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17208500002021 Legislative Talking PointsThink Chiropractic FirstLower costs, better outcomes, less risks and higher patient satisfaction rates with Chiropractic CareThe 2021 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.Actively Address Now – Act TODAY!State LegislationLicensing Bill Background: As H.F. 2627 was amended during the 2020 legislative session, it stated that someone with three years of experience in the last four years of a profession that wanted to come to Iowa could practice that same profession as long as they were not licensed in all 50 states. We had a few issues with that language. What if one state no longer required a license? That would open Iowa up to the potential of having receptionists from a DC’s office claim to be chiropractors in Iowa. What if another state had a different scope of practice and did not allow a certain technique and they come to Iowa and practice something they were not capable of performing? This amendment of HF 2627 stated that you did not need a certain level of formal education to practice if coming from another state.Due to our grassroots, we were able to work with the Governor’s Office, House of Representatives and Senate to address all of our concerns with a new amendment. The intention of this bill was not against chiropractic, but to reduce barriers to entry and get a workforce in skilled positions to Iowa. For 2021: We have been told there is going to be another licensing bill this next session. Although chiropractic was not the profession intended to be in last sessions bill, we need to do our part to make sure this does not happen again. Education is the key! Take Action TODAY! Contact your legislator via letter, email or phone and ask them, “If there is another licensing bill next session, can you please add the board of chiropractic to the exempt list along with board of medicine, board of pharmacy, board of dental and board of nursing ?”Below is a link to House File 2627. Our section is 272c.13 Legislation2021 Medicare Physician Fee Schedule Proposed RulesBackground: On August 3, 2020 CMS proposed policy, payment, and quality provisions changes to the Medicare Physician Fee Schedule for Calendar Year 2021. This proposed rule will reduce the reimbursement rate for chiropractic services by 10% with further reductions as a result. Similar to many healthcare disciplines, COVID-19 has adversely impacted chiropractic providers. As small business owners and essential workers chiropractic providers are impacted by economic impact of COVID-19. Having the 10% decrease in reimbursement for services will further harm these small business, and may influence chiropractic provider participation with Medicare program, which may impact access to care for beneficiaries. Please note, chiropractic providers are on top of the list of reduction for Medicare reimbursement, only below nurse anesthetists and radiologists, which are both impacted with an 11% decrease.Please see page 897 of the rules. Action TODAY! As of now, there is legislation being proposed in the U.S. House of Representatives: H.R. 8505. Take action now by contacting your U.S. Representative asking them to cosponsor and support H.R. 8505. Ask your U.S. Senators to oppose these reductions TODAY! Letter templates and information can be found on the ICS website here. -635098425Seek Opportunities!ICS will continue to seek opportunities that:Expand DC involvement in opioid prevention strategiesBackground: 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 levelBackground: 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 billsBackground: 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 employeesBackground: 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.-698505461000Monitor Bills!ICS will continue to monitor the following bills.FederalFederal - HR 3654 - The Chiropractic Medicare Coverage Modernization Act of 2019 (Medicare Parity) (ACA)Increase access to chiropractic in the military TRICARE program (House and Senate bills)Background: Chiropractic services were first made available to active-duty military personnel in 2000, following the enactment of legislation to create a permanent chiropractic benefit within the DoD health care system. As part of the pilot program--before full implementation--retirees were also granted access to chiropractic services on a space-available basis. At the time, it was noted that the benefit was valued by members of the TRICARE community, which serves not only retirees but also dependents and survivors of military personnel. Today, chiropractic is available only to active-duty service members at more than 60 military treatment facilities in the United States, as well as bases in Germany and Japan. (from ACA)Ask: Help ensure that services delivered by doctors of chiropractic are available to all eligible retirees in the military.H.R.344 – Chiropractic Health Parity for Military Beneficiaries Act Sponsored by Representative Mike Rogers (R-AL)S. 30 – Chiropractic Health Parity for Military Beneficiaries Act Sponsored by Senator Tammy Baldwin (D-WI) The following are Bills that mention chiropractic but are not focused specifically on Chiropractic.H.R.1183 – Acupuncture for Heroes and Seniors Act of 2019 – sponsored by Representative Judy Chu (D-CA)Background: Seeks to change several provisions of federal law to include acupuncturists services in programs to provide care for military members and military dependents, veterans, and Medicare beneficiaries. It also allows for the appointment of qualified acupuncturists in the commissioned Regular Corps and the Ready Reserve Corps of the Public Health Service. Chiropractic is mentioned but no provisions make changes to the laws affecting access to chiropractic. To read the Bill as introduced click here.H.R.2452 – Medicare for America Act of 2019 – sponsored by Representative Rosa DeLauro (D-CT)Background: Would require the Secretary of Health to establish a public health plan option that is offered in the individual market through the Federal and State Exchanges under title I of the Patient Protection and Affordable Care Act to eligible individuals for plan years 2021 and 2022. There is a provision to include chiropractic in covered services.H.R.2359 – Whole Veteran Act – Sponsored by Representative Conor Lamb (D-PA)Background: H.R. 2359 – Whole Veteran Act sponsored by Representative Conor Lamb (D-PA), as amended, would require the Secretary of the Department of Veterans Affairs (VA) to submit to Congress a report on the implementation of the February 1, 2019, WholeHealth Transformation Memorandum. The report would include an analysis of the accessibility and availability of relevant services with respect to the implementation of such memorandum, an assessment of health outcomes, and an assessment of resources necessary to expand Whole Health to the VHA enterprise. It would also require VA to produce a plan on the delivery of VA Whole Health elements to veterans living in areas without access to VA facilities. ................
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