HOUSE BILL REPORT

                      HB 2605

                     As Reported By House Committee on:

                                Health Care

Title:  An act relating to health care for persons receiving public assistance.

Brief Description:  Providing chiropractic services to persons receiving public assistance.

Sponsor(s):  Representatives Morris, Edmondson, R. Meyers, Wood, Day, Casada, R. King, Miller, Jones, Roland, Paris, Pruitt, Nelson, Bowman, Prentice, McLean, Nealey and Tate.

Brief History:

   Reported by House Committee on:

Health Care, February 6, 1992, DPS.

HOUSE COMMITTEE ON

HEALTH CARE

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass.  Signed by 9 members:  Representatives Braddock, Chair; Day, Vice Chair; Casada, Assistant Ranking Minority Member; Cantwell; Edmondson; Morris; Paris; Prentice; and Sprenkle.

Minority Report: Do not pass.  Signed by 1 member:  Representative Moyer, Ranking Minority Member;

Staff:  John Welsh (786-7133).

Background:  The state Medical Assistance program consists of the federal aid medical care program provided to categorically needy persons under Title XIX of the federal Social Security Act (Medicaid).

Medical assistance may include any medical care or other type of remedial care as may be established by the secretary of the Department of Social and Health Services, as well as other diagnostic, screening, preventive, and rehabilitation services. Chiropractic services are not specifically referenced.

Summary of Substitute Bill:  The department is required to offer chiropractic services under the state Medical Assistance program. The department may adopt by rule such measures as peer review, utilization review, care plans, or limitation of treatment to assure that the needs are met at the least cost.

The requirement for the coverage of chiropractic services would not be effective until July 1, 1993.

Substitute Bill Compared to Original Bill:  An effective date of July 1, 1991 was added to the bill.

Fiscal Note:  Requested January 29, 1992.

Effective Date of Substitute Bill:  July 1, 1991.

Testimony For:  The department does not provide for the coverage of chiropractic services in the current budget. This is discriminatory not only to chiropractic, but to patients. A lot of patients depend on these needed services.  Patients are not able to get relief from other physicians. Chiropractic specializes in the treatment of low back problems, and is a less costly service. Any alleged savings to be achieved are illusory and will be translated into more costly medical services as patients shift to other higher cost providers.

Testimony Against:  Chiropractic care is an optional service under the federal Medicaid law. In the current fiscal crisis, painful cuts must be made somewhere. The state will save an estimated $3.2 million in fiscal year 1993. The cut affects some 6,000 patients and over 800 chiropractors.

Witnesses:  David Butters (pro); and Jim Peterson, Department of Social and Health Services (con).