For most of the past 100 years, chiropractic physicians and their patients were the only torch-bearers for safe, patient-centered alternative medicine. During the anti-alternative purge of the 20th century, homeopathy was all but wiped out in this country, surviving only on the fringes in Europe for 60 years. Osteopaths, once allied with chiropractors in their unique approach to health, threw in the towel and were co-opted by mainstream medicine; today, the difference between an osteopathic doctor and a medical doctor is indistinguishable except for the initials after the name. Providers of nutritional and herbal medicine such as the Thompsonians and Eclectics were all but exterminated, and by the 1950s, chiropractic was the only profession left that could provide patients with informed, educated, alternative medicine.
Even then, the level of harassment was formidable. The chiropractic doctor who treated me as a child was -- unbeknownst to me -- one of the leading forces in the fight for chiropractic equality. Dr. Reeve, of Dayton Ohio, was jailed no fewer than 6 times for "practicing medicine without a license," during his struggle to obtain licensure for chiropractic doctors.
Slowly, the tide has turned. Chiropractors are the first and only alternative medicine doctors to obtain licensing in all 50 states. And although few people know this, it was at a chiropractic college that acupuncture first found a home in this country, as New York Chiropractic College was the first college in the U.S. to offer training in acupuncture for doctors.
We are, in a way, accepted by medical insurers. But on a very limited basis and at rates that are prejudiced against chiropractic doctors and their patients. So much of what I could offer patients is denied because their insurance companies refuse to pay for procedures which are medically necessary and part of my scope of practice. And even if they were to pay, the reimbursement offered to a chiropractic doctor runs from 10% to 40% of what a medical doctor is paid for the same procedure -- despite our superior skills and training in many procedures.
But that's all about to change.
TheNational Association of Chiropractic Attorneys (NACA) has announced that it has issued a proclamation recognizing “the historic and profoundly positive legal ramifications for the chiropractic profession and the patient community it serves in Section 2706, ‘Non-Discrimination in Health Care,’ recently enacted as part of the federal ‘Patient Protection and Affordable Care Act.’”
The provider non-discrimination provision says that “A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.”
Once in full effect, health insurance companies will no longer be able to deny my patients their right to receive coverage for their acupuncture treatment, their nutritional therapies or the many other medically necessary services which I provide but which insurers routinely reject.
The provision has long been championed by the American Chiropractic Association (ACA) and members of the Chiropractic Summit. It was achieved primarily due to collaboration with Sen. Tom Harkin (D-Iowa) and help from other key players such as Sen. Chris Dodd (D-Conn.). Although he did not support the final bill overall, Sen. Orrin Hatch (R-Utah) also lent his support for the advancement of the non-discrimination provision. ACA will continue to fight for proper implementation during the regulatory process.
“It is important to recognize this provision as a historic first for the chiropractic profession. We now have a federal law applicable to ERISA plans that makes it against the law for insurance companies to discriminate against doctors of chiropractic and other providers relative to their participation and coverage in health plans,” said NACA Vice President Mike Schroeder. “While there is still much work to be done in the regulatory process, we are encouraged by the fact that Congress has finally acted to end provider discrimination based on one’s license.”
It is also important to note that Section 2706, and its assurance of non-discrimination in terms of participation and coverage, effectively requires that doctors of chiropractic be allowed to provide any“essential benefit” that is within their scope of practice. This will prove to be a particularly significant victory as the essential benefitspackage under the health care reform law is defined over the next couple of years.
“As significant as Section 2706 is to the chiropractic profession, it is possible to lose ground during the regulatory drafting process,” said NACA President Paul Lambert.
Believe me, the opponents of chiropractic care will work long and hard to keep chiropractic patients out in the cold. In fact, the American Medical Association has already begun attacking the provision, once again fearing the economic competition that chiropractic physicians represent.
To support the work being done to ensure the proper implementation of the provider non-discrimination provision, please add your voice to the thousands demanding full and fair insurance coverage at www.chirovoice.org.