HONOLULU (HawaiiNewsNow) – Hawaii chiropractors are protesting new policies by the state\u2019s largest health insurance company, saying the changes are costing some practices tens of thousands of dollars a month and could force some out of business.<\/p>\n
HMSA warned chiropractors in April that they would be subject to new treatment review policies, but providers say the scope of the changes \u2014 and the financial impact \u2014 caught many off guard.<\/p>\n
Denied claims adding up<\/p>\n
Turning Point Chiropractic in Kaimuki, one of Hawaii\u2019s largest chiropractic practices with 17 practitioners, began seeing charges denied for services like follow-up exams after HMSA announced the new policies.<\/p>\n
\u201cThey\u2019ll pay for a few visits, and then all of a sudden, stop paying for the visit,\u201d said chiropractor Joseph Leonardi, D.C. \u201cSo it\u2019s a consistency issue at this particular point, and it really is negatively impacting our patients.\u201d<\/p>\n
Dean Shivvers, president of the Hawaii State Chiropractic Association and owner of Turning Point Chiropractic, said the denied charges have added up to $100,000 a month in lost income at Turning Point alone.<\/p>\n
\u201cWe\u2019re talking significant losses, but, like, not just us, but other practices as well,\u201d Leonardi said. \u201cAnd sometimes it may be even more impactful in a smaller office.\u201d<\/p>\n
Leonardi said many chiropractors have expressed concerns that they may not be able to stay in practice.<\/p>\n
Lawmakers raise provider shortage concerns<\/p>\n
State Rep. Scot Matayoshi, who chairs the House Consumer Protection Committee, said chiropractors are an important part of Hawaii\u2019s overall health care system \u2014 one in which HMSA holds significant influence.<\/p>\n
\u201cWe\u2019re at such a provider shortage already that these big changes, if they rock the boat too much, could lead to an even greater doctor shortage than we already have,\u201d Matayoshi said.<\/p>\n
HMSA statement<\/p>\n
In a statement, HMSA said: \u201cHMSA\u2019s goal is to ensure that our members have access to care that is appropriate, effective, and aligned with evidence-based clinical guidelines. The physical medicine program was updated to give us a more consistent way to review chiropractic care, occupational and physical therapy, and assess whether they support better health outcomes.\u201d<\/p>\n
The new assessment process has also meant more paperwork for patients and, in some cases, delays in coverage determinations.<\/p>\n
\u201cThere are weeks, and a patient is like, \u2018Do I have insurance? Am I covered? Is this \u2014 am I responsible for this?\u2019\u201d Leonardi said.<\/p>\n
Chiropractors said they were encouraged when the governor intervened to stop a separate HMSA plan to change the payment structure for physicians. They said they hope someone will step up for them as well.<\/p>\n
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