News from the NIC - CDPHP

The NYSCA Insurance Committee (The NIC) is bringing you the latest updates on CDPHP.

As previously noted, CDPHP announced an enhanced benefit for their Medicare Advantage members which covers medically necessary ‘assessment, manipulations and modalities’. We have just learned that the enhanced benefit does not apply to all CDPHP's Medicare Advantage members. It applies only to CDPHP’s Medicare Advantage Group members.

The enhanced benefit is not applicable to CDPHP Medicare Advantage Individual members. Those CDPHP members have coverage consistent with traditional Medicare - manual manipulation of the spine to correct subluxation.

The NIC acknowledges Dr. Jeff Riker for bringing this to our attention, and noted the distinction between MA Group and MA Individual members are evident when verifying eligibility on CDPHP’s portal.

We have reached out to CDPHP who verified the above, and confirmed that all CDPHP Medicare Advantage Group members have the enhanced benefit, with no exceptions noted to date.

As always, please continue to share your experiences, challenges and pearls with the NIC so other NYSCA members can benefit.

Together We Are NYSCA

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