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Medicare officials say they wrongly paid for chiropractic care

As you know, aches and pains come with the territory as you age, but it does not mean your clients have to take it lying down. They have every right to continue living an active and passionate life as pain-free as possible, which often means regularly seeing their chiropractors. As you and many other Texans are aware, good chiropractic care can make the difference between suffering through chronic back and extremity pain and feeling on top of the world.

Unfortunately, Medicare does not see it this way. The Centers for Medicare and Medicaid Services claims to solely pay for services that are medically necessary, and it does not consider maintenance therapy, in other words, the bi-monthly chiropractic adjustments that keep your clients aligned and moving freely, to be a necessary service.

However, it has come to light that Medicare has overpaid or wrongly paid millions of dollars to chiropractors across the country. Understandably, you may worry that CMS will send you a notice demanding you reimburse an overpayment to your practice. The following points provide some basic details of what you might need to know about this issue:

  • About 82 percent of Medicare payments to chiropractors in 2013 was wrongly paid.
  • The payment system is far from perfected, so CMS may continue to overpay chiropractors.
  • CMS reports say the overpayments occurred due to services being incorrectly coded, medically unnecessary or not properly documented.
  • Medicare's objective is solely to pay for chiropractic services it deems active or corrective, not maintenance therapy.

Officials from CMS say that it is unlikely they will go after chiropractors or their patients for overpayments on services not covered by the agency. However, it is wise to educate yourself on the chiropractic services that Medicare deems acceptable, so you do not end up with an unpleasant surprise in the form of a demand for repayment. It may help to speak with an attorney if this happens.

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