It’s time to contact your U.S. Senators and ask them to support H.R. 372 – aimed at increasing competition in health insurance markets and lowering prices for consumers.
A nationwide coalition of health care providers is supporting H.R. 372, also known as the Competitive Health Insurance Reform Act of 2017. This bill, if passed by the U.S. Senate and signed by President Trump, will repeal the 1945 McCarran Ferguson Act antitrust exemption for the insurance industry.
According to an American Chiropractic Association update, the bill will ensure that health insurers “are subject to the same laws which prohibit unfair trade practices that other businesses are required to comply with.” These include price fixing, collusion or market allocations to the detriment of consumers, the ACA said.
The bill would authorize the Federal Trade Commission and the Department of Justice to enforce the federal antitrust laws against health insurance companies. It passed the U.S. House of Representatives by a 416-7 vote in March 2017, and now awaits action in the Senate.
Contact your Senators NOW and ask them to take up H.R. 372 — and deliver it to the President for signature.
Our profession has survived for 120-plus years because we fight for what we believe in. During the early years, doctors of chiropractic were thrown in jail – just for providing care to their patients. We owe it to those who paved the way for us – and those who are following in our footsteps — to make sure doctors of chiropractic are compensated fairly and that our patients have unimpeded access to chiropractic services.
As frustrating as the last couple legislative sessions have been we must remember this is an ongoing process and our legislative successes have always required persistence over time to achieve.Every year we run offense and defense! Our current offensive priorities continue to be Fair Pay for our services and Prior Authorization obstacles to the care of our patients and the huge administrative burden it’s placing on our offices. We’re aggressively working both of these issues from every angle possible legislatively, administratively and legally. Defensively, we stand ready to again stop efforts to erode or eliminate the Every Category of Provider protections that require health plans sold in Washington state to provide chiropractic benefits. We have to be at table and in the discussions as this health care system morphs into whatever it becomes. Our state legislators need to know that we are the viable solution to the opioid crisis and that restricting or impeding access to our services is ridiculous!
WE NEED YOU TO ENGAGE financially and physically! Do it for Chiropractic, Do it for your Patients, Do it for your Family, Do it for Yourself. There are more than 2,000 of us practicing in Washington and frankly our performance on behalf of our great profession in numbers is pathetic and we still have one of the best states in the country for chiropractic. What are you going to do to keep it that way or make it better yet? If just half of us engaged, the influence we would achieve would be staggering!
So what do we need you to do?
To meet our contribution goals and most effectively give to State Senate and House campaigns and House and Senate soft money PACs, we need to raise $100,000 over the next three months. WOW that’s $50 per Chiropractor in our state. Unfortunately, my past experience says everyone won’t play. Therefore many of us will need to do more.
It’s also important that you spend time this summer meeting with your legislators. Have coffee, write them a modest check and invite a few of them into your clinic! It makes a difference! You can find your state legislator at this link: http://app.leg.wa.gov/districtfinder. If you would like help setting up meetings with your legislators, contact Lori Grassi, Lobbyist and Executive Director for the WSCA, at LGrassi@chirohealth.org or 206-878-6055.
If you are a regular contributor to the WSCT, it is appreciated. If you haven’t contributed, I urge you to do so today. Visit www.washingtonchirotrust.org and click on the DONATE button to make either a one-time or recurring donation. Or, if you prefer, mail a check to WSCT, PO Box 2163, Seattle, WA 98111.
Make a one-time contribution: $1000, $500, $250, $100 or sign up for monthly credit card withdrawals: $100, $50, $25 monthly.
As many of you know, we were not successful this legislative session on our first attempt to pass our Fair Pay Bill. It’s important to remember that the legislative process is a marathon, not a sprint. We currently continue to work with key legislators and the Office of the Insurance Commissioner (OIC) to address the unfair pay issues. We are collecting EOBs for all insurance companies for spinal manipulation services provided by DOs and NDs, along with corresponding DC EOBs for the same geography and approximate time (within the same month).
Washington State Chiropractic Association (WSCA) lobbyist Lori Grassi and WSCA member Dr. Gina Wolf from Spokane participated in a prior-authorization hearing on March 29 with the House of Representatives Health Care Committee testifying to the concerns with the behaviors of eviCore. We exposed the practices of eviCore and their irrational, baseless and unfair allocation of visits to providers. (Watch the TVW video here.)
Let’s talk about why our bill, SB 5518, didn’t pass. We had a lot of legislative support but the (relatively) few people attending our legislative day questions our resolve and lets legislators on the fence off the hook. We have 2,400 chiropractors in our state and yet fewer than 50 attended). The chiropractors who participated did a good job delivering our message to lawmakers, but lobbying is one of those rare things where sometimes quantity can make the difference. We need a larger presence at our Legislative Day (300-plus DCs). By contrast, our medical and osteopathic counterparts (and the PTs) turn out in the hundreds on their legislative days. When Washington State Chiropractors are ready to compete at that level, we’ll move mountains.
The legislation that we introduced exposed a very technical issue with formulas that the DCs at Legislative Day needed to understand in order to explain to legislators.
Explaining those issues to legislators in 15-minute appointments proved very challenging; especially when they were meeting with lobbyists and constituents in back-to-back meetings. In order to pass this kind of legislation we have to have a repeated, consistent message relayed by many DCs. The call volume by DCs to their legislators on this issue, while strong and impressive, didn’t meet the challenge of such a piece of policy. We have called out disparate pay to other professions who stand to lose income, who don’t want our bill to pass. We have challenged the inappropriate payment practices by influential insurers in Washington State; however, to succeed with this kind of a challenge with opposition from Premera, Regence and Aetna it takes time and large numbers of chiropractors engaging their legislators throughout the session.
Remember that Regence, Premera and Aetna all contribute large amounts of money (part of this equation) to the House and Senate. It’s critical we continue to raise and strategically contribute funds to political campaigns. Less than 15 percent of Washington state chiropractors contribute financially to the political activities that protect and enhance your profession and your patients’ access to your services.
So what happens next? Be assured that we will continue to fight for fair pay and against intrusive, disruptive and costly prior authorization practices and any other actions that interfere with our patients’ access to our services and our ability to compete fairly in the market place.
I am calling on you again to donate to the Trust, to help elect those who support chiropractic. And next year, I will ask you again to come to Olympia, and again to meet with your legislators between sessions back in your home districts. The legislative process is a long one, and at times discouraging. Our lobbyist Lori Grassi is always available to help you facilitate YOUR message with your legislators, both during and between sessions, but it has to be initiated by you. Will YOU? Contact Lori Grassi at 206-878-6055 or by email firstname.lastname@example.org.
If you have contributed recently and/or are a regular contributor to the WSCT, it is appreciated and makes a difference. If you haven’t contributed, I urge you to do so today. You will find on our website www.washingtonchirotrust.org an online donation option. Just click on the DONATE button to make either a one-time or recurring donation. Or, if you prefer, fill out and return the enclosed contribution envelope.
Make a one-time contribution: $1000, $500, $250, $100 or sign up for monthly credit card withdrawals: $100, $50, $25 monthly.
Pay parity for spinal manipulation is gaining traction in Olympia, but the fight is far from over.
Washington State Chiropractic Association Executive Director and Lobbyist Lori Grassi and Dr. Austin McMillin testified last week before the Senate Health Care Committee in support of SB 5518, while insurers presented no new arguments against the bill.
Legislators were engaged, and now we need your help to follow up with them. The bill needs to be moved out of the Health Care Committee by 5:00pm on Friday, Feb. 17.
Dozens of Washington state chiropractors gathered in Olympia Thursday, Feb. 2 for the 2017 Washington State Chiropractic Trust/Washington State Chiropractic Association Legislative Day.
After receiving a briefing from WSCA Executive Director/Lobbyist Lori Grassi and WSCT President Dave Butters, chiropractors spread across the Capitol campus for individual meetings with their state senators and representatives — and talk about unfair payment to chiropractors for spinal manipulation services. Chiropractors are paid up to 50 percent less than other providers who deliver spinal manipulation. There has been no increase in chiropractic reimbursement for spinal manipulation in more than 13 years.
Miss Legislative Day? You are welcome to come to Olympia at any time and meet separately with lawmakers. If you need help, contact Shaka Forest at the WSCA office at 206-878-6055 or email@example.com. He is ready to help you find your legislator as well as call for appointments for you.
Our 2017 Chiropractic Legislative Day is Thursday, Feb. 2 in Olympia. We have an aggressive legislative agenda and it’s critical that we demonstrate the power of our profession by showing up Thursday, Feb. 2 to meet with our legislators.
WSCA Lobbyist Lori Grassi has prepared materials exposing the unfair payment to chiropractors for spinal manipulation services. Chiropractors are paid up to 50 percent less than other providers who deliver spinal manipulation. There has been no increase in chiropractic reimbursement for spinal manipulation in more than 13 years.
We’re also working on two other key issues this session: The inclusion of chiropractors in the list of providers who can deliver the already existing spinal manipulation benefit to adult Medicaid recipients, and inclusion of chiropractic on the list of providers defined as “primary care providers” (PCP), within your scope of practice. Being defined as a PCP means that chiropractors would be eligible for student loan forgiveness when working in a rural community; and would be eligible for PCP copayment levels for patients with spinal manipulation (CMT) benefits.
As always we anticipate significant legislative resistance to these issues, both due to a lack of understanding of your education, and perceptions of your scope of practice. Our primary issue – fair pay – is something that insurers claim is a “contract matter”. The contracts available to chiropractors are take it or leave it contracts, we are at a terrible disadvantage as we are unable to negotiate the contracts and/or the fee schedules. Our goal is to “level the playing field”.
It always starts with a briefing, handouts and a question-and-answer session on our legislative status beginning at 8 a.m. inside on the steps under the Capital Dome of the Legislative Building. Plan a carpool with other chiropractic colleagues from your district.
We need you to make appointments with your legislators NOW! If you need help, contact Shaka Forest at the WSCA office at 206-878-6055 or firstname.lastname@example.org. He is ready to help you find your legislator as well as call for appointments for you. You likely will not be able to “select” your appointment time. Legislative staff will work your appointment request into and around the legislative committee hearing schedules. You’ll need to take the time they give you on Thursday Feb. 2nd. Lori Grassi will accompany you to your appointment if her schedule permits. Tell Shaka to add it to her calendar. See the link below to find your legislators!
Washington State Chiropractic Association Lobbyist Lori Grassi has prepared materials exposing the unfair payment to chiropractors for spinal manipulation services. Chiropractors are paid up to 50 percent less than other providers who deliver spinal manipulation. There has been no increase in chiropractic reimbursement for spinal manipulation in more than 13 years.
We need your help! We need you to coordinate with Lori Grassi and schedule appointments with your legislators now. Lori will attend your meetings with you to provide the materials explaining the unfair payment practices. Her attendance and involvement will help you avoid potential anti-trust violations in the process. Call Lori at 206-878-6055 or email her at LGrassi@chirohealth.org with the word “Legislation” in the subject line.
To be successful, we have to explain to legislators how the insurance payment processes are:
1. Not following the fair process of payment formulas known as the Resource Based Relative Value Scale (RBRVS); and
2. Not negotiating with individual providers — the contracts are “take it or leave it” unless you are in a group of 20 or more
This process is most effective when a chiropractor from the legislator’s district is involved in the discussion. Again, call Lori at 206-878-6055 or email her at LGrassi@chirohealth.org with the word “Legislation” in the subject line.
Please also note on your calendar that Chiropractic Legislative Day in Olympia will be Thursday, Feb. 2, 2017! It always starts with a briefing on our legislative status beginning at 8 a.m. on the steps of the Legislative Building. Plan a carpool with other chiropractic colleagues from your district to this very important one-day chiropractic legislative event. Get your Legislative Day appointments with your legislators set up now (they get booked up)! Be part of our grassroots efforts.
It’s not OK that osteopaths and naturopaths get paid twice as much as chiropractors for providing the same service.
It’s not OK that insurance carriers haven’t increased their fee schedules to chiropractors in 13 years.
It’s not acceptable that insurers are allowed to use EviCore or any other mechanism to obstruct a patient’s access to their Chiropractic benefits.
If you agree with the above, the time is NOW to step up and support your profession!
Not tomorrow. Not next week. NOW!
To complete the financial support of our state legislative friends in this election cycle we must raise $20,000 in the next TWO WEEKS. This is what’s necessary if we want a shot at advancing our agenda in Olympia.
DONATE NOW here or mail a check today to the WSCT, PO Box 2163, Seattle, WA 98111.
We’re always fighting for you, and one of the issues we continue to tackle is educating legislators on the unfair fee schedule used by insurers to pay chiropractors.
This summer, our lobbyist Lori Grassi has been meeting with state lawmakers, using visuals to show them how insurance company fee schedules for Chiropractic Manipulative Therapy (CMT) is paid at, in many cases, 100 percent less than what is paid to osteopathic and naturopathic doctors using the Osteopathic Manipulative Therapy (OMT) codes. This tool clearly shows how these payments are unfair, especially when the patient copay for chiropractic services is much more than the co-payment required for primary care!
In addition, through these visuals legislators also are learning that carriers have not increased fee schedules to chiropractors in 13 years, clearly unfair financial treatment in a market place where three insurers (Regence and Premera, their subsidiaries and Aetna) hold policies for most of the covered lives in Washington state, and chiropractors have no legal effective way to negotiate fees.
We are also educating legislators about the importance of defining chiropractic as a Primary Care profession, along with physician assistants, nurse practitioners, and naturopathic doctors. This will not only level the playing field when it comes to patient co-payments, it would also allow chiropractors to access the loan re-payment program for newly licensed DCs who choose to practice in a rural setting. And, we continue to challenge unfair prior-authorization practices by encouraging providers and patients to file complaints with the Office of the Insurance Commissioner (OIC). OIC confirms that they are receiving our complaints, are fully aware and concerned about the issue and are considering a market conduct review.
Your support is critical to advance this major agenda. To meet our contribution goals and effectively contribute to State Senate and House campaigns and House and Senate soft money PACs we still need to raise $65,000 over the next 3 months. It’s also important that you spend some time this summer meeting with your legislators. Have coffee, write them a modest check and invite a few of them into your clinic! It makes a difference! You can find your state legislator at this link: http://app.leg.wa.gov/districtfinder.
If you have contributed recently and/or are a regular contributor to the WSCT, it is appreciated. If you haven’t contributed, I urge you to do so today. Donate online here to make either a one-time or recurring donation. Or if you prefer, mail your donation to WSCT, PO Box 2163, Seattle, WA 98111.
Make a one-time contribution: $1000, $500, $250, $100, or sign up for monthly credit card withdrawals: $100, $50, $25 monthly.
— Dr. Dave Butters, President
Washington State Chiropractic Trust
On June 23, I participated in a meeting that illustrates how the Washington State Chiropractic Association (WSCA) and Washington State Chiropractic Trust (WSCT) are working hard to protect the chiropractic profession in our state.
The WSCA and the WCT, along with State Rep. Eileen Cody, Chair of the House Health Care Committee, met with insurance company representatives to discuss three critical issues affecting our state’s chiropractors:
Copays that exceed the allowed amount paid to a chiropractor.
Fee schedules that have not increased in more than a decade and disparate pay for chiropractic manipulation services vs. osteopaths and naturopaths (paid nearly 100% more in many cases).
Prior authorization requirements with no rational clinical basis that only serve to disrupt or prevent necessary care and burden providers with unmanageable administrative struggles.
While all insurers were invited, those attending included Regence, Premera, Molina, Group Health and Aetna, along with one representative from the Association Health Plans. Our attendees included WSCA President Garry Baldwin, DC; WSCA Executive Director/Lobbyist Lori Grassi; Austin McMillin, DC and myself.
Rep. Cody opened the meeting by asking insurers to consider that their current copay practices may be creating deterrents to patients following their treatment plans and could be adding to the opioid epidemic, forcing patients to turn to drugs when they are in chronic pain.
Lori Grassi prepared materials to illustrate the disparate payments between professions for virtually the same service. The WSCA attendees provided excellent examples of the discriminatory behavior that insurers are applying to chiropractors.
Dr. McMillin led a remarkable conversation about the development of the CPT codes and how the Relative Value Units (RVUs) are intended to apply regardless of provider type to all services described by a CPT code. He delivered a historical perspective that stifled the insurance representatives and left the room silent.
Compelling examples were provided of why the prior authorization process is arbitrary, non-clinical, disrupts and denies care and benefits.
The meeting can be summarized in these bullet points:
The pay to chiropractors is blatantly unfair and discriminatory, and insurers are using arbitrary methods for establishing chiropractor fee schedules.
Between prior authorization requirements and menial payment for manipulation – whether the payment is a copay paid entirely by the patient or the minimal “allowed amount” actually paid by an insurer – it doesn’t cover the cost of the administrative work shifted to the provider along with providing the care.
The WSCA will likely need to run a bill again to overcome this inequity and we will need strong support from the profession to move the issue through the process.
We will also be meeting with the Office of the Insurance Commissioner on June 30, 2016, to discuss detailed issues regarding the prior-authorization processes used to deny access to chiropractic care.
These are just a couple of ways that the WSCA and WSCT are working to protect the chiropractic profession in Washington State. If you are a regular contributor to the WSCT, thank you. If not, I urge you to do so today!
You can click here to make a one-time or recurring donation online. Or you can mail your donation to WSCT, PO Box 2163, Seattle, WA 98111
Consider a one-time contribution: $1000, $500, $250, $100 or sign up for monthly credit card withdrawals: $100, $50, $25 monthly.
— Dr. Dave Butters, President
Washington State Chiropractic Trust