Cyber-crimes in the healthcare industry are on the rise in the United States.

Are your payments at risk?  Challenged with Eligibility? 

In mid-Summer 2021, the NYSCA issued a memorandum in response to a question about whether chiropractors as merchants could levy a surcharge on a patient who used her credit card to pay for her deductible, copayment or visit charge in order to offset the credit card companies processing fees often referred to as “swipe fees.”

On Wednesday, November 29, 2023 NGS Medicare released a statement that the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) is now available. You can view the new fees using the Fee Schedule Lookup tool located on NGSMedicare.com.

On October 12, 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2024 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2024 Medicare Part D income-related monthly adjustment amounts.

Enrollee benefits have changed for certain groups in The Empire Plan effective July 1, 2023.  We have included information relative to massage therapy and acupuncture, for those NYSCA members who provide these services in their office.  Please note: The New York State Health Insurance Program (NYSHIP) Empire Plan for NY state and local government employees is not Empire Blue Cross Blue Shield.

The NYSCA Insurance Committee (The NIC) is bringing you the latest updates on CDPHP.

The NYSCA Insurance Committee (The NIC) is bringing you the latest updates on MVP.

The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 01/31/2026 will be mandatory on 6/30/23. You may continue to use the ABN form with the expiration date of 6/30/23 until the renewed form (expiration date 01/31/2026) becomes mandatory on 6/30/23. The ABN form and instructions may be found below in the downloads section.

The NYSCA Insurance Committee (The NIC) is requesting your assistance as we compile recent blinded examples of claims which have not been acknowledged or processed and in a timely manner by Cigna.  These are claims which do not involve American Specialty Health (ASH), but are solely the responsibility of Cigna.  Remember: Health Plans subject to the laws of New York are required to acknowledge or process clean claims within 30 or 45 days of receipt.  Failure to do so can result in interest and penalties.

Arlington, Va. – Both the U.S. House of Representatives and the U.S. Senate have reintroduced legislation to increase access to Medicare-covered services provided by doctors of chiropractic. The Chiropractic Medicare Coverage Modernization Act (H.R. 1610/ S. 799) would bring Medicare’s coverage of chiropractic into alignment with most other federal programs and private health plans, giving seniors improved coverage of non-drug treatments to alleviate pain and improve function.

Insurance Updates Effective January 1, 2023

2023 brings forth continued positive changes for doctors of chiropractic practicing in New York. Across the state certain health plans have increased fee schedules and enhanced coverage. In addition, a few third-party administrators have been eliminated, and unreasonable utilization review has been discontinued. Reasonable reimbursement and the elimination of administrative burdens affords us more time to assist our patients in achieving their goals. With significant involvement from our members, the NYSCA continues our drive to parity and fairness in reimbursement and administrative practices.

For those of you who got an early start, please go back and check the fees again as the revised fee schedule has just been posted. Please make sure you are using the most up to date fee schedule when sending your claims to Medicare or billing your patient prior to submitting claims if you are non-participating.

NYSCA members have asked for updates on the Medicare fee schedule. As of now, there are no changes and no changes are anticipated until the House leadership is sorted out.

Many of our members have contacted the NYSCA Insurance Committee after receiving notice from the NY Workers' Compensation Board to renew their authorization to treat injured workers. This was covered extensively at the NYSCA workers' compensation presentation at the Fall Convention and during our workers' compensation webinars.  

The NYSCA Insurance Committee (The NIC) continues to receive numerous calls and emails from our members seeking assistance implementing the new workers' compensation requirements. Our webinars and Lunch and Learn presentations have been well attended. This article will be limited to workers' compensation cases, and offers some pearls which you may find beneficial. The new MVP program (effective 1/1/23) has been addressed in a separate article.

Warm Greetings from the NYSCA Insurance Committee! This summer has brought forth several important changes and deadlines which have impacted how you interface with payers.  The NYSCA Insurance Committee (The NIC) has been inundated with calls, especially with the new Workers' Compensation requirements and the new MVP program effective 1/1/23. This article will address questions related to the New MVP program. Workers’ Compensation will be addressed in a separate piece.

As you prepare for your holiday weekend, the NYSCA Insurance Committee (the NIC) would like to provide you with the following reminders and updates which encompasses three topics: Workers' Compensation, MVP, and Highpoint BlueCross Blue Shield of Western New York. More detailed information and news related to other insurance issues will be disseminated in the next several weeks.

Welcome to Spring!  The NYSCA Insurance Committee (The NIC) would like to provide this summary update of recent insurance-related issues which may impact your practice.  This edition is dedicated to Workers’ Compensation, and in particular the continuing rollout of the NYS Workers’ Compensation OnBoard Initiative and submission requirements.