• Wednesday, April 01, 2020 1:17 PM | Jennifer Casasanta (Administrator)

    Program Description:

    Appropriate Use Criteria

    • Ordering providers role in Appropriate Use Criteria mandatory 1/1/2021
    • Review Clinical Decision Support Mechanism tools available to incorporate in practices work flow to ensure additional clinical data can be efficiently gathered
    • Requirements, exemptions, and ensuring medical necessity
    • Understanding CPT and modifier updates to prevent denials

    Link to the Care Select Demo https://qcdsm.nationaldecisionsupport.com/


  • Monday, March 23, 2020 9:38 AM | Jennifer Casasanta (Administrator)

    Centers for Medicare & Medicaid Services

     

    Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19

     

    CMS announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs. The action comes as part of the Trump Administration’s response to 2019 Novel Coronavirus (COVID-19)

    CMS is implementing additional extreme and uncontrollable circumstances policy exceptions and extensions for upcoming measure reporting and data submission deadlines for several CMS programs.  For those programs with data submission deadlines in April and May 2020, submission of those data will be optional, based on the facility’s choice to report.

    CMS recognizes that quality measure data collection and reporting for services furnished during this time period may not be reflective of their true level of performance on measures such as cost, readmissions and patient experience during this time of emergency and seeks to hold organizations harmless for not submitting data during this period.

    You can find a copy of the press release here:  https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting

    CMS will continue monitoring the developing COVID-19 situation and assess options to additional relief to clinicians, facilities, and their staff so they can focus on caring for patients.

    This action, and earlier CMS actions in response to COVID-19, are part of the ongoing House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, please visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Webpage on CMS.Gov.

     

     

    Centers for Medicare & Medicaid Services (CMS) has sent this Center for Medicare and Medicaid Innovation (CMMI) Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.


  • Monday, March 16, 2020 10:19 AM | Jennifer Casasanta (Administrator)

    Medicaid Update Special Edition, issued by the New York State Department of Health, featuring Guidance for Telephonic Communication Services During a State of Emergency Related to Coronavirus Disease 2019 (COVID–19).

     COVID-19_Telephonic_Services_SpecialEdition_MedicaidUpdate_03-2020.pdf

    This Medicaid Update Special Edition is also available on the Medicaid Update webpage: https://www.health.ny.gov/health_care/medicaid/program/update/2020/index.htm


  • Friday, March 13, 2020 11:18 AM | Jennifer Casasanta (Administrator)

    Centers for Medicare & Medicaid Services

     

    COVID-19 MAC Test Pricing

    Today, the Centers for Medicare & Medicaid Services (CMS) is posting a fact sheet to the CMS.gov website to aid Medicare providers with information relating to the pricing of both the CDC and non CDC tests.  You can find the fact sheet here:  https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf

    Additionally, CMS will be tweeting about this new information.  Tweets can be found below. We encourage relevant stakeholders to retweet.

    • Medicare will be covering  #COVID19 tests, and there is generally no copay for original #Medicare - deductible applies. @CMSGov is also permitting #MedicareAdvantage plans to waive cost sharing for these tests.

     

     

    Earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work CMS is doing in response to COVID-19, please visit the Current Emergencies Website.

     

    Centers for Medicare & Medicaid Services (CMS) has sent this Center for Medicare and Medicaid Innovation (CMMI) Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.


  • Friday, March 13, 2020 10:15 AM | Jennifer Casasanta (Administrator)

    On March 12, 2020, the Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) to the Medicaid.gov website to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the 2019 Novel Coronavirus (COVID-19) outbreak.  CMS is taking this action in its continuing efforts to protect the health and safety of providers and patients, including those who are covered by Medicaid and CHIP.

    A press release with further information can be found here:  https://www.cms.gov/newsroom/press-releases/cms-publishes-first-set-covid-19-frequently-asked-questions-faqs-state-medicaid-and-childrens-health

    The COVID-19 FAQs for State Medicaid and CHIP agencies can be found here:  https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/covid19/index.html

    These FAQs, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work CMS is doing in response to COVID-19, please visit the Current Emergencies Website.  


  • Thursday, March 12, 2020 1:54 PM | Jennifer Casasanta (Administrator)

    The following guidance would only be effective until the official Declared Disaster Emergency in the State of New York over COVID-19 has ended.

    Medicaid Pharmacy Guidance Disaster Emergency in the State of New York.pdf

  • Wednesday, March 11, 2020 9:46 AM | Jennifer Casasanta (Administrator)

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  • Wednesday, March 11, 2020 9:03 AM | Jennifer Casasanta (Administrator)

    The New York State Department of Health issued a special edition of the Medicaid Update today, March 10, 2020, featuring New York State Medicaid Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 (COVID–19).  This Medicaid Update can be found at: https://health.ny.gov/health_care/medicaid/program/update/2020/2020-03-10_covid-19.htm.


  • Tuesday, February 25, 2020 9:31 AM | Jennifer Casasanta (Administrator)

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    CMS-1500 Q&A Webinars

    In order to increase health care provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) is supporting electronic submission of CMS-1500 forms, along with a medical narrative. The CMS-1500 streamlines medical billing and may reduce the paperwork requirements currently in the workers' compensation system.

    Free webinar to address your questions

    The Board is hosting two free online Q&A webinars to give you an update on the initiative and answer your questions about CMS-1500. Each one-hour session will provide a brief overview of the CMS-1500 initiative as well as the most frequently asked questions we’ve received. We will use the remaining time to answer any additional questions you have. Each webinar will cover identical material.

    Registration is required. You can register for either session at:  http://www.wcb.ny.gov/webinars/

    April 7, 2020: 10:00 a.m. - 11:00 a.m.

    April 8, 2020: 2:00 p.m. - 3:00 p.m.

    Register now

    More information

    We encourage you to review the CMS-1500 training video (recorded from the first CMS-1500 webinars held in September 2019) and make note of any questions you have prior to attending one of the webinars.

    You can also visit CMS-1500 Initiative and CMS-1500 FAQ for more information. The Board will post responses to questions received during the webinars in the FAQ section of the website.

    To stay informed of Board news, sign up to get WCB notifications.


  • Thursday, February 06, 2020 3:20 PM | Jennifer Casasanta (Administrator)


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