H.R. 7157 – Chiropractic Patients' Freedom of Choice Act of 2018

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Updated April 16, 2026 at 12:19 AM UTC

The Chiropractic Patients' Freedom of Choice Act of 2018 would expand Medicare coverage to include all services that a licensed chiropractor is authorized to provide under state law, effectively recognizing chiropractors as physicians for Medicare purposes. It also creates a safeguard that limits Medicare payments to spinal‑manipulation services for chiropractors whose billing patterns are deemed abnormal.

Key Provisions

Amends the Medicare definition of a chiropractor in the Social Security Act so that any doctor of chiropractic who is licensed and legally authorized by the state to perform services can be treated as a physician for Medicare coverage, not just spinal‑manipulation procedures.
Adds a payment limitation: if a chiropractor’s billing pattern is found to be unusually high compared to peers, Medicare will only pay for services that involve manual spinal manipulation, restricting payment for other services.

Legislative Activity

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2 earlier actions

HouseCommittee Latest Action

Referred to the Subcommittee on Health.

Health Subcommittee

November 28, 2018

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HouseIntro Referral

Introduced in House

November 16, 2018

HouseIntro Referral

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.

Energy and Commerce Committee

November 16, 2018

HouseCommittee

Referred to the Subcommittee on Health.

Health Subcommittee

November 28, 2018

Bill Text

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Introduced in HouseIssued November 16, 2018

I

115th CONGRESS

2d Session

H. R. 7157

IN THE HOUSE OF REPRESENTATIVES

November 16, 2018

Mr. Paulsen 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.

Short title

This Act may be cited as the Chiropractic Patients’ Freedom of Choice Act of 2018.

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 performance of any function or action, including current service of manual manipulation of the spine to correct a subluxation as demonstrated to exist, as is legally authorized by the State in which such doctor performs such function or action.

3.

Providing Medicare coverage for all physicians’ services furnished by doctors of chiropractic within the scope of their license

(a)

In general

Section 1861(r) of the Social Security 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 chiropractor in the jurisdiction in which he performs such services), and who meets uniform minimum standards promulgated by the Secretary, but only for the purpose of sections 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 authorized to perform by the State or jurisdiction in which such treatment is provided and inserting a doctor of chiropractic 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 authorization to perform such function or action in such State or in the jurisdiction in which the function or action is performed.

(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

Notwithstanding 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 recent previous period for which data is available is determined under paragraph (1) to be aberrant compared to peers, payment may be made under this part only if such services are treatment by means of manual manipulation of the spine.

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