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LEGISLATION ELIMINATING MANDATORY CHIROPRATIC X-RAYS UNDER MEDICARE SUBMITTED.

The American Chiropractic Association (ACA) announced on February 25, 1997, that US Representative, Phil Crane (R-Illinois) ahs agreed to introduce stand-alone legislation to abolish the mandatory X-ray requirement under Medicare law. According to the ACA, Crane is the senior-ranking Republican member of the full House Ways and Means Committee, one of the key committees that has jurisdiction over Medicare in the U.S. House of Representatives. ACA also notes that Crane's proposal is identical to the language contained in President Clinton's fiscal year 1998 budget recommended to Congress. ACA expects the Crane bill to be formally introduced late this week or the beginning of next week. Consequently, ACA is urging all state associations to commence an aggressive grassroots lobbying effort of Congress on this issue. Specifically, in this regard, ACA suggest that:

· This activity should begin as soon as possible once a formal bill number has been assigned to the Crane legislation;

· This support should include letters from doctors and patients, faxes and telephone calls relating to this issue. These contacts should be generated in large quantities for maximum impact;

· Where possible, state association representatives should make personal visits to the district and/or Washington, DC offices of their members of Congress to lobby on this issue;

· Lobbying activities should commence immediately and be sustained through April 1997 or until the ACA advises otherwise;

· Efforts should be targeted at members serving on the House Ways and means Committee; the House Commerce Committee; and the Senate Finance Committee;

· Members not on the foregoing committees should be encouraged to cosponsor the Crane bill and to contact their colleagues in the U.S. Legislature urging them to retain the Crane/Clinton provision in any Medicare Legislation relating tot he federal budget that is expected to move through these committees;

· Health and safety issues relating tot he elimination of unnecessary x-rays should be heavily stressed as part of any lobbying effort. Specifically,

· While X-rays are useful in making an appropriate diagnosis, x-rays are not required, clinically necessary or justified in each and every case;

· The Food and Drug Administration (FDA) has determined that mandatory x-rays in situations analogous to Medicare, "are usually the sources of unnecessary radiation exposure tot he patient" and should not be required unless "such examinations are a direct clinical benefit to the patient." (FDA, Chapter I, Subchapter J, Part 1000, Subpart C. Radiation Protection Recommendations, 21CFR 100.60);

· This requirement is contrary to the intent and purpose of the Radiation Control for Health and Safety Act of 1968;

· In a letter to Members of Congress, DHHS Secretary Donna Shalala stated that, "We also believe the statutory requirement may no longer be appropriate and could expose beneficiaries to unnecessary x-rays";

· In addition to the radiological health care concerns above, the mandatory x-ray requirement should be abolished on the basis that it is an arbitrary barrier to chiropractic care under Medicare;

· Any commitments to co-sponsor the Crane bill, or other "significant intelligence" that develops as a result of a lobbying effort should be transmitted to the ACA.

Anyone who wants additional information is encouraged to contact the ACA Department of Government Relations at (703) 276-8800.

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