I 

116TH CONGRESS 

1ST SESSION H. R. 3654 

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. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 9, 2019 

Mr. HIGGINS of New York (for himself and Mr. REED) introduced the following bill; which was 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 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Chiropractic Medicare 

5 Coverage Modernization Act of 2019’’. 


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1 SEC. 2. FINDINGS; STATEMENT OF PURPOSE. 

2 (a) FINDINGS.—Congress finds the following: 

3 (1) In 1972, coverage was established under the 

4 Medicare program for beneficiaries to receive chiro5 practic care. 

6 (2) Unfortunately, the antiquated statute re7 stricts beneficiaries to one service in a chiropractic 

8 clinic and Medicare chiropractic coverage has not 

9 kept up with private sector coverage and other fed10 eral health delivery systems. 

11 (3) Today, due to positive evidence-based out12 comes and cost effectiveness of the services provided 

13 by doctors of chiropractic, private coverage for chiro14 practic services has evolved and State licensure for 

15 chiropractors has advanced to meet patient needs 

16 and health outcomes. 

17 (4) This Act would bring Medicare chiropractic 

18 coverage more in line with that provided with the 

19 Department of Veterans Affairs, Department of De20 fense, the Federal Employee Health Benefits Pro21 gram, and private health insurance coverage. 

22 (b) PURPOSE.—It is the purpose of this Act to ex23 pand recognition and coverage of a doctor of chiropractic 

24 as a ‘‘physician’’ under the Medicare program in connec25 tion with the performance of any function or action, in26 cluding current service of ‘‘manual manipulation of the 


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1 spine to correct a subluxation’’, as is legally authorized 

2 by the State in which such doctor performs such function 

3 or action. 

4 SEC. 3. PROVIDING MEDICARE COVERAGE FOR ALL PHYSI5 CIANS’ SERVICES FURNISHED BY DOCTORS 

6 OF CHIROPRACTIC WITHIN THE SCOPE OF 

7 THEIR LICENSE. 

8 (a) IN GENERAL.—Section 1861(r)(5) of the Social 

9 Security Act (42 U.S.C. 1395x(r)(5)) is amended by strik10 ing ‘‘a chiropractor who is licensed as such by the State 

11 (or in a State which does not license chiropractors as such, 

12 is legally authorized to perform the services of a chiro13 practor in the jurisdiction in which he performs such serv14 ices), and who meets uniform minimum standards promul15 gated by the Secretary, but only for the purpose of sec16 tions 1861(s)(1) and 1861(s)(2)(A) and only with respect 

17 to treatment by means of manual manipulation of the 

18 spine (to correct a subluxation) which he is legally author19 ized to perform by the State or jurisdiction in which such 

20 treatment is provided’’ and inserting ‘‘a doctor of chiro21 practic who is licensed as a doctor of chiropractic or a 

22 chiropractor by the State in which the function or action 

23 is performed and whose license provides legal authoriza24 tion to perform such function or action in such State or 


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1 in the jurisdiction in which the function or action is per2 formed’’. 

3 (b) CERTAIN COVERAGE LIMITS.—Section 1833 of 

4 the Social Security Act is amended by adding at the end 

5 the following new subsection: 

6 ‘‘(cc) LIMITATION ON PAYMENT OF SERVICES PRO7 VIDED BY CERTAIN DOCTORS OF CHIROPRACTIC.—Not8 withstanding any other provision of this part, in the case 

9 of services of a doctor of chiropractic described in section 

10 1861(r)(5), payment may only be made under this part 

11 for such services if— 

12 ‘‘(1) such services are furnished by a doctor of 

13 chiropractic who is verified once, by a process de14 signed by the Secretary, as attending an educational 

15 documentation webinar, or other similar electronic 

16 product, designed by the Secretary or an updated 

17 modified version of such webinar, as designed by the 

18 Secretary; or 

19 ‘‘(2) such services are treatment by means of 

20 manual manipulation of the spine to correct a sub21 luxation.’’. 

Æ 


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