The American Chiropractic Association has reacted swiftly to the latest attempt by a major insurer to deny coverage for chiropractic care. The ACA has sent a letter to Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Medical Group after learning that the two organizations had revised their chiropractic coverage policy. The policy revision: removing cervical manipulation from the list of covered chiropractic benefits.
"The [ACA] is aware that Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Group have revised their Chiropractic Manipulation Medical Coverage Policy to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage," said ACA President Rick McMichael, DC. "This restriction, if allowed to stand, will be harmful to chiropractic patients and doctors. We have contacted Kaiser to express our grave concern over this change, and we await their reply. ACA will expend every effort to encourage Kaiser to reverse this new restriction, and we will keep our members and the profession informed along the way."
If history is any indication, this could be the first step in a profession-wide effort to reverse Kaiser's policy change. Think back to September 2007, when UnitedHealthcare issued a revised medical policy on chiropractic services. that declared spinal manipulative treatment for headaches and pediatric patients "unproven" and thus not covered under the policy.
Chiropractic organizations including the ACA, the International Chiropractors Association, the Association of Chiropractic Colleges, the Congress of Chiropractic State Associations, the Foundation for Chiropractic Education and Research, and the Council on Chiropractic Guidelines and Practice Parameters sent a joint letter to UnitedHealthcare contesting the policy changes and providing evidence for chiropractic's effectiveness in treating pediatric and headache patients. Shortly thereafter, UnitedHealthcare issued a stay on the policy revisions pending further review and then rescinded the changes altogether.
Look for updates on the Kaiser policy change, including excerpts from the ACA letter and any response from Kaiser, in an upcoming issue.
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.
