H.R.2 – Medicare Access and CHIP Reauthorization Act of 2015
H. R. 2 was introduced 03/24/2015, and on 3/26/2015 it passed the House with a vote of 392 Yeas and only 37 Nays. On April 14, 2015 it passed the Senate with a vote of 92 Yeas and only 8 Nays. On 04/16/2015 H.R. 2 became Public Law No: 114-10.
Subtitle A–Protecting the Integrity of Medicare
Sec. 514) Requires a medical review process for spinal subluxation services to a Medicare beneficiary by a chiropractor.
‘‘(A) PRIOR AUTHORIZATION MEDICAL REVIEW.— ‘‘(i) IN GENERAL.—Subject to clause (ii), the Secretary shall use prior authorization medical review for services described in paragraph (1) that are furnished to an individual by a chiropractor described in section 1861(r)(5) that are part of an episode of treatment that includes more than 12 services. For purposes of the preceding sentence, an episode of treatment shall be determined by the underlying cause that justifies the need for services, such as a diagnosis code.
‘‘(7) REVIEW BY CONTRACTORS.—The medical review described in paragraph (2) may be conducted by medicare administrative contractors pursuant to section 1874A(a)(4)(G) or by any other contractor determined appropriate by the Secretary that is not a recovery audit contractor.
(c) GAO STUDY AND REPORT.— (1) STUDY.—The Comptroller General of the United States shall conduct a study on the effectiveness of the process for medical review of services furnished as part of a treatment by means of manual manipulation of the spine to correct a subluxation implemented under subsection (z) of section 1833 of the Social Security Act (42 U.S.C. 1395l), as added by subsection (a). Such study shall include an analysis of— (A) aggregate data on— (i) the number of individuals, chiropractors, and claims for services subject to such review; and (ii) the number of reviews conducted under such section; and (B) the outcomes of such reviews. (2) REPORT.—Not later than four years after the date of enactment of this Act, the Comptroller General shall submit to Congress a report containing the results of the study conducted under paragraph (1), including recommendations for such legislation and administrative action with respect to the process for medical review implemented under subsection (z) of section 1833 of the Social Security Act (42 U.S.C. 1395l) as the Comptroller General determines appropriate.