During the last decade, physical therapists and their patients across the nation have been disrespected by Anthem-Blue Cross. PTs who have dedicated at least 8 years of higher education to making patients' lives better are now incurring a mountain of student debt, are oftentimes not able to spend enough time with their patients, and are having a difficult time earning a living wage. The following Anthem actions have contributed to a deteriorating work-life balance, as well as social and economic injustice for PTs and their patients:
1. Anthem demanded a ~40% payment cut for PT services in 2010.
2. Anthem has not given PTs a cost-of-living increase in 10 years!
3. Their AIM utilization review program has attempted to "ration" physical therapy services, allowing an average of 3.8 visits/patient for expensive PPO plans and is now rationing care in Medicare Advantage Plans.
4. In 2019, Anthem imposed a contract on PTs that IPTCA's attorney said was loaded with illegal terms and clauses.
5. For 2019, Anthem recorded net income of $4.8 billion after taxes, up 28.2 percent from $3.8 billion the year prior. Meanwhile, many Doctors of Physical Therapy could not keep up with their student loans and/or afford a home.
6. During 2020, Anthem arbitrarily denied specific treatment codes ( i.e. 97530 and 97140) Therapeutic Activities and Manual Therapy. These are "standard of care" procedures in PT treatment and at the core of providing excellent therapy care. Medicare readily accepts these codes, so why is Anthem suddenly denying these long standing approved treatment codes?
We call on Anthem to end the injustice and cover quality PT services for the 99% of patients who believe that an expensive insurance plan should treat them fairly so that they do not have to pay cash.
We believe that essential health care services, like PT, are truly for ALL-- NOT just for the elite 1%, who can afford to pay cash.
PUSH BACK and let Anthem know that you do NOT support the rationing or cheapening of PT services.
And let the CA Department of Managed Health Care (DMHC) know that they should take enforcement action against Anthem, so they that can no longer risk patient outcomes.
Please forward this petition to your patients, friends, and colleagues.
Updates
August 19, 2020
I have been hearing from so many of you about how the AIM program is just making everything impossible and honestly it is exhausting to keep fighting these denials when we should be focused on our patients. I am currently working on a document that outlines these specific patterns so we can show them that we are not going to just let these unfair practices slide by while they sit on billions.
Reached 100 supporters
August 19, 2020
40 Comments
The Blue Cross payments already pay less than cost, especially for clinics, and now with many contracts paying for eval only and no treatment, it is very stressful to work with complex clients in particular. Every week it gets worse
PT's are sometimes the only form of pain relief that I have experienced. PT is not just for the rich....I had 2 knee replacements and due to these therapists I was able to come back to successfully walking 4 miles a day with no pain. THEY ARE ESENTIAL!!!!
Denying Seniors care that is prescribed by their Physician and Doctor of Physical Therapy is wrong and unethical. A computer does not take the place of a highly trained doctor who has actually seen and evaluated the patient.
Anthem is putting profits above ethical actions, harming patients, by their financial harassment of PT. PT's are the alternative to surgery and opioids. Actions like Anthem's are driving PT's out of the profession, because they cannot make a living with the payment schedules Anthem is illegally trying to force upon PT services. This does not serve the patients who need care.
The $75 non negotiable rate is unfair given the cost of living, higher education costs, specialty like mine certified hand therapy. And how is 97530 functional activity and 97140 manual not allowed in the same visit? Does not make sense.
Asking anyone I have had the privilege to treat or guide, to please sign the petition.
.
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During the last decade, physical therapists and their patients across the nation have been disrespected by Anthem-Blue Cross. PTs who have dedicated at least 8 years of higher education to making patients' lives better are now incurring a mountain of student debt, are oftentimes not able to spend enough time with their patients, and are having a difficult time earning a living wage. The following Anthem actions have contributed to a deteriorating work-life balance, as well as social and economic injustice for PTs and their patients:
1. Anthem demanded a ~40% payment cut for PT services in 2010.
2. Anthem has not given PTs a cost-of-living increase in 10 years!
3. Their AIM utilization review program has attempted to "ration" physical therapy services, allowing an average of 3.8 visits/patient for expensive PPO plans and is now rationing care in Medicare Advantage Plans.
4. In 2019, Anthem imposed a contract on PTs that IPTCA's attorney said was loaded with illegal terms and clauses.
5. For 2019, Anthem recorded net income of $4.8 billion after taxes, up 28.2 percent from $3.8 billion the year prior. Meanwhile, many Doctors of Physical Therapy could not keep up with their student loans and/or afford a home.
6. During 2020, Anthem arbitrarily denied specific treatment codes ( i.e. 97530 and 97140) Therapeutic Activities and Manual Therapy. These are "standard of care" procedures in PT treatment and at the core of providing excellent therapy care. Medicare readily accepts these codes, so why is Anthem suddenly denying these long standing approved treatment codes?
We call on Anthem to end the injustice and cover quality PT services for the 99% of patients who believe that an expensive insurance plan should treat them fairly so that they do not have to pay cash.
We believe that essential health care services, like PT, are truly for ALL-- NOT just for the elite 1%, who can afford to pay cash.
PUSH BACK and let Anthem know that you do NOT support the rationing or cheapening of PT services.
And let the CA Department of Managed Health Care (DMHC) know that they should take enforcement action against Anthem, so they that can no longer risk patient outcomes.
Please forward this petition to your patients, friends, and colleagues.
Updates
August 19, 2020
I have been hearing from so many of you about how the AIM program is just making everything impossible and honestly it is exhausting to keep fighting these denials when we should be focused on our patients. I am currently working on a document that outlines these specific patterns so we can show them that we are not going to just let these unfair practices slide by while they sit on billions.
Reached 100 supporters
August 19, 2020
40 Comments
AIM has been the worst advent for patient care and the delivery of PT services that I have ever experienced. Baseless denials for care and a complete lack of service to the patient and contracted PTS. BC has fallen to be one of the worst In network payers in the state which of course trickles down to the patient.
The Blue Cross payments already pay less than cost, especially for clinics, and now with many contracts paying for eval only and no treatment, it is very stressful to work with complex clients in particular. Every week it gets worse
PT's are sometimes the only form of pain relief that I have experienced. PT is not just for the rich....I had 2 knee replacements and due to these therapists I was able to come back to successfully walking 4 miles a day with no pain. THEY ARE ESENTIAL!!!!
Denying Seniors care that is prescribed by their Physician and Doctor of Physical Therapy is wrong and unethical. A computer does not take the place of a highly trained doctor who has actually seen and evaluated the patient.
Anthem is putting profits above ethical actions, harming patients, by their financial harassment of PT. PT's are the alternative to surgery and opioids. Actions like Anthem's are driving PT's out of the profession, because they cannot make a living with the payment schedules Anthem is illegally trying to force upon PT services. This does not serve the patients who need care.
The $75 non negotiable rate is unfair given the cost of living, higher education costs, specialty like mine certified hand therapy. And how is 97530 functional activity and 97140 manual not allowed in the same visit? Does not make sense.
Asking anyone I have had the privilege to treat or guide, to please sign the petition.
.
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AIM has been the worst advent for patient care and the delivery of PT services that I have ever experienced. Baseless denials for care and a complete lack of service to the patient and contracted PTS. BC has fallen to be one of the worst In network payers in the state which of course trickles down to the patient.