A 19-member statutory commission was brought together to report to Governor McKernan of Maine on the "social and financial impacts and medical effectiveness of Maines's mandated benefit laws regarding chiropractic (Chiropractic Mandated Benefit). Among the commission were three MDs; one DC (Robert Lynch Jr.); three public members; and three state legislators.
Chairman of the Mandated Benefits Advisory Commission was David Clough. He noted in the report that the commission met "unexpected difficulty in obtaining data and cooperation from some segments of the insurance industry, from business, state agencies, and others who have a direct interest in this matter."
The report identified 12 policymaking options to be evaluated and voted on by the commission. Commission members ranked each option on a scale of 1 to 4: 1=strong agree; 2=slight agree; 3=slight disagree; and 4=strong disagree.
Curiously, of the 19 voting members, all of which were appointed by the governor or the legislature, five did not return evaluations, i.e., five did not vote (two legislators; an insurance member; a nonprofit hospital representative; and a member representing health insurance consumers). Of the 19 who did vote, two members chose to vote on only 1 of 12 categories (the vice chairman was one of these); two other members voted on only 3 and 4 options respectively. Despite these prominent gaps in the voting, the commission tallied the "agrees" and the "disagrees" to come up with a majority decision on each of the 12 policymaking options. For example, they voted 8-2 in favor of making no changes to the mandate, but nine members did not vote!
But on another item the commission contradicted this stance: They voted 6-4 to narrow the scope of chiropractic mandated services by allowing insurance companies to specify a limit on services (dollar limit or limit on visits).
The group voted 11-0 to encourage the use of managed care programs, and agreed 9-3 not to repeal the mandate. They voted 8-2 to require that insurance companies give reports to the Bureau of Insurance describing the nature of chiropractic services being provided, and to require DCs to submit this data to the insurance companies.
A 9-3 vote favored requiring health insurance plans to cover the services of chiropractors, but it was 5-6 vote against making coverage for chiropractic a require option.
A 7-3 vote in favor of not reducing applicability of the mandate by exempting individual insurance policies.
It was 7-3 against a gatekeeping mechanism to restrict free access to a chiropractor, or allowing companies to require physician referral.
It was 6-4 against allowing companies to have different maximums, deductibles, or copayments for chiropractors than for physicians.
There was a 5-5 deadlock to increase applicability of the mandate to HMOs as well as to insurance plans.
The Maine Chiropractic Association (MCA) provided written testimony to the report of the Mandated Benefits Advisory Commission. It was presented by David Odiorne, M.S. D.C., member of the board of directors of the MCA.
The MCA called in question the accuracy of the commission's report regarding statistics on chiropractic (from the insurance carriers), references to chiropractic studies, and general remarks throughout the text.
The MCA report concluded:
- "For the conditions we treat, chiropractic care is proven to be the most effective approach available.
- "Chiropractic care costs only half as much as medical care for the same condition.
- "The chiropractic mandate makes good financial sense. Chiropractic claims account for only 1% of all health care claims in Maine.
- "Since claims for chiropractic services represent costs shifted from other more expensive providers, this mandate reduces health care costs for the people of Maine.
- "Given the above, the only sensible course of action is to broaden, or at the very lest continue the chiropractic mandate. To the degree that we fail to follow this path, the people of Maine will suffer increased costs and decreased quality of care."
Dynamic Chiropractic editorial staff members research, investigate and write articles for the publication on an ongoing basis. To contact the Editorial Department or submit an article of your own for consideration, email
.