continued...
Both, federal and state laws recognize chiropractic physicians as doctors entitled to parity, but Nevada’s Department of Insurance had not been enforcing the law. Dr. Jason Jaeger went before the DOI in January to explain that Nevada has had a parity law since 1981.
“Nevada’s state laws already say that coverage for treatments by a chiropractic physician must not be limited relative to coverage by any other type of physician. The state and federal laws say that reimbursements for the number of visits that a chiropractor’s patients may have per year should not be less than for any other type of physician. The DOI simply needed to enforce our state laws,” said Jaeger.
The message Dr. Jaeger received from the DOI after his presentation was encouraging, and now Glenn Shippey, Actuarial Analyst for the Nevada Division of Insurance, says Nevada chiropractic doctors will get the support that they need from the Division of Insurance.
“Nevada Revised Statutes mandate reimbursement for treatments by a chiropractor to an amount not less than that for similar treatments by other physicians. The Division of Insurance informed insurance carriers that average reimbursement levels for specific CPT codes submitted by chiropractors that are significantly below the average reimbursement levels for these codes submitted by another provider type would violate NRS,” said Shippey.
According to the website, LawServer, a portion of NRS 689a.049 reads, as follows:
2. The terms of the policy must not limit:
- Coverage for treatments by a chiropractor to a number less than for treatments by other physicians.
- Reimbursement for treatments by a chiropractor to an amount less than that reimbursed for similar treatments by other physicians.
The LawServer summary can be found with linkhttps://www.lawserver.com/law/state/nevada/nrs/nevada_revised_statutes_689a-049
Page 2
Title
Until now, Nevada chiropractic doctors have been reimbursed at twenty to thirty percent of their physician counterparts, who include medical and osteopathic physicians, podiatrists, and dentists.
All states have been slow to enforce the equal reimbursement laws, but recently other states have taken language from the Affordable Care Act to support their demand for insurance reimbursement parity. Oregon adopted and strengthened the ACA’s anti-discrimination language, and in 2015, adopted into law Assembly Bill HB 2468. A portion of SECTION 2 in the summary of the Oregon law reads, as follows:
(2)(a) An insurer may not discriminate with respect to participation under a health benefit plan or coverage under the plan against any health care provider who is acting within the scope of the provider’s license or certification in this state.
The entire summary of Oregon law HB 2468 can be found at https://olis.leg.state.or.us/liz/2015R1/Downloads/MeasureDocument/HB2468/Introduced. An article on the Oregon law can by found with the link https://www.uws.edu/oregon-passes-non-discrimination-bill/
On the Federal level, Iowa’s former senator, Richard “Tom” Harkin, lead the charge to put anti-discrimination law into place in the Affordable Care Act, section 2706a. The law protects chiropractic doctors and other providers from medical and insurance discrimination. The law states:
‘‘(a) PROVIDERS.—A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures." (Emphasis added)
For more information, please contact the Nevada Chiropractic Council, info@nevadachiropractic.org, (702) 518-2188.
