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Two recent studies from John Hopkins University (JAMA, Network Open, 1(16):e183044. doi: 10.1001/jamanetworkopen.2018.3044) confirm what consumers have known for sometime here in Oregon. Health insurance companies and payors who control the purse strings in our medical system have dragged their feet paying for chiropractic spinal manipulation, acupuncture and massage therapy. This despite being prohibited by Oregon law passed in 2015 as House Bill 2468 and now found at ORS 743B.505(2)(a-c).

This in the face of multiple national medical reviews and evidence-based guidelines such as the 2017 Guideline from the American College of Physicians recommending these non-drug treatments. Created by a partnership between the State of Oregon, Health Evidence Review Commission and OHSU’s Center for Evidence-based Policy the “State of Oregon Evidence-based Low Back Pain Management Guidelines,” recommend chiropractic spinal manipulation, acupuncture and massage therapy as first-line non-pharmacologic treatments for low back pain.

More recently the authors of the widely cited 2018 Lancet Medical Journal series on low back pain also recommend moving away from overuse of imaging (e.g. X-rays, MRIs), rest, opioids, spinal injections, and surgery and toward these non-drug treatments. The Centers for Disease Control and Prevention (CDC) as well as the US Department of Health and Human Services (HHS) “US National Pain Strategy” promote these same non-drug treatments.

By hindering the evidence-based treatments of chiropractic spinal manipulation, acupuncture, and massage therapy, Oregon health insurers are both exacerbating our opioid epidemic as well as violating Oregon law.

Vern Saboe, Jr., DC FACO

Albany (Jan. 6)

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