August 2005

‘Incident-to’ rule back into effect
for demo project participants

Chiropractors participating in the Medicare demonstration project must comply with the “incident to” rule, which had been temporarily suspended.

The incident-to requirements state that all office staff — for example, CAs — providing and billing Medicare for incident to therapy services to have received training from a program recognized by the American Medical Association or the American Physical Therapy Association.

The rule had been temporarily suspended when the National Athletics Trainers Association (NATA) filed suit against the U.S. Dept. of Health and Human Services, claiming that the rule restricted athletic trainers in their practice. A federal district court dismissed the NATA lawsuit. The court said it did not have jurisdiction to consider the case. NATA intends to file an appeal.

According to the American Chiropractic Association (ACA), enforcement of the incident-to rule means that chiropractors in the demonstration project must perform all services themselves, unless they have staff that meet the requirements of the rule.

Chiropractors outside of the project are not affected.

Sources: Chiropractic Economics Newsflash, www.chiroeco.com/news/2005/April/CMS.php, National Athletics Trainers Association, www.nata.org; American Chiropractic Association, www.acatoday.com.

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