SB 1319 - This act modifies the law regarding health insurance coverage for chiropractic care. Every health benefit plan must provide coverage for chiropractic care delivered by a licensed chiropractor. The coverage must allow enrollees direct access to a participating chiropractor of their choice within the health carrier's network.
Coverage shall include the initial diagnosis, clinically appropriate and medically necessary services and supplies, and up to twenty-six office visits per year. Health carriers are prohibited from requiring an enrollee or a chiropractor to provide prior notice or authorization as a condition of coverage for the twenty-six visits per year. However, health carriers may require prior notice or authorization for visits in excess of the allowed twenty-six visits per year.
The availability of chiropractic health care benefits must be clearly disclosed to all enrollees. Health benefit plans are prohibited from imposing greater deductibles or establishing different dollar limits for chiropractic health care than for other primary health care. Certain health insurance policies are exempt from providing coverage for chiropractic health care.
This act is identical to HB 1509 (2004).
LORIE TOWE