February 3, 2022
The Workers' Compensation Board is in the process of building a new online business information system, OnBoard, which will eventually replace the Board's legacy paper-based claims systems and the eCase system with a single, web-based platform. OnBoard will provide stakeholders with increased accuracy, paperless transactions and a user-friendly interface for interacting with the Board.
OnBoard: Limited Release, the first phase of OnBoard, will be implemented March 7, 2022. Medical suppliers should be aware of some key dates and updates ahead of the phased launch of OnBoard: Limited Release.
OnBoard: Limited Release (OBLR), which will roll out in three phases, is designed to move several key processes for health care providers and insurers from paper to online. This includes the prior authorization request (PAR) process for medication, durable medical equipment, and medical treatment or testing. It also includes the submission of Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0) within OBLR.
The three phases are explained in detail below, but here is a quick look at the implementation schedule:
|One||Medication PAR & Form HP-1.0||March 7, 2022|
|Two||Durable Medical Equipment PAR||April 4, 2022|
|Three||Treatment/Testing PARs||May 2, 2022|
Phase One (3/7/22): Medication PAR & Form HP-1.0
Medication PARs will be used for medication requests (replacing the current New York Workers' Compensation Drug Formulary [Drug Formulary] prior authorization request process).
As of March 7, 2022, health care providers and medical suppliers will request Board action on unpaid medical bills by submitting Form HP-1.0 online, ensuring accuracy and timely receipt. For now, health care providers and medical suppliers will continue to receive administrative and arbitration awards by mail, and the objection and judgement processes will remain paper based.
Phase Two (4/4/22): Durable Medical Equipment (DME) PAR (new)
- DME PARs will be used for requests in accordance with the new Official New York Workers' Compensation Durable Medical Equipment (DME) Fee Schedule.
DME Fee Schedule
The Board's new DME Fee Schedule, which lists the DME that may be supplied to an injured worker when medically necessary and in accordance with the applicable New York Medical Treatment Guidelines (MTGs), becomes effective on April 4, 2022, to coincide with the rollout of the new DME PAR in OnBoard: Limited Release. The Chair adopted a new DME Fee Schedule and PAR processes that were published in the State Register on March 3, 2021. The DME Fee Schedule was later updated on December 22, 2021, and another proposed update was published January 19, 2022. Information regarding all of these adoptions and proposals is available on the Regulations page of the Board's website.
Some items on the DME Fee Schedule require prior authorization and are marked as "PAR"; the treating provider will need to request prior authorization for these items. Any item not on the DME Fee Schedule also requires prior authorization by the provider. DME suppliers are not able to request prior authorization. Detailed information is available in the DME supplier fact sheet at wcb.ny.gov/onboard.
For more information about the DME Fee Schedule and updates, go to the Durable Medical Equipment Fee Schedule page of the Board's website.
Phase Three (5/2/22): Treatment/Testing
The PAR types for treatment/testing will be implemented in Phase Three. OBLR will use the information that health care providers enter to determine which type of PAR needs to be submitted.
- MTG Confirmation PARs will be used to request confirmation from the insurer that the procedure or test is based on a correct application of the MTGs, which was previously done using the Attending Doctor's Request for Optional Prior Approval and Carrier's/Employer's Response (Form MG-1).
- MTG Variance PARs will be used to request testing or treatment that varies from the MTGs applicable to the body part or condition being treated, which was previously done using the Attending Doctor's Request for Approval of Variance and Carrier's Response (Form MG-2).
- MTG Special Services PARs will be used to request authorization for special service(s), which was previously done using the Attending Doctor's Request for Authorization and Carrier's Response (Form C-4AUTH).
- Non-MTG Over $1,000 PARs will be used for requests for treatment costing over $1,000 for non-MTG body parts, which was previously done using the Attending Doctor's Request for Authorization and Carrier's Response (Form C-4AUTH).
- Non-MTG Under or = $1,000 PARs (new) will be used for requests for treatment costing $1,000 or less for non-MTG body parts.
In recent months, the Board has adopted more than a dozen new or updated MTGs. These will all become effective on May 2, 2022, when the remaining PAR types roll out within OnBoard: Limited Release.
The Board has training available on the new and updated MTGs. Each training provides an overview of the General Guideline Principles, diagnoses associated with the body part or condition, as well as diagnostic and treatment recommendations.
To register for the training courses and receive CME credits, go to MTG Training for CME Credit.
For the non-CME training, go to Training for Non-medical and Administrative Staff.
Information for Medical Suppliers
The Form HP-1 will become obsolete with the implementation of OBLR and will not be accepted after the launch date of the corresponding functionality in the system, which is March 7, 2022.
How to Prepare
Medical suppliers can take steps now to prepare for OnBoard: Limited Release, including:
- Request access to the Medical Portal to assign roles and receive an NY.Gov user ID and password. The NY.Gov credentials will be used to log into the Medical Portal. View the registration instruction guide and video for medical suppliers to learn more.
- Register an online administrator and assign delegates to assist with the drafting and submission of Form HP-1.0.
- Modify current processes to align with the new online submission of Form HP-1.0.
- Begin planning for staff training and administrative support.
- Take the training for the new Medication PAR and/or Form HP-1.0 processes found at wcb.ny.gov/onboard. Training on the other PARs will be available before Phases Two and Three roll out.
Medical Supplier Registration
Medical suppliers will need access to the Board’s Medical Portal to submit Form HP-1.0 through OnBoard: Limited Release. Suppliers who currently have access to the Medical Portal will automatically be granted access to OnBoard: Limited Release using the same login credentials. This will enable suppliers to add delegated users to assist with the drafting and submission of Form HP-1.0 submissions.
Note: Health care providers whose specialty is not listed in the Who Can Do What in the Medical Portal table and who need access to OnBoard: Limited Release to submit Form HP-1.0 will need to request access to the Medical Portal as a medical supplier. Detailed information about assigning delegated users and requesting access as a medical supplier is available on the Medical Portal information page (wcb.ny.gov/medicalportal/). Select the Access and Administration links under Health Care Providers and Medical Suppliers.
The Board has a number of resources available to keep medical suppliers informed about OnBoard: Limited Release and answer questions:
- A medical supplier-specific registration guide, video, training and other information about OnBoard: Limited Release is available at wcb.ny.gov/onboard.
- Training information will be shared via WCB Notifications. Sign up to receive these updates and others at wcb.ny.gov/onboard/#get-involved.
- Sign up for additional notifications related to the Board, such as Subject Numbers, at wcb.ny.gov/Notify.
- For assistance registering for the Medical Portal, contact Customer Support at WCBCustomerSupport@wcb.ny.gov.
- For questions about the MTGs, contact the Medical Director’s Office at WCBMedicalDirectorsOffice@wcb.ny.gov
- For general questions about the OnBoard project, email OnBoard@wcb.ny.gov.
- For any other questions, contact Customer Service at (877) 632-4996.
Clarissa M. Rodriguez