UHC Rescinds Policy Regarding Chiropractic Reimbursement

Treatment of Pediatric, Headache Patients Remains a Covered Service

By Editorial Staff

In a major victory for the chiropractic profession in the ongoing battle against the insurance industry for coverage of chiropractic services, United Healthcare (UHC) has rescinded its policy declaring chiropractic manipulative treatments for pediatric and headache patients to be unproven and therefore not a covered service.

In its recently released Chiropractic Services Policy Update, UHC stated:

"In September of 2007 UnitedHealthcare issued a revised medical policy on Chiropractic Services. This policy stated that spinal manipulative treatment for headaches and for pediatric patients was unproven and therefore not a covered service. As announced in October [2007], the ACN Group Chiropractic Professional Advisory Committee (CPAC) has facilitated the collection of input from the chiropractic professional community regarding this revised policy. As a result of this interaction, UnitedHealthcare will not proceed with the chiropractic services policy change announced in the September 2007 UnitedHealthcare Network Bulletin."

In response to this news, the American Chiropractic Association (ACA) President Glenn Manceaux, DC, told the press, "We are pleased that UHC has decided not to implement this policy. We strongly believe that through the actions of ACA, along with the other chiropractic organizations, the profession made a compelling argument as to why this policy should have been rescinded. We feel that our members, the profession and our patients will be well served by UHC's recent decision."

This important decision came about due to a collaborative effort involving the ACA, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP), the Foundation for Chiropractic Research and Education (FCER), the Association of Chiropractic Colleges, the Congress of Chiropractic State Associations (COCSA) and the International Chiropractors Association (ICA). These groups sent a joint letter to UHC, along with a detailed analysis by the CCGPP supporting the use of chiropractic for treating headaches and its safety for use in pediatric patients. The ACA Council on Chiropractic Pediatrics also sent a separate analysis to UHC. In October 2007, UnitedHealthcare issued a stay on its policy decision while it reviewed research provided by the ACN Group Chiropractic Professional Advisory Committee (ACN-CPAC) and other chiropractic organizations.

As a result of this policy change, UHC also has stated that it will work closely with the various chiropractic organizations to review the chiropractic services policy and obtain feedback from the chiropractic community. Over the next several months, the ACN-CPAC will develop and execute a structured process to:

• distribute the UHC chiropractic services policy;
• review the medical policy content of the policy;
• obtain feedback from the chiropractic profession regarding the policy; and
• compile additional clinical evidence and develop recommendations that will be forwarded to UHC.

Finally, UHC has invited ACN Group to participate on the UnitedHealthcare Medical Technology Assessment Committee as a voting member. This will provide ACN Group with the opportunity to review the clinical evidence supporting technologies and procedures, and approve medical policies for use by UHC. Using a process similar to that described above, the ACN-CPAC will obtain input from the chiropractic profession regarding any proposed medical policy changes impacting the chiropractic profession and will provide this feedback to UHC.

Dr. Manceaux expressed his pleasure at the ability of the various chiropractic organizations to come together in support of this very important decision. "The ACA is proud to have led this effort, which serves as a very important reminder that there is strength in numbers. When all corners of the profession work together with a single vision and a single voice, there is no limit to what we can accomplish. It also underscores the critical role research and evidence play in the reimbursement world and the need for insurers to consult with the chiropractic profession before implementing changes that negatively affect our patients."

Resources

1. "UnitedHealthcare Rescinds Headache, Pediatric Policy." ACA press release, Feb. 5, 2008.
2. UnitedHealthcare Chiropractic Services Policy Update.
3. "Profession Unites to Oppose UHC Policy. Dynamic Chiropractic, Nov. 19, 2007. Available online at www.chiroweb.com/archives/25/24/16.html.
4. "UHC Issues Stay on Policy." Dynamic Chiropractic, Dec. 17, 2007. Available online at www.chiroweb.com/archives/25/26/21.html.