A bill to amend title XVIII of the Social Security Act to provide Medicare coverage for all physicians' services furnished by doctors of chiropractic within the scope of their license, and for other purposes.
- Bill Number
- S. 106
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-01-16: Read twice and referred to the Committee on Finance.
- Last Updated
- 2026-03-06T11:57:02Z
AI-Generated Summary
Purpose of the Legislation
The Chiropractic Medicare Coverage Modernization Act of 2025 aims to update Medicare coverage for services provided by doctors of chiropractic. It seeks to expand recognition of these professionals as "physicians" under Medicare, allowing coverage for all services they are licensed to perform by their state, rather than limiting it to a single type of treatment. This aligns Medicare with broader coverage in private insurance, the Department of Veterans Affairs, Department of Defense, and federal employee health programs, based on evidence of positive health outcomes and cost-effectiveness.
Key Provisions
- Expansion of Physician Definition: Amends Section 1861(r)(5) of the Social Security Act to redefine a "physician" to include doctors of chiropractic licensed by their state, covering any services they are legally authorized to provide (e.g., beyond just spinal adjustments).
- Payment Requirements for Expanded Services: Adds a new subsection (ee) to Section 1833 of the Social Security Act, requiring that Medicare payments for chiropractic services (other than traditional spinal manipulation) be made only to providers who have completed a one-time verification process, such as attending an educational webinar or similar online training designed by the Secretary of Health and Human Services. Traditional spinal manipulation services remain covered without this requirement.
- Findings and Intent: Congress notes that current Medicare chiropractic coverage, established in 1972, is outdated and restrictive compared to state licenses and other health systems. The bill promotes expanded access to chiropractic care to meet patient needs.
Significant Changes to Existing Law
- Broadens Coverage Scope: Previously, Medicare covered chiropractors only for "manual manipulation of the spine to correct a subluxation" (a partial misalignment of spinal bones) under specific sections of the law. The bill removes this limitation, allowing coverage for all state-licensed chiropractic services, such as diagnostic exams or other non-surgical treatments.
- Introduces Training Verification: Adds a new condition for payments on expanded services, requiring a one-time educational check (e.g., a webinar) to ensure providers meet federal standards, while exempting the longstanding spinal manipulation service.
Potential Impacts
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) will need to design and implement the verification process (e.g., webinars), potentially increasing administrative workload but standardizing chiropractic billing. Medicare spending may rise due to broader coverage, though the bill cites cost-effectiveness from evidence-based chiropractic care.
- On Citizens: Medicare beneficiaries, especially older adults with musculoskeletal issues, gain access to a wider range of chiropractic services without out-of-pocket costs for covered treatments, potentially improving health outcomes and reducing reliance on other providers.
- On International Relations: No direct impacts, as this is a domestic health policy focused on U.S. Medicare.
Main Stakeholders Affected
- Medicare Beneficiaries: Primary beneficiaries, who will have expanded access to chiropractic care.
- Doctors of Chiropractic: Gain broader Medicare reimbursement opportunities, limited only by state licenses and the new verification requirement.
- Federal Health Agencies: CMS and the Department of Health and Human Services must update policies, training materials, and payment systems.
- Taxpayers and Insurers: Indirectly affected through potential increases in Medicare program costs, balanced against savings from effective, non-drug treatments.
Notable Legal, Constitutional, or Political Implications
- Legal Implications: Strengthens chiropractors' status under federal law by equating licensed services to those of other physicians for Medicare purposes, potentially reducing disputes over coverage denials. It respects state licensing authority, avoiding federal overreach into professional scopes of practice.
- Constitutional Implications: None significant; the bill operates within Congress's enumerated powers to regulate interstate commerce and spend for the general welfare, as with existing Medicare expansions.
- Political Implications: Bipartisan support (introduced by senators from both parties) highlights non-partisan interest in modernizing healthcare. It could set a precedent for updating other outdated Medicare provisions, influencing future debates on provider equity and program costs, but may face scrutiny over fiscal impacts in budget discussions.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (15)
Sen. Blumenthal, Richard [D-CT], Sen. Daines, Steve [R-MT], Sen. Baldwin, Tammy [D-WI], Sen. Moran, Jerry [R-KS], Sen. Shaheen, Jeanne [D-NH], Sen. Rounds, Mike [R-SD], Sen. Klobuchar, Amy [D-MN], Sen. Heinrich, Martin [D-NM], Sen. Hoeven, John [R-ND], Sen. Coons, Christopher A. [D-DE], Sen. Lummis, Cynthia M. [R-WY], Sen. Wicker, Roger F. [R-MS], Sen. Blunt Rochester, Lisa [D-DE], Sen. Luján, Ben Ray [D-NM], Sen. Hawley, Josh [R-MO]
Recent Actions
- 2025-01-16: Read twice and referred to the Committee on Finance.
- 2025-01-16: Introduced in Senate
Bill Versions
- Chiropractic Medicare Coverage Modernization Act of 2025 — issued 2025-01-16 — PDF (4 pages)