Medicare Advantage - New York State Chiropractic Association

Several Payers Discontinue Medicare Advantage Benefits

by Insurance Committee | Jan 3, 2026 | Aetna, Cigna, Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

The NYSCA Insurance Committee (The NIC) monitors various aspects of rules, regulations and trends which impact our reimbursement. Over the past several years we have reviewed some of these during our meetings and presentations, and discussed possible changes that we...

Clarification on Medicare Advantage (Part C) Chiropractic Coverage for 2026

by Insurance Committee | Nov 10, 2025 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only

It has come to the attention of the NYSCA that some plan materials for certain 2026 Medicare Advantage (Part C) plans have included language that may appear confusing and contradictory. We want to assure members that chiropractic spinal manipulation to...

UHC Medicare Advantage: Request for Redacted Denials

by Insurance Committee | Jul 2, 2025 | Insurance Updates, Medicare Advantage, Members Only, UHC

Have you received a UHC Medicare Advantage claim denial indicating ‘precertification/ authorization/ notification absent’ for cases where clinical submission was not required? Did you follow the correct process? If so, we...

Excellus BCBS and Univera Healthcare Medicare Advantage Erroneous Payment

by Insurance Committee | Mar 14, 2025 | Excellus, Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, Univera

Last week Excellus BlueCross BlueShield and Univera Healthcare sent letters to their Medicare Advantage members receiving chiropractic care. In those letters, both organizations identified they have been ‘processing chiropractic claims...

UnitedHealthcare Modifies Manual Review Process for Medicare Advantage members

by Insurance Committee | Jan 13, 2025 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

If you participate with UnitedHealthcare / Optum you may have received notice of the change in the aforementioned prior authorization program. Based upon the volume of calls, texts and emails received by the NYSCA Insurance Committee (NIC), there has been several...

Medicare Advantage Prior Authorization Program Updates for UHC / AARP members

by Insurance Committee | Aug 26, 2024 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

The NYSCA continues to communicate with Optum regarding the implementation of the new prior authorization program for AARP and UnitedHealthcare’s Medicare Advantage members. We understand many of you have been attempting to determine the impact of this...