January 26, 2024 (Falls Church, VA) The International Chiropractors Association (ICA) has chosen not to endorse HR 1610/S.799, the “Chiropractic Medicare Coverage Modernization Act of 2023”. These are the same bills as previously introduced in the last two congressional sessions. We are unwavering in our focus to have real fixes accomplished in Medicare and will not settle for a bill that excludes the Opt Out Provision and leaves all the decisions in the hands of CMS.
ICA’s Essential Elements Required of Any Medicare Legislation
- Maintain the current mandate for coverage of the adjustment to correct a subluxation.
- Preserve Subluxation reference in definition.
- Remove the restrictive language used to limit reimbursements to the adjustment “only.”
- Ensure that x-ray imaging and exams are covered services.
- Maintain economic neutrality by removing barriers to reimbursements for existing covered services only.
- Establish equitability in reimbursement rates to other physician level providers.
- Eliminate discrimination that denies patients of chiropractic physicians the ability to privately contract and chiropractors to Opt-out of the Medicare system if they so choose.
ICA legislative experts all agree that any Medicare legislation should be clear and give CMS specific instruction with deadlines for implementation. History has proven that Congress must provide specific instructions on coverage and deadlines for implementation, or the legislative goals will not be met. When a Medicare bill is signed into law do you really want to wait 3 to 5 years for CMS to study the matter and publish a proposed rule and then another year or two for that proposed rule to be finalized? Do you really trust Medicare to get it right on what should and should not be reimbursed? That is exactly what is likely to happen if 1610/799 become law.
In the 117th Congress the ICA Endorsed HR 8701 the Chiropractic Act of 2022. With the 118th Congressional session, we are working to see an improved version of that bill introduced. We believe our approach is one that gets everything accomplished that the Chiropractic community is seeking and does so with surety and a timeline. We know the bill, if signed into law will immediately benefit the Medicare Beneficiaries who have paid into the program for decades. Our bill will not increase costs, and principled chiropractors across the country who desire to take care of seniors and people with disabilities who rely on Medicare for their healthcare will agree with this approach. Below is a chart that compares the two bills. A year into the legislative cycle, we want to update the community. We are not ‘going negative’ on the legislation we are not endorsing, rather we are informing the chiropractic community and legislators about our position and to offer facts on both legislative approaches so that we can all work toward the common goal of fixing the issues in Medicare fairly and with certainty.
Compare and Contrast the Two Chiropractic-Medicare Bills
What are the Differences between HR 1610 and the revised Chiropractic Act?
| Compare and Contrast | HR 1610 – “Chiropractic Medicare Coverage Modernization Act of 2023” | Proposed Revised 117th HR 8701 –“ Chiropractic Act of 2022” (seeking introduction) |
| Does the Bill guarantee coverage of the standards of care basics– exams and x-ray imaging? | No – bill calls for full scope coverage which will require a rulemaking with no guarantees of outcome and take years. | Yes – Medicare Beneficiaries who have paid into the system will be able to access. |
| 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 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 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 – CE is a state managed issue |
| 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 -We want to insure that a change with Medicare does not stimulate a state-by-state expansion of scope to include Rx which is not a part of DC training. |
ICA –Standing Firm on our Principles of Protecting and Promoting Chiropractic.
Last updated on January 26, 2024 at 5:33 pm