Does Medicare Reform Have You Confused?
Understand the FACTS and the POSITIONS of Involved Groups
Medicare reform has been a hot topic within the chiropractic profession for years.
The ability to opt out and be reimbursed for exams, x-rays, and instrumentation has been a top priority for subluxation-focused chiropractors.
But now we find some “traditional” groups aren’t even including those “must haves” and are instead considering medical language and full physician objectives.
Where Do Our Political Organizations Stand on This Issue?
Where Do You Stand?
- Physican Language?
- Opt Out?
- Exams and X-rays?
A Vision and Strategy for the Future
Several organizations representing the conservative, traditional faction of chiropractic focused on the location, analysis and correction of vertebral subluxation have come together to endorse legislative language for Medicare that would allow chiropractors to be paid for exams, x-rays, the adjustment, instrumentation and other diagnostic services and add the ability for chiropractors to opt out of Medicare.
The following organizations have joined together in a coalition to support the legislative language:
- The International Federation of Chiropractors and Organizations (IFCO)
- The Foundation for Vertebral Subluxation (FVS)
- The Chiropractic Society of Texas (CST)
- The Florida Chiropractic Society (FCS)
- The Palmetto State Chiropractic Association (PSCA)
- The Chiropractic Fellowship of Pennsylvania (CFOP)
- The Sustainability Group (SG)
Over a decade ago the International Federation of Chiropractors and Organizations (IFCO) participated in the development and promotion of the Chiropractic Medicare Freedom and Benefit Protection Act, along with a coalition of other organizations including the World Chiropractic Alliance and the International Chiropractors Association (ICA). The centerpiece of this Act was a revolutionary bill (HR 2560) that provided a definition of chiropractic that actually reflects what chiropractic has always been and what it should always be.
The Bill was written by legislative staff from Representative Don Manzullo’s office, in collaboration with Christopher Kent DC, JD, President of the Foundation for Vertebral Subluxation and Board Member of the IFCO.
The bill’s purpose was to prevent duplication of services between chiropractors and medical doctors. Contrary to what some in the profession want, not all chiropractors aspire to be medical doctors. Chiropractors have a unique role to play in the health care system – correcting subluxations — and we are the only ones trained to do that.
According to Christopher Kent, DC, JD, “This initiative does not seek to expand chiropractic practice to include a duplication of services already offered by other providers.” Rather than establish a new chiropractic program, such as is currently being recommended by other groups, our initiative establishes a separate chiropractic category. “The language seeks to rectify the errors made in the original Medicare statute including chiropractic care,” Kent explained. “A significant error in this legislation was classifying D.C.s as limited scope physicians. Thus, the chiropractic benefit was characterized as a physician service, permitting medical doctors and osteopaths to provide what is purportedly a chiropractic benefit.”
Recent efforts by the other groups, seek to position chiropractors with full physician status, expand scope and even remove mention of vertebral subluxation from the legislative language of Medicare.
Subluxation-Focused Organizations Endorsing the Manzullo Language
Frequently Asked Questions
Q: Does the proposed Coalition language provide for opt out?
A: Yes. Chiropractors currently do not have the ability to opt out of Medicare. The Coalition proposal would correct this shortcoming.
Q: If a chiropractor is not classified as a “physician,” does this mean chiropractors would be downgraded to “mid-level” practitioners at a lower level of reimbursement?
A. No. Chiropractors would have their own, separate classification. The language would state “or chiropractor” after physician in each place where it appears. Furthermore, “or chiropractic services” would be added after “physician’s professional services.”
Q: Would it be necessary to have a secondary musculoskeletal diagnosis, as is currently required, to obtain reimbursement?
A: No. The proposed language states, in part, “care is clinically necessary when examination by a chiropractor demonstrates objective evidence of a subluxation.”
Q: How can a subluxation be demonstrated under this proposal?
A: The following language is proposed: “Such examination may include—
(i) physical examination;
(ii) radiological examination; and
(iii) specialized diagnostic instruments used in the practice of chiropractic.”
Q: How is subluxation defined in the proposal?
A: It parallels the widely accepted definition adopted by the Association of Chiropractic Colleges:
“For purposes of subparagraph (A), the term ‘subluxation’ means a complex of any or all of the following articular changes that compromise neural integrity and may influence organ system function and general health:
Q: Will the Coalition proposal increase Medicare costs?
A: No. See the attached document.
Medicare Folly by Dr. Christopher Kent
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