Access the Patient Advocacy Flyer and Urge Your UnitedHealthcare and Humana Medicare Advantage Patients to Take Action!
Click here for a pdf flyer you can provide to your UnitedHealthcare and Humana Medicare Advantage patients! The flyer contains the information they need to request the elimination of the new prior authorization requirement for chiropractic care.
Earlier this week, in an email to the profession, we informed you that Humana and UnitedHealthcare recently alerted providers that they are implementing new prior authorization requirements for chiropractic services under their Medicare Advantage plans.
We believe that this unjustified burden will create a barrier for seniors to access a conservative, cost-effective care option, and that no justification exists to require additional pre-conditions for care for those seniors who have chosen a Medicare Advantage plan over those who are covered under traditional Medicare.
The MAC is actively advocating on this issue on your behalf, working with national and other state chiropractic organizations to fight these changes.
One way you can help in this effort is to involve your UnitedHealthcare (Optum) and Humana Medicare Advantage patients. Distribute this advocacy flyer to your UnitedHealthcare and Humana Medicare Advantage patients and urge them to take action TODAY! The flyer explains the issue, details how it will affect your patients, and gives easy-to-follow instructions on how to contact Humana and UnitedHealthcare and urge them to tell their plan representative:
- Respect the treatment plan recommended by my physician and agreed upon by me, without unnecessary delays.
- Do not create barriers to accessing timely and effective care that helps me manage my condition without opioids.
- Stop the prior authorization requirement for chiropractic and other physical therapy care.
The involvement of patients across the state of Michigan and the nation, as well as the chiropractors who provide their care, will be critical to stopping these requirements!
Get involved TODAY and help your patients TAKE ACTION!
Additional MAC Advocacy Efforts
The MAC knows these changes will drastically affect your practice and your patients. As noted above, we are collaborating with national organizations such as ChiroCongress and other state associations to spearhead a coordinated effort to stop these prior authorization requirements. The more chiropractors (and chiropractic patients) nationwide who get involved in this effort, the more likely these requirements can be stopped, preserving chiropractic patients’ access to conservative, drug- and surgery-free chiropractic care.
As part of the coordinated national effort to oppose these changes, the MAC is joining other associations in sending a formal letter to Tim Noel, CEO, UnitedHealthcare Medicare & Retirement. The letter:
- Stresses that their prior authorization program will be detrimental to both Medicare Advantage patients and to the health care system in general by limiting access to conservative care and providers, and potentially driving patients to more costly, invasive options.
- Notes that adding an additional, resource-straining prerequisite to care is a disincentive for providers to treat Medicare patients.
- Emphasizes that Medicare patients in underserved areas may be effectively completely unable to access chiropractic and other conservative treatment options due to provider unavailability, driving patients to greater Emergency Room utilization, more invasive and costly procedures, and potentially addictive medications.
- Hinders providers in their ability to help Medicare Advantage patients because the prior authorization process imposes disproportionate administrative and financial burdens on providers for minimal Medicare reimbursement, discouraging providers from treating Medicare patients due to economic unsustainability.
Finally, these prior authorization requirements override the treating chiropractor’s medical judgment, potentially by non-chiropractic physician reviewers who lack expertise or even familiarity with the spinal adjustment, to assess medical necessity in the procedure(s) under review.
A similar letter to Humana is also being developed.
Moving Forward
As we get closer to the UnitedHealthcare and Humana Medicare Advantage prior authorization implementation dates, the MAC will continue our collaborative efforts and closely monitor all developments. Stay tuned to your email and other MAC communication channels to learn about additional efforts we are taking, as well as steps you can take to involve both yourself and your patients.
Additional Resources
- MAC Email Announcing the Requirements
- UnitedHealthcare Announcement
- Humana Announcement (see page 15)
- Patient Advocacy Flyer
