Medicare paid hundreds of millions to chiropractors for medically unnecessary services in 2013, according to a recent audit by the Office of Inspector General (OIG) at the Department of Health and Human Services.
Nearly 82 percent of the $438.1 million paid by Medicare for chiropractic care did not comply with Medicare requirements. That figure amounts to $358.8 million dollars for services that were not allowable, the audit finds. It is also larger than the gross domestic product of six nations.
The Center for Medicare and Medicaid Services (CMS) was found to be ineffective at preventing payments for medically unnecessary chiropractic services.
The Office of Inspector General provides some insights into how CMS can strengthen their prevention measures. Chiefly, the office suggests that CMS put a cap on the maximum number of chiropractic therapy options. If such a limit were in place in 2013, “it would have prevented chiropractors from billing a high number of medically unnecessary services,” the report finds.
Andy Slavitt, administrator for CMS, rejected the proposal, citing medical evidence that supports the chiropractic services covered, the Journal reports.
Other measures proposed by OIG that purportedly could have saved CMS the $358.8 million: determine a reasonable number of chiropractic services that are necessary to actively treat spinal subluxation and implement a system edit to identify services for review in excess of that number; improve education of chiropractors on Medicare coverage requirements for chiropractic services; and identify significant obstacles to developing a more reliable control for identifying maintenance therapy and work to establish such a control.
If stronger controls are not adopted by CMS, the report warns the center is likely to continue doling out payments for services that do not comply with Medicare requirements.
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