ACS Asked Legislature in 2008 to Reduce Chiropractic Copays and Deductibles from Specialist to PCP Levels

In January 2008, at the request of ACS, the Arizona Legislature considered a bill to reduce copays, coinsurance and deductibles for chiropractic care from specialist to primary care physician (PCP) levels. ACS lobbyist and former state representative Debra Brimhall Pearson met with legislators full-time for months in advance to prepare. In addition, Dr. Immerman and many ACS members met with legislators. Here is the link to the bill, SB 1152 as originally introduced.

Copays are now often as high as $55 for specialists of which DCs are now illegitimately considered one, while copays for PCPs are usually $20. Deductibles for DCs can be $500-$1500 versus $0 for a PCP.  Patients are driven by finances to choose PCPs and not DCs.

Such discrimination is unlawful based on the insurance equality laws passed by ACS and its ancestor organizations in 1990-1991 (see Therefore, ACS is also working to gain proper enforcement of existing law

On 10/24/07, a stakeholders’ meeting was held by House Health Committee Chair Bob Stump. Attendees included Senator Gray, ACS, AAC, and BCBS representatives. BCBS announced that it would lower $60-$70 copays to $55, open up the PPO network to all DCs (which would subject all claims to the copay as compared to non-PPO claims where no copay applies), and no longer call DCs specialists. ACS rejected the $55 copay as clearly far too high and grossly discriminatory. ACS stated it would be moving forward with legislation to require full parity with PCPs.

AAC refused to join ACS in the legislation and thanked BCBS for its show of good faith with the new $55 copay. AAC stated that this amount of incremental gain is acceptable with the hope that future negotiations in years ahead may provide further relief.

Twenty-five BCBS of AZ executives and employees gave campaign contributions to Rep. Stump from 10/17/07 to 10/30/07, apparently at a fundraiser at Nixon's Restaurant in late October. This was a few days after the stakeholders' meeting on 10/24/07. Attendees at the fundraiser included the BCBS CEO, the President, and a former state insurance commissioner who is now BCBS' lead lobbyist. The total raised was over $2800. The report containing the details was filed 1/31/08 with the Arizona Secretary of State and is posted here.

Shortly after the stakeholders' meeting and the fundraiser, one of the attendees at both functions, BCBS lobbyist Chuck Bassett, wrote a damning ten page letter stating that all chiropractic care is merely "feel-good" care that is "not medically necessary" and should not be covered by insurance. He further wrote that BCBS of AZ is not interested in the findings of peer-reviewed scientific studies regarding the clinical or cost effectiveness of chiropractic. His official BCBS anti-chiropractic letter is posted here.

ACS member Nels Larson, D.C., stated in an email to the AAC: “My income has gone down almost100K THIS YEAR! Guess why? A great majority was from BCBS. While you sit and ‘negotiate’, all of the doctors I know are going broke. This is not good. So far I'm not sure whose side you are on.”

On January 3, 2008, AAC President Rich Guarino, D.C. sent an email to all members stating that the AAC would not be supporting any insurance legislation in 2008. Read the email "AAC Plain Talk" here. ACS was left to carry the bill alone.