The NYSCA Officers, Directors and Delegates are pleased to announce that the Association’s hard work has been rewarded. Governor David Paterson has signed into law as Chapter 237 of the laws of 2009, Omnibus legislation (A8402a) containing NYSCA’s retrospective audit provisions.
Once this law takes effect January 1, 2010, carriers will be limited to two years on how far back they can look when conducting a retrospective audit. In the absence of this law, theoretically a carrier could go back six years or more when conducting a routine post payment audit. This bill limits payment to just two years.
Several other key points of the new law:
- Providers must be given notice of any adverse reimbursement change to a provider contract and an opportunity to cancel the agreement before the change takes effect.
- Insurers and HMOs must pay electronic claims promptly and limit their ability to respond to claims by sending a coordination of benefits questionnaire.
- Newly licensed providers and providers moving to New York can be provisionally credentialed until a credentialing determination is made by a insurer or HMO.
Assemblyman Vito Lopez and state Senator Eric Delan, sponsors of the original NYSCA legislation, were instrumental in championing passage of the Omnibus bill on the profession’s behalf. In May, the NYSCA and Council “Joint Legislative Task Force” met with state Senator Neil Breslin and Assemblyman Joe Morelle, members and Chair of the Insurance Committee in their respective chambers and who were also instrumental in drafting and passing this bill.
The profession is deeply grateful for their efforts and the labor of NYSCA’s legislative counsel Donald Mazullo, Esq. and Amy Kellog, Esq. of Harter, Secrest & Emery, in particular.
The law includes many other provisions that be seen in entirety on the NYSCA’s website at www.nysca.com, or, alternatively, at the websites of the state Assembly or Senate.
Sincerely,
Bruce Silber, DC – President, NYSCA
Louis Lupinacci, DC – Vice President, NYSCA
Donald Littlejohn, II, DC – Treasurer, NYSCA
James Hildebrand, DC – Secretary, NYSCA
The New York State Chiropractic Association is committed to the advancement of the chiropractic profession in New York State. Our officers, directors, delegates and district officers are working diligently on your behalf to protect your right to practice and provide the highest quality of care and service to the patients we serve.
