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
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
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
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
Clarification on the New G2211- Are You Billing Correctly? National Government Services (NGS) addresses critical questions and clarifies the new G2211 code to ensure healthcare providers are billing accurately. As part of the Evaluation and Management Services, understanding the nuances of G2211 is crucial for compliance and optimal reimbursement.
The Cigna Group Announces Plan to Divest Medicare Advantage and CareAllies Businesses The Cigna Group announced an agreement to divest its Medicare Advantage, Cigna Supplemental Benefits (which includes Medicare Supplemental Benefits), Medicare Part D, and CareAllies businesses to Health Care Service Corporation (HCSC). This includes all their Medicare plans, networks, and customers, as well as
2024 Deleted CPT Codes Do you need a copy of the 2024 deleted CPT codes? Send an email requesting it, and we will send it to you. You will receive the codes and the AMA's recommended replacement code in this Excel sheet. Please contact MSSNY Payment & Practice with any questions you may have.
CMS Interoperability and Prior Authorization Final Rule CMS-0057-F The Centers for Medicare & Medicaid Services (CMS) affirms its commitment to advancing interoperability and improving prior authorization processes by publishing the CMS Interoperability and Prior Authorization final rule (CMS-0057-F). Through the provisions in this final rule, Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance
New Federal Independent Dispute Resolution (IDR) Administrative Fee and Certified IDR Entity Fee Ranges Posted The Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury (collectively, the Departments) updated the No Surprises Act website to reflect upcoming changes to the Federal Independent Dispute Resolution (IDR) certified
NYRx E&O Update Flovent® and Advair® products continue to be included in the NYRx Brand Less Than Generic Program (BLTG). Due to recent changes announced by the manufacturer including the discontinuation of Flovent® and the decreased production of Advair®, effective December 21, 2023, the NYRx Medicaid Pharmacy Program will allow for the generics to these
