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F I S C A L I M P A C T R E P O R T

SPONSOR Altamirano

DATE TYPED 1/27/05

HB

SHORT TITLE Medicaid Reimbursement for Chiropractors

SB 74

ANALYST Weber

APPROPRIATION

Appropriation Contained Estimated Additional Impact Recurring

or Non-Rec

Fund

Affected

FY05

FY06

FY05

FY06

$2,220.0 Recurring General Fund

(Parenthesis ( ) Indicate Expenditure Decreases)

REVENUE

Estimated Revenue

Subsequent

Years Impact

Recurring

or Non-Rec

Fund

Affected

FY05

FY06

$5,380.0

The same or higher Recurring Federal Medicaid

(Parenthesis ( ) Indicate Revenue Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

Human Services Department

SUMMARY

Synopsis of Bill

Senate Bill 74 proposes to require Medicaid to reimburse licensed chiropractic

physicians for services rendered within their scope of practice.

Significant Issues

Currently, Medicaid does not reimburse for services prescribed by licensed chiropractors. In-

cluding chiropractors and their services would be an expansion to the Medicaid program. Most

states do not cover chiropractor services under their Medicaid program as this is an optional ser-

vice.

Senate Bill 74 -- Page 2

FISCAL IMPLICATIONS

HSD reports Medicare already covers chiropractic services though limits the coverage to specific

manipulations. Since Medicare already provides coverage for the consumers who are dually

eligible for both Medicare and Medicaid, and since chiropractic care is generally not requested

for children, HSD estimates the Medicaid population that could potentially access chiropractic

care would be approximately 100,000 clients.

HSD assumes that approximately 25% of these clients would actually request chiropractic ser-

vices, with an average utilization of 12 visits per year, and that Medicaid would pay the same

rate as Medicare for the service, which is $25.00, the estimated annual expenditure is projected

to be $7,500,000.

Approximately $2,175,000 would come from state general funds. Approximately $5,325,000

would be federal financial participation.

The HSD estimation appears inexact but it is reasonable to assume an additional medical service

will generate additional expenditures. Getting to that exact increase is difficult making the

spending estimation suspect.

MW/yr