ACA responds to UHC policy classifying chiropractic as ‘nonessential’

By Rick McMichael, DC, ACA president

October 29, 2010 — You may recently have heard about United Healthcare (UHC) and another flawed policy proffered by this carrier. Like you, we at ACA are not at all happy about it.

This unfortunate policy, which offers definitions of “essential, mixed, and non-essential benefits” — chiropractic is listed as nonessential — is just another attempt to jockey around impending non-discrimination mandates. We are developing an appropriate response along with our Chiropractic Summit partners so our message is unified and our actions are focused and effective. We will share the response with you once it is available.

As you know, health insurers and the AMA have in the past sought to segregate and eliminate chiropractic services (e.g., the Wilk case). This sort of behavior was a moving factor in the development and passage of state insurance equality/nondiscrimination statutes.

The Harkin nondiscrimination language (Section 2706 of the Patient Protection and Affordable Care Act (PPACA)) was designed to offer patients and providers similar protection, but on a federal level and with an expansive reach that will include self-insured plans.

UHC never envisioned or expected this law to pass with such protections intact. Its policy is an attempt to, once again, segregate and eliminate chiropractic services by listing such services as “nonessential.” 

We see this for what it is — a page from the old play book, only this time it will potentially violate existing state law, and will certainly violate the recent “Harkin language.” It appears UHC is attempting to use the categorization of our services as “nonessential” in hope of “grandfathering” this limitation to 2014 and beyond.

UHC’s action underscores the need for our continued focus on the regulations that will implement the healthcare reform legislation.

As the Chiropractic Summit’s leaders have maintained all along, the critical opportunity for this profession to leverage the healthcare reform law to its favor will come in the regulations that determine “essential services,” as well as the specific provisions for insurance exchanges, grandfathering of existing plan arrangements, primary care, and wellness/prevention services.

Our team of government relations professionals, in conjunction with your leadership, will work with HHS as it proceeds to draft, and issue for comment, regulations that will ultimately define “essential benefits.”

UHC’s action is also of concern to us because it categorizes chiropractic as a treatment versus a profession with multiple diagnostic and treatment options available for patient care.

We do not see this approach taken with any other provider type. Given that DCs provide examinations, rehabilitative care, manipulative services, wellness and preventive services, etc., all of these services should be accessible.

With this perspective, the conservative, cost-effective services we offer should receive a more positive reception (e.g., a new study report, now in press at the Journal of Manipulative and Physiological Therapeutics, reports low back pain care initiated with a chiropractor is 40 percent less costly than care initiated through a medical doctor). Insurance companies should begin to understand that to restrict access to a DC’s care may, inadvertently, increase their cost of care.

Containing costs, while providing quality health care to as many Americans as possible, is of critical importance to us all. As healthcare reform is implemented, we must fully employ the expertise of all leaders in the chiropractic profession to help our nation accomplish these objectives.

ACA and our Chiropractic Summit partners, including ACA, ACC, and ICA government relations experts — working with Richard Gephardt and his team — are striving daily to effectively advance the chiropractic profession. ACA believes there is no individual doctor, executive or association that knows better how to proceed to ensure the best results.

To win, we must move together, following the national leadership and their plan of action. 

Help us spread the word in your states to stay the course …

• Watch for action alerts from ACA and the Chiropractic Summit, taking definitive and timely action as requested; we especially appreciate your continued donations to CHAMP so we can afford to tell your story on the Hill.

• Continue to sign-up your patients to ChiroVoice and strengthen chiropractic’s grassroots.

• Share with us your successes locally; we appreciate receiving your reports as to actions taken and will share them among our members across the country.

ACA appreciates the support of all its members in advancing this profession. We can do this together!

Source: American Chiropractic Association, www.acatoday.org