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HHS/CMS RIN: 0938-AS68 Publication ID: Fall 2016 
Title: Prior Authorization of Certain Chiropractic Services for Certain Chiropractors (CMS-6070-IFC) 
Abstract:

This interim final rule with comment period, in accordance with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), establishes a prior authorization process as a condition of Medicare payment for manual manipulation services provided on or after January 1, 2017 by certain chiropractors whose pattern of billing is aberrant compared to their peers and whose services denial percentage is in the 85th percentile or greater, taking into consideration the extent that service denials are overturned on appeal. 

 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
EO 13771 Designation: uncollected 
CFR Citation: 42 CFR 405    42 CFR 410    42 CFR 414   
Legal Authority: Pub. L. 114-10, sec 514   
Legal Deadline:
Action Source Description Date
Final  Statutory  MACRA section 514  01/01/2017 
Timetable:
Action Date FR Cite
NPRM  01/00/2017 
Regulatory Flexibility Analysis Required: Undetermined  Government Levels Affected: None 
Small Entities Affected: Businesses  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Melanie Combs-Dyer
Director, Provider Compliance Group
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Program Integrity, MS: AR-26-30, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-7683
Email: melanie.combs-dyer@cms.hhs.gov