After meeting with representatives of the four other major chiropractic organizations, the World Chiropractic Alliance (WCA) announced it would throw its support behind a long-standing chiropractic lawsuit against the federal government.

The February meeting brought together representatives from the American Chiropractic Association (ACA), the International Chiropractors Association (ICA), the Federation of Straight Chiropractors and Organizations (FSCO), and the Congress of Chiropractic State Organizations (COCSA). It is the first time that all five groups have met to discuss common ground and seek ways to advance shared goals.

Among the issues addressed was the ACA's lawsuit against the Health Care Financing Administration (HCFA), filed on November 12, 1998. The suit claims that the Medicare+Choice regulations proposed by the HCFA unfairly deny Medicare beneficiaries access to chiropractic services in Medicare managed care.

A key complaint is that, according to regulations and policy statements issued by the Department of Health and Human Services (HHS) and HCFA, Medicare+Choice organizations may allow non-chiropractors to perform subluxation correction services and may operate as medical gatekeepers to shut out chiropractors.

The lawsuit demands that the federal government "correct or rescind any extant regulations, rules, policy statements and/or guidelines which have as their intended purpose any effort to deny Medicare HMO patients the congressionally ordered chiropractic benefit of manual manipulation of the spine to correct a subluxation delivered by a licensed doctor of chiropractic, whether the denial is based (1) on a simple failure to provide the services; (2) on a requirement that a hostile, untrained competitive medical physician make the determination of the need for chiropractic services; or (3) on allowing any and all health care professionals to provide the uniquely chiropractic services."

In May, 1999, the ACA filed an amended complaint against the HHS, alleging, among other counts, that physical therapists, medical doctors and osteopaths were providing chiropractic benefits.

When chiropractic was added to the Medicare program, subluxation correction was considered a uniquely chiropractic service. However, current Medicare Part C regulations allow non-chiropractors to provide these services and use medical gatekeepers to restrict access to chiropractors.

Although the lawsuit has been widely backed by the profession, and has won support from key Congressional members, it has yet to be resolved and many observers fear a continued uphill battle.

After reviewing the current situation regarding the ACA lawsuit, the WCA announced that it would lend its resources to help in the lawsuit efforts.

"The ACA has done an admirable job with the lawsuit and will, no doubt, prevail," stated Terry A. Rondberg, D.C., president of the WCA. "When asked for our support and assistance, we were more than happy to comply."

When asked about the troubled history between the WCA and ACA, he noted, "It's true that we have obvious philosophical differences and have experienced conflicts in the past, but that doesn't prevent us from acknowledging their contributions to the profession in matters such as the HCFA lawsuit. This is one of those areas where nearly all chiropractic organizations can agree and work toward unified action."

The offer of support and assistance is in keeping with the WCA's desire to create a more harmonious atmosphere between diverse elements of the profession. In December 2000, the WCA named Patrick Gentempo, D.C., as its director of Intraprofessional and Legislative Affairs and announced it would work to "eliminate the divisiveness which has plagued the profession in recent years and blocked meaningful legislative progress."

"Sadly, there has been a great deal of friction between chiropractic organizations," Dr. Gentempo explained at the time. "The misunderstanding and distrust between the groups -- and the misinformation being distributed to the profession -- makes it nearly impossible for us to make headway in Washington."

He added, "We can work toward unified action in an atmosphere of trust and cooperation. In fact, we must do that if we are to succeed in making chiropractic a major part of the health care system of the U.S. and the world."

The World Chiropractic Alliance leaders said they would continue their dialogue with the ACA to determine how they and their members can best help to advance the HCFA lawsuit.