Updated Fees for Physicians As part of the New York State (NYS) Enacted Budget for fiscal year (FY) 2023-2024, the NYS Department of Health (DOH) was authorized to benchmark NYS Medicaid fee-for-service (FFS) reimbursement rates to 80 percent of current Medicare reimbursement rates for non-facility services. This change will impact the NYS Physician Fee Schedules: Medicine,
No Surprises Act Independent Dispute Resolution The Federal Independent Dispute Resolution (IDR) process remains temporarily suspended. Disputing parties are unable to initiate new disputes, and, effective August 25, 2023, the Departments have directed certified IDR entities to pause all IDR-related activities. The Departments will issue updates in the near future and will provide specific directions
Registration Open for 2023 CMS Conference on Optimizing Healthcare Delivery Registration is now open for the 2023 CMS Conference on Optimizing Healthcare Delivery to Improve Patient Lives, November 15, from 9 AM – 4 PM ET. After registering, please look for a confirmation email from [email protected]. If you do not see it in your primary
Federal IDR Process Updates Physicians may have received a notification last week regarding suspension of the Federal IDR process. The information that was sent out was from the Department of Health & Human Services. MSSNY is working with CMS to ensure we get updates to provide to our members as this develops. Effective August 7,
National Study to Document Changes in Physician Practice Expense The American Medical Association (AMA) is undertaking a new national study, supported by 173 healthcare organizations, to collect representative data on physician practice expenses. The aim of the Physician Practice Information (PPI) Survey is to better understand the costs faced by today’s physician practices to support
Are You Looking for Premium Increase Data? If you want to collect data on insurance company premiums, this information is available on the Department of Financial Services website. The information can be used for various purposes, from negotiating contracts to general awareness.
Issues with Insurers? MSSNY Recoups Over $7.5 Million for Members MSSNY’s Division of Physician Payment and Practice is here to help our members. Over the last two years, the division has dealt with over 1,000 different issues and has recouped over $7.5 million for our members from medical insurance providers. Heather Lopez, MSSNY’s Director of Physician
Unwinding the Public Health Emergency: Keeping New Yorkers Covered Fidelis Care invites you and your staff to an informational webinar on Thursday, June 22, at 11 am, about the renewal changes underway in Medicaid, Child Health Plus, Essential Plan, Health and Recovery Plans, and Managed Long Term Care plans in New York State. Members of Fidelis Care's
Missed the NYRx Live Medicaid Pharmacy Program? ICYMI: Check out this week’s webinar NYRx, the Medicaid Pharmacy Program Webinar – PDP, DUR, BLTG on the upcoming changes with the NYRx. Topics include: NYRx, the Medicaid Pharmacy Program Overview Preferred Drug Program (PDP) Brand Less Than Generic Program (BLTG) 72 Hour Emergency Supply NYRx Education &
An Update on UHC's GI Endoscopy Prior Authorization Program MSSNY and 172 other esteemed organizations expressed concerns regarding United Healthcare's (UHC) proposed implementation of additional prior authorizations in the GI endoscopy program. We stressed the significant impact such measures would have on our dedicated gastrointestinal physicians and their teams. In recent developments, UHC has temporarily
