Our worst fears are now coming true, is how ACA President Michael Pedigo, DC, reacted to the news that Blue Cross will no longer cover chiropractic under its Senior Secure Plan in Northern California. "We have been warning the profession for some time now that the new Medicare+Choice regulations could seriously threaten chiropractic. This is another concrete example of chiropractic services being dropped from a Medicare managed care plan."
The new Medicare+Choice regulations (Medicare's managed care plan) resulted in the ACA filing a lawsuit on Nov. 12, 1998 against the Health Care Financing Administration (HCFA). The new Medicare managed care plan does require that seniors have access to manual manipulation of the spine, but that care may be provided by any physician. It does not require a chiropractor.
The U.S. Attorney's Office announced it will handle the ACA lawsuit against HCFA, rather than the federal section of the Department of Justice, an indication to Dr. Pedigo that the government is "bringing in the big guns."
HCFA was required to respond to the lawsuit by Jan. 12, but the shift in jurisdiction of the case to the U.S. Attorney's Office has resulted in that office requesting and getting a 30-day extension to reply to the lawsuit.
"Chiropractic in Crisis: Back to the Courtroom," a free audiocassette on the background of the lawsuit is available from the ACA (800) 986-4636. ACA General Counsel George McAndrews details the particulars of the lawsuit, which he calls the most critical issue facing the profession since the Wilk case.
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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.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
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.
