Lost in the sturm und drang of the bipartisan fight over the new national health care legislation — the bulk of which is scheduled to be implemented in 2014 — is that individuals seeking chiropractic treatments may be among the big winners.
The United States House of Representatives passed HR 3590 in 2010. Among the provisions included in the bill was a provider nondiscrimination provision long sought after by the American Chiropractic Association (ACA).
Known as the Harkin Amendment due to the efforts of Sen. Tom Harkin (D-Iowa) to have it included, the provision is considered as an historic first for the chiropractic profession. It created a federal law applicable to the Employee Retirement Income Security Act (ERISA) plans that make it against the law for insurance companies to discriminate against Chiropractors and other providers relative to their participation and coverage in health plans. The ACA argued that discrimination based on a provider’s license is inappropriate.
ACA leaders believe the provision could have a long term positive impact on the profession as a whole. The provider nondiscrimination provision (Section 2706) says that a group health plan and a health insurance issuer offering group or individual health insurance coverage cannot discriminate against any health care provider who is acting within the scope of that provider’s license or certification.
The Harkin nondiscrimination language applies to all health benefit plans, both insured and self-insured. Currently 55 percent of workers are currently covered by self-insured plans that will be positively impacted by the Harkin nondiscrimination language.
The bill also includes a provision specifically including doctors of chiropractic as potential members of interdisciplinary community health teams, which support the development of medical homes by increasing access to comprehensive, community based, coordinated care.
In addition, the legislation establishes a National Health Care Workforce Commission to examine current and projected needs in the healthcare workforce. The commission specifically included chiropractors, defining them as part of the healthcare workforce and health professionals.
Recently the industry received more good news when the Centers for Medicare and Medicaid Services (CMS) announced a trend that would expand coverage for patients to include evaluation and management (E&M) services provided by chiropractors. The announcement comes after a decade of lobbying by the ACA. After the chiropractic demonstration program was included in the 2003 Medicare Modernization Act, the ACA has been working with the Department of Health and Human Services (HHS) for essential chiropractic services to be covered.
