Colorado Medical Society 
News for Colorado Physicians                                                                                   January 8, 2013
Committee on Legal Services votes to repeal Chiropractic Board rule allowing chiropractors to inject non-FDA approved drugs

The Committee on Legal Services voted 8-0 to ask the Colorado Legislature to repeal Chiropractic Board Rule 7c that gives chiropractors the authority to administer non-FDA approved compounds by injection. The Colorado Legislature will vote on the repeal of the rule in its upcoming session as part of the Committee's rule review bill.

CMS and 15 medical associations also filed a lawsuit in state district court in late December to stop the rule. CMS General Counsel Susan Koontz, J.D., says that CMS will not withdraw the lawsuit until such time that the matter is settled completely in the Legislature.

The Committee heard a range of testimony in opposition to Rule 7c, including CMS President Jan Kief, MD; CMS General Counsel Susan Koontz, JD; Marschall Smith, Program Director of the Colorado Medical Board; and Dr. Ken Spresser, a chiropractor for 30 years who has served in leadership roles for both the American Chiropractic Association and the Colorado Chiropractic Association.

Dr. Kief explained that Rule 7c is not only illegal, but bad public policy and potentially dangerous to patients.

"In December, three members of the Chiropractic Board approved a rule that allows chiropractors who complete a 24-hour course to perform injections of non-FDA approved substances as well as to administer them topically and through inhalation," said Dr. Kief. "The rule does not restrict the medical conditions to be treated or where in the human body the injections can be administered. This leaves open to individual interpretation the disease to be treated, the substance they want to inject and the site in which they choose to inject it."

Read Dr. Kief's complete testimony here.

Ken Spresser, D.C., had equally compelling testimony from a practicing chiropractor's perspective.

"Chiropractors do not have the appropriate training to administer drugs by injection. Chiropractors don't learn to inject drugs through residencies or internships or any other clinical rotations. Finally, the 24 hours of study and instruction is woefully inadequate to be competent in the administration of drugs by injection. Please protect the public from this small interest group and the Chiropractic Board of Examiners that only wants to make more money by exceeding their statutory boundaries."

Read Dr. Spresser's complete testimony here.

CMS members are encouraged to write and thank the eight members of the Committee on Legal Services who were present to vote to ask their colleagues in the Colorado Legislature to stop this dangerous rule from being implemented. They are: Rep. Bob Gardner, chair; Sen. John Morse, vice chair; Sen. Morgan Carroll; Sen. Ellen Roberts; Sen. Gail Schwartz; Rep. Claire Levy; Rep. Carole Murray; and Rep. Mark Waller. Their contact information can be located by clicking here.


Medicare Participation Deadline Extended to Feb. 14

The Centers for Medicare and Medicaid Services has announced a six-week extension to the annual Medicare participation enrollment period, which was scheduled to conclude Dec. 31. Physicians' Medicare participation elections or withdrawals must now be postmarked on or before Feb. 14.

While participation status changes can be made into February, the effective date for these changes remains Jan. 1. Payment rate and other changes associated with becoming a non-participating physician will be retroactive to Jan. 1.

This extension comes as Congress averted a 26.5 percent cut in physician Medicare payments that was scheduled for Jan. 1 and delayed sequestration cuts for two months to allow lawmakers time to work out a broader fiscal package.

The American Medical Association has made available a Medicare Participation Kit to help physicians evaluate your participation options. Access the kit here.


Medicaid Primary Care Payment Increase: Attestation Required

Changes to Medicaid primary care reimbursement were enacted as part of the Affordable Care Act (ACA). Eligible physicians will receive supplemental payments for services rendered between Jan. 1, 2013, and Dec. 31, 2014, that raise the Medicaid reimbursement to Medicare rates. A recent study shows that for many Colorado physicians this change would represent an estimated 32% fee increase on average.

To be eligible for the supplemental payment, physicians must self-attest as having a specialty in family medicine, general internal medicine, and/or pediatric medicine. Only physicians can complete this form (staff or other representatives are not allowed).

Make sure that you are eligible for these increased payments by visiting the Colorado Department of Health Care Policy and Financing attestation page here. Learn more about ACA enhanced payments for Medicaid primary care physicians here.

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