I 
115TH CONGRESS 
2D SESSION 
H. R. 7157 
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 
NOVEMBER 16, 2018 
Mr. PAULSEN introduced the following bill; which was referred to the Com-
mittee 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 li-
cense, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Chiropractic Patients’ 
Freedom of Choice Act of 2018’’. 
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SEC. 2. STATEMENT OF PURPOSE. 
It is the purpose of this Act to expand recognition 
and coverage of a doctor of chiropractic as a ‘‘physician’’ 
under the Medicare program in connection with the per-
formance of any function or action, including current serv-
ice of ‘‘manual manipulation of the spine to correct a sub-
luxation as demonstrated to exist’’, as is legally authorized 
by the State in which such doctor performs such function 
or action. 
SEC. 3. PROVIDING MEDICARE COVERAGE FOR ALL PHYSI-
CIANS’ SERVICES FURNISHED BY DOCTORS 
OF CHIROPRACTIC WITHIN THE SCOPE OF 
THEIR LICENSE. 
(a) IN GENERAL.—Section 1861(r) of the Social Se-
curity Act (42 U.S.C. 1395x(r)) is amended by striking 
‘‘a chiropractor who is licensed as such by the State (or 
in a State which does not license chiropractors as such, 
is legally authorized to perform the services of a chiro-
practor in the jurisdiction in which he performs such serv-
ices), and who meets uniform minimum standards promul-
gated by the Secretary, but only for the purpose of sec-
tions 1861(s)(1) and 1861(s)(2)(A) and only with respect 
to treatment by means of manual manipulation of the 
spine (to correct a subluxation) which he is legally author-
ized to perform by the State or jurisdiction in which such 
treatment is provided’’ and inserting ‘‘a doctor of chiro-
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practic who is licensed as a doctor of chiropractic or a 
chiropractor by the State in which the function or action 
is performed and whose license provides legal authoriza-
tion to perform such function or action in such State or 
in the jurisdiction in which the function or action is per-
formed’’. 
(b) CERTAIN COVERAGE LIMITS.—Section 1833(aa) 
of the Social Security Act is amended by adding at the 
end the following: 
‘‘(11) LIMITATION
ON
PAYMENT.—Notwith-
standing any other provision of this part, in the case 
of services of a chiropractor described in section 
1861(r)(5) whose pattern of billing for the most re-
cent previous period for which data is available is 
determined under paragraph (1) to be aberrant com-
pared to peers, payment may be made under this 
part only if such services are treatment by means of 
manual manipulation of the spine.’’. 
Æ 
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