Medicaid Legislation Opioid To Help Fight Opioid Addiction, Bill Would Add Chiropractic Coverage To Arizona's Medicaid By Mitchell Atencio access_time 03/11/2019 pageview353 Views chat_bubble_outlineLeave a comment Arizonans on Medicaid could soon alleviate their chronic pain with a visit to a chiropractor — without having to pay out of pocket. The Legislature may add chiropractic services to the state's Medicaid coverage under Senate Bill 1097, which has passed through the Senate.As critiques of opioid prescriptions grow, chiropractic care is seen as another option for addressing acute chronic pain.And while chiropractic care was sometimes thought of as pseudo-medicine in previous generations, more recent research has shown it as a viable option for pain relief.The National Center for Complementary and Integrative Health, a government agency that researches diverse medical care and practices, says that chiropractic care "appears to benefit some people with low-back pain and may also be helpful for headaches, neck pain, upper- and lower-extremity joint conditions, and whiplash-associated disorders."What the bill would doSB 1097, introduced by Sen. Heather Carter, R-Cave Creek, would allow patients on the Arizona Health Care Cost Containment System to get a prescription from their primary-care physician for 20 yearly chiropractic visits, and more as needed at the physician's discretion.Rep. Randy Friese, D-Tucson, said he spoke with several legislators about adding a per-referral cap to the bill, as a safeguard for the state's first attempt at covering a new practice. "If the limit is being met by a majority of patients, then we can think about removing the limits," said Friese, who is a surgeon.Dr. Renee Haberl, a chiropractor practicing in Scottsdale, said 20 visits might help manage some pain, but more visits may be necessary for some patients."Every body is different. Twenty visits would probably be something where we can get them to the point where the (pain) is a little more managed," Haberl said. "But a second referral would probably be needed for some of the more chronic conditions."Haberl said a patient of hers struggled with opioid addiction for about four years after a car accident where the other driver was uninsured.Haberl treated the patient for free because she was on the state's Medicaid program and unable to pay out of pocket. The patient was unable to work or leave her home because of her pain, but saw improvement after about nine months of chiropractic care."We worked hand in hand with her primary-care physician to be able to reduce her opioids. She was down to maybe a couple of sleeping pills a week and that was it," Haberl said. "She ended up being able to go back to work and now she continues to come in on her own insurance."Haberl said that patient isn't the only time someone on Medicaid was unable to pay for chiropractic care."We get multiple calls from patients with AHCCCS," Haberl said. "The unfortunate thing is we can only take so many on hardship. That’s a population that can’t really afford out-of-pocket care ... that’s one of a 1,000 incidents I hear when we (chiropractors) get together."A majority of states offer this coverageChiropractic care to relieve chronic pain has grown in popularity in recent years. According to Barry Aarons, spokesman for the Arizona Association of Chiropractic, 27 states cover some form of chiropractic coverage under their version of Medicaid.In his testimony to the House Appropriations Committee, Aarons cited a study from the Advanced Medicine Integration Group, which looked at patients on Rhode Island's equivalent program after the state added chiropractic care. AMI promotes integrated and alternative medicine, such as chiropractic, in business, insurance and government fields.Aarons said the study found total per-patient costs decreased by 36 percent, opioid use decreased by 87 percent and total opioid prescriptions dropped by 72 percent, compared to a control group.Friese said the bill would give both doctors and patients more options. "Now that they have this option, I’m hopeful that (chiropractic care) comes in front of that final choice — even a short course of opioids could be avoided," he said.Will expanding services save money?Another potential benefit is the cost for the state. While adding chiropractic care would cost $4.9 million from the state's general fund, the coverage could cut down the total patient cost by reducing expenditures elsewhere, according to Aarons and Carter."I think it’s really important for us to look at a number of different avenues we have to address the opioid crisis," Carter said. "I’m hoping that we can move this idea forward, in hopes of not only providing high-quality care, but also at a more economical price point."There is hope among some legislators that the bill will become law, after multiple attempts in previous years. Potential money for last year's attempt went to teacher raises, and the bill was put on the back burner, according to Aarons."Ultimately, all legislation that has a dollar amount attached to it will end up as part of the larger budget conversation," Carter said.