FINAL BILL REPORT

                           SSB 5736

PARTIAL VETO

                          C 515 L 93

                      SYNOPSIS AS ENACTED

Brief Description:  Regulating chiropractic care for industrial insurance.

SPONSORS: Senate Committee on Labor & Commerce (originally sponsored by Senators Moore, Pelz and Fraser)

SENATE COMMITTEE ON LABOR & COMMERCE

HOUSE COMMITTEE ON COMMERCE & LABOR

HOUSE COMMITTEE ON APPROPRIATIONS

BACKGROUND:

Under the industrial insurance law, an injured worker is entitled to proper and necessary medical care from a physician of the worker's choice.  The Department of Labor and Industries' administrative rules define physician as a person licensed to practice medicine or osteopathic medicine.  The rules also define doctor to include persons licensed to practice medicine, osteopathic medicine, chiropractic, drugless therapeutics, podiatry, dentistry, and optometry.  Doctors are authorized to sign accident report forms for injured workers and temporary disability authorization forms.  Only physicians licensed to practice medicine may examine injured workers to determine the extent of a worker's permanent impairment.

Within the health and rehabilitation services section of the department's industrial insurance division is an office of the medical director.  The department has established several provider advisory committees, including a chiropractic advisory committee to advise the department on such issues as standards for effective and accepted chiropractic treatment for use by attending chiropractors and consultants, standards and minimum credentials for consultant reviews, and reviews of the performance of individual chiropractors.

SUMMARY:

Chiropractic care must be available to injured workers under the industrial insurance system.  The care given must be within the scope of practice for chiropractic care. 

The Director of the Department of Labor and Industries is required to appoint an associate medical director for chiropractic treatment who is eligible to be licensed under Washington law.

The department may develop treatment and utilization standards for chiropractic treatment in consultation with the chiropractic profession, but the standards may not require termination of treatment based solely on the number of treatments.  Within the scope of practice, chiropractors may conduct examinations to determine the rating of permanent disabilities in consultation with medical doctors, or if the department requests, these examinations may be by a single chiropractor.  Chiropractors are expressly made subject to the department's fee schedule and provider audit authority.  A worker may be required to submit to a chiropractic examination to assist the department in evaluating the need for chiropractic care or claim closure.

VOTES ON FINAL PASSAGE:

Senate    38   4

House     96   2    (House amended)

Senate    38   8    (Senate concurred)

EFFECTIVE:July 25, 1993

Partial Veto Summary:  The position of associate medical director for chiropractic in the Department of Labor and Industries is eliminated.  The section prohibiting the termination of chiropractic treatment of injured workers based solely on the number of treatments is vetoed.  (See VETO MESSAGE)