Chiropractors in the state of Connecticut may be feeling a little battle-weary as they continue to fight legislative and public relations efforts aimed at discrediting the chiropractic profession and placing strict boundaries around how they practice.
Starting in late 2005, Dynamic Chiropractic began to report about the situation in Connecticut (see www.chiroweb.com/states/connecticut.html for complete coverage).
This included two anti-chiropractic billboards and a bus advertisement, all sponsored by a group claiming to be concerned about the potential risk of stroke following chiropractic manipulation.
"Late in 2005, the billboards started. They were followed shortly thereafter with the newspaper ads, then it was the buses ... in various markets, followed by more newspaper ads and concurrently other smaller billboards in smaller markets. Each time, despite the www.neck911.com reference on the ads there was always the reference to the 'Chiropractic Stroke Victim's Awareness Group.' Alternately, lately we have seen an appearance of the 'Victims of Chiropractic Abuse.' Most recently, we have seen a spate of unprecedented anti-chiropractic legislation."
The CCA has responded to these events with a public relations campaign of its own. In March of this year, the CCA unleashed print, radio and television advertisements, with the help of many and at a cost of more than $100,000. However, legislation now winding its way through various stages of committee in the state legislature is perhaps the most potentially damaging. The CCA has employed intense lobbying efforts to show its support and its concerns regarding several aspects of these bills.
Perhaps the most damaging bill, at least as introduced, is S.B.249, which requires that insurers report to the state insurance department whenever they pay a medical malpractice claim against a chiropractor. The commissioner will tabulate the results (number of claims and amounts paid) of such malpractice data each year and submit a report to the state General Assembly. The CCA felt strongly that this bill unfairly targeted chiropractic, which has the lowest malpractice claims in the state, according to the association. The CCA voiced its objections to this, but did acknowledge it would not object to malpractice data reporting if other professions were included. CCA lobbyists claimed victory on March 13, when the Insurance and Real Estate Committee voted 13-1 to advance S.B.249 to the floor only after adopting an amendment requiring all medical professionals with malpractice insurance (not just chiropractors) to report claims data to the state insurance department.
The CCA also has set its sights on S.B.1252, which requires that a patient be informed orally and in writing of the risks and possible side effects of any chiropractic procedure, including manipulations, as well as to obtain a patient's written consent before providing treatment. Failure to comply with this provision could lead to disciplinary action by the state chiropractic board of examiners. According to a legislative briefing update sent to members, the "CCA opposes S.B.1252 in its current form. We would have no objection to a statutory requirement governing informed consent if all other medical professions were included. We simply object to being singled out unfairly."
However, not all of the legislation making its way through committee is potentially damaging to the CCA and the chiropractic profession. Passage of S.B.394 is a priority for the CCA. This bill would limit a patient deductible or copayment to the lesser of either the copay or deductible required for a primary care physician visit, or 25 percent of the total fee for services rendered. According to the CCA briefing update, the "CCA strongly supports S.B.394. The legislation will bring equity and fairness back to the payment of chiropractic claims by insurers. Shifting these costs to patients through excessive co-payments or deductibles will be prohibited."
Two additional bills now pending in the Human Services Committee could restore chiropractic coverage to low income residents. S.B.1359 deals with the provision of chiropractic services under the state-administered general assistance program, while S.B.1360 addresses the availability of optional services under the Medicaid program. "The CCA strongly supports both bills. The state is currently facing a substantial budget surplus. A very small part of that surplus should be devoted to reinstating critical health services that were previously available to the low income, needy citizens of Connecticut. The 2007 session is making health care reform and expansion of programs that will cover the uninsured a major priority. Let's not forget the most vulnerable citizens of Connecticut during this debate."
In his open letter to association members, Dr. Pagano praised the CCA's lobbying efforts. "We are informing legislators of the fact that the proposed legislation [S.B.249 and S.B.1252] unfairly singles out the chiropractic profession. We are eroding any support in the committee that might exist for the passage of these bills. Having a permanent presence at the Capitol afforded by our lobbyist has once again proved invaluable as we move forward through this process. When at the Capitol, we have presented a professional impression as would befit a mature, confident profession."
For updates on the CCA's ongoing legislative efforts, visit www.ctchiro.com. To track the status of any of the bills mentioned in this article, visit http://cga.ct.gov.