AANEM News Express

AANEM News Express

AANEM Comments on NY Worker’s Comp Efforts to Drastically Cut EDX Reimbursement

10/26/2018
 
In August 2018, the New York Worker’s Compensation Board (NYWCB) proposed to adopt the new current procedural terminology (CPT) codes for EDX medicine created in 2013 by the Centers for Medicare & Medicaid Services (CMS). The adoption of these codes, under New York’s current worker’s compensation reimbursement system, would result in reimbursement cuts of up to 63%. 
 
AANEM promptly responded to the NYWCB’s proposal in August to outline the implications for both clinicians and patients. Unfortunately, the warnings went unheeded, and New York adopted the proposed changes. However, it did permit a 30 day comment period, so AANEM submitted a second letter.
 
The goals of the proposed changes, as stated in the NYWCB’s proposal, are as follows: “To increase provider participation in the worker’s compensation system and improve injured workers’ access to timely, quality medical care, the Worker’s Compensation Board (Board) is proposing an increase to provider fees.” 
 
“While proposed payment levels would’ve increased under the old EDX CPT codes, we explained that the actual payment for each of the nerve conduction study codes under the new EDX CPT codes would be significantly reduced,” said Millie Suk, JD, MPP, AANEM Health Policy Director. “The letter also outlined that the proposed changes will decrease provider participation, patient access, and quality of EDX care.”
 
While the NYWCB did adopt the proposal, AANEM is hopeful the NYWCB will be more receptive our comments as well as those from affected NY providers and other medical organizations, like the Medical Society of the State of New York, who have all voiced strong opposition. 
 
The comment period will close on November 1, 2018. No clear date was given for the NYWCB to respond to comments, but AANEM anticipates that it will be within the next 30 days. It appears that if the NYWCB proceeds with its adoption of the new codes and reimbursement, the changes would go into effect on January 1, 2019.


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