January 2006

Chiropractic coalition responds to OIG Medicare report

A coalition of four chiropractic organizations has released a jointly developed action plan intended to remedy Medicare claims-processing problems identified in a June 2005 government report.

The report, issued by the Department of Health and Human Services (HHS) Office of the Inspector General (OIG), was highly critical of the chiropractic profession’s participation in the Medicare program.

The four organizations included in the task force are the Association of Chiropractic Colleges (ACC), the American Chiropractic Association (ACA), the Congress of Chiropractic State Associations (COCSA), and the Federation of Chiropractic Licensing Boards (FCLB).

The OIG report, based on a random sampling of claims data from 2001, concluded that 67 percent of the claims examined as part of the study contained documentation errors or omissions that led to what the OIG considered to be inappropriate reimbursement under Medicare. The report also extrapolated that U.S. taxpayers could save more than $280 million per year if improperly documented claims filed by chiropractors were not paid by Medicare.

While documentation errors relating to Medicare claims are common to all provider types, as a class, DCs have the highest error rate in comparison to other provider groups, according to the report.

The proposed action plan relies heavily on the cooperation of state licensing authorities to develop mandatory continuing education courses specific to the issue of documentation and that are targeted at Medicare compliance. The plan also calls on chiropractic colleges to review their curricula to ensure that chiropractic students receive comprehensive training on proper documentation for “medical necessity.”

In addition, the plan relies on the cooperation of COCSA-member state associations to work closely with the ACC, ACA, and state licensing boards to offer a number of quality continuing education opportunities that are uniform in content. The four groups comprising the Task Force will work together to develop “model” content for these training programs, with a core program unveiled by May 2006.

The Action Plan is available online at www.acatoday.com.

Source: American Chiropractic Association, www.acatoday.com

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