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Board of County Commissioners Meeting Minutes - Final December 20, 2016 A motion was made by Vice Chairman O'Bryan, seconded by Chairman Flescher, to make the following changes to the County's Health Care Plan, effective January 1, 2017: (1) cap the maximum amount of visits for acupuncture to 26 per year; and (2) continue to pay out at 60% up to a maximum dollar cap of $45.00 per claim.. Director Boyll informed the Board that according to Florida Statute, if something is covered by a Health Plan, the benefit needs to be covered in the same manner for all other physician services, and restricting the maximum payout to $45.00 per visit would not be permissible. The motion was amended by Vice Chairman O'Bryan, seconded by Chairman Flescher, whereby any out -of -network provider that does not provide staff with requested information, will be paid at 60%, with a cap of up to $45.00; and to treat all physician services the same, effective February 1, 2017. Acupuncture Physician Angela King, 1125 Driftwood Drive, clarified the verbiage in the Florida Statute regarding billing, and spoke about the appropriate billing codes for acupuncture and the allowable insurance amounts to charge patients for out -of -network providers. She suggested that since acupuncture care is out -of -network, the Board should consider instituting not just a $45.00 cap on a claim, but allow up to 26 visits, and/or a reimbursement of up to a maximum of $1,000 per person. She expounded on the resources for ethical acupuncture insurance billing and the e-mails she had sent to staff, and stressed that her business has always properly billed and has not engaged in the practice of allowing employees free visits and supplements. She agreed to assist and meet with staff, at the Board's request. Director Boyll reported that there was no cap on chiropractic services at this time, and wanted to ensure health plans stay consistent and compliant with the law. Acupuncture Physician Alexis Edwards, Absolute Integrated Medicine, spoke on behalf of Jill Jaynes, and stated that County staff had not directly inquired about their billing policies. She described her issues with staff's letter; explained why she thought their business has grown; and acknowledged that customers were not being charged with copays because their business was out -of -network and not required to do so; however, as of January 2017, copays will be initiated. Vice Chairman O'Bryan questioned whether the maximum reimbursement of $1,500 could apply to chiropractic as well as acupuncturist services, and whether it would be agreeable to Florida Blue without a long legal debate. Director Boyll and Administrator Brown felt it might be best to make the motion for acupuncture practices only, and add chiropractic services at a later date, if necessary. Indian River County Florida Page 5