Purpose

The bill changes how chiropractic services are covered under MinnesotaCare and Medical Assistance (MA). It sets age limits, visit caps, and specific service requirements to define what is paid for and by whom, and it repeals a separate existing statute.

Main Provisions

• Coverage focus and eligibility

  • Chiropractic services under MA and MinnesotaCare are limited to individuals under age 21.
  • Coverage is tied to services recommended by a health care professional licensed to provide chiropractic-related care and that follow generally accepted chiropractic standards of care.

• Visit limits and prior authorization

  • For individuals under 21, there is a limit of one annual evaluation.
  • There is a limit of 24 visits per year, with potential for more visits only if prior authorization for a greater number is obtained.

• Covered services under this program

  • Covered services include medical evaluation and management, manual therapy, spinal manipulation, and therapeutic exercises related to the spine.
  • These services are intended to treat acute spinal pain, chronic spinal pain, and neuromusculoskeletal conditions related to the spine.

• Limits on services and requirements for xrays

  • Other than radiographs (xrays), covered services are limited to 24 visits per year unless prior authorization for more visits is obtained.
  • Xray coverage is limited to radiological examinations of the full spine (cervical, thoracic, lumbar, and lumbosacral areas) and/or pelvis or sacroiliac joints, and only when necessary to support a diagnosis of subluxation.

• Repeal of a separate statute

  • The bill repeals Minnesota Statutes 2025 Supplement section 256L.03 subdivision 3b.

Significant Changes to Existing Law

• Introduces a youthful-only coverage limit

  • The new limits apply only to individuals under age 21, effectively restricting chiropractic benefits for older adults under MA and MinnesotaCare.

• Establishes fixed annual caps and the need for prior authorization

  • Sets a strict cap of one annual evaluation and 24 visits per year for eligible minors, with prior authorization required to exceed those caps.

• Specifies covered service types and their scope

  • Defines a narrow set of covered chiropractic services (evaluation, manual therapy, spinal manipulation, therapeutic exercises) and ties them to spinal-related conditions, with clear boundaries on visits and radiographic use.

• Changes in radiography rules

  • Limits coverage of xrays to specific regions necessary to diagnose subluxation, potentially reducing broader imaging.

• Removes a separate statutory provision

  • Repeals a different statute (256L.03 subdivision 3b), which could alter related or contextual regulations outside the MA/MinnesotaCare chiropractic coverage described in this bill.

Relevant Terms - medical assistance (MA) - MinnesotaCare - chiropractic services - under age 21 - annual evaluation - 24 visits per year - prior authorization - manual therapy - spinal manipulation - therapeutic exercises - acute spinal pain - chronic spinal pain - neuromusculoskeletal conditions - full spine / cervical spine / thoracic spine / lumbar spine / lumbosacral - radiological examinations / xrays - subluxation - licensed health care professional - generally accepted chiropractic standards of care