4/1/08

2SSB 5596 Signed by the Governor

On Tuesday, April 1, 2008, Governor Gregoire signed into law the bill to prohibit unfair payment to chiropractors. Insurers may no longer pay chiropractors less than other providers who are delivering the same services described by a payment code used by a nationally recognized reference manual such as the National AMA CPT code book.

The bill had study language requiring that the insurers provide detailed payment information to the OIC for studying the impact of the bill however; since the study would have been paid for out of carrier taxes the Governor vetoed that section of the legislation.

There is what is known as a "sunset" provision on the bill of June 30, 2013, which means that the law will expire if the sunset is not removed by the legislature. The WSCA will work to assure that either a study is performed, because we are sure that it will support our claims, and/or remove the sunset provision before the sunset would take effect.

The effective date of the bill is January 1, 2009.

Thank you all for your support and encouragement through the legislative process. We would now ask in return that you consider your extremely generous contributions to the Washington Chiropractic Trust, Governor Christine Gregoire, and Rep. Tom Campbell, DC. You will also need to be in touch with the local legislators in your district that are Chiropractic Friendly. Our legislative guide will be published in the July/August issue of Plexus to assist you with that process.

WSCA Requests Governor to Sign Our Bill

Dr. Austin McMillin Requests Governor's Signature on Our Bill

3/12/08

After a long day of running from Senate to House and back over and over again, we finally passed the House (again) after agreeing to a technical correction for the Health Care Authority, and Regence (even though they will still request a veto by the Governor) with a vote of 81-16-1 excused. At 4:40pm, we rushed to the Senate to let them know that we were "out of the House and to see if they could schedule us right away. At 6:20pm we were heard on the floor of the Senate. After extremely supportive floor comments by Senators Franklin, Keiser and Pflug, we listened to the misconstruing of details by Senators Rasmussen and Parlette. We passed the Senate with a 46-3 vote! The standing joke is now that each time we run it we get more votes...that doesn't mean we ever want to do this again!!

The bill is now on its way to the governor's desk for signature. Our opponents are working her staff very hard to persuade her to veto the bill. She has 15 days after today to sign or veto the bill.

It was a major feat to have our bill pass through BOTH Houses in the same day. Thanks everyone for your help, and to the staff in the office for "holding it all together." We've had another hard, but successful legislative session and although it's not over yet, we still remain optimistic! For more information and the history of our bill, click here

3/7/2008

At 9:30pm on Thursday, the House of Representatives passed 2SSB 5596 with a strong bi-partisan vote. We accepted an amendment from leadership that will do the following things:

• Prohibits Insurers pay chiropractors less than other providers performing evaluation and management and physical medicine and rehabilitation services, defined by payment codes; and
• Prohibits insurers establish new payment codes for chiropractors to avoid compliance with the bill; and
• Requires insurers provide information in a "data-call" to the Office of the Insurance Commissioner (OIC) to study the total payments made to all providers using the same codes as chiropractors; and
• Inserts a "sunset" provision in the bill, which means the statute expires on June 30, 2013, if the sunset is not repealed during, or prior to, the 2013 legislative session.

While we did have to make some concessions, the bill is considered unprecedented. It is important that we be involved in the data-call by the OIC, and assure that the information is collected and reviewed fairly.

I will be now working the Senate to assure their concurrence to the bill as soon as possible so it is eligible for the Governor's signature.

CALL YOUR SENATOR BEGINNING SATURDAY, MARCH 8, 2007 AND ASK THEM TO CONCURR TO 2SSB 5596 AS IT PASSED THE HOUSE OF REPRESENTATIVES!!! I will be working the doors Saturday to assure concurrence as soon as possible.

Thank you to ALL who have joined us in Olympia this year. Our Chiropractic District Days have made a tremendous difference on how legislators view our issues and our bill. The session doesn’t end until March 13th, so if you want to come down and see how the process works, please feel free to join us! Call the WSCA and let us know when and we’ll give you the tour!

2/29/2008

After much last minute negotiating, our bill has been voted on and passed out of the House Health Care Committee and is on its way to the House Appropriations Committee (the "money" committee). We had a last minute amendment that the committee added to our bill that while we don't love it, it will work and still keep the intent of our bill.

Amendment to 2SSB 5596

Our next hurdle is to get out of Appropriations by 5pm on Monday, March 3rd and then onto the House floor ASAP in order to make the March 7th deadline. Things happen very quickly in a short legislative session and we are definitely running to keep up!

We are also working on 4SHB 1103, which increases the authority of regulators to remove healthcare practioners who pose a risk to the public. A new amendment (the concept came from HB 2907) was added to the bill about creating a pilot project for 4 Department of Health Commission Boards (Dentists, Medical Doctors, Nurses, and Chiropractors) to have independent operating agreements between the secretary of health and healthcare licensing and disciplinary boards and commissions. This would directly effect the Chiropractic Quality Assurance Commission in that it would grant them more governing power. They would be allowed to hire their own executive director and wouldn't be sharing that person with multiple commissions. Their would be more clarity in the roles of commission members and staff. This bill would also create greater accountability of the commission to the consumer.

Our last "Official" Chiropractic Legislative Day is: Thursday, March 6th. If you haven't made it to Olympia this session, you still have a great opportunity. Call or email the WSCA to RSVP and we'll keep an eye out for you.

2/13/2008

2SSB 5596 Passed out of the Senate
Today we passed another large milestone for our fair payment bill. After much anticipation, we passed out of the Senate with a majority vote of 40-9. The Senate was being worked very hard by those who were opposing our bill. At last count earlier this morning, there were 35 lobbyists working against us.

At this time, our bill is on its way over to the House to go through the same process. Please pay attention to our emails and the website, as we will keep you posted for when we need you to take action.

For those of you that called your senators and urged them to support our bill, now's the time to call and thank them for their support. We cannot stress enough how important it is that the legislature here from you directly and not from the lobbyists.

If you haven't yet called your legislator or have participated in your legislative day, we would strongly encourage you to come down and spend a day with us in Olympia. We still have several Chiropractic Legislative Thursdays coming up and you're more than welcome to join in even if it's not your district. Give us a call and we'll give you the tour!

2/6/2008

Please call your Senator and urge them to support 2SSB 5596 Payment Fairness for Chiropractic. Our bill has been passed out of the Ways and Means Committee and is one step closer to being heard on the Senate Floor. Now is the time to be contacting your Senators and reminding them who we are, what our bill is and what it will do. There is no reason why chiropractors should be making less on a same CPT code than similar professions to ours.

2SSB 5596 will right this wrong. It will require the insurers to establish fees for services based on what it costs to deliver them, not who they like best.

• Chiropractors are earning up to 30% less in payment by insurers than what they pay other providers for almost the exact same services.
   
• Payment for services should be based on what it costs to deliver them, not who performs them, as long as it is in their scope of practice.
   
• The state fiscal note is only 1/10th of 1% of the Health Care Authority budget. The state fiscal note admits other providers are paid more than chiropractors for the same service (they admit up to 20%).
   
• We should not be compared to other providers, such as an orthopedic surgeon, because nothing they do and what a chiropractor does is in the respective scopes of practice, or the fee schedules that they use to pay you. It is not a fair comparison.
   
• NO provider, or health profession, is paid based on their skill and credentialing. In fact, credentialing is performed on a "boiler plate" application used for all professions, by most insurers. Insurers do NOT have a mechanism to pay some providers who have greater skill, or training, additional fees than what they pay another. Fee schedules are established based on the profession. The fee schedule used for the chiropractic profession is UNFAIR.
   

Please read our Letter to the Senate, which is being handed out right now to all Senators. It is important that we follow up our handouts with phone calls from constituents. Every chiropractic voice makes a difference! This is a short legislative session this year (60 days), so things move very quickly in Legislature.

For more talking points about the bill, click here.

1/31/2008

2SSB 5596 passed out of Senate Ways and Means January 31, 2008 with a vote of 15 yea, 2 nay, and a handful not signing (which mostly means they were just not in the room). The bill is now referred to Rules. Senator Prentice moved into Executive Session after she saw the Congressional Dist. 7 and 1 doctors in the room where the bill had only one question/comment from Senator Parlette.

In the House, HB 1103, Rep. Campbell's provider disciplinary bill passed out of committee unanimously and is on to the next step.

In an unprecedented move HB 2907 received testimony in favor by every single health profession! This bill will allow the Boards and Commissions to hire and fire an Executive Director and its support staff rather than hire a Program Director from a Dept. of Health employee pool where ED's have more than one profession assigned to them. The bill identifies roles and responsibilities clearly and when there is a disciplinary matter it will be clear who "dropped the ball" if there is a problem with a provider regarding patient safety.

Please make calls to your Senators to ask for their support of 2SSB5596

2008 Legislative Agenda Established

The Board and Trust reviewed many of the issues that are facing chiropractic in the state, and decided to continue on the path started many years ago. Now that our provider contracting bill is in the beginning stages of implementation by the larger insurers, we need to be paid fairly. Provider payments need to be fair to all professions and should not favor one over another. The cost of a service should be based on the service delivered, not by the type of provider. The highest priority for the WSCA legislative efforts is to work on last year's bill SB 5596. This bill says that a carrier may not pay another type of provider more money on a CPT code than what they pay a chiropractor. Too many times we have seen other providers receive a higher payment for the same CPT code if done by another type of practitioner. This is unfair, and we will work to change that.

The second priority is to restore funding for chiropractic to the Department of Social and Health Services budget and to fund chiropractic services for Medicaid patients. Sometimes it is the poorest of patients who need chiropractic care the most. We believe that Medicaid patients who have access to chiropractic care may cost less to the entire government system.

The third priority will be to consider legislation that identifies a health plan that sells a policy that indicates a patient has coverage for chiropractic care however; the co-pays are so high that it is cheaper for the patient if they just pay for the care out-of-pocket. We, at the WSCA, call that illusory benefits-benefits that don't exist. The WSCS will work to change that as well.

Please take the time to join us in Olympia this year for the chiropractic legislative days. A schedule is currently posted on the website.