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HealthCare News

Wednesday, June 28, 2017
 Telehealth Service Coverage Guidelines: A Brief Guide Effective January 1, 2016, the New York telehealth coverage law prohibited commercial insurers and health maintenance organizations from “excluding from coverage a service that is otherwise covered under an enrollee contract because the service is delivered via telehealth.” (NY State Public Health Law § 4406-G, NY State Insurance Law § 3217-H...
Upcoming Request for Medicaid Provider Documentation Under the Payment Error Rate Measurement (PERM) Program Effective July 1, 2017, the Centers for Medicare & Medicaid Services (CMS), in partnership with the New York State Office of the Medicaid Inspector General (OMIG), will be measuring improper payments in the Medicaid and State Child Health Insurance programs under the Payment Error Rate Meas...
  Medicare Part C Reimbursement Reminder  Retroactive to July 1, 2016, Medicaid will no longer reimburse the full Medicare Part C copay or coinsurance amount.Pursuant to 2016 changes to Social Services Law, the New York State Department of Health has revised the Medicaid reimbursement methodology for claims containing Medicare Part C (Medicare Advantage or Medicare managed care) co-payment and/or ...
  Free Online Opioid Prescriber Training Program Available Which Meets the Mandatory Prescriber Opioid Education Requirements in New York State Prescribers licensed under Title Eight of the Education Law in New York to treat people, and who have a Drug Enforcement Administration (DEA) registration to prescribe controlled substances—as well as medical residents who prescribe controlled substances u...
  Electronic Prescribing Update - New Blanket Waiver for Exceptional Circumstances Approved The Commissioner of Health has approved a new blanket waiver with respect to the electronic prescribing requirements of Public Health Law (PHL) § 281 and Education Law § 6810. Effective March 26, 2017, this waiver replaces and supersedes the prior blanket waiver, issued by letter dated March 16, 2016, for e...
Friday, April 28, 2017
Medicare EHR Incentive Program Hardship Exception Application due July 1 Eligible professionals (EP) who are not meaningful users of certified electronic health record (EHR) technology under the Medicare EHR Incentive Program may be exempt from Medicare penalties if they can show meaningful use would result in a significant hardship.To be considered for an exemption and avoid a payment adjustment ...
  2017 Eligible Professionals Transitioning to MIPS May Submit Hardship Form by October 1 An eligible professional who has never successfully attested to meaningful use under the EHR Incentive Program, and is transitioning to the MIPS in Program Year 2017, may submit this EP Hardship Application (Transitioning to MIPS). Click here for instructions.   
Friday, April 28, 2017
New Cognitive Assessment Code Likely to Become Permanent in 2018 In January 2017, the Centers for Medicare & Medicaid Services (CMS) approved payment for a new G-code, G0505, which describes assessment and care plan services for patients with cognitive impairment. This code will likely be converted to a permanent CPT code, approved by the CPT Editorial Panel, in 2018.Code definition: Cognition and...
  All Providers Must Revalidate Enrollment with State Medicaid Agencies Every Five Years to Ensure Payment of Claims The New York State Department of Health has determined that many providers are at risk for not being paid for their services because the ordering/prescribing/referring (OPR) provider has not complied with a federal regulation which requires state Medicaid agencies to revalidate enro...
Sunday, October 19, 2014
Medicare covers an Annual Wellness Visit (AWV) providing Personalized Prevention Plan Services (PPPS). Medicare covers the AWV for beneficiaries who are not within the first 12 months of their first Part B coverage period and have not received an Initial Preventive Physical Examination (IPPE) or AWV within the past 12 months. You must provide, or provide and refer, all components of the AWV prior ...

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