LEGISLATIVE
Legislative Overview
Since 1964, ICS has been serving as the only organization advocating for DCs in Iowa. We take great pride and care in assisting members and building alliances and coalitions with other providers, payers, businesses, government, and communities to improve healthcare outcomes through chiropractic care. ICS has a proud history of successfully pursuing changes at the Iowa legislature to advance access to chiropractic care. The collective voice of our membership has been effective.
How the AMA Tried to Destroy Chiropractic: What sounds like an elaborate spy novel is actually the real-life story of how the American Medical Association once plotted to get rid of the chiropractic profession. Don't miss this surprisingly thrilling webinar series provided by NCMIC!
- The Committee on Quackery
- Spies and Counterspies
- Middle-of-the-Night Witness Disappearances
NCMIC is excited to present a three-part webinar series that tells the story of how the American Medical Association set out to "Contain & Eliminate" the chiropractic profession.
Legislative Priorities
The 2022 legislative year provides opportunities to both defend and advance the profession at the state and federal levels. The ICS will:
Actively address issues that are extremely viable to pass. These are bills or rules that DCs cannot ignore because there is a high likelihood of passing, they may likely have a high impact on our profession, and the timing is immediate.
Seek opportunities to advance the profession through bills or rules that have a path for including DCs.
Monitor bills that have the ability to impact the profession but are not likely to pass. Though the likelihood of them passing may be low, ICS needs to always be prepared that circumstances change and DCs may need to respond.
ICS has provided our doctors tools, training and talking points so you are prepared to talk with your state legislators and congressmen and continue to build your relationships!
Actively Address Now – Act TODAY!
State Updates
Medicaid
ITC is conducting probe audits and comprehensive audits for chiropractic specialty. A few providers have shared they have credentialing concerns with Wellpoint. The ICS is actively working to iron out the issue.
Iowa now allows coverage for non-spinal regions M99.0, M99.06, M99.07, M99.08, and M99.09. This change was effective September 1, 2023.
The ICS will keep you updated as things progress on this front.
2024 Legislative Session Recap
The first session of the General Assembly ended at 4:23 am on Saturday, April 20. The Governor appointed a committee to reduce the number of boards by combining and/or eliminating them. The Iowa Chiropractic Society learned that the committee wanted to combine the Iowa Board of Chiropractic with 4 other Boards - Physical Therapy, Occupational Therapy, Athletic Trainers, and Massage Therapy. The ICS was against having the IBC combined with any other professions and immediately started a grassroots effort to keep the IBC independent.
The hard work and follow-up by ICS and chiropractors throughout the state put chiropractic head and shoulders above all other professions to keep their own board. Our Boards and Commissions bill was passed with a compromise and sent to the Governor and was signed in May. Chiropractic will continue to have its own Board. There are so many key DCs and legislators that helped make this happen.
Rep. Jane Bloomingdale
Rep. Bobby Kaufmann
Rep. Austin Harris
Sen. Chris Cournoyer
Sen. Jason Schultz
Lawmakers want to know their constituents personally. They do not want the only time they meet someone is when they need something. For that reason, we need chiropractors to be assertive and introduce themselves. Big changes can only happen with grassroots of an organization our size.
I challenge you to meet up with your legislators three times per year. Once at Capitol Day during the legislative session, once in the summer, and the third time during your legislative social in September. Please do your part by creating and/or building that relationship.
Bills of Interest
The House version of the elimination of certain Boards and Commissions. The Chiropractic Board of Examiners remains a standalone board in this bill.
The Governor’s Boards and Commissions bill. This bill started with our board merging with four other boards. There was an amendment in our favor to break apart that merged board and keep them all on their own.
This would limit MCOs the ability to recoup money (if there is no fraud) to 24 months.
This bill has passed the HHS committee and can be up for floor debate. Fiscal impact Died in second funnel.
Requires that the MCO shall pay a provider 100% of the claim for reimbursement of items or services if the MCO had approved a prior authorization. The bill also prohibits the MCO from seeking repayment, offsetting against future reimbursement of claims or other payment or reimbursement unless fraud or misrepresentation is founded. Passed sub-committee but died after.
Your participation in grassroots makes a difference!
- Talk with your legislators (it’s their job and they love to do it).
- Donate to their local fundraisers.
- Attend Capitol Day.
- Attend your legislative socials.
- Give to the PAC!
Federal Legislation
Medicare - The Highlights
On April 19,2021 the U.S. House of Representatives reintroduced HR 2654 - Chiropractic Medicare Coverage Act
On April 27, 2021 ACA signed a joint letter to U.S. Senate Chair, Senate Majority Leader, and Republican leaders in congress urging congressional leader to include additional funds for the Medicare Physician Fee Schedule in forthcoming legislation.
- Coalition letter.Infrastructure.Final.4-27-21.pdf (acatoday.org)
To impact of COVID-19 on Medicare and MACs', there are no CERT review available at this point.
WPS GHA CAC Meeting is scheduled on June 18, 2021, which Dr. Sheybani will be attending.
Medicare Fee Cuts: What’s Next?
On April 14, 2021, President Biden signed into law H.R. 1868, delaying the 2% sequestration cut scheduled for April 1st through the end of the year. Unfortunately, the version of the bill signed by Biden did not address another potential cut coming down the road – sequestration cuts necessitated by the latest coronavirus relief bill, the American Rescue Plan. The House originally dealt with this issue in H.R. 1868, but the Senate stripped that language out of the version of the bill they passed.
It is unclear if this automatic 4% cut, required by law to offset costs associated with the COVID relief bill, would take place beginning October 1st, with the beginning of the new fiscal year, or January 1st. Either way, the fight to minimize cuts to the Medicare Physician Fee Schedule will continue throughout 2021. Congress still must act to prevent the 4% sequestration cut.
Additionally, in 2022 the chiropractic profession could be looking at not only an overall reduction in the Medicare conversion factor, but also possible reductions to the relative value units (RVUs) for spinal manipulation that were expected to take pace beginning January 1, 2021. Luckily, these cuts, which could have reduced fees for CMT services by approximately 10 percent, did not take place, but they could be back on the table in 2022.
In late April, the ACA, as part of a coalition of provider organizations, sent a letter to Congress advocating for the inclusion of additional funds for the Medicare Physician Fee Schedule in any forthcoming legislation addressing the nation’s infrastructure needs. These funds would “ensure continued beneficiary access to vital health care services by providing additional financial stability for the nation’s health care system and health care workforce.” Approximately $3 billion would mitigate expected reductions to the conversion factor but would not address the other potential threats to chiropractic fees in the Medicare program. Further grassroots action may need to be undertaken on this issue, so stay tuned.
Update on H.R. 2654, the Chiropractic Medicare Coverage Modernization Act (Prepared on 5/21)
On Monday, April 19th, the Chiropractic Coverage Modernization Act (H.R. 2654) was re-introduced in the U.S. House of Representatives. The bill would allow chiropractors in Medicare to practice to their state’s full chiropractic scope of practice, enabling chiropractic patients to safely access medically necessary conservative, drug- and surgery-free care. Being able to provide Medicare beneficiaries with access to the full complement of the chiropractic profession’s broad-based, non-drug services would improve outcomes and patient satisfaction.
In most states, this would include such services as manual manipulation of the spine and extremities, E/M services, diagnostic imaging, and utilization of other non-drug pain management approaches that have become an important strategy in national efforts to stem the epidemic of prescription opioid overuse and abuse would be covered.
The critical first step in making this bill a reality is securing co-sponsors for this important bill. Last Congress, 90 Members of Congress from both sides of the aisle co-sponsored the bill. With the beginning of the new Congress in January, we started from scratch.
There is little doubt that if H.R. 2654 is passed, it would be the most important patient-centered federal chiropractic victory since the profession was first included in Medicare in 1972. Given the enormous influence that Medicare has on both Medicaid and private health insurance, passage of the Chiropractic Medicare Coverage Modernization Act could revolutionize chiropractic’s standing in America’s health care systems.
The current Medicare law is unfair to chiropractic patients and the profession. It also drives the skyrocketing costs of the Medicare system – a system that we as federal taxpayers are funding – by pushing patients into higher risk, higher-cost medical alternatives and away from the use of safe, efficacious, and cost-effective chiropractic care.
Stay in touch with the ICS for future updates!
Seek Opportunities!
ICS will continue to seek opportunities that:
- Expand DC involvement in opioid prevention strategies.
Background: DCs play a critical role in patient pain management. Chiropractic care relies on non-surgery, non-pharmacologic therapy, preventing opioid abuse and addiction. ICS will continue to seek opportunities to participate in opioid prevention strategies across the state. - Expand Iowa code to allow DCs to do physicals at pre-school level.
Background: Currently, DCs may conduct physicals for students K-12. ICS will continue to seek opportunities so specifically include this provision to include pre-school in Iowa code. - Ensure DCs remain in all of the PCP talks for upcoming bills.
Background: In 2017, DCs were designated as a primary care provider (PCP) in the Iowa Health and Wellness Plan. ICS will continue to ensure DCs are at the table as it relates to PCPs discussions in the state. - Remove x-ray requirement for Medicaid and push for more services covered.
Background: Currently, DCs are required to conduct x-rays before they provide care. In many cases, this is not necessary and a waste of state dollars. ICS will continue to seek opportunities to remove this requirement for DCs and expand service coverage in Medicaid. - Advance open access provider panels for all state employees.
Background: The ICPC network is primarily a closed network with limited provider participation. Any new providers who are able to join receive minimal reimbursement with expansion of the provider network. This network reduces patient access to care, provider participation, and reimbursement. - Limit the chiropractic adjustment to the chiropractic profession and do not let other professions "rename" the use of the adjustment to utilize in their technique.
Background: Other professions will attempt to provide services specific to the chiropractic profession such as a chiropractic adjustment, thrust manipulation and acupuncture which is outside of their scope of practice. ICS will continue to monitor any attempt by other professions to infringe on chiropractors’ scope of practice.
Monitor Bills
ICS will continue to monitor the bills. ICS will provide email legislative updates during the 2023 session. Watch for weekly emails.
Federal: Nothing at this time.
State: Nothing at this time.
For questions related to advocacy, please contact the ICS Lobbyist Matt Fitzgerald any time with your questions and legislative concerns.
Give to the PAC
Nearly every influential organization has a strong political action committee (PAC). What’s a PAC and why are they important?
PACs are the vehicle that support candidates who support and fight for your interests. With today’s political environment, every organization has mobilized their membership to grow their PAC donations. Too much is on the line which we experienced these past legislative sessions. In the 2020 legislative session, a bill was poised to pass that could have nearly decimated the chiropractic profession – your profession, your living, your life’s work. Had this bill passed, others could have practiced chiropractic without the education you have so worked so hard earned, the quality standards you’re expected to uphold, and the training and expertise you’ve acquired over time. Your marketing manager, CA or office manager could have had the opportunity to practice as a chiropractor.
We think that’s wrong! So, membership acted quickly, worked with the governor’s office, and had the bill amended to ensure this didn’t happen. We put the power back in the hands of DCs. While we were successful, we cannot continue to let these things happen. We’ll continue to fight for the interests of DCs.
ICS provides one, unified voice for chiropractic care to the Iowa legislature and the Iowa Board of Chiropractic. ICS advocates in the Iowa legislature for health care legislation that allows patient freedom and access to chiropractic care, as well as ensuring that the unified voice of chiropractic care is heard in any healthcare discussion. No other organization is looking out for DCs. ICS is your trusted champion.
Your donation to the Iowa Chiropractic Society PAC makes an impact. Make your voice heard. Consider a donation today. Any amount helps and no amount is too small. Every commitment is valued. Making a donation is easy and convenient.
Why is it important to give to the PAC?
MESSAGE FROM ICS LOBBYIST - Matt Fitzgerald
Please consider donating to the ICS PAC so we can continue to defend our profession. Thank you to those who have donated.
PAC Donation Levels
Champion
$1,000 or more
Contributor
$500- $999
Defender
$250 - $499
Supporter
$101 - $249
Friend
$100 or less
PLEASE NOTE: PAC donations must be made from personal accounts.
Thank You
ICS would like to sincerely thank all of our 2023 donors who have generously contributed to the PAC.
Champion: $1,000 or More
Dr. Christine Bowman
Dr. Bradley Brown
Dr. Richard Haas
Dr. Michael Hahn
Dr. Daniel Kennedy
Dr. Wesley Nyberg
Dr. Richard Robert
Dr. Troy Scheuermann
Dr. Russell Van Hemert
Contributor: $500-$999
Dr. Brent DeRocher
Dr. Nicholas DeRocher
Dr. Aaron Dixon
Dr. David Haas
Dr. Larry Heffron
Dr. Mark Kauffman
Dr. Rodney Langel
Dr. Gina Lehman
Carl Lingen
Dr. Christopher LoRang
Dr. Wayne Meylor
Dr. Brett Pearson
Dr. Lonnie Pitts
Dr. Michael Powell
Dr. Tom Schiltz
Dr. Kourtne Shanahan Powell
Dr. Jenny Slykhuis-McDowell
Dr. Shane Townsend
Dr. Lauri Wondra
Dr. Tim Wondra
Defender: $250-$499
Dr. Mickey Burt
Dr. Bradley Chicoine
Dr. Matthew Dietz
Matt Fitzgerald
Dr. David Johnson
Dr. Steven Kraus
Dr. Neal Meylor
Dr. Aaron Roelfs
Dr. Matthew Sarver
Dr. Scott Sneller
Dr. Randall Stange
Dr. Robert Vonnahme
Supporter: $101-$249
Dr. Carmen Clemenson
Dr. Larry Formanek
Dr. Lucas Nelson
Dr. Mark Parsons
Dr. Dennis Vonnahme
Friend: $100 or less
Dr. Jack Donovan
Dr. Peter Juergens
Dr. Lee Malmstrom
Dr. Haley Neese
Dr. Doug Olsen
Dr. Aaron Pick
Dr. Brett Renze
Dr. Collin Schiltz
Dr. Michael Soppe
Dr. Nash Stopko
Advocacy
What is advocacy? Advocacy comes in a variety of forms from speaking directly with your legislator, donating to a cause or attending events that support an initiative.
The ICS seeks to keep our members continuously informed about legislative, regulatory and policy matters and engage our members in the advocacy process. There are times when legislators need to hear directly from their constituent chiropractors and chiropractic patients. When these situations arise, we will reach out and ask members to make calls and write letters. The rise of electronic communications, email, and social media have changed the landscape of advocacy. ICS is evolving with the times of social media communication and will maximize our messaging through these newer forms of communication. We will from time to time suggest our members actively utilize these tools to speak out and have your voice heard on pending legislation and policies.
Find Your Legislator
Don’t know who your legislators are? Find your local legislator in your district.
News & Events
NEWS RELEASE
American Chiropractic Association | 4.20.21
House Reintroduces Bill to Modernize Medicare’s Chiropractic Coverage
Arlington, Va. – The American Chiropractic Association (ACA) is pleased to announce that bipartisan legislation to modernize Medicare coverage of chiropractic services was reintroduced April 19 in the U.S. House of Representatives.
The Chiropractic Coverage Modernization Act (H.R. 2654), introduced by Rep. Brian Higgins (D-N.Y.), would increase Medicare coverage of services provided by doctors of chiropractic within the full extent of their state licensure, enabling chiropractic patients to conveniently and safely access additional covered services that may be medically necessary. The change would also align Medicare with chiropractic coverage offered in many private health and Medicare Advantage plans.
Originally introduced in 2019, the bill gained traction in the last congressional session, picking up over 90 cosponsors. Sixteen of those members have signed on as original cosponsors of H.R. 2654: Reps. Jason Smith (R-Mo.), Brian Fitzpatrick (R-Pa.), John Larson (D-Conn.), Thomas Suozzi (D-N.Y.), Robert Aderholt (R-Ala.), Cynthia Axne (D-Iowa), Debbie Wasserman Schultz (D-Fla.), Jefferson Van Drew (R-N.J.), Mary Gay Scanlon (D-Pa.), Brendan Boyle (D-Pa.), Don Bacon (R-Neb.), Mike Rogers (R-Ala.), Kathleen Rice (D-N.Y.), John Joyce (R-Pa.), Kurt Schrader (D-Ore.) and Chellie Pingree (D-Maine).
“We applaud Rep. Higgins and the cosponsors for their support of modernizing Medicare’s chiropractic coverage to meet the needs of today’s beneficiaries, who should not only be able to choose their provider but also access necessary covered services conveniently and safely during these challenging times,” said ACA President Michele Maiers, DC, MPH, PhD.
The opioid crisis, which has worsened during the COVID-19 pandemic, has further heightened the need for Medicare beneficiaries to have access to the chiropractic profession’s broad-based, nondrug approach to pain management, which includes manual manipulation of the spine and extremities, evaluation and management services, diagnostic imaging, and utilization of other nondrug therapies and modalities.
Since 1972, Medicare beneficiaries have been covered for only one chiropractic service—manual manipulation of the spine—forcing them to access additional medically necessary care from other types of providers or to pay out of pocket for the services from their chiropractor. Chiropractors are the only physician-level providers in the Medicare program whose services are restricted in this manner.
To learn more and to urge your member of Congress to support this important legislation, visit www.HR2654.org.
MEDICARE PROPOSES MASSIVE CUTS TO CHIROPRACTIC PAYMENTS
In August, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2021 Medicare Physician Fee Schedule. Under the proposed rule, the conversion factor would be reduced from $36.09 to $32.26, effective Jan. 1, 2021. Learn More Here
A public comment letter was delivered to the Centers for Medicare & Medicaid Services on October 1, 2020 to address the issue. Read Letter
DON'T WAIT! Contact your congressmen TODAY!! Use the helpful example letters below.
DON'T WAIT! Get your patients involved!
Use the example letters below to ask your patients for their support.
Example Letter From DC to Patient
Example Letter from Patient to Congressman
Watch Video from Dr. Jay Greenstein
Supreme Court of Texas Ruling
A major decision was recently ruled by the Supreme Court of Texas. The Supreme Court of Texas reversed the court of appeals’ judgment on a decade old case between the Texas Board of Chiropractic Examiners (the Board) and the Texas Medical Association upholding the rules set out by the Board and maintaining the scope of practice for doctors of chiropractic. You may read the case here:
181223.pdf (txcourts.gov)
or find it attached.
This is an important win for chiropractors across the country and demonstrates the importance of advocacy and perseverance in each state! Today, our doctors in Iowa practice under one of the best scopes of practice acts in the country. But that was fought for and is never a given. ICS will continue to follow these types of cases and continue to protect our practice act. With your help, we know we have the power of numbers behind us. If you know a doctor who is not a member, please share this with them. The profession has more power when we band together.
Thank you for your membership in the ICS community and for all you do for ICS, the profession, and your patients. It is because of your work that we are changing the face of healthcare and the quality of life for patients.
