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Texas chiropractors sometimes ask, “What does the Texas Chiropractic Association do?” In the past decade alone, TCA has defended chiropractors’ right to practice, protected their ability to receive reasonable compensation, and ensured that all Texans continue to have access to chiropractic care. Here are just a few of the victories TCA recently have delivered to the chiropractic profession in Texas.
You can diagnose.
In two lawsuits, the Texas Medical Association (TMA) sued the Texas Board of Chiropractic Examiners (TBCE) over TBCE’s rules permitting chiropractors to render a diagnosis. TCA intervened in those lawsuits to defend chiropractors’ ability to diagnose. While one of those suits was still pending in court, TCA spearheaded legislation at the Texas Capitol to cement chiropractors’ ability to diagnose in statute. In 2017, the bill passed both chambers and was signed by Gov. Greg Abbott.
In two lawsuits, the Texas Medical Association (TMA) sued the Texas Board of Chiropractic Examiners (TBCE) over TBCE’s rules permitting chiropractors to render a diagnosis. TCA intervened in those lawsuits to defend chiropractors’ ability to diagnose. While one of those suits was still pending in court, TCA spearheaded legislation at the Texas Capitol to cement chiropractors’ ability to diagnose in statute. In 2017, the bill passed both chambers and was signed by Gov. Greg Abbott.
You can continue to bill insurance.
As a diagnostic code is required to file an insurance claim for chiropractic care, TMA’s effort to eliminate a chiropractors’ ability to diagnose would have jeopardized their ability to file an insurance claim and be reimbursed for their services. Passage of TCA’s legislation clarifying the ability of chiropractors to render a diagnosis ensured chiropractors can continue to diagnose and bill insurers for their services.
As a diagnostic code is required to file an insurance claim for chiropractic care, TMA’s effort to eliminate a chiropractors’ ability to diagnose would have jeopardized their ability to file an insurance claim and be reimbursed for their services. Passage of TCA’s legislation clarifying the ability of chiropractors to render a diagnosis ensured chiropractors can continue to diagnose and bill insurers for their services.
You can practice without an MD/DO referral.
As a diagnosis is required to treat a condition, TMA’s effort to eliminate chiropractors’ ability to diagnose would have required patients to receive a referral from a provider with diagnostic authority prior to the patient receiving chiropractic treatment. Passage of TCA’s legislation clarifying the ability of chiropractors to render a diagnosis ensured chiropractors can continue to diagnose and then treat patients without the need of a referral.
As a diagnosis is required to treat a condition, TMA’s effort to eliminate chiropractors’ ability to diagnose would have required patients to receive a referral from a provider with diagnostic authority prior to the patient receiving chiropractic treatment. Passage of TCA’s legislation clarifying the ability of chiropractors to render a diagnosis ensured chiropractors can continue to diagnose and then treat patients without the need of a referral.
You can diagnose or treat conditions involving the nervous system.
TMA filed a lawsuit challenging TBCE’s definition of the “musculoskeletal system” because it included nerves and TBCE’s definition of the “subluxation complex” as a “neuromusculoskeletal condition.” If successful, TMA’s suit could have prohibited chiropractors from treating conditions with a neurological component, such as sciatica, pinched nerves, and, arguably, low back pain – potentially obliterating the chiropractic profession in Texas. TCA intervened in the lawsuit and appealed it all the way to the Texas Supreme Court, which ruled in 2021 in favor of TBCE’s definitions and thereby saved chiropractic in Texas.
TMA filed a lawsuit challenging TBCE’s definition of the “musculoskeletal system” because it included nerves and TBCE’s definition of the “subluxation complex” as a “neuromusculoskeletal condition.” If successful, TMA’s suit could have prohibited chiropractors from treating conditions with a neurological component, such as sciatica, pinched nerves, and, arguably, low back pain – potentially obliterating the chiropractic profession in Texas. TCA intervened in the lawsuit and appealed it all the way to the Texas Supreme Court, which ruled in 2021 in favor of TBCE’s definitions and thereby saved chiropractic in Texas.
You can practice acupuncture.
During the 2015-16 Sunset Review of the TBCE, a senator proposed, at the request of the Texas Association of Acupuncture and Oriental Medicine (TAAOM), to prohibit chiropractors from performing acupuncture unless they also held a separate license to practice acupuncture. This would have required chiropractors to obtain a masters/doctorate in acupuncture. The proposal initially gathered significant traction, but TCA was ultimately able to defeat it – ensuring chiropractors with the requisite training as defined by TBCE could continue to treat patients using acupuncture within chiropractic. In 2019, HB 3194 would have redefined acupuncture – jeopardizing chiropractors’ ability to use acupuncture within chiropractic. TCA successfully opposed this legislation and it failed to pass. Finally, in 2023, chiropractic prevailed in the TAAOM v. TBCE trial, with TCA stepping in as an intervenor. The District Court of Travis County issued a verdict that affirmed TBCE’s rules permitting chiropractors to use acupuncture as a modality within chiropractic. This ruling staved off the elimination of chiropractic acupuncture and, potentially, dry needling.
During the 2015-16 Sunset Review of the TBCE, a senator proposed, at the request of the Texas Association of Acupuncture and Oriental Medicine (TAAOM), to prohibit chiropractors from performing acupuncture unless they also held a separate license to practice acupuncture. This would have required chiropractors to obtain a masters/doctorate in acupuncture. The proposal initially gathered significant traction, but TCA was ultimately able to defeat it – ensuring chiropractors with the requisite training as defined by TBCE could continue to treat patients using acupuncture within chiropractic. In 2019, HB 3194 would have redefined acupuncture – jeopardizing chiropractors’ ability to use acupuncture within chiropractic. TCA successfully opposed this legislation and it failed to pass. Finally, in 2023, chiropractic prevailed in the TAAOM v. TBCE trial, with TCA stepping in as an intervenor. The District Court of Travis County issued a verdict that affirmed TBCE’s rules permitting chiropractors to use acupuncture as a modality within chiropractic. This ruling staved off the elimination of chiropractic acupuncture and, potentially, dry needling.
You can own and operate a medically integrated practice.
Prior to the passage of SB 679 in 2017, physicians and podiatrists could jointly own and operate business entities together, but chiropractors could not – an unnecessary barrier that discouraged chiropractors from participating in collaborative care models. TCA spearheaded this change via SB 679, which authorized a chiropractor to jointly own and operate a business entity with a physician or podiatrist.
Prior to the passage of SB 679 in 2017, physicians and podiatrists could jointly own and operate business entities together, but chiropractors could not – an unnecessary barrier that discouraged chiropractors from participating in collaborative care models. TCA spearheaded this change via SB 679, which authorized a chiropractor to jointly own and operate a business entity with a physician or podiatrist.
You are not regulated by the Texas Department of Licensing & Regulation, along with plumbers and electricians.
During the 2015-16 Sunset Review of the TBCE, it was proposed to dissolve TBCE (and several other health care licensing boards) and move regulation of chiropractic to the Texas Department of Licensing & Regulation (TDLR), which oversees a variety of non-health care professionals such as plumbers and electricians. Though TDLR is an efficient and well-run agency, TCA was concerned that regulation of chiropractors by laypersons allow TMA to influence limitations on chiropractic care and access. TCA opposed this effort and TBCE continued as a standalone state agency; however, regulation of other professions, like podiatry, were transferred to TDLR.
During the 2015-16 Sunset Review of the TBCE, it was proposed to dissolve TBCE (and several other health care licensing boards) and move regulation of chiropractic to the Texas Department of Licensing & Regulation (TDLR), which oversees a variety of non-health care professionals such as plumbers and electricians. Though TDLR is an efficient and well-run agency, TCA was concerned that regulation of chiropractors by laypersons allow TMA to influence limitations on chiropractic care and access. TCA opposed this effort and TBCE continued as a standalone state agency; however, regulation of other professions, like podiatry, were transferred to TDLR.
Insurance companies cannot lawfully deny insurance claims you submit for covered services, solely because you’re a chiropractor.
TCA learned from its membership that some insurers were paying insurance claims if the treatment was provided by a physician or physical therapist but denying claims for the same treatment if provided by a chiropractor (even though the treatment was within scope and the chiropractor was an in-network provider). In response, TCA championed SB 1739, which prevents insurance companies from refusing to pay chiropractors for in-scope therapies/modalities if the insurer would pay a physician or physical therapist for the same treatment.
TCA learned from its membership that some insurers were paying insurance claims if the treatment was provided by a physician or physical therapist but denying claims for the same treatment if provided by a chiropractor (even though the treatment was within scope and the chiropractor was an in-network provider). In response, TCA championed SB 1739, which prevents insurance companies from refusing to pay chiropractors for in-scope therapies/modalities if the insurer would pay a physician or physical therapist for the same treatment.
You can remove a student-athlete from play if you suspect they sustained a concussion and can serve on a school district’s concussion oversight team.
As initially passed, the law concerning concussions experienced by student-athletes did not allow a chiropractor to remove a student-athlete from play and did not permit a chiropractor to serve on a school district’s concussion oversight team, which establishes a district’s return-to-play protocols. TCA led two successful legislative initiatives: HB 3024, which granted chiropractors serving as team doctors the authority to remove a student-athlete from play for a suspected concussion; and HB 1002, which authorized chiropractors to serve on school district concussion oversight teams.
As initially passed, the law concerning concussions experienced by student-athletes did not allow a chiropractor to remove a student-athlete from play and did not permit a chiropractor to serve on a school district’s concussion oversight team, which establishes a district’s return-to-play protocols. TCA led two successful legislative initiatives: HB 3024, which granted chiropractors serving as team doctors the authority to remove a student-athlete from play for a suspected concussion; and HB 1002, which authorized chiropractors to serve on school district concussion oversight teams.
If you are a Designated Doctor, you are being paid more.
For years, TCA encouraged the Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) to increase compensation for Designated Doctors to protect the program from collapse. Compensation for most Designated Doctor examinations had not been adjusted since 2003 and providers were leaving the program in droves. TCA spearheaded legislation to adjust the Designated Doctor pay scale to account for inflation. Though the legislation didn’t pass, it provided the TDI-DWC encouragement and support to increase compensation on its own. The TDI-DWC recently proposed rules that will result in a substantial pay increase for Designated Doctors.
For years, TCA encouraged the Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) to increase compensation for Designated Doctors to protect the program from collapse. Compensation for most Designated Doctor examinations had not been adjusted since 2003 and providers were leaving the program in droves. TCA spearheaded legislation to adjust the Designated Doctor pay scale to account for inflation. Though the legislation didn’t pass, it provided the TDI-DWC encouragement and support to increase compensation on its own. The TDI-DWC recently proposed rules that will result in a substantial pay increase for Designated Doctors.
If you’re sued for malpractice, a chiropractor can testify on whether what you did caused the alleged injury.
Prior to 2023, in a malpractice lawsuit brought against a chiropractor, only a physician could serve as expert witness on the causal relationship between an alleged injury and alleged departure from the standard of care, although dentists, podiatrists, and physicians could call on colleagues from their respective profession. TCA championed SB 2171 to passage, which enabled a chiropractor to offer testimony on the causal relationship between a claimed injury and alleged departure from the standard of care.
Prior to 2023, in a malpractice lawsuit brought against a chiropractor, only a physician could serve as expert witness on the causal relationship between an alleged injury and alleged departure from the standard of care, although dentists, podiatrists, and physicians could call on colleagues from their respective profession. TCA championed SB 2171 to passage, which enabled a chiropractor to offer testimony on the causal relationship between a claimed injury and alleged departure from the standard of care.
Advocacy is TCA's No. 1 priority and we do this in different ways:
- Chiropractic Development Initiative (CDI): CDI is a long-term commitment to positively affect changes in statute, regulation, as well as government and public perception. CDI directly supports TCA's advocacy, legal and public relations initiatives to advance chiropractic in the Lone Star State.
- Texas Chiropractic Association Political Action Committee (TCA-PAC): works to promote the inclusion of chiropractic and the improvement of Texas patients’ health care by raising funds and contributing to support worthy candidates for state office who have demonstrated their belief in the value of chiropractic and the legislative agenda of the Texas Chiropractic Association.
