On the Agenda, the official publication of the New York State Chiropractic Association (NYSCA), is published quarterly. It is designed to provide information about the Chiropractic profession and NYSCA activities and initiatives.
As many of you have been aware, the NYSCA has been in communication with both Highmark and the NYS Department of Financial Services regarding of our member's concerns, including Highmark's implementation of a prior authorization program. Please join your fellow NYSCA members on Monday, April 29th, 8pm for an open discussion regarding our current understanding of the Highmark Prior Authorization program.
As a Foundation for Chiropractic Progress (F4CP) Group Member, we want you to know we are working for you every day to continue to promote the positive and combat the negative media as it may arise.
On March 4, 2024, the U.S. Department of Health & Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) published a notice in the Federal Register that clarifies changes to the data elements providers must submit to the National Plan and Provider Enumeration System (NPPES) to obtain and maintain a National Provider Identifier (NPI).
On March 27th, Highmark released a new training video for prior authorization specific to Chiropractic care. Although the process outlined is similar to the previous videos released, there are some important differences. There is additional information regarding self-funded groups as well.
As noted in our previous communication, Highmark BCBS of Western NY and Northeastern NY is implementing a prior authorization program for certain services rendered by DCs, PTs, OTs and home care providers. Prior authorization is required for applicable Highmark members for services rendered on or after May 1, 2024 (including those patients who were under care prior to that date).
As noted in our previous communication, Highmark BCBS of Western NY and Northeastern NY is implementing a prior authorization program for certain services rendered by DCs, PTs, OTs and home care providers.
On March 18, 2024, the OCR updated this guidance to increase clarity for regulated entities and the public.
The NYSCA would like to flag a recent practice alert that was issued by the New York State Board of Chiropractic that you should have all received in your email. We know that you get a lot of email, but this was an important practice alert, and we wanted to make sure you received it and understand the context for the alert.
This week, the Assembly and Senate released their one-house budget proposals. Today, each house passed resolutions, which memorialized their one-house budget proposals. These proposals were compiled after the Assembly and Senate held weeks of joint budget hearings and scores of meetings with a variety of stakeholders, who weighed in on the proposals contained in the Governor’s proposed budget. Each one-house budget accepts, rejects or modifies the Governor’s budget proposals that were released in January and adds priority issues for each respective house.
Pursuant to Education Law §6551(3) and Part 73 of the Commissioner’s Regulations, diagnostic ultrasounds may be used for the detection and diagnosis of conditions that are treatable by a licensed chiropractor. However, a licensed chiropractor must have appropriate training and competency prior to utilization of a diagnostic ultrasound in the course of their practice.
As previously reported, Highmark is planning to implement a prior authorization program for chiropractic care, physical and occupational therapy, and home health care effective on April May 1, 2024. Highmark recently updated their provider news to announce "For Highmark Blue Cross Blue Shield members in commercial plans, providers will need to request authorization for outpatient physical medicine and home health services, effective April May 1, 2024."
According to the 2024 Medicare Physician Payment Schedule (MPFS), chiropractors are experiencing a 5.37 MPFS percent cut this year.
Are your payments at risk? Challenged with Eligibility?
Have you ever received a marketing email like the one below in your inbox?
Cyber-crimes in the healthcare industry are on the rise in the United States.
On the Agenda, the official publication of the New York State Chiropractic Association (NYSCA), is published quarterly. It is designed to provide information about the Chiropractic profession and NYSCA activities and initiatives.
The American Medical Association (AMA) is leading the Physician Practice Information (PPI) Survey in 2023-2024 with the primary purpose to collect representative data on practice expense and hours spent in direct patient care. This important effort aims to collect accurate data on the costs and challenges of modern physician practices and to share that information with policymakers and payers, so they can in turn make more informed decisions when it comes to policy and reimbursement issues.
Chapter 56 of the Laws of 2021 amended Social Services Law § 413 to require additional training to include protocols to reduce implicit bias in decision-making processes, strategies for identifying adverse childhood experiences, and guidelines to assist in recognizing signs of abuse or maltreatment while interacting virtually within the New York State Mandated Identification and Reporting of Child Abuse and Maltreatment/Neglect coursework. This law requires that mandated reporters (which includes New York State Chiropractors), including those who have previously undergone the current training, complete the updated training curriculum by April 1, 2025.
Arlington, Va. – The American Chiropractic Association (ACA) has launched a Health Policy Fellowship to educate doctors of chiropractic about health policy, coding and other complex issues and to prepare them to advocate on behalf of the chiropractic profession in the future.
