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In response to staffing and other changes put in place related to the COVID-19 pandemic, the Workers’ Compensation Board is updating some processes to ensure timely continuity of programs within the workers’ compensation system.
Health care providers have been instructed to submit prior authorization requests for medical procedures to their insurance carrier’s designated email contact as posted on the Board’s website, rather than a fax number. Fax submissions may not be able to be reviewed in a timely manner because many insurer staff members are working remotely. Prior authorization requests for non-formulary medications should continue to be submitted through the medical portal.
All insurance carriers, self-insured employers, and third-party administrators should forward their fax number to their designated email contact to ensure that these non-formulary prior authorization requests are received and acted upon accordingly.
The Board will only issue Orders of the Chair (OOC) for emailed prior authorization requests listed below that are not responded to in a timely manner. An OOC will not be issued for a faxed prior authorization request.
These instructions pertain to the following forms:
Form Type
Carrier's Email Address
Attending Doctor’s Request for Optional Prior Approval and Carrier's/Employer's Response (Form MG-1)
Contacts for Optional Prior Approval
Attending Doctor's Request for Approval of Variance and Carrier's Response (Form MG-2)
Contacts for Variance Approval
Attending Doctor's Request for Authorization and Carrier's Response (Form C-4 AUTH)
Contacts for Pre-Authorization
The NY Workers’ Compensation Drug Formulary Prior Authorization process will continue to be used for prescriptions that require prior authorization.
We also ask that your Medical Treatment Guidelines administrator verify your designated email contact and update it if necessary.
Thank you for your cooperation. Please contact the Board at WCBMedicalDirectorsOffice@wcb.ny.gov if you have any questions.
The Centers for Medicare & Medicaid Services (CMS) extended the 2019 Merit-based Incentive Payment System (MIPS) data submission deadline to April 30 at 8 pm E.S.T.
CMS also announced that the MIPS automatic extreme and uncontrollable circumstances policy will apply to eligible clinicians who are unable to submit their data by the April 30 deadline.
Qualifying clinicians will be identified automatically, without having to take any additional action, and will receive a neutral payment adjustment for the 2021 MIPS payment year.
CMS also reopened the MIPS extreme and uncontrollable circumstances application. Individual clinicians and groups that started but cannot complete their data submission, as well as virtual groups that are unable to start or complete their data submission, should apply. Applications submitted between April 3 and April 30 citing COVID-19 will override all previous data submissions.
Contact the Quality Payment Program at 866-288-8292, Monday through Friday, 8 a.m. to 8 p.m. E.S.T. or by email at QPP@cms.hhs.gov.
Download the Quality Payment Program COVID-19 Response Fact Sheet…
AAOS released updated guidelines on elective surgery during the COVID-19 pandemic. These guidelines should be applied judiciously depending on your location, where your area/institution happens to be situated relative to the curve of the disease, and the availability or scarcity of your resources, including personal protective equipment, intensive care unit (ICU) beds, respirators, and personnel. It is AAOS’ position that every locality should be making their own decisions based on the availability of resources and personnel. In these situations, a panel that includes the head of the hospital (or the designee), chief of the ICU, chief of anesthesia, and chief of orthopaedic surgery should form a committee to review any prospective surgery. W
here feasible, input from the state department of health should be solicited.
Read the guidelines…
AAOS President Joseph A. Bosco III, MD, FAAOS, sent a letter to members detailing the online actions AAOS is taking to help manage and emerge from the COVID-19 pandemic as strong as possible.
AAOS temporarily pivoted off its Strategic Plan to devote nearly all of its resources to helping members mitigate the effects of COVID-19.
The three pillars of the AAOS COVID-19 Action Plan are: (1) communication, (2) advocacy, and (3) practice management.
Dr. Bosco said in closing, “I have faith that each of us will contribute in whatever way we can or have to. There is work and sacrifice to be made, and our profession has a rich history of selflessness in the face of adversity. I am certain that the upcoming weeks will be no exception.”
> Read the letter
On April 2, 2020, New York passed legislation, entitled "Emergency Disaster Treatment Protection Act," (the "Act") that provides comprehensive immunity from liability to health care professionals and health care facilities. Previously, New York's Governor issued Executive Orders that provided for limited liability for thirty day periods. The Act is retroactive to cover acts or omissions that occurred on or after March 7, 2020, the date of the COVID-19 emergency declaration in New York State , through the expiration date of that declaration.
The stated purpose of the Act, which took effect immediately, is to promote the public health, safety, and welfare of all citizens by broadly protecting the health care facilities and health care professionals in New York State from liability that may result during the public health emergency.
The most significant difference in the Act from the Executive Orders is that the health care facilities, along with volunteer organizations and an expanded class of individuals , are protected from liability. The Act also provides immunity protection from criminal liability in addition to civil liability. Finally, the Act clarifies that the exemption for willful or intentional misconduct does not include acts, omissions, or decisions that result from a resource or staffing shortage. This language will protect professionals and facilities against actions and decisions in rationing medical devices and services, among others.
Read the complete summary provided by MLMIC
Healthcare entities should continue to submit requests for PPE through their local Office of Emergency Management. New York State continues to fulfill requests for PPE, as available. However, NYSDOH has become aware of instances in which healthcare providers, facilities, or practices are using or considering alternative means to manage PPE shortages,such as:
If all efforts to obtain PPE through vendors and local Office of Emergency Management are exhausted or unsuccessful, healthcare providers should refer to the CDC guidance entitled “Strategies for Optimizing the Supply of PPE”
Conventional, then contingency, then crisis capacity strategies should be used in that order, as feasible.
Many of the options from the CDC guidance document are summarized in the advisory.
For general guidance on the use of PPE in healthcare settings, please refer to CDC guidance entitled “Healthcare Supply of Personal Protective Equipment”
The Governor announced that, through June 1, 2020, consumers and businesses experiencing financial hardship due to COVID-19 may defer paying premiums under individual and small group health insurance policies. DFS shall consider any liquidity or solvency concerns of the health plans. During this period, health plans will be required to continue to pay claims, not to report late payments to credit rating agencies, and to work with individuals to help them transition to new coverage, if appropriate. In addition, insurers are reminded that they cannot impose late payment fees. Governor Cuomo thanked Connecticut Governor Ned Lamont for his collaboration on this initiative.
Access the complete release (Information found on page 2)
The Federal Bureau of Investigation (FBI) has released an article on defending against video-teleconferencing (VTC) hijacking (referred to as “Zoom-bombing” when attacks are to the Zoom VTC platform). Many organizations and individuals are increasingly dependent on VTC platforms, such as Zoom and Microsoft Teams, to stay connected during the Coronavirus Disease 2019 (COVID-19) pandemic. The FBI has released this guidance in response to an increase in reports of VTC hijacking.
The Cybersecurity and Infrastructure Security Agency encourages users and administrators to review the FBI article as well as the following steps to improve VTC cybersecurity:
CISA also recommends the following VTC cybersecurity resources:
This advisory supersedes specimen collection and handling guidance from NYSDOH, released originally on March 25, 2020.
This update further extends previous recommendations that nasal and oropharyngeal swab specimen collection is an acceptable alternative, with recommendations for the collection of one (1) nasal swab AND one (1) saliva specimen through healthcare personnel (HCP) observed patient self-collection for specimens submitted to Wadsworth Center,if nasopharyngeal (NP) supplies are unavailable.
If you are using a laboratory other than the Wadsworth Center, follow the laboratory’s guidance for all specimen collection, handling, and transport processes, including whether nasal swab AND saliva specimen, or nasal swab AND OP swab specimen collection methods are acceptable alternatives to an NP swab.
Advocating for the orthopaedic surgeon, patients and musculoskeletal health in New York.
info@nyssos.org 1-518-439-0000 Address: PO Box 38004, Albany, NY 12203
