News & PR
There is always something happening at the POMA. Discover what is going on within the organization and with our members.
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Aetna policy change streamlines payment of modifier 25 claims
In a significant win for DOs and their patients, Aetna has agreed to disable automatic claims denials of E/M services billed on the same day as OMT and appended with modifier 25. The AOA worked closely with our physician liaison at Aetna to implement the change, which allows E/M services billed on the same day as OMT codes 98925-98929 to bypass claims edits that previously triggered the denials. The Maine Osteopathic Association (MOA) also provided important advocacy support. “This change will provide relief for thousands of DOs who’ve been repeatedly penalized by claims denials for appropriately billed services,” said AOA CEO Kevin Klauer, DO, EJD.
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Request for Input: Osteopathic Medical Stakeholders and Guardians
Your input is needed! At the recent 2019 United States Osteopathic Medical Regulatory Summit, it was called for a statement(s) defining osteopathic distinctiveness. The below statement was developed for all involved in osteopathic medical education (students, residents, attending physicians, etc.) But, there is a need for a more concise version and one specific to pre-medical students and advisors.
Please review the statement and forward any feedback and suggestions to [email protected] by November 30, 2019.
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Aetna Exempts OMT Codes from Prior Authorization Policy
Effective August 1, 2019, OMT CPT codes 98925-98929 are exempt from Aetna’s prior authorization requirements. Aetna made the announcement to AOA leadership during a conference call earlier this week and highlighted the collaborative efforts of the AOA and the impacted state affiliates, which includes Pennsylvania, as a major factor in their decision.
“This change eliminates a barrier to safe, effective relief for patients seeking treatment for musculoskeletal pain, reflecting the understanding that pharmaceuticals shouldn’t be the only option physicians can immediately provide. AOA appreciates Aetna’s recognition of the value of osteopathic care and its decision to reduce administrative burden for DOs who perform OMT,” says AOA President Ronald Burns, DO, FACOFP.
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PAMELA S.N. GOLDMAN, DO, Installed as the 108th President of the POMA
“We DO...”
As physicians practicing in Pennsylvania:
- We practice in many different professional situations.
- We serve diverse patient populations and speak many languages.
- We manage and administer in healthcare systems.
- We care for multiple generations of families.
- We educate with our osteopathic philosophy.
- We lead in our communities.
No matter the situation, we shape the practice of medicine to treat the whole person and their families. This year, POMA will focus on who we are and what it looks like to practice patient-centered, osteopathic medicine in Pennsylvania.
There are many changes within our osteopathic profession and the practice of medicine. As change is inevitable, POMA is on the front line, not only to inform our members of the changes and to provide ways to make the process less painful, but to have a voice in the process.
The Board of Trustees developed a four-pillar strategy to support the osteopathic physicians of Pennsylvania. Let me tell you about the pillars.
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COCA Announces Standards Revisions Public Comment Period
The Commission on Osteopathic College Accreditation (COCA) has posted for public comment proposed revisions to the accreditation standards for existing colleges of osteopathic medicine (COM) as well as new and developing COMs and their corresponding evidentiary submissions. The proposed revisions may be accessed here, and will be available for public comment until March 22, 2019.
The COCA will also hold a public open forum on Tuesday, March 5, 2019, from 3-6 p.m. (CST) at the American Osteopathic Association offices in Chicago. Individuals may participate in the public open forum either in person or virtually. If you wish to participate in person, please send an email to [email protected] with a subject line of “Open forum participation.” For virtual participation, dial-in information through the Zoom platform will be provided later.
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