What This Bill Does
This bill expands Medicare coverage for chiropractic services provided by doctors of chiropractic. Instead of limiting coverage to only spine manipulation for a specific condition, the bill would allow Medicare to pay for all services that a chiropractor is legally authorized to perform in their state.
Who It Affects
Medicare beneficiaries (people enrolled in Medicare), doctors of chiropractic, and the Medicare program itself.
Key Provisions
• Doctors of chiropractic who are licensed in their state can provide any service their license allows them to perform, and Medicare will cover those services, not just spine manipulation (Sec. 3(a))
• For coverage, either the chiropractor must attend an educational webinar designed by the Secretary (the head of the Department of Health and Human Services) that can be taken once, or the services must be manual manipulation of the spine to correct a subluxation (a misalignment) (Sec. 3(b))
What Changes
Current Medicare law only covers manual manipulation of the spine to correct a subluxation performed by chiropractors. This bill would expand that coverage to include all functions and actions that a chiropractor is legally allowed to perform under their state license.
Important Definitions
• Manual manipulation of the spine: physical treatment to correct a subluxation (misalignment of the spine)
• Subluxation: a misalignment of the spine
• Doctor of chiropractic: a person licensed as a chiropractor by their state
II
118TH CONGRESS
1ST SESSION
S. 799
To amend title XVIII of the Social Security Act to provide Medicare coverage
for all physicians’ services furnished by doctors of chiropractic within
the scope of their license, and for other purposes.
IN THE SENATE OF THE UNITED STATES
MARCH 14, 2023
Mr. BLUMENTHAL (for himself, Mr. CRAMER, Ms. BALDWIN, Mr. WICKER,
Mr. TESTER, Mr. HOEVEN, and Mr. DAINES) introduced the following
bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to provide
Medicare coverage for all physicians’ services furnished
by doctors of chiropractic within the scope of their li-
cense, and for other purposes.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘Chiropractic Medicare
4
Coverage Modernization Act of 2023’’.
5
SEC. 2. FINDINGS; STATEMENT OF PURPOSE.
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(a) FINDINGS.—Congress finds the following:
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•S 799 IS
(1) In 1972, coverage was established under the
1
Medicare program for beneficiaries to receive chiro-
2
practic care.
3
(2) Unfortunately, the antiquated statute re-
4
stricts beneficiaries to one service in a chiropractic
5
clinic and Medicare chiropractic coverage has not
6
kept up with private sector coverage and other fed-
7
eral health delivery systems.
8
(3) Today, due to positive evidence-based out-
9
comes and cost effectiveness of the services provided
10
by doctors of chiropractic, private coverage for chiro-
11
practic services has evolved and State licensure for
12
chiropractors has advanced to meet patient needs
13
and health outcomes.
14
(4) This Act would bring Medicare chiropractic
15
coverage more in line with that provided with the
16
Department of Veterans Affairs, Department of De-
17
fense, the Federal Employee Health Benefits Pro-
18
gram, and private health insurance coverage.
19
(b) PURPOSE.—It is the purpose of this Act to ex-
20
pand recognition and coverage of a doctor of chiropractic
21
as a ‘‘physician’’ under the Medicare program in connec-
22
tion with the performance of any function or action, in-
23
cluding current service of ‘‘manual manipulation of the
24
spine to correct a subluxation’’, as is legally authorized
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•S 799 IS
by the State in which such doctor performs such function
1
or action.
2
SEC. 3. PROVIDING MEDICARE COVERAGE FOR ALL PHYSI-
3
CIANS’ SERVICES FURNISHED BY DOCTORS
4
OF CHIROPRACTIC WITHIN THE SCOPE OF
5
THEIR LICENSE.
6
(a) IN GENERAL.—Section 1861(r)(5) of the Social
7
Security Act (42 U.S.C. 1395x(r)(5)) is amended by strik-
8
ing ‘‘a chiropractor who is licensed as such by the State
9
(or in a State which does not license chiropractors as such,
10
is legally authorized to perform the services of a chiro-
11
practor in the jurisdiction in which he performs such serv-
12
ices), and who meets uniform minimum standards promul-
13
gated by the Secretary, but only for the purpose of sec-
14
tions 1861(s)(1) and 1861(s)(2)(A) and only with respect
15
to treatment by means of manual manipulation of the
16
spine (to correct a subluxation) which he is legally author-
17
ized to perform by the State or jurisdiction in which such
18
treatment is provided’’ and inserting ‘‘a doctor of chiro-
19
practic who is licensed as a doctor of chiropractic or a
20
chiropractor by the State in which the function or action
21
is performed and whose license provides legal authoriza-
22
tion to perform such function or action in such State or
23
in the jurisdiction in which the function or action is per-
24
formed’’.
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•S 799 IS
(b) CERTAIN COVERAGE LIMITS.—Section 1833 of
1
the Social Security Act (42 U.S.C. 1395l) is amended by
2
adding at the end the following new subsection:
3
‘‘(ee) LIMITATION ON PAYMENT OF SERVICES PRO-
4
VIDED BY CERTAIN DOCTORS OF CHIROPRACTIC.—Not-
5
withstanding any other provision of this part, in the case
6
of services of a doctor of chiropractic described in section
7
1861(r)(5), payment may only be made under this part
8
for such services if—
9
‘‘(1) such services are furnished by a doctor of
10
chiropractic who is verified once, by a process de-
11
signed by the Secretary, as attending an educational
12
documentation webinar, or other similar electronic
13
product, designed by the Secretary or an updated
14
modified version of such webinar, as designed by the
15
Secretary; or
16
‘‘(2) such services are treatment by means of
17
manual manipulation of the spine to correct a sub-
18
luxation.’’.
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Æ
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