II 

117TH CONGRESS 

2D SESSION S. 4042 

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 SENATE OF THE UNITED STATES 

APRIL 7, 2022 

Mr. BLUMENTHAL (for himself, Mr. CRAMER, Ms. BALDWIN, and Mr. 

WICKER) introduced the following bill; which was read twice and referred 

to the Committee on Finance 

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 2022’’. 

6 SEC. 2. FINDINGS; STATEMENT OF PURPOSE. 

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


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

2 Medicare program for beneficiaries to receive chiro3 practic care. 

4 (2) Unfortunately, the antiquated statute re5 stricts beneficiaries to one service in a chiropractic 

6 clinic and Medicare chiropractic coverage has not 

7 kept up with private sector coverage and other Fed8 eral health delivery systems. 

9 (3) Today, due to positive evidence-based out10 comes and cost effectiveness of the services provided 

11 by doctors of chiropractic, private coverage for chiro12 practic services has evolved and State licensure for 

13 chiropractors has advanced to meet patient needs 

14 and health outcomes. 

15 (4) This Act would bring Medicare chiropractic 

16 coverage more in line with that provided with the 

17 Department of Veterans Affairs, Department of De18 fense, the Federal Employee Health Benefits Pro19 gram, and private health insurance coverage. 

20 (b) PURPOSE.—It is the purpose of this Act to ex21 pand recognition and coverage of a doctor of chiropractic 

22 as a ‘‘physician’’ under the Medicare program in connec23 tion with the performance of any function or action, in24 cluding current service of ‘‘manual manipulation of the 

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


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1 by the State in which such doctor performs such function 

2 or action. 

3 SEC. 3. PROVIDING MEDICARE COVERAGE FOR ALL PHYSI4 CIANS’ SERVICES FURNISHED BY DOCTORS 

5 OF CHIROPRACTIC WITHIN THE SCOPE OF 

6 THEIR LICENSE. 

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

8 Security Act (42 U.S.C. 1395x(r)(5)) is amended by strik9 ing ‘‘a chiropractor who is licensed as such by the State 

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

11 is legally authorized to perform the services of a chiro12 practor in the jurisdiction in which he performs such serv13 ices), and who meets uniform minimum standards promul14 gated by the Secretary, but only for the purpose of sec15 tions 1861(s)(1) and 1861(s)(2)(A) and only with respect 

16 to treatment by means of manual manipulation of the 

17 spine (to correct a subluxation) which he is legally author18 ized to perform by the State or jurisdiction in which such 

19 treatment is provided’’ and inserting ‘‘a doctor of chiro20 practic who is licensed as a doctor of chiropractic or a 

21 chiropractor by the State in which the function or action 

22 is performed and whose license provides legal authoriza23 tion to perform such function or action in such State or 

24 in the jurisdiction in which the function or action is per25 formed’’. 


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

2 the Social Security Act (42 U.S.C. 1395l) is amended by 

3 adding at the end the following new subsection: 

4 ‘‘(ee) LIMITATION ON PAYMENT OF SERVICES PRO5 VIDED BY CERTAIN DOCTORS OF CHIROPRACTIC.—Not6 withstanding any other provision of this part, in the case 

7 of services of a doctor of chiropractic described in section 

8 1861(r)(5), payment may only be made under this part 

9 for such services if— 

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

11 chiropractic who is verified once, by a process de12 signed by the Secretary, as attending an educational 

13 documentation webinar, or other similar electronic 

14 product, designed by the Secretary or an updated 

15 modified version of such webinar, as designed by the 

16 Secretary; or 

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

18 manual manipulation of the spine to correct a sub19 luxation.’’. 

Æ 


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