Re: The Rogak Report: The Most Useful Publication In The Insurance Claims Industry The Proposed New Acupuncture Fee Schedule
- Right on dude. Mitch Lustig.
Sent from my Verizon Wireless BlackBerryFrom: "Lawrence" <insurancelawyer@...>Sender: TheRogakReport@yahoogroups.comDate: Tue, 02 Nov 2010 19:18:43 -0000To: <TheRogakReport@yahoogroups.com>ReplyTo: TheRogakReport@yahoogroups.comSubject: The Rogak Report: The Most Useful Publication In The Insurance Claims Industry The Proposed New Acupuncture Fee Schedule
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]).