Summary
# H.R. 1610: Chiropractic Medicare Coverage Modernization Act of 2023
## WHAT THIS BILL DOES
This bill expands Medicare coverage (the health insurance program for people age 65 and older) to include more services provided by doctors of chiropractic. Currently, Medicare only covers one specific chiropractic service: manual manipulation of the spine to correct a subluxation (a misalignment of vertebrae). This bill would let Medicare cover all services that doctors of chiropractic are licensed to perform under state law.
## WHO IT AFFECTS
- Medicare beneficiaries (people receiving Medicare benefits)
- Doctors of chiropractic licensed in their states
- The federal government (through Medicare spending)
## KEY PROVISIONS
- Medicare must cover all services that doctors of chiropractic are legally authorized to perform by their state license, not just spinal manipulation (Sec. 3(a))
- Doctors of chiropractic must be licensed by their state to receive Medicare payment (Sec. 3(a))
- Doctors of chiropractic must either complete an educational documentation webinar designed by the Secretary or provide treatment by manual manipulation of the spine to be paid by Medicare (Sec. 3(b))
## WHAT CHANGES
Medicare's rules for paying chiropractors would change from limiting coverage to one specific procedure to covering all procedures allowed under a chiropractor's state license. Chiropractors would need to complete a webinar or provide spinal manipulation services to be eligible for Medicare payment.
## IMPORTANT DEFINITIONS
- **Subluxation:** A misalignment of vertebrae (bones in the spine)
- **Manual manipulation:** Hands-on treatment of the spine
## EFFECTIVE DATE
Not specified in bill text
I
118TH CONGRESS
1ST SESSION H. R. 1610
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 HOUSE OF REPRESENTATIVES
MARCH 14, 2023
Mr. STEUBE (for himself, Mr. HIGGINS of New York, Mr. ALFORD, Mr. LAR-
SON of Connecticut, Mr. MOOLENAAR, Ms. HAGEMAN, Ms. STRICKLAND,
Mr. BOST, Mr. JOHNSON
of South Dakota, Mr. MEUSER, Mr.
FITZPATRICK, Mr. ROGERS of Alabama, Mr. AMODEI, Ms. WASSERMAN
SCHULTZ, Mr. CRAWFORD, Mr. RESCHENTHALER, Mr. BACON, Mr.
GUEST, Mr. LUETKEMEYER, Mr. BOYLE of Pennsylvania, Mr. POCAN,
Mr. VAN DREW, and Mr. HIMES) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
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,
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•HR 1610 IH
SECTION 1. SHORT TITLE.
1
This Act may be cited as the ‘‘Chiropractic Medicare
2
Coverage Modernization Act of 2023’’.
3
SEC. 2. FINDINGS; STATEMENT OF PURPOSE.
4
(a) FINDINGS.—Congress finds the following:
5
(1) In 1972, coverage was established under the
6
Medicare program for beneficiaries to receive chiro-
7
practic care.
8
(2) Unfortunately, the antiquated statute re-
9
stricts beneficiaries to one service in a chiropractic
10
clinic and Medicare chiropractic coverage has not
11
kept up with private sector coverage and other Fed-
12
eral health delivery systems.
13
(3) Today, due to positive evidence-based out-
14
comes and cost effectiveness of the services provided
15
by doctors of chiropractic, private coverage for chiro-
16
practic services has evolved and State licensure for
17
chiropractors has advanced to meet patient needs
18
and health outcomes.
19
(4) This Act would bring Medicare chiropractic
20
coverage more in line with that provided with the
21
Department of Veterans Affairs, Department of De-
22
fense, the Federal Employee Health Benefits Pro-
23
gram, and private health insurance coverage.
24
(b) PURPOSE.—It is the purpose of this Act to ex-
25
pand recognition and coverage of a doctor of chiropractic
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•HR 1610 IH
as a ‘‘physician’’ under the Medicare program in connec-
1
tion with the performance of any function or action, in-
2
cluding current service of ‘‘manual manipulation of the
3
spine to correct a subluxation’’, as is legally authorized
4
by the State in which such doctor performs such function
5
or action.
6
SEC. 3. PROVIDING MEDICARE COVERAGE FOR ALL PHYSI-
7
CIANS’ SERVICES FURNISHED BY DOCTORS
8
OF CHIROPRACTIC WITHIN THE SCOPE OF
9
THEIR LICENSE.
10
(a) IN GENERAL.—Section 1861(r)(5) of the Social
11
Security Act (42 U.S.C. 1395x(r)(5)) is amended by strik-
12
ing ‘‘a chiropractor who is licensed as such by the State
13
(or in a State which does not license chiropractors as such,
14
is legally authorized to perform the services of a chiro-
15
practor in the jurisdiction in which he performs such serv-
16
ices), and who meets uniform minimum standards promul-
17
gated by the Secretary, but only for the purpose of sec-
18
tions 1861(s)(1) and 1861(s)(2)(A) and only with respect
19
to treatment by means of manual manipulation of the
20
spine (to correct a subluxation) which he is legally author-
21
ized to perform by the State or jurisdiction in which such
22
treatment is provided’’ and inserting ‘‘a doctor of chiro-
23
practic who is licensed as a doctor of chiropractic or a
24
chiropractor by the State in which the function or action
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•HR 1610 IH
is performed and whose license provides legal authoriza-
1
tion to perform such function or action in such State or
2
in the jurisdiction in which the function or action is per-
3
formed’’.
4
(b) CERTAIN COVERAGE LIMITS.—Section 1833 of
5
the Social Security Act (42 U.S.C. 1395l) is amended by
6
adding at the end the following new subsection:
7
‘‘(ee) LIMITATION ON PAYMENT OF SERVICES PRO-
8
VIDED BY CERTAIN DOCTORS OF CHIROPRACTIC.—Not-
9
withstanding any other provision of this part, in the case
10
of services of a doctor of chiropractic described in section
11
1861(r)(5), payment may only be made under this part
12
for such services if—
13
‘‘(1) such services are furnished by a doctor of
14
chiropractic who is verified once, by a process de-
15
signed by the Secretary, as attending an educational
16
documentation webinar, or other similar electronic
17
product, designed by the Secretary or an updated
18
modified version of such webinar, as designed by the
19
Secretary; or
20
‘‘(2) such services are treatment by means of
21
manual manipulation of the spine to correct a sub-
22
luxation.’’.
23
Æ
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