ICA CEO, Dr Edwin Cordero stated: “I want to be clear—what’s happening in Montana is exactly why Dr. B.J. Palmer founded the ICA and charged us with guarding the Sacred Trust. This fight was a warning shot—and we all know it won’t be the last. But let me assure you, the ICA will always rise to the occasion and stand firm for principled chiropractic, just as we’ve done throughout this entire legislative battle in Montana.”

Background: Chiropractic legislator Greg Oblander first introduced HB 500 and then HB 929 when the Montana Legislative session opened in January for its 90-day session. The process of introducing and seeing it signed into the law by the Governor has many steps; and as we learned in Montana a bill that has been voted down in committee can be resurrected and a bill that is tabled in committee can be ‘blasted’ to the floor.

The ICA was ‘boots on the ground’ in Montana with Board Member, Dr. Hugo Michael Gibson and Assembly Representative Dr. Donald Gibson both attending and testifying at the State Board meeting the House hearing, and the Senate. Additional ICA doctors in Montana also testified.  They were backed up with the ICA home office, most specifically our CEO and Executive Director.  ICA’s CEO, Dr. Edwin Cordero provided testimony via zoom and the ICA submitted extensive written testimony to both the House and Senate. We did significant outreach first in the House and then in the Senate.  While the legislature does not meet again until 2027, ICA will continue our engagement in Montana. 

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April 11, 2025 (Falls Church, VA) Today, ICA leadership is all hands on deck primed to testify in person and online in opposition to HB 929, the draconian bill introduced by Representative (Dr.) Oblander to expand the scope of practice to include drug prescribing authorities. ICA”s CEO, Dr. Edwin Cordero will testify online while ICA Board Secretary, Dr. Hugo Michael Gibson, a Montana resident, will testify in person.

ICA’s testimony is attached to Dr. Cordero’s opening commments.

Dr. Edwin Corder, “Just Say No to HB 929!”

Falls Church, Virginia, March 31, 2025: The International Chiropractors Association is reaching out to legislators in Montana again to request they reject legislation that moves the chiropractic scope of practice into the realm of medicine. Since its inception, the profession has been focused on the identification and elimination of vertebral subluxations and allowing the body’s own innate healing process to function optimally. All but a tiny fringe element of the profession desire to keep chiropractic a non-prescribing profession. Montana health professionals and their patients would be better served by expanding the opportunity of Telehealth and professional collaboration in real time between chiropractors and medical doctors rather than expanding the scope of chiropractic to include drug prescribing. The path Representative Oblander is now making with his controversial legislation in a third attempt to expand chiropractic into the medical profession would create an increased risk to public safety through inadequately trained individuals prescribing drugs.

The ICA is concerned that the very language of the bill, most specifically provision lines 18-19 of page one, “ WHEREAS, there is widespread support from many health care providers in Montana to allow for doctors of chiropractic to have prescriptive authority;” has misrepresented the facts. It is our understanding that there is significant opposition by both the medical and pharmacy associations in Montana to this bill. (See Attached Fact Sheet) Further, the American Medical Association has an ongoing ‘Scope Creep’ initiative raising concerns nationwide about attempts to broaden other health professionals into the medical doctor scope.

Drug prescribing is not a simple ‘add on’ technique training. Drug prescribing is a key component of medical education throughout all the years of education and residency. It is not something that can or should be taught as a series of weekend seminars.

ICA’s new CEO, Dr. Edwin Cordero stated, “Please oppose House Bill 929. Three college presidents have previously submitted letters explaining the scope expansion into prescribing should be opposed. I would concur. As a former chiropractic college president, chiropractors graduate with the knowledge and skills to evaluate and correct subluxations; to offer health promoting lifestyle advise. They do not graduate with the training to become drug prescribers. The proficiency exams do not include evaluation of knowledge and skills on drug prescribing.”

A century ago, the ICA was established (Originally named the Chiropractic Health Bureau) to work with the states to establish licensure so that our doctors would no longer be jailed for ‘practicing medicine without out license’. During this process chiropractic was established as a distinct and drug-free profession. Chiropractic is now and should remain a profession without drug prescribing in its scope of practice.

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Montana Medical Association Opposition to HB 929

For Immediate Release

Contact: Beth Clay
Email: bclay@chiropractic.org

Just Say No to HB 929!

Montanans need to call their House Member today: https://www.legmt.gov/legislators/

The bill was introduced by Greg Oblander, DC a Montana chiropractor/legislator. The bill had the backing of the Montana Chiropractic Association, who had awarded Dr. Oblander the Chiropractor of the Year award in March 2024.

ICA Board Member, Dr. Hugo M. Gibson led the charge in Montana testifying at both the Chiropractic Board against the legislation; as well as in person at the House Business and Labor Committee. Both the Business and Labor Committee and the Appropriations Committee passed the bill out to the House Floor where it failed by a slim margin.

While ICA is happy with the outcome, we are concerned that the vote was so close. The idea that so many legislators were ready to expand the Montana Scope to include drug prescribing with a list of drugs that included products with mandatory Black Box warnings from the FDA is a wake up call to the need for our entire community to engage and ensure legislators understand that chiropractic is and should remain a drug-free profession. The testimony ICA presented is available below:

March 4, 2025 – True to our mission to protect and promote chiropractic worldwide, the ICA is actively engaged in the fight against expanding the Montana Scope of Practice to include prescribing rights and injections. ICA Board Member Dr. Hugo M. Gibson, Assembly Representative Dr. Donald Gibson, and ICA Member Dr. Jack Berg testified in opposition to HB500 before the Montana House Committee on Business and Labor and the ICA submitted formal testimony to the committee (see attached). 

“Stepping into the world of pharmacology can be a dangerous misstep, not just for us, but most importantly for our patients,” wrote Dr. Hugo M. Gibson in a letter to the House Committee. “Taking a ‘board-approved course’ does not and will not constitute adequate training.” 

H.B. 500 would allow chiropractors to prescribe pharmaceuticals, including muscle relaxers, NSAIDs, steroids, and trigger point injections. The bill also gives the Montana Board of Chiropractors authority to expand the list of permissible drugs. The ICA submitted evidence confirming the proposed list of approved drugs are not innocuous but include products with FDA black box warnings; and incredibly complex drug-drug interactions that are potentially life threatening. Expanding chiropractic to include drug prescribing is a dangerous and misguided step. ICA promotes patient centered care that includes professional collaboration among healthcare professionals to meet the needs of patients who may need prescriptions. We stringently oppose HB500.  

“The over-prescribing of pain medication is linked to long-term dependency, and we must ask ourselves: are we prepared to manage that risk?” Dr. Gibson asked. “When chiropractors step into the role of prescribing medications, even for seemingly harmless muscle relaxants, we’re entering a realm that we’re not equipped to navigate fully.” 

The ICA urges Montana chiropractors and the public to contact their legislators in the House and Senate and educate their patients on the risks of this bill. While working to stop it in the House, the ICA stands ready to oppose it in the Senate if necessary. As of March 4, the Bill has passed a “second reading” in the House and an Appropriations Committee hearing is in process.

January 22, 2025: Given that H.R. 538/S.106 the Chiropractic Medicare Coverage Modernization Act of 2025 contains the exact same text as the last three legislative sessions, the ICA once again finds itself unable to endorse these bills. As a result, the ICA will be offering legislators a bill that provides a comprehensive solution to Medicare, including the Opt-Out Provision that is essential for eliminating disparities and discrimination against Medicare beneficiaries who seek chiropractic care.

The International Chiropractors Association (ICA) is in consensus with the entire US-based chiropractic community that Medicare needs to be fixed. For too long the vestiges of restraint of trade discrimination have lingered in the Social Security Act laws through which Medicare is administered.

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 the subluxation reference in the definition.
3. Remove the restrictive language used to limit reimbursement to the adjustment “only.”
4. Ensure that radiographic (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 chiropractic patients the ability to privately contract and chiropractors the ability to opt out of the Medicare system if they so choose.

ICA legislative experts all agree that any Medicare legislation should be clear, specific, and give CMS specific instruction with deadlines for implementation. We do not believe it is in the best interest of chiropractors and their patients to leave the details up to CMS to develop, even with a friendly Director at CMS who will take office in 2025. Further, if a bill were passed into law that leaves the details up to CMS, a multi-year rulemaking will be required; and there will be no guarantees at the end of the process of what will be covered.

Below is a chart that shows the differences between the two approaches.

As we engage with our legislators in Washington, it is important for ICA members and those across the profession who desire a full and certain solution to the issues in Medicare to engage with your senators and representatives to express your support for the bill we are bringing to them for introduction and passage. The road to introduction and passage into law is long.

If you have any questions or would like to help, please email our Executive Director, Beth Clay, at bclay@chiropractic.org.

Excerpts of our comments:

At the request of our Florida members, the International Chiropractors Association (ICA)  has reviewed the proposed legislation “HB 1063  Practice of Chiropractic Medicine”  introduced by Rep. Christine Hunschofsky and Rep. Allison Tant.  We stand in strong opposition to this legislation.

• Dry Needling is an invasive technique with risks to patient and doctor. 
• Dry Needling is NOT chiropractic.
• Dry Needling is NOT Evidence-Based.
• Doctors of Chiropractic do not need dry needling to meet the needs of their patients.

… The ICA objects to any scope expansion that increases risks to patients through the puncturing of skin for a therapeutic intervention such as IVs, joint injections, injections of any kind, or dry needling which is referenced in HB 1063 as “the use of monofilament intramuscular stimulation treatment for trigger points or myofascial pain.” 

… Nowhere within the definition of chiropractic in the Florida statute does or should inserting needles fit into the science, art, and philosophy of the chiropractic profession.

 “..a noncombative principle and practice consisting of the science,  philosophy, and art of the adjustment, manipulation, and treatment of the human body in which vertebral subluxations and other malpositioned articulations and structures that are  interfering with the normal generation, transmission, and expression of nerve impulse between the brain, organs, and tissue cells of the body, thereby causing disease, are adjusted, manipulated, or treated, thus restoring the normal flow of nerve impulse which produces normal function and consequent health by chiropractic physicians using specific chiropractic adjustment  or manipulation techniques taught in chiropractic colleges accredited by the Council on Chiropractic Education. No person other than a licensed chiropractic physician may render chiropractic services, chiropractic adjustments, or chiropractic manipulations.”

The ICA strongly opposes expanding the Florida scope of practice to include any invasive techniques or procedures such as dry needling.  It is in the interest of the public’s safety as well as the preservation of chiropractic as a separate and distinct profession.  The entire profession is based upon our philosophy that our doctors identify subluxations through evaluations and imaging when needed, and then correct the subluxation (or misalignment) to remove the interferences and allow the body to optimize its innate self-healing, self-generating capacity. 

If a patient has additional needs of care that would include invasive techniques, our doctors should be referring to the appropriately trained and credentialed health professional. The ICA is confident that the chiropractic system of healing as a profession is ‘enough’ on its own and does not need to be expanded to include medical procedures and invasive techniques such as dry needling.  We arrived at our stance on this matter by a review of two primary issues.  First – the risk/benefit ratio of dry needling.  We do not find the evidence substantial enough to support the risks both to patient and to the provider (needle sticks are a very real concern and can spread hepatitis, HIV, etc.).  Second, and equally important is the evaluation based on whether dry needling is in the lane of chiropractic or the lane of medicine?  Clearly as an invasive technique dry needling is in the lane of medicine; and thus, does not belong in the chiropractic scope of practice…

Risks Associated with Dry Needling:

• The top three recognized adverse events associated with dry needling are: bleeding, bruising, and pain.
• The same paper goes on to report that “Since dry needling involves a needle penetrating the skin, iatrogenic injury to vessels, nerves, spinal cord, internal organs, implanted devices, or infection are possible hazards for patients.”

• Other reported major adverse events in this study were pneumothorax (A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall and can be life threatening.) Additionally , nerve injury, infection, or excessive symptom exacerbation. [7] 
• Acute onset chest pain, haemoptysis and exertional dyspnoea following a dry needling session. Diagnosis Chest x-ray showed bilateral pneumothoraces, worse on the right side were also reported in a case study. [8]

…In Conclusion:  ICA urges the Florida Senate to reject scope dry needling in the scope. Dry needling is in the lane of medicine, not the lane of chiropractic.  Our patients benefit most from a focus on identifying and correcting subluxations through appropriate evaluation and the chiropractic adjustment. 

To read the full response below.

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