As reported last month in DC,1 UnitedHealthcare (UHC) recently issued a special bulletin (Network Bulletin, Volume 21, September 2007) restricting chiropractic treatment of children, adolescents and headache patients and describing chiropractic care for these populations and conditions as "unproven."
The UHC policy evoked unprecedented opposition from the entire chiropractic community, including the ACA, ACC, COCSA, CCGPP, FCER and ICA, who banded together in a joint letter to UHC contesting the "flawed" and "unconscionable" policy.
After a meeting on October 25, 2007 between UHC and the ACN Chiropractic Professional Advisory Committee (CPAC), UHC has issued a stay on its policy, pending further review.2 UHC Senior Medical Policy Director, Dr. Richard Justman, reportedly apologized for the process in developing the policy and called for it to be put on hold for immediate review.
Over the next three months, UHC will be reviewing research and information provided by the CPAC and other chiropractic organizations, and will conduct more extensive consultation with well-respected researchers, published authors and clinical experts. UHC has agreed to delay implementation of a revised policy until the ACN Group has completed its background research. ACN/OptumHealth has notified providers of UHC's policy reconsideration through an October 29 letter and an article in the November 2007 UHC Network Bulletin.
The ACA continues to ask for answers to the questions posed in its original letter to UHC and has reasserted its appeal for the complete rescission of the policy. Kevin P. Corcoran CAE, executive vice president of the ACA, writes: "We fail to understand how UnitedHealthcare could have come to these conclusions without having done careful research. We again request the process involved in that research so that we can understand how such unfounded policies could have been developed. As the largest national association representing doctors of chiropractic and their patients, we would be remiss in not demanding answers to the fair questions posed in our letter."3
The ACA has praised the change in UHC's position as an example of how effective the chiropractic profession can be when united behind a single cause. "UHC's decision to review this policy is a victory for millions of chiropractic patients - young and old - who rely on chiropractic care to keep them well," said ACA President Dr. Glenn Manceaux. "The profession made it clear to UHC that this policy was incredibly harmful to the patients we serve and an insult to the chiropractic profession. The ACA is proud to have led this effort, which serves as a very important reminder that there is strength in numbers. When all corners of the profession work together with a single vision and a single voice, there is no limit to what we can accomplish. It also underscores the critical role research and evidence play in the reimbursement world and the need for insurers to consult with the chiropractic profession before implementing changes that negatively affect our patients."2
To supplement UHC's review of the literature, chiropractic organizations are being asked to submit pertinent peer-reviewed and published research to Dr. David Elton, ACN's senior vice president of clinical products, at: OptumHealth, 6300 Olson Memorial Hwy, Golden Valley, MN 55427.
References
- "Profession Unites to Oppose UHC Policy." Dynamic Chiropractic, Nov. 19, 2007. Available at www.chiroweb.com/archives/25/24/16.html.
- "UHC Issues Stay on 'Flawed' Policy on Children and Headaches; Profession Unites Behind ACC-CCGPP-Led Effort." ACA press release, October 26, 2007.
- Letter from Kevin Corcoran, ACA executive vice president, to Robert Sheehy, chief executive officer of UnitedHealthcare, Nov. 5, 2007.
