Background:
In 1987 the state legislature passed the “Chiropractic Insurance Equality Statute” (Wis. Stat. § 632.87(3)) in the 1987-89 state budget. Prior to this law, insurers could treat chiropractors and chiropractic services differently from physicians and their services. Many insurance companies did not cover diagnosis and treatment of a patient by a chiropractor. This law was an attempt to remedy the situation by requiring that insurance companies treat chiropractors and physicians equally in a series of enumerated areas.
The Wisconsin Chiropractic Association (WCA) reports that its members have experienced a lack of compliance by the insurance industry and a lack of enforcement by the Wisconsin Office of the Commissioner of Insurance. Therefore the WCA has called for a modernization of Wis. Stat. § 632.87(3).
The Chiropractic Insurance Equality Modernization Act of 2015
State Senator Roger Roth (R-Appleton) and Representative Kathleen Bernier (R-Chippewa Falls) have agreed to author WCA’s Chiropractic Insurance Equality Modernization Act of 2015. The bill has yet to be introduced, but the WCA seeks to modernize various definitions in Wis. Stat. § 632.87(3) in order to modernize the language of the law to reflect current practices. However, the WCA also seek substantive changes to the law in order to correct the perceived lack of enforcement and compliance.
To attempt to secure compliance with the Office of the Commissioner of Insurance (OCI) the WCA is seeking to require insurers to submit an annual report to the OCI that demonstrates compliance with the law.
To attempt to stop violations by insurance companies the WCA proposes a new private right of action against insurance companies by parties with standing that do not comply with the law to recover “actual loses” resulting from the violations. Without the bill draft, the WCJC is unable to elaborate on the cause of action further at this time. We will keep you up-to-date as this bill moves forward.
For more information about the proposed bill click here.