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What the Biden-Harris Administration Emergency Regulation Means for YOU

Yesterday, Thursday, November 4, 2021 the Biden-Harris Administration Issued Emergency Regulation Requiring COVID-19 Vaccination for Health Care Workers. Click here if you wish to read that proposed regulation or the Interim final rule with comment period.

Jason Martin, PCA General Counsel, has since reviewed the HHS/ CMS proposed language and has offered the following response:

Background: The Centers for Medicare & Medicaid Services (CMS) establishes health and safety standards, known as the Conditions of Participation, Conditions for Coverage, or Requirements for Participation for 21 types of providers and suppliers, ranging from hospitals to hospices and rural health clinics to long term care facilities (including skilled nursing facilities and nursing facilities, collectively known as nursing homes).


Most of these providers and suppliers are regulated by this interim final rule with comment period (IFC). Specifically, this IFC directly regulates the following providers and suppliers, listed in the numerical order of the relevant CFR sections being revised in this rule:

● Ambulatory Surgical Centers (ASCs) (§ 416.51)

● Hospices (§ 418.60)

● Psychiatric residential treatment facilities (PRTFs) (§ 441.151)

● Programs of All-Inclusive Care for the Elderly (PACE) (§ 460.74)

● Hospitals (acute care hospitals, psychiatric hospitals, hospital swing beds, long term care hospitals, children’s hospitals, transplant centers, cancer hospitals, and rehabilitation hospitals/inpatient rehabilitation facilities) (§ 482.42)

● Long Term Care (LTC) Facilities, including Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), generally referred to as nursing homes (§ 483.80)

● Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) (§ 483.430)

● Home Health Agencies (HHAs) (§ 484.70)

● Comprehensive Outpatient Rehabilitation Facilities (CORFs) (§§ 485.58 and 485.70)

● Critical Access Hospitals (CAHs) (§ 485.640)

● Clinics, rehabilitation agencies, and public health agencies as providers of outpatient physical therapy and speech-language pathology services (§ 485.725)

● Community Mental Health Centers (CMHCs) (§ 485.904)

● Home Infusion Therapy (HIT) suppliers (§ 486.525)

● Rural Health Clinics (RHCs)/Federally Qualified Health Centers (FQHCs) (§ 491.8)

● End-Stage Renal Disease (ESRD) Facilities (§ 494.30)


This IFC directly applies only to the Medicare- and Medicaid-certified providers and suppliers listed above. It does not directly apply to other health care entities, such as physician offices, that are not regulated by CMS. Most states have separate licensing requirements for health care staff and health care providers that would be applicable to physician office staff and other staff in small health care entities that are not subject to vaccination requirements under this IFC

Bottom line is this does not apply to chiropractors in private practice.

ACA Celebrates 100th Cosponsor on Chiropractic Medicare Coverage Modernization Act

This week, Reps. Gregory Steube (R-Fla.), Brian Mast (R-Fla.) and Drew Ferguson (R-Ga) joined their colleagues in supporting H.R. 2654, the Chiropractic Medicare Coverage Modernization Act, bringing the total number of cosponsors of the bill to 100.
Introduced in April by Rep. Brian Higgins (D-N.Y.) with 16 original cosponsors, the measure would allow beneficiary access to the full scope of current Medicare services allowed under a chiropractor’s state licensure.
“For nearly 50 years, beneficiaries have been denied full access to Medicare covered services in a chiropractic clinic,” said Dr. Michele Maiers, ACA president. “The current statute is antiquated and needs to be changed. I thank Congressman Higgins and the 100 cosponsors who support Medicare patients and who have supported this legislation.”
The chiropractic benefit in Medicare dates back to 1972 and only covers “manual manipulation of the spine to correct a subluxation.” H.R. 2654 would allow Medicare beneficiaries access to the chiropractic profession’s broad-based, non-drug approach to pain management, which includes manual manipulation of the spine and extremities, evaluation and management services, diagnostic imaging and utilization of other non-drug approaches that have become an important strategy in national efforts to stem the epidemic of prescription opioid overuse and abuse.
“The more cosponsors we have, the greater the likelihood of our success,” noted ACA Legislative Committee Chair Dr. Keith Overland. “I want to thank all the dedicated ACA volunteers, as well as the numerous chiropractic state associations, organizations and individual supporters from all 50 states, who have answered the bell and helped move this vital piece of legislation. But our work is not done; we need the profession to continue to garner additional cosponsors and support.”
H.R. 2654 was referred to two House committees, Ways and Means, and Energy and Commerce. A Senate companion bill has not yet been introduced; however, work is underway to secure introduction in that chamber.
For a full list of H.R. 2654 cosponsors, click here.
For more information on the Chiropractic Medicare Coverage Modernization Act, and how you can help, go to

2022 ICD-10-CM Updates Effective October 1, 2021

Provided as a courtesy of the PCA

The 2022 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2022. These 2022 ICD-10-CM codes are to be used for discharges occurring from October 1, 2021 through September 30, 2022 and for patient encounters occurring from October 1, 2021 through September 30, 2022.

This year's coding updates that will affect chiropractic claims are listed below:

  • M54.5 Low back pain. Loin pain and Lumbago NOS have been deleted from the description
  • New Code: M54.50 Low back pain, unspecified. This includes Loin pain and Lumbago NOS.
  • New Code: M54.51 Vertebrogenic low back pain, Low back vertebral endplate pain
  • New Code: M54.59 Other low back pain
  • M54.8 Other dorsalgia. Revise low back pain (M54.5) to low back pain (M54.5-)
  • G44.86  Cervicogenic cephalgia  (Code also the associated cervical spine condition, if known. Cervicogenic cephalgia is a secondary code.

Click Here for Full Document Downloads from CMS

*Be sure to send out all your billing up to September 30 due to the updated ICD10 codes above that go into effect on October 1*

 Medicare ABN Changes

Click Here to Read More

Link to the New Form and Instructions

As previously stated in the communications sent to members in February 2021, which was also distributed to the Office of Governor Tom Wolf, PA General Assembly Members, and PA Congressional Delegation.

September 14, 2021

PCA Statement on Patient Choice

The Pennsylvania Chiropractic Association (PCA) supports the Pennsylvania health care consumers’ rights regarding their own health and well-being regardless of age, race, religion, creed, sex, sexual orientation, national origin, physical or mental challenges, or sources of payment.

The health and well-being of the health care consumer depends primarily on a collaborative effort between the patient and the health care provider. Therefore, all individuals have the right to receive understandable information about their diagnosis, treatment and prognosis, as well as the right to make informed decisions regarding their plan of care, course of treatment, and other important decisions for themselves and their families.

Since health care procedures and services often involve varying degrees of risk, it is essential that patients educate themselves with information about specific procedures and treatments and alternatives to existing treatments.

The Pennsylvania Chiropractic Association opposes mandated or compulsory medical procedures of any kind, as they infringe on the individual's ability to exercise the right to freedom of choice in personal health care decisions.

The Pennsylvania Chiropractic Association also supports other basic rights of the patient, such as a patient’s choice of providers and insurance plans.  Any willing provider should have the ability to participate in health insurance plans. All patients should have access to emergency services, taking an active and leading role in their personal treatment decisions, the right to privacy and confidentiality, as well as considerate and respectful care from healthcare providers.

PCA has taken actions regarding this issue. Now it’s YOUR turn to make your position known:

US Senator:
US Congressperson:
Governor Tom Wolf:
PA Senator:
PA Representative:

HRSA Logo 2015

New Provider Relief Funding Available

Today, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing $25.5 billion in new funding for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.

Get Ready to Apply! The application will open on September 29, 2021.

Click Here to Learn More!!!

Important Medicare Update

Medicare update, including FAQs to assist Doctors of Chiropractic with their Medicare issues and proper documentation:


Residents in some Pennsylvania counties are being urged to wear masks again, regardless of vaccination status, this DOES NOT change the CDC recommendations for continued masking in Healthcare settings, including DC offices.

August 1, 2021

Residents in some Pennsylvania counties are being urged to wear masks again, regardless of vaccination status, due to transmission levels of COVID-19.

The U.S. Centers for Disease Control and Prevention updated its guidelines Tuesday to urge vaccinated people in certain areas of the country to resume wearing masks because of COVID-19.The CDC said people in areas with high or substantial COVID-19 transmission levels should resume wearing masks.

The PCA has consistently relied upon Federal and Pennsylvania mandates, guidance and recommendations for COVID-related matters.  As of June 28, 2021, Pennsylvania will remove the masking requirements.  The PCA sought clarification directly from the Pennsylvania Department of Health as to whether this lifting of the mask mandate applies to chiropractors and other health care providers.

Following is the response to PCA’s “mask guidance” question from Dr. Wendy E. Braund, COVID-19 Response Director for the PA DOH:

“Even though the statewide mask mandate will be lifted on June 28, DOH will continue to strongly recommend that healthcare providers follow CDC guidance, which includes the use of PPE by healthcare personnel in healthcare settings.”

Wendy E. Braund, MD, MPH, MSEd, FACPM

COVID-19 Response Director

Pennsylvania Department of Health

As of today, the CDC guidance for use of personal protective equipment (PPE), including masks, has remained unchanged.

To access the CDC recommendations, please click on this link:

Get a POSTER for your office to promote HR2654 for Medicare

There is QR code to have patients click the link and then send a message to their Reps in seconds. WANT FULL MEDICARE ACCESS to exams x-rays therapies and to be able to help your Medicare fixed income patients to not have the out of pocket expenses or have to get their x-ray elsewhere? Well this is how you do it! Sample of 1 of 6 versions of the poster is shown, pick the one that "speaks" to you.


Courtesy of Dr. Dennis J. Fitterer, PCA Member and International Chiropractic Association Representative from Pennsylvania.

By Pennsylvania Chiropractic Association | September 13, 2021

International Chiropractors Association Policy on Health Freedom Click Here To Read More

Read More

Doctors Of Chiropractic Often Think That DCs Are Unfairly Targeted By Insurers For Fraud And Abuse.

By Pennsylvania Chiropractic Association | April 12, 2021

Following is an informative and brief advisory (click on the article’s links, for Highmark’s observations and their plan) that demonstrates Highmark is targeting many more health professionals than DCs. HIGHMARK TARGETS HEALTH CARE FRAUD, WASTE, AND ABUSE ( – Sent to PCA courtesy of David J. Cutich, DC PCA Insurance Committee

Read More
Brent Shealer, DC - Pittsburgh, PA 
"I just wanted to chime in quickly and give a  Special shout out to the PCA in this group. Simply put, join! Because of my membership I was recently able to reach out to leadership and get a problem resolved very quickly from the state BPOA when I was getting nowhere with them prior. Also, I've been able to stay on top of a lot of the nonsense that is happening with UPMC/AMI right now among other important issues in changes over the years.  For example, there also working on problems with how terrible Aetna is, meeting with Congressman trying to get equal pay for Chiro's that MD's get paid for the same service (EM codes for example), and still working on the problem with doc's having to direct supervise therapy and rehab.
 I see it said on here often, "does PCA know about this and" or "what is the PCA doing about this" regarding issues. Well, yeah, they do, and frankly for the cost of one adjustment a month ($50)  You can be a member and see your answer to those questions yourself, amongst many other discussion points while being informed. They can't solve every problem, but they do try and work hard on your behalf, member or not. So why not support them? A stronger State association, with more members, carries a lot more weight in matters. Thanks!"
Jeff Snyder, DC - Phoenixville, PA
"The PCA is an absolute for any doctor of chiropractic in the Commonwealth of PA. We know membership is essential in order to have strength in numbers when dealing with issues pertaining to practice and public health issues where we can make a huge impact. The PCA has our back and the backs of the consumer (no pun intended). As a practicing chiropractor, the membership fee is a NO BRAINER! Why would you, as a chiropractor, practice without the largest state association in your back pocket, on speed-dial, so you can manage the issues that come up day to day in practice.
The staff at the home office has never been better. Our executive vice president is cordial, respectful, and a true leader who has years of experience which has helped the association greatly over the past number of years.
I'm thankful for the PCA and what we as an association have accomplished to protect the rights of chiropractors to practice as well as protecting the health of individuals throughout our state."

Ed Kropf, DC - Pittsburgh, PA 

"As a PCA member over 31 years I have been a distant observer of Chiropractic in our state as well as the several factions of philosophy practiced here. As so far as the PCA is viewed, I feel the current system in place is providing the best communication with it's members. PCA has put into place several terrific members and administration that take on the problems from many fronts, report and attempt to correct/improve the position for the future of Chiropractic in our state.

Good job, you all are doing things so very much better, keep it up!!!"

Jeffrey Sklar, DC - Philadelphia, PA 
"In full disclosure, I have been a district director for the PCA for the last 2-3 years. However, I have been a member my entire career. The current leadership of the PCA has more passion and commitment toward protecting all PA chiropractors right to practice and patient accessibility than I have ever experienced. Whether you are a member or not, you have been benefiting from all the efforts of volunteer board members and PCA associates from lobbying to legal.
The level of responsiveness from any direct inquires to the Execs or affiliates(legal, political) has always been unparalleled with Ed Nielson as Executive Director. Whether you are a member or not, you have benefited from battles won by the PCA that may have never crossed your front steps.
The PCA has been a major contributor to my success in practicing in Pennsylvania. I am grateful to serve and more grateful to have such selfless colleagues that freely donate hours and hours of their time for our benefit as Pennsylvania DCs!"
Ladeluca Chiropractic
"The PCA helps chiropractors and I have found they are professional and very reliable. I can call them with specific questions and if they cannot answer then they refer me to the right person."

“I am a retired doctor, who was hit with a $17,000 recoupment request from a Pennsylvania health insurer, TWO years after I retired. As a retired-status member, I immediately contacted the Pennsylvania Chiropractic Association.  PCA’s  staff were responsive and very helpful, including referring me to Mr. Jason Martin, PCA’s General Counsel, for a free legal consultation.

After talking at some length with Mr. Martin, he assisted me with the audit and provided very solid advice. I followed his advice and I was able to resolve the audit with the health insurer without any payment on my part.   I am thrilled with the supportI was given by PCA staff and General Counsel Martin’s legal advice.

Thanks to my membership in PCA, I received very responsive and immediate support for my problem.  Most importantly, my membership in PCA saved me $17,000of my hard-earned money!  Thank you, PCA!”

Lori Kalie, DC - Lancaster, PA 

"I actually sold my practice. About two hours after you posted the ad, I got a call from a doctor who was interested. He officially took over today. I received quite a number of calls about the practice since the ad was up. The service you provide is valuable, and I just wanted to thank you and the PCA for offering this service."

Brian Meenan, DC - Pittsburgh, PA 

"I just started my own practice a couple of months ago. $600 is a bit steep but it is worth it! Charge me monthly, that’d be great."

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