In a letter sent to the American Chiropractic Association’s (ACA) House of Delegates (HOD) the Vice President of the ACA David Herd, DC stated that the ACA believes that their legislative approach to Medicare is the best means to achieve the goal of all Medicare patients having coverage for all services, authorized under state law, provided or ordered by their doctor of chiropractic.
The Vice President’s letter follows on the heels of a letter sent to the HOD by the ACA President Anthony Hamm DC stating that in order to accomplish their objectives vertebral subluxation must be removed from the language:
“ACA is of the opinion that nothing less than removal of the “subluxation” language in the definition of physician section will accomplish our objectives. Historically, the facts are that this language has proven to be the major barrier within HHS and CMS when we advocated for regulatory remedies expanding our reimbursement and coverage for the full range of services provided by a DC.”
In his letter Herd attempted to address the subluxation issue stating:
“We have taken our proposal to the Chiropractic Summit leadership and have worked to add a section to the bill clarifying legislative intent, making it clear that there is no attempt to eliminate coverage for the treatment of subluxations.”
Of course, if it’s not in the language then no one actually believes subluxation would be covered but since the subluxation is a divisive issue related to this initiative, the ACA and the Association of Chiropractic Colleges (ACC) are attempting to placate the subluxation faction by “clarifying legislative intent”.
While this may work for the politically naieve anyone who has dealt with the Medicare issue over the past 20 years understands it is not that simple.
Others have argued that the best fix to Medicare is to focus on chiropractic's strategic competitive advantage instead of duplicating services, increasing costs, expanding scope and pretending to be primary care physicians.
The following is the full text of Herd’s letter:
Dear Colleagues:
Every day, 11,000 new beneficiaries become eligible for Medicare, most of them permanently losing their coverage for many of the wide variety of chiropractic services available under their previous health care plans. We have all faced circumstances where, in the middle of a course of treatment, a patient transfers to Medicare coverage, necessitating a change or even discontinuation of the treatment.
We have also sat in the treatment room with patients who fret over whether to pay for their continued chiropractic care, their medications, their food, or their housing. Current statute forces patients to choose services that are often more expensive with increased risks and worse outcomes, resulting in lower patient satisfaction.
This is why the American Chiropractic Association (ACA) has launched its National Medicare Equality campaign, the profession’s most important legislative effort since national health care reform. Over the last 20 years, ACA has led the fight in Washington to modify the unconscionable discriminatory nature of chiropractic coverage under Medicare.
It has become abundantly clear that until Medicare law is amended, there will be no improvement in coverage for our patients. There are multiple other federal payment systems which also cannot be improved until the Social Security Act is amended, including federal workers’ compensation and the Family Medical Leave Act.
ACA maintains a staff of eight in our Public Policy and Advocacy Department in Arlington, Va., dedicated to correcting this issue. No other entity has the extensive experience, staffing, resources, presence on Capitol Hill and deep relationships with legislators and regulators required to lead the charge for this legislative change.
ACA has proposed amended Medicare language which will grant patient reimbursement for all covered services allowed to be performed under your state scope of practice. The treatment you currently provide will not be changed on any level. ACA’s proposal avoids the use of a laundry list of services and procedures that will complicate and likely never be added to the law.
Avoiding a list of specific services also prevents cherry picking by the Centers for Medicare and Medicaid Services on what procedures they will cover. We are advocating that DCs be afforded the same language that defines what MD’s and DO’s can perform. Please remember this is a coverage issue with an insurer, not a scope of practice issue.
We have taken our proposal to the Chiropractic Summit leadership and have worked to add a section to the bill clarifying legislative intent, making it clear that there is no attempt to eliminate coverage for the treatment of subluxations.
The overwhelming majority of the Summit leadership roundtable voted in favor of our legislative approach. ACA is focused on results not ideology. ACA's legislative proposal, if enacted, will mean that all Medicare patients will have coverage for all services, authorized under state law, provided or ordered by their doctor of chiropractic. ACA is dedicated to achieving full parity in terms of Medicare recognition. Based on knowledge and experience, ACA believes that our legislative approach is the best means to achieve this goal.
Sincerely,
David Herd, DC
Vice President
American Chiropractic Association
