The Senate and now the House of Representatives has voted 314-112 to repeal a provision in the healthcare reform law that requires all businesses, including chiropractic practices to submit a 1099 form each time they spend $600 or more. The measure now goes to President Obama for his signature.
The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) today announced that their work with key congressional supporters has resulted in two important pieces of pro-chiropractic legislation being introduced in the U.S. House of Representatives. These bills, if enacted into law, would increase patient access to vital health care—which includes chiropractic care—and benefit chiropractic physicians and students.
One of the legislative initiatives, the Access to Frontline Health Care Act (H.R. 531), would establish a new program that would help chiropractic physicians and other select health care providers repay their student loans if, in exchange, the providers establish and maintain practices in medically underserved areas. The legislation, introduced Feb. 8 in the U.S. House of Representatives by Rep. Bruce Braley (D-Iowa) would designate certain types of health care providers as “frontline” providers. ACA and ACC worked closely with the sponsor of the bill to ensure that chiropractic physicians are specified in the bill as qualifying for this status.
“Many regions of our nation, particularly the rural parts of America, simply do not have sufficient numbers of qualified health care professionals to meet the needs of the local population,” said ACA President Rick McMichael, DC. “This legislation would provide vital health care to underserved patients across the country, and it would also help newly graduated chiropractic physicians establish practices and repay their student loans.”
The second piece of legislation, the Chiropractic Membership in the Public Health Service Commissioned Corps Act of 2011 (H.R. 664), introduced by Rep. Gene Green (D-Texas) on Feb. 11, would also benefit the public and the profession by requiring the inclusion of chiropractic physicians in the U.S. Public Health Service (USPHS) Commissioned Corps.
The Commissioned Corps is an elite team of more than 6,000 well-trained, highly qualified public health professionals dedicated to delivering the nation’s public health promotion and disease prevention programs and advancing public health science. Officers in the Corps provide health care services in a variety of locations and venues, including care to members of the U.S. Coast Guard and at community health centers.
"Both of these pieces of legislation are critical to the integration of chiropractic care in every federal health care program,” said Frank J. Nicchi, DC, president of the Association of Chiropractic Colleges. "Chiropractic students and alumni will benefit immensely from the opportunity to provide care to citizens in medically underserved areas and to participate in the Commissioned Corps. We applaud Reps. Braley and Green for their leadership and support for the inclusion of chiropractic care in these important national health care initiatives.”
The introduction of both pieces of legislation fairly early in the First Session of the current 112th Congress was intentional by ACA, ACC and the bill’s supporters. “Early introduction allows for the time necessary to build critical momentum for these pro-chiropractic initiatives,” said John Falardeau, ACA’s vice president of government relations. “Having that momentum increases the likelihood of these bills successfully advancing through the legislative process.”
To view the full text of HR 531, click here.
To see the full text of HR 664, click here.
ACA and ACC request that chiropractic physicians contact their congressional representatives and urge them to cosponsor both of these bills.
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.
The Association of Chiropractic Colleges represents accredited chiropractic colleges in North America and seeks to advance chiropractic education, research and service.
Carpenter, Ann M., D.C. (nee) Gowdy age 76 formerly of Suffern, NY died Sunday, February 27, 2011. Devoted mother of Karen M. Carpenter. Dear sister of Bettina Pearce, her husband Karl, and the late James Gowdy. Loving aunt of Janine Karabas, Valerie Powell, and Camille Rance. Her memory will continue to be cherished by her many loving family members and friends. Ann was a dedicated and faithful member of the Baha’i faith for over 45 years. As a professional, Ann began her career as a Chiropractor in the early 1980’s and continued until her retirement in 2008 from her practice at Beacon Chiropractic in Beacon, NY. She received her Doctorate of Chiropractic from The New York Chiropractic College, where she received the D.D. Palmer Memorial Award for Meritorious Achievement. She continued her distinguished career as a Chiropractor as a Fellow, American College of Chiropractors, and Consultant to the National Board of Chiropractors. Prior to that she flourished in her first love of teaching at Haaren High School and also at Harlem Preparatory School, a school which she co-founded. At Harlem Prep, the nation's first alternative school, she supervised 600 students, 25 teachers and 15 teacher aides.She received her Masters from City College. Family and friends are invited to attend a service on Friday beginning at 11AM at the Volk Leber Funeral Home, 789 Teaneck Rd., Teaneck. Interment to follow at George Washington Memorial Park, Paramus.
Guest Book
Friday, March 4
11:00 AM - 1:00 PM
Volk Leber Funeral Home
789 Teaneck Road
Teaneck, NJ 07666
201-836-0202
Interment immediately following the service at George Washington Memorial Cemetery, Paramus, NJ
Memorial service planned for Saturday, April 2 at the Baha'i Cabin in Teaneck. (More details will follow for the memorial service.)
(Arlington, Va.) -- The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) today expressed support for newly introduced legislation in the U.S. House of Representatives designed to expand the availability of the services delivered by chiropractic physicians in the federal Department of Veterans Affairs (VA) and to those who utilize the military’s health care delivery system, TRICARE, run by the Department of Defense (DoD).
Ranking member of the House Veterans Affairs Committee, Rep. Bob Filner (D-Calif.), has again introduced the Chiropractic Care to All Veterans Act (H.R. 329), a bill similar to legislation that was overwhelmingly passed by the entire House in 2010 but was not considered in the Senate. H.R. 329 would require the VA to have a chiropractic physician on staff at all major VA medical facilities by 2014. It would also amend the current statute, the Department of Veterans Affairs Health Care Programs Enhancement Act of 2001, ensuring that chiropractic benefits are included in the U.S. Code of Federal Regulations and therefore, cannot be denied.
“Our nation’s veterans and active-duty military, along with their family members, have sacrificed so much for our country. They deserve the best health care available, and that includes chiropractic care,” said ACA President Rick McMichael, DC. “It makes me proud to see the chiropractic profession working with our congressional allies in support of this important legislation.”
Through previous congressional action, chiropractic care is now available at 36 VA facilities across the country; however, in the more than 100 major VA medical facilities without a chiropractic physician on staff, the chiropractic care benefit Congress authorized for America’s veterans remains virtually nonexistent. Detroit, Denver, and Chicago are a few of the major metropolitan areas still without a chiropractic physician at the local VA medical facility.
The ACA and ACC believe that integrating chiropractic care into the VA health care system would not only be cost-effective, it would also speed the recovery of many of the veterans returning from current operations overseas. A 2010 report from the Veterans Health Administration indicates that over half of all veterans returning from the Middle East and Southwest Asia who have sought VA health care were treated for symptoms associated with musculoskeletal ailments – the top complaint of those tracked for the report.
In addition, Rep. Mike Rogers (R-Ala.) has re-introduced another piece of legislation in the House that would extend chiropractic care to U.S. military retirees, dependents and survivors as part of the TRICARE program. H.R. 409, the Chiropractic Health Parity for Military Beneficiaries Act, would require the Secretary of Defense to develop a plan to allow any beneficiary covered under TRICARE to select and have direct access to a chiropractic physician. The plan deadline is Aug. 31, 2011. Currently, only active duty members are afforded the chiropractic benefit.
“I am pleased that Congress has taken these two important steps that, when taken together, facilitate access by our veterans, active military and their families to fundamental health care benefits such as chiropractic care,” said ACC President Dr. Frank Nicchi, “Chiropractic continues to enjoy high levels of satisfaction among our servicemen and women.”
H.R. 409 defines “chiropractic services” as diagnosis (including X-ray and tests), evaluation and management, and therapeutic services for the treatment of neuromusculoskeletal health conditions. The legislation specifically notes that chiropractic services may only be provided by a chiropractic physician. Rep. Rogers introduced nearly identical legislation in the past two sessions of Congress.
To view the full text of H.R. 329, click here.
To see the full text of H.R. 409, click here.
ACA and ACC request that chiropractic physicians contacttheir congressional representatives and urge them to cosponsor both of these bills.
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.
Complementary and Alternative Medicine in Back Pain Utilization
Structured Abstract
Objectives: This systematic review was undertaken to evaluate which complementary and alternative medicine (CAM) therapies are being used for persons with back pain in the United States.
Data Sources: MEDLINE®, EMBASE®, CINAHL® and Cochrane Central® and a variety of CAM specific databases were searched from 1990 to November 2007. A grey literature search was also undertaken, particularly for clinical practice guidelines (CPG) related to CAM.
Review Methods: Standard systematic review methodology was employed. Eligibility criteria included English studies of adults with back pain, and a predefined list of CAM therapies.
Results: A total of 103 publications were evaluated; of these 29 did not present CAM therapy use stratified for back pain. There were a total of 65 utilization studies, 43 of which were American. Four publications evaluated the concurrent use of four or more CAM therapies and these suggest that chiropractic/manipulation is the most frequently used modality followed by massage and acupuncture. A limited number of publications evaluated utilization rates within multiple regions of the back and show that CAM was used least for treating the thoracic spine and most for the low back. However, rates of use of massage were similar for neck and lower back regions. Concurrent use of different CAM or conventional therapies was not well reported.
From 11 eligible CPG, only one (for electro-acupuncture) provided recommendations for frequency of use for low back pain of all acuity levels.
Eighteen cost publications were reviewed and all but one publication (cost-effectiveness) were cost identification studies. There is limited information on the impact of insurance coverage on costs and utilization specific to back pain.
Conclusions: There are few studies evaluating the relative utilization of various CAM therapies for back pain. For those studies evaluating utilization of individual CAM therapies, the specific characteristics of the therapy, the providers, and the clinical presentation of the back pain patients were not adequately detailed; nor was the overlap with other CAM or conventional treatments.
PDF File
A new study finds that low back pain care initiated with a doctor of chiropractic (DC) saves 40 percent on health care costs when compared with care initiated through a medical doctor (MD), the American Chiropractic Association (ACA) announced today. The study, featuring data from 85,000 Blue Cross Blue Shield beneficiaries, concludes that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.
Low back pain is a significant public health problem. Up to 85 percent of Americans have back pain at some point in their lives. In addition to its negative effects on employee productivity, back pain treatment accounts for about $50 billion annually in health care costs—making it one of the top 10 most costly conditions treated in the United States.
The study, “Cost of Care for Common Back Pain Conditions Initiated With Chiropractic Doctor vs. Medical Doctor/Doctor of Osteopathy as First Physician: Experience of One Tennessee-Based General Health Insurer,” which is available online and will also be published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics, looked at Blue Cross Blue Shield of Tennessee’s intermediate and large group fully insured population over a two-year span. The insured study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays.
Results show that paid costs for episodes of care initiated by a DC were almost 40 percent less than care initiated through an MD. After risk-adjusting each patient’s costs, researchers still found significant savings in the chiropractic group. They estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee.
“As doctors of chiropractic, we know firsthand that our care often helps patients avoid or reduce more costly interventions such as drugs and surgery. This study supports what we see in our practices every day,” said ACA President Rick McMichael, DC. “It also demonstrates the value of chiropractic care at a critical time, when our nation is attempting to reform its health care system and contain runaway costs.”
The American Chiropractic Association, based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of ethics and patient care, contributing to the health and well-being of millions of chiropractic patients.
ABSTRACT
Cost of care for common back pain conditions initiated with chiropractic doctor vs medical doctor/doctor of osteopathy as first physician: experience of one Tennessee-based general health insurer.
OBJECTIVE: The primary aim of this study was to determine if there are differences in the cost of low back pain care when a patient is able to choose a course of treatment with a medical doctor (MD) versus a doctor of chiropractic (DC), given that his/her insurance provides equal access to both provider types.
METHODS: A retrospective claims analysis was performed on Blue Cross Blue Shield of Tennessee's intermediate and large group fully insured population between October 1, 2004 and September 30, 2006. The insured study population had open access to MDs and DCs through self-referral without any limit to the number of visits or differences in co-pays to these 2 provider types. Our analysis was based on episodes of care for low back pain. An episode was defined as all reimbursed care delivered between the first and the last encounter with a health care provider for low back pain. A 60 day window without an encounter was treated as a new episode. We compared paid claims and risk adjusted costs between episodes of care initiated with an MD with those initiated with a DC.
RESULTS: Paid costs for episodes of care initiated with a DC were almost 40% less than episodes initiated with an MD. Even after risk adjusting each patient's costs, we found that episodes of care initiated with a DC were 20% less expensive than episodes initiated with an MD.
CONCLUSIONS: Beneficiaries in our sampling frame had lower overall episode costs for treatment of low back pain if they initiated care with a DC, when compared to those who initiated care with an MD.
Journal of Manipulative and Physiological Therapeutics (JMPT) 2010 Nov-Dec;33(9):640-3. Epub 2010 Oct 18.
Dr James B. Juenger, D.C., 60, passed away on November 30, 2010 after a one-year battle with lung cancer. Dr Juenger graduated from Cornell University and Logan College of Chiropractic. He practiced in Trumansburg, NY for the past 32 years where his office staff and loyal patients became his extended family. Dr. Juenger was a NYSCA member for most of his professional career and held almost every district office at one time or another. He was always happy to help out a new practioner in any way. Dr. Juenger is survived by his 5 children, 9 grandchildren and two brothers. He was a truly devoted father, friend colleague, and mentor. He will be greatly missed by so many.
President Obama signed into law legislation that delays for one year the scheduled 25% cut in Medicare payment to doctors.
Medicare - Some good news for a change:
The Red Flags Rule requires creditors and certain businesses to develop and implement written identity theft prevention programs to help identify, detect and respond to patterns, practices or specific activities that could indicate identity theft. The applicability of the rule to health care providers has been debated over the past several months. On Tuesday, November 30, 2010, the Senate passed legislation (S3987) that clarifies the definition of a creditor and in effect would exempt health care providers from the Red Flags Rule. On December 7, 2010, the House of Representatives passed S3987 and sent the bill to President Obama. The President is expected to sign the bill before the Red Flags Rule goes into effect on January 1, 2011.
Thanks to the efforts of the ACA along with other healthcare provider groups whose efforts were instrumental in removing this additional administrative burden for doctors of chiropractic and other health care providers.
And more good news for a change:
The Senate has passed a $15 billion bill that would block the impending 25% cut in the Medicare payment rate to physicians and instead keeps rates steady through 2011. The cut was scheduled to take effect on January 1, 2011. It is likely that the House would pass the bill – it would by the fifth and longest extension of Medicare physican payment rates enacted this year and puts us back in the “yearly extension cycle” that we have all become familiar with. Unfortunately, the bill does not fix the sustainable growth rate (SGR) problem and doctors would be subject to a cut of more than 25% for treating Medicare patients in 2012 unless Congress figures out a long term solution in the meantime.
Update on NYS Workers Compensation fee schedule:
As you know, 97140 was not included in the chiropractic fee schedule. Carriers will be notified that the 97139 code (unlisted therapeutic procedures) will be used instead with the descriptor being the procedure that was performed. This code usually requires a report for the service, but that will not be necessary. The 97940 omission will be addressed in the future.
Effective December 1, 2010 the “new” C4 family of forms must be used. The exception is in the physician shortage are in Rochester where the forms go into effect Jan 1, 2011. These are the 4 page new patient C4 and the 2 page C4.2. The forms can be found on the NYS WCB website (click on the link below):
http://www.wcb.state.ny.us/content/main/Forms.jsp
And a reminder: Any condition that is resultant from a work related injury is compensable by workers compensation insurance. Under no circumstances, can the doctor charge the patient for any treatment related to a workers compensation injury (even if a variance is denied).
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The New York State Chiropractic Association is committed to the advancement of the chiropractic profession in New York State. Our officers, directors, delegates and district officers are working diligently on your behalf to protect your right to practice and to provide the highest quality services to the patients we serve.
Many plans have limits on how much can be paid out in coverage, limits which would be phased out under the new health reform law.
The feds though have granted waivers from that law, amid worry that certain Unions and Big Companies would drop their health insurance programs entirely. Those waivers are good for one year, and can be considered for renewal.
The list of the 222 733 Unions and Big Companieswaivers are available by clicking on the link below.
THE LIST
Both measures expected to receive quick White House approval
Medicare requires that services provided to a patient are authenticated in the patient health record. Hand written or electronic signatures are acceptable. A handwritten signature is a mark or sign by an individual on a document to signify knowledge, approval, acceptance or obligation. Signature must comply with the following:
* Stamp signatures are not acceptable.
* You must be familiar with your Local Coverage Determination (LCD) policy on authenticating records as these policies will take precedence over the guidelines below.
* If, in the course of a patient health record review, a signature is found to be illegible, Medicare contractors will look for a signature log or attestation statement to determine the identity of the provider.
* A signature log includes a list of the typed or printed name(s) of the author(s) of the associated initials or illegible signature(s).
* The signature log can be included on the page where the initials or signature are present, or may be in a separate document.
* Although a reviewer may encourage providers to list their credentials in the signature log, a claim should be not denied if the log is missing a provider’s credentials.
* All signature logs should be considered regardless of the date the log was created.
Attesting to a Signature’s Validity
Providers can include an attestation statement in the documentation they submit. Only the author of the medical record can attest to the record in question.
Attestations will be accepted by reviewers regardless of the date of the attestation, except in those cases where the regulations or policy indicate that a signature must be in place prior to a given event or a given date. For example, if a policy states the physician must sign the plan of care before therapy begins, an attestation can be used to clarify the identity associated with an illegible signature but cannot be used to “backdate” the plan of care.
CMS recommends that, rather than backdating a patient health record, providers should use the signature authentication process explained below. In some situations, a provider may be contacted by a contractor and asked to submit an attestation statement or signature log. Providers will have 20 calendar days from the date of the contractor’s call, or the date that the request letter is received by the post office, to provide the information. To be valid for Medicare medical review purposes, the attestation statement must be signed and dated and contain sufficient information to identify the beneficiary. An example is included below:
“I, _____[print full name of the physician/practitioner]___, hereby attest that the medical record entry for _____[date of service]___ accurately reflects signatures/notations that I made in my capacity as _____[insert provider credentials, e.g., DC]___ when I treated/diagnosed the above listed Medicare beneficiary. I do hearby attest that this information is true, accurate and complete to the best of my knowledge and I understand that any falsification, omission, or concealment of material fact may subject me to administrative, civil, or criminal liability.”
The current requests for audits by Medicare are not an unusual review. In New York, there is currently a special services pre payment audit request for 98941 services as of October, 2010 and for 98942 services as of November 2009. Also, Medicare does ongoing CERT reviews on Chiropractic claims in which they will review records for proper documentation to support the claim and diagnosis that has been billed.
With the prepayment audit review, they seem to be sending a request letter for each patient and they are only asking for 3 months of records. A special services CERT request letter is usually 3-4 pages long, and they may ask for multiple patients or multiple dates of service, listed in chart form and they usually request 6 months of previous records.
According to Dr. Ritch Miller, ACA Medicare Committee chairman, you should and must comply. If for some reason you speak with anyone from the carrier/contractor, log the persons name, ID #, station number or whatever and write word for word what you are told. Normally we recommend not speaking with the contractor. KEEP TRACK OF EVERYTHING, and make 2 copies of everything you send to them.
Doctors are encouraged to review the Local Coverage Determination (LCD) for Chiropractic Services (L27350). LCDs can be accessed from the Medical Policy Center on the www.ngsmedicare.com web site; enter keyword L27350 in the Medical Policy Center search form field to access the Chiropractic Services policy. There is a detailed description on what you documentation should include for the initial visit and subsequent visits.
We also suggest before you start working on the audit, go to the ACA Medicare Webpage www.acatoday.org/medicare and read the links on audits/appeals. You and your staff should take the free 2 hour ACA Medicare documentation webinar. Then, we recommend that you read everything else on the webpage. You need to know everything you can about Medicare, now. So even if you think you know everything there is to know about Medicare, you need to read everything once again. In particular, some of the things (but not all) they are looking for include the diagnosis with a subluxation to correlate with the service code that is billed (98940, 98941, 98942). There should be a treatment plan for the condition. You should note the level of the subluxation adjusted. A PART exam should be done on the onset date of the condition treated with subsequent periodic re-exams and function assessments. Finally, every visit should be signed in full by the provider of the service. If you have not signed your notes attaché an attestation page with the visits. This can be found at www.ngsmedicare.com key word signature.
Other suggestions from Dr. Miller include the following. With regard to what documentation to send, we recommend you send everything in from the BOX 14 (CMS 1500) date on, even if it is a month or two longer than the 3 months, if that date is less than the 3 months then we suggest you send in 3 months documentation if the patient was treated at that time. Make sure you send all supporting documentation even if it is several years old, like the patients original intake forms if that has historical information on it, if this information is found in no other place in the records.
Many doctors’ first react with anger and frustration when they start to get these audits. That is not helpful and in past cases has made things a whole lot worse. Be as pleasant as you can be with anyone you speak with.
Only send in patient records, do not send in any explanatory letters or anything that is not an "official" patient record, since it can be used against you and since it is not official it cannot be used in your favor.
If you get denied on any of the claim(s), you we recommend that you consider an appeal, if the documentation supports the service billed, even if you are asked to return only $20. It is a temptation to not go further, but that may be seen as admission of guilt and they more than likely will continue with future audits.
Hopefully this won't turn into the battle that many other states are going through across the country, but you must prepare for the worst and expect the best. There are doctors across the country, (and again hopefully you are not one of them), that have been carrying on this battle for over two years. So you must take this very, very seriously.
The ACA is working on this with CMS and hopefully we can turn this around. Unfortunately, with the executive branch and administration's increased and well publicized focus on fraud and abuse, don't plan on that.
If you have any questions, please first go to the ACA webpage www.acatoday.org and see if you can find the answer there. If not please contact Dr. Lupinacci or Dr. Penna. If you have any questions specific to this notice, please feel free to contact either of us also.
Sincerely,
Dr. Louis Lupinacci, DC
NY Medicare Chiropractic CAC Rep
Dr. Mariangel Penna, DC
NY Alternate Medicare CAC Rep
WC changes are here as of Dec 1, 2010. Learn how to treat your patients and get paid under the new system.
Chiropractic Services have been Unbundled!
Learn how to correctly bill modalities and avoid costly mistakes.
The forms, the treatment, get the information you need now by clicking on the link below!
Workers’ Compensation Program
The House of Representatives has passed legislation temporarily stoping the 23% cut in physician payments under Medicare scheduled to take effect on Dec. 1. The same measure has already passed the Senate.
The ICC is a non-profit organization that encourages a high code of ethics among practitioners, researchers, educators and others in the chiropractic profession. The Fellow designation is bestowed upon those whose contributions have made or who will make significant impact upon the science of chiropractic and to those who render valuable and meritorious service to the profession.
The committee after careful consideration has invited Dr. Penna to become a Fellow. In his letter to Dr. Penna, James Mertz, D.C., Secretary-Treasurer of ICC, stated, “your record of outstanding service has richly earned this honor for you.” Dr. Penna is immediate past president of NYSCA and remains active on assorted committees and the organization’s goals of protecting NY patients and Doctors of Chiropractic rights to equal healthcare access and reimbursement.
made a lifetime contribution of lasting significance toward the advancement of chiropractic in the scientific and academic communities, and the public acceptance of the profession.
The deadline for paper submission for presentation at the conference is January 15, 2011. Those also go the AHC office, address above.
Increasingly the New York State Board for Chiropractic has been receiving questions and concerns about certain types of advertising. The information provided in this brief article may help clarify some of the responsibilities we have as practitioners when we advertise.
The New York State Board for Chiropractic frequently receives requests for information regarding spinal decompression from practicing doctors and from the general public.These treatments can become expensive and often are not covered by insurance. Coding for these services can also be confusing. There were a series of articles recently authored by James Edwards, D.C and Cynthia Vaughn,D.C.,F.I.C.C. which were published in Dynamic Chiropractic from the middle of 2008 through March of 2009.These articles would be of interest for anyone considering decompression in their practice. These should not be considered a complete guide but rather a starting point.
