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Highmark"s PMMP Targeting Chiropractors is Postponed Again

  • DrTirpak

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by: DrTirpak posted: October 09, 2012

Chiropractors given more hurdeles to reimbursement

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

Filed Under Tags:  Chiropractors  ·  PA  ·  WV

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