Chiropractors Suit Against the HCFA Updated
As reported in our article below, the American Chiropractic Association (ACA) sued for parity with the medical profession on reimbursement of Medicare fees. The Health Care Finance Administration wanted the ACA to use the administrative procedural remedies established for such petitions before being able to bring a lawsuit. The ACA wanted to proceed with the matter before the courts rather than starting with the administrative procedure established by the HCFA.
On January 22, 2001, the US District Court for the District of Columbia decided that the ACA did not have to go through the administrative hearing remedies on the counts in its lawsuit. The case will proceed in court.
The court ruled that the administrative hearings would be biased against chiropractors. The suit now will go before a federal court that will decide whether HCFA must set the same financial parity payments for chiropractors as established for other healthcare providers who do spinal manipulations. The court will also rule on the allegation that managed care associations did not properly allocate portions of their monthly payments from Medicare for covering manual manipulations. In summary, chiropractors are seeking equal status with concomitant professionals in other fields who are reimbursed by Medicare for similar work that is the sine qua non for their field.
Recently, the American Chiropractic Society (ACA) has filed a suit against the federal government’s Health Care Financing Administration. They would like the government to require physicians to exclusively refer patients who require correction of misalignments of the vertebrae (subluxations) to chiropractors. There are about 50,000 licensed chiropractors in the USA. The ACA contends that physicians in the Medicare program use physical therapists or do the work themselves.
Figures indicate that in 1998 about 32.9 million seniors were covered through traditional Medicare and another 6.3 million were enrolled in HMO Medicare plans. Less than 10% of individuals in the traditional Medicare programs are referred to chiropractors and less than 1% in Medicare HMO’s visit chiropractors. Chiropractors feel it is an attempt to squash their profession.
In 1997, a federal court judge ruled that the American Medical Association had to stop their refusing of referrals to chiropractors. The AMA saw them as an unscientific cult. They felt that some chiropractors practice beyond their training and the general philosophy taught at chiropractic schools (treat diseases with spinal manipulation with no scientific basis).
The goal of the law suit is to force the HFCA to issue new regulations to make it clear that only chiropractors are qualified to deliver chiropractic services and not allow Medicare HMO’s to substitute other providers for chiropractors. Chiropractors feel that the type of care they provide is as effective as traditional medicine for certain ailments.
See our article "Does Medicare Cover Chiropractic Care"
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By Harold Rubin, MS, ABD, CRC, Guest Lecturer
Updated February 1, 2001
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