House of Representatives

HB 2114

AHCCCS; chiropractic services

Sponsors: Representative Stump, Representative Mason, Representative Murphy, et al.



Committee on Health


Committee on Appropriations


Caucus and COW


House Engrossed



HB 2114 creates a pilot program covering chiropractic services under the Arizona Health Care Cost Containment System (AHCCCS). 



A.R.S. § 32-925 defines doctors of chiropractic as health care providers that diagnose and correct subluxations and other neuromuscular skeletal disorders, give physical and clinical examinations, order certain lab procedures, and perform spinal and articular adjustments.  Chiropractors are not authorized to prescribe or administer drugs or perform surgery.  A.R.S. § 32-921 provides that, in order to practice in Arizona, chiropractors must be licensed by the Arizona Board of Chiropractic Examiners. 


The AHCCCS provides low or no-cost health care for certain low-income Arizonans.  The AHCCCS reports to the Center for Medicare and Medicaid Services (CMS); the federal office that oversees all state Medicare and Medicaid programs.  Although Medicaid is administered at the state level, CMS helps ensure that state programs comply with the general guidelines set forth in U.S. Code. For example, 42 USC 1396a requires that covered medical services be equally available to all enrolled Medicaid participants.  However, CMS can issue a waiver of this requirement to allow limited-participation demonstrations, such as the proposed pilot program. 


Currently, the AHCCCS does not cover chiropractic services.  Federal guidelines do not require state programs to cover chiropractic services, but they are approved for coverage if a state program so chooses.  Twenty-four states have Medicaid programs that cover chiropractic services.



·          Creates the Chiropractic Care Pilot Program (Program), and requires the AHCCCS to enroll 3,000 members previously treated through the system for back or neck pain. 

·          Includes under the AHCCCS’s covered health and medical services, medically necessary chiropractic services through self-referral for a minimum of twelve annual visits for members enrolled in the Program. 

·          Directs the AHCCCS administration to apply for a waiver from CMS to allow the Program.

·          Requires the AHCCCS administration to submit a report by September 1, 2011 to the Governor, Speaker, and President about the Program and its effectiveness, including the number of participants, the average number of treatments and the average cost of treatment before and after enrolling in the Program, and an analysis of cost effectiveness. 

·          Defines chiropractic services and musculoskeletal.

·          Includes a conditional enactment clause, beginning the pilot program on October 1, 2008 only if the necessary waiver is received by September 30, 2008.




·          Eliminates the specification of a minimum of twelve annual visits.

·          Makes the Program subject to legislative appropriation. 

·          Ends the Program on October 1, 2011.

·          Changes enrollment in the pilot program from one group of 3,000 self-referring members to the following three groups: 

·          Five hundred members who have previously received treatment through AHCCCS for neck and back pain and who are eligible to receive chiropractic services after referral by a primary care physician (PCP).

·          Five hundred members who have previously received treatment for neck and back pain and who are eligible to receive chiropractic services without a PCP referral pursuant to guidelines established by AHCCCS.

·          Five hundred members who have previously received treatment through AHCCCS for neck and back pain who are not eligible to receive chiropractic services.

·           Changes the reporting deadline for the Program’s evaluation to December 31, 2011.



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·          Forty-eighth Legislature

·          First Regular Session        2          February 8, 2007


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