Opportunities Look Bright for the Chiropractic Profession
 
The U.S. Department of Health and Human Services (HHS) today released a bulletin outlining proposed policies that will give states more flexibility and freedom to implement certain provisions of the Patient Protection and Affordable Care Act (PPACA). 
 
The HHS proposal describes "an inclusive, affordable and flexible proposal and informs stakeholders about the approach that HHS intends to pursue in rulemaking to define essential health benefits. HHS is releasing this intended approach to give consumers, states, employers and issuers timely information as they work toward establishing Exchanges and making decisions for 2014." This approach was developed with significant input from the public, including ACA's comments provided during the Institute of Medicine hearings, as well as reports from the Department of Labor, and research conducted by HHS. Today's HHS proposal offers for public comment four alternative "benchmark plans" for flexible choice by the states in designing how to meet the new health care reform essential health benefit (EHB) requirements.
 
Although the American Chiropractic Association's (ACA) leadership has just begun to analyze the HHS proposal, its first impression is positive for the chiropractic profession. "Overall, this is one of the best outcomes we could achieve," said Keith Overland, DC, president of ACA. "Given that virtually every state has chiropractic services or some sort of insurance equality included among their existing insurance plans; this HHS proposal released today appears to be very good news."
 
ACA understood in 2010 that the health care reform legislation was not likely to include chiropractic services as a named essential benefit. Therefore, its strategy has been to ensure that DCs are able to provide their services under the categories of EHBs included in plans offered through the health exchanges. "We will continue to make our position crystal clear at the highest levels of HHS-that language considered at the federal and state level relative to essential benefits must include the services provided by doctors of chiropractic. Anything less would be a disservice to the millions of Americans that benefit from chiropractic care on a daily basis," said Dr. Overland.
 
ACA and its Chiropractic Summit partners will examine the HHS proposal and, in partnership with the state associations, work to advocate that state governments  choose benchmark plans that include chiropractic services among the EHBs.
 
As projected by ACA, the HHS bulletin allows for public comment before Jan. 31, 2012. It is also expected that HHS will revert to the standard regulatory process on this issue next year, where further opportunity to comment will be available before a final rule is issued.

 
The American Chiropractic Association (ACA), based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of patient care and ethics, and supports research that contributes to the health and well-being of millions of chiropractic patients. Visit www.acatoday.org.

New York Chiropractic College held commencement exercises Saturday, December 3, 2011, conferring degrees upon 91 candidates for Doctor of Chiropractic.  Graduating student C. Michael Begley addressed his class expressing gratitude to the many people who had helped him along the way.

Medicare has released a revised version of the ABN. They previously indicated that mandatory use of this version would begin on Nov. 1, 2011. Medicare has now delayed the implementation date to Jan. 1, 2012. All ABNs with the release date of March, 2008, that are issued on or after January 1, 2012 will be considered invalid.

New York Chiropractic College has received approval from the New York State Education Department to offer an Advanced Certificate Program in Sports Science and Human Performance.  The program is designed to provide the student with a solid foundation of exercise science and sports medicine principles that leads to unique hands on clinical workshop experiences at a variety of sporting events.

Mariangela Penna, DC was inducted as a Fellow into the International College of Chiropractors at the annual American Chiropractic Association meeting recently held in Portland, OR. Presenting Dr. Penna with her award is H. William Wolfson, DC, ACA NY Downstate Delegate. Dr. Wolfson informed the attendees of the untiring efforts and hard work Dr. Penna has performed on behalf of the chiropractic profession. Dr. Penna’s recognition is richly earned and deserved. She is immediate past president of the New York State Chiropractic Association and serves as the NYSCA NY State Affiliate representative to the ACA.

The American Chiropractic Association (ACA) recently honored Long Island resident H. William Wolfson, DC, with its prestigious 2011 Delegate of the Year award during the association’s annual House of Delegates meeting in Portland, OR. The award is presented annually for exceptional service, achievement and leadership within the association’s governing body.

Seneca Falls, NY: New York Chiropractic College employees know that the College is a great place to work, and the Chronicle of Higher Education agrees! For the third year running, NYCC has earned recognition by the Chronicle as a “Great College to Work For.”   The College also achieved, once again, a place on the Chronicle’s select “Honor Roll,” joining only seven other schools of similar size nationwide to repeat this distinction.

Seneca Falls:  New York State Chiropractic Association past-president Dr. Mariangela Penna presented NYCC President Dr. Frank J. Nicchi with the association’s highest honor, the Ernest G. Napolitano Award, during the College’s Homecoming weekend attended by more than 430 alumni, students and members of the faculty.

The National Prevention Council (NPC), recently called for the development of a National Prevention Strategy to outline goals and recommendations for improving health and wellness for all Americans. The National Prevention Strategy highlights several preventative measures throughout the report including alternative therapies for back and neck pain.

According to the report, one key aspect of expanding preventive services is to “enhance coordination and integration of clinical, behavioral and complementary health strategies.” The report also specifically touts the benefits of spinal manipulation stating, “Complementary and alternative therapies for back and neck pain (e.g., acupuncture, massage, and spinal manipulation) can reduce pain and disability.”

 Read the full report here.

Abstract

Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP).

Method: A total of 894 cases followed 1 year using workers’ compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care.

Results: Controlling for demographics and severity, the hazard ratio [HR] of disability recurrence for patients of physical therapists (HR = 2.0; 95% confidence interval [CI] = 1.0 to 3.9) or physicians (HR = 1.6; 95% CI = 0.9 to 6.2) was higher than that of chiropractor (referent, HR = 1.0), which was similar to that of the patients non-treated after return to work (HR = 1.2; 95% CI = 0.4 to 3.8).

Conclusions: In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.


Journal of Occupational & Environmental Medicine: April 2011 - Volume 53 - Issue 4 - p 396–404

According to a Congressional Budget Office (CBO) report released this week, Medicare payments to physicians will be reduced by 29.4% on Jan. 1. 2012, unless Congress takes action. 

The reduction is the result of several years of legislative action intended to either maintain or increase Medicare physician payments as those rates were scheduled to decrease according to Medicare’s Sustainable Growth Rate (SGR), a mechanism used to determine reimbursement rates.

There is general consensus that the SGR needs to be amended. Determining how best to change the formula has been the topic of numerous congressional hearings this year.  CBO's new report provides input into the costs of proposals to replace or amend the Medicare fee schedule formula. CBO reports that if Congress were to eliminate the SGR and freeze Medicare payments to physicians at current rates, the cost to the federal government would be almost $298 billion over 10 years. By contrast, providing a 2% pay increase each year until 2021 would cost $389 billion over 10 years. One of the less expensive options would be to reset the SGR by having Congress forgive all previous spending above the cumulative targets as of the end of 2010.  That solution would cost $195 billion over 10 years.

On Tuesday, May 03, 2011, members of the NYSCA and Council’s Joint Legislative Task Force met with key legislators in Albany regarding our priority legislative items for 2011.The meetings proved to be effective and productive. Members from both parties in the Senate and Assembly agreed to sponsor and support our legislation.

(Arlington, Va.) -- The American Chiropractic Association (ACA) applauds federal efforts to curb prescription drug abuse following the U.S. government’s announcement in late April that the problem has reached crisis level. ACA encourages patients and health care providers to explore drug-free, conservative approaches to pain management as a first-line defense against painkiller abuse.
 
The government’s report, “Epidemic: Responding to America’s Prescription Drug Abuse Crisis,” notes that while the use of some illegal drugs has diminished, the abuse of prescription medications has sharply increased, particularly prescription opioid pain relievers such as Oxycontin and Vicodin. It points out unintentional opioid overdoses—once almost exclusively the fate of heroin abusers—are today increasingly caused by prescription painkiller abuse.
 
“This new report shows that while sometimes the use of these powerful drugs may be necessary, their overuse and abuse can lead to deadly consequences. The chiropractic profession offers non-drug interventions for pain relief,” said ACA President Dr. Rick McMichael. “We urge health care providers, whenever possible, to recommend drug-free conservative care interventions for their patients before prescribing medications that may be associated with harmful side effects. It’s critical that patients know their options.”
 
The government report outlines a four-part strategy to reduce the incidence of overdose caused by painkiller abuse, including increased education; monitoring of “doctor-shoppers” who obtain multiple prescriptions; the safe disposal of prescription medications; and cracking down on “pill mill” clinics that dispense hundreds of pills per patient. ACA believes prevention is also key and that increased use of conservative approaches for pain management may curb the need for painkillers and thereby reduce the likelihood of patient dependency, overuse and possible overdose.
 
Chiropractic care is best known for its effectiveness in treating painful conditions such as back pain, neck pain, and headaches—which are serious causes of disability in the United States. According to the U.S. Bone and Joint Decade, the number of prescription medications has increased in the past 10 years. Chiropractic care may lessen or eliminate the need for medications in some cases and help patients avoid unnecessary surgery. Chiropractic physicians treat the whole person, promote wellness and strive to address the underlying cause of patients’ ailments, not just their symptoms.
 
Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain. In 2007, the Annals of Internal Medicine published low back pain guidelines developed by the American Pain Society and the American College of Physicians recommending that, for patients who do not improve with self-care, doctors should consider non-pharmacologic therapies such as chiropractic care, massage therapy and acupuncture.

Abstract (provisional)

S3741, sponsored by Senator George Maziarz, and A6294, sponsored by Assemblyman Keith Wright, has been introduced in both houses of the legislature.  This bill would prohibit the application of the medical treatment guidelines to workers compensation patients who had a date of accident or date of disablement prior to December 1, 2010.