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.
HHS Announces Delay in ICD-10 Implementation
Health and Human Services (HHS) Secretary Kathleen G. Sebelius has announced a postponement for the implementation of ICD-10. The delay comes as the result of feedback from the American Medical Association, the American Hospital Association and the provider community. Each expressed concerns about the challenges and administrative burdens implementation will place on providers.
Marilyn Tavenner, acting CMS administrator, states that CMS will be re-examining the pace of ICD-10 implementation. The revised deadline date should be announced soon.
Although the deadline is postponed, it's important to prepare for this transition. ACA has a Web page dedicated to ICD-10. Please check this page frequently for important updates.
Source: American Chiropractic Association