News / Profession

Empire Blue Cross/Blue Shield Fined $1.1 Million

Discrimination Against Chiropractors Cited
Dynamic Chiropractic Staff

Empire Blue Cross/Blue Shield, the largest nonprofit health insurer in New York, has been fined $1.1 million by the state's insurance regulators.

Among other things, Empire was charged with denying health coverage to certain patients:

Denying advanced chemotherapy and bone marrow treatments to some women with breast cancer, while approving treatments for others.

Denying in vitro fertilization procedures to some while approving the procedure for others.

Paying physical therapists for certain procedures, but denying payment to chiropractors for the identical procedures.

The $1.1 million fine is the largest ever levied against a health insurer in the state of New York. Since the time of these infractions, Empire has seen the number of policyholders reduced by approximately 50 percent (to 4.8 million).

While Empire has positioned a new management team to recoup its losses, the fine should send a clear message to other carriers. The New York Insurance Department is expected to keep a close watch on Empire over the next three years.

April 1996
print pdf
Trending
News / Profession
NBCE-FCLB Merger Approved
NBCE-FCLB Merger Approved

The proposed merger of the National Board of Chiropractic Examiners and Federation of Chiropractic Licensing Boards was approved by NBCE delegates and FCLB members at their respective annual meetings, held jointly in Atlanta, Ga., this year. Per the new bylaws, the new entity takes the NBCE name, with FCLB continuing as a department within NBCE. The federation will continue to enjoy Board of Directors representation on what will be a single, expanded board.

 |  Digital Exclusive
Dynamic Chiropractic Staff
Diagnosis & Diagnostic Equip
When Radiculopathy Isn’t Radiculopathy: A Clinical Series (Pt. 3)
When Radiculopathy Isn’t Radiculopathy

Before introducing subscapularis syndrome as an upper extremity analog, it is essential to revisit piriformis syndrome as a well-established example of myogenic pseudo-radiculopathy. Piriformis syndrome has long served as a clinical exception to disc-centric models of lower extremity pain and provides an important framework for understanding how deep muscular dysfunction can mimic radiculopathy in the absence of nerve root compression.

Ken Kaufman, DC
Healthcare / Public Health
From Pain Scores to Performance Metrics
From Pain Scores to Performance Metrics

Pain has become the dominant language of musculoskeletal healthcare. Numeric pain-rating scales and symptom reports are routinely used as primary indicators of clinical success. But while pain reduction is meaningful, it is an incomplete and often misleading representation of recovery. This has real consequences for patient adherence, long-term outcomes, and how conservative care is perceived within the broader healthcare system.

Christopher Proulx, DC, PhD(ABD), CSCS