What bills passed in the last legislative session, and how you can help now for next year

Dr. Dave Butters

We introduced a bill in the 2023 legislative session to require health care insurers to provide cost-of-living increases. It included all health care providers who are not employed by a hospital or an affiliate of a hospital and would require annual reimbursement increases based on the consumer price index.

It’s important to remember that nearly every bill introduced in the legislature requires more than one year to pass. Two or three years of educating legislators and building support is routinely required. Success depends on hard work not just during the session but also in the interim between sessions – which is now.

I understand that many believe this is too little too late; our reimbursement for spinal adjustment has been stagnant for years. We need to start somewhere. This is a way we can shine light on the issue and apply pressure on the insurers. The federal antitrust laws have made this issue very difficult.

Here’s part of the bill language:

For private health plans issued or renewed on or after January 1, 2025, compensation provisions in a provider contract between a health care provider not employed by a hospital or any affiliate of a hospital and a health carrier for health care services to enrollees of such private health plans must include an increase in compensation from the prior year for health care services that reflects increases in the consumer price index for all urban consumers over the previous year.

How can you help ensure this bill is passed? Here’s the Legislative Plan of Action we’ve designed for Washington State chiropractors:

First, we will identify one doctor who will serve as the contact for each of the 49 legislative districts. That person will agree to activate as many chiropractors as possible to visit with their legislator between now and Aug. 31, 2023. These actions can be as simple as inviting them for coffee, offering a tour of your clinic, or attending a campaign event. Every House member will be up for election in 2024, along with half of the Senate. When you meet with your legislator this summer, it cannot hurt for you to contribute to their election! This is not about party preference; it is about which lawmakers, republican or democrat support our profession and our patients.

If you are willing to be a contact for your legislative district, email our lobbyist Lori Grassi today at WSCA@Chirohealth.org and put “Legislative Contact” in the subject line.If you need guidance on your legislative district for your home, or office, you can go to the DistrictFinder website and search both your home (where you vote) and office addresses. In some cases, they will be the same.

Second, we will identify other health professionals who are not working as a hospital employee or affiliated with a hospital, such as physical therapists, massage therapists, behavioral health providers and optometrists, to name a few examples. Invite them to join you in meeting with your legislators. Stick to the subject of the provider fee schedule issue that you can all agree on and inform legislators that the contracts you are given are not negotiated; make it clear that they are “take-it-or-leave-it” contracts.

Third, you should schedule a second meeting with the same legislators between September and December to confirm their support of the bill and ask if they have any questions. Refer them to HB 1655 from the 2023 legislative session and report back to Lori regarding their opinion on the bill. (Lori can be reached at WSCA@Chirohealth.org.)

If you need assistance with a meeting, contact Lori at the same email address and put “Legislative Meeting” in the subject line. She will respond with guidance or attend a meeting with you.

Other bills impacting the chiropractic profession did pass during the 2023 Legislative Session:

HB 1082 is the bill that allows physical therapists and occupational therapists to incorporate into a business structure with other health care providers, such as chiropractors. Keep in mind that you still cannot supervise another health profession whose scope of practice is not wholly within your scope.

HB 1197 is legislation specific to adding behavioral health providers as attending providers for injured workers, specifically first responders, and it also places the language designating chiropractors as attending providers, into statute rather than in rule.

HB 1357 This bill modernizes the prior authorization process for services outside of the initial six visits for chiropractors. It does not change the language allowing for the initial six visits without prior authorization requirements for drugless services offered by several health professions, including chiropractors.

SB 5066 This bill doesn’t sound interesting, but mechanically it will be useful behind the scenes, requiring both insurers and benefit managers (eviCore, Tivity, Optum etc.) to file their contracts between each other with the Office of the Insurance Commissioner. This will allow OIC to be able to see the contracts and identify if there are inappropriate incentives being offered to benefit managers for blocking access to contracted care in patient policies.

State Budget  The legislature delayed access to chiropractors for adult Medicaid recipients until January 1, 2025, when it had been scheduled for 2024. The state legislature also allowed for chiropractors to be eligible to compete for loan repayment again, but only for the 2023-2025 biennium. However, the candidate must be able to treat a volume of Medicaid patients for eligibility, and with the delayed implementation it makes the loan repayment almost a moot point. We will work to reconcile both efforts and make loan repayment eligibility permanent.

As you consider the bill for cost-of-living adjustment to fee schedules along with other major legislative goals, such as DOT and sports physicals, animal adjusting, and other legislative efforts, you must weigh that effort with the engagement of the profession. If you don’t show up and contribute, your message is not heard and we are limited in our ability to accomplish our goals for the profession, and for patient access to your care.

It’s critical that you donate to the Trust now. If you have donated recently and/or are a regular contributor to the WSCT, it is appreciated, and it makes a difference. Click here to make either a one-time or recurring donation.

— Dr. Dave Butters, President
Washington State Chiropractic Trust