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Chiropractic Legislative Agenda ~ News Update

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Chiropractic Legislative Agenda ~ News Update

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SOURCE:   International Chiropractors Association


November 16, 2010 — In the Congressional changes that just took place Nov. 2, 2010, the chiropractic profession lost several longstanding advocates, but fortunately retained a greater number of allies.

There have been numerous statements about using the appropriations process to “de-fund” health reform implementation and also talk of outright repeal of some or all of the law’s provisions. The outcome of the 2010 Congressional elections notwithstanding, the prospects of any legislative repeal of any of the provisions of the Patient Protection and Affordable Care Act are minimal to impossible (it would take 60 votes in the U.S. Senate to pass and 67 Senate votes to override a Presidential veto).

There will be two so-called “Lame Duck” sessions before the new Congress is sworn in. During that time, it is logical to assume that the Democratic majority in both houses will use this limited time to clean up as much unfinished business on their agenda as possible.

Among issues to top concern to chiropractic are:

  • Senate passage of Rep. Bob Filner’s chiropractic veterans legislation: Thanks to the courageous and determined efforts of Rep Bob Filner (D-CA), HR 1017 passed the U.S. House of Representatives on May 24, 2010.

This vitally important legislation requires the U.S. Department of Veterans Affairs (DVA) to place doctors of chiropractic on staff at no fewer than 75 major VA medical centers before the end of 2011 and at all major VA medical centers to have a doctor of chiropractic on staff by the end of 2013.

Following passage by the House, HR 1017: Chiropractic Care Available to All Veterans Act was sent to the United States Senate, where it has been held up by a number of Senators who have expressed concern about cost but who also have a history of not being supportive of chiropractic initiatives.

There are a total of 160 DVA facilities nationwide but under the present legislation chiropractic services are only available as 32 of those care centers. Senate passage of HR 1017 is a top ICA priority and urges all DCs to contact their U.S. Senators and secure their support for this long overdue improvement in care for the nation’s veterans.

  • Repeal of insurance industry exemption to national antitrust laws: The McCarran–Ferguson Act, 15 U.S.C. §§ 1011-1015, is a United States federal law that exempts the business of insurance from most federal regulation, including federal anti-trust laws.

The McCarran–Ferguson Act was passed by Congress in 1945. This law is the basis on which, on the one hand doctors are currently prohibited from collective bargaining with insurance carriers under antitrust laws, and on the other, also exempts the insurance industry from federal anti-trust enforcement.

The net result is a pattern of exploitation, price-fixing, predatory trade practices and the cheating of policy holders and providers alike, with little or no recourse for those who are injured.

Legislation in the current Congressional session to repeal the anti-trust exemption for the insurance industry is also stalled in the U.S. Senate despite passage of such legislation by the U.S. House of Representatives by a massive margin of 406-19 (HR 4626: Health Insurance Industry Fair Competition Act) . ICA considers the repeal of this act a top legislative priority and will continue to aggressively lobby for this urgently needed national policy change.

The ICA urges all DCs and all chiropractic organizations to immediately contact their United States Senators and urge an immediate vote to pass HR 4626 in the remaining sessions of the current Congress.

  • Medicare fee cut postponement: On June 25, 2010, Congress, with Obama Administration support, postponed until Nov. 30 the looming 21 percent Medicare fee cut scheduled to take effect in 2010.

According to the Centers for Medicare and Medicaid Services (CMS), “Under Medicare’s sustainable growth rate (SGR) formula, CMS’ final physician fee schedule rule for 2011 requires physician payments to be reduced on Dec. 1, 2010, and then again on Jan. 1, 2011. The total reduction in [Medicare physician fee schedule] rates between November 2010 and January 2011 under the [SGR] system will be 24.9 percent, according to the rule.”

Congress has acted to apply the so-called “doc fix” 10 times in the past eight years, four of them this year alone. Efforts to enact a permanent fix for the mandated SGR formula have hung up on the expected cost since all parties agree that it would be expensive to implement a permanent fix or even a five year moratorium.

There is legitimate concern among all Members of Congress that doctors will en masse stop serving Medicare patients if their fees are cut so drastically.

At the present time, estimates are that 25 percent of all medical doctors and a growing number of doctors of chiropractic already no logger accept Medicare patients in their practices.

ICA supports a responsible postponement of the looming cuts and is urging Members of Congress to seek a bi-partisan, fair solution to this ongoing problem.

Visit Find Your Senator to contact your U.S. Senators on these three key issues!

ICA’s Legislative Committee and ICA-PAC will continue to work to secure these and other urgently needed policy changes on behalf of chiropractic providers and patients.

Read the full, unabridged article at ChiroEco

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.

8 Comments

  1. […]Chiropractic Legislative Agenda ~ News Update […]

  2. seattle chiropractic November 18, 2010 at 12:52 pm

    All DC’s, Please post the link to your Facebook page and urge your patients to take a minute to contact their US Senators!

  3. I agree with Seattle Chiropractic. I don’t understand why medicare keeps doing this to us! Soon will we be providing free chiropractic care to people with medicare?

  4. Frank November 18, 2010 at 11:55 pm

    Dr. Steve

    It’s not Medicare that’s doing it…it’s the cap set on the budget for Medicare AND the outrageous fees MDs get.

    During the Demo Project, as more people chose chiropractic over physical therapy, a funny thing happened. Even though PTs saw LESS people, their per-person charges went up, to make up for their losses. In other words, their yearly charges increased to cover their shortfall.

    Another funny thing is how much MDs are paid for using the E&M codes (99201-5 and 99211-5). Their payout is almost par with what BCBS pays, whereas CMT codes are paid at about 60% of the BCBS rate card (and of course, they dont’t pay US for E&Ms). And…since an MD codes with an E&M for EVERY visit, it’s not hard to see why and how they gobble up the whole pie.

    The deal with the Demo was that as long as the “total cost” didn’t rise, then they’d consider including us in services…but the medical crowd saw to it that expenses rose, just to shut us out. In that environment, nobody is paying attention to the FACT that they’s actually save money if they put us as the gatekeeper in hospitals etc. for all NMS complaints.

  5. seattle chiropractor November 20, 2010 at 2:10 am

    The Federal Government, through its Medicare regulations, is beginning the rationing of medical care, partly on the pretext that “medical care is just too costly these days.” Well, whose fault do you think all that is in the first place????

  6. Frank November 20, 2010 at 11:09 am

    Seattle

    I’ve heard that comment (rationing) before, but in fact, Medicare pays for any claim that demonstrates medical necessity. When the allotted budget is met, they stop paying everyone, or they reduce the amount they will pay for services during the next year, to re-capture the loss.

    What I think needs to be done is to carefully review medicine’s rate card. Why are they paid virtually 100% of the BCBS rate for E&Ms while they only pay us 60% of BCBS’s approved charge, even though chiropractic provides better results at a lower cost? Enquiring minds want to know!

  7. Peter December 7, 2010 at 8:42 am

    Do you really expect the Federal government to do anything BUT ration out care?

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