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Health Care Bill Update ~ How It Effects Chiropractic

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Health Care Bill Update ~ How It Effects Chiropractic

The Chiro.Org Blog

Over the past year, Palmer College of Chiropractic has closely watched the healthcare reform debate and subsequent actions taken by Congress. Palmer administrators, faculty, staff, students and alumni have been working behind the scenes with government officials, other chiropractic organizations, and at the grass-roots level for more than a year to facilitate chiropractic’s inclusion in healthcare reform legislation, and with the signing of this new law, these joint efforts have resulted in several provisions that are positive for chiropractic.

The provisions in the new law that specifically benefit chiropractic include an important provider non-discrimination provision, also known within the chiropractic profession as the “Harkin Amendment,” which was incorporated into the bill primarily due to the efforts of Sen. Tom Harkin (D-Iowa) with help from other key legislators such as Sen. Chris Dodd (D-Connecticut) and Sen. Orrin Hatch (R-Utah).

This provision makes it a federal crime for insurance companies to discriminate against doctors of chiropractic and other providers relative to their participation and coverage in health plans, as long as they are licensed or certified at the state level and are providing care within their scope of practice.

SEE PAGE 51 of the actual Law:

Two provisions of the law specifically mention the chiropractic profession. First, doctors of chiropractic are included as potential members of interdisciplinary community health teams. Community health teams are integrated teams of providers including primary care providers, specialists, other clinicians, licensed integrative health professionals and community resources designed to enhance patient care, wellness and lifestyle improvements.

Second, the new law establishes a National Health Care Workforce Commission to examine current and projected needs in the healthcare workforce. The commission includes doctors of chiropractic by defining them as part of the healthcare workforce, and in the definition of health professionals.

The National Health Care Workforce Commission is tasked with providing comprehensive, unbiased information to Congress and the Obama Administration about how to align federal healthcare workforce resources with national needs. Chiropractic colleges are included among the health professional training schools to be studied as part of this effort.

Chiro.Org’s Blog reviewed this legislation on November 20, 2009, and that material is available for your review.

You may also want to review National Chiropractic Association commentaries about House Bill 3590 from the ACA and the ICA.

You can also read the complete H.R. 3990 Bill in Adobe Acrobat format.

Thanks to Palmer College for access to this information.

About the Author:

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.


  1. Ken Whidden March 26, 2010 at 8:59 pm

    While the provisions mentioned are positive for the profession, I among many others are very concerned about the long term effects and changes that can take place with this legislation. Judging from past experiences with Medicare and Medicaid, I don’t think anyone can feel comfortable with more encompassing government health care programs.

    Ken Whidden, DC
    Emerald Coast Chiropractic

  2. Chiropractor in Oklahoma City April 2, 2010 at 10:26 am

    I am a chiropractor, and I liked your insights. This is my first time visiting your website, but I will likely be back. Keep up the good work!

  3. Phoenix Chiropractor April 5, 2010 at 6:35 pm

    Great update…inclusion to some degree is a great start but like Ken I am worried about the long term undetermined affects along with how much the ‘fix it’ packets will impact our profession if at all.

  4. Frank April 5, 2010 at 7:08 pm

    Well, none of us can predict the future, but since the law prevents insurance from discriminating against chiropractic as an option for care, it’s reasonable to expect to see more patients. What’s less clear is whether they will be at Medicare rates. That would not be exciting, unless I saw a hundred a day.

  5. Scott October 27, 2010 at 3:03 pm

    ummm…..has anybody read the entire “Harkin Amendment”?? The bill does not apply if the chiropractor has a signed a contract with the insurance company.

    Q: what will change?
    A: nothing!!

    I am a chiropractor; I am contracted with every insurance/managed care network in my area. Long story short, the law doesn’t apply to me or anyone else that accepts Medicaid, Medicare, or any private insurance. The insurance company can continue to discriminate because I “agreed” to it in my contract. The only way we can practice this law is to have all the chiropractors re-negotiate the provider agreements we sign when joining a network. (good luck with that)

  6. seattle chiropractor November 9, 2010 at 10:39 pm

    Seniors will suffer huge setbacks in their healthcare, Medicare and Medicaid will be destroyed one piece at a time.

    As with all socialism….the people will be forced to pay. But then again, the bottom 45% of income earners pay no federal ncome tax anyway. So what do they care if someone else pays for their health insurance?

    And yet we’ll all lose a little more freedom.

  7. Frank M. Painter, D.C. June 30, 2012 at 12:30 am

    Hi Scott,

    Now that we have the whole law available, I can respond. Aspects of the Harkin amendment were incorporates as Section 2706

    SEE PAGE 51 of the actual Law:

    As for any binding agreement a doctor has with an Insurer (like if your CHOSE to be a “preferred provider”) then, sure, no law gets to mess with a deal you struck with the Devil.

    However, if you don’t like the agreement you struck, especially if you agreed to accept hideously reduced rates, in the hopes of seeing more of their insured, you can always cancel the agreement.

  8. Scott July 20, 2012 at 11:25 am

    I agree with Dr. Painter…in fact, that was my point.

    Before the ‘harkin amendment’ = you get paid low rates/no free market in health care.

    After the ‘harkin amendment’ = you get paid low rates/no free market in health care.

    My only hope is that this new health care law will force doctors to open cash-practices. This is the only way we will be able to compete for price and quality of care.

    • Frank M. Painter, D.C. July 20, 2012 at 1:20 pm

      Hi Scott

      I fail to see how this immediately translates to “low rates/no free market

      1.   NO Insurer can force me to accept a lower fee, except for Medicare, UNLESS I willfully sign a contract with them, agreeing to accept the pittance they provide.   THAT is what I meant by the “deal you struck with the Devil.”   If you remain “out of network”, the patient is responsible for paying the rest of your fee.   Most patients will agree to this, and appreciate your help.

      2.   There’s NOTHING WRONG with an all-cash practice in theory, EXCEPT that:

      a.   An insured patient will probably blow you off because
      b.   You are an obstacle to them collecting the benefits they already paid for, and because it suggests that
      c.   You care more about fast money than you do about their needs.

      Ask yourself if you would accept that behavior from YOUR Doctor?

      In a fully insured world, the cash-only concept is just another wedge between you and potential patients, IMHO. The closest you can get to your ideal would be to refuse to accept assignment. I already do that for anyone insured by the robber baron companies like United Health Care, since it’s impossible to predict what, or IF they will pay, not to mention the delaying tactics they like to play.

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