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Dangers of HR 3654

Last week, the CST advised the Chiropractors across the state of Texas to OPPOSE HR 3654. Read that information here. I would like to further expand on why we chose to recommend opposition to this legislative measure. (HR 3654 is currently lobbied/supported by the ACA, COCSA, and most Chiropractic Colleges including Parker University and Texas Chiropractic College)

At the initial conversation of what this measure would mean to Chiropractic, as a profession, a lot of positive communication surrounded the Act. Chiropractors were told that they would be able to opt-out of Medicare. There was talk of X-Rays being covered under the new changes, and other evaluation methods for evaluating the Vertebral Subluxation. Unfortunately, any benefit to the profession is not seen.  In fact, the dangers of this legislation in Congress could completely change the landscape of Chiropractic. HR 3654 is a pro-drug bill disguised as an equal opportunity bill. Let’s dive deeper into HR 3654 and what it will mean for Chiropractic in the United States.

1. Expansion of scope and services beyond Chiropractic care. The expansion of services that this will allow includes everything that local state scope allows. In some states, this means drugs will be allowed as covered services. This also includes removing the subluxation mandate from Medicare. Meaning, a Chiropractor will no longer be required to analyze or care for the Vertebral Subluxation. This is what the initial Medicare inclusion required. Currently, in order to care for and get re-reimbursed for care, would require a Chiropractor to care for the Subluxation. This will all change should it pass as written. A Chiropractor would be able to treat patients without evaluating for the Vertebral Subluxation.

2. A Chiropractor is referred to as a “physician”. This is no surprise, as the ACA has a track record of “me too” behavior with Medicine. The ACA is responsible for this language in this Act. Perpetuating terminology, like “physician”, will continue to foster the inability of the general public to distinguish Chiropractic as being a separate and distinctly different profession. Maintaining Chiropractic’s difference in healthcare is what perpetuates our profession. Chiropractors have something different than any other health profession, it is the Vertebral Subluxation. It appears that in a time of increased opioid addiction, the ACA and COCSA has determined it would be best to assume a “me-too” profession and include drugs, among other ancillary therapies determined on a state level.

3. There is no opt-out clause of Medicare. The right for Chiropractors to “opt-out”, as medical doctors have, is not included.  The fundamental changes that we were told needed were to “put Chiropractors on an even playing field”. This Act does not help the inequities that exist. Because the latest draft does not allow the option to opt-out, the Chiropractor is forced to practice in a medical model of care.

After careful inspection, the bill’s agenda is what most of the past legislative actions by the ACA  have been: The opportunity to bill for more services, allowing Chiropractors to make more money without having to actually perform Chiropractic care. This “modernized act” will force Chiropractors to continue to infringe on Medicine’s scope, with lawsuits soon to increase from entities such as the TMA (Texas Medical Association) locally.

For these reasons, the CST encourages all Chiropractors to OPPOSE HR 3654.

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