In order to increase health care provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) is supporting electronic submission of CMS-1500 forms, along with a medical narrative. The CMS-1500 streamlines medical billing and may reduce the paperwork requirements currently in the workers' compensation system.

To further assist medical providers in the implementation of the CMS-1500 for workers’ compensation patients, the Board has created a medical narrative report template that can be used to create the medical narrative that must accompany all CMS-1500 submissions.

In response to the CMS call for Feedback on Scope of Practice, the NYSCA has submitted the following:  

The NYSCA Workers' Compensation Committee has received numerous calls from our members regarding the revised 1/1/2020 Workers' Compensation Chiropractic Fee Schedule.  A fair amount of misinformation is being communicated, particularly in the downstate region, resulting in confusion in the application of the 1/1/2020 Schedule.

Have you received a request for documentation from a Medicare contractor but not sure if your records comply? We understand the challenges Doctors of Chiropractic face when determining what to include in responding to a request for medical records. The A/B Medicare Administrative Contractors (MACs) partnered together to create this job aid to help you properly respond to these requests.

Download the Job Aid from CMS.gov

The NYSCA has been in contact with the American Chiropractic Association (ACA) regarding possible changes to Medicare as outlined in the following letter from National Government Services.

The New York State Chiropractic Association (NYSCA) and New York Chiropractic Council have been actively working with the New York State Workers' Compensation Board (WCB) to achieve parity in the system for services provided by Doctors of Chiropractic in New York State.

Please be advised that the proposed increase to the chiropractic conversion factor will be going into effect on January 1, 2020 as anticipated. This change recognizes the need for parity in the Workers Compensation system and represents a positive step forward in the recognition of the value of chiropractic care. We appreciate the willingness of the WCB to address this issue.

National Government Services (the Medicare contractor for our region) is offering a seminar on Medicare billing to providers on Wed, Dec 18, 2019 10:00 AM - 11:15 AM EST.  You may sign up by following the link below:

Please note the following notification from American Specialty Health (ASH) relative to employees of Suffolk County.

Recently, the Centers for Medicare & Medicaid Services (CMS) has developed and released a Medicare Documentation Job Aid to assist chiropractors in responding to medical records requests, medical necessity documentation, and corrective treatment documentation. These PDF downloads are available on the CMS.gov website. 

Click here to learn more

Through the hard work of the NYSCA, the New York State Workers Compensation Board (WCB) is proposing to change the chiropractic conversion factor, creating parity for the first time since our inclusion in workers' compensation for doctors of chiropractic. The disparity in the conversion factor has been a priority of the joint efforts from NYSCA and the Council. Working together, and working with the WCB, positive change is coming.

Don't forget to implement the New NYS Workers' Compensation Fee Schedule for services rendered on and after 4/1/19.  

As you may be aware, the New York State Workers' Compensation Board recently released an updated fee schedule.  This effective date of the fee schedule is April 1, 2019.

As you know the WCB has updated the fee schedule and the changes will be implemented on April 1st, 2019.  We have been waiting for the release from the Department of Financial Services regarding No-Fault.  It has now arrived, you can view it using the link below:

 Pursuant to the provisions of the State Administrative procedure act, the Workers Compensation Board will be adopting the Proposed Medical Fee Schedule changes effective April 1, 2019. 

The NYSCA heard your concerns and has responded to the revised Workers Compensation Fee Schedule. 

The following information has been received from Aetna to assist in your transition to the new program.

Please know NYSCA has heard the profession’s voice. We are as concerned as you are and are actively advocating for necessary changes.  Of particular concern are the chiropractic conversion factor, the 180-day wording, and impact on specialty practices.

Please be aware that after initial public comment period, the Workers Compensation Board (WCB) has produced a revised proposed fee schedule. There are comments available for review on the State Register and the fee schedule is available for review on the WCB website.