AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven. The ACA and numerous other chiropractic organizations united in opposition to the policy, and UHC ultimately reversed course.
Fast forward to 2018 and UHC has been up to its old tricks, updating its policy on manipulative therapy to state manipulation is "unproven and/or not medically necessary" for headache.
According to the July 23 letter: "If UHC refuses to withdraw this policy, we plan to provide this information to our members so they may assist their patients in challenging your flawed guideline under ERISA appeals procedures ... We will also notify employers and other stakeholders that your guideline is flawed, does not reflect the most recent outcomes research, and improperly denies essential chiropractic care for headache pain. In addition, we will alert them as to how the use of this flawed policy, as a basis for adverse coverage determinations, may violate plan-governing documents in contravention of fiduciary responsibility."
A boxed section at the bottom of the policy titled "Policy History / Revision Information" now states:
Revised coverage rationale: Replaced language indicating manipulative therapy is unproven and/or not medically necessary for: "Treating non-musculoskeletal disorders, including but not limited to lungs (e.g., asthma), internal organs (e.g., intestinal), neurological (e.g., headaches), and ear, nose, and throat (e.g., otitis media)" with "treating non-musculoskeletal disorders (e.g., asthma, otitis media, infantile colic, etc.) and internal organ disorders (e.g., gallbladder, spleen, intestinal, kidney, or lung disorders)."
The ACA remains cautious, saying only that it "is aware that the [UHC] policy on manipulative therapy posted online has reverted back to its previous version. Talks between ACA and UHC regarding the headache policy continue." Stay tuned.
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