Chiropractors complain about HMSA payment changes

Hawaii chiropractors are raising alarms over new billing policies implemented by HMSA, the state’s largest health insurer. Many practitioners report that these shifts are causing severe financial disruption, with some clinics facing monthly revenue losses in the tens of thousands of dollars.

The situation centers on updated treatment review policies introduced in April. Providers like Dean Shivvers of Turning Point Chiropractic state that these rules lead to inconsistent claim denials for routine follow-up exams. For larger practices, these losses accumulate rapidly, while smaller offices face an even more precarious future where maintaining operations becomes difficult.

State Representative Scot Matayoshi, who leads the House Consumer Protection Committee, noted the broader risks of these changes. Hawaii currently faces a significant provider shortage, and the addition of these administrative hurdles threatens to reduce the available number of specialists for local patients. The situation has forced some patients to endure confusion regarding their own insurance coverage and potential out-of-pocket costs.

HMSA maintains that these updates are necessary to standardize care across chiropractic, physical therapy, and occupational therapy services. The insurer states that the intent is to align treatments with evidence-based clinical guidelines. However, the disconnect between these goals and the current on-the-ground experience remains a point of friction.

Chiropractors are looking for a resolution to the ongoing payment instability. They recall recent instances where government intervention prevented similar payment structure changes for physicians, and they hope for a similar outcome here. As it stands, the community waits to see if further action will be taken to address the financial strain on these medical practices.