Some of our members have contacted the NYSCA Insurance Committee regarding the processing of claims for billed services rendered to EmblemHealth's senior care members. Emblem has recently posted the following information relative to copayments:
The NYSCA is pleased to announce that our Scope Modernization bill has been reintroduced in the 2023 legislative session. A4150 with Assemblyman Danny O’Donnell as our Assembly sponsor once again and S6047 with our new sponsor, Senator Andrew Gounardes from Brooklyn, New York.
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.
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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.
The NYSCA Insurance Committee (the NIC) has been in contact with American Specialties Health (ASH) to better define the benefits available to Wellcare members. Please note that All Wellcare insureds DO NOT have the insurance rider which covers all of the services listed in the ASH G9 fee schedule. NYSCA members have reported a difference in benefits when checking eligibility on ASHLink vs talking to a representative or when performing an ASHLink Inquiry.
Dr. Robin Stein’s NYSCA involvement began in 2007. She joined NYSCA following the opening of her office in East Islip. Dr. Stein was appointed treasurer of District 7 (Suffolk County) later that year and held that position for 11 years. She then took on the role of Vice President for District 7 and currently remains in that position.
On the Agenda, the official publication of the New York State Chiropractic Association (NYSCA), is published quarterly. It is designed to provide information about the Chiropractic profession and NYSCA activities and initiatives.
The 2023 legislative session began on January 9, 2023, and the legislative committee has been hard at work on the legislative priorities for NYSCA. As a reminder, all legislation in New York operates on a two-year cycle. At the end of the two-years, all bills must be reintroduced again in the new cycle. This year marks the start of a new cycle, so our priority bills will have new bill numbers.
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.
Recently, the New York State Department of Health (DOH) weighed-in, backing away somewhat from the Department’s previous face mask mandate for certain health care settings, principally facilities regulated by the Department under Articles 28, 36 and 40 of the New York State Public Health Law (PHL) relating to hospitals, home healthcare services, and hospices, respectively.
Dr. Anthony M. Palumbo is a 1995 summa cum laude graduate of Life College. He had the honor of acting as his class Salutatorian. Following his College’s credo; to give, to do, to love, to serve, out of your own abundance, he has proudly contributed to the Profession of Chiropractic in many roles.
ALBANY, N.Y. (February 10, 2023) – The New York State Department of Health today issued a COVID-19 advisory for the use of masks and face coverings in health care facilities, aligning the State's guidance with the latest federal recommendations from the Centers for Disease Control and Prevention (CDC).
Recently, the New York Chiropractic Council (the Council) released a video regarding the Scope Modernization Bill. As a result of this video, we felt that some clarification is in order.
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We hear every day that many Americans are not financially prepared for their future. People find the financial planning process overwhelming, and they don’t know where to begin.
Governor Kathy Hochul delivered her second State Budget address this afternoon. The Governor began the address by noting that the general economic outlook is far less rosy than it was last year. Nonetheless, the Governor presented an optimistic vison of the State’s finances and progress for the upcoming year, as New York expects to end its current fiscal year with an $8.7 billion surplus as the result of increased tax collections throughout the prior fiscal year. For Fiscal Year 2024, the Governor is proposing a $227 billion budget, which represents a 2.4% increase over the prior year budget.
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.
Today, Governor Kathy Hochul delivered her second State of the State address. While this was her second address, it was her first address as the elected Governor. During her address, Governor Hochul laid out her vision for leading New York State. The Governor set an optimistic and hopeful tone for the future of the State but noted that there was much to be done to reach that future. The Governor pledged a collaborative approach, aiming to work with the Legislature, municipalities, and businesses across New York for the people of New York State.
Join your fellow healthcare professionals and the New York Yankees for select games in May at Yankee Stadium. The dates for the games are May 8-14, 2023
