A second attempt at federal legislation would expand the scope of chiropractors’ practice and with it, patient safety concerns and possibly overall Medicare costs – a threat the American Medical Association, Texas Medical Association, and more than 90 other medical associations and organizations urged Congress to stop.
The Chiropractic Medicare Coverage Modernization Act of 2025, (Senate Bill 106 and House of Representatives Bill 539) would amend the Social Security Act’s definition of “physician” under the Medicare Part B program, allowing chiropractors to offer services that they haven’t been trained to provide, medicine warned in an April 28 letter. This is the second introduction of the legislation, the first being in 2023.
“TMA firmly opposes [the legislation], which would allow chiropractors to be recognized as physicians under Medicare without the rigorous training MDs and DOs undergo,” TMA President Jayesh “Jay” Shah, MD, told Texas Medicine Today. “This legislation blurs critical distinctions in education, clinical experience, and patient responsibility – putting safety at risk.”
By removing the current “manual manipulation” limitation in the Social Security Act, the legislation would “establish a pathway for coverage and payment for chiropractors providing medical services for which they may have very limited or no formal training. ... Such expansion could increase overall Medicare costs and jeopardize the health and safety of Medicare patients,” the letter states.
AMA made the same arguments in a missive sent to the legislation’s original co-authors when it was first introduced in 2023.
Both letters to Congress note that chiropractors’ training is not equivalent to the four years of medical school, three to seven years of residency training, and up to 16,000 hours of clinical training that is required of all physicians. By comparison, chiropractors must complete only 4,200 instructional hours of combined classroom, laboratory, and clinical patient care experience in order to be licensed, according to the Council on Chiropractic Education.
Citing a recent AMA survey that found 27% of patients incorrectly identified chiropractors as medical doctors, medicine warned the proposed “legislation would exacerbate such patient confusion and prompt further misconceptions and false expectations regarding the care they receive.”
“TMA joins national partners in urging Congress to reject this bill and protect the integrity of the physician role,” Dr. Shah said. “Patients deserve care led by fully trained, licensed medical professionals.”
Read Texas Medicine Today for legislative updates and learn more about how TMA’s advocacy shapes national and state policy on the association’s webpage.