"suggest[s] that if insurers cover a health condition, they must pay any providers that are licensed to treat that condition. If the insurer covers a service provided by medical doctors . . ., for example, it must also cover that service when provided by another legal provider, such as NDs, acupuncturists or chiropractors."
Much to the chagrin of naturopaths, acupuncturists and chiropractors, this outcome doesn't appear to have "suggested" itself to the health insurers themselves. Nor to the Department of Health and Human Services. HHS issued an interpretation more narrowly defining Sec. 2706's mandate. This
With the possibility of either total repeal or substantial amendment to the ACA looming over them in today's political climate, chiropractors are leaving nothing to chance. They have moved to the state legislative level to push for provisions similar to the ACA's Sec. 2706. Oregon and Rhode Island have already passed such laws.
Wisconsin already has a law on the books preventing an insurer from excluding diagnosis and treatment of a condition by a chiropractor if the same diagnosis and treatment is covered for a physician.
- provide insureds with reasonable and timely access to chiropractic care; and
- apply the same standards to chiropractors that are applied to primary care physicians to ensure that insureds receive the same reasonable and timely access to chiropractors that they receive to primary care physicians, including such standards as geographic accessibility, waiting times, and provider-to-insured ratios. [emphasis added.]
Insurers will also have to file annual reports showing that they have complied with the law.
A particularly disturbing feature of the existing law, retained in the bill, mandates coverage when the chiropractor is "acting within the scope of the chiropractor's professional license." That
"To examine into the fact, condition, or cause of departure from complete health and proper condition of the human; to treat without the use of drugs . . . or surgery; to counsel; to advise for the same for the restoration and preservation of health . . . ."
As with Sec. 2706, Wisconsin law implies that, no matter what the actual education and training of the chiropractor is, if state law grants him a broad scope of practice, insurance must cover his diagnosis and treatment. Actual competency need not be demonstrated.
Unfortunately, as we know,
With the current push to
Notably, not only medical organizations, but also a number of insurers oppose the Wisconsin bills. Insurers, perhaps better than any group, realize the penchant of chiropractors to overtreat, which has itself led to
Interestingly, Kentucky's chiropractic practice act is of the old-fashioned, straight, subluxation-based variety.
" 'chiropractor' means one qualified by experience and training and licensed by the board to diagnose his patients and to treat those of his patients diagnosed as having diseases or disorders relating to subluxations of the articulations of the human spine and its adjacent tissues by indicated adjustment or manipulation of those subluxations and by applying methods of treatment designed to augment those adjustments or manipulation."
Does this mean that the insurer will have to reimburse a chiropractor treating
It will be interesting to see how these laws play out in the states. Currently, insurers use