The 2025 Medicare Fee Schedule has been posted to the NGS Medicare website.

On November 1, 2024, the Board issued a reminder that it will require health care providers to contract with an electronic submission partner to submit the CMS-1500 universal medical billing form electronically on their behalf beginning August 1, 2025.

On the Agenda, the official publication of the New York State Chiropractic Association (NYSCA), is published quarterly. It is designed to provide information about the Chiropractic profession and NYSCA activities and initiatives. 

Hello, NYSCA members and friends!

Effective November 16, 2024, the New York State’s Clean Slate Act goes into effect.

Chapter 56 of the Laws of 2021 amended Social Services Law § 413 to require additional training to include protocols to reduce implicit bias in decision-making processes, strategies for identifying adverse childhood experiences, and guidelines to assist in recognizing signs of abuse or maltreatment while interacting virtually within the New York State Mandated Identification and Reporting of Child Abuse and Maltreatment/Neglect coursework. This law requires that mandated reporters (which includes New York State Chiropractors), including those who have previously undergone the current training, complete the updated training curriculum by April 1, 2025.

We are pleased to announce that registration is now open for ACA Engage 2025, which will take place in Washington, D.C., Jan. 22 - Jan. 25 2025. A luxurious landmark in one of D.C.'s premier neighborhoods, the Omni Shoreham Hotel is the optimal location to host Engage 2025. Join us in the heart of our Nation’s Capitol for an unforgettable chiropractic event.

All Medicare providers and suppliers, including pharmacies, must not bill Medicare beneficiaries in the Qualified Medicare Beneficiary (QMB) eligibility group for Medicare Part A or Part B cost-sharing. This includes Medicare Part A and Part B deductibles, coinsurance, and copayments.

Read More: MLN Matters Fact Sheet October 2024

Mergers. Acquisitions. Affiliations. Increasingly common and complex. These relationships may have no bearing or influence on our practice and ability to provide high quality care to our patients, while others can have a profound impact. A current affiliation awaiting approval from New York State involves CDPHP and Lifetime Healthcare.

Beginning Jan. 1, 2025, the $15 copayment for the EmblemHealth-GHl portion of the Senior Care Plan will resume. Senior Care members will be required to pay a $15 copay each time they use the health services listed below. Copays are limited to one copay per provider per date of service.

Starting today 11/18/2024, healthcare providers won’t have access to beneficiary eligibility information on the NGS Medicare interactive voice response (IVR) system. This includes all beneficiary eligibility information that was obtained under Option 1, Eligibility. The IVR will continue to offer the other non-eligibility transactions.

Northeast College of Health Sciences will celebrate Veterans Day and its longtime partnership with the United States Department of Veterans Affairs (VA) by providing Veterans with complimentary healthcare screenings at its outpatient health centers in Depew, Levittown, and Seneca Falls, N.Y., throughout November. 

Northeast College Holds Long Island Campus Ribbon Cutting, Brings Chiropractic Education Back to Greater NYC Area

Northeast College of Health Sciences celebrated the official ribbon cutting of its new branch Long Island Campus on Oct. 11, 2024. During the event, local and state leaders welcomed Northeast and recognized the College for bringing chiropractic healthcare education back to the Greater New York City area.

UnitedHealthcare's Prior Authorization requirements for certain Medicare Advantage members (including UHC and AARP) are now in effect.  For more information, and to join us for a lunch and learn next week, please visit the UnitedHealthcare page in the members' only section of our website:

UnitedHealthcare

Every year there are updates to the ICD-10 codes. Listed below please find the codes most relevant to the Chiropractic profession per the cms.gov website. These changes take effect 10/1/2024. 

National Chiropractic Health Month to Promote Musculoskeletal Health for Aging Well

Arlington, Va. – The American Chiropractic Association (ACA) and doctors of chiropractic nationwide will celebrate National Chiropractic Health Month this October with the theme “Plan for a Strong Healthspan.” The campaign will raise awareness of the importance of a strong musculoskeletal (MSK) system for healthy aging and the benefits of chiropractic care.

On the Agenda, the official publication of the New York State Chiropractic Association (NYSCA), is published quarterly. It is designed to provide information about the Chiropractic profession and NYSCA activities and initiatives. 

Effective August 29, 2024, Humana is requiring prior authorization of certain Medicare Advantage members for chiropractic manipulative therapy rendered on or after August 29, 2024. The NYSCA Insurance Committee (NIC) reached out to Humana over the past week to ascertain whether prior authorization was required for Humana Medicare Advantage members in New York.

The NYSCA continues to communicate with Optum regarding the implementation of the new prior authorization program for AARP and UnitedHealthcare's Medicare Advantage members. We understand many of you have been attempting to determine the impact of this requirement on your practice and the patients you serve.  

In our next session of Your Morning Briefing, Amy L. Hemenway and Anna S.M. McCarthy will discuss how to address employee speech in the workplace. With the country gearing up for election season, and the strong feelings that are often elicited by differences in political opinions or reactions to any number of global current affairs, employers may face the challenge of how to handle conflicts that occur when employees discuss non-work-related topics with each other, wear or display polarizing images or text, or post opinions on social media.