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HR 2560 Offers Positive, Innovative New Approach to Chiropractic in Medicare

The International Chiropractors Association has joined the Chiropractic Coalition in enthusiastically endorsing legislation crafted by Illinois Representative Don Manzullo that would significantly enhance the status of the doctor of chiropractic and chiropractic patient in the federal Medicare program. HR 2560, the "Chiropractic Medicare Freedom and Benefit Protection Act" would set up a separate doctor level category for doctors of chiropractic, making chiropractic services uniquely theirs. No longer would an MD, DO, or physical therapist be able to provide or receive reimbursement for subluxation correction services. According to the bill's author, the bill will "not only reshape the definition of chiropractic in federal policy...it will blow the lid off the definition of chiropractic in federal policy... We will make it clear once and for all that chiropractic is equal -but unique."

"This powerful legislative initiative has been so thoughtfully crafted and is so innovative, opening new doors for chiropractor and chiropractic patient alike in Medicare, that it deserves the strong and immediate support of everyone in the chiropractic profession," said ICA President Dr. Dr. CJ Mertz. ICA urges all DCs and concerned patients to write their Members of Congress today in support of HR 2560. For model letters, click here or call ICA at 1-800-423-4690.

HR 2560 would:

*Amend the Social Security Act to expand and clarify the scope of chiropractic services that may be furnished under the Medicare program and to state specifically that "chiropractors are the only health care professionals qualified under that program to furnish those services."

*Set up a separate provider category just for chiropractic - we'll no longer be lumped into the same box as medical doctors.

*Prevent MDs and DOs from claiming to provide chiropractic services (and get paid for them).

*Ensure that "medical necessity" criteria and the resulting endless harassment in validating chiropractic claims that presently dominates the Medicare process will no longer apply to chiropractic care.

*HR 2560 won't restrict any D.C. from practicing the way he or she chooses - from neuromusculoskeletal to subluxation-based. It doesn't prohibit any chiropractic service allowed by state scope laws.

"Medicare is a limited reimbursement program only and HR 2560 would have no impact at all on chiropractic scope of practice, ability to bill for evaluation and management codes, or the status of the DC as a doctor level professional," said ICA Legislative Committee Chairman Dr. Michael S. McLean. "Medicare law only deals with what DCs are paid for under this one program. Presently, the only reimbursable Medicare service is subluxation correction. HR 2560 would significantly expand the list of chiropractic services recognized by the Medicare program."

The bill adds a provision to the Medicare code that states that the term "chiropractic services" means "clinically necessary care by means of adjustment of the spine (to correct a subluxation) performed by a chiropractor legally authorized to perform such adjustment by the State or jurisdiction in which such care is provided."

 

This wording was carefully chosen to ensure that the bill will protect a DC's right to correct subluxation, and to perform services as specified by his or her state statutes. To avoid the use of the "medically necessary" criteria, the bill further states that services are considered "clinically necessary" when examination by a chiropractor demonstrates objective evidence of a subluxation. The bill, therefore, gives DCs -- and only DCs -- the authority to determine when chiropractic care is needed.

 

The bill also states that such examination may include physical examination, radiological examination, and "specialized diagnostic instruments used in the practice of chiropractic." This provision will be used to obtain Medicare reimbursement for a broad range of examination services, including x-rays.

The Chiropractic Coalition, founded in November 2002 by three major chiropractic organizations -- the International Chiropractors Association (ICA), the World Chiropractic Alliance (WCA), and the Federation of Straight Chiropractors and Organizations (FSCO) -- brings together diverse subluxation-based chiropractic organizations working in the best interest of the public and the profession.

> news release | bill text
> model letters: patient / doctor