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Medicare: Patient Access to Chiropractic

Legislation championed by ACA to increase Medicare coverage of chiropractic services has been introduced in the U.S. House of Representatives.

The Chiropractic Medicare Coverage Modernization Act of 2019 (H.R. 3654) would allow Medicare beneficiaries access to the chiropractic profession’s broad-based, non-drug approach to pain management, which includes manual manipulation of the spine and extremities, evaluation and management services, diagnostic imaging and utilization of other non-drug approaches that have become an important strategy in national efforts to stem the epidemic of prescription opioid overuse and abuse.

H.R. 3654:

  • Appropriately defines a Doctor of Chiropractic (DC) as a “physician” in the Medicare program.
  • Provides patient access to all Medicare-covered benefits allowable under a chiropractor’s state licensure.
  • Requires that DCs complete a documentation webinar.
  • Is bipartisan legislation, introduced by Reps. Brian Higgins (D-N.Y.) and Tom Reed (R-N.Y.).

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Background

To best serve their senior patients, chiropractic physicians must be allowed to practice and be reimbursed to the fullest extent of their licensure, training and competencies. Medicare parity is ACA's top legislative and regulatory priority.

Since the chiropractic profession was first included in Medicare in 1972, Doctors of Chiropractic (DC) and their patients have been burdened by arbitrary limitations that lack any scientific or sound policy justification.

Research demonstrating positive patient outcomes and cost effectiveness resulting from chiropractic care have advanced private coverage and state licensures to meet patient needs.

The federal Medicare program, which serves as a model for private insurance plans, currently serves more than 55 million individuals. Various projections forecast the number of people age 65 or older increasing by about one-third over the next decade. Chiropractic inclusion in the Medicare program was established in 1972 and has seen little change since then, other than elimination of the X-ray requirement in 1997.

Medicare Timeline through 2019

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