INSURANCE UPDATE


Lori Grassi WSCA Executive of Legislation and Policy


On July 29, 2025, the Washington State Chiropractic Association (WSCA) notified members of an important request for public comment from the Office of the Insurance Commissioner (OIC). The request relates to proposed clarifications and updates in Rule 2025-05 (pre-publication draft), which would address minimal standards for personal injury claims handling by property and casualty insurers.


This issue is particularly critical to chiropractors because insurers have increasingly relied on databases and survey tools—such as Fair Health and other benchmarking systems—to arbitrarily reduce provider payments. These reductions are often made without a reasonable investigation into the necessity, appropriateness, or cost-effectiveness of the care actually delivered.


As many of you know, such practices create significant barriers to reimbursement, undermine the value of chiropractic services, and ultimately harm patients by restricting their access to care.


The OIC is now inviting public comment on whether its rules should explicitly prohibit insurers from denying or reducing claims without first conducting a reasonable investigation. This would be a crucial step in holding insurers accountable and ensuring fair treatment for both providers and patients.


Why Your Voice Matters


• Chiropractic care saves costs: Studies consistently show that chiropractic treatment can reduce overall health care spending by lowering unnecessary imaging, prescription drug use, and invasive procedures.


• Unfair denials harm patients: When insurers rely on arbitrary databases to cut claims, it places patients at risk of losing access to effective, non-invasive care.


• Public comment influences policy: The OIC relies on feedback from providers and stakeholders when finalizing rule language. Without strong provider input, insurers’ perspectives will dominate the conversation.


Action By Chiropractors


• By submitting a comment to share your experience with arbitrary claim reductions, and emphasizing the importance of reasonable investigations, you help the OIC understand what insurers are doing in real-life claims.


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• Highlighting how this practice impacts real-world delays or denials that affected patient care is powerful evidence for policy change.


• Supporting these proposed protections encourages the OIC to adopt language ensuring that insurers cannot deny or reduce claims solely based on database benchmarks.


The WSCA also submitted formal comments on behalf of our members, but individual voices are equally important. Regulators need to hear directly from practicing chiropractors and their patients about the impact of these insurer practices for the agency to move ahead with rules.


The public comment period closed on August 8, 2025, and we are proud to report that a great number of providers submitted comments. Your voices emphasized the need to prohibit insurers from denying or reducing claims without first conducting a reasonable investigation. Many of you shared data, professional insight, and patient stories that clearly showed how current insurer practices harm both providers and patients.


What Happens Next


We are now waiting for the OIC to decide whether it will move forward with a proposed rule. If it does, there will be a formal rule-making process that includes another opportunity for public input before adoption.


Thank You for Taking Action


The WSCA extends sincere thanks to all who submitted comments. Your participation demonstrated the strength and unity of the chiropractic profession in Washington. By standing together, we increase the likelihood of fairer claims handling standards that protect both providers and the patients we serve.


We will keep members informed as soon as the OIC announces its next steps.


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