Falls Church, VA:  September 22, 2025 – President Donald J. Trump was joined by Secretary of Health Kennedy and four leading HHS medical experts – the NIH Director, the CMS Administrator, the FDA Commissioner, and the Acting Assistant Secretary of Health.  The thrust of the extended press conference was that the epidemic increase in autism rates is not due to better diagnostics, nor an expanded definition, but rather is artificially induced. 

Secretary of Health, Robert F. Kennedy, Jr. announced that an all agency approach has been implemented, to gather the data from all sources of known and suspected causal factors in autism, as well as solutions.  The first evidence-based confirmed cause was announced (Acetaminophen) as well as the evidence-based solution (leucovorin) to be officially approved for autism.

President Trump started the press event by sharing that he has been concerned about the causes of autism since first meeting Secretary Kennedy some 20 years ago.  The President reiterated at least three times during the event his own opinions, calling for parents to spread their shots out, to split the Measles, Mumps, and Rubella vaccines back up into single disease shots – citing his understanding this would reduce risks.  He also suggested that the Hepatis B vaccine should be delayed to 12 years of age because there is typically no reason to give an infant a vaccine for a sexually transmitted disease.  He also reiterated that pregnant women should avoid acetaminophen during pregnancy and that infants should also not be given acetaminophen.  President Trump stated that ending the autism epidemic during his administration is as important to him as ending the 7 wars he has helped end.  He recounted knowing several mothers of children who developed autism after their vaccines.  The President was not speaking out against vaccines, he was speaking about giving one vaccine at a time.  For families who heed the suggestion, there will be a delay and cooperation required by CDC to order these shots from the manufacturers who stopped making single antigen vaccines 25 years ago when this was initially suggested.   

Secretary Kennedy promised the American public that the agency was going to do a deep dive into existing data from all available sources and will make public what is known about all the potential causes of autism spectrum disorders. 

The last Autism and Developmental Disabilities Monitoring (ADDM) Network study conducted through the Centers for Disease Control and Prevention (CDC) has provided that among 8-year-olds in the United States, 1 in 31 are on the Autism Spectrum. Boys are three times more likely to be diagnosed on the spectrum than girls.   A cooperative effort with the Directors of NIH, FDA, and the CMS Administrator has been  evaluating existing data, peer reviewed information, and consultation with experts and parents.  The promise has been radical transparency and an accelerated sharing of information with the public.

Dorothy Fink, MD, Acting Assistant Secretary for Health and a women’s health scholar, noted the evidence is substantial to caution women not to take acetaminophen during pregnancy unless unavoidable, and if absolutely necessary to take as low a dose as possible for as short a duration as feasible.

FDA Commissioner, Dr. Marty Makary announced the agency has initiated the process for a label  change.  Given that evidence in recent years has suggested a correlation between acetaminophen use during pregnancy and subsequent diagnosis of conditions like autism and ADHD. Multiple large-scale cohort studies, including the Nurses’ Health Study II and the Boston Birth Cohort, find this association. Some studies have described that the risk may be most pronounced when acetaminophen is taken chronically throughout pregnancy.  FDA also reminded the public that aspirin and ibuprofen have well-documented adverse impacts on the fetus when taken by women during pregnancy.

NIH Director Jay Bhattacharya, M.D., Ph.D. announced the National Institutes of Health has launched the Autism Data Science Initiative (ADSI), a landmark research effort that will harness large-scale data resources to explore contributors to the causes and rising prevalence of autism spectrum disorder. More than $50 million in awards will support 13 pioneering projects that draw on genomic, epigenomic, metabolomic, proteomic, clinical, behavioral and autism services data. These projects will integrate, aggregate and analyze existing data resources, generate targeted new data and validate findings through independent replication hubs.  He stated, “By bringing together genetics, biology, and environmental exposures, we are opening the door to breakthroughs that will deepen our understanding of autism and improve lives.” 

A key feature of ADSI is the use of exposomics—the comprehensive study of environmental, medical, and lifestyle factors in combination with genetics and biology. Projects will investigate a wide range of influences, including environmental contaminants such as pesticides and air pollutants, maternal nutrition and diet, perinatal complications, psychosocial stress, and immune responses during pregnancy and early development.

Addressing Vertebral Subluxations in Autism Population:  Many families turn to doctors of chiropractic to help pick up the pieces when their child develops autism. ICA firmly believes that our chiropractors – those focused on identifying and eliminating vertebral subluxations are integral partners of the solution to this epidemic of suffering.

ICA Executive Director, Beth Clay, who formerly served as staff-lead on the Congressional investigation that identified the epidemic increase in autism stated, “Autism is a complex multifactorial condition with a spectrum of intensity.  The children on the front end of the epidemic, injured in the late 1980s are now middle-aged adults. It is imperative that the NIH include individuals of all ages and all levels of severity in their studies.  Autism is a chronic health condition that is unique to each individual and requires a comprehensive team effort of health care professionals working together. Regular evaluation for subluxations and chiropractic adjustments should become an integral component of a personalized, whole person, evidence-informed care protocol to be studied in real time for clinical benefit and daily quality of life improvement.”   

Dr. Joe Betz, ICA President stated, “The best available research on the topic has demonstrated an association between environmental factors, including acetaminophen use during pregnancy, and the development of autism and other neurodevelopmental disorders. It’s time for the American health care system to incorporate natural health care options including chiropractic care as the first approach and avoid the use of dangerous drugs.”

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ICA’s Essential Elements Required of Any Medicare Legislation

1. Maintain the current mandate for coverage of the adjustment to correct a subluxation.
2. Preserve Subluxation reference in definition.
3. Remove the restrictive language used to limit reimbursements to the adjustment “only.”
4. Ensure that x-ray imaging and exams are covered services.
5. Maintain economic neutrality by removing barriers to reimbursements for existing covered services only.
6. Establish equitability in reimbursement rates to other physician level providers.
7. Eliminate discrimination that denies patients of chiropractic physicians the ability to privately contract and chiropractors to Opt-out of the Medicare system if they so choose.

ICA legislative experts all agree that  any Medicare legislation should be clear and give CMS specific instruction with deadlines for implementation. History has proven that Congress must provide specific instructions on coverage and deadlines for implementation, or the legislative goals will not be met. When a Medicare  bill is signed into law do you really want to wait 3 to 5 years for CMS to study the matter and publish a proposed rule and then another year or two for that proposed rule to be finalized?  Do you really trust Medicare to get it right on what should and should not be reimbursed?  That is exactly what is likely to happen if 1610/799 become law.

In the 117^th Congress the ICA Endorsed HR 8701 the Chiropractic Act of 2022. With the 118^th Congressional session, we are working to see an improved version of that bill introduced. We believe our approach is one that gets everything accomplished that the Chiropractic community is seeking and does so with surety and a timeline.  We know the bill, if signed into law will immediately benefit the Medicare Beneficiaries who have paid into the program for decades. Our bill will not increase costs, and principled chiropractors across the country who desire to take care of seniors and people with disabilities who rely on Medicare for their healthcare will agree with this approach.   Below is a chart that compares the two bills.  A year into the legislative cycle, we want to update the community.  We are not ‘going negative’ on the legislation we are not endorsing, rather we are informing the chiropractic community and legislators about our position and to offer facts on both legislative approaches so that we can all work toward the common goal of fixing the issues in Medicare fairly and with certainty. 

Compare and Contrast the Two Chiropractic-Medicare Bills

What are the Differences between HR 1610 and the revised Chiropractic Act?

ICA –Standing Firm on our Principles of  Protecting and Promoting Chiropractic.

• strengthened guidance on best practice and evidence-based care;

• detailed proper informed consent;

• clarified practice that is within a chiropractor’s skills, competence and expertise;

• and discussed advertising that is in accordance with the National Law; communication; and good practice with vulnerable communities, including children and young people.

ICA notes that the Board noted that no actual reports of harm were received by the Board in children. The systematic review of the literature for the pediatric population that was replicated in 2022 returned similar outcomes to the 2019 study, which is that the available published studies included in the review were ‘consistent in finding that it is difficult to draw conclusions on safety and effectiveness.’

ICA is pleased that the strong voices of both science and the public were heard in Australia and that children once again will be able to receive regular chiropractic care.

One important next step in the global chiropractic community is to develop a pediatric research agenda in regular chiropractic care to add to the evidence base. The ICA looks forward to working with our colleagues in the global research community on this important topic.

To read the full statement from the Board – please click here. https://www.chiropracticboard.gov.au/Codes-guidelines/Position-statements/Statement-of-Paediatric-care.aspx

ICA Endorsed Medicare Legislation Introduced

August 12, 2022 (Falls Church, VA) Today, Congressman Bill Posey of Florida introduced H.R. 8701: The Chiropractic Act of 2022. The International Chiropractors Association (ICA) is proud to endorse this legislation. The entire U.S-based chiropractic profession has asked for years to improve Medicare. H.R. 8701 provides the needed solutions. This legislation can be quickly passed into law. It provides clear instructions for standards of care evaluation and management services (exams and radiological imaging, when needed).

Three years ago, in passing SUPPORT for the Patients and Communities Act of 2018 (Public Law 115-271), Congress confirmed the need to make changes in Medicare to remove barriers to non-opioid, non-pharmacologic alternatives for both acute and chronic pain. The Center for Medicare and Medicare Services (CMS) responded to remind them that they cannot make these needed fixes for accessing chiropractic without Congressional action. Medicare beneficiaries deserve legislation that can be enacted upon passage, which is what can happen with H.R. 8701. While chiropractic does more than address back and neck pain, it is a first line of care for these symptoms, and experts say that if chiropractic is the first line of care for low back pain, the patient is at least 50% less likely to end up with an opioid prescription. Chiropractic focuses on resolving issues, not simply suppressing the symptom of pain.

The Chiropractic Act of 2022

1. Provides specific instructions to CMS to cover what is standard of care – evaluation and management services – specifically including examination and when needed radiographic imaging services, while specifically excluding any expansion of scope for the prescribing of drugs – an important clarification that the Congress agrees with a majority of the chiropractic profession.
2. Streamlines provisions regarding a patient’s freedom to privately contract for services so that all physicians as defined in Medicare (which includes chiropractors) are able to privately contract. This is commonly referred to as the Opt-Out Provision. Chiropractors are the only physicians currently not included in this provision.
3. Eliminates the vestiges of the antitrust discrimination against chiropractors that were at play in 1972 when chiropractic was included in Medicare.
4. This bill provides swift implementation so that Medicare beneficiaries may benefit from the changes as quickly as possible.

Dr. Selina Sigafoose Jackson, ICA President, said, “Today is a day that will go down in the chiropractic history record books. Decades of work from so many ICA warriors, have culminated in H.R 8701. So proud of our Board, past and present, and the entire ICA team to have achieved this bill’s introduction. Now my friends, let’s roll up our sleeves, and get to work and get this passed. The time is now for Medicare patients to be respected through this legislation, to be able to choose chiropractic and to be reimbursed fairly.”

Beth Clay, ICA Executive Director, said, “The ICA appreciates Congressman Bill Posey’s introduction of H.R. 8701, the Chiropractic Act of 2022. This bill is the solution to the barriers to access for Medicare beneficiaries who desire to seek chiropractic care and to be treated equitably in the program they have paid into for decades. We look forward to building support for it quickly and seeing it signed into law.”

To learn more about how you can support this legislation and to read the bill, visit https://www.chiropactic.org.

H.R. 8701 The Chiropractic Act of 2022

January 21, 2022 (Falls Church, VA) Today, Federal Judge Jeffrey Brown issued an order that blocks the enforcement of a COVID Vaccine Mandate on federal employees. Judge Brown had issued an opinion in September indicated that President Biden had exceeded his authority related when issuing an Executive Order that required federal employees consent to vaccination against COVID-19 or lose their jobs. This injunction summarizes the question at hand:

“The court notes at the outset that this case is not about whether folks should get vaccinated against COVID-19…It is instead about whether the President can, with the stroke of a pen and without the input of Congress, require millions of federal employees to undergo a medical procedure as a condition of their employment. That, under the current state of the law as just recently expressed by the Supreme Court, is a bridge too far…”

This is an example of the the branches of government providing the intended checks and balances envisioned by the Founding Fathers and embodied in the US Constitution.

January 13, 2022 3:00 pm (Falls Church, VA) Mid-afternoon today, the Supreme Court blocked the Biden Administration’s vaccine and testing mandate for large employers, while allowing a separate vaccination mandate for employees for healthcare facilities that receive Medicare and Medicaid funding.

The first ruling official statement in the docket is: Nat. Fed’n of Indep. Bus. v. Dept. of Labor (21A244) and
Ohio v. Dept. of Labor (21A247) consolidated

The applications for stays (21A244 & 21A247) presented to JUSTICE KAVANAUGH and by him referred to the Court are granted. OSHA’s COVID–19 Vaccination and Testing; Emergency Temporary Standard, 86 Fed. Reg. 61402, is stayed pending disposition of the applicants’ petitions for review in the United States Court of Appeals for the Sixth Circuit and disposition of the applicants’ petitions for writs of certiorari, if such writs are timely sought. Should the petitions for writs of certiorari be denied, this order shall terminate automatically. In the event the petitions for writs of certiorari are granted, the order shall terminate upon the sending down of the judgment of this Court. VIDED.

The second official statement in the docket is: Biden v. Missouri (21A240) and Becerra v. Louisiana (21A241) consolidated

The applications for stay presented to JUSTICE ALITO (21A241) and JUSTICE KAVANAUGH (21A240) and by them referred to the Court are granted. The District Court for the Eastern District of Missouri’s November 29, 2021, order granting a preliminary injunction is stayed pending disposition of the Government’s appeal in the United States Court of Appeals for the Eighth Circuit and the disposition of the Government’s petition for a writ of certiorari, if such writ is timely sought. Should the petition for a writ of certiorari be denied, this order shall terminate automatically. In the event the petition for a writ of certiorari is granted, the order shall terminate upon the sending down of the judgment of this Court. The District Court for the Western District of Louisiana’s November 30, 2021, order granting a preliminary injunction is stayed pending disposition of the Government’s appeal in the United States Court of Appeals for the Fifth Circuit and the disposition of the Government’s petition for a writ of certiorari, if such writ is timely sought. Should the petition for a writ of certiorari be denied, this order shall terminate automatically. In the event the petition for a writ of certiorari is granted, the order shall terminate upon the sending down of the judgment of this Court. VIDED.

Stay tuned for updates.

“The court ordered that OSHA ‘take no steps to implement or enforce’ the ETS [Emergency Temporary Standard] ‘until further court order.’ While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation,” OSHA said. While the agency and the administration maintain they believe they have the authority, the courts extensive response to the court case spells out a very different view.

In a 22-page ruling last week, the 5th U.S. Circuit Court of Appeals wrote that the administration’s COVID-19 vaccine and testing mandate was “fatally flawed” and ordered that OSHA not enforce the requirement “pending adequate judicial review” of a motion for a permanent injunction.

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CMS is clear – this interim final rule does not apply to other health care entities such as ‘physician’ office, only to the providers and suppliers listed below.

This is an extensive document (over 200 pages). You can read it here in its unofficial posting

https://public-inspection.federalregister.gov/2021-23831.pdf

The ICA will be reviewing and providing comments to CMS. We had previously notified membership through a press release of September 13 which provided:

Updated September 13 at 3:30 pm: CMS provided the following information on background regarding clarification on the mandate rule:

“This regulation does not directly apply to physician’s offices as these are not regulated under the provider-specific Medicare health and safety regulatory provisions, generally referred to as “Conditions of Participation.”

Given that Doctors of Chiropractic are ‘physicians’ in Medicare, this mandate as currently issued, will not apply to chiropractors in private practice. ICA will keep you posted if this changes.

Updated September 13 at 1:10 pm: Official Statement from CMS Spokesperson on background, “

On background and attributable to CMS spokesperson:

CMS anticipates that the staff vaccination requirement would apply to Medicare and Medicaid-certified provider and supplier types that comply with the Medicare health and safety regulatory provisions, known as the Conditions of Participation, which includes, but is not limited to, hospitals, dialysis facilities, ambulatory surgical centers, and home health agencies.”

It would appear the spokesperson was accurate on September 13.

The List of providers and Suppliers included in this interim final rule.

● Ambulatory Surgical Centers (ASCs) (§ 416.51)

● Hospices (§ 418.60)

● Psychiatric residential treatment facilities (PRTFs) (§ 441.151)

● Programs of All-Inclusive Care for the Elderly (PACE) (§ 460.74)

● Hospitals (acute care hospitals, psychiatric hospitals, hospital swing beds, long term

care hospitals, children’s hospitals, transplant centers, cancer hospitals, and rehabilitation

hospitals/inpatient rehabilitation facilities) (§ 482.42)

● Long Term Care (LTC) Facilities, including Skilled Nursing Facilities (SNFs) and

Nursing Facilities (NFs), generally referred to as nursing homes (§ 483.80)

● Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID) (§ 483.430)

● Home Health Agencies (HHAs) (§ 484.70)

● Comprehensive Outpatient Rehabilitation Facilities (CORFs) (§§ 485.58 and 485.70)

● Critical Access Hospitals (CAHs) (§ 485.640)

● Clinics, rehabilitation agencies, and public health agencies as providers of outpatient

physical therapy and speech-language pathology services (§ 485.725)

● Community Mental Health Centers (CMHCs) (§ 485.904)

● Home Infusion Therapy (HIT) suppliers (§ 486.525)

● Rural Health Clinics (RHCs)/Federally Qualified Health Centers (FQHCs) (§ 491.8)

● End-Stage Renal Disease (ESRD) Facilities (§ 494.30)

If you are not employed in one of these facilities and thus you are not effected.

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Updated Friday morning 8:00 am – Overnight CMS issued the formal announcement with a press release. The link is available here: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care

FAQ link: https://www.cms.gov/files/document/cms-omnibus-staff-vax-requirements-2021.pdf

Midway through the FAQ page it again reiterates this rule – this vaccine mandate- does not apply to “physician officers” (Doctors of Chiropractic are categorized as physicians in Medicare) – so you and your staff if not in one of the named facilities are not subject to this mandate.

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The OIG states: Under the Proposed Arrangement: Requestor would permit all patients, including Federal health care program beneficiaries, to utilize any offered discounts on the same terms. Any such discounts would be offered and advertised to the general public and not targeted to Federal health care program beneficiaries. Consistent with its current practice, under the Proposed Arrangement, Requestor would offer various discount promotions throughout the year, each of which would be limited in supply, expire on a specified date, or both. Requestor does not and would not notify patients of any discount offers while patients are at a clinic; in other words, patients already must be aware of a
discount offer and must affirmatively ask for the discount when they present for an appointment. Requestor charges its standard rates to patients who do not request a discount.

It was noted, “The chiropractors are enrolled as non-participating providers with Medicare.” and that “Requestor certified that, when billing Medicare beneficiaries, it adheres to the Medicare Physician Fee Schedule, which sets limiting charges for covered services.”

Through the ruling, it was obvious there was some back and forth between the OIG and the Clinic in order to be entirely accurate in the information they were evaluating.

The OIG Issued Opinion Stated, “Based on the relevant facts certified in your request for an advisory opinion and supplemental submissions, we conclude that: (i) although the Proposed Arrangement, if undertaken, would
generate prohibited remuneration under the Federal anti-kickback statute if the requisite intent were present, the OIG would not impose administrative sanctions on Requestor in connection with the Proposed Arrangement under sections 1128A(a)(7) or 1128(b)(7) of the Act, as those sections relate to the commission of acts described in the Federal anti-kickback statute; and (ii) although the Proposed Arrangement, if undertaken, would generate prohibited remuneration
under the Beneficiary Inducements CMP, the OIG would not impose administrative sanctions on Requestor in connection with the Proposed Arrangement under the Beneficiary Inducements CMP or section 1128(b)(7) of the Act, as that section relates to the commission of acts described in the Beneficiary Inducements CMP.

CAUTION: This does not mean you are clear to use discounts with Federal beneficiaries.

The OIG in the ruling that this is not a ruling that applies across the board. This opinion ONLY applies to the requestor, not to all chiropractors. Remember the law referenced carry both criminal and monetary penalties, so caution is warranted. This is good news though, on many levels. The most important of which is that what one has done, others may also do.

A RoadMap Now Exists: The great news is that now a roadmap exists for you if you desire to seek a similar advisory opinion, your attorney is not starting from scratch.

Thank you to the “Unnamed Clinic Owner” for blazing this trail!

While the ICA reported last year finding an active duty military officer who is a doctor of chiropractic, his duties within the military were not related to delivering chiropractic care. There are over 1.4 milllion active duty military personnel and over 330 reserve military personnel relying on the military health system for care. That symstem, currently has less than 100 chiropractors delivering chiropractic care at military facilities. These doctors are not active duty military members. They are either hired as civilian employees or as contractors. The mission of the military health system also includes that they are to provide medical benefit commensurate with the service and sacrifice of more than 9.6 million active duty personnel, military retirees and their families.

Chairman of the Senate Armed Services Committee, Jack Reed (D-RI) and Ranking Member Jim Inhoff (R-OK) and members of the committee have now directed the Secretary of Defense to brief both the Senate and House Armed Services Committee by March 1, 2022 on their assessment of the feasibility of using the Department’s statutory authority to commission chiropractors as military officers. The Committee instructed the Secretary to include in the assessment the following:

1. Any combatant commander requirements for chiropractors as part of operating or generating forces;
2. The potential role of military chiropractors in deployed medical units;
3. The conditions under which the Department would deem military chiropractors as a critical wartime medical
   specialty; and
4. Any recommendations, as may be required, for the committees to clarify related authorities or adjust end-
   strength allowances for the commissioning of chiropractors as military officers.

ICA Executive Director, Beth Clay explained, “The Senate and House include requests such as this in the report that accompanies the appropriations bill, because there are strict limits on what will be included in the actual bill. The accompanying report provide the details. It is in these reports that legislators will offer official praise and consternation, and in this instance, instructions for actions to be taken which includes a report back to the Committee in a relatively short period of time (six months).” `

We have many supporters on Capitol Hill. We feel it is important to say thank you when they take action that will advance the profession. A link to our letter is provided below.