Michigan governor signs expanded scope law
Michigan Gov. Jennifer Granholm signed into law an expanded chiropractic scope of practice bill
Earlier this month, Michigan Governor Jennifer Granholm signed legislation that will restore Michigan’s chiropractic scope of practice to the level enjoyed by chiropractic patients prior to the rewrite of the Public Health Code in the late 1970s. The bills passed the legislature with strong bipartisan support.
The bill authorizes the treatment of “misalignments that cause nerve interference or joint dysfunction,” rather than just the “misalignments of the human spine” currently within the scope of practice. The bill also allows the use of “imaging technology” in addition to X-rays by chiropractors.
“This is a great victory for Michigan patients and health care consumers,” said Don Reno, DC, president of the Michigan Association of Chiropractors (MAC). “Increased access to chiropractic care will help lower skyrocketing health care costs while increasing patient choice. Under our old scope, chiropractors across Michigan have had one hand tied behind their backs, and it’s the patients who suffered, because they were not allowed to receive the full range of chiropractic services. This is a giant step forward.”
However, a provision in another bill signed by the Governor at the same time established that health insurance policies would not have to cover services authorized under any easing of the scope of practice restrictions for chiropractors, beyond what was allowed under the licensure law as of Jan. 1, 2009.
According to MAC, Michigan had the most restrictive chiropractic scope of practice in the nation. The new bills bring Michigan into line with the vast majority of other states, including all of the neighboring Great Lakes states, in which doctors of chiropractic are currently allowed to perform the services outlined in the bills.
The MAC press release also noted that Michigan’s old scope had a negative impact on the economy, “driving some DCs out of the state entirely and discouraging newly graduated doctors from moving in. More importantly, it caused some patients to take their health care dollars to Ohio, Indiana and Wisconsin in order to receive the full benefits of chiropractic treatment.”
James Gregg, DC, chairman of the MAC government relations committee stated: “The previous scope completely ignored not only the scientific and educational foundation of chiropractic care, but also the economic impact that a restricted scope has on the state of Michigan. With Michigan in dire financial straits, every opportunity to boost our economy and curb costs must be explored. Chiropractic care can be an essential element to a streamlined and more efficient health care system.”
The MAC issued a warning noting that while the new scope is law, it “strongly recommends all Michigan DCs refrain from performing any of the new services outlined in the new practice act. The language of the Act gives rule making authority regarding these new services to the Michigan Department of Community Health (MDCH), working in conjunction with the Michigan Board of Chiropractic, to determine exactly which testing procedures and other services are allowed under the bills. It is strongly suggested that all DCs refrain from performing any of the new services until it is better known how the MDCH will proceed.”
Dr. Christophe Dean, MAC public relations committee chairman added: “For more than 30 years, chiropractors in Michigan have tried to get our antiquated scope law brought into the current century. Each time we went to the legislature as two combating state associations, the politicians would say, ‘Don’t make us decide between your two organizations. Come to us with a single position!’
“When we did unify, it took us only three years to pass a good law; even going up against a strong alliance of the Big Three auto makers, the big insurance industry and the Michigan medical profession. Michigan chiropractors had a powerful legislative partner. Over 9,000 patients contacted their legislator to support this bill,” Dr. Dean emphasized.
“The former two Michigan associations spent nearly 30 years attempting to pass legislation, said Dr. Tom Klapp, chairman of legal affairs.”To the doctors in our profession who still believe we are stronger when we are divided, we offer Michigan as a successful example of what unification can do for the chiropractic profession. In our three short years of existence, we have made a monumental stride for DCs in our state. Fear is what kept us divided. Respect and tolerance for each other is what united us.”
The bills, Senate Bill 968 and House Bill 5091, were signed into law on Jan. 5, 2010.