Opioid and Drug Use Disorder Information
If you want to become more involved with Substance Abuse Prevention in your area, contact the Illinois Association for Behavioral Health.
Read MoreAuthor: ICS Staff
What is the MIPS Impact to Non-Participating Medicare Providers?
Statistics indicate that only about 3% of chiropractic physicians participated in the initial roll-out of MIPS (2017), and, with the new thresholds that exempt more providers in 2018, that number fell to 1%. However, some non-participating providers have asked how MIPS impacts their practice.
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UnitedHealthcare Corrects Policy Following ICS Request
As the Illinois Chiropractic Society reported in July, UnitedHealthcare released a new medical policy stating that manipulative therapy as treatment for neurological disorders (including headaches) was “unproven and/or not medically necessary.”
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ICS Responds to UHC “Headache Policy”
UnitedHealthcare issued a new reimbursement policy on June 1, 2018 that negatively impacts evidence-based practice reimbursement in a chiropractic physicians office.
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New Medicare Cards Arriving in Illinois
Medicare is now in full swing of changing their patient cards. In fact, all Medicare patients will receive new cards by April 2019, and Medicare announced this week that they have begun to ship cards to patients in Illinois. If you are not aware of this change, we are encouraging our members to familiarize with the cards and what to expect.
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Are Chiropractic Physicians Able to Opt-Out of Medicare?
Chiropractic Physicians are not allowed to opt-out of Medicare. However, in an attempt to avoid the regulations, billing requirements, and documentation requirements, some chiropractic physicians attempt to find the loopholes in this prohibition.
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BCBSIL Denial of Claims with Modifiers Update
The ICS now has heard from numerous members about the significant financial and administrative impact on their practices, resulting from a BCBSIL claims processing protocol that began in November 2017. When applied, this claim edit, described by BCBSIL as “code-auditing enhancement” via “clinically validating modifiers,” automatically denies some providers’ claims on codes that require the modifiers 25 or 59 (including XE, XS, XP, XU). The EOBs state the reason for the denial as: “The procedure code is inconsistent with the modifier used or a required modifier is missing…,” even though the modifiers are both present and consistent with CPT® and other guidelines followed by BCBSIL.
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PTs Seeking Direct Access to Patients
Physical therapists in Illinois have introduced legislation, HB 4643 (Burke, D.), to allow physical therapists to independently treat patients(direct access) without a physician referral. This legislation would also allow physical therapists the independent authority to diagnose patients. Allowing a physical therapist to independently diagnose a patient would be unprecedented under Illinois law and would seriously compromise patient safety.
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