Yesterday, following an agreement between Gov. Murphy and the New Jersey Education Association, the School Employee Health Benefits Program’s (SEHBP) Plan Design Committee passed several resolutions enacting reforms to reduce costs under the plan. The SEHBP covers all employees of K-12 schools and community colleges that opt into the state program.
As previously reported, the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act requires a disclosure form to be signed by patients beginning August 29, 2018. We have updated our interim sample form (to be replaced by official form once released by the Board of Chiropractic Examiners) to include sections for both in and out of network providers/patients.
The Government Accountability Office (GAO) released a report on July 31 which was, in essence, following up on several directives issued to the Centers for Medicare & Medicaid Services (CMS) in the 2015 MACRA law (Medicare Access and CHIP Reauthorization Act).
Originally taking effect on June 1, 2018, United amended their policy on manipulative therapy (including chiropractic and osteopathic manipulation) to consider the treatment “unproven and/or not medically necessary for treating . . . headaches.” Immediately, the ANJC reached out to United/Optum to contest the policy. The ANJC also signed on to a letter from the ACA to United contesting the policy change along with 40 other chiropractic associations.
As you are aware, on June 1, 2018, Governor Murphy signed into law the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act. The main components of the bill were designed to protect patients from unexpected out-of-network bills for providers operating at in-network hospitals or other healthcare facilities. There are however several new disclosure requirements that apply to all out-of-network providers, including chiropractic physicians.
October 3, 2018
Presented By: Jeffrey Randolph, Esq.
Holiday Inn Parsippany - 707 US-46, Parsippany, NJ 07054 Phone: 973-263-2000
October 4, 2018