The simple truth about Medicare and chiropractic equality

February 22, 2016 — The American Chiropractic Association (ACA), through its National Medicare Equality Campaign launched last October, intends to bring an end to the blatant discrimination against doctors of chiropractic and patients that has been allowed to exist in the Medicare program for over 40 years.

Despite what you might be hearing from a small faction of the profession, the campaign is aimed at eliminating the antiquated discriminatory definition of a chiropractic physician in Medicare in order to allow patient coverage and reimbursement for our full scope of practice under state law. Period. Simply put, if a service or set of services is covered by Medicare and it falls under a DC’s state scope of practice, the DC should be allowed to provide that service and the patient should be reimbursed.

Our strategy to address this injustice is a straightforward one:  the law must be changed to grant DCs the very same status enjoyed by MDs and DOs in Medicare. In short, this means changing the Physician Definition Section of 1861(r) of the Social Security Act.  Such a statutory change, as suggested by ACA, would:

1. Define DCs in the same manner as MDs and DOs under the law
2. Preserve the ability of DCs to treat and correct spinal segmental dysfunctions/subluxations under Medicare
3. Allow DCs to provide and be reimbursed for any Medicare covered service that falls within the individual’s state scope of practice and is reasonable and necessary
4. Provide DCs with the similar authority to order diagnostic tests
5. Leave intact all state scope of practice laws as they relate to the chiropractic profession

Regardless of the difficulties and obstacles that may be placed in our path, ACA will not rest until full equality is achieved for our profession and the millions of chiropractic patients who both need and deserve full coverage of chiropractic services in Medicare.

Smaller fringe groups confusing the issue

Despite the fact that the above intent is simple and clear, and there is a broad coalition of support throughout the profession, some smaller fringe groups object to this strategy. One of those groups has confused the issue by stating that somehow the proposal being considered would eliminate subluxation care. ACA has reviewed the comments and concerns expressed by this group, and we are struck by the degree of misunderstanding over the plain language of ACA’s Medicare legislative proposal.  ACA’s draft language contains an entire section that states the law must “include but not be limited to” covering manual manipulation of the spine to correct a subluxation and also all other services allowed by state law.  In addition, the proposal specifically provides for the inclusion of “the performance of any function or action” authorized under state law.

Unless this fringe group is prepared to argue that manual manipulation of the spine to correct a subluxation is somehow not a function or action authorized under state law, then its arguments are completely without merit. ACA’s position is that this language directly and completely includes manual manipulation of the spine to correct a subluxation given the long history of doctors of chiropractic performing this “function or action” in all states over the course of many years. ACA’s proposal parallels the language used in the definition of medical doctors as “physicians” under Medicare. We have done this in order to eliminate any possibility that the Centers for Medicare and Medicaid Services may misconstrue the meaning of the statute’s mandate of full inclusion and complete recognition of a doctor of chiropractic as a “physician” limited only by state law.

Regardless of what you might be hearing from the vocal minority within the profession, confronting this great challenge head on and in a forthright manner remains both the duty and responsibility of ACA — and it is one from which we shall not waver.

Here’s how you can help

Make no mistake about it:  ACA’s campaign to achieve full coverage for our patients in Medicare is nothing less than a national crusade and profession-wide ”Call to Arms,” in which every doctor of chiropractic and chiropractic organization can and should play a vital role.

The task at hand is monumental and we can’t do it alone.  This will be an “all hands” effort and one where we’ll need your help.  You can become involved by visiting the links below and participating in this campaign.

1. “How to” information for DCs
2. Bulletin to the profession from ACA President Dr. Anthony Hamm
3. Website widget to place on your website with a direct link to sign up for the campaign
4. Video  with tips for your clinic

5. Infographic showing money saving potential of chiropractic care
6. Webinar describing the campaign and how you can participate
7. “White board” animated graphic with background information on how you can help
8. FAQs on just about everything associated with the campaign
9. Testimonial videos featuring various profession leaders
10. Medicare timeline regarding chiropractic
11. Podcast that you can download and share that describes the National Medicare Equality campaign
12. Dedicated Facebook page where you can receive updates and information

The National Medicare Equality Campaign is the first nationwide effort to ensure full, unimpeded coverage and reimbursement for chiropractic patients in Medicare.  Full support and participation by doctors of chiropractic around the country is the lynchpin to our success. Be part of the solution and support the campaign today. Sign and share the petition at www.acatoday.org/equality.

Source: American Chiropractic Association