By John Falardeau
With the new year and the first session of the 117th Congress now underway, the American Chiropractic Association (ACA) is ready to tackle several important legislative issues on behalf of ACA members, patients and the chiropractic profession.
The ACA Legislative Committee met recently and established the following priorities for the new congressional session:
ACA’s No. 1 legislative priority is to push for For several years, ACA’s strategy to expand reimbursable services in Medicare has largely been focused on a regulatory fix; however, guidance and rulings by the Department of Health and Human Services (HHS) forced ACA to seek a legislative remedy. In July 2019, during the previous congress, bipartisan legislation, the Chiropractic Medicare Coverage Modernization Act (HR 3654), was introduced by Reps. Brian Higgins (D-N.Y.) and Tom Reed (R-N.Y.). The bill ended the session with 91 cosponsors, split very evenly between Democrats and Republicans.
The ACA Legislative Committee’s goal is to introduce the bill again this year and couple that with a May 2021 "Virtual Day on the Hill" to boost cosponsors. Strong support of the bill in the House will be a springboard for success in the 117th Congress. Also, given the wide support of the House bill, ACA will work to introduce a Senate companion. We continue to work with the prestigious Capitol Hill Consulting Group (CHCG), a nationally known lobbying firm that is working to raise ACA’s visibility, credibility and exposure on the Medicare issue before Congress.
Monitoring Healthcare Reform
Closely following our Medicare priority is our effort to through the regulatory process. This is done chiefly through the administration, and we will continue to take guidance from key congressional allies.
We must also continue to watch for any attempts to legislatively edit, amend or repeal our key provisions—especially Section 2706 (the provider anti-discrimination provision).A provision was passed as a larger bill in late 2020 to direct three federal agencies (HHS, Treasury, and Labor) to draft a rule that will finally lead to enforcement of the provision. ACA’s advocacy team will work with our non-MD coalition to ensure the rule reflects congressional intent, as signed into law in 2010, that insurers cannot discriminate on the basis of provider types as it relates to coverage and reimbursement.
Rounding Out 2021-2022 Priorities
Covid-19 relief packages will continue to get maximum attention on Capitol Hill during the 117th congress. ACA was instrumental in getting chiropractors designated as part of the “essential” healthcare workforce in 2020 and included as eligible for much of the programs that were initiated and implemented for healthcare providers. It is imperative, however, that ACA remain vigilant in making sure chiropractors can participate in any further relief package that is geared toward healthcare providers and small businesses. Specifically, ACA will remain attentive in advocating for lifting exclusions for patent access to telehealth services in Medicare and ensuring that chiropractors have fair and equitable access to any future expansion of the Provider Relief Fund and Paycheck Protection Progra
Resolution of Department of Defense chiropractic healthcare benefit program issues, including expansion of the chiropractic benefit for retirees, reservists and National Guard personnel enrolled in the Tricare program. A 2019 Pentagon report indicated that Tricare would expand access to services in 2021 and 2022. This is a huge win for Tricare enrollees who previously could not access services provided by a doctor of chiropractic. The Department of Defense announced earlier this year that access to chiropractors will soon be available in Army/Air Force exchanges, an encouraging first step to further access. Here too, ACA must remain attentive to change within the Pentagon’s healthcare delivery system.
To help those burdened with economic hardship during the Covid-19 pandemic, Democratic leaders in the Senate, and many in the House, have outlined a plan to cancel up to $50,000 in federal student loan debt for federal student loan borrowers. Tied to this, ACA shall support legislation where loan relief is featured and continue work that will open opportunities for chiropractors to access student loan repayment programs, including chiropractic inclusion in the National Health Service Corps. Chiropractic inclusion in Federally Qualified Health Centers is also paramount.
With the passage of legislation to end health insurers’ anti-trust exemption via an amendment to the McCarran-Ferguson Act, it will be paramount to work with our coalition partners to ensure that any rules and regulations passed down from the Federal Trade Commission and other federal agencies do not conflict with congressional intent and provide a federal enforcement provision that can actually uphold the law.
Opioid legislation, in some form or fashion, may be considered in both the House and the Senate, and ACA is prepared to add language similar to what has been passed in West Virginia and Oregon to increase access to nonopioid alternatives such as chiropractic in any federal opioid vehicle.
John Falardeau is ACA’s senior vice president for public policy and advocacy. Learn more about ACA’s legislative activities at www.acatoday.org/Advocacy or follow us on Twitter for the latest news from @ACAonTheHill.