Washington State Chiropractors Petition the Insurance Commissioner for Relief

SeaTac, Wash., Sept. 12 – Citing “the growing threat to our patients and our profession,” the Washington State Chiropractic Association (WSCA) announced today that it has petitioned Washington State Insurance Commissioner Mike Kreidler to stop some insurance companies from discriminating against the chiropractic profession.

The WSCA has filed formal petitions with the Insurance Commissioner requesting new rules designed to fix the growing problems caused by the few large health insurers dominating Washington markets. “We can no longer ignore the growing threat to our patients and our profession,” said Dr. Bill Davis, WSCA President. “Chiropractors want to spend time with patients not contracts. “We are asking the Insurance Commissioner to step in and stop the discrimination and unfair practices of some companies.”

According to the WSCA, the large insurers are forcing chiropractors into lopsided contracts that small practices cannot afford to reject. Insurers tie one product to another so that the chiropractor cannot choose between plans or programs. They terminate contracts without cause, forcing patients to find new doctors, and refuse to pay chiropractors who step in to take care of a colleague’s patients.

“Imagine what your life would be like if there was only one grocery store and they made you buy a pack of cigarettes with every gallon of milk and kicked you out if you complained,” Davis said. “That’s our life with the big insurers.”

The Commissioner has 60 days to rule on the petitions, and may accept, reject or change the requested rules. The petitions seek improvements to existing rules governing contracts between insurers and practitioners. The amendments would ban some existing insurer practices and would set new standards for the health care networks of the three largest insurers in Washington. Copies of the petitions can be found on the WSCA web site.

The Washington State Chiropractic Association (WSCA) is Washington’s only professional organization representing Doctors of Chiropractic. Established in 1991, WSCA has been growing strong ever since with doctors from across the entire state joining forces to protect, promote and improve the chiropractic profession for a strong and healthy future for all.

The following documents make up the formal rule-making filing with the Washington State Insurance Commissioner, and the Washington State Department of Health. The PDF documents are the forms filed with brief descriptions of each proposed rule, with some rationale. The WORD documents are the actual rule that is currently in place; our proposed language is identified with underlined text in the document. The letters to the Insurance Commissioner and the Secretary of the Department of Health, and the exhibits, provide supporting materials for additional rationale.

Petitions filed with the Office of the Insurance Commissioner on September 8, 2005:
Letter to Honorable Mike Kreidler, Washington State Insurance Commissioner	Letter to OIC
101. Require health carriers to recognize “locum tenens” in the chiropractic profession to the same extent as health carriers recognize “locum tenens” for physicians.	101 Petition	101 Proposed Rule
102. Prohibit health carriers from tying practitioner participation in one product offering to practitioner participation in other product offerings.	102 Petition	102 Proposed Rule
103. Prohibit health carriers from refusing to do business with chiropractors who purchase a retiring chiropractor’s practice.	103 Petition	103 Proposed Rule
104. Require health carriers to amend their dispute resolution process with chiropractors to allow an independent outside review of payment disputes.	104 Petition	104 Proposed Rule
105. Require health carriers to clearly disclose the method and amount of prospective payment for services before a chiropractor signs a contract with the carrier or agrees to participate.	105 Petition	105 Proposed Rule
106. Require health carriers to contract with groups of five (5) or more practitioners to the same extent as health carriers recognize group contracting for physicians.	106 Petition	106 Proposed Rule
107. Prohibit health carriers with a statewide market share of more than 20% from terminating a chiropractor except for cause.	107 Petition	107 Proposed Rule
108. Require health carriers with a statewide market share of more than 20% to contract with chiropractors who meet the carrier’s credentialing standards.	108 Petition	108 Proposed Rule
OIC's reponse to these petitions WSCA's counter response to OIC >>

Petitions cross-filed with the Department of Health on September 8, 2005:
Letter to Mary Selecky, Secretary of State, Washington State Department of Health	Letter to DOH
202. Prohibit health carriers from forcing chiropractors participating in a carrier's health plan to also participate in every other plan, program and arrangement marketed by the carrier.	202 Petition	202 Proposed Rule
207. Prohibit health carriers with a market share of excess of 20% within the state of Washington from terminating a contracted chiropractor without cause.	207 Petition	207 Proposed Rule
208. Require health carriers with a market share in excess of 20% within the state of Washington to contract with qualified chiropractors in the service area of the plan.	208 Petition	208 Proposed Rule
DOH's Response to Cross-Filed Petitions >> WSCA's counter response to DOH >>

Contact Information:
Lori Bielinski, Executive Director
Washington State Chiropractic Association
21400 Int'l Blvd. Ste. 207
SeaTac, Washington 98198
Ph: (206) 878-6055 | Fax: (206) 878-8699
Email: wsca@chirohealth.org
www.chirohealth.org

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OIC Petitions

OIC Response

WSCA Counter Response

DOH Petitions

DOH Response

WSCA Counter Response

Exhibits

Contact Information