Chiropractic Medicare Coverage Modernization Act of 2025
- Bill Number
- H.R. 539
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-01-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-06-30T08:07:09Z
AI-Generated Summary
Purpose of the Legislation
The Chiropractic Medicare Coverage Modernization Act of 2025 aims to update Medicare's coverage for chiropractic services by expanding the recognition of doctors of chiropractic as "physicians" under the program. This allows Medicare to cover a broader range of services that chiropractors are legally authorized to provide under state licenses, beyond the current narrow focus on spinal manipulation. The goal is to align Medicare with more modern coverage in private insurance, Veterans Affairs, Department of Defense, and federal employee health programs, based on evidence of chiropractic care's effectiveness and cost savings.
Key Provisions Outlined
- Expanded Definition of Chiropractors as Physicians: Amends Section 1861(r)(5) of the Social Security Act to define a "doctor of chiropractic" (or chiropractor) as a physician for Medicare purposes if they are licensed by the state where services are performed and authorized to provide those services.
- Broadened Service Coverage: Medicare will cover any physicians' services within the chiropractor's state-licensed scope, including the existing service of manual manipulation of the spine to correct a subluxation (a misalignment of the spine).
- Payment Requirements for New Services: Adds a new subsection (ee) to Section 1833 of the Social Security Act, limiting Medicare payments for these expanded chiropractic services to cases where:
- The chiropractor has been verified (once) as having attended an educational webinar or similar electronic training designed by the Secretary of Health and Human Services (HHS); or
- The service is the traditional spinal manipulation to correct a subluxation (no training required).
- Congressional Findings: Recognizes that 1972 Medicare chiropractic coverage is outdated and limited, while state licenses and other health systems have evolved to support broader, evidence-based chiropractic care.
Significant Changes to Existing Law
- From Limited to Expanded Coverage: Current law (since 1972) restricts Medicare chiropractic benefits to only manual spinal manipulation for subluxation, performed by licensed chiropractors meeting federal standards. The bill removes this restriction, allowing coverage for all state-authorized services (e.g., potentially including exams, diagnostics, or other treatments chiropractors are licensed for).
- Introduction of Training Mandate: Adds a one-time verification process for chiropractors to access payments for non-spinal services via HHS-designed education, ensuring providers are informed about Medicare rules without ongoing requirements.
- No Change to Existing Spinal Coverage: The traditional spinal manipulation service remains fully covered without additional hurdles.
Potential Impacts
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS, part of HHS) will need to design and implement the educational webinar, verify chiropractor attendance, and update payment systems, potentially increasing administrative workload but promoting cost-effective care.
- On Citizens: Medicare beneficiaries (primarily seniors and disabled individuals) gain access to more comprehensive chiropractic services, improving health outcomes for conditions like back pain without needing referrals to other providers. This could reduce overall healthcare costs by leveraging non-drug, evidence-based treatments.
- On International Relations: No direct impact, as the bill focuses on domestic U.S. healthcare policy.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary beneficiaries, who will have expanded access to chiropractic care.
- Doctors of Chiropractic: Gain broader Medicare reimbursement opportunities, potentially increasing their role in primary care-like services within state scopes.
- Federal Agencies: HHS and CMS, responsible for implementation, training, and oversight.
- Taxpayers and Insurers: May see long-term savings from cost-effective chiropractic interventions, aligning Medicare with private and other federal programs.
- State Licensing Boards: Indirectly affected, as coverage ties to state-defined scopes of practice.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: Strengthens chiropractors' status under Medicare by equating them to physicians for licensed services, potentially reducing legal disputes over coverage denials. The bill respects state authority over licensing, avoiding federal overreach.
- Constitutional Implications: None apparent; it operates within Congress's enumerated power to regulate interstate commerce and provide for public welfare via Social Security amendments.
- Political Implications: Bipartisan support (introduced by Republicans and Democrats) highlights non-partisan interest in modernizing healthcare access. It could influence future expansions of Medicare to allied health professions, addressing criticisms of outdated 1970s-era restrictions amid growing evidence for integrative care.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Steube, W. Gregory [R-FL-17]
Cosponsors (166)
Rep. Larson, John B. [D-CT-1], Rep. Smith, Adrian [R-NE-3], Rep. Boyle, Brendan F. [D-PA-2], Rep. Van Duyne, Beth [R-TX-24], Rep. Davis, Donald G. [D-NC-1], Rep. Zinke, Ryan K. [R-MT-1], Rep. Omar, Ilhan [D-MN-5], Rep. Wasserman Schultz, Debbie [D-FL-25], Rep. Soto, Darren [D-FL-9], Rep. Franklin, Scott [R-FL-18], Rep. LaHood, Darin [R-IL-16], Rep. Nehls, Troy E. [R-TX-22], Rep. Sewell, Terri A. [D-AL-7], Rep. Hoyle, Val T. [D-OR-4], Rep. Cherfilus-McCormick, Sheila [D-FL-20], Rep. Gooden, Lance [R-TX-5], Rep. Hern, Kevin [R-OK-1], Rep. Burlison, Eric [R-MO-7], Rep. Tlaib, Rashida [D-MI-12], Rep. Comer, James [R-KY-1], Rep. Carey, Mike [R-OH-15], Rep. Tiffany, Thomas P. [R-WI-7], Rep. Tokuda, Jill N. [D-HI-2], Rep. Hageman, Harriet M. [R-WY-At Large], Rep. Scanlon, Mary Gay [D-PA-5], Rep. Graves, Sam [R-MO-6], Rep. Davids, Sharice [D-KS-3], Rep. Himes, James A. [D-CT-4], Rep. Hill, J. French [R-AR-2], Rep. Goldman, Craig [R-TX-12], Rep. McBride, Sarah [D-DE-At Large], Rep. Finstad, Brad [R-MN-1], Rep. Leger Fernandez, Teresa [D-NM-3], Rep. Begich, Nicholas [R-AK-At Large], Rep. Haridopolos, Mike [R-FL-8], Rep. Grothman, Glenn [R-WI-6], Rep. Yakym, Rudy [R-IN-2], Rep. Gosar, Paul A. [R-AZ-9], Rep. Rutherford, John H. [R-FL-5], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Bost, Mike [R-IL-12], Rep. Davidson, Warren [R-OH-8], Rep. Massie, Thomas [R-KY-4], Rep. Aderholt, Robert B. [R-AL-4], Rep. Mann, Tracey [R-KS-1], Rep. Johnson, Dusty [R-SD-At Large], Rep. Schneider, Bradley Scott [D-IL-10], Rep. Sorensen, Eric [D-IL-17], Rep. Fitzgerald, Scott [R-WI-5], Rep. Huizenga, Bill [R-MI-4] and 116 more
Recent Actions
- 2025-01-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-01-16: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-01-16: Introduced in House
- 2025-01-16: Introduced in House
Bill Versions
- Chiropractic Medicare Coverage Modernization Act of 2025 — issued 2025-01-16 — PDF (4 pages)