ACA, ICA at Odds Over H.R. 7157

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."

Editor's Note: To learn more about this important new legislation, read our front-page article in the January 2019 issue, "Time to End the Medicare Madness."