Proposed Change: • Limit carrier recovery (“claw-back”) requests to six (6) months.


• Extend to nine (9) months only when a patient has coordinating benefits with more than one carrier.


2. Provider Contracting


Federal anti-trust laws prohibit you from discussing fee schedules with providers outside your own tax ID (i.e., those not in your practice).


Over several sessions, the WSCA has pursued legislation to ensure fair compensation for providers:


• 2023: Introduced a bill (HB 1655) to require carriers to apply a cost-of-living adjustment (COLA) to independent provider fee schedules, based on the Consumer Price Index – Urban (CPI-U).


— We received a hearing in the House Health Care Committee, but the bill didn’t move out of committee.


• 2024: Reintroduced the bill in House Health Care Committee and passed the House Health Care Committee, but did not get a hearing in the fiscal committee due to projected costs.


— Legislators were supportive in concept but hesitated due to carrier claims that premiums would rise substantially for consumers.


• 2025: Introduced HB 1589/SB 6161, requiring carriers to negotiate fee schedules and contract provisions with providers. — The bill passed the House (73–23 bipartisan) but stalled in the Senate, again due to the outrageous claims of a $300 per member, per month increase.


These ongoing efforts started withWSCA’s successful passage of fair payment legislation in 2009 (Evaluation & management and Physical Medicine and Rehabilitation) and again in 2019 (spinal manipulation codes). The myriad statutes and rules demonstrate insurers’ resistance to equitable chiropractic reimbursement as well as other providers. We are not in this alone. When legislators fear the premiums will increase exponentially, there is no political appetite to solve the problem.


Next Steps:


WSCA is exploring a way to shift the argument to a health care policy entity that is directed by the legislature to research and study how insures are contracting with providers now, along with the stagnant pay they offer to independent providers. We will need to request a budget proviso through the Office of the Insurance Commissioner’s regulatory account and are working through the conversations now to secure support for our proposal. This can be a complicated process but we feel we have to try a different approach to accomplishing our goal.


This initiative may begin as a budget proviso funding a state-level policy study.


This bill would allow chiropractors to adjust animals and receive reimbursement for those services.


The Washington State Veterinary Medical Association (WSVMA) has expressed concerns, but discussions continue to minimize opposition and craft a mutually acceptable proposal.


4. Physical Therapists as Attending Providers (L&I)


Currently, physical therapists (PTs) are not recognized as “attending providers” under Labor & Industries (L&I). In 2026, the American Physical Therapy Association – Washington Chapter (APTA-WA) intends to pursue legislation to change that.


The WSCA has raised the issue of reciprocal referrals—chiropractors commonly refer to PTs, but PTs rarely refer to DCs. Ongoing discussions aim to address this imbalance within any proposed legislation.


5. Clean Claim Legislation


WAC 284-83-325, adopted in the 1990s under Commissioner Deborah Senn, requires insurers to promptly process and pay “clean” claims (those submitted with complete, accurate information).


The Washington State Hospital Association (WSHA) plans to introduce legislation moving these provisions from rule into statute, improving enforcement and strengthening provider protections.


The WSCA will support this bill if it includes all providers. 6. Use of the Term “Doctor”


The Washington State Medical Association (WSMA) is expected to propose legislation restricting how non-physician healthcare professionals use the term “doctor.”


Current law already requires that chiropractors identify themselves clearly (e.g., “Dr. Smith, Chiropractor”) to avoid patient confusion. The WSCA will monitor the proposed bill and oppose any unreasonable restrictions.


These are the bills we know about now and will continue to monitor the bills as the introductions are made each day of the legislative session. The budget for the state is going to focus on cuts, not added programs, so I will be working diligently to make sure we are not on the chopping block.


I hope you will plan to attend the legislative day in Olympia on January 29, 2026, at 8am. Make your appointments on your own and let me know if you need assistance during your meetings. There will be people to help with your meetings.


Ple x u s Oct/Nov 20 Ple x u s Nov/Dec 20 2 5 11


3. Animal Chiropractic


The Chiropractic Quality Assurance Commission (CQAC) and the Veterinary Board of Governors (VBOG) formed a Joint Task Force on Animal Chiropractic to develop legislation both professions can support.


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