SENATE BILL REPORT

SB 5934

BYSenators Warnke, Lee, Smitherman, West, Tanner, Conner, Cantu, Gaspard, Vognild, Moore, Johnson, Deccio, Bottiger, Bauer, Rinehart, Owen, Halsan, Talmadge, Pullen, Kiskaddon, Fleming, Stratton, Metcalf, Bender, von Reichbauer and Garrett

Providing that state employees have right to choose health care services.

Senate Committee on Commerce & Labor

Senate Hearing Date(s):March 3, 1987; March 5, 1987

Majority Report:  Do pass.

      Signed by Senators Warnke, Chairman; Smitherman, Vice Chairman; Cantu, Lee, Tanner, Vognild, West.

Senate Staff:Jean Meyn (786-7472)

                  March 5, 1987

AS REPORTED BY COMMITTEE ON COMMERCE & LABOR, MARCH 5, 1987

BACKGROUND:

The State Employees Insurance Board (SEIB) determines which insurance programs the state will provide state employees.  Current law states that employees shall be provided the services of various practitioners on an "equal participation basis".  Chiropractor associations believe state workers do not have equal access to their services under some health maintenance organizations (HMO).

Patients generally enter the HMO system through a "gatekeeper" or primary care physician who determines the appropriate type of service for the individual.  Because most of the gatekeeper physicians are medical doctors (M.D.), they are not likely to make many referrals for chiropractic care and proponents believe that some patients are not getting freedom of choice of type of service.

Proponents suggest a definition of "equal participation basis" that would allow more freedom of choice.  In 1986 an Attorney General Opinion stated that the current interpretation of equal participation basis allowed for the restrictions on choice in the HMO's.

HMO's consider that this proposal will change the entire way that they do business.

SUMMARY:

State employees' freedom to choose health care services is limited by restrictions applied only after they have gained access to their choice of primary health services, or after peer review.

A peer review committee consists of licensed practitioners and at least one consumer, none of whom may have a fiduciary relationship with the patient on review.

Fiscal Note:      none requested

Senate Committee - Testified: Jeff Parsons, Chiropractors' Political Action Committee; Dr. James Burket, D.C., Chiropractic Society of Washington; Darlene Burgess, Group Health Cooperative; Robert Flanagan, Group Health Cooperative