Hello and welcome to this week’s edition of HealthBeat, Chiropractic OnLine Today’s Health, News and Informational Podcast, and Proud to be the #1 Search Result for Chiropractic Podcasts in the iTunes Podcast Directory.
In this week’s news: We’ll Be Looking At –
- Medicare Policy Regarding Chiropractic Services
- Defining Essential Health Benefits
- And Finally a Story about Yoga and Back Pain
For HealthBeat, This is Dr. Todd Eglow!
Welcome to HealthBeat Podcast #330, recorded November 4, 2011.
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And Now for some news ….
Medicare Policy Regarding Chiropractic Services
A recent ChiroCode Newsletter outlined the Medicare Learning Network (MLN) document SE1101 highlights Medicare policy regarding coverage of chiropractic services for Medicare beneficiaries.
This article was revised on September 9, 2011, to clarify some of the language. No changes in policy are conveyed by these clarifications.
The “Key Points” section reviews Medicare policy for coverage of chiropractic services and emphasizes the billing and documentation requirements.
The following key points are discussed in detail:
- Medicare coverage of chiropractic services.
- Subluxation may be demonstrated by X-ray or physician’s examination.
- Documentation requirements must be placed in the patient’s file.
- Necessity for treatment.
- Key billing requirements.
- Beneficiary responsibility
Numerous audits of chiropractic service claims have found a significant portion of the claims to have been paid inappropriately. Correct claim payment depends largely on providers complying with Medicare requirements for coverage, coding, and documentation of services. The goal of this article is to translate published Medicare coverage and payment requirements for chiropractic services into a few practical tips for better Medicare compliance to effectively lower the frequency of improper payments (and corresponding error rates).
A recent study by the Office of Inspector General (OIG) entitled “Inappropriate Medicare Payments for Chiropractic Services” found inappropriate Medicare payments for chiropractic services.
The OIG study found that:
- Claims lack initial visit dates for treatment episodes, hindering the identification of maintenance therapy; and
- There is lack of compliance with the manual documentation requirements. For example, treatment plans, an important element in determining whether the chiropractic treatment was active/corrective in achieving specified goals, were either missing or lacked treatment goals, objective measures, or the recommended level of care
Surf to our Show Notes for Links – http://www.chirocode.com/Overview_of_Medicare_Policy_Regarding_Chiropractic_Services
Defining Essential Health Benefits
According to the New England Journal of Medicine, when Congress enacted the Affordable Care Act (ACA), it mandated that a broad package of “essential health benefits” (EHBs) equivalent to that of a “typical employer plan” be offered by qualified health plans participating in newly created state-based insurance exchanges, as well as by new plans offered to individuals and small employers outside these exchanges.
Congress directed the Department of Health and Human Services (DHHS) to flesh out the details. The DHHS, in turn, asked the Institute of Medicine (IOM) to recommend a process for defining and updating the EHB package — but notably, not to develop a specific list of benefits.
In a report released on October 7, the IOM recommended that the initial EHB package be equivalent in scope to what could be purchased by the average premium that a small business would pay on behalf of an employee (see Key Recommendations of the IOM Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans).
If the DHHS endorsed a more expansive package, the IOM’s Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans cautioned in its report, many currently uninsured individuals and small businesses would find it unaffordable, which would undermine the overriding goal of the reform law — to make coverage both meaningful and nearly universal.
Surf to our Show Notes for the Full Article and Links to the IOM – http://www.nejm.org/doi/full/10.1056/NEJMp1109982
Yoga and Back Pain
Weekly yoga classes relieve symptoms of low back pain about as well as intense, regular stretching sessions, according to a new Archives of Internal Medicine study.
The research found that yoga and stretching were equally effective in easing chronic back pain and improving function, but participants had to practice each regularly to see benefits. The subjects in both groups took weekly 75-minute classes and practiced yoga or deep stretching at home for about 20 minutes at a time at least three days a week.
The study is the largest and most thorough to date to look at whether yoga has an effect on chronic low back pain, a problem that affects millions and has no surefire long-term remedy. A number of earlier studies suggested that regular yoga classes might benefit back pain sufferers, though most were limited by small sample sizes, short study periods and other flaws.
Chronic low back pain is a common problem lacking highly effective treatment options. Small trials suggest that yoga may have benefits for this condition. This trial was designed to determine whether yoga is more effective than conventional stretching exercises or a self-care book for primary care patients with chronic low back pain.
The study concluded that Yoga classes were more effective than a self-care book, but not more effective than stretching classes, in improving function and reducing symptoms due to chronic low back pain, with benefits lasting at least several months.
Reminder to discuss all back related issues and questions with your Doctor of Chiropractic for other treatment options.
Surf to our Show Notes for Links – http://well.blogs.nytimes.com/2011/10/24/yoga-and-stretching-equally-effective-for-back-pain/?smid=tw-nytimesscience&seid=auto
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Finally, I leave you with the following quote:
“All this worldly wisdom was once the unamiable heresy of some wise man”.
– Henry David Thoreau
For Chiropractic OnLine Today’s HealthBeat, This is Dr. Todd Eglow.