OFFENSE
Chiropractors as primary care providers within their scope of practice
This is an important issue that is always in front of everything we do. There is a Primary Care Provider shortage in Washington State and chiropractic can help. A PCP needs to be educated in performing a differential diagnosis and have the ability to triage and refer to the appropriate provider if the patient needs are outside of your scope of practice. You can assist in non-drug options to pain management and you can have a direct impact on the volume of musculoskeletal conditions that present, unnecessarily, in a PCP office. We know that the majority of complaints presenting in the MD-PCP office are musculoskeletal and likely receive a prescription for pain. Chiropractors will have a positive effect on changing the direction of opioid use in Washington State, if they are defined as primary care.
DEFENSE Prior Authorization Strategy
One of the most interruptive practices for patients to access benefits has been the use of prior authorization by third party entities on behalf of issuers. The administrative burden to a practice alone has created an extremely adversarial relationship between providers and issuers, as well as associations. The third party companies are not regulated and their agreements with issuers are not transparent, so we don’t know if there are incentives of pay to the third party for interrupting access to patient care. We are continually collecting materials and strategizing (weekly!) different methods of approach to address these concerns. The WSCA played a strong role in a legislative work session in March of this year exposing the practices of, specifically eviCore, in their processes for interrupting patient care. By the time of this publication the WSCA will have held meetings with the leaders of each caucus and held specific meetings in Spokane with Sen. Shelly Short, R-7, who was instrumental in scheduling the work session. The WSCA needs as many members as possible to schedule meetings with their legislators to talk about the financial impacts of this practice on patient access to conservative care that is more effective!
OFFENSE
Remove the Sunset Provision on the CQAC Independent Pilot
In 2013 legislation was passed to allow the Chiropractic Quality Assurance Commission (CQAC) the opportunity to engage in a five- year pilot project to have authority over budget development, spending, and staffing in addition to managing licensing and disciplinary compliance responsibility. The pilot has a report due to the legislature on December 15, 2017, and will conclude June 30, 2018 if the Sunset (deadline date) provision is not repealed by the legislature during the 2018 session. In the years of the project the Commission has reduced the chiropractic licensing and renewal fees three times while continuing to maintain substantial and responsible monetary reserves. The WSCA will strongly support this effort.
DEFENSE Doctor of Medical Science Sunrise
This past legislative session brought a proposal from the Lincoln Memorial University-DeBusk College of Osteopathic Medicine to create a new health profession called “Doctor of Medical Science.” The WSCA opposed the applicant report for several reasons, including that we thought the applicant was self-serving in their creation of a profession for which they were the only educators in the entire country. In addition, the new profession, if passed, included no barrier for what constitutes primary care in order to determine the limits of their actual practice. The final report can be read on the WSCA website or emailed to you by contacting the office.
OFFENSE
Chiropractic fair payment for spinal manipulation services
In 2017 we initiated legislation to require issuers to pay providers within the allowed variance defined by the Resource Based Relative Value Scale (RBRVS). This RVU formula allows for the differences in costs between health professions delivering the same service. Introduced in 2017 and passed from the Senate Health Care Committee, but blocked from obtaining a hearing in the Senate Ways and Means committee. The WSCA will initiate legislation in 2018 to accomplish the same goal. Chiropractors MUST lay the groundwork by meeting with legislators in every single district, for this to be accomplished.
In addition to the agenda that we prepare for, there are as many proposals that we are not prepared for and we must be able to react and respond. Your individual engagement with legislators is the difference between success and failure. Please take the time to meet with your legislators now and plan to attend the 2018 legislative day on Thursday, January 25, 2018.
Plexus
Oct/Nov 2017 11
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