On Sept. 4, more than two months into New Hampshire's fiscal year, Governor Craig Benson finally signed a compromise budget, nearly identical to one he vetoed in June. The new budget, which received widespread approval from the state legislature, restores a host of Medicaid services Benson had cut in the original budget - including chiropractic care.
New Hampshire's original budget included cuts to the Medicaid program that removed coverage for chiropractic; eyewear; physical therapy; occupational therapy; adult day care; emergency care; and ambulance rides.1 Although Gov. Benson originally recommended the cuts, and the budget was approved by both houses of the legislature, he then vetoed it for other reasons, including a 10-percent spending increase over the last budget, and heavy reliance on an $83 million federal bailout created by President Bush's latest tax cut.
The compromise budget also restores to previous levels the reimbursement rate in payments to health care providers who provide services under the Medicaid system. Gov. Benson had proposed a 5-percent reduction in Medicaid reimbursements in his original budget.
But as the citizens of New Hampshire rejoice over their ability to keep receiving chiropractic care under Medicaid, Michigan residents are bemoaning the fact that chiropractic services in their state will no longer be covered as of Oct. 1. Approximately 600,000 adults will be affected by the budget cuts, which eliminate Medicaid coverage for chiropractic, dental services, podiatric services and hearing aids.
State officials claim the cuts are drastic, but necessary. According to a spokesperson at the Michigan Department of Community Health, chiropractic and podiatric care account for $7 million in annual spending, while adult dental services account for approximately $20 million per year.
"With the revenue situation as it is, we had to make decisions between the very important and the vital," said Geralyn Lasher. "... there's simply not the funding to cover these services."2,3
According to the Michigan Chiropractic Association, however, the fault lies not with the state legislature, but Gov. Jennifer Granholm, who used her line-item veto privilege to remove chiropractic coverage from the Medicaid program - even though it had been approved by both the House and Senate as part of this year's budget.
For now, Michigan's Medicaid cuts will stay in effect until the end of the fiscal year, in Sept. 2004. However, lawmakers have vowed to work on restoring coverage for at least some services when the legislature resumes its session this fall. Thousands of Michigan DCs and their patients hope chiropractic is on that list.
References
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
