5587-S AMS BENT S2290.1

SSB 5587 - S AMD - 134

By Senators Benton and Roach

                        RULED OUTSIDE THE SCOPE AND OBJECT 3/11/99

    On page 9, after line 14, insert the following:

    "NEW SECTION. Sec. 7.  (1) For purposes of this section, chiropractic health care services includes all services included in the chiropractic scope of practice under chapter 18.25 RCW.

    (2) Health care carriers shall ensure that enrolled patients have direct access to timely and appropriate covered chiropractic services from the participating chiropractor of their choice in accordance with subsection (3) of this section.

    (3)(a) Health care carrier policies, plans, and programs written, amended, or renewed after January 1, 2000, shall provide enrolled patients with direct access to the participating chiropractor of their choice for covered chiropractic health care services without the necessity of prior referral from another type of health care practitioner.

    (b) Nothing in this section shall prevent health care carriers from restricting patients to seeing only health care practitioners who have signed participating provider agreements with the health carrier or from utilizing other managed care and cost containment techniques and processes."

    Renumber the remaining sections consecutively and correct any internal references accordingly.

    On page 9, line 19, after "through" strike "6" and insert "7"

EFFECT:  Permits patients to have direct access to chiropractic care within the coverage of the particular plan but without the intervening involvement of an MD gatekeeper.  Specifies that the plan may restrict patients to seeing providers who have signed participating provider agreements and that health carriers may utilize other managed care and cost containment techniques and processes.  Does not require that a plan provide chiropractic coverage.

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