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Chiropractic News

March 2010

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House passes healthcare reform bill, chiropractic to benefit

March 22, 2010 — The U.S. House of Representatives passed HR 3590, the Senate-passed version of national healthcare reform legislation. The final vote took place after a nearly 13-month battle, culminating in a contentious struggle to garner votes from undecided members of the Democratic majority in Congress.

This means the provisions contained in HR 3590 now only await President Obama’s signature to be enacted into law. These provisions include an important provider nondiscrimination provision long championed by the American Chiropractic Association (ACA).

Incorporation of this provider nondiscrimination provision, also known as the “Harkin Amendment,” was achieved primarily due to the efforts of Sen. Tom Harkin (D-Iowa), with help from other key players such as Sen. Chris Dodd (D-Connecticut). Although he did not support the final bill overall, Sen. Orrin Hatch (R-Utah) also lent his support for the advancement of the non-discrimination provision.

“Regardless of how you feel about this legislation and its overall impact on the nation, it has to be recognized as an historic first for the chiropractic profession. We now have a federal law applicable to ERISA plans that makes it against the law for insurance companies to discriminate against Doctors of Chiropractic and other providers relative to their participation and coverage in health plans. Such discrimination based on a provider's license is inappropriate and now must stop,” said ACA president, Dr. Rick McMichael.

“While this does not fully level the playing field for doctors of chiropractic in our health care system, this is a highly significant step that has the potential for positive, long-range impact on the profession and the patients we serve. Congress has finally addressed the issue of provider discrimination based on one's license, and they have said that such discrimination must stop.”

The provider nondiscrimination provision (Section 2706) to be enacted into law reads in part: “A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care

provider who is acting within the scope of that provider’s license or certification under applicable State law.”

Regarding this provision, John Falardeau, ACA’s vice president of government relations said, “The Harkin nondiscrimination language will be applicable to all health benefit plans both insured and self-insured. National healthcare reform is designed to eventually cover 30 million currently uninsured Americans. The nondiscrimination language will, over time, apply to those individuals as well. However, that number of covered individuals pales in comparison to the 55 percent of workers who are currently covered by self-insured plans that will be affected by the Harkin nondiscrimination language. The potential impact in this regard cannot be overstated.”

Additionally, the legislation passed by the House includes two other provisions that impact the chiropractic profession. Doctors of chiropractic are specifically included as potential members of interdisciplinary community health teams. These teams support the development of medical homes by increasing access to comprehensive, community based, coordinated care.

Community health teams are integrated teams of providers that include primary care providers, specialists, other clinicians, licensed integrative health professionals and community resources to enhance patient care, wellness and lifestyle improvements.

The language in the bill ensures doctors of chiropractic can be included in these patient-centered, holistic teams.

Dr. McMichael noted, “This language was a critical inclusion to give doctors of chiropractic increased opportunities to be fully engaged as part of the healthcare team.”

Furthermore, the legislation establishes a National Health Care Workforce Commission to examine current and projected needs in the healthcare workforce. The commission specifically includes doctors of chiropractic by defining them as part of the healthcare workforce, and includes them in the definition of health professionals.

In addition, chiropractic colleges are included among the health professional training schools to be studied. The National Health Care Workforce Commission is tasked with providing comprehensive, unbiased information to Congress and the Obama administration about how to align federal healthcare workforce resources with national needs.

Congress will use this information when providing appropriations to discretionary programs or in restructuring other federal funding. The language in the bill guarantees the need for doctors of chiropractic will be addressed when considering federal healthcare workforce programs, another very important inclusion.

Source: American Chiropractic Association,

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2012-07-01 08:51:54
Name: CLS

Location: Illinois
Will we likely be seeing more high deductibles, which are essentialy cash payments with strings attached? If so, aren't the unuinsured just going to be paying for a benefit they seldomly use? Is there any movement in the works that protects uninsured from having to pay for something they do not use or use very little of?

2012-06-30 00:18:51
Name: Doctor

Location: Texas
Medicare does not work. Unfortunatly I can not afford to see patients over 65. I give quality holistic service with adjustments. Patient visits range for 30 to 60 minutes which may include nutrition evaluation,eduaction,physiotherapy,exercise prescription and adjustments. Medicare will pay less than $20.00 a visit. My student loans are currently $180,000.00. I pay malpractice fees, continuing education fees, facility fees,and licensing fees. If Obama care is like Medicare and I am forced ta

2011-04-28 17:50:09
Name: Rick

Location: San Diego
It most cases the insurers "allowance" of chiropractic participation will be limited to the patient's co-pay, with no further payment from the insurer, thus eliminating the insurers financial responsibility, limiting the patient's costs, and obligating the doctor to treat for extremely low fees.

2010-03-23 20:16:00
Name: Michael Whitmore

Location: Georgia
good question. After reading the above I still do not know how much the Chiropractor will get paid for an adjustment and if some one has to first give me promission to adjust the patient. And what is covered. If someone comes up the the answers please be kind to tell me so that I can pass the word along

2010-03-22 14:53:32
Name: Jerry

Location: Washington
Section 2706 also goes on to say that a provider contracting with an insurer must follow the provisions of the contracted plan. Sounds like a loop-hole.

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