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Committee lays over bill to expand chiropractic coverage under Minnesota health programs
Summary
Senate File 595, which would remove an annual exam limitation, add qualifying diagnoses, and expand covered therapeutic services for chiropractic providers under Medical Assistance and MinnesotaCare, was laid over after testimony from chiropractors and Department of Human Services officials.
The committee heard Senate File 595, a bill to modify Medical Assistance and MinnesotaCare coverage for chiropractic services. Sponsor Sen. Greg Lisky said the bill removes an annual-evaluation limitation, adds qualifying diagnoses (acute spinal pain, chronic spinal pain, neuromusculoskeletal pain) and adds therapeutic exercise and manual therapy techniques as covered services.
Dr. Richard Prenton, a practicing chiropractor employed at Hennepin Healthcare, testified that the current policy—which allows only a single chiropractic evaluation per year—creates access barriers when patients present with new injuries during the year and cannot afford an out-of-pocket exam. He said therapeutic exercise and manual/soft-tissue therapies are already used by physical therapists and other providers and that adding chiropractors as providers of those services would allow timely patient care and reduce reliance on emergency departments for spinal pain.
Department of Human Services staff described the fiscal approach DHS used to estimate costs: DHS compared services provided by physical and occupational therapists, estimated average payments, and projected a potential uptick in utilization if chiropractors provided those services. DHS staff said the largest cost driver in their estimate was payment for evaluation and management visits that are not currently paid for chiropractic providers under MHCP.
Committee members questioned fiscal assumptions and substitution effects (whether increased use of chiropractors could reduce use of more expensive services). Senator Lisky urged continued attention to patients who rely on chiropractic care; Senator Kupak and Sen. Abler sought more detail on fiscal estimates and substitutionary savings. The committee laid the bill over for possible inclusion.
