H.R.539 - Chiropractic Medicare Coverage Modernization Act of 2025 (119th Congress)
Summary
H.R.539, the Chiropractic Medicare Coverage Modernization Act of 2025, aims to amend Title XVIII of the Social Security Act to broaden Medicare coverage for chiropractic services. The bill seeks to include all physicians' services furnished by doctors of chiropractic within the scope of their license. This expands upon the current coverage, which is limited to manual manipulation of the spine to correct a subluxation.
Expected Effects
The bill would expand the definition of 'physician' under Medicare to include doctors of chiropractic performing any legally authorized function or action within their state license. It also mandates that doctors of chiropractic attend an educational documentation webinar to be eligible for Medicare payments, unless the services are limited to manual manipulation of the spine.
Potential Benefits
- Increased Access to Care: Beneficiaries gain access to a wider range of chiropractic services.
- Alignment with Other Healthcare Systems: Medicare coverage would align more closely with the Department of Veterans Affairs, Department of Defense, the Federal Employee Health Benefits Program, and private health insurance.
- Modernization of Medicare: Updates Medicare coverage to reflect advancements in chiropractic care and state licensure.
- Potential Cost Savings: Evidence-based outcomes and cost-effectiveness of chiropractic services may lead to reduced healthcare costs.
- Patient Choice: Empowers patients to choose chiropractic care for a broader range of conditions.
Most Benefited Areas:
Potential Disadvantages
- Increased Medicare Spending: Expanding coverage could lead to higher Medicare expenditures.
- Potential for Overutilization: Broader coverage might result in unnecessary or excessive use of chiropractic services.
- Administrative Burden: Implementing and monitoring the educational documentation webinar requirement could create administrative challenges.
- Lack of Evidence for All Services: The evidence base for the effectiveness of all chiropractic services may not be as strong as for manual manipulation of the spine.
- Potential for Fraud: Expanded coverage could create opportunities for fraudulent billing practices.
Most Disadvantaged Areas:
Constitutional Alignment
The bill appears to align with the general welfare clause of the Constitution (Preamble), as it aims to improve healthcare access for Medicare beneficiaries. However, the specific details of implementation and potential costs would need further scrutiny to ensure fiscal responsibility and avoid unfunded mandates on states. The bill does not appear to infringe upon any specific individual rights or liberties outlined in the Bill of Rights.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).