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Advocacy Action Center: BCBS of Michigan: Hyaluronan Injections No Longer Payable (Effective 4/1/18)

Members & Publications

March 6, 2018

*This message was sent on behalf of your Michigan Academy of Physical Medicine & Rehabilitation*

Michigan Academy of Physical Medicine & Rehabilitation
Steven Arbit, M.D., President
8391 Commerce Road
Suite 107
Commerce Twp, MI 48382
mapmr@icloud.com

Hello Michigan Physiatrists,
 
The Michigan Academy of PMR has been revived. There is an issue that has come to the forefront that we need to take action on. 
 
Blue Cross Blue Shield of Michigan recently released their guidelines on the use of Hyaluronan injections in the knee. Based on these guidelines, BCBS of Michigan has determined that "the use of intra-articular injections of Hyaluronans is considered not medically necessary for osteoarthritis of the knee and all other knee conditions. "
 
Effective April 1, 2018, Hyaluronan injections will no longer be payable. These include: J7320, J7321, J7322, J7323, J7324, J7325, J7326, J7327 and J7328. This is based on a medical policy decision to change the status of the procedure code to experimental and no longer payable.
 
Attached is a sample letter you can copy and paste on your letterhead and send to BCBSM to argue their decision. The letters should be mailed or emailed to Dr. Thomas Simmer, Sr. VP and Chief Medical Officer at tsimmer@bcbsm.com.
 
Thomas Simmer MD
Senior VP and Chief Medical Officer
500 Renaissance Dr. Tower 500
11th floor
Detroit, MI 48243
 
Thank you for your attention to this matter.
 
Sincerely,
Steven Arbit, M.D

Attachment

 

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.

 

 

 

 

 

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