The 2021 session of the Washington State Legislature opened Jan. 11, and although it will operate remotely this year due to COVID-19, we are committed to monitoring issues that matter to the chiropractic profession.

The Legislature’s remote format presents many challenges to our efforts this year to champion pro-chiropractic legislation. There will be no face-to-face meetings with legislators on campus, no in-person hearings and no way to learn about stakeholder engagement in the normal manner, by talking to each other.

I encourage you to reach out to your legislators now. You can find your state legislator at this link: http://app.leg.wa.gov/districtfinder. Talk to them about any issue that may be impacting your district (transportation, taxes, health care, agriculture). Tell them you are a chiropractor and ask them to please inform and discuss with you any issues that may come up during the session that might impact your profession and your patients.

Also ask your legislators about the best way to reach out to them during the legislative session-do they prefer you call them, email them, or text them? If text, get their number.

As we navigate the challenges of this remote session, we will be focusing on educating legislators about policy issues that remain our priorities as indicated in the following WSCA legislative agenda:

1. Challenging medical physicians and Washington Medical Commission attempts to remove prohibitions on medical doctors from performing spinal manipulation.

2. Including chiropractors into the list of providers eligible to treat adult Medicaid recipients within the already existing spinal manipulation benefit.

3. Protecting laws already in place for patient access to chiropractic care and fair reimbursement.

4. Making permanent chiropractic eligibility for loan repayment through the Washington Student Achievement Council (we were funded for one biennium with a promise to make this permanent).

In addition, we are working with the State Office of the Insurance Commission to address chiropractors’ complaints about insurers who have demonstrated a lack of good faith in implementing both the Fair Pay and Prior Authorization legislation.  he WSCA continues to hear a high volume of insurance complaints from members, and we will research the issues you raise and work to mitigate these negative practices on your behalf.

I encourage all Washington state chiropractors to file complaints with the Office of the Insurance Commissioner if you experience violations of the prior authorization and/or fair pay laws or anytime you believe a patient is being inappropriately denied their chiropractic benefits. You can submit your complaint online at bit.ly/onlineOICform. There is also a printable version at bit.ly/printableOICform that you can fill out, then fax or mail. Insurance laws can be confusing so here is a little information to help you:

State laws only apply to state regulated health plans. How do you know if they are state regulated or under federal regulation?

1. Have the patient call their insurer and ask for their “plan summary description” and that will describe the type of plan.
2. The plan must NOT be a union bargained plan through their employer. These are federally regulated plans known as “Taft Hartley” plans.
3. The plan must NOT be a self-insured/self-funded plan. These are federal regulated plans for larger employers that are allowed to  set their own benefits and rules because they are assuming and paying for all of the risk.  They hire insurers to manage benefits that they structure under federal law rather than buying a plan that is sold on the Washington State market.

The Office of the Insurance Commissioner only enforces  state regulated health plans. State regulated plans are those that are bought on the Washington State market by individuals and employers. The majority of plans are state regulated.

During a normal year, in January we would be hosting our in-person Chiropractic Legislative Day at the state capitol – our annual opportunity to make our presence known to lawmakers in Olympia.  While that is not possible this year, we are instead planning to sponsor remote legislative information sessions with our lobbyist, Lori Grassi. Watch your email for details about these events.

Your financial support of the WSCT and membership in the WSCA is EVERYTHING! You have and will continue to benefit from EVERYTHING that we do. If you have donated recently and/or are a regular contributor to the WSCT it is appreciated, and it makes a difference. Please return your donation in the enclosed remit envelope. You can also visit www.washingtonchirotrust.org and click on the DONATE button to make either a one-time or recurring donation.

— Dr. Dave Butters, President
Washington State Chiropractic Trust

It seems hard to believe that it’s been three months since the end of the 2020 legislative session, and it’s been a while since I’ve provided an update.

I know you can all relate when I say that navigating the weekly, sometimes daily, changing directives in running a chiropractic practice during this COVID-19 pandemic has been stressful and time-consuming. Most of us have been working hard to manage and mitigate our losses, which has included applying for the SBA Paycheck Protection and EIDL loans. We’ve been there for our patients who need us! If you have received a Paycheck Protection Program loan, the WSCA is preparing a video with information you need to know about PPP loan forgiveness — getting that process right is important for loan forgiveness. Watch for information coming from the WSCA.

On a positive note, good things have happened and continue to be happening on legislative and administrative fronts. I’m pleased to report that chiropractic and our patients fared well during the 2020 state legislative session. Two important bills passed – one regulating benefit managers and the other regarding prior authorization – and both were signed into law by the governor. The prior authorization law becomes effective June 11, 2020 and the benefit manager bill will be implemented on January 1, 2022. The Office of the Insurance Commissioner (OIC) has taken up our complaints against Kaiser and Aetna regarding unfair payment practices.  Thus far, as a result of OIC’s review, Kaiser has recently retroactively made additional payments to chiropractors for previously provided spinal manipulation services; we expect to hear soon in regard to E&M and other services that Kaiser has refused to reimburse chiropractors for.  We understand that OIC is still reviewing and communicating with Aetna on these same issues.

Here’s a summary of each bill passed in 2020:

2SSB 5601– Regulating Benefit Managers

Gives OIC regulatory oversight over health care benefit managers. These are entities like Evicore, Tivity, Optum and ASHN, which routinely and arbitrarily deny patients access to their chiropractic benefits with no accountability.

2SSB 5887– Prior Authorization

Provides access to up to six (6) visits of care without prior authorization for each episode to each of the following: a chiropractor, physical therapist, occupational therapist, acupuncturist, massage

2SSB 5887– Prior Authorization

therapist and speech and hearing therapists.  Importantly:  A new episode is defined as 90 days without treatment for the same condition.  The intent of the legislation is to also allow an episode of 6 visits not requiring prior authorization for treatment of a new condition not previously treated, if the patient is currently treating for a different condition.

You can see the full text of both these bills at at this link..

I understand that we’re in very challenging times (strangest in my lifetime). The reality is none of this changes the fact that we have a major election in November 2020 and there are key state House and Senate races up for election. Our continued success depends on our continued involvement in the legislative process. It’s about having friends in the state Legislature who understand and appreciate what we do as chiropractors — every day — to improve the health of our patients.  Simple as that!

I also understand that the political division in our country is probably as high as you can get on the Richter scale. Please remember that the Washington State Chiropractic Trust (WSCT) and Washington State Chiropractic Association (WSCA) function as special interest entities for Chiropractic.  We are bipartisan, we have members and contributors from both sides and in the middle. We’re about strategic positioning legislatively to win as a profession and for our patients. We have friends on both sides of the aisle.

I invite you to learn more about our legislative efforts by attending a virtual Go2Meeting, presented by WSCA lobbyist Lori Grassi.  They are organized by WSCA Legislative District – but anyone is welcome to attend any session. You can earn 1.5 CE credits by attending, but to receive the CE credits, you must register. You can register at www.chirohealth.org/events/event_list.asp

We have the following sessions coming up:

Tuesday, July 21 at  noon     Central King County

Thursday, July 23 at 10 AM   Thurston & South Pierce Counties

Thursday, July 23 at 2 PM     Chelan, Kittitas, Eastern Pierce and Eastern King Counties

Your financial support of the WSCT and membership in the WSCA is EVERYTHING! You have and will continue to benefit from EVERYTHING that we do.  If you have donated recently and/or are a regular contributor to the WSCT, it is appreciated, and it makes a difference. You can also click on the DONATE button to make either a one-time or recurring donation.And you can become a WSCA member by filling out the membership application at www.chirohealth.org/page/join_wsca.

— Dave Butters, WSCT President

The 2020 session of the Washington State Legislature is fast approaching, and it’s critical that you learn more about the issues impacting your practice – and how you can support the Washington State Chiropractic Trust’s efforts to protect chiropractic and our patients.

We have scheduled several two-hour legislative and policy update seminars for chiropractors in specific legislative districts (see information below). These seminars are free, and you can receive 2 CE credits attending. WSCA lobbyist Lori Grassi will discuss a range of important issues, including which Washington State laws protect your patients’ access to chiropractic care, an update on bills that passed and failed during the 2019 legislative session, and chiropractic legislative priorities for 2020.  You will also receive current details on our challenges to the Kaiser E&M payment and other insurance-related issues.

Here’s a recap of our 2020 legislative agenda, as approved by the Washington State Chiropractic Association Board of Directors:

Legislation:

1) Regulating Benefit Managers (ASHN, Tivity, eviCore, Optum)

2) Prior authorization (clarifying “episode of care”)

3) Medicaid inclusion of chiropractors

Policy:

1) Monitoring the implementation of SB 5380, passed during the 2019 session, which addresses prescription opioid misuse via prevention, education and treatment.

2) Tracking the details and service area requirements for a program in underserved communities that would make chiropractors eligible for student loan repayment.

3) Monitoring the progress of Cascade Care, the state’s new public option health plan and the state’s new Universal Health Plan Work Group. Making every effort to maintain access to chiropractic services consistent with statutory protections, such as Every Category of Provider.

Insurance:

Continue to challenge unfair practices regarding chiropractic coverage and push for fair laws.

It is important that all chiropractors connect now with their state senators and representatives. Those relationships will be important as we begin meeting with lawmakers to get support for our issues in 2020. Invite your legislators to coffee or lunch or take them on a tour of your office. It’s all about educating them about what you do to provide health and wellness care in your community.

You can find the names and contact information of your legislators here.

We have numerous requests from legislators for campaign contributions, and we need to make those contributions soon to meet the campaign contribution cutoff date. Our strong financial participation in key campaigns is critical to successfully moving our agenda. We need donations now!

Click DONATE to make a one-time contribution of $1,000, $500, $250, $100 or sign up for monthly credit card withdrawals. If you prefer, you can do the same by filling out and returning the enclosed contribution envelope.

Here’s a list of the legislative information sessions scheduled so far. Please note that while they are scheduled by district, chiropractors from any area are welcome to attend. You can register online by date at www.chirohealth.org/events/event_list.asp or you can call the WSCA office at (206) 878-6055. Meals are available for purchase at each venue.

Legislative District 1 – Bothell
Monday, Oct. 14, 2019

Revolve Restaurant
10024 Main St.
Bothell, WA 98011
6:30-8:30 p.m.

Legislative District 34 – Burien
Monday, Oct. 21, 2019

Angelo’s of Burien
601 S.W. 153rd St.
Burien
6:30-8:30 p.m.

Legislative District 12 – East Wenatchee
Friday, Oct. 25, 2019

Shari’s
501 Valley Mall Parkway
East Wenatchee, WA 98802
509-886-9502
Noon-2 p.m.

Fall is right around the corner, then the holidays, then the New Year and then the 2020 legislative session.  This means that we are working hard to lay the groundwork to move our legislative agenda in the 2020 session of the Washington State Legislature.

Our 2020 agenda as approved by the Washington State Chiropractic Association Board of Directors includes:

Legislation:

• Regulating Benefit Managers (ASHA, Tivity, eviCore, Optum)
• Prior authorization (clarifying “episode of care”)
• Medicaid inclusion of chiropractors

Policy:

• Monitoring the implementation of SB 5380, passed during the 2019 session, which addresses prescription opioid misuse via prevention, education and treatment. There is huge opportunity here as its clear legislative intent is that patients be directed toward trials of non-drug treatment prior to opioid prescriptions being administered.
• Tracking the details and service area requirements for a program in underserved communities that would make chiropractors eligible for student loan repayment.
• Monitoring the progress of Cascade Care, the state’s new public option health plan and the state’s new Universal Health Plan Work Group. Making every effort to maintain access to chiropractic services consistent with statutory protections, such as Every Category of Provider.  So much to keep track of!

Insurance:

• Continue to challenge unfair practices regarding chiropractic coverage and push for fair laws.

While many of us are still enjoying summer activities, the January 2020 legislative session will be here before we know it! I encourage all chiropractors to connect now with their state senators and representatives.  Those relationships will be important as we begin meeting with lawmakers to get support for our issues in 2020. Invite your legislators to coffee or lunch or take them on a tour of your office.  It’s all about educating them about what you do to provide health and wellness care in your community.

You can find the names and contact information of your legislators here: https://app.leg.wa.gov/districtfinder/.

We have numerous requests from legislators for campaign contributions.  To move our agenda successfully we must participate financially and at a grass roots level.  We can’t be successful without your contributions!

If you are a regular WSCT contributor, it is appreciated. If you haven’t donated, please do so now!  Click here to make either a one-time or recurring donation.  Or, if you prefer, fill out and return the enclosed contribution envelope. You can make a one-time contribution of $1,000, $500, $250, $100 or you can sign up for monthly credit card withdrawals.

Finally, here’s a reminder to place the WSCA’s Annual Fall Conference on your calendar.  It will be October 4-5 at Bellevue Marriott, and you can earn up to 25 CEs. Continuing education topics include:

• Today’s Chiropractor on the Witness Stand: Presenting and Defending Treatment of Acute and Chronic Injuries, with featured speakers Richard Adler, JD and Dan Murphy, DC, DABCO
• Current Evidence-Based Approach to Diagnosis, Triage, and Clinical Chiropractic Management of Common Lumbar Spine Conditions, with Anthony Lisi, DC
• Establishing Trust with Patients through Professional Marketingby Siouxsie Jennett

Learn more and register at www.chirohealth.org/wsca19. Hope to see you there!

— Dr. Dave Butters, President
Washington State Chiropractic Trust