BCBSIL/Orthonet Patients Information

BCBSIL/Orthonet Patients Information

The Illinois Chiropractic Society continues to work diligently on the BCBSIL/Orthonet issue. As mentioned in previous communications, we have met on several occasions with BCBSIL regarding the Orthonet changes and tiering assignments, and we continue to share our findings with our members.

Communication

The ICS is providing you with an updated informational flyer to give to all patients who have BCBSIL health insurance. We believe that proper communication with patients holding BCBSIL health insurance is extremely important to this process. We also believe patients will be best served by receiving information as soon as possible concerning their coverage for physical medicine procedures.

For patients who ask what they can do, advise them they may contact their Human Resources Director, Union Representative, or Insurance Agent as soon as possible. Additionally, patients should contact BCBSIL directly and voice their concerns over the proposed changes. As a valued health care provider, we recommend that your patients take action immediately.

Law

If our doctors have concerns about raising this issue with patients, here is an excerpt from Illinois law: “(215 ILCS 134/30) Sec. 30. Prohibitions. (a) No health care plan or its subcontractors may prohibit or discourage health care providers by contract or policy from discussing any health care services and health care providers, utilization review and quality assurance policies, terms and conditions of plans and plan policy with enrollees, prospective enrollees, providers, or the public.”

In addition to informing our members and empowering your patients, the Illinois Chiropractic Society has been working on several other initiatives concerning this potentially crippling coverage change:

  • Filed a letter requesting an advisory opinion from the Illinois Department of Insurance regarding whether this program will violate the Affordable Care Act’s provider non-discrimination clause, which will become law January 2014.
  • Filed a letter requesting an advisory opinion from the US Department of Health and Human Services’ (HHS) Secretary Sibelius regarding whether this program will violate the Affordable Care Act’s provider non-discrimination clause, which will become law January 2014.
  • Launched a patient information campaign to ensure patients are aware of how this proposed program may affect their coverage of chiropractic services, physical therapy, and occupational therapy from BCBS-IL.
  • Consulted with attorneys about potential legal remedies for a number of different issues surrounding the implementation of this specific pre-authorization program.

As always, we will continue to keep our members informed about our progress, any changes as they occur, or additional information as it becomes available.

About Author

Marc Abla, CAE

Marc Abla began working at the Illinois Chiropractic Society in 2002 and became the Executive Director in 2008. He brings his extensive financial, administrative and association experience to the ICS. He is a Certified Association Executive and a graduate of the Certified Leadership Series through the Illinois Society of Association Executives. Additionally, he is a member of the Illinois Society of Association Executives, the American Society of Association Executives, Association Forum, Congress of Chiropractic State Associations, and the American Chiropractic Association.


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