The Maryland Chiropractic Association has delivered a formal Policy & Regulatory Brief directly to CareFirst BlueCross BlueShield’s President and CEO, Chief Medical Officer, and Medical Director of Health Care Policy, documenting serious concerns affecting Maryland chiropractors and demanding resolution.
The letter addresses two categories of issues: (1) CareFirst’s systematic denial of physical therapy service reimbursement to Maryland chiropractors who hold PT privileges under state law, a practice the MCA has documented as contrary to both Maryland statute and CareFirst’s own published medical policy, and (2) a pattern of administrative and operational failures causing significant financial harm to Maryland practices.
The MCA made the following formal requests of CareFirst:
- Reversal of the PT reimbursement denial policy, including written confirmation of provider eligibility, updates to CareFirst’s adjudication systems, retroactive reprocessing of improperly denied PT claims, and written guidance to CareFirst staff.
- Immediate engagement, including a meeting with CareFirst leadership and provider operations staff, designation of a named provider liaison with escalation authority assigned specifically to Maryland chiropractors, and a written response within 30 days.
- Resolution of specific operational failures, including the pre-authorization misrepresentation that caused providers to lose revenue through no fault of their own, the complete cessation of National Accounts claims processing since January 1, 2025, portal defects creating unappealable denial situations, and improper bundling of E/M and manual therapy codes with CMT.
We have already received an initial response. Our entry contact at CareFirst has acknowledged receipt of the brief and has committed to forwarding it to higher levels within the organization. While this is an early step, it is an encouraging sign that the letter is being taken seriously. CareFirst has been asked to provide a substantive written response within 30 days, and the MCA will continue to press for meaningful action.
Members wishing to contribute claims documentation or their own experience to this effort should submit through the MCA Member Forums. The full brief is available to members in the members area.
If you are not yet a member of the MCA, now is the time to join. Chiropractors across the state are being affected by this rapidly evolving situation, and there is strength in numbers. MCA members will be the first to receive critical updates, advocacy alerts, and opportunities to take action. Membership dues will be prorated based on your join date. For more information about becoming a member, visit the MCA website.