At the end of August, the ChiroCongress Medicare Advisory Group (MAG) became
aware of a recent multijurisdictional meeting Noridian hosted on the LCD related to
cervical fusion. A set of questions were presented to a panel for discussion.

Unfortunately, chiropractic representation was not included in the panel of experts, nor
was chiropractic care mentioned as a conservative approach to cervical spinal care to
prevent spinal fusions.

As part of ChiroCongresses mission to empower our state associations, the ChiroCongress
Medicare Advisory Group (MAG) provided the Contractor Advisory Committee (CAC) members
with optional template language they could use as their official response to their respective
Medicare Administrative Contractors (MACs) during the open comment period.

Here is the template language provided to the CACs:

I am writing to provide official comments and provide feedback on the recent
national LCD meeting concerning cervical fusion. I represent our chiropractors,
and we wish to express our concerns regarding our absence from the panel of
experts. It came to our attention that a significant portion of the meeting was
dedicated to discussing conservative alternatives to cervical fusion.

We believe it was an oversight and a missed opportunity that chiropractic
treatment, which has been supported by numerous studies as an effective and
cost-efficient conservative treatment option, was not discussed. We respectfully
request the opportunity to submit our research and to be actively involved in
future discussions and planning sessions. Excluding chiropractic options from
any published conservative treatment alternatives would not only be a disservice
to chiropractic beneficiaries but also a strategic and fiscal oversight on the part of
CMS. We urge you to consider chiropractic feedback for any conservative
treatment options that may be incorporated into this LCD.

Our national leaders are in the process of preparing for you the currently
compiled research that underscores the significance of chiropractic as a vital
conservative treatment option. We are planning to submit this compilation to you
as soon as it is available.

Thank you for your attention to this matter. We look forward to a collaborative
approach in the future!

If you have any questions, please email