HCS HB 1509 -- CHIROPRACTIC CARE

SPONSOR:  Luetkemeyer (Portwood)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Financial
Services by a vote of 19 to 0.

This substitute changes the laws regarding health insurance
coverage for chiropractic care.  The substitute requires health
care plans to allow an enrollee direct access to a participating
chiropractor of the enrollee's choice within the plan's network
for at least 26 visits per policy period.  Current law states
that an enrollee may have access to chiropractic care for a total
of 26 visits.  The substitute also prohibits a health care plan
from denying medically necessary and clinically appropriate
chiropractic care for additional diagnostic tests or treatment,
provided the attending chiropractic physician submits
documentation supporting the necessity for additional tests or
continued treatment.

FISCAL NOTE:  No impact on General Revenue Fund in FY 2005, FY
2006, and FY 2007.  Estimated Income on Other State Funds of
$8,000 in FY 2005, $0 in FY 2006, and $0 in FY 2007.

PROPONENTS:  Supporters say that the bill merely clarifies the
intent of a bill enacted last year.  Changing "may have direct
access" to "shall have direct access" should solve the gatekeeper
problem that still exists.  During the past year, every
chiropractor that was not part of the health care plan's network
was denied, and most of the health care plans interpreted the
reference to 26 visits to be the limit on coverage, rather than a
minimum, which was not the intent of the legislation last year.
We need chiropractors to be able to request additional visits
when it is medically necessary.  The average number of visits to
a chiropractor is about eight, so allowing more than 26 when
necessary will not be a financial burden for health care plans.

Testifying for the bill were Representative Portwood; and
Missouri State Chiropractic Association.

OPPONENTS:  Those who oppose the bill say that a law to include
chiropractic care was enacted last year.  There haven't been any
complaints from health care plan members or chiropractors, so
there doesn't seem to be any great need for changes.

Testifying against the bill were Missouri Association of Health
Care Plans; Group Health Plan; and Conventry Healthcare Plans.

Richard Smreker, Senior Legislative Analyst

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:15 am