Federal auditors assail $359 million in Medicare costs for chiropractic care

spinal cordFederal auditors have found that 80 percent of Medicare spending in a recent year on chiropractic care−some $359 million−was medically unnecessary. The federal insurance program for senior citizens should not have thrown taxpayer dollars at chiropractors to treat strains, sprains, or joint conditions, the Department of Health and Human Services’ Office of Inspector General says.

Its auditors, reporting on 2013 claims, said Medicare should impose limits on how often seniors can receive chiropractic care, which they said became excessive after a dozen visits; after 30 sessions of treatment, the federal watchdogs said, patients were receiving unnecessary care.

The chiropractors’ association denounced the audit and the proposed curbs on their practitioners’ care. The acting director of the Centers for Medicare and Medicaid Services resisted the recommendations for caps on chiropractic treatment, noting the absence of cited evidence and differences in individual patients. The agency noted that it has tightened its rules on chiropractic claims, including requirements soon to take force that will require advance approval for certain kinds of this care.

Setting aside placebo effects, and the strong likelihood that just a good massage might make patients with sprains and strains feel better, the core question of whether chiropractic care is a scientific, valid treatment remains controversial.

I’ve written about the bunkum of homeopathy and naturopathy, and chiropractic claims about “benefits” from “spinal manipulation” may fit into a 2016 curiosity closet of types of care that persist in the face of fact-based science and research evidence. (A former naturopath, by the way, is getting attention for ripping her onetime chosen field as a “terrifying” fraud in which practitioners’ chief motivator is money.)

That said, I also know from my work on malpractice lawsuits that chiropractors can harm patients, for example, manipulating their necks to cause strokes. Such risks, along with the thought of Uncle Sam shelling out for chiropractic care the equivalent of 70 times what the nation will devote this year to help get youths off the streets in the nation’s capital ($5 million), gives me a pain in an area of the low back.

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