June 2003

Coalition drafts 'revolutionary' Medicare bill

The Chiropractic Coalition ‑‑ made up of numerous chiropractic organizations including the founding members, the World Chiropractic Alliance (WCA), International Chiropractors Association, and Federation of Straight Chiropractors and Organizations (FSCO) ‑‑ is working closely with influential legislative leaders to draft a proposed bill that would establish chiropractic as a separate and distinct health care provider category under Medicare statutes.

The move would clearly distinguish doctors of chiropractic from medical physicians such as M.D.s or osteopaths, and make it impossible for non‑D.C.s to be reimbursed for subluxation correction or other services provided exclusively by D.C.s.

Rep. Donald Manzullo (R‑Ill.), chair of the House Small Business Committee and member of the Financial Services Committee, announced the formulation of the bill at the WCA International Summit.

"We will be introducing legislation soon that will not only reshape the definition of chiropractic in federal policy... it will blow the lid off the definition of chiropractic in federal policy," he said. "We are talking about a revolution. We will make it clear once and for all that chiropractic is equal, but unique. We will finally have a definition of chiropractic that actually reflects what chiropractic has always been and what it should always be."

The bill will remove the term "chiropractor" from the Medicare definition of "physician" (42 U.S.C., Sec. 1395x(r)) and create a new section under the Medicare statute that will define chiropractor as a primary care, portal‑of‑entry health care provider and include specific reference to the services provided by D.C.s.

Since reference to spinal adjustments, and subluxation correction will be contained only in this section, these will be made exclusively chiropractic services. Medical providers, including D.O.s and M.D.s, will not be able to be reimbursed for these services. D.C.s' right to perform other services allowed by their state statute will be protected as well.

Rep. Manzullo, who has long been one of the most chiropractic‑friendly legislators in Washington, was enthusiastic about the bill, saying it "will set chiropractic apart from medicine; it will resolve many of the fights you have endured with HCFA/CMS regarding when care was necessary; and it will make it clear that chiropractors and only chiropractors are educated and trained to do what you do. This bill will empower chiropractors to be chiropractors. This bill will enable you to look in the mirror and look at this statute and see yourself reflected there. Finally, a statute that looks like you."

Terry A. Rondberg, D.C., WCA president, was equally excited about the bill.

"We know this is something the profession has been working on for a long time," he stated. "The ACA is approaching it from the litigation end, and we are approaching it from the legislative end. Personally, I think getting this bill passed will be our best chance of a lasting solution, but it doesn't matter. What matters is that, one way or the other, we're going to finally have the federal government recognize that chiropractic is a separate health care field that offers a unique service ‑‑ subluxation correction."

Exhilaration about the bill permeated the Summit, and climaxed with a presentation by Manzullo's chief of staff, Adam Magary, a staunch supporter of chiropractic and tireless worker on its behalf.

Comparing the bill to the American Colonist's revolt against British tyranny, Magary said: "They marched down to the Boston harbor and dumped a bunch of boxes of tea into the water. They made a statement that said 'get ready things are about to change!' So today, we, too, are declaring that we have had enough. We, too, are reclaiming something we see being taken away from us. We, too, are dumping something into the harbor to serve notice that things are going to change"

The dynamic political staffer won a rousing round of applause at the Summit when he noted that chiropractors are not medical doctors and do not want to be medical doctors, and asked: "Anyone here wish they were delivering babies instead of doing what you are doing? Anyone here wish they were operating on ligaments instead of doing what you are doing? Anyone here wish they had their name on a little pad that says take this mind‑altering drug?"

Dr. Rondberg said the bill should generate widespread support from within and without the profession.

"I can't think of any reason why a chiropractor would oppose the bill since it protects the rights of all D.C.s, gives us the exclusive domain over subluxation‑correction, and reinforces our unique role in health care," he noted. "I think the medical profession will support the bill as well, since it separates us from the physician category and indicates that we are not duplicating their services or intruding on their turf."

To assure that the bill is passed in Congress, the Coalition will launch a massive grassroots effort, asking all D.C.s to write to their legislators.

"Members of our profession have been willing to donate more than $5 million to find a solution through litigation," Rondberg stated. "I am confident they will be willing to donate a few minutes of their time to find a permanent solution through strong, protective legislation."

Additional information on the campaign, including sample letters and talking points, will be made available by the Coalition as the bill is introduced.