Proposed Chiropractic Care Provision For Veterans Dropped From House Bill

An amendment regarding chiropractic care for veterans prepared by the staff of the House Veterans Affairs Committee and due to be inserted in legislation pending before the full U.S. House of Representatives was dropped from inclusion in the overall measure after the American Chiropractic Association, the Association of Chiropractic Colleges, and the International Chiropractic Association rejected the watered-down proposal as inadequate.

Preparation of the congressional staff-authored proposal came after chiropractic groups urged the House Veterans Affairs Committee to include a "full scope and direct access" chiropractic provision in the Department of Veterans Affairs Health Care Personnel Act of 2000 (H.R. 5109) when the bill was marked up by the House VA Committee in mid-September. According to the ACA, several members of the committee indicated their support for including a chiropractic-related amendment in the bill, provided acceptable legislative language could be agreed upon prior to a vote on the measure by the full House of Representatives.

ACA, ACC and ICA submitted a detailed and jointly developed legislative proposal to the committee. The proposal included provisions that would have required the Department of Veterans Affairs to provide chiropractic care on a "direct access" basis, and would have allowed doctors of chiropractic to practice their "full scope" of practice within the VA health-care system, as allowed by state law. Under current VA policy, chiropractic care, which is rarely provided as a VA benefit, can only be obtained after first receiving a medical doctorís referral, and chiropractors are effectively limited to treating only low back pain.

In response to the chiropractic groupsí proposal, the House VA Committee staff prepared an "alternative" proposal that would have required the VA to develop, but not fully implement, a program to improve access to chiropractic care within the VA, the ACA said.

The proposal mentioned direct access to chiropractic care, but did not provide for it and called for a study period of at least two years. The proposal would have secured employment authority for chiropractors, but under the provisions of Title 38, Section 7402, as non-primary providers, chiropractors would have been placed in the same category as "other health care providers" such as physical therapists, dietitians and dental technicians, according to the ICA.

After reviewing the proposal, issued 18 hours before the bill was to be voted on by the full House, the ACA, ACC and ICA unanimously rejected it. The House VA Committee then dropped the proposal from the bill. The House of Representatives passed the bill in mid-September, without any chiropractic provision attached. The bill will be married with similar legislation that has already passed the Senate, and itís anticipated the bill will become law this year, ACA said. ACA, ACC and ICA representatives said they plan to continue their efforts when Congress reconvenes in January.

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