HB 219: "An Act relating to chiropractic health care services provided by a health maintenance organization."
00HOUSE BILL NO. 219 01 "An Act relating to chiropractic health care services provided by a health 02 maintenance organization." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 21.86 is amended by adding a new section to read: 05 Sec. 21.86.065. Chiropractic health care services. (a) An enrollee may use 06 the services of a licensed chiropractor of the enrollee's choosing and may not be 07 required to obtain the prior approval of the enrollee's health maintenance organization, 08 a gatekeeper, or primary care physician. Within 10 days after an enrollee's first visit, 09 a chiropractor shall transmit a report containing the enrollee's primary complaint, 10 related history, examination findings, initial diagnosis, and treatment plan to the 11 enrollee's health maintenance organization. If the enrollee and the enrollee's 12 chiropractor determine that the condition of the enrollee has not improved within 30 13 days after the initial treatment, the chiropractor shall refer the enrollee back to the 14 enrollee's health maintenance organization for examination and possible concurrent
01 care. 02 (b) If the enrollee's chiropractor recommends chiropractic treatment beyond 03 30 days, the chiropractor shall conduct a second examination and transmit the findings 04 to the enrollee's health maintenance organization. The transmitted information must 05 include the enrollee's current status regarding the primary complaint, the progress of 06 a revised treatment plan, and the objectives for continued care. 07 (c) After receiving a 30-day treatment report from a chiropractor under (b) of 08 this section, the enrollee's health maintenance organization may request a review by 09 another chiropractor. The reviewing chiropractor shall conduct a physical examination 10 of the enrollee. The findings of the reviewing chiropractor must be disclosed to the 11 enrollee and the enrollee's chiropractor. Charges for additional chiropractic care 12 recommended by the reviewing chiropractor must be included as covered health care 13 services provided by the health maintenance organization. 14 (d) If the enrollee's treating chiropractor and the reviewing chiropractor 15 determine that the enrollee's condition has stabilized, ongoing preventative or 16 maintenance care is limited to two chiropractic visits a month. If the treating 17 chiropractor and the reviewing chiropractor disagree on the enrollee's continued 18 treatment, the enrollee and the health maintenance organization shall jointly select a 19 third chiropractor to review the enrollee's chiropractic treatment. Selection of a third 20 chiropractor must occur not more than 60 days after the date of the enrollee's initial 21 treatment by the enrollee's treating chiropractor. Until the third chiropractor's opinion 22 is received in writing by the enrollee and the health maintenance organization, the 23 enrollee may receive chiropractic treatment recommended by the treating chiropractor. 24 The opinion of the third chiropractor as to continued chiropractic treatment is binding 25 on the enrollee and the health maintenance organization. This subsection does not 26 apply if a new documented injury or a substantial exacerbation of the enrollee's 27 previous primary complaint occurs.