Federal Bill Introduced to Expand Medicare Patients Choice
Editor’s Note: This legislation expired with the end of the General Assembly. However, new legislation has been introduced in 2019. You can read about that new bill here.
In 1972, Medicare added coverage for manual manipulation of the spine, which marked the first time chiropractic physicians could receive reimbursement for services to Medicare patients. Since that time, Medicare patients have been required to pay for all other services performed by chiropractic physicians, including services required by Medicare (i.e. examinations). This, of course, has created an excessive burden on patients and a barrier to the important care that Doctors of Chiropractic provide to these patients.
Now, 46 years later, the United States House of Representatives has introduced legislation to expand coverage of services performed by chiropractic physicians. “Chiropractic Patients’ Freedom of Choice Act of 2018” (H.R. 7157) was introduced last month by Rep. Erik Paulsen (R-MN) to address the current Medicare limit to reimbursement. If this bill, or a similar bill introduced next session, were to pass, Medicare patients would have a broader choice of provider for services that are currently reimbursed by Medicare only if performed by providers other than chiropractic physicians.
The new law would expand reimbursement to include services performed by a chiropractic physician “whose license provides legal authorization to perform such function or action in such State or in the jurisdiction in which the function or action is performed.” In short, if passed, when chiropractic physicians provide Medicare-covered services (not limited solely to manual manipulation of the spine), Medicare will reimburse the chiropractic physicians to the full extent of their scope of practice. Since Illinois’ chiropractic physicians have a very broad scope, this change would provide Medicare patients with a wide choice of providers and eliminate current barriers to care.
The American Chiropractic Association has been instrumental in its efforts to bring the proposal to this point, as even the introduction of legislation is a daunting political process. The Illinois Chiropractic Society has already signed onto the profession-wide letter pressing for the bill’s passage addressed to the United States Senate and House of Representatives. Additionally, in January, the ICS will be in Washington, D.C. with the American Chiropractic Association lobbying for this and other important chiropractic issues.
This bill introduction is still in its early stages, and the national political process can seem formidable. We will continue to keep you informed about the bill’s progress. As a reminder, the political process is defined in very specific steps but can have various nuances within the steps.
Here are the steps for how a bill becomes a federal (U.S.) law (state steps are similar):
1. The Creation of a Bill. Members of the House or Senate draft, sponsor and introduce bills for consideration by Congress;
2. House Committee studies, refers to subcommittee, revises, and votes to advance;
3. Full House debates, amends, and votes to pass;
4. Senate Committee studies refers to subcommittee, revises, and votes to advance;
5. Full Senate debates, amends, and votes to pass;
6. Conference Committees meets to resolve differences in House and Senate versions; and
7. Presidents signs or vetoes.
The ICS looks forward to advancing the profession and continuing to work to improve patient choices.