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National Health Service Corps
Veterans Affairs
Department of Defense
Medicare
For most current information go to
www.acatoday.com.
"The Quick Six"
Recent ACA Accomplishments
- The ACA filed a federal lawsuit against the Health Care Financing Administration after it issued a formal policy allowing physical therapists and medical doctors to correct subluxations.
- The ACA filed a federal lawsuit against National Blue Cross Blue Shield and Trigon Blue Cross Blue Shield (VA) for their unfair reimbursement policies for chiropractic care.
- In 2000, the ACA was responsible for chiropractic doctors being assigned to the Attending Physician's Office at the U.S. Capital, where they now treat members of Congress
- Again in 2000, Pres. Clinton signed ACA-sponsored legislation that made chiropractic a permanent benefit for our men and women in the armed services.
- Early last year, Pres. Bush signed ACA-sponsored legislation into law that made chiropractic a permanent benefit for American veterans.
- And late last year, Pres. Bush signed ACA-sponsored legislation into law that will make chiropractic doctors eligible to get their student loans reimbursed by practicing in underserved areas.
National Health
Service Corps
President Bush Signs Bill to Include Doctors
of Chiropractic in National Health Service Corps Program
ARLINGTON, VA - After nearly two years of
effort by the American Chiropractic Association (ACA) and
the Association of Chiropractic Colleges (ACC), President
Bush signed S. 1533 into law (PL 107-251) on October 26.
The legislation, known as the Health Care Safety Net Improvement
Act, will, for the first time ever, make doctors of chiropractic
eligible to participate in the National Health Service Corps'
(NHSC) student loan reimbursement program - a move the ACA
is hailing as a significant victory for chiropractic students
and the profession as a whole.
The NHSC is a federally funded program which
allows, under certain circumstances, health care professionals
engaged in the delivery of primary care services to be reimbursed
for student loans in return for establishing and maintaining
their practices in geographic areas designated as "medically
underserved" by the federal government.
This new legislation will allow doctors of
chiropractic to take part in a three-year "pilot program,"
or test period. After the three-year pilot program, Congress
would review the results of the test and consider making
the chiropractic profession a permanent fixture in the program.
The president's favorable action came as part of a long-planned
overhaul of federal legislation currently governing the
operations of the NHSC program.
Passage of legislation making the chiropractic
profession eligible to participate in the NHSC program has
long been a goal of the ACA and the ACC. Both organizations
have worked tirelessly to gain chiropractic inclusion, and
have been supported in this pursuit by Senator Tom Harkin
(D-IA) and Representatives Billy Tauzin (R-LA) and Michael
Bilirakas (R-FL).
Veterans Affairs
President Bush Signs Historic Chiropractic
Veterans Legislation into Law
ARLINGTON, VA - President Bush signed legislation
late last night mandating the establishment of a permanent
chiropractic benefit within the Department of Veterans Affairs
(DVA) health care system. The American Chiropractic Association
(ACA) is hailing the new law (Public Law 107-135) as not
only an enormous triumph for the profession but also proof
of the powerful role chiropractic plays on Capitol Hill
and in the nation's health care system.
"This profession has been fighting to
make this law a reality for 65 years. It is just tremendous
to finally see it happen," said ACA Chairman James
Edwards, DC.
The law, called the Department of Veterans
Affairs Health Care Programs Enhancement Act of 2001 (H.R.
3447), had been passed by the Senate during one of the last
actions of the 107th Congress before its adjournment for
the year.
The law authorizes the hiring of doctors of
chiropractic in the DVA health system, sets a broad scope
of chiropractic practice, and allows the chiropractic profession
to oversee the development and implementation of the new
benefit through an "advisory committee," partially
composed of representatives of the chiropractic profession.
The agreement is similar to legislative language that became
law last year requiring the Department of Defense to establish
a permanent chiropractic benefit for active duty military
personnel.
Key provisions of the new law include:
- Immediate phase-in of the program.
- Designation of at least one DVA medical
center in each geographic service area of the Veterans
Health Administration to provide chiropractic services.
The designated sites will be medical centers and clinics
located in urban and rural areas.
- Scope of chiropractic services that "shall
include a variety of chiropractic care and services for
neuromusculoskeletal conditions, including subluxation
complex."
- Dissemination of educational materials
on chiropractic to primary care teams "for the purpose
of familiarizing such providers with the benefits of chiropractic
care and services."
- Establishment of a chiropractic advisory
committee that will advise the Secretary on protocols
governing referral to doctors of chiropractic, direct
access to chiropractic care, scope of chiropractic and
other issues.
The chiropractic profession's task will now
be to ensure that the DVA properly and expeditiously moves
forward to implement this law. The ACA will carefully monitor
the implementation of this new benefit, and will provide
updates as events warrant.
Department
of Defense
President Clinton Signs into Law Permanent Chiropractic
Benefit for Military
Washington, D.C.-Culminating nearly a decade
of joint lobbying efforts by the American Chiropractic Association
(ACA) and the Association of Chiropractic Colleges (ACC),
President Bill Clinton yesterday signed into law historic
legislation mandating that chiropractic care be made available
to all active duty personnel in the United States armed
forces.
The law, formally known as the National Defense
Authorization Act for Fiscal Year 2001, requires access
to chiropractic services "which includes, at a minimum,
care for neuromusculoskeletal conditions typical among military
personnel on active duty."
The law requires that full implementation
of the benefit be phased in over a five-year period, throughout
all three service branches of the military. When completed,
all active duty personnel stationed in the United States
and overseas are to have access to the chiropractic benefit.
The law further requires the DoD to develop, by March of
2001, a full "implementation plan" to ensure the
benefit is adequately provided. ACA and ACC also fought
for - and won - a provision within the law requiring that
DoD consult with the chiropractic representatives serving
on the Chiropractic Health Care Demonstration Project's
(CHCDP) Oversight Advisory Committee regarding the development
and implementation of the phase-in plan. According to ACA
officials, the president's signing of the legislation could
result in the commissioning of doctors of chiropractic as
officers in the military.
Medicare
Chiropractic Patients' Freedom of Choice Act
- H.R. 902 (from 2002)
| ISSUE: |
AMEND TITLE XVIII OF
THE SOCIAL SECURITY ACT TO PROVIDE REIMBURSEMENT FOR
ALL PHYSICIAN SERVICES FOR DOCTORS OF CHIROPRACTIC,
WITHIN THE SCOPE OF THEIR LICENSE, UNDER THE MEDICARE
PROGRAM.
As amended in 1972, the Medicare statute
defines doctors of chiropractic (D.C.s) as "physicians",
but only for the purpose of "manual manipulation
of the spine to correct a subluxation" (section
1861(r)(5) of the Social Security Act). The practical
result of this outdated definition is to deny Medicare
beneficiaries' any real choice of most services that
doctors of chiropractic are licensed to perform. It
offers beneficiaries an extremely limited benefit
that is both insufficient for the delivery of proper
care and difficult to obtain. |
| STATUS: |
On March 9, 2001, Representative Wes Watkins (R-OK)
introduced H.R. 902, "Chiropractic Patients' Freedom
of Choice Act." This legislation would grant Medicare
beneficiaries access to any service presently covered
under Medicare that doctors of chiropractic are licensed
to perform under state law. In the 106th Congress, this
legislation received tremendous bipartisan support (87
cosponsors). |
ACTION
NEEDED: |
Members of Congress are requested to co-sponsor the
Watkins bill - H.R. 902 and work to ensure its inclusion
in Medicare reform legislation, which is expected to
pass through the following key committees of jurisdiction:
House Ways & Means Committee, House Commerce Committee
and Senate Finance Committee. |
POLICY
RATIONALE: |
- H.R. 902 would expand beneficiaries'
access to covered services while at the same time
significantly improving their choice of licensed
health care providers.
- Current Medicare law is blatantly
anti-competitive. It bars doctors of chiropractic
from fully competing within the Medicare system
and eliminates a source of provider competition
that could reduce cost. H.R. 902 would assist in
correcting this problem.
- In recognition of the need to control
Medicare costs, this proposal would not add or require
coverage of a single new service under the program.
Rather, it would simply provide beneficiaries access
to currently covered Medicare services when performed
by D.C.s. For example, Medicare currently covers
diagnostic x-ray services when performed by medical
radiologists. Under this proposal, patients would
receive coverage for that same service when furnished
by a D.C., since the performance of x-rays falls
within a D.C.'s legal scope of practice. Wherever
there is overlap between the services Medicare covers
and the services D.C.s are licensed to perform,
beneficiaries would enjoy the ability to obtain
care from a chiropractor.
- Expanding access to a range of reimbursed
services provided by chiropractors (within their
scope of practice) would expand beneficiary access
to care in rural and medically underserved areas
where physician and primary care services are not
always readily available.
- Under Section 1802 of the Social
Security Act, Medicare beneficiaries are guaranteed
the freedom to select a physician of their choice.
Unfortunately, limitations on the services of doctors
of chiropractic erode the effectiveness of this
guarantee.
- Chiropractic care is highly cost-effective,
particularly for low back pain - a malady afflicting
up to 80% of Americans at some point in their lives
and costing at least $20 billion a year in direct
medical costs. Increasing access to cost-effective,
non-surgical care for millions of senior citizens
who suffer from this condition could significantly
benefit the Medicare program and decrease cost.
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