New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
This Is Your Only Chance.....
The U.S. Department of Health and Human Services is in the process of developing a new Medicare fee schedule. This fee schedule will be based on the Resource-Based Relative Value Scale developed by Dr. William Hsiao of Harvard University. (Be watching future issues of "DC" for a clearer understanding of this revised scale.) The same scale will be used for all health care physicians according to their work relative value units.
The resource costs of each health care physician category is to be defined by the total of three components or relative value units. These components are: overhead costs, malpractice costs, and work costs (work relative value units). The work relative value unit is defined as your income, less your overhead and malpractice expenses. Every health care physician specialty is being asked to provide the Department of Health and Human Services (HHS) with information regarding these three components in order to be included in the proposed new rule.
Charles R. Booth, the director of the Office of Payment Policy for the Bureau of Policy Development, HHS has asked the chiropractic profession to provide them with the information necessary to allow chiropractic to be included in this process. Dynamic Chiropractic has been chosen to distribute the necessary survey and collect the information.
THIS WILL AFFECT HOW YOU ARE PAID BY MEDICARE!!!