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Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services)

6/13/2019

 
June 13, 2019 DWC Newsline Update

From the article: "The Division of Workers’ Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1."

"The Physician and Non-Physician Practitioner Fee Schedule update order adopts the following Medicare changes:
  • CMS Medicare National Physician Fee Schedule Relative Value File RVU19C July 1, 2019 quarterly update
  • National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits July 1, 2019 quarterly update
  • National Correct Coding Initiative Medically Unlikely Edits July 1, 2019 quarterly update (excluding MUE “0” value codes)
  • CMS ZIP Code to Carrier Locality files July 1, 2019 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping"

"The order adopting the OMFS adjustments is effective for services rendered on or after July 1, 2019 and can be found on the DWC website."

Another Secret to Success in Physical Therapy – Contract with high quality providers at a fair rate and then get out of the way.

6/5/2019

 
"Treating the patient - not just the injury - works!"
by Steve Cattolica - June 4, 2019

Ms. Michelle Despres, P.T. recently discussed one of the most widely known secrets of healthcare since the biopsychosocial model of practicing medicine was first discovered by a mother, father, grandparent or other loving adult when their child fell and skinned their knee. Studies by universities have confirmed what they knew!  Treating the patient - not just the injury - works!

With zeal to put this age old “secret” into practice, workers’ compensation systems nationwide have developed complete infrastructures capturing and packaging and controlling their contracted providers on behalf of their client, the claims administrator.  That infrastructure, including the costs of the claims duties it is purported to replace as more efficient, is now the costliest component in the work comp system - not injured worker indemnity benefits and not the actual hands-on care.

Let’s quickly examine the components of the model:

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HHS Pain Management Best Practices Inter-Agency Task Force Report:  Updates, Gaps, Inconsistencies, and Recommendations

6/4/2019

 
From the Assistant Secretary for Health report on May 30, 2019 report: "The Comprehensive Addiction and Recovery Act of 2016 (CARA) required the Pain Management Best Practices Inter-Agency Task Force to develop the Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations - PDF*, which identified gaps or inconsistencies, and proposed updates to best practices and recommendations for pain management, including chronic and acute pain."

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