The NYSCA Insurance Committee (The NIC) continues to communicate and work with the NYS Workers' Compensation Board (WCB) to keep our members updated on current and forthcoming changes that may impact your care of New York's injured workers. Since our December 23rd notice on the Third-Party Administrator (TPA) changes, we have received a letter directed to our members from the President of FCS Administrators.
The NYSCA Insurance Committee (The NIC) has been communicating with both the Workers' Compensation Board and Third-Party Administrators to define and advise our members on a recent change impacting the Special Fund for Disability Benefits, the Uninsured Employers’ Fund, the Second Injury Fund (also referred to as the Special Disability Fund), and the Fund for Reopened Case. This change has already been implemented - seemingly without overt provider communication on many of these cases.
On October 1, 2025, the Workers’ Compensation Board (Board) announced updates to the Notice of Objection to a Payment of a Bill for Treatment Provided (Form C-8.1B) requiring payers to provide a detailed explanation of their objections to bills for medical treatment in boxes 12 and 20 within Section C, Objection Reasons-Legal and Medical Treatment Guidelines.
The NYSCA is pleased to announce that New York State Workers’ Compensation Board (WCB) Executive Director Steven Scotti and Medical Director Dr. James Tacci will join us at the Fall Convention in Syracuse on Friday, October 17, 2025, at 4:00 p.m.
Recently, the NYS Workers' Compensation Board released an updated version of the C-4.3 permanent impairment form. For more information please login to the NYSCA website:
The Workers’ Compensation Board (Board) is requiring health care providers to submit the CMS-1500 universal billing form electronically, through a Board-approved electronic submission partner, effective August 1, 2025. Starting that date, the workers’ compensation payer can deny payment of services if the CMS-1500 form was not submitted through a Board-approved electronic submission partner and the Board will not enforce payment.
Effective August 1, 2025, the NYS Workers’ Compensation Board (Board) will require health care providers to submit the CMS-1500 universal billing form electronically, through a Board-approved electronic submission partner. But don’t wait! All providers are encouraged to move to electronic submission as soon as possible to take advantage of key benefits.
On Monday, March 24th, the NYS Workers' Compensation Board posted notice regarding changes to durable medical equipment (DME) prior authorization requests (PARs), which also impacts all draft PARs (whether from providers, their delegates, or responses from payer reviewers).
Thank you to those who attended our recent CMS-1500 webinar for health care providers, highlighting that, beginning August 1, 2025, the Board will require health care providers to contract with an electronic submission partner to submit the CMS-1500 universal medical billing form electronically on their behalf.
On November 1, 2024, the Board issued a reminder that it will require health care providers to contract with an electronic submission partner to submit the CMS-1500 universal medical billing form electronically on their behalf beginning August 1, 2025.
Many of our members have contacted the NYSCA Insurance Committee after receiving notice from the NY Workers' Compensation Board to renew their authorization to treat injured workers. This was covered extensively at the NYSCA workers' compensation presentation at the Fall Convention and during our workers' compensation webinars.
The NYSCA Insurance Committee (The NIC) continues to receive numerous calls and emails from our members seeking assistance implementing the new workers' compensation requirements. Our webinars and Lunch and Learn presentations have been well attended. This article will be limited to workers' compensation cases, and offers some pearls which you may find beneficial. The new MVP program (effective 1/1/23) has been addressed in a separate article.
As you prepare for your holiday weekend, the NYSCA Insurance Committee (the NIC) would like to provide you with the following reminders and updates which encompasses three topics: Workers' Compensation, MVP, and Highpoint BlueCross Blue Shield of Western New York. More detailed information and news related to other insurance issues will be disseminated in the next several weeks.
Welcome to Spring! The NYSCA Insurance Committee (The NIC) would like to provide this summary update of recent insurance-related issues which may impact your practice. This edition is dedicated to Workers’ Compensation, and in particular the continuing rollout of the NYS Workers’ Compensation OnBoard Initiative and submission requirements.
The Chair has determined that the solicitation or receipt of payments from a third party for chiropractic or other health care treatment and services (including so-called "fitting fees" or "service fees") are prohibited by the Workers' Compensation Law, the Rules of the Board of Regents governing the professions, and the New York State Education Law governing the practice of medicine. The Chair has taken, and will continue to take, administrative action against any provider found violating the law.
Welcome to Summer!
As previously reported, the NYS WCB continues to develop and refine their CMS-1500 and OnBoard electronic communication initiatives. These initiatives are designed to submit claims and related documentation, enhance communication, and will allow access to information in a transparent, streamlined manner.
As you may have heard, The New York State Workers’ Compensation Board is in the process of developing a new business information system, OnBoard. OnBoard will be a Better System for a Better Board – providing an intuitive, user-friendly system, increased accuracy and quality, and paperless transactions to our system participants.
NYSCA has previously communicated that the revised January 1, 2020 New York Workers' Compensation Fee Schedule included reference to an updated Durable Medical Equipment (DME) Fee Schedule.
As some of you are aware, the availability of telemedicine services for New York's injured workers was set to expire on July 20th. The NYSCA workers' compensation committee contacted the WCB to ensure telemedicine would remain available for those injured workers who could not seek chiropractic care as a result of COVID-19.
