The American Chiropractic Association has provided details on several recent important legislative victories for the Chiropractic profession 

ACA Legislative Action Results in Expansion of Coverage Under the Blue Cross Blue Shield Federal Employees Plan

Largest federal carrier recognizes landmark PPACA provision

The 2014 Blue Cross and Blue Shield Service Benefit Plan, as authorized by the Federal Employees Health Benefits law, has announced that effective January 1, 2014 it will "now cover any licensed medical practitioner for covered services performed within the scope of that license, as required by Section 2706(a) of the Public Health Service Act (PHSA).

Previously, benefits for certain medical practitioners were limited to services performed in Medically Underserved Areas (MUAs)." And it further announced that due to such compliance with Section 2706(a): "Benefits for chiropractic care are no longer limited to one office visit and one set of X-rays per year." Coverage for those services will be based upon "the benefits we provide for office visits and ... for our coverage of radiological services performed by covered professional providers."

Section 2706(a) "Non-discrimination in Health Care" was passed under the Patient Protection and Affordable Health Care Act and was spearheaded by the ACA. This follows a long history of ACA legal and legislative action which included a first time chiropractic benefit into the Blue Cross Blue Shield Federal Employees Plan, the expansion of coverage to include physical therapy services as well as preserving the physician status for doctors of chiropractic under the program.

For a list of 2014 federal benefit brochures by state, click here

ACA Works With Coalition to Ensure Inclusion in New Medicare Payment Reform Medicare

Doctors of chiropractic must retain physician status in any new program created by Congress

Enacted as part of the Balanced Budget Act of 1997, Medicare’s Sustainable Growth Rate (SGR) is a complex and flawed formula that attempts to contain spending for Medicare’s physician services by setting a spending target for services offered under Medicare Part B. For several years this flawed formula has led to substantial cuts in the Medicare Physician Fee Schedule (over 20-percent in recent years), which have been averted only after last-minute Congressional action and considerable lobbying efforts.

To solve this problem and avoid the continued need for stop-gap efforts, this year Congress made the most significant effort to replace this formula since its inception. The House Energy and Commerce and Ways and Means committees, along with the Senate Finance Committee have held hearings and considered legislation with their version of a “doc-fix.” These bills create new physician payment models tied to increased quality and performance measures that doctors of chiropractic have, and will continue to participate in.

However, in several instances, doctors of chiropractic were largely limited in their ability to participate in the programs established under the proposals, and in some cases, were eliminated altogether as all the bills initially defined providers as physicians using the narrow MD/DO physician definition, preventing entire classes of physician providers from participating under the proposals.

This caused great concern within the ACA, and subsequently, we have had several victories in influencing the final outcome of these bills. Perhaps the most significant win for the profession was the change we were able to make in the Senate Finance bill which passed out of the committee last week.

In the first draft of the Finance Committee’s proposal, DCs were not included or defined as physicians. To correct this inequity, ACA’s government relations team met with policy makers working for both the committee and staff of Senators who sit on the committee and were told after reviewing the second draft of the Finance Committee’s proposal that the physician definition would include all non-MD/DO providers, currently defined as physicians. This victory was short term; however, as we discovered that the legislation to be marked up by committee and reported to the full Senate for consideration had once again eliminated all but the MD/DO providers.

Upon learning this, ACA government relations once again went into action, aggressively lobbying the Senate Finance Committee staff on both sides of the aisle, and several of the top Senators on the committee and were ultimately able to change the physician definition back to current law, enabling doctors of chiropractic to fully participate in the proposals created by the Senate. This major win for the profession was the result of the tireless efforts of ACA’s government relations department and an example of the daily efforts they make on behalf of the profession, which simply cannot be understated strongly enough.

CMS to Significantly Increase Value of Chiropractic CPT Codes in 2014

ACA’s longtime advocacy efforts result in positive step forward for the chiropractic profession in Medicare

The ACA has also recently learned that the Centers for Medicare and Medicaid Services (CMS) will increase the value of Chiropractic Manipulative Treatment (CMT) CPT® codes up to 10 percent in the 2014 Physician Fee Schedule beginning Jan. 1. The change comes after ACA provided CMS-appointed coding committees with key information about the physician-level work involved in the procedures.

The increase in CMT code values is an important step forward for the profession, resulting from ACA’s long campaign to expand and increase the value of chiropractic services in Medicare. It was in late 2012 that ACA representatives presented data from a random profession-wide survey on the physician work inherent in CMT codes 98940, 98941 and 98942 to the American Medical Association’s RVS Update Committee (RUC) Health Care Professionals Advisory Committee Review Board (HCPAC). The RUC-HCPAC subsequently recommended an increase in the Relative Value Units (RVUs) for each of the CMT codes in 2014, which CMS accepted.

ACA is encouraged by this latest positive change and are committed to continuing our campaign to expand the availability and value of chiropractic in Medicare. ACA is also especially grateful to ACA Vice President Anthony Hamm, DC, and our research consultant Christine Goertz, DC, PhD, for their tireless efforts in helping the RUC-HCPAC to understand the high-quality physician-level treatment that doctors of chiropractic provide their patients.

More information and the new values to be used to calculate the allowable payment for each CPT® code that doctors of chiropractic bill, can be found by clicking here.

Senate Veterans Panel Advances Pro-Chiropractic Legislation for Final Vote in Full Senate

This month, the Senate Committee on Veterans Affairs delivered S.944 - Veterans Health and Benefits Improvement Act of 2013 to the Senate for final passage. S. 944, an omnibus veterans’ bill, includes provisions of the bipartisan Chiropractic Care Available to All Veterans Act, S.422, introduced by senators Richard Blumenthal (D) of Connecticut and Jerry Moran (R) of Kansas, which would improve veteran health care by expanding the availability of chiropractic services to more U.S. Department of Veterans Affairs (VA) medical centers.

Specifically, S. 944 requires that the VA chiropractic program be carried out at no fewer than two medical centers or clinics in each Veterans’ Integrated Service Network (VISN) by no later than two years after the date of enactment and no fewer than 50 percent of all medical centers in each VISN by no later than three years after enactment, an increase of sites with doctors of chiropractic serving within a VA Medical Center from 48 today to 76 by 2017.

The Senate Veterans Committee, acknowledging that the VA is long overdue in establishing a firm, comprehensive policy to provide a full scope of chiropractic services to veterans, expanded the existing chiropractic services available to veterans by amending paragraph 6 of section 1701 of title 38, U.S.C., to include chiropractic services on the list of available medical services provided by VA. The bill would also include chiropractic services in the list of available rehabilitation and preventive health services.

A companion bill in the U.S. House of Representatives, H.R. 921, was introduced by Rep. Mike Michaud (D-Maine), the ranking member of the House Committee on Veterans Affairs.

State associations, doctors of chiropractic, chiropractic students and chiropractic supporters can contact their congressional representatives and urge them to cosponsor H.R. 921 to ensure the initiative passes this Congress.

Contact: [email protected]