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New York: Board adopts new fee schedule, addresses narcotics use

The Workers' Compensation Board adopted regulations to implement new health provider fee schedules.

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The new fee schedules include a 30 percent increase in evaluation and management services in the medical and podiatry fee schedules. The chiropractic fee schedule was restructured to allow chiropractors to bill separately for individual treatment modalities rather than billing for an office visit that includes all treatment. The schedules adopt the medical treatment guidelines as the basis for treatment to the mid and lower back, neck, shoulder, and knee. Additionally, current procedural terminology codes were updated to accommodate changes made by the American Medical Association. The new fee schedules went into effect on Dec. 1, 2010. The board also announced that it plans to study the overall health provider fee schedule over the next 12 months and propose a revised set of provider fee schedules. For more information, visit www.wcb.state.ny.us/content/main/SubjectNos/sn046_447.jsp.

Narcotic medications. The Workers' Compensation Board issued a bulletin addressing concerns that have been raised that claimants on long-term narcotics and other pain medications will have their medications discontinued because of recommendations in the medical treatment guidelines. The board stated that claimants who have been receiving long-term narcotics and other pain medications prior to Dec. 1, 2010, should continue to have their prescriptions paid for by carriers and filled by pharmacies without a variance request. The guidelines state that use of narcotic medications beyond two weeks is acceptable in appropriate cases. Use beyond two weeks should be documented and justified beyond the diagnosis and invasive procedures. The board mentioned that further guidelines for the long-term use of narcotics and other pain medications will be developed in the near future. For a copy of the bulletin, visit www.wcb.state.ny.us/content/main/SubjectNos/sn046_457.jsp.

January 24, 2011

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