2SSB 5597 -
By Representative Cody
ADOPTED 04/06/2007
Strike everything after the enacting clause and insert the following:
"NEW SECTION. Sec. 1 A new section is added to chapter 48.43 RCW
to read as follows:
(1) A health carrier must reimburse a chiropractor who has signed
a participating provider agreement for services determined by the
carrier to be medically necessary if:
(a) The service is:
(i) Covered chiropractic health care, as defined in RCW 48.43.515,
by the health plan under which the enrollee received the services; and
(ii) Provided by the chiropractor, or the chiropractor's employee
specified in RCW 18.25.190 (2) or (3) who works in the same location as
the chiropractor and to whom the chiropractor, pursuant to rules
adopted by the Washington state chiropractic quality assurance
commission, has delegated the service. The employee must meet the
health carrier's reasonable qualifications for all such providers in
the relevant class, including but not limited to standards for
education and background checks, as applicable; and
(b) The chiropractor complies with the terms and conditions of the
participating provider agreement. Violations of the participating
provider agreement by an employee of the chiropractor to whom he or she
has delegated a service may be deemed by the carrier to have been
committed by the chiropractor.
(2) If a health carrier offers a participating provider agreement
to a chiropractor within a single practice organized as a sole
proprietorship, partnership, or corporation, the carrier must offer the
same participating provider agreement to any other chiropractor within
that practice providing services at the same location. The agreement
may allow either party to terminate it without cause.
Sec. 2 RCW 41.05.017 and 2000 c 5 s 20 are each amended to read
as follows:
Each health plan that provides medical insurance offered under this
chapter, including plans created by insuring entities, plans not
subject to the provisions of Title 48 RCW, and plans created under RCW
41.05.140, are subject to the provisions of RCW 48.43.500, 70.02.045,
48.43.505 through 48.43.535, 43.70.235, 48.43.545, 48.43.550,
70.02.110, ((and)) 70.02.900, and section 1 of this act.
NEW SECTION. Sec. 3 This act does not affect any existing right
acquired or liability or obligation incurred prior to the effective
date of this act.
NEW SECTION. Sec. 4 If any provision of this act or its
application to any person or circumstance is held invalid, the
remainder of the act or the application of the provision to other
persons or circumstances is not affected.
NEW SECTION. Sec. 5 This act takes effect January 1, 2008."
Correct the title.