ACA Champions H.R. 7157; ICA Voices Major Concerns
Dynamic Chiropractic Staff
| DIGITAL EXCLUSIVE
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations – to Congress urging swift passage of the Chiropractic Patients' Freedom of Choice Act of 2018, the International Chiropractors Association is "urging caution" on H.R. 7157 based on the language of the bill being "incongruent with promises made." Specific ICA concerns include the following:
HR 7157 inserts a 'qualifier' which will set the entire profession up to become 'aberrant billers'. Rather than leave the "manual manipulation of the spine to correct a subluxation" intact, the language included in the statement of purpose will become part of the notes section of the law and inserts "as demonstrated to exist" as a new, unnecessary and arbitrary qualifier for compensation not required of any other physician level provider.
[HR 7157] includes a provision to limit services reimbursed by chiropractors, who are determined to be aberrant billers on a quarterly basis. In essence, the promised expansion of coverage will be eliminated for anyone the Centers for Medicare and Medicare Services (CMS) determines to be over billing. This is a provision ripe for abuse by over-zealous Medicare administrators.
All important decisions on coverage specifics, including dates and timelines, are at the discretion of CMS personnel. As written, CMS may drag out the implementation for 3-5 years.
HR 7157 also ignores the request of the chiropractic community to be treated equally in Section 1395a of the Social Security Act provision on private contracting.
In its press release, the ICA concluded: "HR 7157 provides no guarantee that any expanded compensation will be provided in the near future. As currently written the ICA does not support HR 7157 and recommends caution to the profession regarding the language in the legislation. The ICA is in the final stages of crafting legislation that is practical, feasible and has a realistic prospect of passage."
The chiropractic profession is under a sophisticated and relentless assault from corporate medicine, so strategically executed that most don’t even recognize it happening. The campaign is powerful, calculated, and well-funded, demonstrated by its covert tactics and the millions being invested to carry it out. Corporate medicine's endgame wants only two things from chiropractic: all our patients and all our money – and it is getting it.
Over the past two decades, more than 18 million spinal surgeries have been performed in the United States, and cervical disc replacements represent a fair share of those. Device recalls due to design flaws can place patients in difficult clinical situations, especially those who are symptomatic and reluctant to undergo revision surgery. This case highlights the role of chiropractors in managing complex postsurgical patients, particularly those with recalled spinal implants.
UnitedHealth Group, parent company of UnitedHealthcare, has announced sweeping changes to its prior-authorization (PA) requirements that will eliminate the requirement for chiropractic care and numerous other healthcare services by the end of 2026. Doctors of chiropractic, other providers and patients have long lamented prior authorization requirements because they can delay needed treatment, limit access and even cause some patients not to pursue care.
