2006 Legislative Agenda
Lori Bielinski, LMP, WSCA Executive
Director & Government Relations Director

By the time you read this article the legislative session will be well underway and our proposed bills will be prepared and hopefully scheduled for hearings. The December meeting of the WSCA Board of Directors (BOD) was a joint meeting with the Washington
Chiropractic Trust board and we discussed many of the issues that we have been working on as well as new concerns that we are getting hit with out of the blue.

The BOD has approved the following issues for legislative consideration:

Associate DC Coverage: We have heard you! Since the recent denialof our proposed rule making petitions with the Office of the Insurance Commissioner (OIC), the WSCA plans to put this issue into legislation. This proposed legislation, if passed, is intended to require an insurance carrier to contract with providers who are employees of an already credentialed chiropractor. Our intent is to require the inclusion of associate chiropractors and other types of providers who are employed by the already credentialed chiropractor.

Delegation of Duties: This proposed legislation is intended to clarify when, and who, a chiropractor can delegate certain duties to a chiropractic assistant or other staff member.

Sale of a Practice: This bill would have the effect of requiring an insurer to allow the selling provider contract to be transferred to a purchasing provider as long as the provider is able to be credentialed (no sanctions on their license, no issues with the National Provider Data Bank) and is willing to abide by the rules of the contract. This would maintain provider continuity of care for their patients when a long-time DC is planning to retire or relocate. Patients deserve the ability to stay with the same clinic to maintain continuity of care.

Preceptorship: This issue has recently been addressed by the Quality Assurance Commission to allow 12th quarter students to work with a chiropractor. However, the statute disallows a 12th quarter student to perform an adjustment on patients. This proposed legislation would amend the statute to allow 12th quarter students to perform an adjustment under the supervision of a licensed DC.

Tax on Supplements: Currently chiropractors are the only provider required to collect a sales tax on supplements that you sell in your clinic. It is intended that we add the term “provider” to the list of providers exempt from collecting the sales tax on supplements sold in your clinic.

Fee Equity: This issue is being raised by several provider categories and being lead by Rep. Dr. Tom Campbell. This would require insurance companies to pay providers equally for the same services delivered, or at the maximum, not allow a fee to have a greater discrepancy than allowed by the Resource Based Relative Value Scale (RBRVS).

All Products: This issue was also one of the denied rule-making petitions filed with the OIC and the Department of Health. This would disallow insurance companies and their provider networks to tie contracted products to one provider contract. Example: If you sign up to be a provider with American WholeHealth Networks to treat Premera patients, you would not be forced to take a non-health insurance product that they obtain also, such as Pemco, or Safeway Stores. This would require the provider network to contract separately for each type of product that they offer.

External Review: This issue would require a carrier to allow for external review of billing disputes and would require the “losing” party to reimburse the prevailing party for the costs of the independent review.

Fee Disclosure and Fee Schedule Methodologies: This would require insurers to disclose the fee schedules, and all of the allowed codes, to providers prior to contracting. They would also have to describe the methodology of establishing a fee for a particular service, and provider.

Market Penetration: There are two issues we have raised regarding the saturation of a carrier in the market. If a carrier has a large percentage of the market in a defined geographic area and a provider is not allowed into the network, the provider cannot compete. This proposed legislation would establish how much of the market an insurer is allowed to have before they are required to allow all providers into the network in that geographic area, and it would not allow a carrier to terminate a provider without cause.

Many of these issues may be in one proposed bill and others will remain independent. Once the bills are drafted and assigned bill numbers, the frantic pace of the legislative session will be on fast track with a short sixtyday session beginning on Jan. 9, 2006.

Legislative district days will be scheduled for Thursdays as in 2004, and your attendance is greatly appreciated. Click here for more details. Any chiropractor who wishes to come to Olympia and work with me on any day is more than welcome with prior notice to me. Contact me by calling the WSCA office at (206) 878-6055 or (800) 824-4918.