July 28, 2018—The American Chiropractic Association (ACA), supported by chiropractic organizations across the country, strongly opposes a new policy by UnitedHealthcare (UHC) that denies headache sufferers the option to treat their pain without drugs using spinal manipulative therapy (SMT).
In a letter to UHC President and CEO Dan Schumacher, ACA calls the policy–which denies coverage of SMT for headache treatment because it states it is “unproven and/or not medically necessary”–flawed because UHC failed to include key studies in an analysis conducted in advance of its determination.
“We urge UHC to withdraw its policy based on the most recent research, systematic reviews, and practice guidelines (including AHRQ), which support the use of spinal manipulation for the treatment of headache,” writes ACA President N. Ray Tuck, Jr., DC.
The letter is cosigned by the Congress of Chiropractic State Associations, the Clinical Compass (formerly known as the Council on Chiropractic Guidelines and Practice Parameters), the American Black Chiropractic Association and 24 state/regional chiropractic associations.
Offering additional justification for the policy’s withdrawal, ACA points to the “insufficient and inadequate” management of migraine and cervicogenic headache using drugs along with the relative safety of SMT compared to other treatments covered by UHC for headache. “Providing headache sufferers with viable alternatives for managing their condition is an important aspect of patient-centered care,” the letter states.
This was not the first time that UHC has tried to deny coverage of SMT for headache. In 2008, the company made a similar determination but later reversed its decision after reviewing evidence provided by ACA and others. ACA and its partners plan to oppose the current policy with equal vigor by reaching out not only to UHC but also potentially to employers and other stakeholders to share information regarding the serious issues raised by UHC’s determination.
ACA’s letter adds, “The use of this flawed policy constitutes, in our view, a breach of fiduciary responsibility for a health plan administrator who must ensure that the plan claims are decided in accordance with plan documents and valid evidence.”