Filtered by category: Insurance News Clear Filter

The NYSCA Co-Signs ACA Response to UHC Headache Policy

 

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The NYS WCB Announces Public Comment Period for Proposed Medical Fee Schedule

 

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Proposals to Improve Medical Care for Injured Workers

To increase provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) is proposing an increase to provider fees and adoption of the universal CMS-1500 form to reduce administrative burden, among other measures.

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Revised WC Medical Authorization Request Forms

Please note that the WCB has updated a few common forms including the MG-2 and MG-2.1. They have been revised to include a place for providers to include their National Provider Information (NPI) number.

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Urgent: New CMS Billing Rules Effective 01/01/2018

Please note that CMS implemented a new rule to requires doctors of chiropractic to add a 2nd modifier when billing Medicare for non-covered physical medicine services.

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MIPS - To Participate or Not Participate: That is the Question

Medicare’s Merit-based Incentive Payment System (MIPS) Final Rule increased the threshold for participation. With this increase, a significant number of providers fall into the exempt category and they are now breathing a sigh of relief. However, there’s one hidden tidbit which you may have missed - the potential damage to your reputation and practice if you DO NOT participate. As incredulous as this may sound, it’s a possibility to consider as your scores will be published on the Physician Compare website for all the world to see. Those scores may also be used for other third-party physician rating websites. One study found that 65% of people are aware of these rating sites and many use them regularly. Providers with high scores have an advantage over their competitors. Damage to online reputations could take years to undo.

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2018 Permanent Impairment Guidelines for Schedule Loss of Use Evaluations

The Workers’ Compensation Board has finalized the new Schedule Loss of Use Impairment Guidelines after consideration of much input from a variety of stake holders, including health care professionals.

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Chiropractic Treatment Visit Note Standards

As we at ChiroCode worked to find an example of the perfect daily treatment visit note, we came across many authoritative sources. For your convenience, we have included them here. The four sources here include Medicare, a chiropractic network, one state board's rules, and one insurance company's requirements. At first glance they may appear to be very different, but, there are many similarities. For the 2018 ChiroCode DeskBook, we considered all these sources and created a SOAP note format that we believe captures all of these requirements so that you can use the same layout for all payers and circumstances. You can read about it in Chapter 4.3 in the 2018 ChiroCode DeskBook.

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NYS WCB Chair Proposes Revised Impairment Guidelines

 

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Deadline Approaching for Required Registration with WCB

By now most, if not all, healthcare providers will have received notice from the New York State Workers' Compensation Board advising providers of their responsibility to register with the WCB and update their office address and contact information. Authorized providers are asked to register with the Board and update their office address(es) and contact information by December 29, 2017. This registration process will be an ongoing initiative every two to three years.

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Quality Payment Program Year 2

CMS has issued the final rule and comment period for the 2018 (year 2) Quality Payment Program.

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New Health Care Provider Registration Coming Soon

The Workers’ Compensation Board (Board) has initiated a registration process to update and maintain a current list of medical providers who are authorized to treat injured workers. The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.

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CMS Reveals New Medicare Card Design

Removing Social Security numbers strengthens fraud protections for about 58 million Americans

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Chair Proposes New Permanent Impairment Guidelines

In April 2017, Governor Andrew M. Cuomo signed into law the 2017-2018 Executive Budget, which contained several significant pieces of workers’ compensation reform designed to protect workers while also achieving savings for businesses. Included in the reforms was Workers’ Compensation Law (WCL) § 15(3)(x), which requires new Permanency Impairment Guidelines (“Guidelines”) to be adopted by January 1, 2018. The new Guidelines cover determinations of permanency under WCL § 15(3)(a) through (v), which are also known as scheduled loss of use.

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New Medicare Cards with New Numbers: 3 Changes You May Need to Make

The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. CMS will begin mailing new Medicare cards with a new Medicare number (currently called the Medicare Claim Number on cards) to your patients in April 2018. You may need to change your systems to:

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Compliance with Medicare Documentation Continues-CMS

Provider Compliance

Chiropractic Services:
High Improper Payment Rate within Medicare FFS Part B

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5 Ways for Healthcare Providers to Get Ready for New Medicare Cards

Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.  

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Medicare Update: Revised ABN Effective Date 6/21/2017

 

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Legislative Update - Budget Worker's Compensation Reform

The final NYS budget passed both houses late last Sunday night. Despite no significant workers’ compensation reforms being included in the original proposed budget bills, there were many last minute negotiations regarding worker’s compensation reform that we followed closely. 

Of specific concern  was PPO language that would create a 120 day opt-out and any general provisions that would have limited patient access to the provider of their choice. Working with the Council, our lobbyists shared our concerns with key legislators as to the negative impact this would have on worker’s compensation patients. We are happy to report that this language was not included in the final budget. 

As workers compensation reform was on the table, we made a concerted push to ensure that the reforms included IME reform. We have discussed this over the years as an item for the Joint Legislative Task Force with the Council.  The enacted legislation calls for the creation of an IME Advisory Committee to “conduct a thorough study of the utilization of independent medical examinations” with a goal of “regulatory and statutory proposals” that will consider a new method of assigning these independent medical examinations.

This advisory committee will be composed of representatives from organized labor, business, carriers, self-insured employers, medical providers and other stakeholders and experts as the chair deems fit to include.  We have already talked to the chair of the Workers’ Compensation Board about this advisory committee, and the chair assured us that he will seek our active engagement in this process.  We will keep you updated on the status of the advisory committee and our role in the process.

The final enacted workers’ compensation reforms also included adoption of impairment guidelines and as well as performance standards for insurance carriers.  In what we are viewing as a very positive development, the final reforms also included development of a drug formulary.  It is our hope that the adoption of a drug formulary will lead to less opioid abuse and over prescription and encourage a return to conservative proven care such as chiropractic.

We waited to send this update on workers’ compensation because on Tuesday, April 11, 2017, our Workers’ Compensation committee, in conjunction with the Council’s committee, met with the chair of the Workers’ Compensation Board.  The meeting was very productive.  

This was a follow up to our meeting in the fall where we discussed several issues facing our members that led to the creation of the Workers’ Compensation response form that both Associations asked our members to use in order for us to track concerns and issues.  We presented to the chair the information we gathered and the issues we are seeing, and he promised to review those issues and address training and carrier issues that he is empowered to address.  We will be following up with him and scheduling another meeting in the near future.  Also, as noted above, he indicated a strong desire to have chiropractic actively involved and engaged in the IME reform initiatives.

While issues remain with workers’ compensation, we hope that the just enacted reforms will help to alleviate some of the problems and that our ongoing dialogue and engagement with the chair of the Workers’ Compensation Board will lead to some relief for our members.













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2017 MAC Satisfaction Indicator (MSI) - JK Now Available!!

CMS is once again conducting their annual survey of Medicare Administrative Contractors (MAC) performance and requesting feedback from the provider community we serve through the MAC Satisfaction Indicator (MSI).
 
The MAC Satisfaction Indicator (MSI) is the best way to share your opinions of our service directly with the CMS. This survey should only take 10 minutes of your time and helps us understand how we can better serve you. To take the survey, click on the URL below:

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