PT's, Chiro's and Spinal Manipulation
Charles Barocas
Description
Collection
Title:
PT's, Chiro's and Spinal Manipulation
Creator:
Charles Barocas
Date:
9/28/2003
Text:
Manipulation: A Covered Physical Therapist Service
With the filing of a Stipulation of Dismissal, Medicare's recognition of physical therapists as providers of manipulation services is no longer under challenge. The Federal Government and the American Chiropractic Association (ACA) have agreed to the dismissal of Count II of the ACA's suit (American Chiropractic Association, Inc v Tommy G Thompson, Secretary of Health and Human Services), which sought a ruling from the Court that physical therapists could not perform manual manipulation of the spine as a Medicare covered service.
With dismissal of Count II, the government's long-standing policy of treating manipulation of the spine provided by a physical therapist as a Medicare covered service remains in effect. This policy frequently was affirmed in the Government's pleadings to the Court. In one instance, the Government wrote that a physical therapist may provide, and be reimbursed by Medicare for, the services of manipulative treatment of the spine as long as that service is appropriate and within the scope of the physical therapist's license. And in another, while affirming that manipulation of the spine to correct a subluxation is a physician service, the government went on to say that this reading of the statute does not, however, preclude physical therapists from providing whatever services they are authorized to perform under the scope of their licenses.
The ACA based its decision to file the stipulation of dismissal on the publication of a revised version of the Centers for Medicare and Medicaid Services' (CMS) Operational Policy Letter #23. This Letter states that the statute specifically references manual manipulation of the spine to correct a subluxation as a physician service (emphasis added) and that Medicare+Choice organizations may not use non-physician physical therapists for manual manipulation of the spine to correct a subluxation (emphasis added). The letter concludes with the statement: Medicare+Choice organizations may continue to use physical therapists to treat enrollees for conditions not requiring physician services. On several occasions CMS representatives have confirmed that these physical therapist treatments include manipulation of the spine services, precisely as was stated in the Government's submissions to the Court.
In light of the dismissal of Count II, APTA withdrew its motion to intervene in the lawsuit because ACA is no longer seeking relief that would adversely affect physical therapists. APTA has reserved its right to ask the Court for permission to file an amicus brief on the remaining issues before the court if future developments warrant that action.
With this somewhat surprising turn of events, another challenge to the right of physical therapists to manipulate the spine falls quietly by the wayside.
With the filing of a Stipulation of Dismissal, Medicare's recognition of physical therapists as providers of manipulation services is no longer under challenge. The Federal Government and the American Chiropractic Association (ACA) have agreed to the dismissal of Count II of the ACA's suit (American Chiropractic Association, Inc v Tommy G Thompson, Secretary of Health and Human Services), which sought a ruling from the Court that physical therapists could not perform manual manipulation of the spine as a Medicare covered service.
With dismissal of Count II, the government's long-standing policy of treating manipulation of the spine provided by a physical therapist as a Medicare covered service remains in effect. This policy frequently was affirmed in the Government's pleadings to the Court. In one instance, the Government wrote that a physical therapist may provide, and be reimbursed by Medicare for, the services of manipulative treatment of the spine as long as that service is appropriate and within the scope of the physical therapist's license. And in another, while affirming that manipulation of the spine to correct a subluxation is a physician service, the government went on to say that this reading of the statute does not, however, preclude physical therapists from providing whatever services they are authorized to perform under the scope of their licenses.
The ACA based its decision to file the stipulation of dismissal on the publication of a revised version of the Centers for Medicare and Medicaid Services' (CMS) Operational Policy Letter #23. This Letter states that the statute specifically references manual manipulation of the spine to correct a subluxation as a physician service (emphasis added) and that Medicare+Choice organizations may not use non-physician physical therapists for manual manipulation of the spine to correct a subluxation (emphasis added). The letter concludes with the statement: Medicare+Choice organizations may continue to use physical therapists to treat enrollees for conditions not requiring physician services. On several occasions CMS representatives have confirmed that these physical therapist treatments include manipulation of the spine services, precisely as was stated in the Government's submissions to the Court.
In light of the dismissal of Count II, APTA withdrew its motion to intervene in the lawsuit because ACA is no longer seeking relief that would adversely affect physical therapists. APTA has reserved its right to ask the Court for permission to file an amicus brief on the remaining issues before the court if future developments warrant that action.
With this somewhat surprising turn of events, another challenge to the right of physical therapists to manipulate the spine falls quietly by the wayside.
Citation
Charles Barocas, “PT's, Chiro's and Spinal Manipulation,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/221794.
