ACA Declares “State of Emergency” in Response to Senate Bill
The American Chiropractic Association (ACA) House of Delegates (HOD) is battling a Senate small-business health-plan bill that the ACA says could eliminate state-mandated chiropractic coverage for millions of patients. The action, approved by the ACA’s HOD, underscores the ACA’s commitment to defeating S 1955, a proposed legislation that would deregulate the health-insurance market and gut state patient-protection laws.

“We have no choice but to mobilize the profession and throw all necessary resources behind killing this potentially devastating bill,” says ACA President Richard Brassard, DC.

The bill, known as the Health Insurance Marketplace Modernization and Affordability Act, attempts to expand health care access and reduce insurance costs through the creation of small-business health plans. The plans offer insurance coverage purchased through nonprofit organizations on behalf of the small businesses that compose their memberships.

If passed, the bill would preempt state insurance laws. As a result, insurance companies and small-business owners, rather than locally elected policy makers, would decide the benefits that consumers should have when they purchase health care. States would have no recourse to protect residents, and they would lose their incentives to enact consumer-protection laws in the future.

The first week of May is "Health Week" in the Senate, and S 1955 is scheduled to come to the floor at that time. The ACA currently has an S 1955 survival kit to be sent to 60,000 DCs across the country. It is essential that DCs ask their patients to sign and send letters to their senators.

For more information, and to take action on this issue, visit the “S 1955 Action Center” on ACA’s Web site at www.acatoday.org

Alternative Medicine Reduces Tension in Heart-Surgery Patients
A study funded by the Minneapolis Heart Institute Foundation, Minneapolis, and published in the January 1, 2006, issue of Annals of Thoracic Surgeons found that patients who receive complimentary alternative medical therapies, including massage before and after open-heart surgery, experience less pain and tension during recovery than patients who receive standard care.

“One major side effect of having your chest wall pried open with a jack during open-heart surgery is the misalignment of the ribs and upper-thoracic vertebra,” Frank M. Painter, DC, says. “It is common for postsurgical upper and midthoracic pain, which can frequently lead to chronic pain syndromes. Chiropractic is very effective in reducing rib and vertebral subluxations, thus reducing or eliminating that pain.”

In the study, 104 heart-surgery patients, both men and women, were randomly divided into two groups—one that received alternative therapies at critical points in the preoperative and recovery periods, and one that received standard care. Prior to surgery, patients assigned to the complimentary alternative-medicine group received a 30-minute massage, relaxation-skills training, and guided imagery. During the first 2 days after surgery, they received more light massage and listened to 20 minutes of country-western, classical, or light instrumental music. The patients assigned to the standard-care group spent most of their time before and after surgery resting.

Physicians and nurses monitored the heart rates and blood pressures of patients in both groups and had patients rate their levels of pain and tension on a scale from 0 (no pain) to 10 (the worst pain). While the heart rates and blood pressure in the patients in both groups were similar, the mean postoperative pain and tension scores from patients who received alternative therapies were significantly lower than the scores from patients in the standard-care group.

Michigan Governor Signs Bill Regulating Acupuncture
On February 23, 2006, Gov Jennifer Granholm (D-Mich) signed SB 351, making Michigan the 41st state to implement laws regulating the practice of acupuncture. According to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) one in 10 adults has had acupuncture, making it one of the most popular forms of alternative medicine.

“The law certainly will ensure that Michigan will move into the category of states that have high standards for acupuncture,” says Betsy Smith, associate deputy director for NCCAOM.

Several states, including North Dakota, South Dakota, Wyoming, Kansas, Oklahoma, Kentucky, Mississippi, and Alabama do not regulate the practice of acupuncture.

In most of these states, physicians with little or no formal education in acupuncture are allowed to practice. As a result, health care consumers in these states may not experience the full efficacy of the acupuncture treatment. In addition, there is a potential for an unqualified individual to claim that he or she is an acupuncturist, and the patients have no way of confirming the validity of his or her expertise.

Proposal Submitted to Fund Pilot Study
The Wolfe-Harris Center for Clinical Studies at Northwestern Health Sciences University, (Bloomington, Minn) submitted a grant proposal to the National Institutes of Health’s National Center for Complementary and Alternative Medicine (NCCAM) to fund a 2-year motion-assessment pilot project.

In the proposal, $275,000 was requested to develop automated software to track and quantify segmental motion in the lumbar spine; to establish the accuracy and limitations of automated motion analysis within a spine model; and to assess the reliability of the process in humans.

"This proposal is a part of an ongoing collaboration with Mayo Clinic," says Craig Schulz, DC, assistant professor at Northwestern Health Sciences University. "Currently, motion assessment can be done by hand, but it is an intensive process."

If the software is developed, it will be used to investigate the effect of spinal manipulation on lumbar intersegmental motion and to explore the relationship between the clinical effects of spinal-manipulation therapy on intersegmental-motion changes. Ultimately the software could be used by DCs as a diagnostic tool for patients and could help DCs select a treatment.

It will take NCCAM about 6 months to review the proposal.

ACA Criticizes Study Claiming Chiropractic is Ineffective
A recently released study in the Journal of the Royal Society of Medicine (JRSM) that claims chiropractic is ineffective for treating any condition is misleading, according to the American Chiropractic Association (ACA).

The article, by Professors Edward Ernst and Peter Canter, at the Peninsula Medical School at Exeter, United Kingdom, titled, “A systematic review of systematic reviews of spinal manipulation,” attempts to demonstrate a lack of scientific basis for chiropractic care. The article claims that there is “no convincing evidence from systematic reviews to suggest that spinal manipulation is a recommendable treatment option for any condition.”

In a March 23, 2006, letter to the journal’s editor, Richard D. Brassard, ACA president, writes, “The truth be told, the authors have limited the evidence to suit their own arguments, and in fact they have included so much of their own opinionated research—approximately one fifth of the papers cited—that their study is closer to personal opinion than an unbiased review.”

Brassard’s letter points to scientific studies that refute the authors’ claims, including: a March 2004 study in the Journal of Manipulative and Physiological Therapeutics that found that chiropractic care is more effective than medical care for treating chronic low back pain in the patients’ first year of symptoms; a study published in the July 15, 2003, edition of the medical journal Spine, which found that manual manipulation provides better short-term relief of chronic spinal pain than does a variety of medications; and a 2001 report released by the Duke University Evidence-Based Practice Center in Durham, NC, which found that spinal manipulation may be an effective treatment option for tension headaches and headaches that originate in the neck.

NYCC and NYSCA Create Task Force
The New York Chiropractic Council (NYCC) and the New York State Chiropractic Association (NYSCA) have united to create a joint legislative task force that will develop a unified approach to identify and pass legislation that will benefit chiropractic patients and the profession. Currently, two major chiropractic issues affecting New York-area DCs are the insurance equality law of 1998 and the workers’ compensation equality bill.

In 1998, Gov George Pataki (R-NY) passed a law that entitled New York-area chiropractic patients to a minimum of 15 insured chiropractic visits; this provided the DC and his or her patients 15 visits before the carrier could request documentation supporting medical and/or clinical necessity. However, the NYCC and NYSCA say that the insurance companies have found ways to circumvent the bill’s intention. The bill is currently being reviewed by the insurance committee and has plenty of interest from the legislature.

The workers’ compensation bill also asks for parity. New York-area DCs are currently paid one fee for the evaluation and management service 99213.

Depending on the DC’s ZIP code, he or she would be reimbursed approximately $30 for this service. A patient willingly chooses chiropractic care, and the provider delivers the care; regardless of the care provided, one fee is paid. However, other health care providers in the workers’ compensation system are reimbursed based on the type of service they perform and at a higher fee, when they perform some of the same services that are performed by DCs.

New York-area DCs can voice their concerns by calling (800) 426-6922.