06/23/2023    Paul Kesselman, DPM

Cigna and 20600 20605 Restrictions

Cigna Health Care recently announced a total limit
of four injections for each CPT code 20600
Arthrocentesis, aspiration and/or injection; small
joint or bursa (e.g., fingers, toes); without
ultrasound guidance) or 20605 ((Arthrocentesis,
aspiration and/or injection; intermediate joint or
bursa (e.g., temporomandibular, acromioclavicular,
wrist, elbow or ankle, olecranon bursa); without
ultrasound guidance).

This misguided policy by CIgna Health Services
should be the last straw for providers to
seriously consider their stop cooperating with any
insurance company with misguided policies. How in
the world will a hand surgeon know that a DPM or
other MD/DO provided an injection to the
foot/ankle or vice versa? Patients certainly will
not know. Hopefully APMA will work with other
organizations representing other providers) to
convince CIgna to abandon a bad policy. At the
same time that this policy was announced, Becker's
HealthCare announced the salaries of some Health
Insurance CEO salaries and I would assume they are
similar for Cigna and other insurance companies.


BCBS Michigan
CEO Daniel Loepp
Salary: $1.7 million
Bonus: $13.8 million
Total: $16.9 million
(Source: Detroit Free Press)
Administrative costs for Blue Cross Blue Shield
plans rose in 2022, according to an analysis from
Sherlock Company.
Costs increased by 7.2 percent in 2022, compared
to a 0.4 percent decline in 2021.
I wonder why?

Hawaii Medical Service Association
CEO Mark Mugiishi, MD
Salary: $1.02 million
Bonus: $2 million
Other: $6,000
Total: $3.03 million
(Source: Honolulu Star Advertiser)

Excellus BCBS
President and CEO James Reed
Salary: $1.15 million
Other compensation and bonuses: $1.05 million
Total: $2.2 million
(Source: Buffalo Business First)

A seven figure bonus? Are you serious?

Let's not forget that there is a recent
whistleblower case out there brought by a former
Cigna Medical director backed by others, whereby
Cigna en masse denied appeals without ever opening
the file. That was at a rate of thousands of
claims denied per minute without ever even opening
the file.

When will our Congress finally get the message?
When will you? When will self-insurance plans
whose beneficiaries cannot obtain required
healthcare say enough?

Paul Kesselman, DPM, Oceanside, NY

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