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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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FYI: When Will CMS Notify Clinicians about MIPS Eligibility

The Centers for Medicare and Medicaid Services (CMS) has yet to release critical 2017 Merit-Based Incentive Payment System (MIPS) eligibility information to allow providers to determine if they fall under the low-volume threshold exemption.

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Medicare: New ABN to be Used in 60 Days

The Centers for Medicare and Medicaid Services (CMS) announced on March 28 that the Advance Beneficiary Notice of Noncoverage (ABN) Form and instructions were approved for renewal. The effective date for use of the updated ABN form is May 27.

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CMS Extends Deadline for 2016 PQRS EHR Submission

 

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Recoupment Audits

Edited: Gerald Stevens DC, MS, MPH

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Filing Paper Claims from NGS Medicare & CMS

 

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NY Workers' Compensation Update

As Governor Cuomo delivered his State of the State addresses, one of the issues again highlighted was workers compensation reform. As you know, this impacts your patients and your practice. The NYSCA, working with the NY Chiropractic Council, has recently met with the WCB to welcome its new Chair and discuss the issues facing the chiropractic patient. NYSCA's WC Committee will continue to address the issues we face.

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Optum Health / UnitedHealthcare Update

As some of you are aware, there are some changes coming to the Optum Health / UnitedHealthcare program which may impact your practice. The NYSCA Insurance Committee has responded to dozens of calls to assist our members in understanding these impending changes. A summation of our knowledge to date, as already conveyed to many of our members, has been posted in the members only section of NYSCA.com.  

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Social Security Number Removal Initiative

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number on new Medicare cards for transactions like billing, eligibility status, and claim status.

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Social Security Number Removal Initiative

What do you need to do to get ready?

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ICD10 Coding Update

There are thousands of code changes going into effect on October 1. Here is a list of the 70 or so that are most relevant to chiropractors. All of this information, and a whole lot more can be found in our brand new 2017 ICD-10 Coding for Chiropractic book. Order your ChiroCode book today and get a free cheat sheet!

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ICD-10 Updates Coming Oct. 1

Doctors of chiropractic should be aware that there are some significant updates regarding ICD-10 that go into effect Oct. 1 due to the partial code freeze being lifted. Of particular interest to DCs is the addition of numerous injury codes (chapter 19), musculoskeletal codes (chapter 13), and clarifications on “Excludes” notes and laterality. Doctors should review the 2017 ICD-10-CM Guidelines to familiarize themselves with the changes and make sure that all ICD-10 reference material is up to date.

Medicare Update: Comprehensive Error Rate Testing Chiropractic Services

The CERT program’s review of claims for chiropractic services has consistently yielded high improper payment rates. The majority of chiropractic services claims were the result of insufficient documentation, such as:

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