Table 1.
Issues | Challenges | Recommendations | |
---|---|---|---|
Claims documentation | OIG reports inadequate documentation of chiropractic claims.19,52 | DCs must correct deficiencies. Medicare requires documentation of chiropractic evaluation and services but does not reimburse for same. |
State and national chiropractic organizations should continue and strengthen efforts to improve claims and documentation practices. |
Maintenance care | Medicare considers “maintenance care” to be an unnecessary service.53 Small clinical trials support the effectiveness of “maintenance care,”35,36,40,54 but more evidence is needed. |
To conduct the research required to demonstrate any benefits of “maintenance care” | Conduct rigorous efficacy/effectiveness studies. |
Uncertain consequences of increased coverage on costs | A demonstration project projected increased costs from expansion of coverage.17 | Methodological concerns about the demonstration Lack of cost-effectiveness data |
Conduct needed clinical studies, targeted at the triple aim of high-quality care, affordability, and improved health. |
DC, doctor of chiropractic; OIG, Office of the Inspector General.