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Workers' Compensation Fee Schedule Update

As you may recall, the NYS WCB proposed a much needed update to the fee schedule. On behalf of the profession the NYSCA and Council responded with formal public comments on the proposed WC fee schedule.

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Further Updates on Aetna/NIA Prior Authorization Program

Members of the NYSCA insurance committee met with Aetna and NIA to discuss the implementation of the new Pre-Authorization Program which went into effect on 09/01/18.  We understand that many of you were not notified until late July / early August and could not attend NIA's webinar on August 7, 9 or 16.  There has been some confusion regarding different aspects of the program, resulting in our reaching out to Aetna to discuss your concerns.

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Important Updates to ICD-10

It’s that time of year again. As you may be aware, every year since its inception, there have been updates to ICD-10 codes. Some years have more changes, others fewer. As of October 1, 2018 the following changes will go into effect:

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Providers Invited to Webinar for Updated Aetna Physical Medicine Program

Note from the NYSCA Insurance Committee:

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Update on Claims Processing for the Aetna/NIA Prior Authorization Program

Please note the following update relative to Aetna's new Prior Authorization Program which went into effect 9/1/18.

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New TPAs for Workers' Compensation, Volunteer Firefighter, and Volunteer Ambulance Claims

 

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WC Update: Special Funds Closes Down

 

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Changes to Aetna Program Effective 09/01/18

 

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The NYSCA and Council Submit Comments on the Proposed NYS Workers' Comp Fee Schedule

 

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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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