By MELANIE EVANS | WSJ | Oct. 19, 2016

More than 80% of the money that Medicare paid to chiropractors in 2013 went for medically unnecessary procedures, a new federal audit found.

The federal insurance program for senior citizens spent roughly $359 million on unnecessary chiropractic care that year for treatment of strains, sprains or joint conditions, a review by the Department of Health and Human Services’ Office of Inspector General found. 

The OIG called on the Centers for Medicare and Medicaid Services to tighten oversight of the payments, noting its analysis was one of several in recent years to find questionable Medicare spending on chiropractic care. “Unless CMS implements strong controls, it is likely to continue to make improper payments to chiropractors,” the OIG said.

While Medicare doesn’t limit how many times patients can see chiropractors, it should determine whether there should be a cutoff in visits, the OIG said. Medicare pays for active treatment, but not “supportive” care, or maintenance therapy. Patients who received more than a dozen treatments were more likely to get medically unnecessary care, the OIG found. All chiropractic care after the first 30 treatments was unnecessary, the review found.

CMS Acting Administrator Andy Slavitt, in a letter to the OIG in response to the review, rejected the call for a numerical limit on chiropractic care, saying CMS is unaware of medical evidence that supports the move. However, in recent years, CMS has sought to clarify for chiropractors what they can bill to Medicare, Mr. Slavitt said. The agency also began in 2011 to use algorithms to monitor for fraud. A CMS spokesman declined to comment beyond the letter. . .

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