Highmark"s PMMP Targeting Chiropractors is Postponed Again
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Poster Profile:
Name: DrTirpak
Email: Amy@cecruncher.com
Age: ????
Location: Tampa, FL
Position: Owner
Sign: Gemini
Bio:Helping Chiropractors find some class is my job.
Experienced Chiroprctor and Internet lover, Amy Tirpak, DC, started CE Cruncher with the support of the Advertising Agency that she co-owns.
by: DrTirpak posted: October 09, 2012
Again Highmark is delaying the full implementation of their Physical
Medicine Management Program (PMMP), until January 1, 2013. Highmark's Physical
Medicine Management Program was created to limit Chiropractic, physical therapy
and occupational therapy visits by requiring prior authorization for any services after the 8th treatment annually.
Highmark, an independent licensee of the Blue Cross and Blue Shield Association, claims they
are extending the soft implementation based on feedback from providers needing
more time to understand the program's requirements.
The Pennsylvania Chiropractic Association offers a different
view. For months they have been lobbying PA State officials and Highmark to get
rid of the new program. Pennsylvania Chiropractic Association President Dr. Daniel
Schatzberg stated the software in flawed and unproven.
The PCA’s lobbying has had an impact. On September 28 a
press releases from Pennsylvania
State
Rep. Camille “Bud” George, D-74 of Clearfield County, stated that he is seeking
co-sponsors for a resolution urging Highmark Inc. to rescind its use of the Physical Medicine Management
Program.
He
feels this unfairly hurts patients who have a legitimate need to see a physical
or occupational therapist or chiropractor. Rep George said, “Let’s use a little common sense: Who is better to
make that determination, a physician or a computer program?”
The Pennsylvania
Chiropractic Association also met with the Pennsylvania State Insurance Department Commissioner Michael Consedine. Unfortunately
that agency is not capable of stopping the implementation of the program
because they lack the authority and the limitations of the current laws.
For more information on the
PMMP visit the Pennsylvania Chiropractic Association
Donate to the Pennsylvania Chiropractic Association’s Legal Fund
Prior Stories: Highmark Slowing the Implementation of PMMP for Chiropractors
Highmark Will Require Prior Authorization for Chiropractic