American Chiropractic Association Issues Statement in Response to Inspector General’s Report
Arlington, Va. (June 23, 2005) — The American Chiropractic Association today responded to the report issued by the Office of the Inspector General with the following statement: It is the opinion of the American Chiropractic Association (ACA) that the findings stated in the report issued by the Department of Health and Human Services, Office of the Inspector General reflect a universal problem in physician documentation and do not represent a concerted effort by doctors of chiropractic to over bill the government for non-reimbursable Medicare services. As has been shown with other physician groups, the documentation process frequently presents challenges and oftentimes results in perceived errors; however, it is simply wrong to conclude, based solely on this report, that chiropractic care typically rendered to Medicare beneficiaries is not necessary or appropriate. In far too many instances, chiropractic providers are simply failing to adequately document the medically necessary care provided. The ACA is committed to working with Centers for Medicare and Medicaid Services (CMS) to develop and implement efficient mechanisms to greatly improve the documentation process and help eliminate errors. It is unfortunate that the Inspector General’s report, drawn from 2001 data, provided only a passing reference to a program initiated in October 2004 that specifically addresses the very problems mentioned in this report. In addition, the Inspector General’s analysis completely ignores ACA’s vigorous and ongoing development of a documentation manual for use by doctors of chiropractic, and its educational programs targeted at state associations, chiropractic colleges, and Medicare carriers. The solution offered by the Inspector General -- to impose arbitrary caps or limits on chiropractic services -- does not take into account the individual needs of the patient. Medicare beneficiaries have the right to receive care which is reasonable and necessary, and the solution offered by the OIG arbitrarily cuts short this right, rather than to addressing the true problem of documentation. The ACA contends that placing arbitrary limits -- or caps -- on care is not an appropriate solution. Lastly, the ACA strenuously objects to the suggestion made in the report that it, at any time, supported the notion of arbitrary caps on services. The cited letter does not support that contention. The ACA is highly confident that the chiropractic care being provided through the Medicare program is both appropriate and medically necessary. We believe access to chiropractic care in Medicare saves taxpayer dollars as it is typically far less expensive than alternative forms of treatment, which often require the use of drugs and surgery. The ACA will continue to pursue all possible means to ensure that doctors of chiropractic have access to the resources they need to help correct the documentation issues raised in this report. We will also continue to protect the rights of all Medicare beneficiaries so they may continue to receive chiropractic services.
