Chiropractor Association sues HHS

The U.S. District Court for the District of Columbia has ruled against an attempt by HHS to dismiss a lawsuit by the American Chiropractic Association (ACA), Arlington, Virginia, over chiropractic services in Medicare HMOs. The January 22 decision states that the ACA can bring its claim before a Federal

court. In a July 7, 2000, decision, the district court had ruled that the ACA had standing to sue on behalf of the chiropractic profession, but the court deferred its judgment on whether the ACA needed to exhaust HHS's administrative process before it could seek relief from the Federal court pending additional briefing by the parties in the lawsuit.

The ACAs lawsuit alleges, among other things, that the HHS Secretary has improperly permitted physical therapists, medical physicians, and osteopathic physicians to provide to Medicare beneficiaries the chiropractic benefit of manual manipulation of the spine to correct a subluxation. HHS has argued that these concerns could be addressed through the agency's internal administrative process.

In another lawsuit involving the ACA, the national Blue Cross/Blue Shield Association, Chicago, Illinois, has withdrawn its motion to dismiss the ACAs landmark lawsuit against it and Trigon Blue Cross/Blue Shield, Richmond, Virginia. In August 2000, the ACA, the Virginia Chiropractic Association, five chiropractors, and 18 chiropractic patients filed suit against Trigon and the national Blue Cross/Blue Shield Association, alleging conspiracy, racketeering, extortion, mail fraud, and antitrust violations by Trigon. The lawsuit questions the policy adopted by many Blue Cross/Blue Shield plans and other insurers that singles out chiropractors for what the lawsuit calls discriminatory treatment.

On December 20, 2000, the national Blue Cross/Blue Shield Association had argued its motion to dismiss the case in the Federal district court in Abingdon, Virginia, stating that court was not the proper venue because the company does not do business in the district. Upon discovering that it does business in the district, the Blue Cross/ Blue Shield Association withdrew its motion.

This lawsuit could have a significant impact on the managed care industry as a whole by requiring that chiropractic benefits offered by HMOs include payment to chiropractors who perform covered services.