New York employers already reeling from rapidly escalating workers’ compensation medical costs would face substantial new increases if a bill to increase chiropractic fees is approved in the legislature, according to the Alliance of American Insurers (AAI).
“Assembly Bill 2946, now in the Labor Committee, expands the scope of the chiropractic fee schedule for treatment of injured workers under workers compensation and increases fees for chiropractic care to the high rates physicians receive for providing comparable services,” Alliance Vice President John Cucci commented. “We estimate it will add from $150 to $200 million in additional workers compensation medical costs.”
Currently, chiropractors receive a single fixed fee for each office visit, which also covers the cost of any necessary treatments or modalities. The bill expands the scope of the existing fee schedule by permitting payment for each individual component of treatment, service or procedure.
“By ‘unbundling’ the office visit fee into its component elements, the sum of the parts is greater than the existing fixed fee,” Cucci explained. “Rather than charging a single amount per visit, the chiropractor will essentially itemize for each ice pack, heat treatment, vertebrae alignment, etc., thereby significantly increasing the cost to employers.”
Since no-fault motor vehicle reimbursement rates are determined by express reference to New York’s workers compensation rate schedule, the bill negatively impacts on the cost for both systems, Cucci added. “The cost increase can rise exponentially as chiropractic treatments tend to require more frequent visits, over a longer period of time, than do medical treatments. The overall cost of unbundling alone is expected to be dramatic, costing hundreds of millions of dollars.”
The bill also seeks reimbursement of chiropractic procedures at the higher rates charged by physicians providing comparable services. Current law recognizes that chiropractic services are not the same as medical care administered by a physician, he noted.
“There has been a steady growth in the utilization of chiropractic treatments and procedures during the last several years,” Cucci said. “In limited contexts, chiropractic services can serve a valuable therapeutic purpose. However, elevating chiropractic services to the same level and fee schedule as physician-administered medical care is not warranted by New York state professional standards of practice nor the underlying level of cost for services rendered.
“Sponsors of AB 2946 attempt to equate the administration of equal services for equal fee without distinguishing the significantly different qualifications of a licensed medical doctor and a licensed chiropractor. Even when a physician provides care that may be administered by a chiropractor, the injured employee is receiving more than just the limited chiropractic services. The injured employee is receiving such care within the context of the overall professional medical opinion and judgment of a medical doctor. The ability to practice medicine and assess the employee’s overall health needs is undoubtedly more comprehensive than the provision of a limited service with chiropractic care alone,” Cucci concluded.
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