H.R. 539: Chiropractic Medicare Coverage Modernization Act of 2025
This bill, titled the Chiropractic Medicare Coverage Modernization Act of 2025, aims to amend the Social Security Act to broaden Medicare coverage for chiropractic services. Here’s a breakdown of what the bill proposes:
Key Findings
- Chiropractic services have been included in Medicare since 1972.
- The current Medicare chiropractic coverage is limited to one specific service, which has not kept pace with private sector and other federal healthcare programs.
- There is growing evidence showing the effectiveness and cost benefits of chiropractic services in patient care.
- The bill seeks to align Medicare chiropractic coverage with that offered by the Veterans Affairs, Department of Defense, Federal Employee Health Benefits Program, and private health insurers.
Purpose of the Bill
The primary goal of the bill is to recognize doctors of chiropractic as “physicians” under Medicare. This includes coverage for a wider range of functions that chiropractors are allowed to perform within their state licensure, including but not limited to the manual manipulation of the spine to correct subluxations.
Medicare Coverage Expansion
General Provisions
The bill proposes to alter section 1861(r)(5) of the Social Security Act. The modification would mean that coverage extends to services provided by licensed doctors of chiropractic, as long as these services fall within the scope of practice defined by the state in which they operate.
Payment Limitations
Additionally, there will be limitations on the payment for chiropractic services described in section 1861(r)(5). According to the new provisions, Medicare will cover services only if:
- They are provided by chiropractors who have verified attendance in an educational documentation webinar or other similar training designed by the Secretary of Health.
- The services include manual manipulation of the spine to correct a subluxation.
Conclusion
The Chiropractic Medicare Coverage Modernization Act of 2025 is aimed at expanding Medicare's coverage for chiropractic services, thus allowing Medicare patients greater access to the range of services that licensed chiropractors can offer.
Relevant Companies
- HLT - Hilton Worldwide Holdings Inc. may be indirectly impacted as chiropractic services can play a role in employee wellness programs, particularly for workers in physical jobs or those suffering from back pain, potentially affecting employee health outcomes and corporate healthcare costs.
- ANTM - Anthem, Inc. could see changes in cost structures and reimbursements in Medicare-related services, which could affect their broader health insurance offerings and partnerships with chiropractic services.
This is an AI-generated summary of the bill text. There may be mistakes.
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Actions
2 actions
Date | Action |
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Jan. 16, 2025 | Introduced in House |
Jan. 16, 2025 | Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. |
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