ICS Responds to UHC “Headache Policy”

UnitedHealthcare (UHC) issued a new reimbursement policy on June 1, 2018 (Commercial Reimbursement Policy Number 2018T0541I) that negatively impacts evidence-based practice reimbursement in a chiropractic physicians office. The notable change to the policy is found in this paragraph:

“Manipulative therapy is unproven and not medically necessary for treating non-musculoskeletal disorders (e.g., asthma, otitis media, infantile colic, etc.) and internal organ disorders(e.g., gallbladder, spleen, intestinal, kidney, or lung disorders)” and changing it to: “manipulative therapy is unproven and/or not medically necessary for treating non-musculoskeletal disorders, including but not limited to lungs (e.g., asthma), internal organs (e.g., intestinal), neurological (e.g., headaches), and ear, nose, and throat(e.g., otitis media)” (Emphasis added)

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The Illinois Chiropractic Society opposes this policy change for the simple reason that current, substantiated, and ample data directly contradicts it.

As a result, the ICS has addressed our concerns and cited the evidence directly with the UHC Medical Director of Reimbursement. You can find our letter here. In the letter to UnitedHealthcare, ICS President, Dr. Timothy Bertelsman, states, “The ICS does not support cost-containment policies that are contradictory to current evidence-based practice.”

In our continued effort to advocate for the chiropractic profession, the Illinois Chiropractic Society continues to address insurance carrier medical and reimbursement policies that contradict the current evidence.