H.R. 3654 Turns One (But Time to Celebrate Is Short)

This Thursday, July 9, marks one year since the Chiropractic Medicare Coverage Modernization Act (H.R. 3654) was introduced in Congress. To celebrate, ACA Blogs checked in with ACA’s top lobbyist John Falardeau (pictured) to see how far we have come in generating support for this game-changing legislation…and what still needs to be done to get the bill passed before the end of the congressional session later this year.

Q: Can you explain briefly what H.R. 3654 would do – and not do.

A: H.R. 3654 basically would remove a nearly 50-year restriction on services Medicare beneficiaries can receive in a chiropractic clinic.  Currently, the only service covered by Medicare is “…manual manipulation of the spine to correct a subluxation….”  As we all know, under a chiropractor’s state licensure, he or she can provide many more services that are covered by Medicare.  What the bill does NOT do, is add additional services to Medicare. The bill would simply allow a patient to access current Medicare-covered services in a chiropractic clinic, should those services be allowed under a chiropractor’s licensure.  Services like evaluation and management, diagnostic imaging and post-therapy services—all Medicare-covered services—would be accessible, and the DC, would be reimbursed for.

Q: What progress has ACA made in advancing the bill?

A: We were fortunate that two prominent members of the House of Representatives, Brian Higgins (D-N.Y.) and Tom Reed (R-N.Y.) have introduced the bill.  Both are also members of the House Ways and Means Committee, which has primary jurisdiction of Medicare issues.  That said, it’s up to us to get the bill passed and, by that, I mean we need to build the number of cosponsors because the more cosponsors we have the better the likelihood of our success.  Missouri’s entire House delegation is on-board, and a hat-tip needs to go out to that state’s alternate delegate, Dr. Quinn James, who has been instrumental in garnering those cosponsors.  Florida and Pennsylvania each have seven cosponsors on the bill.  Wisconsin did a terrific job getting the message out to their members. A complete list of cosponsors can be found here.

Q: What messages about why this legislation is needed are resonating with members of Congress? 

A: Many representatives and staff that we talk to have no idea of the current constrains chiropractic Medicare patients face…the mere fact that Medicare services are restricted simply by provider type has raised eyebrows.  We are also able to share great cost-savings data and, of course, it gets legislators’ attention when they learn about the ability of chiropractors to manage pain without the use of opioids.  All of this is factored in when talking to congressional members and staff.

Q: What are some of the typical questions that you get asked about it? 

A: We are often asked, why can’t this be fixed going the regulatory route?  The answer here is that the limiting language that is found in federal statute and that there is no way regulators at HHS and CMS can get around it.  Therefore, the only recourse is to change the statute and the only way to do that is through legislation.  We are also asked, mainly by congressional staff, about the cost issue.  We do not have an accurate cost of the legislation, but we counter that with cost-saving data and other tangible evidence that shows that access to chiropractic services can bring costs down.  The research is there.  A plethora of resources regarding the bill can be found here.

Q: How long do you have left to get this bill passed? What do you need members of the profession to do to help you get that done?

A: The bill is live through the end of this congressional session, which will be sometime in late December, based on how long of a “lame duck” session we have after the election.  We are working to find a legislative vehicle to attach it to but it’s hard to put a timetable on that.  What I must reiterate is that the more cosponsors we have, the greater the likelihood of our success.  So, it’s a numbers game right now…and this is where we need every chiropractor, chiropractor student and patient to contact their federal representative and urge them to cosponsor H.R. 3654.  We’ve made it easy to do so…simply click here and you will be taken to ACA’s Legislative Action Center where you can send an electronic letter we drafted to Capitol Hill.  The more messages these congressional offices get, the more our voice is heard and the more likely your representative will cosponsor the bill.  Also, contact your representative’s office to see if they are doing virtual town halls this summer and participate.  Let them know chiropractors are a vital part of their healthcare community.

Q: The COVID-19 outbreak and related relief bills have dominated Capitol Hill in recent months. Will other legislation, like H.R. 3654, have a harder time getting passed now?

A: There is no question that the COVID-19 pandemic has put the brakes on many initiatives.  However, H.R. 3654 has health care implications for seniors and Congress is looking at all options here.  COVID-related legislation will continue to be considered through the end of this year, at least, and we are working with Congress to get the provisions contained in H.R. 3654 part of a larger legislative vehicle.  What will make that happen, however, is more support for the bill and again, that’s where the need for more cosponsors comes in.

Q: What is your strategy for getting this legislation to the finish line?

A: In the immediate, as pointed out before, urge chiropractors, chiropractic students, and importantly, patients to contact their federal representative and urge them to cosponsor H.R. 3654.  We’ve developed resources for doctors to set up in their clinics to urge patients to act…and remember, you don’t need to be a Medicare patient to participate. We all know a Medicare beneficiary and someday we’ll all be one, so it behooves everyone to get involved.  Through the rest of the year, it’s up to the ACA lobby team to find targets of opportunity with House members and senators to ensure the bill gets full consideration. But we can’t do it alone. Again, this is a Herculean effort and every chiropractor, student, and patient needs to become involved.