Chiropractic Medicare Coverage Modernization Act of 2025
- Sponsor
- Rep. Steube, W. Gregory [R-FL-17]
- Committees
- Ways and Means Committee (primary)
- Last action
- Jan 16, 2025
Bottom line
This bill modernizes Medicare coverage for chiropractic care to align with state licensure scopes and private insurance, potentially increasing access to a wider range of chiropractic services for beneficiaries.
What it actually does
This bill expands Medicare coverage for services provided by doctors of chiropractic. Currently, Medicare only covers manual manipulation of the spine to correct a subluxation. This Act would broaden coverage to include all physicians' services furnished by chiropractors that are within the scope of their license in the state where they practice. It also introduces a requirement for chiropractors to complete an educational webinar or similar electronic product to receive payment for these newly covered services, while the existing manual manipulation service remains covered without this new requirement.
Proponents argue
Supporters argue that the current Medicare statute is antiquated and restricts beneficiaries to only one service, manual manipulation of the spine, which does not reflect modern chiropractic practice or coverage provided by private insurers and other federal health systems like the VA and DoD. They contend that expanding coverage will improve patient access to evidence-based, cost-effective chiropractic services, aligning Medicare with current healthcare standards and patient needs.
Opponents contend
Opponents might express concerns about the potential increase in Medicare expenditures due to expanded coverage for a broader range of services, especially without clear evidence of cost-effectiveness for all newly covered services. They might also question the necessity of expanding the definition of 'physician' for chiropractors beyond their traditional scope within Medicare, or raise concerns about oversight and quality control for these new services.
The bill is very short and easy to read, making it accessible for a quick evaluation.
Section 3(a), amending Section 1861(r)(5) of the Social Security Act
Expanded Definition of Doctor of Chiropractic as a 'Physician'
This provision changes the Social Security Act to recognize a doctor of chiropractic as a 'physician' for all functions and actions legally authorized by their state license. Currently, Medicare only recognizes chiropractors as physicians for the specific purpose of manual manipulation of the spine to correct a subluxation. This amendment broadens that recognition to encompass the full scope of practice allowed by state law, thereby allowing Medicare to cover a wider array of chiropractic services.
Supporters argue
Supporters argue this modernization aligns Medicare with current state licensure laws and private insurance practices, ensuring beneficiaries have access to the full range of chiropractic care deemed safe and effective by state regulatory bodies. They contend it addresses an 'antiquated statute' that limits patient choice and access to care.
Critics contend
Critics might argue that expanding the definition without specific service-by-service evaluation could lead to coverage of services without sufficient evidence of efficacy or cost-effectiveness within the Medicare population. They may also raise concerns about potential cost increases to the Medicare program.
Tradeoffs
The bill balances increased patient access and alignment with modern chiropractic practice against potential increases in Medicare spending and the need for robust oversight of newly covered services.
Section 3(b), adding new subsection (ee) to Section 1833 of the Social Security Act
Requirement for Educational Webinar for Expanded Services
This provision states that for services provided by a doctor of chiropractic, *other than* manual manipulation of the spine to correct a subluxation, Medicare payment can only be made if the chiropractor has completed an educational documentation webinar (or similar electronic product) designed by the Secretary. This requirement applies only once per chiropractor. The original manual manipulation service remains covered without this new webinar requirement.