Utilize the Patient Advocacy Flyer
This flyer includes vital information about the prior authorization changes and guidance on how patients can advocate for themselves by contacting their insurance providers directly.
It clearly instructs your patients on how to contact Humana and UnitedHealthcare directly. It encourages them to demand respect for the treatment plans you recommend and to urge their insurers to stop the prior authorization requirement for chiropractic and other physical therapy care.
We strongly urge you to share this flyer widely to ensure that patients are informed and empowered to protect their access to essential care.
Download the Patient Advocacy Flyer
What Are the Changes?
UnitedHealthcare (through its Optum subsidiary) and Humana will now require prior authorization for chiropractic and other therapy services under Medicare Advantage plans.
UnitedHealthcare (Optum) announced providers must obtain approval for defined treatment plans (request a number of visits). This policy will apply to chiropractic manipulative therapy (CMT), physical therapy, occupational therapy, and other related services, excluding the initial evaluation. Although UHC initially stated the program would apply to “multi-disciplinary offices,” the updated version indicates that it could apply to all chiropractic practices.
Humana has stated it will apply the requirement for a listed set of codes, including all CMT codes: “98940, 98941, 98942, 98943.”
This new requirement imposes an additional administrative burden on providers and could significantly delay patient care, particularly for Medicare Advantage patients, who have chosen these plans expecting streamlined access to conservative care options.
Humana Announcement (see last page)
What Is NCCA Doing for You?
The NC Chiropractic Association is fully aware of the challenges these changes will bring to your practice and your patients. In response, NCCA has taken proactive steps to oppose these new requirements:
- Advocacy Efforts: We sent a formal letter to Mr. Tim Noel, the CEO of the UHC Medicare division, outlining our strong opposition to the prior authorization requirements. In this letter, we highlighted the unjustified burden this will place on providers and patients alike, the potential delays in care, and the adverse impact on patient health, particularly in underserved areas. We have prepared a similar letter to send to Humana.
- Collaboration: The NCCA is not alone in this fight. We are working closely with national associations, such as ChiroCongress and other state chiropractic associations, to build a united front against these prior authorization requirements. Our collective voice amplifies the concerns of chiropractic physicians across the nation and seeks to protect our patients’ access to timely, effective care.
The NCCA will continue to monitor the situation closely and keep you informed of any new developments.