HCS HB 121 -- INSURANCE COVERAGE FOR CHIROPRACTIC CARE

SPONSOR:  Holand (Portwood)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 11 to 0.

This substitute requires health insurers to provide chiropractic
care as part of basic health care services for covered
conditions.  Health plan enrollees must be able to select their
own chiropractic physician from the provider network without a
referral or prior authorization.  If applicable, the substitute
requires that a referral or prior authorization clause apply
equally to providers in the network.  Health carriers that
utilize gatekeepers may not misinform enrollees of the
availability of chiropractic care.  The substitute also requires
health carriers to apply the same deductibles, co-payments,
co-insurance amounts, fees, benefit limits, practice parameters,
and utilization review to all in-network health care providers.
It also prohibits health carriers from discriminating against any
health care provider or group of providers based on licensure.

FISCAL NOTE:  Estimated Net Income to Insurance Dedicated Fund of
$8,000 in FY 2004, $0 in FY 2005, and $0 in FY 2006.  Estimated
Net Cost to Highway Fund of Unknown in FY 2004, FY 2005, and FY
2006.

PROPONENTS:  Supporters say that in recent years, federal
legislation has required the provision of chiropractic health
care benefits for certain federal employees.  Chiropractic care
is effective and would result in cost savings to patients and
health insurers.

Testifying for the bill were Representative Portwood; and
Missouri State Chiropractors Association.  A written letter of
support was submitted by Missouri Physical Therapy Association.

OPPONENTS:  Those who oppose the bill say that mandating
insurance coverage for chiropractic care will result in increased
health care costs.  The bill would not apply to insurance plans
regulated by the federal government.  The bill does not clearly
define the scope of chiropractic care and contains a direct
access provision which will be costly to implement (these
provisions were revised in the substitute).

Testifying against the bill were Missouri Association of Health
Plans; Group Health Plan; Coventry Health Plan; United Healthcare
of the Midwest; Missouri State Medical Association; and
St. Louis Area Business and Health Coalition.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
Last Updated July 25, 2003 at 10:10 am