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State to work with WCA on new Medicaid reimbursement policy

Wednesday, June 15, 2016   (0 Comments)
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  • State will update Medicaid policy to allow DC reimbursement for Evaluation & Management (E&M)

  • October 2015 policy switch ended payments to DCs for E&M

  • Timeline for implementation unclear; WCA to work with state on new language




In response to ongoing advocacy and information-sharing efforts by the Wisconsin Chiropractic Association, the Wisconsin Department of Health Services recently announced it would "update" state Medicaid policies so that chiropractors can once again receive reimbursement for appropriate Evaluation and Management procedures. This would reverse an October 2015 policy change that ended payments to DCs for E&M procedure codes and "off-set" the alteration by increasing the fee for adjustments.


Despite assurances from state officials that this off-set would be "budget neutral", data collected from WCA members showed decreased overall compensation for chiropractors. After sharing this data with the state Medicaid office, the WCA requested that the state reconsider the October 2015 Medicaid policy change. It now appears as though that process is underway.


According to a June 10 letter from Kevin Moore, the Wisconsin Medicaid Director, to WCA Executive Director John Murray, the state intends to "implement this change prospectively... " and "will share the draft policy publication with the Wisconsin Chiropractic Association in the coming months for review and comment... "


The WCA thanks the many member DCs who became active and engaged as a result of the October 2015 Medicaid policy change. Your voices were heard in Madison.