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Dynamic Chiropractic – June 3, 2008, Vol. 26, Issue 12

National Associations Focus on Medicare

By Kathryn Feather, Senior Associate Editor

Sometimes it seems as if the American Chiropractic Association (ACA) and the International Chiropractors Association (ICA) don't agree on much, but both recently stepped forward to address chiropractic and Medicare billing issues.

Each group sees Medicare billing issues as a significant and potentially dangerous problem currently facing the chiropractic profession.

The ACA is concerned that continued high claims error rates will be used as an argument against allowing chiropractors to provide additional services under Medicare. In an April 4, 2008 letter to state chiropractic licensing boards, ACA President Glenn Manceaux, DC, noted that the Centers for Medicare and Medicaid Services (CMS) is scheduled to issue a special report to Congress in 2009, detailing the results of the Medicare Chiropractic Demonstration Project.

"It is abundantly clear that unless we can convincingly demonstrate that our profession has put into place various educational and training programs, along with policies and requirements that will collectively lead to a significant reduction in Medicare claims errors, then the U.S. Congress will likely reject any proposals allowing DCs to provide additional services within Medicare," Dr. Manceaux said. "The ACA is fully prepared to wage an intensive battle to secure expanded and permanent chiropractic benefits under the Medicare program; however, we need the support of every chiropractic organization and every chiropractic office across the country."

For its part, the ICA held its first National Conference on the Future of Chiropractic in Medicare April 24, 2008 in Washington, D.C. In the day-long session, 17 presenters covered a variety of topics such as the Recovery Audit Contractors Program Medicare has implemented, various documentation challenges, the Medicare Chiropractic Demonstration Project and Medicare savings accounts. The ICA also invited three members of the U.S. House of Representatives and a state senator to attend. Rep. Bob Filner (D-Calif.), Rep. Kathy McMorris Rogers (R-Wash.), and Rep. Don Manzullo (R-Ill.), and Sen. Ben Cardin (D-Md.) offered widely divergent views on how national Medicare policy can and should be adjusted to meet rising demands.

"It is clear that there is a massive amount of work that needs to be done to secure chiropractic's rightful place in the Medicare program and in any national healthcare reform initiative," said ICA President Dr. John K. Maltby. "The ICA recognizes that it will take an historic cooperative effort to achieve success and the ICA hopes that the conference represents a first step along that path."

The ICA also released a white paper titled "The Future of Chiropractic in Medicare." The white paper states, in part, "Chiropractic's position in this massive program, while statistically small, is vitally important to the millions of Medicare beneficiaries who seek chiropractic care as their personal choice. According to the U.S. Department of Health and Human Services, Medicare reimbursement for chiropractic services has grown significantly in recent years, from $255 million for 11.2 million chiropractic adjustments in 1994 to $683 million in 2004, for 21 million chiropractic adjustments. For the current year, estimates are for expenditures upwards of $724."

The authors go on to say, "In the coming period of national debate on Medicare, the chiropractic profession must position itself as an uncompromising champion of patient rights and competition in the Medicare system."

To view the white paper in its entirety or for highlights of the ICA Conference on the Future of Chiropractic in Medicare, visit The ACA also has a variety of Medicare resources on its Web site:

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