HHS Prohibits Physical Therapists from Providing Chiropractic Service Under Medicare
ACA Declares Major Victory in Lawsuit Against HHS, But Vows to Continue the Fight
ARLINGTON, VA – The Department of Health and Human Services (HHS) has issued a new policy directive that, under Medicare, physical therapists cannot provide manual manipulation of the spine to correct a subluxation. The American Chiropractic Association (ACA) is hailing the ruling as a major victory in its lawsuit against the Centers for Medicare & Medicaid Services (CMS), formerly HCFA, but has vowed to continue its fight to prohibit medical doctors and doctors of osteopathy from providing the chiropractic service.
In a January 15, 2002 revision to an Operational Policy Letter originally issued in 1994, Medicare’s Center for Beneficiary Choices writes: “The (Medicare) statute specifically references manual manipulation of the spine to correct a subluxation as a physician service. Thus, Medicare+Choice organizations must use physicians, which include chiropractors, to perform this service. They may not use non-physician physical therapists for manual manipulation of the spine to correct a subluxation.” (emphasis added)
“The ACA is extremely pleased that Secretary Tommy Thompson and his department have formally recognized the unfairness and injustice to doctors of chiropractic and their patients that the 1994 Operational Policy Letter imposed,” said ACA Chairman Dr. James Edwards. “We will continue the ACA’s lawsuit to guarantee that no one other than doctors of chiropractic can deliver the chiropractic service since only the issue of illegal use of physical therapists has been resolved.”
The ACA first filed its lawsuit in November 1998, claiming that HHS guidelines unlawfully allow Medicare managed care plans to substitute the services of other health care providers for services that should legally be performed by doctors of chiropractic. Specifically challenged in ACA’s lawsuit was the 1994 Operational Policy Letter.
“The infamous Policy Letter gave the green light to Medicare HMOs to misappropriate taxpayer dollars to pay non-physician physical therapists to deliver the chiropractic physician service of ‘manual manipulation of the spine to correct a subluxation,'” added ACA President Dr. Daryl D. Wills.
The issuance of the revised policy letter follows seven years of intense, but futile, negotiations between ACA and the prior Secretary of HHS. Those negotiations culminated in the ACA’s lawsuit filed against former Secretary Donna Shalala and the Department of HHS more than three years ago.
The ACA will now begin vigorously monitoring managed care organizations to see that they fully comply with the new directive and the law in providing chiropractic services to the nation’s senior citizens. If not, the ACA will take or encourage the taking of all legal steps to ensure compliance. ACA will also continue to vigorously pursue the other counts in its ongoing lawsuit with HHS pertaining to the improper provision of the chiropractic service by medical doctors and doctors of osteopathy.
For More Information, Call:
ACA Legal Department
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