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February 1, 2010

Help Stave Off Drastic Medicare Cuts!

Call to Action: Get Involved and Help Stop 21% Medicare Fee Cut Proposed for 2010

As we have previously reported, Congress has delayed the 21% fee cuts that had been proposed for 2010 until March 1. Congress must take action prior to March 1 to address this decrease for the remainder of the year. Please contact your member of Congress today to urge them to block the implementation of these drastic fee cuts. The easiest way to do so is to visit the ACA Legislative Action Center* and create an e-mail message using a template the ACA has created for your convenience.

* If you received this email by fax, the ACA Legislative Action Center can be found by going to www.acatoday.org, clicking on “Advocacy,” and then “Legislative Action Center” in the menu at left.

February 25, 2009

Results of the 2009 MAC Workers’ Compensation Survey

MAC Will Not Ignore Pattern of Discriminatory Activity of Employers and WC Carriers

By: Dr. Donald Reno, MAC President

In late January, the MAC Weekly Review contained a survey regarding Michigan’s workers’ compensation system – we specifically wanted to gather information regarding chiropractic participation with workers’ comp and ways to increase this participation. The survey was developed by MAC Board of Directors member Dr. Dennis Whitford of Mt. Pleasant, our representative to the Workers’ Compensation Health Care Services Advisory Committee. This important body is charged with reviewing rules and regulations pertaining to health care benefits and services under workers’ comp.

The results show that access to chiropractic care in Michigan’s workers’ compensation system is sorely lacking. The results show:

 73 percent of respondent doctors do not see as many Workers’ Comp patients as they would like
 93 percent would take on more Workers’ Comp cases if patients had direct access to chiropractic services
 63 percent have had a patient told by their employer, after the “10-Day Rule” has expired,” not to see a chiropractor
 51 percent have had a patient told by the workers’ comp carrier, after the “10-Day Rule” has expired, not to see a chiropractor
 73 percent have had trouble collecting from workers’ comp carriers
 49 percent have had a patient told they do not have a work injury because they have a pre-existing condition
 51 percent have had a workers’ comp carrier deny a service based on an arbitrary managed care fee/utilization schedule

On February 10, Dr. Whitford presented this information to the Workers’ Compensation Health Care Services Advisory Committee. His first suggestion was to mandate a notification of the workers’ comp rules to all injured workers. Second, he let the Committee know that the MAC is not going to let this pattern of discriminatory activity of carriers continue.

As a result of Dr. Whitford’s efforts and the findings of this survey, the State is now working with him to survey third-party payers on their policies toward chiropractic care. The MAC is committed to ending discrimination against doctors of chiropractic and their patients.

If you have any additional evidence of discrimination by employers or workers’ comp carriers, please fill out the MAC Insurance Complaint Form, which can be found online at www.chiromi.com/insurance.

Attention DCs Who Bill BCBSM for 97012 and Other Physical Medicine Codes!

In the May 2008 edition of the BCBSM Record, on page 31, the following appeared: When billing chiropractic claims, include all required documentation. Chiropractors who bill using procedure code *97012 and other physical therapy codes must include the following in their documentation in the patient record to be reimbursed for this service:

The device used to apply the therapy
The location of the therapy (for example, cervical, thoracic, or lumbar region of the spine
The time of treatment (duration of the treatment)
The medical reasoning (for example, to reduce a disc bulge or reduce scarring)

Please note: The documentation must be included in the patient record. It is not necessary to send it with the claims.