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Re: The Rogak Report: The Most Useful Publication In The Insurance Claims Industry The Proposed New Acupuncture Fee Schedule

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  • lbins123@yahoo.com
    Right on dude. Mitch Lustig. Sent from my Verizon Wireless BlackBerry ... From: Lawrence Sender: TheRogakReport@yahoogroups.com
    Message 1 of 2 , Nov 2, 2010
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      Right on dude. Mitch Lustig.

      Sent from my Verizon Wireless BlackBerry


      From: "Lawrence" <insurancelawyer@...>
      Sender: TheRogakReport@yahoogroups.com
      Date: Tue, 02 Nov 2010 19:18:43 -0000
      To: <TheRogakReport@yahoogroups.com>
      ReplyTo: TheRogakReport@yahoogroups.com
      Subject: The Rogak Report: The Most Useful Publication In The Insurance Claims Industry The Proposed New Acupuncture Fee Schedule

       

      Dear Readers:

      This past July, the New York State Insurance Department published notice of its Proposed Thirty-Second Amendment to Regulation No. 83 (11 NYCRR 68).  The proposed regulation would add new Part L to Appendix 17-C of 11 NYCRR to read as follows:

      (L)  Licensed Acupuncture fees

           (a)     A licensed acupuncturist is an individual who has complied with the requirements of Article 160 of the Education Law.

           (b)     The maximum permissible charge for treatment rendered by a licensed acupuncturist shall not exceed the maximum permissible charge for a licensed physician certified to perform acupuncture in accordance with the Official New York Workers' Compensation Medical Fee Schedule referenced in 12 NYCRR 329.3.
      >

      There seems to be a lot of uncertainty out there about whether this new fee schedule has taken effect.  It has not.   I asked Buffy Cheung, the Supervising Insurance Examiner at the Property Bureau of the NYSID, and she responded to me today, as follows:  "The proposed amendment is not effective yet.  The Department is still reviewing the public comments."

      Therefore, for now, acupuncturist payments under No-Fault are guided by the prevailing court decision:  "As a matter of law... an insurer may use the workers' compensation fee schedule for acupuncture services performed by chiropractors to determine the amount which a licensed acupuncturist is entitled to receive for such acupuncture services" (Great Wall Acupuncture, P.C. v Geico Ins. Co, 26 Misc 3d 23, 24 [App Term, 2d, 11th & 13th Jud Dists 2009]).

      Larry Rogak 

      http://www.newyorknofaultadvisor.com/

       

       

       

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