February 2008

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New AMA guidelines: Possible violation of Wilk injunction

Feb. 15, 2008 — New guidelines issued to medical doctors by the American Medical Association (AMA) violate the Wilk vs. AMA lawsuit, according to the American Chiropractic Association (ACA). ACA has asked for an immediate withdrawal of restrictive language in the AMA’s “Guides to the Evaluation of Permanent Impairment, 6th Edition.”

The guideline limits evaluations by doctors of chiropractic to the spine only. ACA has also contacted the Federal Trade Commission and the U.S. Department of Justice regarding concerns about the new guidelines.

“In our view, the action of the AMA in issuing this standard unlawfully restricts competition and excludes a competitive rival, i.e. doctors of chiropractic from the provision of impairment ratings,” writes ACA General Counsel Thomas R. Daly in a Feb. 13 letter to AMA Executive Vice President Michael D. Mabes, MD. “We note that neither the ACA, nor any other major chiropractic group, was approached or provided input in the standard setting process that established this new restriction.”

The language in question is published on page 20 of the AMA guide in a section entitled “Fundamental Principles of the Guides.” Specifically, Item 6 of Table 2-1- states: “A licensed physician must perform impairment

“This new standard has a devastating effect on doctors of chiropractic in that it will be used to prevent doctors of chiropractic from performing adequate and complete ratings,” ACA’s letter to the AMA states. “It targets doctors of chiropractic for exclusion or elimination from this important service which they currently provide under state law in competition with medical doctors.”

ACA’s letter also reminds the AMA of the Wilk decision and states that the “recent action which implements a new and onerous restrictive standard on the practice of doctors of chiropractic violates existing antitrust law as well as the provision of the permanent Wilk injunction.”

ACA’s legal team is also seeking meetings with representatives of the Federal Trade Commission and the anti-trust division of the Department of Justice to outline the association’s concerns. In addition, ACA is identifying members of Congress who might be willing to assist the association in its efforts to redress the problem.

For more background on the Wilk injunction, go to www.ChiroEco.com/wilk.

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