BCBS Federal Expands Coverage

The American Chiropractic Association announced yesterday that effective January 1, 2014, the BCBS Federal Employee plan will “now cover any licensed medical practitioner for covered services performed within the scope of that license, as required by Section 2706(a) of the Public Health Service Act (PHSA).”

Directly from the Service Benefit Plan Document for Illinois (http://www.opm.gov/healthcare-insurance/healthcare/plan-information/plan-codes/2014/states/il.asp):

Advertisement

“Covered professional providers are medical practitioners who perform covered services when acting within the scope of their license or certification under applicable state law and who furnish, bill, or are paid for their health care services in the normal course of business. Covered services must be provided in the state in which the practitioner is licensed or certified. Your Local Plan is responsible for determining the provider’s licensing status and scope of practice.” And Physicians are defined as, “Doctors of medicine (M.D.); Doctors of osteopathy (D.O.); Doctors of dental surgery (D.D.S.); Doctors of medical dentistry (D.M.D.); Doctors of podiatric medicine (D.P.M.); Doctors of optometry (O.D.); and Doctors of Chiropractic/chiropractors (D.C.).”

This was a critical step in the implementation of the PPACA non-discrimination clause and the result of considerable effort by the American Chiropractic Association.