HEALTHCARE NEWS

Differentiation in examination requirements for Expanded Problem Focused (EPF, 2-5) and Detailed (6-7) levels of service developed by the National Government Services (NGS) will no longer be considered mandatory as of 7/1/2017. This delineation of levels, initiated in response to provider queries a...

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 Pu...

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 (Medic...

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 Mar...

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 Measureme...

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 under a facility DEA registration numbe...

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 ...

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 Click here for instructions.  

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 enrollment of all pro...

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,...

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...

Health insurance was always a major issue in the US. As of January 1, 2014 more than 1million people, that never had insurance before, are now covered by health insurance plans. The Affordable Care Act, also known as Obamacare allows everyone to enroll into a health insurance plan of their choic...

 2013 brings big coding changes for prescribers and non-prescribers alike.  On the psychiatry front, perhaps the most notable change is the elimination of the med-management code 90862.   The 908XX psychiatric code series (90807 and 90817, for example) which covered therapy with ...

Starting October 1, 2012, claims for patients who meet or exceed $3,700 in therapy expenditures will be subject to a manual medical review. For outpatient therapy services that exceed $3700 there will be an advanced approval process that will be implemented in three distinct phases. Providers will b...

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseas...