SENATE BILL REPORT

                   SB 5776

              As Reported By Senate Committee On:

           Health & Long‑Term Care, February 3, 2000

Title:  An act relating to access to chiropractic health care services.

Brief Description:  Expanding access to chiropractic health care services.

Sponsors:  Senators Franklin, Roach, Prentice, Zarelli and Costa.

Brief History:

Committee Activity:  Health & Long‑Term Care:  2/25/99; 1/24/00, 2/3/00 [DPS-WM].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  That Substitute Senate Bill No. 5776 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

  Signed by Senators Thibaudeau, Chair; Costa, Deccio, Franklin and Winsley.

Staff:  Jinnah Rose-McFadden (786-7444)

Background:  All health plans in Washington are required to allow access to every category of health care providers, including chiropractors.  Some are concerned that the practice of using medical gatekeepers to screen patients before referring them to other health care providers inhibits access to chiropractors.

Summary of Substitute Bill:  Health care carriers must allow enrolled patients to have direct access to chiropractic services.  No prior referral is required.

Carriers may restrict an enrolled patient's: choice of chiropractic services, to those covered under its plan; and choice of provider, to those providers who have signed a provider agreement with the carrier.  A carrier=s use of managed care and cost containment techniques and processes are not restricted.

Substitute Bill Compared to Original Bill:  The substitute clarifies the scope of the bill.

Appropriation:  None.

Fiscal Note:  Not requested.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  Most health carriers require patients to visit their general practitioner and obtain a referral prior to accessing chiropractic care.  However, studies reveal that less than 20 percent of medical doctors will refer patients to chiropractors.  This bill is necessary to ensure that patients obtain access to chiropractic services.

This bill reduces the costs associated with a "gatekeeper" system.  Because patients may access chiropractic care without first visiting their general practitioner, a duplication of services is avoided.

Testimony Against:  There are concerns that this bill is confusing.  It is feared that this bill limits the authority of health carriers to restrict the number of annual chiropractic visits available to each patient.  In addition, health carriers believe that this bill would raise the cost of insurance premiums.

Testified:  Steve Wehrly (pro); Ken Bertrand, Group Health (con).