The U.S. House of Representatives has reintroduced ground-breaking bipartisan legislation that would expand chiropractic coverage within Medicare. Rep. Brian Higgins (D-N.Y.) introduced the Chiropractic Coverage Modernization Act (H.R. 2654) on April 19, 2021. The act's purpose and language mirror the original legislation, introduced in 2019, in that H.R. 2654 would "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."
According to the American Chiropractic Association, which has advocated for the coverage change in Congress and played a key role in introducing the original legislation as well, H.R. 2654 "would increase Medicare coverage of services provided by doctors of chiropractic within the full extent of their state licensure, enabling chiropractic patients to conveniently and safely access additional covered services that may be medically necessary. The change would also align Medicare with chiropractic coverage offered in many private health and Medicare Advantage plans."
As all chiropractors who treat Medicare patients know all too well, Medicare currently only reimburses doctors of chiropractic for a single service under Medicare Part B: "manual manipulation of the spine ... if medically necessary to correct a subluxation. Medicare doesn't cover other services or tests a chiropractor orders, including X-rays, massage therapy, and acupuncture."
Ninety-two co-sponsors ultimately signed on to the 2019 legislation (H.R. 3654); thus far, 19 congressional members have signed on as original co-sponsors to the 2021 legislation. As of press time, H.R. 2654 has been referred to both the House Committee on Energy and Commerce, and House Committee on Ways and Means. To track the progress of H.R. 2654, visit www.congress.gov/bill/117th-congress/house-bill/2654/actions?r=4&s=1.
The chiropractic profession is under a sophisticated and relentless assault from corporate medicine, so strategically executed that most don’t even recognize it happening. The campaign is powerful, calculated, and well-funded, demonstrated by its covert tactics and the millions being invested to carry it out. Corporate medicine's endgame wants only two things from chiropractic: all our patients and all our money – and it is getting it.
Over the past two decades, more than 18 million spinal surgeries have been performed in the United States, and cervical disc replacements represent a fair share of those. Device recalls due to design flaws can place patients in difficult clinical situations, especially those who are symptomatic and reluctant to undergo revision surgery. This case highlights the role of chiropractors in managing complex postsurgical patients, particularly those with recalled spinal implants.
UnitedHealth Group, parent company of UnitedHealthcare, has announced sweeping changes to its prior-authorization (PA) requirements that will eliminate the requirement for chiropractic care and numerous other healthcare services by the end of 2026. Doctors of chiropractic, other providers and patients have long lamented prior authorization requirements because they can delay needed treatment, limit access and even cause some patients not to pursue care.
