ACA Coalition Fights for Provider Reimbursement Fairness

The American Chiropractic Association (ACA) collaborated recently with the Patient Access to Responsible Care Alliance (PARCA), a coalition of non-MD healthcare providers, in submitting a letter to federal regulators 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 healthcare providers. The letter is addressed to the Secretaries of the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury. 

View the PARCA letter

This is a critical issue to chiropractors and the entire non-MD community, and ACA needs your help! ACA has posted a dedicated section on where DCs can share their personal stories about how they have been compensated unfairly by a group health plan or health insurer. We encourage you to visit that section using the link below to submit your experiences with provider discrimination. Your personal stories will be vital to our advocacy efforts.

Provider Discrimination Report Form

In addition, DCs can view ACA’s activity and analysis on this issue here:

Your Help is Needed to
Put an End to Provider Discrimination

Section 2706(a) of the Affordable Care Act prohibits health insurers from engaging in discriminatory reimbursement practices by paying different payment rates to certain medical providers over others. The recently enacted “No Surprises Act” included an ACA-supported provision to require federal agencies to promulgate a regulation to enforce Section 2706. To date, no federal agency has issued this most important rule to enforce fair payments to providers. If the federal government does not act, individual states may enforce the Section, but no state has taken this step.

In January, the federal agencies held a listening session on the issue for stakeholders, and ACA participated by outlining general instances of provider discrimination. The PARCA letter includes the following text written by ACA that shows exactly how doctors of chiropractic (DC) can be victims of reimbursement discrimination:

“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.”

ACA will highlight specific examples of payment discrimination against DCs to members of Congress and federal regulators, so please share your experiences with us. We will continue to work with PARCA and other allies to secure fair provider payments.

Steve Kline is ACA’s associate director of federal government relations. You can reach Steve at [email protected] .

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