New Independent Dispute Resolution Resubmission Process The Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) are announcing a new process by which the Federal IDR portal will send disputing parties a unique web form to resubmit disputes that were originally improperly submitted instead of receiving a request from your certified […]
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MSSNY in Action: Expanding Nebulizer Treatment Coverage for NYS Medicaid Patients MSSNY was recently made aware by Lisa Chinnici from Panoram Pediatric office that NYS Medicaid would only cover one in-office nebulizer treatment per month. If multiple CPT codes were billed within a month, the patient would be denied coverage, resulting in a loss of […]
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New CMS 588 Electronic Funds Transfer (EFT) Authorization Agreement There is a new version of the CMS 588 Electronic Funds Transfer (EFT) Authorization Agreement (11/23). Effective 4/30/24, the Medicare Administrative Contractors (MAC) may only accept the CMS 588 EFT (11/23) version. If a provider submits the outdated form, it will be returned. Please note: If […]
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COVID-19 Vaccines Billing Guide We are monitoring COVID-19 vaccine updates from state and federal governments. Effective September 11, 2023, for New York State Medicaid Fee-for-Service (FFS) and for Medicaid Managed Care (MMC) Plans, reimbursement is available to enrolled and qualified providers for COVID-19 vaccines and their administration as approved by the FDA or authorized for […]
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Important Cybersecurity Update: Change Healthcare Incident Briefing Resources The following resources are from a recent HHS briefing on the Change Healthcare cyberattack, emphasizing the necessity for vigilant cybersecurity in healthcare. The comprehensive material, including UnitedHealth Group’s slides and a webinar recording, is available on the HHS YouTube page. We urge you to review and share these insights with […]
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Let’s Chat Open Forum: Change Healthcare/Optum Payment Disruption Accelerated/Advance Payment Program Part A and Part B Providers experiencing cash flow problems related to Change Healthcare/Optum Payment Disruption (CHOPD), which began on 2/21/2024, may be eligible for Accelerated/Advance Payments (AAP). Accelerated and Advance Payments are intended to provide necessary funds to Part A and B providers, […]
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Register Today! The NY State Pain Society and the NY Workers Compensation Forum invite you to the Annual Meeting on Friday, April 6, 2024. You can earn up to 7 CME/ CEU in one day! 8:00 AM – 6:00 PM LIVE at the SUNY Global Center in NYC or Simulcast Online. Hurry – LIVE Seating […]
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NYRx, The Medicaid Pharmacy Program Notice to Providers: Program Update The NYRx Clinical Call Center is experiencing higher than normal call and fax volume. Prescribers should not send duplicate prior authorization (PA) requests to NYRx. Prescribers may experience a higher volume of requests for PA, but only one submission is necessary. Pharmacies should only request […]
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Pediatricians, We Need Your Help! It has come to the Payment and Practice Division’s attention that Medicaid will only allow and reimburse in-office nebulizer treatments once per month. DOH has advised they are willing to re-look at this policy but has asked for some supporting information. Please answer the 4 questions below and send your […]
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CMS Update on Change Healthcare Security Incident The Centers for Medicare & Medicaid Services (CMS) and National Government Services, Inc. (NGS) are aware that Change Healthcare recently suffered a cyber-attack. Change Healthcare is a clearinghouse vendor that connects providers with insurance payers and has operations that impact the submission of Medicare claims, including NGS. At […]
