Complete Story
06/27/2010
OSCA Making Headway on BWC/MCO Issues.
Ohio Bureau of Workers Compensation & Managed Care Organizations are important payers to many of our members.
The Ohio State Chiropractic Association continues to work on a behalf of its membership towards improving a more chiropractic friendly environment for treating injured workers. Dr. Jeff Zaika, Dr Otto Schmidt, Dr Jud Sprandel and Dr. Richard Thompson as well as our lobbyists David Leland, Nikki Reiss, Colleen O'Donnell, and Hugo Trux from the executive office, met with top administrative officials for the Bureau and managed-care organizations. To date, meetings have been held with:
BWC Director Marsha Ryan, and Bureau of Workers Compensation (BWC) Chief operating officer Ray Mazzotti, and also with the
Executive Director for the Managed Care Organization League of Ohio, George Smith, III.
During these meetings, topics of discussion have centered on the following issues:
(1) Specific needs and challenges associated with chiropractic management of chronic cases. One possible proposal might be the adoption of Ohio State Chiropractic Association Treatment Guidelines (which are still available from the OSCA -- click for order form).
(2) Negatively minded reviewers. Specifically we desire to increase the pool of file reviewers - stop cherry picking negative reviewer's to deny care, and also initiate data collection on reviewers to include number of reviews performed, # of approvals, number of denials.
Discussions to include a criteria letter outlining the specifics of a case requesting treatment for chronic care in an attempt to minimize the treatment requests being sent out for file reviews.
These ongoing meetings are a result of extensive effort by the Executive Committee and our new lobbyist, and they represent a first, in many years of concern about BWC/MCO issues. The lobbyist and the office are also working closely with the Provider Coalition to maintain Chiropractic in the Medicaid budget. This is an important matter for our members and we are actively pursing it! . We will keep you informed with even more details as they become available.
And, what can you do? Your State legislators are home now. Visit with them; invite them to your clinic. Tell them your story, your frustrations. They work for YOU.