Medicare Complicates Local Chiropractic Medicare Complicates Local Chiropractic

Arianna Spears office manager at University Chiropractic and Natural Healing says, accepting Medicare can be challenging for some local chiropractors….

“The lack of reimbursement, the amount of time the billing would take, Medicare would also have really high guidelines of what you have to do as a chiropractic office just to get paid.”

Local Chiropractors say, Medicare is restricting coverage on certain chiropractic visits…

“Medicare is no longer trying to cover the initial appointment… that leaves us in a funny area because now we have to charge our Medicare patients.”

This potential change is forcing doctors to make some tough decisions…

” Some offices after they heard the rule were like we’re not going to take it anymore, other offices were like we’ll bite the bullet.”

Currently, with so few local doctors accepting Medicare, Spears fears this new rule will prevent patients from getting the treatment they need. Scarlett Lisjak N-C-C News.

By Scarlett Lisjak. Syracuse N.Y. (NCC News)- Last month, two New York State Congressmen introduced the Chiropractic Medicare Coverage Modernization Act of 2019.  Intended to expand the scope of chiropractic procedures covered by Medicare, the bill was a progressive change in healthcare. Currently, the only chiropractic procedure Medicare-covers is the treatment of subluxations which is the misalignment of the spine.

The limited procedures covered by Medicare forces patients to pay out of pockets to get the full treatment they need.

Additional treatments can be expensive for Medicare patients. Still, some patients are willing to pay extra to avoid medications and surgeries, often advised by medical doctors, to treat subluxations. 

Despite patients’ need for additional chiropractic treatments, and the push for medicare expansion of such treatments outlined in the Chiropractic Modernization Act of 2019, Arianna Spears, the office manager at University Chiropractic and Natural Healing, said Medicare will no longer cover initial visits.

If Medicare is the primary insurance of a patient and Blue Cross Blue Shield is the secondary, Spears states, “we have to follow Medicare rules.” Spears emphasizes that they would “have to charge our Medicare patients for their initial appointments, like cash-patients” because “Medicare is no longer trying to cover initial appointments.”

The initial visits can vary in price depending on the chiropractor, and as a result, become expensive for the patient.

Spears said this complicates what is “best for the actual patient.” The chiropractic offices want to treat them, she said, but the offices must inform patients that they are not accepting Medicare anymore.

While “other offices were like… we’ll bite the bullet on it” and treat the patient, “because it’s not the financial part of it, it’s about treating your patients and making sure their taken care of,” she said.

She said most local chiropractic offices already don’t accept Medicare because of the complex guidelines chiropractors have to meet to get paid, along with the long wait periods and lack of reimbursements, and the time billing takes.

Spear fears this new change could further limit the number of chiropractors willing to accept Medicare, and therefore, prevent patients from getting the care they need.

However, not all Medicare plans are problematic with chiropractic. She said some local offices do have good experiences with accepting Medicare, while others are choosing to not bother with it anymore.

Contacted the Medicare office for confirmation, as of yet, there has not been a response nor comment on this matter.

Related Articles