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American Chiropractic Association Continues to Fight Proposed Medicare Payment Cuts

(Arlington, Va. - Nov. 2, 2006) The American Chiropractic Association (ACA) is calling on Congress to halt proposed reductions in Medicare physician payments that are scheduled to take effect in January 2007.

ACA officials say that changes recently put forth in a final rule issued by the Centers for Medicare and Medicaid Services (CMS) undermine Congress' goal of preserving patient access and achieving greater quality of care. The association is pressing for a one year delay in implementation of the rule to provide CMS more time to assess the negative impact of the changes.

The final rule, which was recently released by CMS on its Web site, outlines a plan to revise the way it calculates "relative value units" (RVUs) for certain services under the Medicare physician fee schedule. Despite alternative recommendations from many health care organizations, including ACA, CMS has elected to pay for increased costs related to these revisions by applying an adjustment across the work RVUs for all services. This adjuster results in significantly different outcomes depending on the specific provider community. Based on this rule alone, in 2007 doctors of chiropractic will take an 8 percent cut in reimbursement. ACA is also pressing Congress for action on another possible Medicare cut, which involves a legally mandated formula to control Medicare spending -the Sustainable Growth Rate (SGR). ACA is urging Congress and CMS to explore alternatives to the "inequitable" formulas used to determine physician reimbursement and to correct the system that consistently leaves millions of beneficiaries' care in jeopardy each year.

The combination of the two cuts would result in a 13.1 percent total decrease to chiropractic reimbursement rates effective January 2007.

How Can Doctors of Chiropractic Help?
Now that CMS has issued a final rule, ACA is urging doctors of chiropractic and chiropractic patients to lobby Congress. Any action taken during a November/December lame-duck session of Congress should move to prevent these dramatic cuts in reimbursement. Specifically, the ACA is asking doctors of chiropractic to contact their U.S. Representatives and Senators and:

Ask them to delay implementation of the CMS final rule on the five-year RVU review for at least one year and direct CMS to determine the effect this proposal will have on patient access.
Urge them to take action and prevent the 5.1 percent SGR decrease from taking effect.

Because this issue is time sensitive, ACA is asking doctors of chiropractic to immediately contact their representatives and senators through the Capitol switchboard at (202) 224-3121.

For more information, visit ACA’s Web site at www.acatoday.org/feeschedule.

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2006 Research Summaries

Improvement of lower extremity electrodiagnostic findings following a trial of spinal manipulation and motion-based therapy

Chiropr Osteopat. 2006 Sep 12;14:20

ABSTRACT: BACKGROUND: Lumbar disc herniation is a problem frequently encountered in manual medicine. While manual therapy has shown reasonable success in symptomatic management of these cases, little information is known how manual therapy may affect the structure and function of the lumbar disc itself. In cases where lumbar disc herniation is accompanied by radicular symptoms, electrodiagnostic testing has been used to provide objective clinical information on nerve function. This report examines the treatment rendered for a patient with lower extremity neurological deficit, as diagnosed on electrodiagnostic testing. Patient was treated using spinal manipulation and exercises performed on a Pettibon Wobble Chairtrade mark, using electrodiagnostic testing as the primary outcome assessment. CASE PRESENTATION: An elderly male patient presented to a private spine clinic with right-sided foot drop. He had been prescribed an ankle-foot orthosis for this condition. All sensory, motor, and reflex findings in the right leg and foot were absent. This was validated on prior electromyography and nerve conduction velocity testing, performed by a board certified neurologist. Patient was treated using spinal manipulation twice-weekly and wobble chair exercises three times daily for 90 days total. Following this treatment, the patient was referred for follow-up electrodiagnostic studies. Significant improvements were made in these studies as well as self-rated daily function. CONCLUSION: Motion-based therapies, as part of a comprehensive rehabilitation program, may contribute to the restoration of daily function and the reversal of neurological insult as detected by electrodiagnostic testing. Electrodiagnostic testing may be a useful clinical tool to evaluate the progress of chiropractic patients with lumbar disc herniation and radicular pain syndromes.

The Research Abstract of the Month is bought to you by Dean Smith, DC, PhD.

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ChiroCredit.com Announces New Online Courses in Pain Management, Nutritional Support for various conditions and New Wellness Courses

(Rocky Hill, CT) www.ChiroCredit.com, the leading provider of Continuing Education Programs by Distanced Based Learning is proud to announce that they have released more new Online Courses.

Here is a listing of some of the new courses and their educational objectives:

Nutrition 123
Title: Nutritional Support for ALS (Amyotrophic Lateral Sclerosis)

Define the common signs and symptoms leading to the diagnoisis of Amyotrophic Lateral Sclerosis

Utilize conventional and alternative lab test for Amyotrophic Lateral Sclerosis

Learn about the conventional treatment options for ALS, including drug therapies and new drug research

Utilize nutritional support strategies for ALS, including diet, and nutritional supplements

Coordinate care with the Medical Profession for innovative drug strategies for ALS

Nutrition 124
TITLE: Nutritional Support for Cognitive Enhancement and Mental Decline

Review Age-Associated Mental Decline, including its symptoms, causes and innovative drug therapies

Discuss and define nutritional support strategies for Age-Associated Mental Decline, including vitamins, hormones and antioxidants