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 email@example.com 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