Final Session Notes

Lori Bielinski, LMP, WSCA Executive Director & Government Relations Director

The last issue of Plexus notified you that our main bill, SSB 5597, was delivered to the Governor for signature on April 18, 2007. Session ended on April 22, but the final phase of the session continued to challenge us with an ever-intense group of meetings.

We were scheduled for bill signing on Friday, May 11, 2007. I made contact with the Governor’s policy staff to assure that we would be signed, and not removed from the list, and we were notified that our bill still had a great deal of opposition coming in and careful consideration was being made on all aspects of the policy.

On Thursday, May 10, I received a call from the Governor’s staff asking for a meeting to discuss the details of the bill and to be sure that the Governor did everything possible to work on our issue prior to having the matter resolved in legislation. Drs. Michael Schweitzer, David Butters, and Garry Baldwin dropped everything and came to Olympia for the first round of discussions to review the issues with the Governor’s staff. We reviewed the language of the bill again to be certain that the unintended consequences were minimized at every possible level. After the initial meeting we broke for lunch and discussed our options, and returned for another set of conversations. At the end of that day we were notified that our bill was being removed from the signing list for May 10, for further review.

On Friday, May 11, we were offered a possible resolution by Regence, through the Governor’s office, and careful consideration was made. Another negotiation meeting took place with Drs. Schweitzer, Butters, Baldwin and Butch Corbin. We made a counter-offer to Regence through the Governor’s staff, and entered the weekend not sure what the outcome would be, only knowing that we would have an answer by the end of the day on Tuesday, May 15, because that was the last date that bills could be signed or vetoed.

May 14 arrived and I made the standard calls to the Governor’s policy staff for a status and was told that we would know something later in the afternoon. At 3:00 p.m., I was notified that our bill was scheduled for signature for May 15, the last possible day for signing, still unsure if the bill would be signed or vetoed.

Letters and calls from other legislators were sent at the last minute supporting our bill and asking for the Governor’s signature making SSB 5597 law. Our sponsors and supporters worked very hard up to the end helping the Governor’s staff with the details of the session and our issues. In the early evening, I received a call from the Governor’s legislative staff that the bill would be signed the next morning. Our bill-signing ceremony was confirmed and we had only to make it to the next day.

With a great deal of nervousness and excitement, we headed to Olympia on Tuesday, May 15. Several WSCA Board members attended the signing ceremony and our Senate Prime Sponsor, Rosa Franklin (D-Tacoma) was there as well. After the Governor signed the bill, and we confirmed it was not with invisible ink, the onlookers cheered because they knew how hard we all had to work to get the bill passed, and then signed.

Some of you might wonder why the Governor needed such confirmation on our bill. I would like you to consider the bill in a little different light. Why did so many large corporations and organizations oppose the bill, drawing such overblown attention to our bill? The bill would only affect insurance plans regulated in Washington State. Our opposition included large corporations such as Boeing and Weyerhaeuser—two companies that are self-insured (regulated by ERISA) and can set whatever rules they want. The insurers told these corporations that it would raise their costs to all purchasers. The Washington State Hospital Association opposed our bill and wouldn’t even tell us why. We don’t have hospital privileges, so why would they engage in our legislation anyway? Pemco and Safeco are property and casualty insurers and the bill only affects health insurers. The Association of Washington Business (AWB), who claims they are the state’s "chamber of commerce," added our bill to their "job-killers" list, not recognizing that as a small business owner your inability to compete means that your business is diminished by unfair treatment from an insurance company. The Puget Sound Health Alliance, which claims they do not take political position on legislation, testified against us as well, claiming this is an "any willing provider" type of bill when it clearly allows the carriers to not contract with those who do not meet the criteria set by the insurer.

This is an amazing list of opponents and it was no surprise that the Governor needed to be sure she had all the information to make a good decision for consumers of Washington State. It is impressive when a Governor and her staff consider the details of legislative policy with such careful review. It is comforting to know that the Governor and her staff did everything in their power to make sure that the language of the bill says what it should to accomplish the goals that were stated as a need to resolve consumer access to chiropractic care. For that, the WSCA Board of Directors and I publicly thank Governor Gregoire for her diligence on behalf of Washington State healthcare consumers. All of this effort for a chiropractic benefit that has an average limit of 12 visits, must be medically necessary, you have to give a huge discount, and in many cases the co-pays exceed the cost of the service. But in the end, it is all about patient access and being treated fairly. There is still a great deal of work ahead of us to achieve fair treatment by insurers to chiropractic doctors, and this is one more stepping stone to getting there.

Explanation of the Bill:

The following bill analysis is largely stated by the final bill analysis report provided by the State Legislature. Some additions were made by the WSCA for clarity. Please see the footnotes below.

Effective January 1, 2008, health carriers are required to reimburse chiropractors for medically necessary services if the service is covered chiropractic healthcare and it is provided by the chiropractor or an employee who works at the same location. The employees that qualify to deliver delegated services are those that meet the qualifications of 18.25.190 (2)¹ and (3)². Violations of the participat- provider agreement by an employee of the chiropractor are deemed to have been committed by the chiropractor.

Participating provider agreements provided to a chiropractor within a sole proprietorship, partnership, or corporation must be offered to any other chiropractor within that practice at the same location.

As is today, any contract can be terminated by either party without cause.

Footnotes:
1. 18.25.190 (2)... is a regular senior student in an accredited school of chiropractic approved by the commission if the practice is part of a regular course of instruction offered by the school and the student is under the direct supervision and control of a chiropractor duly licensed pursuant to this chapter and approved by the commission.

2. 18.25.190 (3)... a person serving a period of postgraduate chiropractic training in a program of clinical chiropractic training sponsored by a school of chiropractic accredited in this state if the practice is part of his or her duties as a clinical postgraduate trainee and the trainee is under the direct supervision and control of a chiropractor duly licensed pursuant to this chapter and approved by the commission.