New Chiropractic Demonstration Project Gets an Adjustment: One State, 19 Counties Added to List of Test Sites

In the Dec. 16, 2004 issue, we reported on a new chiropractic demonstration project established as part of the Medicare Prescription Drug, Improvement and Modernization Act. The project allows chiropractors in the entire states of Maine and New Mexico, and parts of Virginia and Illinois, to provide services to any beneficiary enrolled under Medicare Part B, and allows for expanded coverage for services used to treat neuromusculoskeletal disorders, including X-rays, diagnosis, and other therapies.

Since the publication of that article, Dynamic Chiropractic has learned that the Centers for Medicare & Medicaid Services (CMS) has more than tripled the number of counties in Illinois that will be involved in the demonstration project. The agency has also added a county in eastern Iowa to the project, bringing the total number of states in the demonstration to five and allowing hundreds of thousands of Medicare recipients throughout the country to experience the benefits of chiropractic care firsthand.

The original project, announced Nov. 10, 2004, called for chiropractic services to be delivered at four test sites - two in urban areas and two in rural areas, with one site from each category in a designated "health professional shortage area." The entire states of Maine and New Mexico were included, as were 17 counties in central Virginia, and eight counties that comprised the Chicago metropolitan area.

Two weeks after the original announcement, the CMS announced that it was increasing the size of the Chicago site to help facilitate a better evaluation of the care chiropractors provide. As a result, the site has been expanded to include the entire northern section of Illinois, and now features a total of 26 counties, stretching out from Cook County in the northeastern section of the state, across to Rock Island and Mercer counties in the west, ending just across the Mississippi River in Scott County, Iowa - home to Davenport, site of Palmer College of Chiropractic.

Iowa Sen. Charles Grassley and Rep. Jim Nussle, both longtime advocates of chiropractic, confirmed that Iowa had been added to the list of demonstration sites in a statement to the Quad-City Times:

"Not only is the demonstration project beneficial to the chiropractic community, but it's also beneficial to the Medicare beneficiaries in Iowa who will have increased access to the services on which they rely," said Sen. Grassley. A spokesperson for Rep. Nussle explained that the Chicago site had been expanded to include Davenport and the Quad-Cities area because it would "take in a broader range of areas according to their level of chiropractic service."

The chiropractic demonstration project officially begins in April 2005, and is scheduled to run for two years. Language contained in the Medicare Prescription Drug, Improvement and Modernization Act also requires the Secretary of Health and Human Services to conduct an evaluation of the project, including cost-effectiveness, cost-benefit, Medicare beneficiary satisfaction, and "such other matters" as deemed appropriate, and to submit the evaluation no later than one year after the project's conclusion.

Sources

1. Devitt M. CMS announces four-state chiropractic demonstration project. Dynamic Chiropractic, Dec. 16, 2004: www.chiroweb.com/archives/22/26/04.html.
2. Tibbetts E. Medicare plan adjusts chiropractic coverage. Quad City Times, Nov. 23, 2004.
3. CMS identifies sites for Medicare demonstration to expand coverage of chiropractic services. Centers for Medicare & Medicaid Services, Nov. 10, 2004.
4. MMA section 651 expansion of coverage of chiropractic services demonstration. Centers for Medicare & Medicaid Services, Nov. 24, 2004.