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[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H. Con. Res. 62 Introduced in House (IH)]

106th CONGRESS
  1st Session
H. CON. RES. 62

 Expressing the sense of Congress regarding the guaranteed coverage of 
        chiropractic services under the Medicare+Choice program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             March 18, 1999

  Mrs. Cubin submitted the following concurrent resolution; which was 
referred to the Committee on 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

_______________________________________________________________________

                         CONCURRENT RESOLUTION

 
 Expressing the sense of Congress regarding the guaranteed coverage of 
        chiropractic services under the Medicare+Choice program.

    Resolved by the House of Representatives (the Senate concurring),

SECTION 1. SENSE OF CONGRESS REGARDING GUARANTEED COVERAGE OF 
              CHIROPRACTIC SERVICES UNDER THE MEDICARE+CHOICE PROGRAM.

    (a) Findings.--The Congress finds the following:
            (1) In 1972 Congress included chiropractors under the 
        medicare part B definition of physician to provide treatment by 
        means of manual manipulation of the spine to correct a 
        subluxation. This language was crafted to identify a specific 
        chiropractic service using terminology that at the time was 
        unique to chiropractic. No other medical profession used the 
        term manual manipulation of the spine to correct a subluxation. 
        Congress was aware in 1972 that patients required direct access 
        to chiropractic if the benefit was to have any practical 
        meaning.
            (2) Under traditional fee-for-service medicare, 
        beneficiaries were given direct access to doctors of 
        chiropractic for this benefit. The sole limitation, shared by 
        all medicare providers, is the limitation outlined in section 
        1862(a)(1) of the Social Security Act, which requires medicare 
        to pay only for those services that are determined to be 
        reasonable and necessary.
            (3) Treatment by manual manipulation of the spine to 
        correct a subluxation is uniquely chiropractic. Doctors of 
        chiropractic are the only providers educated and trained to 
        perform the treatment of manual manipulation of the spine to 
        correct a subluxation.
            (4) In 1982 Congress established the Medicare HMO/CMP 
        program directing that all HMO's provide all part B benefits to 
        medicare beneficiaries. In promulgating regulations, the Health 
        Care Financing Administration created a regulatory authority 
        for HMO's to specify which provider would furnish medicare 
        benefits.
            (5) In 1990 Congress directed the Health Care Financing 
        Administration to study the extent to which medicare HMO's make 
        chiropractic services available to medicare beneficiaries. 
        Based on the findings of this study, the Secretary of Health 
        and Human Services was required to make specific legislative 
        and regulatory recommendations necessary to ensure access to 
        chiropractic services. The study and subsequent recommendations 
        have not been forthcoming.
            (6) Historically, chiropractic patients in medicare have 
        encountered near total exclusion from chiropractic services 
        once they enter into a medicare HMO.
            (7) The Balanced Budget Act of 1997, which instituted part 
        C of medicare, establishes that each Medicare+Choice plan 
        ``shall provide those items and services . . .  for which 
        benefits are available under parts A and B''.
            (8) As a covered service under part B of medicare, 
        chiropractic care which includes treatment by means of manual 
        manipulation of the spine to correct a subluxation as performed 
        by a doctor of chiropractic, should be a covered service under 
        part C.
    (b) Sense of Congress.--It is the sense of Congress that--
            (1) treatment by means of manual manipulation of the spine 
        to correct a subluxation is a uniquely chiropractic service, 
        which Congress recognized in 1972 as a medicare part B benefit;
            (2) it is the unequivocal intent of Congress to ensure that 
        every Medicare+Choice beneficiary has access to all services 
        covered under the original part B medicare fee-for-service 
        program; and
            (3) as a covered medicare part B service, treatment by 
        means of manual manipulation of the spine to correct a 
        subluxation provided by a doctor of chiropractic is a 
        guaranteed service for beneficiaries under the new 
        Medicare+Choice program.
                                 <all>
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