HF97 (Legislative Session 94 (2025-2026))

Coverage of chiropractic services modified in the medical assistance and MinnesotaCare programs.

Related bill: SF595

AI Generated Summary

Purpose

The bill aims to change how chiropractic care is covered for people enrolled in Minnesota’s health programs. It adds chiropractic services to coverage under Medical Assistance (MA) and MinnesotaCare, clarifies what is covered, and sets limits on use.

Main Provisions

  • Coverage addition: Chiropractic services and related care recommended by a licensed health professional, done according to generally accepted chiropractic standards, would be covered for MA and MinnesotaCare.
  • Included services: Services can include medical evaluation and management, manual therapy, spinal manipulation, and therapeutic exercises to treat acute spinal pain, chronic spinal pain, and neuromusculoskeletal conditions involving the spine.
  • X-ray coverage: Radiographic exams needed to support a diagnosis of subluxation in relevant spine regions would be covered.
  • Visit limits (non-X-ray services): For services other than X-rays, coverage would be limited to one annual evaluation and 24 visits per year unless a health care professional obtains prior authorization for more visits.
  • Provider requirement: Coverage applies when the services are provided by a health professional licensed to perform chiropractic care.

Changes to Existing Law

  • Repeal: The bill repeals a current MinnesotaCare provision (256L.03 subdivision 3b) that previously covered chiropractic services (including exams, manual manipulation, and X-rays).
  • New framework: It replaces the old MinnesotaCare chiropractic coverage with the updated MA/MinnesotaCare coverage rules described above, including the visit caps and X-ray provisions.

How This Works for Patients

  • For MA and MinnesotaCare enrollees, eligible chiropractic care would be available under the new rules, subject to the annual evaluation and 24-visit limit (with possible exceptions if a prior authorization is granted).
  • Imaging decisions would be tied to diagnosing conditions like subluxation, using X-ray exams as needed within the new coverage scope.
  • The aim is to improve access to chiropractic care while setting reasonable limits and requiring professional authorization for additional visits beyond the standard cap.

Impact Considerations

  • Access: Potentially broader access to chiropractic services for MA and MinnesotaCare participants.
  • Cost and utilization: Visit caps and prior authorization requirements could affect how often individuals receive care.
  • Standards: Care must align with generally accepted chiropractic standards and be prescribed by licensed professionals.

Relevant Terms - chiropractic services - Medical Assistance - MinnesotaCare - spinal manipulation - manual therapy - therapeutic exercises - acute spinal pain - chronic spinal pain - neuromusculoskeletal conditions - spine - subluxation - X-rays / radiological examinations - full spine - cervical spine - thoracic spine - lumbar spine - lumbosacral spine - pelvis - sacroiliac joints - annual evaluation - visits per year - prior authorization - generally accepted standards - licensed chiropractor

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
February 10, 2025HouseActionIntroduction and first reading, referred toHealth Finance and Policy
February 13, 2025HouseActionAuthor added
February 17, 2025HouseActionAuthor added
February 19, 2025HouseActionAuthor added
March 06, 2025HouseActionAuthor added
April 07, 2025HouseActionAuthor added

Citations

 
[
  {
    "analysis": {
      "added": [
        "Explicit coverage for chiropractic services and related services recommended by a licensed health care professional using generally accepted chiropractic standards of care."
      ],
      "removed": [],
      "summary": "This bill amends Minnesota Statutes 2024, section 256B.0625, subdivision 8e, to modify coverage for chiropractic services under Medical Assistance by including additional services and establishing visit limits and prior-authorization rules.",
      "modified": [
        "Defines covered services to include medical evaluation and management, manual therapy, spinal manipulation, and therapeutic exercises to treat acute spinal pain, chronic spinal pain, and neuromusculoskeletal conditions related to the spine.",
        "Limits non-X-ray chiropractic services to one annual evaluation and 24 visits per year unless prior authorization for more visits is obtained.",
        "Limits coverage for X-rays to radiological examinations necessary to support a diagnosis of subluxation and to evaluate the spine."
      ]
    },
    "citation": "256B.0625",
    "subdivision": "8e"
  },
  {
    "analysis": {
      "added": [],
      "removed": [
        "Repeal of chiropractic services coverage for MinnesotaCare under 256L.03, subdivision 3b."
      ],
      "summary": "This bill repeals Minnesota Statutes 2024, section 256L.03, subdivision 3b, which previously provided chiropractic services coverage under MinnesotaCare.",
      "modified": []
    },
    "citation": "256L.03",
    "subdivision": "3b"
  }
]
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