DEMONSTRATION OF COVERAGE OF CHIROPRACTIC SERVICES UNDER MEDICARE.

SEC. 651. DEMONSTRATION OF COVERAGE OF CHIROPRACTIC SERVICES UNDER MEDICARE.(a) Definitions.—In this section:(1) Chiropractic services.—The term “chiropractic services” has the meaning given that term by the Secretary for purposes of the demonstration projects, but shall include, at a minimum—(A) care for neuromusculoskeletal conditions typical among eligible beneficiaries; and(B) diagnostic and other services that a chiropractor is legally authorized to perform by the State or jurisdiction in which such treatment is provided.(2) Demonstration project.—The term “demonstration project” means a demonstration project established by the Secretary under subsection (b)(1).(3) Eligible beneficiary.—The term “eligible beneficiary” means an individual who is enrolled under part B of the medicare program.(4) Medicare program.—The term “medicare program” means the health benefits program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).(b) Demonstration of Coverage of Chiropractic Services Under Medicare.—(1) Establishment.—The Secretary shall establish demonstration projects in accordance with the provisions of this section for the purpose of evaluating the feasibility and advisability of covering chiropractic services under the medicare program (in addition to the coverage provided for services consisting of treatment by means of manual manipulation of the spine to correct a subluxation described in section 1861(r)(5) of the Social Security Act (42 U.S.C. 1395x(r)(5))). (2) No physician approval required.—In establishing the demonstration projects, the Secretary shall ensure that an eligible beneficiary who participates in a demonstration project, including an eligible beneficiary who is enrolled for coverage under a Medicare+Choice plan (or, on and after January 1, 2006, under a Medicare Advantage plan), is not required to receive approval from a physician or other health care provider in order to receive a chiropractic service under a demonstration project.(3) Consultation.—In establishing the demonstration projects, the Secretary shall consult with chiropractors, organizations representing chiropractors, eligible beneficiaries, and organizations representing eligible beneficiaries.(4) Participation.—Any eligible beneficiary may participate in the demonstration projects on a voluntary basis.(c) Conduct of Demonstration Projects.—(1) Demonstration sites.—(A) Selection of demonstration sites.—The Secretary shall conduct demonstration projects at 4 demonstration sites.117 STAT. 2333(B) Geographic diversity.—Of the sites described in subparagraph (A)—(i) two shall be in rural areas; and(ii) two shall be in urban areas.(C) Sites located in hpsas.—At least 1 site described in clause (i) of subparagraph (B) and at least 1 site described in clause (ii) of such subparagraph shall be located in an area that is designated under section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) as a health professional shortage area. (2) Implementation; duration.—(A) Implementation.—The Secretary shall not implement the demonstration projects before October 1, 2004.(B) Duration.—The Secretary shall complete the demonstration projects by the date that is 2 years after the date on which the first demonstration project is implemented.(d) Evaluation and Report.—(1) Evaluation.—The Secretary shall conduct an evaluation of the demonstration projects—(A) to determine whether eligible beneficiaries who use chiropractic services use a lesser overall amount of items and services for which payment is made under the medicare program than eligible beneficiaries who do not use such services;(B) to determine the cost of providing payment for chiropractic services under the medicare program; (C) to determine the satisfaction of eligible beneficiaries participating in the demonstration projects and the quality of care received by such beneficiaries; and(D) to evaluate such other matters as the Secretary determines is appropriate.(2) Report.—Not later than the date that is 1 year after the date on which the demonstration projects conclude, the Secretary shall submit to Congress a report on the evaluation conducted under paragraph (1) together with such recommendations for legislation or administrative action as the Secretary determines is appropriate.(e) Waiver of Medicare Requirements.—The Secretary shall waive compliance with such requirements of the medicare program to the extent and for the period the Secretary finds necessary to conduct the demonstration projects.(f) Funding.—(1) Demonstration projects.—(A) In general.—Subject to subparagraph (B) and paragraph (2), the Secretary shall provide for the transfer from the Federal Supplementary Insurance Trust Fund under section 1841 of the Social Security Act (42 U.S.C. 1395t) of such funds as are necessary for the costs of carrying out the demonstration projects under this section.(B) Limitation.—In conducting the demonstration projects under this section, the Secretary shall ensure that the aggregate payments made by the Secretary under the medicare program do not exceed the amount which the Secretary would have paid under the medicare program if the demonstration projects under this section were not implemented.117 STAT. 2334(2) Evaluation and report.—There are authorized to be appropriated such sums as are necessary for the purpose of developing and submitting the report to Congress under subsection (d).