3/9/06 Hi Everyone,

While the legislative session has officially ended, I am doing some wrap-up things and getting over a mild state of depression that we didn't come away with anything offensively.

I am happy to report that we didn't lose anything either, that I am able to tell right now. We successfully blocked a repeal of the "every category of provider" law in all small group plans, and we blocked a study that the House Republican's wanted that could have, if not handled appropriately, been detrimental to inclusion of chiropractic in health plans.

We will re-group and plan our actions for the interim, and how we want to plan for the 2007 session. In fact, our Dr. Butters, Dr. Corbin and I) first meeting with John Conniff is today at 9am!

I may or may not be in the office today (Thursday) and Friday, but I am available on my cell phone. I will spend the weekend painting my ceramics, gardening (weather permitting) and reminding myself what my wine cellar has in store for the weekend.

Thanks for everything!
Lori

2/27/06: Hi Everyone,

After a very depressing weekend I have come to realize that we must amend our bill if we are going to pass anything this year. The insurers have been successful (oh, I HATE saying that!) putting enough red herrings into the mix that it has caused one of our normal votes, Jim Kastama (D-25, Puyallup) to change his vote on us which wouldl have locked our bill into the Senate Health and Long Term Care committee.

Additionally, the opposition by the Director of the Health Care Authority (Steve Hill, appointed by Governor Gregoire) has generated a fiscal note that started at $50 million, and with our House amendments it has now dropped to $5 million, is still too large to get through the Senate Ways and Means committee (the money committee in the Senate).

Today we will introduce an amendment that is supported by Senator Kastama, and he signed the bill out of committee. Today is the fiscal cut-off day, so hopefully we will get a hearing. In that hearing I will testify that the fiscal note is virtually gone now that we have an amendment that will just give the Office of the Insurance Commissioner the authority to address the provider contracting provisions that we complain about. The bill should move but I suspect that the insurers will still oppose all our efforts.

While this sounds like a defeat, it isn't what we wanted, but it isn't over. I still need you all to come to Olympia on Tuesday and Thursday (unless the bill passes by then, but I doubt it) and help me work the doors and talk to legislators.

I am definitely sad, but we drew a TON of attention (the second most noted bill, or set of bills, of the 2006 session!) to our issues and with this provision the Insurance Commissioner will have to do something to assist us in our challenges.

Thanks for everything, and keep the calls to the Senate.
Lori

2/24/06: On Thursday, February 23, we had only one chance to get our bills moved out of the Sennate Health and Long Term Care commitee by the Friday's cut-off. It maybe easier if I do this as a time-line so you know how challenging things are right now.


9:30am-positive meeting with Senator Mike Hewitt, Senate Republican Minority Leader. If I get the bill out of committee he may be able to help us with some votes on the floor. No hard committment but good conversaion.

10:30am-Meeting with Governor's staff about the position of the Director of the Health Care Authority. Explained bills, made progress.

11:30am-Dr's Eileen Schofield, Mike Kinnear and Larry Hansen arrive in Olympia to help talk to the Senate Democratic Floor Leader, Tracey Eide. Afterher brief conersation with Senator Keiser, Chair of the Health and Long term care commitee we learned that both bills weere dead, that we didn't have enough votes to get either bill out of committee.

Doctors left and I ran to meet with Senator Kastama. I waited outside of a committee to get to talk to him and after exlaining the employee and sale of a practice bill he agrees to vote or that one only.

HB 2942 is dead, ESHB 2943 has the votes.

Notice to Senator Keiser, chair of the committee, and Senator Eide, foor leader, is made and agreement to move thebill is secured.

3:15pm-meeting wth Senate Majorty leader, Lisa Brown. We share with her the policy issues, and the politics attachedto the bill. Since the last bill left is controversial, we may hae trouble, but a good conversation was had.

3:30pm-Senate Health and Long Term Care committee begins.

7:00pm-ESHB 2943 is passed out of committee, subject to majority signatures, and is sent to Waysthem and Means committee.

Simultanneous to all of that, Dr. Butters is on the phones calling DC's and working on the broadcast fax invitinng DC's to work the doors with me next Tuesday and Thursday-MARK YOUR CALENDERS!!!!!!!!!

Now the bill is in Ways and Meas and we haveyet another deadline to meet, and the bill has to be moved out of Committee by Monday.
There are two cahances to do that, today and Monday.

Ways and Means is the committee that considers the fiscal impact to the state. We will challenge the fiscal note to ths bill and also ask for a new one to be established.

The bils are not dead! Serious heavy lifting is underway with little time left to pas the one bill left. We are not giving up yet!

Thanks everyone! Have a great day and call your Senators.

2/23/06 A hearing was held on Wedensday, February 22, at 8:00am in the Senate Health and Long Term Care committee. Our opponents signed in in droves against our bills, but we held our own while testifying to the Senators on the committee. These bills need to be passed out of the Senate Health and Long Term care committee today, by the end of the committee hearing (at 5:30pm) or they will be dead for this session.

At the hearing our opposition included Boeing, Weyerhaeuser and other entities that are not even affected by these bills. The opponents also included the Puget Sound Health Alliance, out of Seattle, without even giving the proponents (US!) an opportunity to share our side of the issues. And, the opposition also included the Health Care Authority even after all of the changes that we made to the bills in the House of Representatives at their request!.

The issues are no longer about policy, it is all politics. We are meeting with the leaders of both caucuses, the Governor's staff, and the Health Care Committee chair to assure that these bills move out of committee to Rules.

The opponents are saying that the bills will cost them money and that they cannot control cost containment, or quality of provider. We argued that they can, and do so today, by using provisions in the provider contract to control these things. These bills do NOTHING different in a provider contract than what is done today. They simply require the carriers to allow more providers into a panel that is closed for no other reason than "they say so".

Call your Senators TODAY and ask them to support these two bills!

Senate Phone Roster >>

Our friends who are also supporing these bills include the Physical Therapy Association of WA, American Massage Therapy Association, WA Chapter, WA State Podiatric Medical Association, WA State Nurses Association, ARNP's United, Optometric Physicians of WA, Washington Association of Naturopathic Physicians.

2/15/06 Hi Everyone,

Now that the first major legislative cut-off has passed, we are still in the process! That is a good thing! Both ESHB 2942 and ESHB 2943 have passed the House of Representatives. This is the best bi-partisan vote that we have ever yielded and now we have some "heavy lifting" in the Senate.

I am told we are scheduled for a hearing next week, although I haven't yet seen a schedule with our bills listed, and after that we will have just a short time to get the bills out of committee, through the Rules process, and then to the floor of the Senate for a final vote.

Please take the time to call your Senator now and ask them to support ESHB 2942 and ESHB 2943. These bills are fair and will create jobs. Every chiropractor who cannot get into a provider panel is being limited from working and every patient who cannot see their provider limits access to services they are already paying for in an insurance premium.

Appointments have been made with all of the Senate Health and Long Term Care committee members and we will cover our issues with them through next week.

Although we are all tired after late nights leading to the cut-off, we can see the light at the end of the tunnel. Thanks for your support and keep the Senate phones ringing. [senate phone roster]

2/2/06 I am sending this email from the House Health Care Committee, frpm my phone. HB 2942 and HB 2943 are passed out of committee with our amendments. 9 yeah and 4 nay, no votes are Bailey, Alexander, Hinkle and Condotta. Thanks everyone! Turn on the phones to the House of Representatives, only! We are in the final stretch of phase 1 of session! Now I need ypu! Lori

2/1/06 Hi Everyone, This is the second email to update you about the legislative session and progress we are making on our bills.

On Thursday, January 26, there were approximately 25 chiropractors in Olympia to meet with their legislators and discuss the issues that we are raising for legislative consideration this year. While I appreciate greatly the 25 of you who attended, I am hopeful that in the future that we can increase our numbers of participation. It looks like every other year we will have a "1 day" chiropractic legislative day, and every other year (during the longer session) we will do our legislative district Thursday's. I hope that helps DC's to attend at least one time during the legislative session.

On Tuesday, January 31, 9 chiropractors attended the legislative session where we had all four of our bills heard in two committees. After a planning session with Rep. Campbell, DC, we went to the Capitol House Health Care committee to testify on all three of our provider contracting bills, while Dr. Butters went to the Senate Ways and Means committee to testify on our sales tax exemption on supplements sold in chiropractic clinics.

The House Health care hearing was rough, but typical for what we are up against between business and the insurance companies. We had great testimony by Karen Thola, DC, whose sister is battling stage 4 breast cancer and Regence won't give her a provider contract to fill in for her sister while she is going through treatment. The optometrist lobbyist and I gave technical briefings about the bills and the Health Care committee gave excellent questions to the insurers that exposed just how hard it is to deal with a monopoly that the insurers hold over individual providers.

It sounds like the politics will allow HB 2942 and HB 2943 to pass out of committee, with some amendments. Our amendments will need to allow an insurer to pass the cost of credentialing and application on to the provider, and we will work as hard as we can to manage that cost. They testified that it costs approximately $250 to credential and communicate with providers.

The second area they want an amendment, also to HB 2942, is a definition of "local area" when considering a carriers 40% of the market of covered lives. This is going to require assistance from the Office of the Insurance Commissioner, and a meeting is scheduled already.

HB 2944 will probably not be passed out of committee by the cut off however, I am working to get subsection 4, addressing the "tying of contracts" into HB 2943 so that it will not have to wait until next year.

The policy cut-off is this Friday where the bills must be moved out of committee, and then to the Rules committee. After that we will have until February 14 to pass out of the House of origin where the bill will move then to the Senate to go through the same process.

What you should do! Now is the time to call your House of Representative members and ask them to pass HB 2942, HB 2943 and HB 2944.

SB 6698, to remove the sales tax on supplements is not a high priority, so you need to make calls to your senators asking them to pass SB 6698 out of committee.

As always, you are invited to join me in Olympia on any day, I just need a phone call the day before to manage scheduling. Thanks for your support, and call your legislators NOW!!!

1/18/06 This is to serve as a session update for you after the first week and a half. Feel free to share this with any DC that you have on an email list; just remind them that it is a rough note to you all and being written while I am in the cafeteria at the legislature waiting for a hearing this evening.

There are 42 bills in my tracking list so far and every day there are bills added. Our three primary bills, addressing all of the provisions in our proposed rules, now have bill numbers and are HB 2942, HB 2943, and HB 2944. The attached word document will help you to discuss them with people and encourage them to attend legislative day next Thursday. Remember, we will start our briefing as close to 8am as possible. Our bills have bipartisan support and have a great bit of excitement attached to them!

We will have a hearing on Tuesday, 1/31/06, at 1:30pm, and as many board members who can attend as possible is greatly appreciated.

I was able to get a quick little bill dropped in the Senate regarding the sales tax on supplements, and hope to get a hearing, but not sure that will happen.

There seems to be a lot of pressure on “evidence based medicine” and because of that I have included Dr. Gerry Clum in the winter conference conversation regarding the CCGPP presentation. I sure don’t want the government deciding which evidence is best to use for patient care!!!

There are a lot of other insurance bills as well, and they are hard to follow, and know the effects of them. We will do the best we can! One insurance bill I am particularly distressed about is the Office of the Insurance Commissioner’s “fraud protection” bill. This gives the OIC the right to police and investigate health care providers who may be perceived as being fraudulent. I am concerned that honest billing errors are considered fraud by the OIC. There is a very vague definition of fraud, and there is a confidentiality clause in the bill. How does one accused of something prepare a case if they cannot have access to files/paperwork that indicates the fraud exists? The Trial Lawyers are on this one for us, and we are helping on the side.

This is a quick update for you-please plan to attend next week, and on the 31st, and call everyone to join us for legislative day and conference!


Thanks everyone!!! Lori