Author: Marc Abla, CAE

BCBSIL Delays September 1 Implementation Date

BCBSIL Delays September 1 Implementation Date

The ICS has previously relayed information published in the May 2014 and June 2014 editions of the Blue Review regarding billing for services rendered by licensed massage therapists in the physician office. Blue Cross and Blue Shield of Illinois (BCBSIL) announced upcoming policy changes that would: 1) require licensed massage therapists to obtain an NPI and bill all services to BCBSIL under the massage therapist’s NPI, rather than under the supervising provider’s NPI; and 2) that a “reimbursement differential” would apply to services rendered by a licensed massage therapist.

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BCBSIL Billing for Medically Unnecessary and/or Medically Unproven Services

BCBSIL Billing for Medically Unnecessary and/or Medically Unproven Services

“Effective for dates of service on or after July 14, 2014,* claims submitted to BCBSIL for services that are deemed to be medically unnecessary and/or medically unproven (experimental and investigational) will be denied with a message specifying that the member will not be financially responsible for charges associated with…any outpatient procedure or other services that are determined by utilization management to be medically unnecessary and/or medically unproven.

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Employee Concealed Carry

Employee Concealed Carry

In July 2013, Illinois enacted the Firearm Concealed Carry Act, which authorizes permit holders to carry loaded handguns, concealed or partially concealed, on their persons or in their vehicles. The law prohibits permit holders from carrying firearms into certain types of premises and establishments, including: schools of any kind; any government building or court; any hospital, mental health or nursing home; any establishment where more than 50% of the gross receipts are from the sale of alcohol; public playgrounds or parks; casinos; public transportation; sports stadiums; airports; and amusement parks or zoos.

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