It's been eight years since the provider nondiscrimination provision, Section 2706(a) of the Affordable Care Act, went into effect. While the law says broadly that health plans and insurers must not discriminate against providers based on their license, no federal action has been taken to enforce it.
As a result, we know chiropractors are still, in many cases, reimbursed unfairly compared to other providers, and that patients who wish to receive chiropractic treatment are sometimes denied access. Your story could help change this.
This is a critical issue to all non-MD providers, not just our profession. As such, the ACA is working as part of the Patient Access to Responsible Care Alliance (PARCA), a group of non-MD associations, to get regulators to enforce Section 2706(a) and ensure fair patient access and provider reimbursement.
The PARCA coalition submitted a letter to federal regulators in March urging them to enforce a rule that requires group health plans and health insurers to fairly compensate non-MDs for the same services delivered by other health care providers. The PARCA letter includes one example of how chiropractors can fall prey to unscrupulous coverage policies:
"Payers are changing policies to bundle services in preparation for moving away from fee for service, however, rather than create a combined fee, they simply eliminate one fee and pay for the other. This is not in keeping with the calculation of relative values. In other words, chiropractic manipulative treatment may be bundled with manual therapy and providers have been notified that no reimbursement will be made for manual therapy whatsoever when these services are performed together, regardless of the modifier used. These limitations are not applied to other provider types."
If you have one or more personal stories to share about how your patients have had access limited or how you may have been compensated unfairly compared to other providers, visit ACA's provider nondiscrimination page online or download the reporting form directly here. The more examples we can share, the better chance we have of convincing federal regulators that something needs to be done to compel health plans and insurers to follow the law as Congress intended.
Steve Kline is the ACA's associate director of federal government relations. He can be contacted at
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