New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
Canada Keeps Cutting Chiropractic
Manitoba is the only remaining Canadian province that covers a portion of chiropractic care for all residents, but a new funding formula effective June 1 cuts $4.8 million from Manitoba Health's annual subsidies for chiropractic, reduces the allowable number of visits to a DC from 12 to seven per year, and lowers the per-visit coverage amount from $12.30 to $8.29. (On April 1, 2018, coverage will increase to $10 per visit, but still significantly lower than previously.)
Note that this coverage amount is for the chiropractic adjustment only, according to the Manitoba Chiropractors Association (MCA), and "does not include other services such as the examination, re-examination, x-rays, consultation, general information on exercises or nutrition, or other therapies used to support the chiropractic adjustment."
In an article in the Canadian Chiropractor reporting on the cuts, Dr. Greg Stewart, a spokesperson for the MCA, emphasized the funding scale-back "flies in the face of the national opioid strategy. ... Although we have the provincial government signing on to the federal government's national opioid strategy about improving access to nonpharmacological care, at the same time within months of each other, they decrease access for the same nonpharmacological care. It's hard to understand."
Longtime readers of Dynamic Chiropractic will recall that Ontario delisted chiropractic as a partially covered service in 2004, and Alberta followed suit in 2009, leaving Manitoba as the sole Canadian province offering any measure of chiropractic coverage for all residents. One wonders whether the provincial government's next cost-saving step will be to remove chiropractic entirely from Manitoba Health. Stay tuned.