If you didn’t attend legislative day and have questions — or want to visit Olympia another day to meet with your lawmakers — email lobbyist Lori Grassi.
The annual WSCA Legislative Day is a time for chiropractors from all over the state to take part in grassroots lobbying on behalf of the entire profession. This year, in addition to meeting with your legislators, the WSCA will offer a continuing education program where you may earn up to 4 CEs
Following meetings with legislators, attendees can take the DASH from the capitol to the seminar venue. The DASH is a free bus that runs through the capitol and surrounding areas every 12 minutes. Attendees will board the DASH outside the Insurance Building (next door to the legislature) and take it to Sylvester Park, three stops down Capitol Way. Directly across the street from Sylvester Park is the Red Lion Inn & Suites Olympia, Governor Hotel.
The free continuing education program will be held from 1:00-4:00pm in the Legislative room.
Leading our technique-based continuing education program will be Dr. Marvin Kunikyo of Finesse Chiropractic in Lacey.
There is no fee to attend Legislative Day or the continuing education program that follows. Although we expect most of the legislative meetings will take place in the morning, it is possible that some will be held in the afternoon. If that is the case for you, don’t worry–you are free to come and go from the seminar as needed.
Washington state chiropractors are encouraged to participate in 2020 Chiropractic Legislative Day, an annual gathering at the state Capitol in Olympia, on Thursday, Jan. 30.
Legislative Day, sponsored by the Washington State Chiropractic Trust and the Washington Chiropractic Association, is a time for chiropractors statewide to take part in grassroots lobbying on behalf of the entire profession. As always, we’ll meet in the Capitol Rotunda at 8 a.m. The location if 416 Sid Snyder Ave. S.W., Olympia.
It’s key that you schedule appointments to meet with your legislators after our 8 a.m. meeting. You can find a list of your legislators at https://app.leg.wa.gov/DistrictFinder/.
Contact the WSCA office at 206-878-6055 to RSVP for Legislative Day and for assistance in making your appointments. A large turnout of doctors in Olympia Jan. 30 is key to showing our strength to legislators who will be deciding these issues on our behalf!also
This year, in addition to meeting with legislators, the WSCA will offer a continuing education program where you may earn up to 4 CEs.
Following meetings, attendees can take the DASH from the capitol to the seminar venue. The DASH is a free bus that runs through the capitol and surrounding areas every 12 minutes. Attendees will board the DASH outside the Insurance Building (next door to the legislature) and take it to Sylvester Park, three stops down Capitol Way. Directly across the street from Sylvester Park is the Red Lion Inn & Suites Olympia, Governor Hotel.
The free continuing education program will be held from 1-4 p.m. in the Legislative room.
Leading our technique-based continuing education program will be Dr. Marvin Kunikyo of Finesse Chiropractic in Lacey.
There is no fee to attend Legislative Day or the continuing education program that follows. Although we expect most of the legislative meetings will take place in the morning, it is possible that some will be held in the afternoon. If that is the case for you, don’t worry — you are free to come and go from the seminar as needed.
Marvin Kunikiyo, DC is a graduate of Palmer Chiropractic College West and practices at Finesse Chiropractic in Lacey, WA. He uses Motion Palpation technique for diagnosis and the Gonstead technique for adjusting. Dr. Kunikiyo teaches spinal adjusting to chiropractors throughout the state and has lead several other programs through the WSCA over the years. Join us as we advocate for chiropractic in Washington, and after you meet with your legislators, learn why Dr. Kunikyo’s tag line is “Gentle Adjusting with Results.”
The Washington State Chiropractic Trust is on a mission: To promote and protect patient access to chiropractic care. And our work is more important than ever, as the chiropractic profession has been under attack lately on multiple fronts.
We have compiled the detailed information below because we believe that knowledge is power. You need to know what the challenges are, and you need to see how we – in conjunction with the Washington State Chiropractic Association – are responding.
Here is a list of the issues we are focused on, with accompany documentation enclosed. It’s important for every member of our Washington state profession to read these documents, and then act accordingly. (Specific steps on how you individually can make a true difference in protecting our profession and our patients are included at the end of this message.)
We responded to the Washington Medical Commission’s attempted “grab” at spinal manipulation in MD Scope of Practice. The WSCT and the WSCA learned Nov. 12 that the Washington Medical Commission introduced an Interpretive Statement to ignore the two statutory prohibitions on a medical doctor’s ability to perform spinal manipulation. These prohibitions are found in both the Chiropractic and Medical Practice Acts within the Revised Code of Washington. After hearing protests from both the Washington State Chiropractic Association and the Chiropractic Quality Assurance Commission, the medical commission backed down and withdrew — for now. But they made it clear that they would work with their staff and have a new draft for their January meeting. (Details of our efforts to fight this “grab” are here.)
We provided public comment on needed changes to Washington Health Benefit Exchange Draft Standard Plans for Cascade Care. Our comment outlines recommended changes to coverage in Cascade Care, the so-called “public option” approved by the state Legislature. In our comments, we stress the importance of ensuring chiropractic access and benefit limits are at least equal to those provided for PT/OT, and that appropriate constraints are provided for insurance pre-authorizations. We also point out how chiropractic care addresses the Legislature’s stated concern about providing nonpharmacological pain management alternatives in light of the opioid crisis. (Read more in the Cascade Care public comment here.)
We provided public comment on the Apple Health Nonpharmacologic Pain Treatment Coverage Draft Report to the Legislature. Our comment points out key areas for reconsideration, improvement and clarification in the report regarding chiropractic care, including system-wide fiscal savings offered by chiropractic care, the role of chiropractic as an integrated health care profession, and the benefit structure included in the Apple Health coverage. (Read more in the Apple Health public comment here.)
We have been working since November 2018 with the Office of the Insurance Commissioner to address the unfair practice of Kaiser Permanente and their refusal to pay chiropractors for Evaluation and Management (E&M) Services. In July 2019, we learned that Aetna was acting in the same manner. We are continuing to advocate for the chiropractic profession and our patients as the OIC works through the legal documents related to this issue. (Read more in the OIC and Kaiser/Aetna Nonpayment of E&M Services summary here.)
We have researched and are seeking clarification with the Veterans Administration — on behalf of state chiropractors – that doctors can still contract directly with TriWest to treat military veterans rather than going through EmpowerChiro. (Read more in the EmpowerChiro Contracting for Veteran Services letter here.)
Here’s a link to our 2020 Legislative Agenda, which includes issues of critical importance to our profession – some of which are mentioned above. They include:
Regulating Benefit Managers
Correcting Prior Authorization bill regarding “Episode of Care”
Making DC education loan repayment program permanent
Creating chiropractic access for Adult Medicaid recipients
Blocking the MD request to remove prohibition on spinal manipulation
Blocking PT from modifying spinal manipulation endorsement agreement
It’s time to become engaged in protecting your profession and your patients. Resolve after the holidays to engage with members of your state legislative delegation, as they will be considering many of these issues during the upcoming session, which starts Jan. 13, 2020. All chiropractors should plan to attend our annual state Legislative Day, this year on Thursday, Jan. 30. We’ll meet at 8 a.m. in the Capitol Building Rotunda. It’s key that you schedule appointments to meet with your legislators after our 8 a.m. meeting. You can find a list of your legislators at https://app.leg.wa.gov/DistrictFinder/.
Contact the WSCA office at 206-878-6055 to RSVP for Legislative Day and for assistance in making your appointments. A large turnout of doctors in Olympia Jan. 30 is key to showing our strength to legislators who will be deciding these issues on our behalf!
We also need your financial support! If you have contributed recently and/or are a regular contributor to the WSCT, it is appreciated, and it makes a difference. Click hereto make either a one-time or recurring donation. Or you can mail your donation to the WSCT, PO Box 2163, Seattle, WA 98111
Make a one-time contribution of $1000, $500, $250, $100. Or sign up for monthly credit card withdrawals of $100, $50 or $25 monthly.
P.S. It’s critically important that every member of our profession join the WSCA, they work tirelessly and jointly with the WSCT to advocate for Doctors of Chiropractic in Washington State and to move all of our issues forward. You can join online at www.chirohealth.org/page/join_wsca.
— By Dr. Dave Butters
President, Washington State Chiropractic Trust Legislative Director, Washington State Chirorpactic Assocation
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:
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:
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.
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
All Washington State Chiropractors are invited to attend Legislative Day Thursday, Jan. 31, 2019 in Olympia. It’s your opportunity to meet with the legislators who represent you, and to advocate for your profession and your patients.
So we know how many are coming to Olympia Jan. 31, please register in advance at http://bit.ly/2019chiroday.
Also, call or email your legislators as soon as possibleand make your appointments to meet with them on Thursday Jan. 31. You can find your state legislator at this link: http://app.leg.wa.gov/districtfinder. If you would like help setting up meetings with your legislators, contact Shaka Forest at sforest@chirohealth.org or 206-878-6055 and he will help you.
If you cannot attend the Legislative Day on Jan. 31, you can still come any day during the session. Just schedule your time in advance with lobbyist Lori Grassi at LGrassi@chirohealth.org.
The 2019 Washington State Legislative session begins Jan. 14, and we again have our work cut out for us.
Last year we celebrated what we thought were two major legislative wins for Chiropractic: the passage of both Fair Pay (ESB 5518) and Prior Authorization (ESSB 6157) bills. I am sure you are aware by now that some of the insurers have demonstrated a lack of good faith in implementing both the Fair Pay and Prior Authorization legislation.
Over the past couple months, we have been working with our chiropractic friends in the state Legislature to propose new bills to demand the insurers implement the 2018 laws as directed, and as always, we will need your help this session.
Based on Premera’s 2019 fee schedules, we filed complaints with the State Office of the Insurance Commissioner – and every Washington state chiropractor should do the same. You should also be submitting complaints to your state representatives and senators. Find your legislators and their contact information at http://app.leg.wa.gov/districtfinder
Fair Pay: Tell them it is unacceptable that insurers have modified the Resource Based Relative Value Scale (RBRVS) methodology by reducing the conversion factor for spinal manipulation. The conversion factor is the dollar amount assigned to a geographic location multiplied by the relative value unit (RVU) of the specific service (CPT) to determine fair reimbursement for that service. This violates the Legislative intent and a new bill to demand the appropriate methodology will need to be introduced.
Prior Authorization: Tell them that some benefits managers like ASHN and OPTUM have chosen to manipulate the terminology in the Prior Authorization law to get around a patient’s access to the initial 6 visits of their benefits in a new episode of care. Their stories: ASHN isn’t requiring prior authorization, they’re just requiring prior proof of medical necessity if the provider wants to get paid and OPTUM uses a “concurrent process” to determine medical necessity — so it is a game of semantics.
Yes, I’m very frustrated and disappointed too! But It’s not the first time I’ve felt this way. It reminds me of a quote often used by my good friend, the late Dr. Frances “Butch” Corbin: “Life is just one damn thing after another. The only glory is in going on.” Be assured that we are committed to seeing this issue through on behalf of our profession and our patients.
It’s critical that you attend Legislative Day, set this year for Thursday, Jan. 31, 2019 in Olympia. We will meet in the Capitol Rotunda at 8 a.m. It’s your opportunity to meet with the legislators who represent you, and to advocate for your profession and your patients. We are counting on a large chiropractic turnout to ensure that legislators are focused on our issues.
1) So we know how many are coming to Olympia Jan. 31, please register in advance at http://bit.ly/2019chiroday
2) Also, call or email your legislators as soon as possible and make your appointments to meet with them on Thursday Jan. 31. You can find your state legislator at this link: http://app.leg.wa.gov/districtfinder. If you would like help setting up meetings with your legislators, contact Shaka Forest at sforest@chirohealth.org or 206-878-6055 and he will help you.
3) If you cannot attend the Legislative Day on Jan. 31, you can still come any day during the session. Just schedule your time in advance with our lobbyist Lori Grassi at LGrassi@chirohealth.org.
Finally, if you are a regular WSCT contributor, it is appreciated. If you haven’t donated, please click to make either a one-time or recurring donation. You can make a one-time contribution of $1,000, $500, $250, $100 or you can sign up for monthly credit card withdrawals. Or you can mail your donation to WSCT, PO Box 2163, Seattle, WA 98111.
Wishing all the best in 2019!
Dr. Dave Butters, President Washington State Chiropractic Trust
That’s my simple message as we prepare to advocate once again for chiropractic during the 2019 Washington State Legislature.
Yes, we achieved tremendous gains during the 2018 session, including fair pay regarding spinal manipulation (which becomes effective Jan. 1, 2019) and six visits without prior authorization for each new episode of care, new episode = 90 days with no treatment for same condition (in effect since June 6, 2018).
Now, in this critical mid-term election year we must support those state legislators who supported us. To complete our contribution objectives we need to raise an additional $30,000 between now and the general election. Our legislative strength and effectiveness depends on this!
Our main priority for the 2019 legislative session, as outlined by the WSCA Board of Directors, is to emphasize drugless services to combat the opioid crisis: This proposed legislation is modeled after legislation that passed in West Virginia this year. This bill is intended to do three things:
1) Require health plans to increase their visit limits to 20 for drugless services such as chiropractic, acupuncture, physical therapy, massage therapy and occupational therapy.
2) Require the copay for these drugless services to be the same as Primary Care services.
3) Require patients who seek opioid services/prescriptions to first visit for a trial of care at least one of the named drugless providers prior to receiving an opioid prescription.
We have expended enormous political capital to achieve our latest legislative wins, and much will be expected of us. I can’t stress enough how important it is to donate to the Trust, to help elect those who support chiropractic. Your donations ensure that we have access to legislators who are in a position to help our profession and our patients.
If you have contributed recently and/or are a regular contributor to the WSCT, it is appreciated and makes a difference. If you haven’t contributed, I urge you to do so today. Just click on the DONATE button.
Make a one-time contribution of $1,000, $500, $250, or $100, or sign up for monthly credit card withdrawals: $100, $50 or $25.
— By Dr. Dave Butters, President Washington State Chiropractic Trust
In my last letter, I shared information about the historic legislative achievements in 2018 for the Washington State Chiropractic Association, the Washington State Chiropractic Trust and chiropractic as a whole, including passage of chiropractic Fair Pay and Prior Authorization bills.
Now, we must work to support those state legislators who supported us. This is a critical mid-term election year and all of us must work together to re-elect our supporters – those willing to fight for our issues.
You have probably received communications from the WSCA regarding hosted meetings in various legislative districts around the state explaining the passage and implementation of the Fair Pay and Prior Authorization bills for which 2 hours of CE is offered at no cost. There is a component of the meetings where legislators from the district are invited to attend. Maybe you have already attended one of these meetings. We still need chiropractors to host more of these meetings inviting the chiropractors and the legislators from your area to attend. Our lobbyist, Lori Grassi, speaks at the meeting and will help you to set it up, and to invite the chiropractors and the legislators. Contact Lori at 206-878-6055 or by email lgrassi@chirohealth.org.
While we did accomplish amazing legislative gains this year, there’s always more work to do. Here are the priorities for the 2019 legislative session, as outlined by the WSCA Board of Directors:
Emphasizing drugless services to combat the opioid crisis: This proposed legislation is modeled after legislation that passed in West Virginia this year. This bill is intended to do three things: 1) Require health plans to increase their visit limits to 20 for drugless services such as chiropractic, acupuncture, physical therapy, massage therapy and occupational therapy. 2) Require the copay for these drugless services to be the same as Primary Care services. 3) Require patients who seek opioid services/prescriptions to first visit for a trial of care at least one of the named drugless providers prior to receiving an opioid prescription.
Regulating benefits managers: Benefits managers like ASH, eviCore and others are hired by insurers to implement some, or all, of the following services; prior authorization, clinical review, billing, network creation and management. We are working to introduce legislation that would require them to be licensed by the Office of the Insurance Commissioner. This legislation would also include provisions that would require disclosure of the agreements between the benefits managing company and the insurer, exposing financial incentives to blocking access to care.
Ensuring chiropractors receive Primary Care Status: Chiropractors are the only physician-level providers who are not statutorily defined as primary care. Our message to legislators is that a primary care provider’s job is to triage, treat and/or make appropriate referrals, working within their scope of practice. Legislators are not knowledgeable about and do not understand the chiropractic education, we need doctors to help educate them about our training which includes differential diagnose and our practice of triaging our patients and referring to other providers for conditions outside of the chiropractic scope. The most common presenting complaints to a primary care provider’s office are musculoskeletal in nature and physicians routinely prescribe a muscle relaxer and/or an opioid We are always monitoring other legislation and opportunities for new ideas to present themselves We may not achieve legislative wins every year but it is important to remember that over the past many decades the chiropractic profession in Washington State has not endured losses of previous accomplishments. Year after year we have defended and protected against legislative attempts to undermine patient access to our services, especially yearly attempts to erode or eliminate the Every Category of Provider law, which requires that all plans sold in Washington State provide chiropractic benefits.
We have expended enormous political capital to achieve our latest legislative wins, and much will be expected of us. I can’t stress enough how important it is to donate to the Trust, to help elect those who support chiropractic.
If you have contributed recently and/or are a regular contributor to the WSCT, it is appreciated and makes a difference. If you haven’t contributed, I urge you to do so today. Just click here to make either a one-time or recurring donation.
Make a one-time contribution: $1000, $500, $250, $100
Sign up for monthly credit card withdrawals: $100, $50, $25 Monthly
P.S. Regarding the new Prior Authorization Bill, we have heard that some doctors are having trouble with coverage under specific health plans. To help the WSCA track this issue, ask your patient to request from their employer or their insurance company the “Summary Plan Description.” Then scan and email the following information to us: The name of the employer purchasing the plan, the plan name (or number) and the group name (or number). Email to wsca@chirohealth.org — put “Summary Plan Description” in the subject line
— Dr. David Butters, President Washington State Chiropractic Trust
