99 Years Strong, the ICA -the Moderate Voice in the Chiropractic Community – Standing Firm on our Principles in Protecting and Promoting Chiropractic

The International Chiropractors Association (ICA) celebrating 99 years of protecting and promoting chiropractic. We stand true to promoting chiropractic for the entire community, with a focus on advancing access, improved reimbursement, and increased high quality clinical research in chiropractic adjusting to advance the evidence-based.

ICA is excited about the new Administration and the opportunities of having fresh leaders who understand the value of chiropractic coming into positions where change may occur.

ICA is regularly engaged with Administration officials, legislators and policymakers during this 119th Congress. We work where ever and when ever possible in professional collaboration in health care and in the chiropractic profession. ICA promotes policies and legislation that are focused on improving access to chiropractic and improved treatment of the chiropractic profession in government programs for research, loans, and reimbursement.

ICA 2025 Medicare Goal:

Legislation that Gets the Whole Job Done in a Time Certain

Eliminating the barriers to fair access to chiropractic for Medicare Beneficiaries can only be accomplished through legislation.  Fair access means, coverage of the standards of care – evaluation and management services, (Exams and Imaging/X-rays) as well as the chiropractic adjustment.  It also means the freedom of Medicare Beneficiaries to privately contract with their chiropractor in the same way they have the freedom to do so with their MD. 

Given that the language from HR 539/S 106 remains unchanged from the last three legislative sessions, the ICA cannot endorse it.   As a result, we are focusing on providing members of Congress with legislative language that provides a comprehensive solution to Medicare which can be implemented in by a certain date and not be bogged down for years in rulemaking procedures and have no guaranteed outcomes.  Let’s be clear, it’s been 50 years since we had legislation passed related to Medicare, and we will get one chance to get it right, once chance to be comprehensive and specific.  If someone tells you support a bill that does not include the Opt-Out Provision because “we can come back next year” they are not acknowledging the fact that legislators really don’t like making the effort to get legislation passed into law only to have you come back a year later and ask for additional changes to finish the job.   

ICA’s Medicare Solution

1. Eliminates discrimination that denies chiropractic patients the ability to privately contract with their chiropractor the same way they can with their MD. (Opt Out Provision)
2. Remove the restrictive language used to limit reimbursement to the adjustment “only.”
3. Ensure that radiographic (x-ray) imaging and exams are covered services.
4. Maintain economic neutrality by removing barriers to reimbursements for existing covered services only.
5. Establish equitability in reimbursement rates to other physician level providers.
6. Maintains coverage of the chiropractic adjustment to correct a subluxation.
7. Preserve the subluxation reference in the definition.
8. Keeps Prescribing out of Chiropractic in Medicare.

ICA legislative experts all agree that any Medicare legislation should be clear, specific, and give CMS specific instruction with deadlines for implementation. We do not believe it is in the best interest of chiropractors and their patients to leave the details up to CMS to develop, even with a friendly Director at CMS.  Reality is, if a bill is passed into law that leaves the details up to CMS, a multi-year rulemaking will be required; and there will be no guarantees at the end of the process of what will be covered.

As we engage with our legislators in Washington, it is important for ICA members and those across the profession who desire a full and certain solution to the issues in Medicare to engage with your senators and representatives to express your support for the bill we are bringing to them for introduction and passage. The road to introduction and passage into law is long.

If you have any questions or would like to help, please email our Executive Director, Beth Clay, at bclay@chiropractic.org.

Comparing HR 539 /S106 to the ICA Proposed Legislation

Compare and Contrast	Introduced HR 538/S.106 Chiropractic Medicare Coverage Modernization Act	Proposed Revised HR8701 Chiropractic Act of 2025
Does the bill guarantee coverage of the standards of care basics– exams and x-ray imaging?	No – The bill calls for full scope coverage which will require rulemaking with no guarantees of outcome and may take years.	Yes –Medicare beneficiaries who have paid into the system will be able to access shortly after passage into law.
Does the bill include a date of enactment?	No	Yes
Does the bill protect the chiropractic -specific terminology in the definition.	No	Yes
Does the bill create a two-tier reimbursement model within Medicare based on mandated Continuing Education?	Yes	No
Does the bill federalize Continuing Education (CE) requirements to be determined and managed by HHS/CMS?	Yes	No  – (1) CE is a state issue and (2) CMS already has authority and has provider compliance training in place – no legislation specific only to chiropractic needed. (https://www.cms.gov/training-education/medicare-learning-network/resources-training)
Does the bill instruct CMS to continue using the physician codes and reimbursement rates (efficient and fair) rather than creating new chiropractic specific codes at lower reimbursement rates?	No	Yes
Does the bill include the provision to allow Medicare beneficiaries to privately contract with their chiropractor (commonly referred to as the Opt-Out Provision)?	No	Yes
Does the bill keep chiropractic in the lane of chiropractic by making it clear to CMS that chiropractors are not drug prescribers?	No	Yes – A provision in the legislation prevents the inclusion of drug prescribing to prevent a state-by-state expansion of scope to include Rx which is outside the lane of chiropractic and in the lane of medicine.
Does the bill call for a revision of the coverage determination that currently precludes chiropractors from providing care for prevention and chronic conditions?	No	Yes – A provision in the legislation calls for the secretary to include covered services on health promotion, whole person care, and prevention services in chiropractic coverage for services that are covered by any other type of physician.

We anticipate our bill being introduced soon. We will keep you posted.

State Level Advocacy – Protecting Chiropractic as a Distinct Profession

As we did 99 years ago in the challenges to have all states and territories develop a fair and appropriate doctor of chiropractic license, the ICA stands firm and speaks up when proposals, proposed legislation and policies do not meet the high standard of staying true to chiropractic as a separate and distinct profession based on its own science, art, and philosophy. The ICA is actively engaged in promoting our legislative, policy, and research goals.

The ICA actively works to help those who care about chiropractic – doctors, students, and patients get the facts about laws, proposed laws and policies and give them tools to become effective advocates. We actively encourage everyone to engage in advocating for improvements to the laws and policies that affect the relationship between patient and provider.

International Advocacy -Promoting the Profession Worldwide

ICA works world wide with our nation level colleagues to insure chiropractic remains a distinct profession, that only those with legitimate degrees may call themselves chiropractors, and to protect the public from unskilled individuals posing as chiropractors. Additionally we work to advance research and education with our international schools and colleagues.