ICA Congressional Initiatives Seek to Open Up New Access
to Chiropractic Services
FROM THE INTERNATIONAL CHIROPRACTORS ASSOCIATION
EXCLUSIVE TO CLINICAL CHIROPRACTIC JULY 9, 2001
Legislation has been introduced in the U.S. House of Representatives at
the request of the International Chiropractors Association aimed at
opening up new access to chiropractic services for upwards of 20 million
Americans through the Medicare and Federal Employees Health Benefits
programs. These two initiatives represent responsible, practical and
affordable policy enhancements that, when enacted, will make a major
difference in the chiropractic economy in the United States and in the
quality of health care and quality of life for millions of our citizens.
MEDICARE: H.R. 2284, introduced by Representative John Lewis (D-GA),
will expand the list of services reimbursed under Medicare to include
examinations and x-ray services. This landmark bill will also provide
that only doctors of chiropractic are authorized to deliver chiropractic
services under Medicare.
“This important legislation represents a major step forward for the
chiropractic patient in that it removes the practical barriers that have
kept millions of Medicare beneficiaries from realistic access to
chiropractic services,” said ICA President Dr. D.D. Humber. “In order to
provide the care our senior citizens need, examinations and imaging
procedures such as x-rays are absolutely essential for the provision of
quality chiropractic care. When seniors discover that Medicare only pays
for the adjustment, too many make the painful decision not to seek
chiropractic care because they simply cannot afford to pay for those key
elements in the chiropractic care program. This bill will open the door
for those millions of citizens.”
Representative John Lewis, a longtime chiropractic advocate in the U.S.
House, stated in a letter to his Congressional colleagues that:
“The Medicare Improvement Act of 2001”, will add an important element of
fairness and equity in the Medicare program for those patients whose
healthcare needs can best be met through chiropractic services and whose
health orientation and/or individual needs preclude the standard,
expensive, invasive, drug-based and often high-risk traditional medical
procedures. Medicare is not a public assistance program; it is an
individually funded health program for which citizens pay all their
working lives. Citizen needs and citizen choices deserve to be protected
and expanded at every opportunity.
This legislation is designed to make chiropractic services accessible to
more of our senior citizens, on an equitable and competitive basis. I
believe that each of our citizens should have access to the health care
services of their choice. This is particularly true in the area of
chiropractic because of the highly cost-effective, drug-free, natural
approach to health and healthcare that chiropractic care offers. There
is no doubt that those Medicare beneficiaries who seek the care of a
doctor of chiropractic would, if they did not have that option, be
seeking standard medical care, often involving highly expensive
specialists. Thus, rather than costing Medicare more, this bill will end
up saving Medicare money.”
“ICA supported the introduction of this piece of legislation because
such a targeted list of services is the only way new benefits are likely
to be added for the chiropractic Medicare patient,” said ICA President
Dr. D.D. Humber. “Other legislative efforts that would have provided for
full scope inclusion have, after a period of years, not been successful.
ICA has been frankly advised by senior Members of Congress that only a
targeted, specific list of new benefits has a chance of passing the
current Congress. In the best interests of the profession, ICA has
heeded this advice.” H.R. 2284 represents the elderly chiropractic
patient’s best hope for a major expansion of the list of chiropractic
services Medicare will pay for.
The Lewis bill specifically provides for the following improvements in
the current Medicare program:
A. It would change the current law by the inclusion of the following
statement: “Chiropractic services may only be furnished under this title
by a doctor of chiropractic.” At the present time, managed care plans
have been allowed under Part C regulations to substitute “chiropractic
like” procedures delivered by physiatrists, DOs and other
non-chiropractic providers to fulfill the obligation on Medicare’s part
to cover chiropractic care. This amendment to the current law would
close this loophole and guarantee the honest provision of real
chiropractic services. No other proposal before this Congress would
achieve this vital goal.
B. It would require payment for “Diagnostic x-ray tests.”
C. It would provide for payment for “Such other appropriate chiropractic
examination procedures that the Secretary identifies by regulation.”
D. It would require the Secretary of Health and Human Services to
consult the chiropractic profession in a “negotiated rulemaking
process,” before regulations outlining additional reimbursable
chiropractic services are finalized, thus guaranteeing a voice in the
final shape of the rules governing the proposed new benefits. This
provision is a powerful protection against any prejudicial
interpretation by the Secretary.
E. It would further establish the unique service of the “chiropractic
adjustment by amending the law identifying those chiropractic services
authorized for reimbursement to read, “...chiropractic adjustment or
manual manipulation of the spine to correct a subluxation.” The current
law only specifies “manual manipulation” which has widely been
interpreted as a generic procedure which might be applied by a wide
range of providers. Under the new proposal, only a DC can administer a
chiropractic adjustment.
F. It provides for the establishment of a legal obligation to pay for
examinations and x-rays for Medicare beneficiaries, opening up
meaningful access to chiropractic services for more than 10 million
senior citizens who, at the present time, are unable to pay for those
necessary services out of pocket, and have no supplemental insurance.
Medicare presently covers 39 million beneficiaries and administers the
nation’s largest health insurance program, at a cost of just under $200
billion.
ICA has studied the legislative situation and conferred with a wide and
diverse group of analysts and authorities, including Members of both
Houses of Congress, and concluded that the approach taken in H.R. 2284
represents the best chance for new benefits under the Medicare program.
“The post-tax-cut atmosphere in Congress has both parties looking more
closely than ever at the costs associated with any new spending
initiative,” said Dr. Humber. “We have been bluntly told that Congress
simply will not pass an open-ended benefit expansion for chiropractic
services based on state scope, both because of the cost and because
Congress will not saddle HCFA with a chiropractic services program that
is different in every state.”
The chiropractic profession is facing the traditional battle for scarce
federal funds, a struggle massively complicated by the current debate
over a Medicare prescription drug benefit. ICA is determined, however,
to use this new drug spending issue to promote the expansion of a more
cost-effective, natural care choice through chiropractic. “ICA is asking
the entire chiropractic profession to get behind the prompt passage of
H.R. 2284 because the window of realistic opportunity is very limited,”
said Dr. Humber. “Only a massive grass-roots campaign involving
chiropractic practitioners, students and, most importantly, Medicare
patients, will bring this bill to a successful conclusion.”
In this Congress, when the nation is contemplating the investment of
billions more in Medicare to fund a prescription drug benefit, ICA
believes it is only fair and proper to make additional provisions for
enhanced care for those hundreds of thousands of senior citizens who,
for reasons of conscience, religion or their own health situation,
cannot or choose not to take drugs. Chiropractic, because of its focus
on the structures of the spine and nervous system and how they interact,
offers one of the most valued elements in the quality of life of our
senior citizens, help in maintaining mobility. As well, because
chiropractic is a drugless science, it offers a choice that preserves
clarity of mind.
ICA is asking all who are interested in fairness and equity in the
Medicare program to write their Congressional Representatives and urge
their support for H.R. 2284 as a co-sponsor of the bill.
FEDERAL EMPLOYEES HEALTH BENEFITS: HR 2087, the Federal Employees Access
to Chiropractic Health Care Act of 2001, was introduced at ICA’s request
on June 4, 2001 by Vermont Representative Bernard Sanders. This
important initiative will enhance the quality of care and increase
competition in federal employees health benefits programs by insuring
that beneficiaries in these programs have the right to access
chiropractic care if they feel it best meets their health care needs.
This patient choice bill represents an important step forward in
insuring that federal employees have the widest possible range of health
care choices. This bill also is intended to enhance competition in
federal health care programs since chiropractic services are highly
cost-effective, and represent a highly effective, drug-free, natural
approach to health and healthcare that no other profession offers.
Beneficiaries of these programs who seek the care of a doctor of
chiropractic would, if they did not have that option, be seeking
standard medical care, often involving highly expensive specialists.
Study after study has affirmed the cost effectiveness of chiropractic
care. Thus, rather than costing more, this bill will end up saving the
taxpayers money. This bill does not mandate new services, it allows the
nine million beneficiaries of these plans to choose from a wider range
of providers, including the proven, highly effective option of
chiropractic care.
The International Chiropractors Association urges all in the
chiropractic profession to contact their Members of the U.S. House of
Representatives and urge them to contact Rep. Sanders and ask to be
added to the co-sponsors list for HR 2087.
Additional details of these important initiatives, along with model
letters and informational materials are available via ICA’s website at
www.chiropractic.org, or on request by calling ICA at 1-800-423-4690.
You can also find your Congressional Representatives via ICA’s website
through the Congressional Action Center in ICA’s Legislative Affairs
section.