Fall Edition - Vol. 14 No. 4
Many members have received a letter from Aetna regarding a new pre-authorization process coming January 1, 2019. Aetna’s contract with Triad/eviCore is expiring on December 31, 2018. A vendor called National Imaging Associates (NIA) will be managing this new pre-authorization program immediately following the Triad contract expiration. The process will apply to all physical medicine procedure codes regardless of what type of provider performs them whether it be a DC, PT or MD. The pre-authorization program will be applied to in-network providers on fully funded plans only.
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).
November 7, 2018
November 8, 2018
November 8, 2018
Presenter: Lora Tanis, DC, DICCP
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