Medicare pilot project expands coverage for chiropractic care

Orthopedic surgeons call for a study of outcomes under the demonstration program.

By David Glendinning, AMNews staff. Dec. 13, 2004.

Washington -- Starting next spring, the Centers for Medicare & Medicaid Services will begin paying licensed chiropractors in four states for services beyond manual manipulation of the spine to correct pre-diagnosed malfunctions.

The demonstration, which was mandated in last year's Medicare reform act, will not create any new benefits. Instead, it will allow doctors of chiropractic in those areas to provide expanded care, such as diagnostic services, x-rays and physical therapy under Medicare. The four states are Illinois, Maine, New Mexico and Virginia.

The fact that Medicare has covered only one chiropractic service since incorporating the practice into its benefits has convinced chiropractors that they have a long way to go toward government acceptance.

"This has been a sore point with them since their inclusion in Medicare in 1972," said Rick Miller, a lobbyist and consultant with the American Chiropractic Assn. "And there are still pockets of resistance."

Congress has long been the primary driver behind expanding access to chiropractors, and the ACA believes that any future progress will have to come on the legislative level, Miller said. The care "is not going to be substantially embraced by CMS anytime soon," he stated.

The chiropractic community has champions on Capitol Hill. Senate Finance Committee Chair Charles Grassley (R, Iowa), who hails from a state that founded the first chiropractic college, led the effort to include the two-year demonstration project in the Medicare bill.