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Provider Updates What Providers Need to Know

What Providers Need to Know - Archived Updates

September 28, 2021

Updates to Medical Treatment Guidelines

Board Chair Clarissa M. Rodriguez has adopted amendments to 12 NYCRR 324.2 to incorporate updates to the New York Medical Treatment Guidelines (MTGs)

You can access full details on the amendments, including a PDF of the respective MTGs, via Subject Number 046-1441, Subject Number 046-1442, and Subject Number 046-1443.

Training Available!

As a reminder, the Board recently launched online training on the newly adopted and updated MTGs. Each training, accessible on the Board's website, provides an overview of the General Guideline Principles, diagnoses associated with the body part or condition, as well as diagnostic and treatment recommendations.

As an added benefit, there is opportunity to obtain up to three complementary continuing medical education (CME) credits upon completion of each course. For those on your staff who would benefit from the training but do not need CME credit, non-CME versions of the presentations are available.

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.

CMS-1500 Transition Updates

To reduce the administrative burden on Board-authorized health care providers, the Board made the strategic decision to consolidate and eliminate certain medical billing forms and transition to using Form CMS-1500. The following timeline for this transition has recently been updated.

For more information, visit the CMS-1500 page or email CMS1500@wcb.ny.gov.

Reminder: CMS-1500 Medical Narrative Template & Requirements

The Board has developed a medical narrative report template that can be used to create the medical narrative report that accompanies provider submissions of Form CMS-1500.

The template includes at the top of the page the three mandatory elements to include with most narratives:

  1. the patient's work status,
  2. causal relationship of the injury to the patient's work activities, and
  3. temporary impairment percentage.

A medical narrative report may be found legally defective if these elements are missing.

When the medical narrative template is used, providers must attach a narrative report with examination findings, including:

In lieu of using the template, the provider's own medical narrative report is acceptable, if it includes and prominently displays:

For more information, visit the CMS-1500 page or email CMS1500@wcb.ny.gov.

Drug Formulary Update and Medical Marijuana Clarification

Regulations regarding the New York Workers' Compensation Drug Formulary (Formulary) that were adopted by Chair Clarissa M. Rodriguez and published in the September 1, 2021, State Register will be deferred from September 1, 2021, and will coincide with the launch of OnBoard: Limited Release, the first phase of the Board's new business information system. Those regulations include the following:

The Board is committed to giving stakeholders a four-week notification of the implementation date of OnBoard: Limited Release.

Visit the Board's website for more information about the Formulary.

Provider Registration and Delegate Assignment Continues for OnBoard: Limited Release

While we prepare for the Board's new business information system, OnBoard, and its early component OnBoard: Limited Release, the Board continues to encourage health care providers to register and assign delegates in preparation for the launch of our new system.

Health care providers must use the Medical Portal to access OnBoard: Limited Release (or to apply for Board authorization, or to renew their registration with the Board) which requires an NY.gov user ID and password for access.

The updated Medical Portal section of the website contains all of the details and information you need regarding how to register and get an NY.gov user ID and password (and grant access to others to act as your delegate) to access OnBoard: Limited Release.

Assigning delegates now will benefit you when OnBoard: Limited Release launches, as delegates can assist you by:

For additional information, including a walkthrough of the registration process, you can view a video tutorial, check out the provider registration guide or view a recording of the May 11, 2021 webinar for health care providers. You can also view an OnBoard: Limited Release fact sheet and FAQs for providers. Questions? Write to onboard@wcb.ny.gov.

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