March 17, 2009 — The American Chiropractic Association (ACA), in coordination with the National Chiropractic Legal Action Fund (NCLAF), has initiated an “all fronts” response to the Blue Cross Blue Shield Association’s (BC/BSA) Jan. 1 policy change that removed doctors of chiropractic from the classification of “physician” in the Blue Cross Blue Shield Federal Employees Health Benefits Plan (BC/BS FEP).
According to reports from chiropractors, this policy change has caused the local Blues Plans to interpret the application of BC/BSA’s action in different ways. Some states report that doctors are being restricted from performing therapeutic modalities or referring federal employee patients for other services, including diagnostic and physical or occupational therapy services. In addition, ACA has received reports that as a result of the Jan. 1 reclassification, one commercial Blues Plan denied allowance of coverage for E/M services performed by a doctor of chiropractic.
According to ACA officials, the change in the BC/BS FEP physician status of doctors of chiropractic has potentially devastating effects on the degree to which chiropractic will be included in the final version of any national healthcare reform plan. The BC/BS FEP is increasingly becoming the standard for current and future legislation. Further, BC/BS FEP is currently used in federal law as the “benchmark” for health coverage.
As an example, under the SCHIP program, Section 2109 “Coverage Requirements for Children’s Health Insurance” lists the “Blue Cross/Blue Shield preferred provider option service benefit plan” (42 U.S.C. 1397cc(b)) as a “Benchmark Benefit Package.” No other private health insurer is identified in such a manner. In addition, SCHIP law provides that “physician services” are included in “basic services” that must be covered whereas the services of other health care providers are considered “additional services” that are optional (42 U.S.C. 1397cc(c)(2)).
President Obama has pointed to federal employee health plans, such as the BC/BS FEP, as his template for national health care reform. The President has stated on his official Web site that he intends to “establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.”
In addition to the threat posed by BC/BSA, the ACA has information to indicate that several insurers and managed care companies are making policy changes to diminish the role of chiropractors. In some plans, chiropractic manipulative treatment may be administered only by an MD or DO. Furthermore, the American Medical Association (AMA) recently adopted a policy that would make it a felony for anyone other than an MD or DO to refer to oneself as a “physician.” ACA has also seen a Federation of State Medical Boards’ resolution that would call on state medical boards to consider passing similar preclusions for use of the term “doctor.”
The ACA and NCLAF urge doctors of chiropractic to support the ACA and to contribute to NCLAF in order to provide the resources needed to take on the forces assembled against the profession. For more details on how you can donate to NCLAF and assist in the efforts to reverse the aforementioned policies, visit www.acatoday.org/nclaf. The ACA will distribute further information and updates regarding this situation as more details are available.
Source: American Chiropractic Association, www.acatoday.org
