HB 1509 -- Health Insurance for Chiropractic Care

Sponsor:  Portwood

This bill changes the laws regarding health insurance coverage
for chiropractic care.  In its main provisions, the bill:

(1)  Requires every health benefit plan to provide coverage for
chiropractic care delivered by a licensed chiropractor;

(2)  Requires the coverage to allow an enrollee direct access to
a participating chiropractor of the enrollee's choice within the
health carrier's network;

(3)  Requires coverage for initial diagnosis and clinically
appropriate and medically necessary services and supplies.  Up to
26 office visits for chiropractic health care per diagnosed
disorder per plan year are covered;

(4)  Prohibits a health carrier from requiring an enrollee or
chiropractor to provide prior notice or to request prior
authorization as a condition of coverage for the first 26 office
visits for chiropractic health care;

(5)  Allows a health carrier to require the enrollee or
chiropractor to provide prior notice or request prior
authorization as a condition of coverage for chiropractic office
visits in excess of the 26 office visits per diagnosed disorder
per plan year.  The excess office visits which are clinically
appropriate and medically necessary will be covered;

(6)  Requires the coverage to clearly disclose to enrollees the
availability of chiropractic health care benefits and any
limitations or exclusions in coverage;

(7)  Prohibits any health benefit plan from imposing greater
deductibles and co-insurance or establishing different dollar
limits for chiropractic health care than for other out-patient
primary health care; and

(8)  Exempts certain health insurance policies from providing
coverage for chiropractic health care.

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