Filtered by category: Insurance News Clear Filter

NYSIF Announces Launch of Online Medical Provider Portal

The NYSCA WC committee would like you to be aware of upcoming changes proposed by the New York State Insurance Fund (NYSIF). Please note this will not impact claim submission, but will change the way providers receive information about the status of their claim.

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CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10

With less than three months remaining until the nation switches from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline. In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 code set. For more details, please see the joint announcement on the CMS ICD-10 website.

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Get Ready for ICD-10 with the CMS ICD-10 Infographic

 

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ICD-10 Compliance Deadline 10/01/2015

Get Ready Now with the New CMS Quick Start Guide!

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ICD-10 Compliance Step 5

 

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ICD-10 Compliance Step 4

 

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ICD-10 Compliance Step 3

 

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ICD-10 Compliance Step 2

 

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ICD-10 Compliance Step 1

 

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Announcing the NYS WCB BPR Roadshows!

In lieu of holding Summer District Dialogue sessions, the BPR team is going on the road to update interested stakeholders on the status of the BPR project. Roadshow sessions will be held in each District Office beginning in mid-June and ending the first week of July.

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ACA Efforts Result in Federal Agency's Clarification of PPACA Language on Access to Non-MD/DO Providers

 

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Position Paper: Workers’ Compensation/ No-fault Fee Schedule Proposed Update

On May 4, in a report issued by the New York State Assembly Labor and Insurance Committees regarding the proposed Workers Compensation fee schedule changes, the Assembly Majority clearly recommended that the new fee schedule not be adopted, as requested by both NYSCA and the Council. In support of their decision to oppose the new fee schedule, the report included specific references to testimony jointly offered by the NYSCA and the Council, who testified at a hearing in the fall, along with other specialty groups. The summary of our joint testimony is on pages 16-17 of the report.  Both Jason Brown, DC, of the NYSCA and Bryan Ludwig, DC, of the Council and testified and raised numerous concerns about the new fee schedule, in particular its proposed linkage to the Medicare fee schedule. The report also specifically cited the testimony of Dr. Brown, detailing many of his concerns and objections. Here is a link to the full report: http://assembly.state.ny.us/comm/Labor/20150504/index.pdf. This is very good news for the profession!

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Senate Clears Legislation to Prevent Medicare Payment Cuts

Chiropractic documentation education, new quality-reporting incentives included in measure

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Attention Medicare Providers: Update on the 2015 Medicare Physician Fee Schedule Provisions that Expired on April 1

On April 1, 2015, the Medicare Physician Fee Schedule (MPFS) was updated using the Sustainable Growth Rate (SGR) methodology as required by current law. The SGR methodology required a 21% decrease in all MPFS payments beginning April 1, 2015. The Centers for Medicare & Medicaid Services (CMS) took steps to limit the impact on Medicare providers and beneficiaries by holding claims paid under the MPFS with dates of service on and after April 1, 2015. In the absence of additional legislation to avert the negative update, CMS must update payment systems to comply with the law, and implement the negative update.

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Update on the Status of Medicare Provisions Expiring on April 1

The negative 21% payment rate adjustment under current law for the Medicare Physician Fee Schedule is scheduled to take effect on April 1, 2015.  CMS is taking steps to limit the impact on Medicare providers and beneficiaries by holding claims for a short period of time beginning on April 1st.  Holding claims for a short period of time allows CMS to implement any subsequent Congressional action while minimizing claims reprocessing and disruption of physician cash flow in the event of legislation addressing the 21% payment reduction.  Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. As we stated in our recent email to physicians, CMS will provide more information about next steps by April 11, 2015.

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Congress Fails to Pass Legislation to Prevent Medicare Payment Cuts

CMS to hold claims until April to avert reimbursement cuts

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Service-Specific Prepayment Review Results For CPT Codes 98940 & 98941 For September-December 2014

Providers in Connecticut (98941), Queens, NY (98940), Downstate NY (98941) and Upstate NY (98941)

National Government Services’ Medical Review Department is currently conducting a prepayment review on JK Part B chiropractic services in the states of CT and NY. This article includes the results of these reviews for September, October, November and December 2014.

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WCB Chair Announces Board Adoption of ICD-10 Timetable to be Consistent with Medicare and Medicaid

 

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BREAKING: CMS bends on reporting periods for meaningful use

The CMS just blinked in the ongoing cold war between providers and the agency over meaningful-use requirements for electronic health-record systems.

The CMS announced Thursday that it is considering proposals to shorten the meaningful-use reporting period to 90 days in 2015, something providers and others have been requesting. 

Shortening the period essentially means providers can meet the meaningful-use requirements and avoid financial penalties with software in place for less time than is currently required.

The College of Healthcare Information Management Executives, a key advocate for changes in the reporting period, was positive about the announcement. “It is indeed” what the organization was looking for, said Jeff Smith, the organization's vice president of public policy. 

In a separate statement, Russ Branzell, CHIME's president and CEO, said, “Meaningful use has the potential to be a transformative program for the nation's healthcare delivery system and we commend CMS for recognizing the need for a course-correction.”

The Medical Group Management Association and the American Medical Association praised the CMS for agreeing to modify the window, and they urged the agency to issue the new rule quickly. The MGMA noted that the number of physicians who have attested to meeting the program's Stage 2 requirements dropped sharply from the number who cleared the first bar.The AMA, meanwhile, also took a broader swipe at the program, saying that it fails to "help physicians improve care for their patients." 

The CMS also is considering changing reporting periods to the calendar year to “allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other CMS quality programs,” and will “modify other aspects of the program” that may lessen providers' reporting burdens. 

The CMS clarified that the rulemaking on reporting period flexibility will be separate from the upcoming third-stage meaningful-use rule, which may be released in March. 

The changes may mollify calls from providers and legislators to change reporting periods. Rep. Renee Ellmers (R-N.C.) and 29 fellow House Republicans had sent a letter to Sylvia Matthews Burwell grousing about the reporting periods in the program. Bipartisan legislation also had been introduced by Ellmers and then-Rep. Jim Matheson (D-Utah) to change the reporting periods. 

Follow Darius Tahir on Twitter: @dariustahir

















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Instructions on how to access the 2015 Medicare Fee Schedule

Please review these instructions for how to access the 2015 Medicare Physician Fee Schedule (MPFS)

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