Support H.R. 3654 and a Safer Future of Pain Management for Medicare Patients
MEDICARE
Robert C. Jones
DC,
Keith S. Overland
DC,
John Falardeau
When the American Chiropractic Association (ACA) first approached Reps. Brian Higgins (D-N.Y.) and Tom Reed (R-N.Y.) about potentially sponsoring a bill to update the statute governing chiropractic services in Medicare, much of the conversation focused on how seniors are in dire need of alternatives for pain management to avoid or at least reduce their need for prescription opioid medications. The congressmen, who have each battled the opioid crisis in their respective districts, understood immediately the opportunity that ACA’s proposed legislation presented. By simply removing an arbitrary barrier to qualified providers with non-drug options for pain, many people might be spared from addiction or worse.
After months of close work between ACA and the Higgins/Reed teams, the Chiropractic Medicare Coverage Modernization Act of 2019, H.R. 3654, was introduced on July 9, 2019. This bipartisan bill would enable seniors to have access to all Medicare-covered benefits allowable under a chiropractor’s state licensure.
While it expands access for beneficiaries, the bill does not add any new services to Medicare (nor does it remove any current services covered by Medicare). It simply enables beneficiaries to choose from which provider they prefer to receive their services.
At the same time, as studies have shown, the bill has the potential to reduce costs for many of the conditions that chiropractors address for their senior patients. It will also mean less out-of-pocket costs and logistical hassles for seniors: No more getting adjusted by your chiropractor and then having to schedule another appointment, on another day, with a different provider, for a service your chiropractor is licensed to provide and could have effectively rendered at the time of the first appointment.
In addition, the bill would fully recognize chiropractors as “physicians” in the Medicare program, acknowledging their level of education as well as the level of care they provide, and bringing coverage of their services in line with how other physicians in the Medicare program are treated. At this time, chiropractors are the only physician-level providers whose services are arbitrarily restricted by statute.
Introduction of the Medicare Bill is Only the Start
Now that H.R. 3654 has been introduced, the critical work to gain cosponsors begins - the more cosponsors, the greater chance that the bill will pass. ACA aims to bring on 300 to 400 cosponsors in the next six to seven months. Our online legislative action center enables chiropractors to easily send a message to their elected representative in the U.S. House. Simply go to www.HR3654.org and click “Take Action.”
But don’t stop there. Talk to your family, friends and patients-especially your senior patients-and ask them to do the same, using the same link. The voice of the chiropractic profession combined with the voice of actual patients puts more momentum behind efforts to get H.R. 3654 through Congress and to the president’s desk for his signature.
Opioid Crisis Calls for “Out-of-the-Box” Strategies
Musculoskeletal (MSK) pain, led by spinal disorders, costs the U.S. healthcare system $874 billion per year and is the most common cause of severe long-term pain and disability, according to the U.S. Bone and Joint Initiative (USBJI). The prevalence and impact of MSK disorders only increase with age, and forecasts predict the number of Medicare beneficiaries-now about 55 million-will triple in the next 10 years.
The rise of the opioid crisis added a new layer of threat to the equation. Many seniors already take multiple medications for chronic conditions such as heart disease and diabetes, and by combining those with prescription pain medications for their MSK issues, they are left more vulnerable to not only negative drug interactions but also opioid addiction or overdose.
Between 1993 and 2012, hospitalizations for opioid overuse increased fivefold among Americans age 45 to 85 and older, according to the Agency for Healthcare Research and Quality. In a 2018 hearing on the opioid crisis, Sen. Robert Casey Jr. (Pa.), ranking Democrat of the Senate Special Committee on Aging, noted that, “In 2016, one in three people with a Medicare prescription drug plan received an opioid prescription. This puts baby boomers and our oldest generation at great risk.”
With H.R. 3654, the chiropractic profession has an unprecedented opportunity to help America’s aging population live healthier and pain free. Congress is looking for out-ofthe-box strategies to solve the opioid epidemic. The chiropractic profession has an approach to pain management that is safe and effective... we have an opportunity to make a positive difference in the lives of millions of people.
Put patients first and join us in the effort to generate more congressional support for H.R. 3654. Our moment of impact, as a profession, is now.
Learn more, and contact your member of the U.S. House of Representatives, at www.HR3654.org.
Dr. Robert C. Jones is the president of ACA.
John Falardeau is ACA's Senior Vice President of Public Policy and Advocacy.
Dr. Keith Overland is chairman of ACA's Legislative Advisory Board
