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NYS Society of Orthopaedic Surgeons, Inc.
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New - Medical Treatment Guidelines
Important Notice to All Orthopaedic Surgeons who
Treat Workers Compensation Patients
BE PROAVTIVE – Learn About New Medical Treatment Guidelines that will Become Mandatory In the Very Near Future
If you treat workers compensation patients in your office, you cannot afford to ignore recent activities of the NYS Workers Compensation Board with regard to new Medical Treatment Guidelines (MTG). As you recall, NYSSOS has been encouraging members to participate in the PILOT project the WCB is conducting to test the new guidelines. Soon participation with be mandatory for all providers.
The overhaul of the WBC MTG’s is the outgrowth of a law passed in 2007 that amended substantial portions of the workers compensation law. NYSSOS Board Members, including Joseph Bosco, MD, John Olsewski, MD, A. Philip Fontanetta, MD, William Walsh, MD and James Slough, MD have reviewed all of the medical treatment guidelines and submitted their comments to the WBC through a formal comment process. Many of their recommended changes have been adopted as part of the reforms.
All of the new draft WCB MTG’s are available for your inspection on the official website of the WCB which is WCB. The direct link for the new Medical Treatment Guidelines is: Medical Treatment Guidelines. Spend some time on this site and encourage your office staff to do the same. The site explains the genesis of the changes and the new requirements that will be applied to physicians treating workers compensation patients including the requirement that the section of the guidelines that the physician follows will be required to be included on forms submitted to the WBC. Additionally, if a physician does not believe that following the guidelines is in the best interest of his or her patient, the physician will be required to submit a request for a variance. Variances will be reviewed by the WCB Medical Director within a certain number of days. It should also be noted that following the guidelines will result in an insurer not being able to deny payment to a physician and alternative guidelines from workers compensation insurance carriers will be eliminated. Furthermore, physicians following the guidelines will not have to seek approval to provide treatment that exceeds the current $1,000 pre-approval threshold.
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