Youngstown Daily Legal News

With goal of reducing opioid use, Medicaid coverage of chiropractic care proposed

KEITH ARNOLD
Special to the Legal News
Published: March 22, 2019

A bill before a committee of lawmakers in the Ohio House of Representatives could help Ohioans kick their opioid habit by expanding chiropractic care to Medicaid beneficiaries.

The Health Committee last week heard testimony from the Republican sponsor of the bill, Rep. Scott Lipps of Franklin.

"Chiropractic care is widely-recognized as one of the safest, drug-free, non-invasive treatments for conditions such as back and neck pain," Lipps told fellow lawmakers. "Chiropractic methods can solve the root cause of pain, instead of masking the pain and risking dependency on opioids."

He noted that one in six Ohio Medicaid beneficiaries between 2016 and 2017 received an opioid prescription.

"The hope for this bill is to offer an alternative to opioids and curb addiction related to the opioid crisis," he said. "One study done in New Hampshire found that adults receiving chiropractic services were 55 percent less likely to fill a prescription for opioids."

Filed as House Bill 102, the measure seeks to require the state Medicaid program to cover all services provided by a licensed chiropractor acting within the scope of his or her practice.

Currently, coverage is limited to treatment of a diagnosed subluxation - a slight dislocation of vertebrae in the spine - or diagnostic analyses to determine if a subluxation exists.

Patients also are limited in the number of outpatient treatments they can receive per year unless a physician has given prior authorization for chiropractic care.

"This bill will also protect chiropractors, by requiring that Medicaid reimburse them at the same rate as other physicians," Lipps said. "This will encourage more chiropractors to accept Medicaid patients and give Ohioans receiving Medicaid more options."

He said, often, Medicaid patients who are denied chiropractic care often seek out covered but more expensive treatments, such as surgeries or prescription medications.

"By ensuring coverage of all chiropractic services, Ohio could realize savings as patients substitute chiropractic services in place of more expensive treatments," the lawmaker continued. "According to an analysis done by the Ohio State Chiropractor Association, Ohio Medicaid could save $32 million to $65 million per year by simply covering more chiropractic services.

"The State of Missouri, which is the model legislation for HB 102, found $12 million in savings, by calculating the use of chiropractic services in lieu of prescribing opioids for pain which would reduce the costs for hospital, pharmacy and physician services."

Current federal law limits coverage for chiropractic services to treatment by means of spinal manipulation, Ohio Legislative Service Commission analysis noted.

"This means that other chiropractic services that the bill requires the Medicaid program to cover are not eligible for FFP (federal financial participation) absent a waiver from the U.S. Centers for Medicare and Medicaid Services," attorney Jason Hoskins wrote for the commission.

Ohio law generally prohibits a component of the Medicaid program from being implemented without federal approval if the component requires federal approval, sufficient federal financial participation for the component and sufficient nonfederal funds for the component that qualify as funds needed to obtain the federal financial participation.

The bill exempts the chiropractic services it requires Medicaid to cover from the limitations and requires Medicaid to cover chiropractic services in the absence of sufficient federal financial participation, Hoskins concluded.

A second hearing of HB 102 had not been scheduled at the time of publication.

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