During the past 2 weeks, I have been deluged with emails from many chiropractic associations urging chiropractors and their patients to write to their representatives about the House Bill HR 2560, supported by The Chiropractic Coalition—comprised of the World Chiropractic Alliance (WCA), International Chiropractic Association (ICA), and the Federation of Straight Chiropractors and Organizations.

HR 2560, named the “Chiropractic Medicare Freedom and Benefit Protection Act, seeks to: 1) Amend title XVIII of the Social Security Act to clarify the scope of chiropractic services and that chiropractors are the only health care professionals who can provide these services under the Medicare program; 2) Assign a provider category specifically for chiropractic; 3) Ensure the “medical necessity” criteria no longer applies to chiropractic care; 4) Prevent medical doctors (MDs) and osteopaths (DOs) from providing and being reimbursed for chiropractic services; and 5) Ensure that chiropractors are not restricted from practicing the way they choose, whether neuromusculoskeletal or subluxation-based. (ICA press release, July 24, 2003.)

When HR 2560 was first introduced by Representative Don Manzullo (R-Ill), chair of the US House of Representatives Committee on Small Business, on June 23, 2003, it was referred to the House Committee on Energy and Means, then the Committee on Ways and Means. As of July 1, 2003, it has been referred to the Subcommittee on Health, where it remains.

“[HR 2560] would create a separate but equal category that makes chiropractic services exclusive to the chiropractic profession,” said Terry Rondberg, DC, WCA president,in a press release. Barry Pineles, regulatory counsel, House Committee on Small Business, said that this bill defines subluxation as a term of art, and that by limiting the codes strictly to chiropractic, there would be more accuracy.

But not everyone agrees that HR 2560 is in the best interest of the chiropractic community. The American Chiropractic Association (ACA) does not support HR 2560. A memorandum to ACA representatives from the association’s attorney Thomas R. Daly, of the law offices of Odin, Feldman & Pittleman, PC, warns “The unanimous view is that the proposed changes, if enacted would devastate chiropractic reimbursement both within and outside of Medicare....[T]his provision would provide ammunition to those entities on a state level which would seek to either eliminate or block the ability of a chiropractor to refer to himself or herself as ‘physician’ and ironically serve the legislative policy goals of the American Medical Association.” (www.americhiro.org/pdf/TomDalyanalysis.pdf. Accessed July 30, 2003.)

The bill that the ACA does support is the Medicare Chiropractic Demonstration Project (section 440 of the Medicare Bill S 1) establishing a pilot program to allow DCs “to be reimbursed for all covered Medicare services within their state scope of practice.” This program would provide cost and positive outcomes data for Congress to enact permanent legislation providing a “full scope” chiropractic inclusion in Medicare. Senator Chuck Grassley (R-Iowa), chairman of the Senate Finance Committee, championed this bill. Unfortunately, the House version (HR 1) does not contain a chiropractic provision. For the Senate pilot program provision to become law, it must have enough support to be included in the final version of the bill that will be voted on in both chambers—possibly in early to mid-September. (www.amerchiro.org/government/medicare/alert_050503.shtml.  Accessed July 30, 2003.)

Whether your chiropractic philosophy supports the Coalition or the ACA, your profession needs your support. Participate in the grassroots letter-writing campaign. Form letters for the Coalition can be found at: www.chiropracticoalition.org/legislation/2560.html and www.chiropractic.org (click on “model letters: patient/doctors.”) The ACA URL above provides a form letter for their bill. The Coalition suggests faxing because security measures have made mail delivery difficult. To find your representative’s fax number, visit www.congress.org.

Join chiropractors from all over the nation and deluge Capitol Hill with your letters. In some plays, the deus ex machina, translated literally as “god from a machine,” was lowered onstage and then proceeded to make sure that all was right in the world. Let us show the House what a force chiropractors can be and set things right. CP

Miwon Seo
mseo@medpubs.com