NJ health benefits (SHBP) commission openly discriminates against chiropractors and acupuncturists.
Good decisions as well as bad decisions are made behind closed doors. State workers who rely on chiropractors and acupuncturists to stay healthier should be alarmed by the recent move by the NJ health benefits (SHBP) commission to treat chiropractors and acupuncturists who are out of network differently than if they were other types of doctors treating patients out of network.
If your chiropractor or acupuncturist is an out of network doctor, chiropractic out of network benefits will be limited to $35 while out of network acupuncture fees will be limited to $60, an amount that can be up to 70 percent lower than the actual cost of care.
As an in network doctor who is participating, I am alarmed that our profession is being singled out, especially since we help many patients stay healthier and more functional than their medical counterparts are capable of doing, as Consumer Reports, Bottom Line Personal and other studies show. Chiropractors have been shown to have much higher levels of satisfaction than their medical counterparts for problems such as neck and back pain, so why would you want to make access for many common musculoskeletal complaints more difficult.
In network doctors like myself are also alarmed because the poor treatment our profession has had by Aetna and Horizon Blue Cross Blue Shield over the years has created a huge distrust of the larger insurers which are now becoming larger with the recent mergers you may have read about in the newspaper. Many of the reasons for the distrust include Horizon’s chiropractic reimbursement which until recently, was discriminatory, Aetna’s recent action with the billing code for myofascial release treatment which was overturned by our own ANJC (Assn. of NJ Chiropractors) and many other things they have attempted to do to harm the profession.
If SHBP is allowed to do this, without having it challenged, it will cause irreparable harm to people who use out of network providers (who have their reasons for being out of network), and it may empower them to return to unfair policies of the past with regards to chiropractic, something our profession and our patients will not tolerate.
These proposed policies will likely save little with regards to the rising healthcare costs you now find yourself paying for, with higher personal contributions for healthcare, yet at the same time, when you look at the numbers below, the cost problem was never addressed.
See for yourself…
Total 2016 New Jersey State Budget – $34.4 billion
Horizon’s CEO/Marino’s salary exceeding – $4.5 million
AETNA CEO/Bertolini 2014 salary – $15 million (In 2013 it was $30.7 million)
Total savings reducing chiropractic care to NJ Workers -$2 million (0.1%)
For many of our teachers and well educated state employees, this policy makes little sense. Someone clearly has an agenda that does not include reducing healthcare costs, but it does include reducing the usage of state workers by chiropractors, even though they have proven their worth and cost effectiveness to their patients.
It is quite likely, that if they are allowed to get away with this, your personal healthcare contribution for chiropractic both in and out of network will increase over time, and as some people use other more expensive and less effective services, everyone will pay more of their salary toward the SHBP, which makes the problem worse, rather than better.
By discriminating against the chiropractic profession with a possible illegal action of violating state and federal laws, the NJ State Health Benefits Plan has now incurred a “Formal Appeal” that will be heard by the Appellate Division of the New Jersey Superior Court.
We are asking for your help. Please stop by our offices and sign our petition against this bad idea which will be delivered to our legislators as well as the appropriate labor unions.
It’s your health, and your health plan. Act today, and let them know you care and that this is not appropriate or a cost effective solution to our overpriced healthcare system..
Dr. William Charschan.