Radiology societies voice ‘strong opposition’ to bill expanding Medicare coverage for chiropractic services
Radiology societies are voicing “strong opposition” to a recently proposed bill that would expand Medicare coverage for chiropractic care.
The federal payment program for seniors has covered such services since 1972, but “outdated provisions” force beneficiaries to seek diagnostic tests and other items from different providers. In response, members of the U.S. House and Senate are proposing the Chiropractic Medicare Coverage Modernization Act, ensuring reimbursement for all medically necessary services provided by chiropractors.
However, the American College of Radiology and American Society of Neuroradiology have now joined over 90 other doc lobbying groups led by the AMA to announce their disapproval. They shared their concerns in a recent letter to the two bills’ sponsors, which ASNR promoted in an update published Tuesday.
“Our organizations are concerned that permitting chiropractors to bill Medicare for the full and likely expanded scope of their license in a given state will lead to an unnecessary redistribution of scarce Medicare resources,” the American Medical Association, all 50 state physician societies, ACR and ASNR recently wrote to lawmakers. Doing so, they added, will likely take funds from medical groups, redistributing them “to nonphysician practitioners for services that they lack sufficient training and expertise to perform. Such expansion would increase overall Medicare costs and jeopardize the health and safety of Medicare patients.”
The letter is addressed to Sens. Kevin Cramer, R-N.D., and Richard Blumenthal, D-Conn., who are sponsoring the Senate bill, along with Reps. Greg Steube, R-Fla., and John B. Larson, D-Conn., who introduced the House version. Supporters say the legislation would provide a path for Medicare recipients to better manage pain without resorting to opioids. Currently, the program only covers chiropractic care deemed “medically necessary, subjecting beneficiaries to “burdensome red tape requirements.” The Chiropractic Medicare Coverage Modernization Act seeks to remove these obstacles, bringing coverage rules more in line with rules imposed by private payers.
Along with joint mobilization, physiological therapy, and soft tissue massage techniques, the bill also would extend coverage to include X-rays and other related diagnostic services needed.
“My legislation will provide Medicare beneficiaries across the country with more flexibility in their treatment options and will help lower the risk of individuals turning to opioids for pain management,” Rep. Steube said in a statement. “Medicare beneficiaries deserve access to all chiropractic services without burdensome red tape.”
The radiology societies said they “greatly value the contribution of chiropractors.” However, they’re troubled the legislation would authorize them to use the title “physician” under the Medicare Part B program and be paid the same rate as MDs and DOs. Removing the current “manual manipulation” of the spine limitation in the program opens the door for chiropractors to provide other services “they have not been specifically trained to provide.” Physicians are required to complete upward of 16,000 hours of clinical training, while chiropractic students only must meet a minimum of 4,200 instructional hours, the groups wrote.
“Given their relatively limited education and training, chiropractors’ scope of practice is appropriately restricted under Medicare to treatment by means of manual manipulation, i.e., by the use of the hands,” the radiology societies wrote. “This limitation is aligned with chiropractic training and the treatments that chiropractors most often provide involving common musculoskeletal complaints such as back pain.”
The legislation also is supported by the American Chiropractic Association and the North Dakota Chiropractic Association, among others, lawmakers noted. Other co-sponsors include Sens. Tammy Baldwin, D-Wis., Chris Coons, D-Del., Steve Daines, R-Mont., Martin Heinrich, D-N.M., John Hoeven, R-N.D., Amy Klobuchar, D-Minn., Jerry Moran, R-Kan., Mike Rounds, R-S.D. and Jeanne Shaheen, D-N.H.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.