This new policy, championed by Senator Tom Harkin (D-IA), chair of the Senate Health, Education Labor and Pensions Committee, states the following:

“A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates
based on quality or performance measures.”

Moving Forward

All laws passed by Congress are specific in some ways and general in others. In cases where implementation requires more specifics than can be found in the precise language of the law, the executive branch of the federal government creates rules to clarify the meaning of the law for affected individuals, groups, and businesses. Section 2706 has now entered this rulemaking, or regulatory, phase of the process. Sometime not too far in the future (months, or possibly years), the Department of Health and Human Services (HHS) will publish rules detailing exactly how the provider nondiscrimination section is to be applied.

While the new AMA resolution calls on Congress to repeal the nondiscrimination section of the health reform law, the chances of that happening are slim to none. The AMA knows this. Their true goal is to pressure HHS to promulgate a set of rules that will limit the reach of the nondiscrimination law and make its enforcement as difficult as possible, thus preserving their privileged position to the maximum feasible extent. There are countless ways to accomplish this, which include using the word “may” instead of “shall,” creating extremely long timelines for implementation, and appointing regulators who do not believe in the regulations they are supposed to enforce. Old Washington hands are skilled in these arts.

PARCA

Fortunately, the AMA is not the only player on the field. Nor do chiropractors stand alone in seeking to have the law applied in the manner Congress intended. Since the early 1990s, the Patient Access to Responsible Care Alliance (PARCA)—initiated by the American Chiropractic Association and now including a wide range of non-MD/DO professions*—has played a key role in health legislation and its implementation. In its own words, PARCA “provides federal policymakers with access to information from all areas of the healthcare community, in order to assist in the formulation of responsible, well-rounded healthcare policy. The coalition is committed to quality, cost-effective care, and ensuring patients have options in the delivery of such care.”

PARCA, along with chiropractic organizations such as the ACA and ICA, is working tirelessly to ensure that the nondiscrimination law accomplishes its goals of fairness and equal treatment, which will benefit not only the involved professions but their many tens of millions of patients.

 * The PARCA coalition includes the American Academy of Audiology, American Academy of Nurse Practitioners, American Association of Nurse Anesthetists, American Chiropractic Association, American College of Nurse Midwives, American Occupational Therapy Association, American Optometric Association, American Physical Therapy Association, American Podiatric Medical Association, American Psychological Association, American Speech-Language-Hearing Association, and National Association of Social Workers.

Daniel Redwood, DC, is a Professor at Cleveland Chiropractic College–Kansas City and Editor-in-Chief of Health Insights Today and
The Daily HIT.