Industry News

January 23, 2019 – NYS Workers Compensation Board releases new Medical Fee Schedule

The New York State Workers Compensation board released a notice today that the new Medical Fee Schedule has been adopted.   The new Medical Fee Schedule will be effective for services provided on or after April 1, 2019.  

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January 17, 2019 – OIG anticipates 2.9B in investigative recoveries for Fiscal Year 2018 according to semiannual report to congress

The Office of inspector General announced that they anticipate recovering approximately 2.91 billion dollars from those whom commit fraud and abuse towards the HHS programs for FY 2018.   As the crackdown on illegally prescribing opioids and prescription drugs continues…

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December 5, 2018 – Proposed changes to the NYS Workers Compensation Pharmacy fee schedule

New York State Workers Compensation Board released an amendment of the existing pharmacy fee schedule.   Public comments to be accepted for up to 60 days from the date of this release and may be sent to  

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November 15, 2018 - NYS Workers Comp Board moves to adopt CMS 1500 form

New York State Workers Compensation Board moves to adopt the CMS 1500 form for claim submission.  The Workers Compensation Board will be consolidating and eliminating certain forms to convert to the CMS 1500 form.   The Board will replace the following forms with the CMS-1500:

  • Doctor's Initial Report (Forms C-4, EC-4)

  • Continuation to Carrier/Employer Billing Section (Form C-4.1)

  • Doctor's Progress Report (Forms C-4.2, EC-4.2)

  • Ancillary Medical Report (Forms C-4AMR, EC-4AMR)

  • Doctor's Narrative Report (Form EC-4NARR)

  • Occupational/ Physical Therapist's Report (Forms OT/PT-4, EOT/PT-4)

  • Psychologist's Report (Form PS-4)

  • Ophthalmologist's Report (Form C-5)

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November 1, 2018 – CMS releases changes to the Medicare Physician fee schedule for Calendar year 2019

Centers for Medicare and Medicaid Services has issued updates to payment policies provided under the Medicare Physician fee schedule on or after January 2019.   One of the biggest changes will be the Evaluation and Management services.  

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October 12, 2018 – CMS announces 2019 Medicare Part A and B premiums and deductibles

Centers for Medicare and Medicaid services has issued an announcement for 2019 Part A and Part B premiums and deductibles. 

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July 25, 2018 – Revision to the C4 Auth form

New York State Workers Compensation Board’s C4 Auth form has been revised to remove instructions that a C8.1 disputed medical bill must be filed in cases where the insurance carrier denies the request for prior authorization (C4 Auth form)

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April 17, 2018 – Proposed changes to NYS Workers Compensation/No Fault fee schedules

New York State Workers Compensation Board announces a proposal to increase provider rates and adoption of the universal CMS 1500 form.   The current rates have been unchanged since June 2012.   The workers Compensation Board will be accepting public comments/concerns in the coming months.   Proposed rates and adoption of the CMS 1500 form are scheduled to go into effect late 2018/early 2019. 

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April, 6, 2018 – NYS Workers Compensation Board changes several medical authorization forms

New York State Workers Compensation Board has revised 5 medical authorization forms which will go into effect April 2018.   Forms which have changed are as follows:

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