December 2018 Health Newsletter

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Current Articles

» Back Pain Facts and Statistics
» Back Pain Prevention and Treatment
» Aetna Revises SHBP/SEHBP Medicare Advantage Plans
» Update: Revised SHBP/SEHBP Aetna Medicare Advantage Plans Now Posted
» State Retiree Benefits
» Quick Facts for Patients about Aetna Medicare Advantage Plan
» Can Eating Organic Food Lower Your Cancer Risk?
» Non Surgical Spinal Decompression for Disc Herniation/Degeneration
» State Health Retiree Plan Updates
» Conservative vs Surgical Care For Lower Back Pain

Back Pain Facts and Statistics

Back Pain Facts and Statistics

"Although doctors of chiropractic treat more than just back pain, many patients initially visit a chiropractor looking for relief from this pervasive condition. In fact, about 31 million Americans experience low back pain at any given time."

For more information, please visit: https://www.acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Facts-and-Statistics

Author: American Chiropractic Association
Source: American Chiropractic Association
Copyright: American Chiropractic Association 2018


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Back Pain Prevention and Treatment

Back Pain Prevention and Treatment

"Back pain is a fact of life for many people. Research shows that up to 80% of the population will experience back pain at some point during their lives. It is also the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections."

"Sometimes back pain is sharp and intense, caused by a wrong move or an injury, and heals in a few days or weeks. Others experience back pain as a chronic condition, seriously altering their ability to work and enjoy time with family, friends and other leisure activities—leading to depression in some cases. A recent global survey of health conditions identified back pain as the single most disabling condition worldwide."

"Moreover, as lifestyles have become more sedentary and the rate of obesity has risen, back pain has become increasingly prevalent, even among young children."

"Spinal health is an important factor in preventing back pain, as well as maintaining overall health and well-being. The American Chiropractic Association (ACA) encourages people to take steps to improve their spinal health and avoid injury."

"Things such as better nutrition, exercise, ergonomic workspaces and proper lifting and movement techniques can go a long way in helping people to strengthen their spines and potentially avoid serious injury and chronic pain. When back pain hits, research shows that a conservative approach to treatment is the best option."

For more information, please visit: https://www.acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Prevention

Author: American Chiropractic Association
Source: American Chiropractic Association
Copyright: American Chiropractic Association 2018


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Aetna Revises SHBP/SEHBP Medicare Advantage Plans

Aetna Revises SHBP/SEHBP Medicare Advantage Plans

 

The following is a message from the director of insurance and regulatory affairs of the Association of New Jersey Chiropractors Matt Minnella:

 

"Dear ANJC Members,


We were notified by Aetna of revised plan designs for the SHBP/SEHBP Medicare Advantage plans for 2019. They advised that for these New Jersey state government programs, chiropractic care would NOT require prior authorization for up to 30 visits per year. Further, Aetna’s communication advises that there will be coverage for 'other services within the scope of the chiropractor’s license, such as heat therapy.'


All the Summary of Benefits and Coverage documents for all of the Aetna Medicare Advantage plan were not available on the NJ Division of Pension and Benefits website on Friday afternoon and are still not available at the time of this writing. We have requested these documents will be reposted soon to reflect these revisions and provide patients and providers transparency.


There are still a number of important details regarding coverage and reimbursement that we have asked Aetna to clarify. Outstanding items we are seeking confirmation on include, but are not limited to: specifically what additional services under the chiropractic scope will be covered; will pre-authorization still be applied to any other physical medicine services such as PT or acupuncture; and how will services that do not have a Medicare fee schedule amount (98943, acupuncture) be reimbursed?
We will advise as soon as we receive confirmation.


Matt Minnella
Director of Insurance & Regulatory Affairs
Association of New Jersey Chiropractors (ANJC)"

Author: Matt Minnella
Source: Association of New Jersey Chiropractors
Copyright: Association of New Jersey Chiropractors 2018


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Update: Revised SHBP/SEHBP Aetna Medicare Advantage Plans Now Posted

 Revised SHBP/SEHBP Aetna Medicare Advantage Plans Now Posted

"Dear ANJC Members,


As a follow up to our earlier email regarding the revisions to Aetna’s SHBP/SEHBP Medicare Advantage plans please be advised that the Summary of Benefits and Coverage documents for these plans have been updated and re-posted to the NJ Division of Pension and Benefits website.


The Summaries of Benefits and Coverage for the Aetna Medicare Advantage plans as well as the available Horizon plans that can be selected as secondary to traditional Medicare (NJ Direct 1525, 2030, HMO, HMO1525 and HMO2030) can be found here:


We will continue to update membership as we receive new information.


Matt Minnella
Director of Insurance & Regulatory Affairs
Association of New Jersey Chiropractors (ANJC)"

Author: Matt Minnella
Source: Association of New Jersey Chiropractors
Copyright: Association of New Jersey Chiropractors 2018


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State Retiree Benefits

State Retiree Benefits

The following is a message from the President of the Association of New Jersey Chiropractors, Steve Clarke:

"Dear ANJC Members,


Doctors throughout the state have been inundated with calls and questions regarding the health insurance changes occurring for a huge number of retired state workers and teachers. The ANJC is working hard to spread the word to retired state workers and school employees who are on the SHBP or SEHBP plans to let them know they do have a choice, and they CAN opt out of automatic enrollment in the Aetna Medicare Advantage plan if they choose. But they need to act fast -- by Nov. 30th.


If you have patients affected by the change in coverage, click here to download a flyer, and direct them to www.savemybenefitsnj.com for details and links to other plans they can choose as secondary and still keep traditional Medicare. Advise them to share the link with anyone they know who could be affected.


Meanwhile, tune in NJ 101.5 FM for commercials we are running throughout November directing state retirees to the website, and see a picture at the bottom of this email of the digital billboard we have purchased on the Atlantic City Expressway leading into the city for the weeks of the New Jersey Teachers Convention and the convention of the state League of Municipalities."

Author: Steve Clarke
Source: Association of New Jersey Chiropractors
Copyright: Association of New Jersey Chiropractors 2018


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Quick Facts for Patients about Aetna Medicare Advantage Plan

Quick Facts for Patients about Aetna Medicare Advantage Plan

For those members with patients affected by the SHBP and SEHBP plan changes, we have boiled down some differences between their current plans and the new Aetna Medicare Advantage (MA) plan that may help you explain why they should carefully consider whether to opt out.
Encourage them to review the full Summary of Benefits and Coverage for the Aetna MA plan vs. the options available to be secondary to traditional Medicare. The top three items to point out:


1. The Aetna MA plan covers only spinal manipulation for chiropractic vs. full scope of practice, and all services previously allowed under traditional Medicare with a Horizon secondary AND the Horizon Medicare Advantage plan that the SHBP adopted in 2016.
2. The Aetna MA plan will impose pre-authorization requirements on all physical medicine to include at least chiropractic, physical therapy and occupational therapy.
3. Generally under Medicare Advantage plans, the government pays a carrier a fixed amount, and the carrier is then responsible for the cost of its members' care. Therefore, these carriers can profit more by limiting care and paying out less than the government pays them, and they could lose money if they pay out more than the government pays them. It may be difficult to define precisely when a particular patient will be affected by this – but the gatekeeper of their care has financial incentive to allow and pay for less care under the Medicare Advantage plans.


If your patients do not want to be automatically enrolled in the Aetna Medicare Advantage plan, they must act by Nov. 30th. Links to the other plans available as secondary to traditional Medicare may be found at www.savemybenefitsnj.com.

Author: Association of New Jersey Chiropractors
Source: Association of New Jersey Chiropractors
Copyright: Association of New Jersey Chiropractors 2018


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Can Eating Organic Food Lower Your Cancer Risk?

Can Eating Organic Food Lower Your Cancer Risk?

"In a study, those who ate more organic produce, dairy, meat and other products had 25 percent fewer cancer diagnoses over all, especially lymphoma and breast cancer."

 

For more information, please visit: https://www.nytimes.com/2018/10/23/well/eat/can-eating-organic-food-lower-your-cancer-risk.html

Author: Roni Caryn Rabin
Source: The New York Times
Copyright: The New York Times 2018


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Non Surgical Spinal Decompression for Disc Herniation/Degeneration

Non Surgical Spinal Decompression for Disc Herniation/Degeneration

"If you have lasting back pain and other related symptoms, you know how disruptive to your life it can be. You may be unable to think of little else except finding relief. Some people turn to spinal decompression therapy -- either surgical or nonsurgical. Here's what you need to know to help decide whether it might be right for you. What Is Nonsurgical Spinal Decompression?Nonsurgical spinal decompression is a type of motorized traction that may help relieve back pain. Spinal decompression works by gently stretching the spine. That changes the force and position of the spine. This change takes pressure off the spinal disks, which are gel-like cushions between the bones in your spine, by creating negative pressure in the disc. As a result, bulging or herniated disks may retract, taking pressure off nerves and other structures in your spine. This in turn, helps promote movement of water, oxygen, and nutrient-rich fluids into the disks so they can heal."

 

For more information, please visit: https://www.webmd.com/back-pain/guide/spinal-decompression-therapy-surgical-nonsurgical#1

Author: WebMD
Source: WebMD
Copyright: WebMD, LLC. 2018


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State Health Retiree Plan Updates


State Health Retiree Plan Updates

 

Dear ANJC Members,
We have previously reported that all Medicare eligible retirees under the SEHBP (teachers) who are enrolled in traditional Medicare with either the NJ Direct 10 or NJ Direct 15 plans will be automatically enrolled into new Aetna Medicare Advantage plans. It has come to our attention that additionally, any retired SHBP (police, fireman, etc.) employees who had been enrolled in the Horizon Medicare Advantage NJ Direct 10 or 15 will also be moved to new Aetna Medicare Advantage plans. Unlike the Horizon Medicare Advantage plans, the Aetna plans state that they will only cover spinal manipulation for chiropractic care.
It is important to note that all these employees under the SHBP and SEHBP do have the option to maintain their traditional Medicare coverage with one of 5 Horizon plans as their secondary to Medicare. These plans are the:


• Horizon NJ Direct 1525
• Horizon NJ Direct 2030
• Horizon HMO10
• Horizon HMO 1525
• Horizon HMO 2030


The details of these plans can be viewed here: https://www.state.nj.us/treasury/pensions/hb-sbc-state-retired-19.shtml
In order to avoid being enrolled in the Aetna Medicare Advantage policies Jan. 1st the employee must submit an application to enroll in one of these plans as secondary to Medicare no later than November 30th, 2018. The applications to do so can be found at the links below:
SHBP Medicare Eligible Retiree Health Benefit Change Form
SEHBP Medicare Eligible Retiree Health Benefit Change Form
The NJEA explains the options and the process in their FAQ here: https://www.njea.org/medicarefaq/
An excerpt explaining the opt out action directly from the FAQ:
“If you are enrolled in Horizon NJ Direct 10 or Horizon NJ Direct 15 and wish to enroll in a plan other than the one you are scheduled to be transferred into, you will need to complete an SEHBP Medicare Eligible Retiree Enrollment/Change Form and return it directly to the NJ Division of Pensions and Benefits. You can obtain the form by downloading it from the NJ Division of Pensions and Benefits website at www.nj.gov/treasury/pensions/”

©2018 ANJC Association of New Jersey Chiropractors
77 Brant Avenue, Suite 210
Clark, NJ 07066
info@anjc.info
p 908 722 5678
f 908 722 5677

Author: Association of New Jersey Chiropractors
Source: Association of New Jersey Chiropractors
Copyright: Association of New Jersey Chiropractors 2018


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Conservative vs Surgical Care For Lower Back Pain

Conservative vs Surgical Care For Lower Back Pain

 

"Treatment options are considered "conservative" when they are non-invasive (such as medication) or markedly less invasive (such as injections or chiropractic manual manipulation) than surgery."

 

For more information, please visit: https://www.spine-health.com/conditions/lower-back-pain/conservative-vs-surgical-care-lower-back-pain

Author: Peter F. Ullrich, Jr., MD, Orthopedic Surgeon
Source: Spine-Health
Copyright: Veritas Health 1999


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