8-22-03 The following is an ACA response to a recent "urgent message" email from Dr. Terry Rondberg pertaining to HR2560. Dr. Rondberg's original email is in black and the ACA response is in red and underlined. WHO IS FOR IT .... The International Chiropractors Association supports it. "This powerful legislative initiative has been so thoughtfully crafted and is so innovative, opening new doors for chiropractor and chiropractic patient alike in Medicare, that it deserves the strong and immediate support of everyone in the chiropractic profession." - CJ Mertz, D.C., President, International Chiropractors Association ACA response: This legislation was not "thoughtfully crafted". In fact, it is so fatally flawed that it will actually further the legislative goals and policies of the AMA. The World Chiropractic Alliance supports it. "This is the most important legislative issue chiropractic has faced since the licensing laws. It will set the tone for chiropractic for generations to come. With support from all field doctors, and the combined strength of the three major organizations that make up the Chiropractic Coalition, we will finally win this major victory in Congress." - Terry A. Rondberg, D.C., President, World Chiropractic Alliance ACA response: This legislation will devastate third party payment and leave the "field doctors" to pay the ultimate price in reduced compensation. The Federation of Straight Chiropractors and Organizations supports it. "This legislation offers our profession the best chance of solving many Medicare problems. It's proof that the Coalition is an effective and action-oriented group of like-minded organizations working together for the good of chiropractic." - Gary Horwin, D.C., President, Federation of Straight Chiropractors and Organizations. ACA response: HR 2560 is the worst option to solve any Medicare problem. It is the classic example of the profession shooting itself in the foot. Rep. Donald Manzullo (R-IL), chair of the House Small Business Committee supports it. "This bill will not only reshape the definition of chiropractic in federal policy...it will blow the lid off the definition of chiropractic in federal policy... We will make it clear once and for all that chiropractic is equal, but unique." - U.S. Representative Donald Manzullo ACA response: We respect the Congressman's good intentions, but the legislation is a recipe for disaster. The Chiropractic Coalition supports it. The only group that brings chiropractic organizations together in united efforts and mutual support! The Coalition is comprised of the ICA, WCA, FSCO and the following affiliates: The Australian World Chiropractic Alliance ** The Chiropractic Association of Ireland ** Chiropractic Awareness Council of Ontario ** Chiropractic Fellowship of Pennsylvania ** Colorado Chiropractic Wellness Alliance ** Florida Chiropractic Society ** Israel Doctors of Chiropractic ** Michigan Chiropractic Association ** Oregon Doctors of Chiropractic ** Palmetto State Chiropractic Association ** The Peruvian Chiropractic Association ** Virginia Society of Chiropractic ACA response: These are all small organizations representing a handful of individuals. With all due respect, the views of doctors in Ireland, Ontario, Israel and Peru are not germane to U.S. legislation. Numerous legislative experts and chiropractic leaders say it will help ALL chiropractors and will NOT reduce Medicare reimbursements. ACA response: Other than the admission from one of the Bill's authors that it would reduce the value of chiropractic services, the profession has seen no reports, no studies, no analysis from any expert or from the Bill's proponents of the potential impact of this legislation. The burden rests with them to show that this risky and far reaching proposal will do more good than harm. "You will no longer be bound to terms like maintenance care' or 'not medically necessary.' Which is usually determined by a dollar sign or a dart board. Finally, you will still get paid according to the physician fee schedule-which is the pot of money that is split among Medicare providers." - Adam Magary, Chief of Staff for Rep Donald Manzullo ACA response: Chiropractors will be paid from the "pot of money" but will be paid far less for chiropractic services. "Medicare is a limited reimbursement program only and HR 2560 would have no impact at all on chiropractic scope of practice, ability to bill for evaluation and management codes, or the status of the D.C. as a doctor level professional," -- ICA Legislative Committee Chairman Dr. Michael S. McLean ACA response: Where is the analysis to support this position? "HR 2560 would solve a longstanding problem. Chiropractic would be recognized as a separate health profession, exams, x-rays, and instrumentation would be included. The criteria for chiropractic care would be objective indicators of subluxation. This bill would benefit all chiropractors." - Christopher Kent, D.C., researcher, President Council on Chiropractic Practice ACA response: The Bill would also devastate chiropractic reimbursement. "Would you rather have codes solely developed for chiropractors or ones that are developed for chiropractors and physicians?" -- Barry Pineles, Regulatory Counsel for the House Committee on Small Business ACA response: Mr. Pineles continues in his quote by stating "It would seem to me that by simply limiting the data to chiropractors, you would get more accurate data and potentially lower relative value units, i.e., chiropractic services would be cheaper and more readily used by Medicare patients." Again, this is a direct admission that chiropractic services will be valued at a lesser amount and chiropractic will be paid less under this proposal. --------- WHO IS AGAINST IT ... The American Chiropractic Association opposes the bill. It has even gone so far as to ask allied state organizations to write letters denouncing it and the people who support it. They are misrepresenting the bill and making personal attacks against Coalition leaders. ACA response: The ACA, ACC, NACA, and 35 major state chiropractic associations oppose this legislation because of the devastating effects it will have on chiropractic reimbursement. There are three major reasons they want to stop HR 2560: ** it would make the ACA's $5 million lawsuit and continuing fundraising effort unnecessary ACA response: It would make ACA lawsuits unnecessary because it would hand insurance companies and third party payers with the perfect excuse to refrain from paying chiropractors for physician level E&M codes and give them every reason to reduce reimbursement for chiropractic service due to the substantial reduction in relative values. It would forever raise the white flag on the critical issue of payment parity for chiropractic services. ** it would correct the problems with Medicare - problems they helped create when they worked with the AMA to develop chiropractic physician codes but haven't been able to fix ACA response: The CMT codes dramatically increased the relative value for the manipulation service and HR2560 seeks, by its proponents own admission, to reduce those relative values and thereby reduce payments to chiropractors. HR2560 would abandon the field of manipulation to D.O.'s and weekend trained M.D.'s and P.T.'s. Chiropractors would be paid less for adjustment services than is paid to lesser trained providers for manipulation services. ** it would prove to the profession and Congress that the Chiropractic Coalition - made up of the ICA, WCA, FSCO and numerous affiliated groups around the world - is an effective and powerful force ACA response: It would prove that these groups are an effective and powerful force to wreak havoc on the chiropractic profession in a manner never dreamed of by the AMA and opponents of chiropractic. Please, call your state organization leaders and ask them to support HR 2560. Tell them their help is needed to convince legislators that HR 2560 has the support of the chiropractic profession! For more information on HR 2560, visit the Chiropractic Coalition website. ACA response: We respectfully urge all doctors of chiropractic, all students in chiropractic colleges and all chiropractic patients to examine the list (attached) of the 36 state chiropractic associations that have already contacted Congressman Manzullo to express their opposition to HR 2560. If your state association is one of the few not yet actively opposing HR 2560, please contact the leadership and urge them to do so today. If you have any questions or if you need any additional information concerning the ACA's legislative priorities, please contact ACA Government Relations at (703) 276-8800 or mowens@acatoday.com. Daryl D. Wills, D.C., President American Chiropractic Association James D. Edwards, D.C., Board Chairman American Chiropractic Association ***STATE CHIROPRACTIC ASSN LETTER TO*** REP. MANZULLO August 1, 2003 The Honorable Donald A. Manzullo U.S. House of Representatives 2228 Rayburn Building Washington, DC 20515 Fax - (202) 225-5284 Dear Rep. Manzullo: Thank you for past support for chiropractic and your interest in working to eliminate barriers to chiropractic care. I am extremely concerned about the unintended negative consequences on doctors of chiropractic and chiropractic patients in our state and across the country if your bill, HR 2560, were to be enacted in it current form. As you know, a number of very serious flaws in the bill were identified in a detailed legal analysis prepared by the American Chiropractic Association (ACA) and delivered to your office on July 24th. Please know that HR 2560 is unacceptable to our members and to the mainstream of the chiropractic profession. On behalf of our members and their patients, I respectfully request that you immediately withdraw HR 2560, and begin working with the ACA on Federal legislation to help realize our shared goal of improved access to chiropractic care. If you have any questions or if you need any additional information concerning the harm HR 2560 will do in this state, please do not hesitate to contact me. Once again, thank you. Sincerely, cc: Dr. Daryl Wills President , American Chiropractic Association 1701 Clarendon Boulevard Arlington, VA 22209 Fax -- (703) 243-2593