Chiropractic Future has a national effort underway targeting unfair Medicare policies, ERISA abuse and provider discrimination.
Chiropractic Future has a national effort underway targeting unfair Medicare policies, ERISA abuse and provider discrimination.Chiropractic Future has submitted three formal comments to the US Department of Justice’s Anticompetitive Regulations Task Force that address systemic violations of provider nondiscrimination law under 42 USC Sec 300gg-5, critical regulatory limitations within Medicare and possible misuse of ERISA preemption by insurers to limit chiropractic participation.
The comments elucidate regulatory practices that exclude DCs from equitable access to federal healthcare systems and private insurance markets; these practices continue despite legal recognition of DCs and their authorization to deliver services within their defined scope of practice.
“This is not just about doctors of chiropractic. It’s about fairness, access and patient choice in America’s healthcare system,” said Kristi Hudson, chairperson of the Chiropractic Future Leadership Committee. “Through this effort, we’ve drawn a clear line. Discrimination and competitive suppression must be addressed through federal enforcement.”
Key highlights from the comments
Provider nondiscrimination clause in the Affordable Care Act. DCs continue to experience lower reimbursement, excessive preauthorization requirements and exclusion from provider networks despite delivering services within their licensed scope and billing health insurance using the same codes as other providers.
These practices could suppress competition and patient access to proven, cost-effective care.
Medicare limitations. Although DCs are recognized under federal law as “physicians,” current Centers for Medicare and Medicaid Services (CMS) rules limit reimbursement for DCs to spinal manipulation only. Evaluations, diagnostic testing and rehabilitative care that fall within DCs’ scope of practice and are routinely reimbursed when delivered by other Medicare-recognized provider types are excluded from coverage when performed by DCs.
This policy limits patient access, raises costs and undermines clinical equity.
Employee Retirement Income Security Act (ERISA) preemption. These plans may allow insurers to impose lower reimbursement rates for DCs, arbitrary visit number caps and post-payment recoupments without due process.
These tactics could potentially violate fiduciary duties and allow insurers to favor higher-cost provider types.
Leaders call for nationwide, profession-wide support
Chiropractic Future encourages organizations, schools and individual providers to share these filings, support advocacy work and push for regulatory reforms that recognize the full value of nonpharmacologic, conservative care.
Marc Abla, CAE, chairperson of the Reimbursement Workgroup, urged colleagues across the profession to engage. “We’re calling on every doctor of chiropractic and every stakeholder in this profession to see these comments for what they are—a meaningful step toward opening the door to reform,” he said.
The organization also acknowledged the efforts of other national chiropractic groups that submitted similar comments to the Justice Department, emphasizing that the profession benefits from a unified push against regulatory barriers. These efforts share Chiropractic Future’s goal of ensuring patients have access to care from all qualified providers, supported by fair, consistent reimbursement policies.
About Chiropractic Future
The Chiropractic Future Strategic Plan is a collaborative initiative dedicated to creating better access, better reimbursement and a brighter future for the profession. Focused on driving national change, the initiative leverages innovation, data, research and technology to shape the future of chiropractic healthcare across the US. For more information, visit chiropracticfuture.org.
