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. 

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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.

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Act Now to Prevent Psychology Prescribing in New York

Late last week, a bill (S. 5824) was introduced in the NYS Senate that would expand the scope of practice of psychology by authorizing psychologists to prescribe medication used in the diagnosis, treatment, and management of individuals with psychiatric, mental, cognitive, nervous, emotional or behavioral disorders.

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Jamaica Hospital Hosts Veterans Mental Health Training Session

On April 2, 2015, NYSPA and the Queens District Branch hosted a joint Grand Rounds at Jamaica Hospital Medical Center as part of its Veterans Mental Health-Primary Care Training Initiative (VMH-PCTI).  The VMH-PCTI provides educational programs on mental health issues affecting returning veterans and is supported by a $165,000 grant from the New York State Legislature.  The grant is intended to provide training for primary care providers, including physicians, physician assistants and nurse practitioners.  The training focuses on veteran-specific mental health disorders, including combat-related post-traumatic stress disorder (PTSD), depression, anxiety, substance use disorders and traumatic brain injury.  

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The Deadline for Mandatory Electronic Prescribing in 
New York has been Postponed until March 27, 2016

Visit the E-Prescribing section of our website where you will find a copy of the live webinar, FAQs about electronic prescribing and resource links. Additional information will be added as it becomes available.

 

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NYSP-PAC

 PAC Flag

by clicking HERE

 

Open Payments Physician Data Will Be Posted September 30, 2014 
Initial Deadline of August 27, 2014 to Review and Dispute Inaccuracies

Under the Open Payments program, CMS is required to publish data annually regarding payments and other transfers of value received by physicians from healthcare manufacturers and group purchasing organizations.  Physicians may register to view any financial data reported about them and request corrections where necessary. 

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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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Parity Enforcement Project

The Parity Enforcement Project is a joint initiative of NYSPA and the APA intended to provide psychiatrists and their patients with a new approach and new tools to fight back against discriminatory practices by health plans. The central goal of the Project is to identify and challenge existing parity violations, particularly in the context of disparate medical necessity reviews for behavioral health benefits, including:

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New Patient Disclosure Requirements Effective March 31, 2015

Public Health Law §24, enacted into law last year, requires, effective March 31, 2015, that all physicians, other health care providers and hospitals make certain disclosures to patients in treatment.  The new statutory requirement was prompted by the perceived problem of so-called “surprise bills” received by patients when they received inpatients or outpatient hospital and other outpatient surgical procedures. 

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ACA Audit Requests

Some NYSPA members have recently received requests for patient records sent by or on behalf of insurance carriers. These requests cite audit requirements established by the Affordable Care Act.

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Fair Insurance Coverage: It's the Law

Federal law prohibits your private health insurance plan from discriminating against you because you have a mental illness, including a substance use disorder. Click here to download a copy of a poster prepared by the APA that outlines your rights.

 

United Health Care Class Action Suit Update

On Tuesday, April 22nd, attorneys representing NYSPA and other plaintiffs in our federal lawsuit against United Health Care, filed our brief with the US Court of Appeals seeking to overturn the lower court decision dismissing our case. 

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Change to Dual Eligible Co-Payments

Effective July 1, 2015 there has been a change to the coinsurance reimbursement for dual eligible claims. Below is an excerpt from the June 2015 Medicaid Update addressing the reimbursement change.

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New York's Highest Court Issues Key Decision on Physician-Patient Privilege

 On May 5, 2015, the New York State Court of Appeals unanimously held in People v. Rivera that the physician-patient privilege was not abrogated in a criminal proceeding where a defendant's psychiatrist was called to testify at trial concerning the defendant's admission that he had abused a child.  NYSPA filed an amicus brief in the case arguing that the physician-patient privilege precluded the psychiatrist's testimony, which should not have been allowed.  The Court of Appeals agreed with NYSPA's position, affirming the Appellate Division's holding that the lower court erred in permitting the psychiatrist to testify and remanding the case for a new trial. 

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Attorney General Announces Parity Settlements with ValueOptions and Excellus Health Plan

The New York State Attorney General's Office recently announced two new settlements with insurance carriers aimed enforcing federal and state parity laws. On March 5, 2015, the Attorney General's Office released details regarding its settlement with ValueOptions (now known as Beacon Health Options), the managed care company that administers behavioral health benefits for The Empire Plan, MVP Health Care and EmblemHealth, among others. Just two weeks later, on March 18th, the Attorney General announced a settlement with upstate carrier Excellus Health Plan, part of the Blue Cross Blue Shield Association.

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NYSPA Launches Veterans Mental Health – Primary Care Training Initiative

The New York State Psychiatric Association was pleased to present the inaugural training session of the Veterans Mental Health – Primary Care Training Initiative (VMH-PCTI), a comprehensive program addressing veterans' mental health issues, at the Albany Medical Center, in Albany, New York, on Friday, November 14, 2014.  The program was jointly hosted by the Capital District Branch of the American Psychiatric Association and the Albany Medical Center Department of Psychiatry.

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NYSPA Signs Joint Letter Urging Delay In Mandatory eRx Implementation

NYSPA has joined with the Medical Society of the State of New York and 17 other provider organizations to urge New York State to delay implementation of the March 27, 2015 requirement for mandatory electronic prescribing because of concerns regarding vendor readiness. 

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NYSPA Honors C. Deborah Cross, M.D. with Distinguished Service Award

At its Spring meeting on March 22, 2014, the NYSPA Council awarded the NYSPA Distinguished Service Award to C. Deborah Cross, M.D. in recognition of her dedication, prodigious effort, intelligence and leadership in the profession of Psychiatric Medicine nationally and in the State of New York.   

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