Week in Review
Pro-Chiropractic Bills Introduced in Michigan Senate!
SBs 887 and 888 Would Require Payment for All Services Legally Delivered Under Michigan’s Chiropractic Scope in Auto No-Fault and Workers’ Comp!
Make your voice be heard! The MAC – through our online grassroots partner CAPWIZ – has made it very simple for you to contact your lawmakers regarding this issue. Just click on the Legislative Action Center below and Take Action on “End No-Pay Provisions in Michigan Law TODAY!” It’s fast, easy, and will make a difference!
State Senators Mike Nofs (R-Battle Creek) and Wayne Schmidt (R-Traverse City) – two great friends of chiropractic in the Michigan Senate – have introduced legislation that would require Michigan auto no-fault and workers’ compensation insurers to pay for all services legally performed under Michigan’s current chiropractic scope of practice, regardless of whether or not the service was allowed under the former scope. Senate Bills 887 and 888 have been referred to the Senate Insurance Committee.
These bills are in response to legislation Michigan’s insurance industry successfully added to our scope of practice bills in 2009. At the time, the industry claimed this would keep health care costs down and that they did not want to pay DCs for fewer services, just not more. This claim has been proven to be false.
Senate Bill 887 would apply to Michigan’s auto no-fault system. Senate Bill 888 would apply to Michigan’s workers’ compensation system.
Background. In 2009, the Michigan Legislature passed legislation that brought Michigan’s chiropractic scope into line with the rest of the nation, allowing for the adjustment of the extremities, differential diagnosis, the use of physical measures, etc. Michigan’s previous chiropractic scope, was the most restrictive in the nation.
The new scope law was a great step forward! However, the insurance industry pushed legislation at the same time stating that Michigan insurers MAY reimburse for the services allowed under the new scope, but they were not required to. The MAC vigorously opposed these bills. Unfortunately, the insurance lobby was successful, and their language was “tie-barred” to our bills, meaning that the scope bills could not take effect unless the other bills were also enacted into law. Similar legislation had been tacked on to all other major attempts to enhance a health profession’s scope of practice.
NOW is the time to pass Senate Bills 887 and 888 and end this discrimination against chiropractors and chiropractic patients. Get involved TODAY and contact your lawmakers on this critical issue!
Important ICD-10 Code Changes Now in Place
October 1 Brought New Changes to ICD-10… Are YOU Ready?
The ICD-10-CD code set, which was put into use October 1, 2015, has been updated, with some codes being eliminated and new ones being introduced. This is very important information for you! If you use a code that has been eliminated, it can result in your claims being denied!
Most of these changes will not apply to chiropractors, but there are some changes that could put your reimbursement at risk if you don’t adjust your coding. The easiest way to find these new codes, and determine whether they will affect your office, is from our friends at ChiroCode Institute. They have a list of the 70 code changes most likely to impact chiropractic offices.
To print a copy of this list:
- Go to www.chirocode.com
- Click on “Blogs” from the top menu
- Click on “Top ICD-10 Code Changes for Chiropractors in 2017”
- Print the list
In addition, ChiroCode has a free webinar on the changes available on their website.
In addition, Wisconsin Physicians Services (WPS) has published an updated Medicare Local Carrier Determination (LCD) that incorporates these new codes. You can access this new version of the LCD on the MAC website. Just go to www.chiromi.com and click on “Medicare LCD Effective 10/1/2016 [Includes ICD-10].” It can also be accessed through WPS’s Medicare site, www.wpsmedicare.com.
Just like the evolution of the ICD-9 code set that was replaced by ICD-10, the ICD-10 code set will continue to evolve. You can expect that there will be small changes to the code set every October 1st. We will keep you updated!
Medicare 2017 Fee Schedule Now Available!
Rates Effective January 1, 2017 - December 31, 2017
WPS Medicare recently released the 2017 fee schedule for dates of service January 1 – December 31, 2017. The new fee schedule reflects changes passed by Congress in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MACRA repealed the Sustainable Growth Rate (SGR) formula, the cause of potential huge cuts to the fee schedule providers have been dealing with for more than a decade.
Locality 01 (Macomb, Oakland, Washtenaw, and Wayne Counties)
|Procedure Code||Par Amount||Non-Par Amount||Limiting Charge|
Locality 99 (All Other Michigan Counties)
|Procedure Code||Par Amount||Non-Par Amount||Limiting Charge|
|Medicare Deductible for 2017: $183|
Electronic Health Records Incentive Program Penalties
All Medicare eligible professionals who do not adopt and successfully demonstrate meaningful use (MU) of a certified electronic health record (EHR) technology are subject to a reduction in the Medicare physician fee schedule amount for covered professional services.
The adjustment for 2017 (based on demonstration of MU in 2015) is 98% of the Medicare physician fee schedule covered amount. Providers could face additional decreases in 2018 and each subsequent year, based on demonstration of MU in 2016 and subsequent years. Depending on the total number of Medicare eligible professionals who are meaningful users under the EHR Incentive Programs after 2018, the maximum payment adjustment can reach as high as 5%.
Physician Quality Reporting System (PQRS) Payment Adjustments
Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a continued payment adjustment under PQRS in 2017.
The PQRS payment adjustment applies to all of the eligible professional’s Part B covered professional services under the Medicare Physician Fee Schedule (PFS). For 2017 and subsequent years (based on participation in 2015 and subsequent years), the payment adjustment is 2.0%.
Expanded Medicare Fee Schedule Available
If you did not participate in the EHR Incentive Program, PQRS, or either program, an expanded Medicare fee schedule reflecting the above penalties for 2017 is available to MAC MEMBERS ONLY. Contact Tim at the MAC office at firstname.lastname@example.org or (517) 367-2225 or visit the Medicare section of this website for the expanded fee schedule.
Source: WPS Medicare