A decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven and ineligible for reimbursement. The American Chiropractic Association and numerous other chiropractic organizations united in opposition to the policy,1 and UHC ultimately reversed course:2
In September of 2007 UnitedHealthcare issued a revised medical policy on Chiropractic Services. This policy stated that spinal manipulative treatment for headaches and for pediatric patients was unproven and therefore not a covered service. As announced in October [2007], the ACN Group Chiropractic Professional Advisory Committee (CPAC) has facilitated the collection of input from the chiropractic professional community regarding this revised policy. As a result of this interaction, UnitedHealthcare will not proceed with the chiropractic services policy change announced in the September 2007 UnitedHealthcare Network Bulletin.
Fast forward to a few months ago and UHC was up to its old tricks again, updating its policy on manipulative therapy to state that manipulation is "unproven and/or not medically necessary" for headache. Just like a decade ago, the ACA and others intervened, with the ACA sending a research-supported letter, cosigned by nearly 40 state and national chiropractic organizations as of press time, challenging the policy.3 And once again, UHC appears to have backtracked quickly by removing the language from its policy.
In the July 23, 2018 letter to UHC President / CEO Dan Schumacher, Dr. N. Ray Tuck Jr., president of the ACA, stated (excerpted): "Given insufficient and inadequate pharmacological management of migraine and cervicogenic headache, in particular, providing headache sufferers with viable alternatives for managing their condition is an important aspect of patient-centered care. This is why we were astounded to learn that a recently adopted UHC policy would deny coverage of chiropractic spinal manipulative therapy (SMT) for headache to thousands of affected patients by defining manipulative therapy as applied to the treatment of headache as 'unproven and/or not medically necessary.'"
"If UHC refuses to withdraw this policy, we plan to provide this information to our members so they may assist their patients in challenging your flawed guideline under ERISA appeals procedures (29 CFR 2560.503-1). We will also notify employers and other stakeholders that your guideline is flawed, does not reflect the most recent outcomes research, and improperly denies essential chiropractic care for headache pain. In addition, we will alert them as to how the use of this flawed policy, as a basis for adverse coverage determinations, may violate plan-governing documents in contravention of fiduciary responsibility."
As of press time, a boxed section at the bottom of the UHC policy on manipulative therapy4 titled "Policy History / Revision Information" suggests the headache restriction has been removed from the policy [our emphasis in italics]:
Revised coverage rationale:
Replaced language indicating manipulative therapy is unproven and/or not medically necessary for:
The ACA took a cautious tone when commenting on the apparent policy reversal, stating: "The American Chiropractic Association (ACA) is aware that the UnitedHealthcare policy on manipulative therapy posted online has reverted back to its previous version. Talks between ACA and UHC regarding the headache policy continue." Stay tuned.
References
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
