienced a security incident. The law firm, Orrick, Herrington & Sutcliffe, LLC (Orrick), served as legal counsel to EyeMed during its 2020 security event.
In relation to this representation, Orrick detected that an unauthorized third party gained access to a portion of its network between February 28 and March 13, 2023, including a file used to store certain client files of EyeMed containing IU Health Plan vision benefit plan members’ information. IU Health Plans first learned of this incident on June 29, 2023, and promptly initiated a review at that time.
Orrick immediately took steps to block the unauthorized access and initiated its response process, including launching an investigation of the incident with the support of a third-party forensics firm. Orrick also notified law enforcement. In addition to these actions, Orrick deployed additional security measures and tools with the guidance of third-party experts to strengthen the ongoing security of its network.
IU Health Plans began notifying affected members on August 31, 2023. The information affected by the Orrick security incident may have included: member name, address, date of birth, phone number, email address, vision insurance account/ID number, health insurance account/ID number, health insurance account/ID number, and full or partial Social Security numbers. IU Health Plans wants to ensure that its information is protected, and Orrick will be offering free credit monitoring to those IU Health Plans members impacted.
If you have any questions, please call toll-free at 866-347-7897, Monday through Friday from 9:00 am to 6:30 pm Eastern Time, excluding major U.S. holidays. Callers who are deaf, hard-of-hearing, or speech-disabled may utilize their TeleTYpewriter (TTY) or Telecommunication Device (TDD) to access an operator at 866-347-7897, Monday through Friday, from 9:00 am to 6:30 pm Eastern Time, excluding major U.S. holidays.
COVID-19 Coverage and Billing - Public Health Emergency Set to End
As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.
Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:
If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:
Commercial: 866.895.5828
Medicare Advantage: 800.455.9776
Latest on COVID-19: Testing & Vaccines
IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.
Updated August 9, 2023
For IU Health Medicare Advantage only: IU Health Plans reports notice of MOVEit data security incident involving its vendor, TMG Health.
IU Health Plans announced today that its claims processing vendor, TMG Health, Inc. (TMG), discovered a security incident involving TMG’s use of a third-party service, MOVEit Transfer, which recently reported a security vulnerability.
It is noteworthy that IU Health Plans is among more than 500 companies affected by the MOVEit security incident. In response to this situation, we want to assure all our members that safeguarding data privacy remains our top priority.
This security incident impacted IU Health Plans Medicare Advantage members only. Other IU Health Plans products lines (including IU Health Plans fully insured commercial products and the IU Health Team Member Plan) were not impacted.
On June 22, 2023, IU Health Plans was notified of the security incident by TMG who immediately initiated an investigation confirming downloads had been made by an unauthorized party between May 30, 2023 and June 2, 2023. The downloaded data included IU Health Plans Medicare Advantage member names, member identification numbers, and effective dates of plans, and in limited circumstances, banking account and routing numbers.
IU Health Plans began notifying affected Medicare Advantage members on Aug. 4, 2023. All IU Health Plans Medicare Advantage members impacted are being provided free credit monitoring by TMG. Additionally, TMG deployed the requisite security measures to ensure its systems are updated to block these activities from occurring in the future.
Moving forward
In the dynamic field of digital advancements, the challenge of preventing unauthorized access to data is an ongoing and pressing concern for all healthcare organizations, and IU Health Plans is no exception. IU Health Plans has taken steps to collaborate closely with our vendor, TMG. Together, we are strengthening our systems to prevent unauthorized activities, and continuing to set up strong defenses to stop any potential breaches in the future.
Since June 2, 2023, there has been no observed unauthorized activity, signifying a successful containment of the breach.
If you have any questions, please call toll-free 1-888-727-2311 or visit the TMG website at https://response.idx.us/notice-info. A list of frequently asked questions is also available online at https://response.idx.us/notice-info.
IU Health posted a notice about the incident on its website at: https://iuhealth.org/for-media/press-releases.
August 31, 2023
IU Health Plans reports security incident by third-party vendor’s law firm
IU Health Plans announced today that the law firm of its network vision manager, EyeMed, recently experienced a security incident. The law firm, Orrick, Herrington & Sutcliffe, LLC (Orrick), served as legal counsel to EyeMed during its 2020 security event.
In relation to this representation, Orrick detected that an unauthorized third party gained access to a portion of its network between February 28 and March 13, 2023, including a file used to store certain client files of EyeMed containing IU Health Plan vision benefit plan members’ information. IU Health Plans first learned of this incident on June 29, 2023, and promptly initiated a review at that time.
Orrick immediately took steps to block the unauthorized access and initiated its response process, including launching an investigation of the incident with the support of a third-party forensics firm. Orrick also notified law enforcement. In addition to these actions, Orrick deployed additional security measures and tools with the guidance of third-party experts to strengthen the ongoing security of its network.
IU Health Plans began notifying affected members on August 31, 2023. The information affected by the Orrick security incident may have included: member name, address, date of birth, phone number, email address, vision insurance account/ID number, health insurance account/ID number, health insurance account/ID number, and full or partial Social Security numbers. IU Health Plans wants to ensure that its information is protected, and Orrick will be offering free credit monitoring to those IU Health Plans members impacted.
If you have any questions, please call toll-free at 866-347-7897, Monday through Friday from 9:00 am to 6:30 pm Eastern Time, excluding major U.S. holidays. Callers who are deaf, hard-of-hearing, or speech-disabled may utilize their TeleTYpewriter (TTY) or Telecommunication Device (TDD) to access an operator at 866-347-7897, Monday through Friday, from 9:00 am to 6:30 pm Eastern Time, excluding major U.S. holidays.
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Yes Maybe Later NeverBeginning July 1, 2022, as a part of the Transparency in Coverage regulation, the Tri-Agencies (U.S. Departments of Health and Human Services, Labor, and Treasury) require health plans (including self-funded group health plans and insurers offering coverage in the individual and group markets) to publish negotiated rates for all items and services for Commercial coverage (In-Network files) and historical payments to, and billed charges from, Out-of-Network providers (Out-of-Network files) in the form of machine-readable files made publicly available on an internet website.
This information will be updated monthly. The data in these files is based on the requirements of the Transparency in Coverage (TIC) regulation.
These files are not designed as a consumer tool. Members are encouraged to use the more member-friendly price estimator tools available. Starting in 2023, members will be able to log in to an IU Health Plans Cost Calculator to shop for health services and understand how costs differ from doctor to doctor.
| File Name | Date | Link |
|---|---|---|
| 2023-08-22_encore-health_encore-combined_in-network-rates.json | 15-09-2023 | Download |
| 2023-08-22_encore-health_encore_in-network-rates.json | 15-09-2023 | Download |
| 2023-09-05_772929c3-e82d-4595-b3d1-c8117e6bee5a_Aetna-Signature-Administrators.json.gz | 15-09-2023 | Download |
| 2023-09-05_962524937_index.json.gz | 15-09-2023 | Download |
| 2023-09-05_Aetna-Signature-Administrators-ASA-04-51209_index.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_8PO_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_8RI_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_8RO_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_FVA_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IQD_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IQE_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IQF_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IQG_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_ISO_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IST_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IUP_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_IUQ_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_LBW_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_LFD_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_LFE_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_LFJ_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_NAH_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_O67_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_PKH_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_PKK_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-05_FH_962524937_PKL_FH_UmbrellaClient_962524937.json.gz | 15-09-2023 | Download |
| 2023-09-15_IUHealthPlans_index.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_comm_lg_fi_hmo_allowed_amt.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_comm_lg_iu_empl_allowed_amt.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_iuh_employee_nw_inn.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_iuh_narrow_nw_inn.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_iuh_premier_nw_inn.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_iuh_select_nw_inn.json | 15-09-2023 | Download |
| 2023-09-15_healthedge-iuh_plans_one_care_nw_inn.json | 15-09-2023 | Download |
