In response to the advocacy efforts of the Wisconsin Chiropractic Association and concerns raised by key legislative allies of both political parties, the Wisconsin Medicaid Office has agreed to pause moving forward with changes affecting access to chiropractic care.

Potential Changes Include:

According to information obtained during a recent meeting between WCA leadership and Medicaid representatives, WI Medicaid is looking to limit the number of chiropractic visits to 20 per calendar year, after which preauthorization would be required. Current Wisconsin Medicaid policy allows 20 chiropractic visits per spell of illness with no calendar year limit.

The other changes appear to be modifications to the 30-day “pause” between spell of illnesses. The rationale behind these changes appears to be a cohort of chiropractors who are consistently exceeding the 20-visit limit each year. 

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The Wisconsin Medicaid program is considering a change in policy that would require prior authorization for patient visits that exceed 20 per calendar year, instead of the current 20 per spell of illness (SOI) limit.

The WCA opposes this change and is strongly advocating against it. We are working with the Wisconsin Medicaid Office, the Governor’s Office, and key allies in the Wisconsin Legislature, including Rep. Clint Moses (R - Menomonie), the only chiropractor in the Legislature.

“Our number one priority is protecting patients’ access to effective chiropractic care in Wisconsin. This proposed change makes it more difficult for Medicaid patients to access the care they need,” ~ WCA Executive Director John Murray.

The Wisconsin Medicaid Office is pointing to a recent rule from the Centers for Medicare and Medicaid Services (CMS) related to interoperability of Medicaid payment systems. It is unclear why Wisconsin Medicaid is using this rule as an excuse to make major policy changes that affect access to chiropractic care.

Watch for more updates on this important issue, including a possible member call to action.

Questions? Email WCA Executive Director, John Murray at jmurray@wichiro.org

WCA - Backed Budget Provision Expands Medicaid Coverage to Extremities and Therapies.

A marathon session of the Wisconsin Legislature that started yesterday culminated in passage of the 2025-2027 state budget at around 1:00AM this morning and the signature of Governor Evers approximately followed 30 minutes later.

The $111 billion dollar state spending plan included a provision backed by the WCA that expands chiropractic coverage to extremity adjustments and commonly used therapies for Medicaid patients. Current Medicaid policy limits chiropractors to care related to the spine.

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In his biennial state budget address to the Wisconsin Legislature, Governor Evers has proposed a number of provisions aimed at cracking down on health insurance companies who have high rates of denying or restricting patient care.  The Governor is proposing a number of solutions including audits of companies with high denial rates, limits on the use of pre authorizations, greater transparency of denied claims and a new office within WI OCI to handle consumer health care complaints.  The Governor’s budget address marks the official start of the 2025-2026 state budget process which happens in the odd year of the two year session of the Wisconsin Legislature.

The Governor included his health insurance reform ideas as part of the Wisconsin Office of the Commissioner of Insurance’s budget package.  

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Not a member? Access this information when you join the WCA today!

A collaboration between the Wisconsin Chiropractic Association (WCA) and the Medical College of Wisconsin (MCW) paid dividends last month when Governor Evers signed into law Senate Bill 788 relating to the delegation of adjunctive services to a medical assistant.

Assembly Bill 507 would address many of these anti-patient practices.

The Assembly Committee on Health, chaired by Rep. Clint Moses (R-Menomonie), held a public hearing last month on legislation that would address many of tactics employed by health insurance companies and their associated utilization management companies that inhibit the ability of chiropractors, physical therapists and occupational therapists to provide necessary care to their patients without going through onerous pre-authorization steps.

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Physician titling legislation - which was at one point tied to APRN legislation - appears stalled in both houses of the legislature.

After months of discussions between the bill’s author, the Wisconsin State Medical Society and the Governor’s office, word in the capitol was that there was no agreement on the advanced practice nurse bill (SB 145) or the physician titling bill (SB 143).  Despite no apparent deal, the Wisconsin State Senate this week passed SB 145 giving advanced practice nurses more autonomy to practice in Wisconsin with three years of supervised practice experience. The bill now heads to the Wisconsin State Assembly for their consideration.

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Medicaid Funding Increase for Chiropractic Included

Governor Evers signed the 2023-2025 biennial state budget into law today that included a WCA-backed provision that increases reimbursement rates paid for chiropractic services to the same rate paid to physicians, applicable to procedure codes for which both a chiropractor and a physician are allowed to claim reimbursement.

The most common procedure codes used by chiropractors and physicians are the examination and X ray codes. 

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The Joint Finance Committee approved an omnibus budget motion late last night that funded a number of programs within the Wisconsin Department of Health Services including the state Medicaid program. A provision was included in that motion that:

"increases reimbursement rates paid for chiropractic services to the same rate paid to physicians, applicable to procedure codes for which both a chiropractor and a physician are allowed to claim reimbursement." 

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• Allow chiropractors to treat extremities, provide therapies, and get reimbursed at higher rates for those services comparable to other providers;
• Increase reimbursement for chiropractic manipulation services to 100% of Medicare; and
• Pay chiropractors the same as other providers who are paid higher reimbursement rates for examinations, X-rays, and laboratory tests.
  

How You Can Help:

Use 'Voter Voice' to Contact Your State Legislator
Use the button below to access the Voter Voice advocacy platform and send a message to your state legislator in support of this important state budget provision.

Respond via Voter Voice >>

If you want to get paid better for the services you provide, take action today! We are in the final few weeks of the state budget process - make your voice heard and contact your state legislator today.

John Murray,
WCA Executive Director

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Online CE Rule Set to Go Into Effect July 1, 2022

The long-awaited administrative rule that will allow Wisconsin chiropractors and their staff to take a portion of their required continuing education credits via online courses is set to go into effect July 1, 2022.

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Senator Tammy Baldwin (D-Wisconsin) announced last week that she will be one of three original cosponsors of Senate Bill 4042, the Chiropractic Medicare Modernization Bill, which was introduced by Senator Richard Blumenthal (D-Connecticut).

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The Chiropractic Examining Board (CEB) was close to inadvertently delaying the long awaited administrative rule CR 21-085 that will allow Wisconsin chiropractors and their staff to take a portion of their required continuing education credits via online courses.  

Read more here >>

• Online continuing education rule update
• CEB members and staff discuss options for addressing delays in CT, CRT license approvals
• WCA asked DSPS for data related to boundary-related complains

A summary of each issue is provided on the WCA Government Affairs website. 

Learn more here

Read WCA Letter to Governor Evers

Dr. Jason Mackey - Chair of the WCA Education and Convention Committee and WCA Executive Director and CEO John Murray sent a letter to Secretary Crim saying:

We respectfully ask that you enact immediate administrative measures within your department to expedite these license approvals to avoid further economic damage to the chiropractic profession and loss of access to care by their patients. Furthermore, we ask that you direct DSPS policy staff to work closely with the Chiropractic Examining Board to determine if there are policy obstacles contributing to these licensure delays and take action to remedy them. We suggest that the CEB develop a process whereby new chiropractors and staff could practice (with a background check and close oversight) with a temporary license until their final credential is approved.

The letter was also sent to Dr. Bryan Gerondale, Chair of the Chiropractic Examining Board, with a request that the issue be placed on the agenda of the upcoming April 1, 2021 meeting of the Board.

"We look forward to working with Secretary Crim and Chairman Gerondale to find a solution to this serious issue affecting members and patients," said John Murray, WCA Executive Director and CEO.

The Wisconsin Chiropractic Association has sent a letter (read the letter) to Wisconsin Senator Tammy Baldwin (D-Wisconsin) asking her to be the Senate sponsor of Medicare modernization legislation this congressional session. (link to letter).  Last session, the WCA supported HR 3654 - bipartisan legislation to remove the antiquated barriers patients face in Medicare.  From the WCA letter to Senator  Baldwin:

This is an issue that also needs to be addressed in the Senate and we urge you to introduce companion legislation that will allow all seniors the right to choose their licensed care provider under Medicare.  With Medicare currently serving more than 60 million Americans, with over one million in Wisconsin, and projections for that number to grow by a third over the next ten years, we believe Congress should ensure patients have access to all forms of care to prevent high-cost interventions and prescriptive opioids.  Such legislation would not need to add new services under Medicare; it simply allows patients to choose a chiropractor when they wish to do so.

“The WCA will continue its advocacy work with members of the Wisconsin Congressional delegation to build support for Medicare modernization,” said WCA Executive Director and CEO John Murray.