Governor Signs Medicaid Bill – A Big Win for Chiropractic
“25% of Illinoisans are enrolled in Medicaid, and this legislative change may bring the much-needed care that chiropractic physicians deliver to this underserved population.”Dr. Vijay Patel, Illinois Chiropractic Society President
The Illinois Chiropractic Society has been working for the last few decades to improve the availability of chiropractic care for the Medicaid population. We increased our efforts about 8 years ago when the adjustment (CMT) was removed from the budget and from the Medicaid law (except for All-Kids).
This year, the ICS legislative team worked diligently again with several legislative stakeholders to introduce strong legislation to add full coverage for chiropractic in Medicaid. Representative Robyn Gabel (D-Evanston) sponsored our legislation that added this language for potential full chiropractic coverage:
“services performed by a chiropractic physician licensed under the Medical Practice Act of 1987 and acting within the scope of his or her license, including, but not limited to, chiropractic manipulative treatment.”
After a long legislative session and multiple meetings, this language was ultimately included in an omnibus bill (a bill that includes many different bills in one) that came out of the Medicaid workgroup comprised of bipartisan state representatives and senators, as well as representatives of the governor’s office. A special thank you to ICS Board Member Dr. Vince Roberts for his work with our original bill sponsor Representative Gabel and for testifying before the Medicaid workgroup.
At the end of May, the Illinois legislature unanimously passed the Medicaid omnibus bill that added chiropractic coverage.
Then this week, Governor Pritzker signed the bill.
In case you missed that – The chiropractic Medicaid bill passed and was signed! This is an enormous positive step and should be celebrated. The language of the bill now permits Medicaid to change its coverage to include any service that is within chiropractic scope.
As a part of his signing, Governor J.B. Prizker stated, “We won’t stop until everyone can access all aspects of [Medicaid].”
Although this is a monumental step, we are not finished. The law reads that Health and Family Services (HFS) “by rule, shall determine the quantity and quality of and the rate of reimbursement for the medical assistance for which payment will be authorized, and the medical services to be provided, which may include all or part of the following…” This means that HFS must make a determination as to what chiropractic services they will actually cover (i.e., CMT, examinations, x-rays, therapies, etc.). The following must happen before any coverage will be included in Medicaid:
Bill must pass both House and Senate– Completed May 31, 2021 Bill must be signed by the Governor– Completed July 6, 2021
- HFS will form a larger plan with all the Medicaid changes and submits it to the federal government (Centers for Medicare and Medicaid services, or CMS).
- CMS (federal government) will have to approve the above plan.
- HFS (state agency) will then write rules that will align with the plan sent to CMS.
Because HFS has full authority to limit coverage for certain services, we will be advocating strongly in the coming months to maximize appropriate coverage for services rendered by chiropractic physicians. For example, there are currently restrictions in place that limit coverage for certain services when rendered by a specific category of licensed provider, even though those services are within scope for multiple providers. The ICS will work with HFS to eliminate these barriers to care.
The earliest that Medicaid coverage will be available is early 2022. Practically speaking, the steps above can be a lengthy process and implementation may be later 2022. Nonetheless, we celebrate the passage of this critical legislation, knowing that we have a long way to go, but excited for our doctors to play a key role in increasing access to quality health care.
Thank you to our members for supporting this initiative over the years and congratulations to the entire chiropractic profession!