''SEC. 2706 o42 U.S.C. 300gg–5.. NON-DISCRIMINATION IN HEALTH CARE.

''(a) PROVIDERS.—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.⁶

The passage of the PPACA, with section 2706 in place, creates a federal law that leaves insurance companies, including CMS, only two choices moving forward.

After January 1st, 2014 health insurance companies can force the appending of the AT modifier on all of the four corrective drug classes mentioned earlier, and eliminate payment for all maintenance drugs, which would eliminate the discriminatory practices against us, or they can remove the requirement of the AT modifier for Chiropractic adjustments, and pay us for Chiropractic maintenance care. There is no middle ground under this new law. I bet you can guess which option they won't take. The removal of payment for maintenance class drugs would result in an outcry from the public at large, as well as financially damage the pharmaceutical industry, which are two very powerful lobbying groups.

So how do we get the insurance industry to comply with this new law? Well in order to begin, ALL OF US have to understand that we are being discriminated against on a daily basis, and begin to reframe the conversation. We as a profession have to give a voice to this issue and let congress, Medicare, and the insurance industry know that we've had enough.

Start talking to and writing insurance companies' provider relations departments about this issue. If they know we're on to them on a national scale it will affect the game I assure you. Also, we need to begin talking to our patients about maintenance drugs and how they fit the same definition as maintenance adjustments, but that maintenance adjustments are not covered and drugs are, even though drugs are more expensive and have some bad side effects.

Next, our national organizations must begin to take this fight to CMS and private insurance companies and not be afraid to stand up to them. It's high time that we as a Chiropractic profession quit rolling over and playing dead for the insurance industry. We are not the bargain basement of health care, and should not be discriminated against. Lastly, it may take legal action against the insurance industry to win this fight, but it is a fight that we must have, and a fight that we can win.

Dr. Jarod Adlington, DC CCIHS is the president and CEO of HRV Enterprises, and a clinician in full time Chiropractic practice for over 11 years. He is also an educator, and author in the field of Heart Rate Variability. He has delivered post graduate seminars on HRV to doctors and staff throughout the United States. He is the author of several books, including A Physician's Guide to HRV and ANS Assessment. He can be reached at .

References:

1. Medicare Policy Benefit Manual Chapter 15, Section 30.5. Pages 20-21.
2. Beers, M. H., & Berkow, R. (1999). Infectious Diseases. In The Merck manual of diagnosis and therapy (17th ed.,sec. 13, chap. 153, page 1101).
3. Beers, M. H., & Berkow, R. (1999). Fungal Skin Infections. In The Merck manual of diagnosis and therapy (17th ed.,sec. 12, chap. 113, page 802).
4. Beers, M. H., & Berkow, R. (1999). Infectious Diseases. In The Merck manual of diagnosis and therapy (17th ed.,sec. 13, chap. 154, page 1127).
5. Beers, M. H., & Berkow, R. (1999). Oncology. In The Merck manual of diagnosis and therapy (17th ed.,sec. 13, chap. 144, page 986).
6. Patient Protection and Affordable Care Act of 2010. Subtitle C-Quality Health Insurance Coverage for All Americans ''SEC. 2706 o42 U.S.C. 300gg–5.. NON-DISCRIMINATION IN HEALTH CARE. Page 51.

Dr. Jarod Adlington, DC, CCIHSis the president and CEO of HRV Enterprises, and a clinician in full time Chiropractic practice for over 11 years. He is an educator and author in the field of Heart Rate Variability. He has delivered post graduate seminars to doctors and staff throughout the United States. He is the author of several books, including A Physician's Guide to HRV and ANS Assessment. He can be reached at .