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Highmark Slowing the Implementation of PMMP for Chiropractors

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by: DrTirpak posted: August 30, 2012

Pennsylvania Chiropractic Association Fights BCBS Highmark

On Aug 29th 2012 days before the Physical Medicine Management Program (PMMP) was set to start Highmark sent out a press release stating they decided to institute a “soft implementation”. They went on to explain that the PMMP, which is intended to limit chiropractic and physical therapy visits, would not issues any denials based on medical necessity or appropriateness with dates of service prior to Oct. 1, 2012.

The Pennsylvania Chiropractic Association since the first remarks from Highmark about PMMP has been mouting an attack on the behalf of chiropractors against this attempt at limitng a patient's use of benefits. Two weeks ago the Pennsylvania Chiropractic Association’s Board of Directors authorized an aggressive fund-raising campaign to stop the Highmark Physical Medicine Management Program, jokingly known as ‘pimp’. As of today they have raised $58,400 with the goal of $150,000. Discussing the PCA Legal Fund PCA President Dr. Schatzberg stated, “Our practices and those of the future will be irrevocably changed if this policy (Highmark’s PMMP) is allowed to be implemented. Let’s be clear: this is not our final battle; in fact, our fight is just beginning.”

The PMMP system requires chiropractors and physical therapists to submit prior authorizations through Highmark's NaviNet after 8 visits. According to the press release providers are still expected to submit requests for authorizations for treatment for September of 2012 and Highmark reserves the right to review any of those payments after they have been received.

Donate to the Pennsylvania Chiropractic Association’s Legal Fund

Prior Story: Highmark Will Require Prior Authorization for Chiropractic

Filed Under Tags:  Chiropractors  ·  PA  ·  WV

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