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.
Positioning the Budget Amendment for Approval
The WCA worked with a strong team of pro chiropractic lawmakers including Rep. Todd Novak (R-Dodgeville), Senator Rachel Cabral Guevara (R-Appleton), Rep. Clint Moses (R-Menomonie) and Speaker Robin Vos (R-Rochester) to position the budget amendment for approval by the Wisconsin Legislature. The provision appropriates $3.75 million in 2025-2027 to fund these new services. Included in the provision (which is now law) is language directing the Wisconsin Medicaid Office to seek any required approvals from the Centers for Medicare and Medicaid (CMS) needed to draw down the federal match (FMAP) funds for implementation.
Resolving Line Item Veto Concerns
The language in the provision directing the Wisconsin Department of Health Services (DHS) to seek any required federal approvals to implement it caused some concerns with Republican lawmakers due to the Governor's ability to line item veto budget language to create new laws in ways not intended by the Legislature. The WCA worked with lawmakers to provide different language options to alleviate veto concerns. Ultimately, Legislative leaders were able to negotiate veto assurances with the Governor on a number of budget items including the Medicaid provision expanding chiropractic care.
"Our pro chiropractic allies in the Wisconsin Legislature and Governor Evers really stepped up to get the expansion of chiropractic care under Medicaid across the finish line," said WCA President Dr. Chris Resch.
The Budget Provision Language:
Chiropractic Services Reimbursement
- Provide $1,250,000 ($500,000 GPR and $750,000 FED) in 2025-2026 and $2,500,000 ($1,000,000 GPR and $1,500,000 FED) in 2026-2027 to support an expansion of MA coverage for services provided by chiropractors to the full chiropractic scope of practice, contingent on approval of federal financial participation for newly covered services.
- Require DHS to submit a waiver or state plan amendment to secure federal approval for federal financial participation, and specify that DHS is not required to provide coverage of chiropractic services not approved for federal financial participation.
What is Next for the Expansion of Chiropractic within Medicaid?
Now that the state budget provision expanding coverage of chiropractic care within Medicaid to extremity adjustments and commonly used therapies is signed into law, what happens next?
The WCA will continue working with the Wisconsin Medicaid Office to secure the required federal approval to implement this provision and secure the matching federal funds. The first question that will need to be answered will be whether a state Medicaid plan amendment will be sufficient to implement this expansion of services or if a full Medicaid waiver will be required. The Wisconsin Medicaid Office will make this determination with input from CMS.
"We look forward to working closely with the Wisconsin Medicaid Office to implement this important expansion of chiropractic services in a timely manner," said John Murray, WCA Executive Director.