AMA on Warpath to Overturn Provider Non-discrimination Provision of the Affordable Care Act
ACA Press Release ~ June 26, 2012
The American Chiropractic Association (ACA) today reaffirmed its commitment to fighting provider discrimination, responding to a recent decision by the American Medical Association’s (AMA) House of Delegates to initiate a lobbying effort against Section 2706, the provider non-discrimination provision in the Patient Protection and Affordable Care Act (PPACA).
Section 2706 prohibits insurance companies from discriminating against health care providers relative to their participation and coverage in health plans. It is applicable to all Employee Retirement Income Security Act (ERISA) health care plans, including self-insured, multi-state plans that are not subject to provider-friendly state laws. ACA (and the ICA) worked hard to ensure the inclusion of this provision in the health care reform legislation.
| See our previous article on this topic: |
In its ongoing advocacy work, ACA highlights the value that DCs add to the health care system, particularly in respect to challenges faced by to today’s health care consumer:
- The primary care shortage – According to the Association of American Medical Colleges, by 2015 the U.S. will face a shortage of more than 60,000 physicians across primary care, surgical and medical specialties. Every health care provider will have to practice to the fullest extent of his or her scope of practice. ACA believes that since DCs are already in the local physician supply pool and have legislative recognition as a “portal of entry” to the health care system, they should be among the first providers utilized to help relieve this shortage.
- Runaway health care costs – PPACA was designed to address the need to control unbridled health care costs. Section 2706 was included to encourage full utilization of health care providers and reduce the cost of patient care. Studies have repeatedly shown that the services provided by doctors of chiropractic are effective, and they cost less than medical care.
- Lack of treatment options – Patients are becoming more aware of the downsides of over reliance on prescription drugs and the premature use of surgical care for common health conditions such as low-back pain. DCs offer care that is not dependent on drugs or surgery, AND is highly effective for many health conditions.
“It is important to recognize Section 2706 – an act of Congress to end provider discrimination based on one’s license – as historic for the chiropractic profession,” said Mike Schroeder vice president of the National Association of Chiropractic Attorneys (NACA).
“However, as significant the provision is, it is possible to lose ground during the implementation of PPACA, so NACA strongly encourages DCs to support ACA in its efforts to ensure the patient protections intended in the provision.”
Believe it or not I had a patient that I treated for a disc lesion and the insurance company refused to pay. They said that if he had received back surgery they would have covered the expense. The cost of my fees were insignificant to that of what spinal surgery would have been. After complaining to the insurance commissioner the bill was paid. When you see the ads on TV for the side effects of the different drugs the people are subjected to, it is amazing that a person would be willing to take a chance of suffering some of the catastrophic effects including death. I still think that if fees were paid on outcome assessments that chiropractic would be at the top.
Hi Russell
Yes, there are a few sleazy Insurance Companies out there, who want to dodge paying what they promised to, figuring that you will take the easy-out by beating up on the patient to collect from them. To those Insurers, it’s just a game, BUT filing a complaint with your State Insurance Commission usually clears out their subluxated thinking…hehehe
You are so right about looking at Outcomes of chiropractic, but there are many Insurers who already see the light. I called for verification on a policy and the woman told me:
For medical care, deductible = 500, co-insurance 70%
I said, yeah fine, but I am a Chiropractor. Then she said…”Oh, you’re a chiropractor!” (all breathless, like I was a Rock Star!)
for chiropractic deductible = 250, co-insurance 80%
so this company preferentially prices things to ENCOURAGE patients to seek chiropractic care FIRST (to the extent that they can). ASTOUNDING!!!
This is a strong indication that (some) Insurers have been following the literature (see our Cost-Effectiveness of Chiropractic Page) and want to capture the savings associated with safe and effective chiropractic care.
Dylan was right (belatedly), because
“The times, they are a changing!”
My best days were the 80’s as was for many chiropractors. I don’t know if we will ever see those days again, but it would be nice to see change for the better.
The AMA is another example of a “too big to fail”. They do have power and money. Maybe not like in times gone by but they are still somewhat relatively powerful. They will try to monopolize their presense like many powerful big organizations/corporations have. Actually they don’t want or like competition. Just my opinion. They don’t want chiropractors pointing out to some patients that have been on HTN meds for ten years and haven’t tried(trial period) to reduce/get off meds. Lifestyle management(medicine) could be dominated by chiropractors and they don’t want to give up this newer market/approach to health care.
I have heard the old timers talk about the greatness of the 80’s. I graduated in ’95 and just missed all the glory. I feel pretty good about the way things are going. However, I do get upset at some DC’s who are trying to sell their own insurance policies with “I’ll treat you as many times as you want for $100/mo.”
Unfortunately, we are in times where many chiropractors are just hanging on and have relegated themselves not much higher than massage therapist.
Hi Russell
It appears the Golden Days of print-a-bill-and-get-paid-ism is over, that’s true, BUT I’m not sure what you mean by your statement: “have relegated themselves not much higher than massage therapist“???
I agree with Dr. White that routinely offering a low monthly fee for care de-values what we provide.
Reduced fees, based on financial hardship, is a time-honored tradition, but CUT-RATES, motivated by financial desperation, or the misguided belief that everyone-needs-constant, never-ending-care is very unprofessional.
The statement was not meant to be ubiquitous, but there are a those chiropractors that do not add to what many of us have fought for over the past many years. When I was involved in a pain group at a local hospital I had to lecture to a cross section of medical doctors on what chiropractic was and how it could be applied to their group. In my presentation I reviewed the educational background of chiropractors only to have one of the doctors state he thought we only went to school for a few years and wanted to be called a doctor. If we want to experience parity within the health care system, it is important that we are able to compete at a higher level. I have had patients come to me with serious problems that were missed because the chiropractor did not evaluate them properly. Chiropractic research has come a long way and is very important and I don’t want other chiropractors to cheapen our profession only for a few dollars.
Chiropractors are definitely more than just a massage therapist. It’s a shame that more people do not respect this. Good post.
Chiropractic care does cost relatively less, but I will say I believe we are also under paid.
I am looking forward to the everybody has crappy insurance days. That way they will all be cash patients and understand that it will cost them money to see a chiropractor. How many times have you had a patient with a $5,000 deductible which hasn’t been met at all say their insurance should “cover everything”.
Dr. Adam
Insurance is fine, as long as you haven’t signed a provider contract with them, agreeing to work for peanuts.