DrFirst Named as New NYSPA Endorsed eRx Vendor

NYSPA is pleased to announce that it has endorsed DrFirst as its new preferred vendor for electronic prescribing software. NYSPA's previous endorsement agreement with RxNT recently ended and NYSPA has been in the process of identifying a new preferred vendor. As before, NYSPA's relationship with DrFirst will offer NYSPA members the opportunity to purchase electronic prescribing software at a significant discount.

DrFirst is a leading software company that offers an electronic prescribing platform in both a desktop and mobile application format.  DrFirst provides medication history data access, legend drug and controlled substance e-prescribing (EPCS) and patient medication adherence support.



Psychiatrists who treat Medicare Part B patients and who do not qualify for a 2017 exclusion have less than 2 months to participate in MIPS during 2017 to avoid a penalty in 2019.  The Merit-Based Incentive Payment System (MIPS) is the new Medicare Quality Payment Program that consolidates all pre-existing quality programs, including PQRS, the Medicare EHR Incentive Program and the Value-Based Modifier. 


100% Pre-Payment Review of CPT Code 99214

Medicare has initiated a special targeted pre-payment review of all CPT code 99214 services.  After conducting a review of documentation for this level outpatient office visit for an established patient, Medicare has concluded that the documentation often failed to meet the CPT documentation requirements for this service.  Psychiatrists may be using Code 99214 in combination with an add-on psychotherapy visit such as 90833, 90836, or 90838.  NYSPA has prepared a guideline for minimum documentation requirements for Code 99214.  Members can click here to read and download the NYSPA guidelines. Failure to record the minimum required documentation for a Code 99214 can result in disallowance or reduction to a lower level E/M code and recovery of overpayments.

Under pre-payment review, your claim will be pended until documentation is reviewed. If you do not respond to the records request, the claim will be denied.


New ICD–10–CM Coding Updates at a Glance

New ICD–10–CM codes are to be used for coding purposes in the United States for dates of service beginning October 1, 2016.


Electronic Prescribing Waiver Applications Now Available

The Bureau of Narcotic Enforcement (BNE) recently released its online electronic prescribing waiver request process, available through the Health Commerce System. Prescribers must have a Health Commerce System account in order to use the online waiver application. Paper applications are also available by calling BNE at 1-866-811-7957. One-year waivers may be granted to prescribers who demonstrate economic hardship, technological limitations or other exceptional circumstances. BNE has provided the following instructions for completing the online waiver application via the Health Commerce System: 

Instructions for Individual Practitioners - Click Here

Instructions for Group Practices - Click Here 


NYSPA Responds to Executive Order on Homeless

NYSPA responded on January 4, 2016 to an Executive Order from Governor Cuomo requiring local governments across the state to bring homeless individuals to shelters in freezing temperatures. A copy of both the Executive Order and NYSPA's letter to Ann Sullivan, MD, Commissioner of the New York State Office of Mental Health, can be accessed by clicking the links below.

Text of Executive Order signed by Governor Cuomo

Letter from NYSPA to Commissioner Sullivan



Eighth Annual Scientific Paper Contest

The New York State Psychiatric Association is pleased to announce its Eighth Annual Scientific Paper Contest

Eligibility: Any APA Resident Fellow Member (RFM) who is a Resident or a Fellow in an approved program in NYS is eligible.


Workers’ Comp Board: Physicians Must Register by January 15, 2018

The Workers’ Compensation Board (Board) has initiated a registration process to update and maintain a current list of medical providers who are authorized to treat injured workers. The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.

You should have been be notified in November when registration opened for Board-authorized medical providers. Authorized providers are asked to register with the Board and update their office address (es) and contact information by January 15, 2018. This registration process will be an ongoing initiative every two to three years.

Medical providers who have not registered by January 15, 2018 will:

  • be removed from the public directory of Board authorized providers, and
  • become ineligible for the Board’s disputed bill process.

Creating an Account in the New York State Health Commerce System (HCS). The Board will use the existing New York State Health Commerce System (HCS) for this registration process. For the initial registration and for future updates to your practice information, you will need to have an HCS account. If you don’t already have one, you can view directions to create an account on the New York State Department of Health website.

Need Help?
If you are not sure if you already have an HCS account, contact the Commerce Account Management unit (CAMU) at (866) 529-1890 and select option 1. For general questions about health care provider registration, please contact the Board’s Customer Support at (844) 337-6305.

Worker Comp Questions? Email us or call Customer Service at (877) 632-4996


Identifying Fee and Reimbursement Discrimination for Mental Health Services 

As part of our efforts to enforce federal mental health parity laws, the New York State Psychiatric Association has prepared two forms for individuals to submit to their health insurance plans to request information about the fees paid for outpatient services including services used in the treatment of mental illness.  NYSPA spearheaded successful efforts to secure mental health parity in New York.  The American Psychiatric Association was a key advocate for enactment of federal law mandating health insurance parity for the treatment of mental illness.  Once state and federal parity laws were passed and became effective, our efforts now must switch to parity enforcement.


NYSPA Congratulates Richard Gallo, 

recipient of the Families Together in New York State (FTNYS) 2017 Advocate of the Year Award. 

In announcing the award, FTNYS stated: “Richard Gallo is a familiar


NYSPA Congratulates Glenn Martin, M.D.. DFAPA

on his promotion to the dual positions of Senior Associate Dean for Human Subjects Research and Executive Director of the Program for the Protection of Human Subjects (PPHS) at Icahn School of Medicine at Mount Sinai (ISMMS).  Dr. Martin has been a member of the full-time ISMMS Department of Psychiatry faculty for nearly twenty years, most recently serving as Director of Medical Informatics at Elmhurst Hospital Center and Queens Hospital Center.


NY Out of Network Preservation Group

Join the NY Out of Network Preservation Group, a unified, coordinated effort by 300 Physicians from all NY societies, associations, institutes and departments to pool resources for future strategies to maintain Out of Network Coverage, including PR to warn NY patients about losing their freedom to choose Physicians.   

No dues or applications required. Email Einbinder@aol.com

OMIG Rescinds Medicaid Crossover Audit

Today, NYSPA received a letter from the NYS Office of the Medicaid Inspector General rescinding demand letters for repayment of claimed Medicaid overpayments for services provided to individuals who were covered by both Medicare and Medicaid.


NGS Medicare Will Soon Reject Handwritten Claim Forms

Beginning August 7, 2017 for upstate providers (localities 03 and 99) and November 13, 2017 for downstate providers (localities 01, 02 and 04) all handwritten claims submitted to NGS Medicare will be returned to providers with a note attached stating that a new claim will need to be submitted. All submitted, or resubmitted, claims after these dates will need to be either printed (not handwritten) paper claims or electronically submitted claims.


Mandatory Prescriber Education Requirement

The Department of Health recently issued FAQs on the new requirement for mandatory prescriber education in pain management, palliative care and addiction pursuant to Public Health Law §3309-a(3). 

The statute requires all physicians (including all non-physician prescribers) who have a DEA registration number to complete at least three hours of course work or training in pain management, palliative care and addiction no later than July 1, 2017 and once every three years thereafter.  The course work or training must cover eight mandatory training topics, including New York State and federal requirements for prescribing controlled substances; pain management; appropriate prescribing; managing acute pain; palliative medicine; prevention, screening and signs of addiction; responses to abuse and addiction; and end of life care.


Summary of New Requirements for Health Care Providers Under Section 1557 of the Affordable Care Act

The U.S. Department of Health and Human Services (HHS) recently promulgated regulations to implement Section 1557 of the Affordable Care Act, which prohibits discrimination in certain health programs and activities based on race, color, national origin, sex, age or disability. The new rule requires that health care entities subject to Section 1557 provide notice of their nondiscriminatory policies to the public.


NYSPA Letter Expresses Concerns About Justice Center Investigations

Last week, NYSPA sent a letter to Jeff Wise, Executive Director of the NYS Justice Center, expressing concerns raised by psychiatrists regarding the manner in which Justice Center investigations are conducted. Many NYSPA members work in facilities under the jurisdiction of the Justice Center, including inpatient psychiatric units in general hospitals, CPEPs and outpatient mental health clinics. We identified the following issues of concern:


Federal Court Holds That NYSPA
Has Standing to Sue United Healthcare

In a precedent-setting decision issued earlier today, the Second Circuit Court of Appeals held that NYSPA has associational standing at this point in the litigation to challenge alleged parity violations by United HealthCare in its role as claims administrator. 


Providers Must Transition to ICD-10 by October 1, 2015

As you may be aware, on October 1, 2015, all HIPAA-covered entities must transition from using ICD-9 codes to using ICD-10 codes.

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