Editor's Note: The following is excerpted from a longer article by Dr. Sherry McAllister, executive vice president of the Foundation for Chiropractic Progress, set to appear in our next issue. That article also mentions recent Oregon legislation initially reported on in this issue.

Prior Authorization and Fair Pay in Wash.

In Washington, ESSB 6157 – Prior Authorization, and ESB 5518 – Fair Pay, validate the growing demand for chiropractic care among consumers. Under the Prior Authorization bill, a patient is allowed up to six consecutive visits of chiropractic care in a new episode of care – defined as a new or recurrent condition the patient has not been treated for in the previous 90 days – without prior authorization.

The Fair Pay bill give insurers the option to:

• Match the pay of DCs up to what they pay other providers for spinal manipulation;
• Reduce the payment for other providers down to what they pay DCs for spinal manipulation; or
• Pay DCs the appropriate payment methodology identified by CMS using the Relative Value Unit formula to set fair payments for all.

Reduced Opioids and Increased Access in W.V.

In West Virginia, SB 273, "Reducing Use of Certain Prescription Drugs," was recently signed into law. The purpose of the bill is to reduce the overuse of opioid prescriptions and create a method to provide other treatment plans. Practitioners treating a patient "for any of the myriad conditions that cause pain" are now required to refer the patient to alternative treatments before prescribing an opioid.

"Senate Bill 273 benefits the chiropractic profession in West Virginia and provides for [DCs] to treat pain while decreasing the amount of prescriptions in our state," said Chad Robinson, executive director of the West Virginia Chiropractic Society.

SB 273 also restricts initial opioid prescriptions for acute pain to four days for ER or urgent care centers; three days for dentists and optometrists; and seven days for other providers. The law also requires insurance companies operating in the state to cover at least 20 visits to alternative therapy providers for treatment of pain. And, patients will be able to seek such treatment without a doctor's referral.