What Providers Need to Know - Archived Updates
April 21, 2025
CMS-1500 electronic mandate approaching! Cost offset available now.
The Board encourages health care providers who are still submitting paper CMS-1500 medical bills to move to electronic submission as soon as possible to take advantage of increased accuracy and more timely payment, among other key benefits.
To assist providers with the transition, the Board has been hosting regular webinars for providers. The sessions cover the benefits of electronic submission as well as the process, and include time for questions. Visit the Upcoming Webinars section of the Board's website to register or go to the Recorded Webinars page to watch a recording of a recent session.
The Board has also created a fact sheet to walk providers step-by-step through the process of working with an electronic submission partner.
Read more in a notification dated April 10, 2025.
Clarification of Subject Number 046-124: Rights and Responsibilities of Parties to a Workers' Compensation Claim When Communicating with Treating Health Care Professionals and Independent Medical Examiners
The Board is aware that some attorneys believe that Subject Number 046-124 precludes interested parties from any communication with a health care professional who has treated or examined an injured worker. To clarify, Subject Number 046-124 was never intended to be interpreted as precluding proper communication with a health care professional who has treated or examined an injured worker. Proper communication can be helpful to obtain clarity and avoid unintended disputes resulting in litigation.
Read more in Subject Number 046-1749.
Proposed Amendments to Sections 440.3, 440.4, and 441.3 and Title 12 of the NYCRR (Network Pharmacies)
The Chair proposes amendments to section 440.3, 440.4, and 441.3 of Title 12 of the NYCRR to provide that a payer must notify the claimant that they may use a non-network pharmacy when the payer maintains (or will maintain) a legal objection that the medication is for treatment of an injury or condition that has not yet been accepted or established by the Board.
The Board is currently assessing public comments received during the public comment period.
Read more in Subject Number 046-1731.
Reminders
- Interested in treating injured workers? If you are interested in applying for Board authorization to treat injured workers, the process is easy and is done online. Read more about becoming authorized on the Board's website.
- The What Providers Need to Know section of the Board's website features a one-stop-shop that walks health care providers through getting started in the workers' compensation system, treating injured workers, billing for services, and more.
- Telehealth is now a permanent option in the workers' compensation system. Read more in Subject Number 046-1613.
- Use of the CMS-1500 form is mandatory. Visit CMS-1500 initiative for more details and send your questions to CMS1500@wcb.ny.gov.
- Visit the Board's website for OnBoard training guides, webinar recordings, and other resources.
- Efficiency Enhancements is a new communication with tips and best practices on using Board systems, processes, and forms in the most efficient, effective manner. Sign up to receive these, and other updates, straight to your inbox.
- The latest versions of several Paid Family Leave presentations are available, including family care, foster care/adoption, military leave, and bonding. Visit the Paid Family Leave website for more information.
Stay informed!
Check out Recorded Webinars for health care providers on the Board's website. Health Care Providers Recorded Webinars web page for past webinars.
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