ACA Champions H.R. 7157; ICA Voices Major Concerns
Editorial 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."
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?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
