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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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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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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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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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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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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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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“Dietetic and nutrition services” means the integration and application of food science and nutrition to individuals and groups. A chiropractic physician may provide dietetic and nutrition services, which includes nutrition counseling, assessment, and therapy. A chiropractic physician may also provide a medically prescribed diet (a diet in which nutrient levels need to be monitored, altered, or both, for an individual whose health is impaired by disease, injury or surgery), for any individuals other than residents of nursing homes.
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