Shared by PEICK & ASSOCIATES, P.S. is a law firm located in Bellevue, Washington serving the State of Washington. jpeick@peick-usa.com Thanks to the legislative efforts of Dr. Thomas Campbell, DC, as a state representative to the Washington State Legislature, and prime sponsor of HB 2501, and the lobbying support provided by Lori Bielinski of the Washington State Chiropractic Association, there have been some exciting clarifications to the chiropractic profession's ability to diagnose and treat patients. Through the foregoing efforts, chiropractic doctors should no longer be hobbled by overly restrictive definitions which interfere with patient care or advocacy to managed care plans and other health entities. HB 2501 which has passed the Legislature and been signed by Governor Locke, makes the following clarifications in the definition of chiropractic and its scope of care. The provisions of the bill become effective 90 days after the close of the Legislative session, which should be June 23, 2002. 1. Under the prior law, extremity manipulation was allowed ONLY if complementary or preparatory to a chiropractic spinal adjustment. This restriction limited a chiropractic physician's ability to treat musculoskeletal disorders or articular dysfunctions otherwise within the definition of chiropractic under RCW 18.25.005(1). HB 2501 deletes the inconsistent language limiting extremity adjusting. When HB 2501 becomes effective in late June, 2002, chiropractic physicians can perform extremity adjustments whether or not linked to a chiropractic spinal adjustment. 2. Since prior regulations allow chiropractic physicians to charge for procedures within their scope, then the next logical clarification in HB 2501 was to remove the billing prohibition for extremity adjustments. After the effective date of the bill, chiropractic physicians can now legally bill for extremity adjustments. We anticipate that some health plans may be ignorant of the law change, or resist payments, but the law after the effective date of HB 2501 clearly allows separate billing for the adjustment and it is no longer considered a part of the spinal adjustment. 3. Under the prior law, chiropractic physicians could recommend nutritional supplements, but because the law prohibited recommendation of "medicines of herbal, animal or botanical origin", there could be no linkage between the recommendation and the anticipated effect on resolving a health condition. The foregoing language has been deleted from the statute, so chiropractic physicians may now make the linkage between use of the nutritional supplement and the desired effect on the patient's overall health. HOWEVER, the physician must still be able to justify such linkage and is not immune from claims of misleading or false conduct if nutritional supplements are sold for conditions for which no appropriate healthcare clinical literature can be found in support. These changes, while clarifications, should have a profound impact on the ability of chiropractic physicians to address the healthcare needs of their patients in a more comprehensive manner, and to be reimbursed fairly by managed care and healthcare entities. If you read the definition of chiropractic in RCW 18.25.005(1) and realize the inconsistent restrictions have been removed from subsections (2) and (10) of the prior law, chiropractic is in a much more favorable position to assume its proper role in the healthcare delivery system. We owe a large debt of gratitude to Rep. Thomas Campbell, and to the WSCA, for sponsoring and supporting these clarifications to bring the Washington State chiropractic physician closer to realizing their full healthcare potential and training. PEICK & ASSOCIATES, P.S. is a law firm located in Bellevue, Washington serving the State of Washington. We provide legal services in serious personal injury and wrongful death, healthcare regulatory compliance, fraud and abuse defense, professional discipline defense, practice sales and acquisitions, and provider/ business consulting. Visit our website at <">http://www.peick-usa.com/> www.peick-usa.com; or call us for assistance in the State of Washington at 425-462-0660, or email John Peick at <">mailto:jpeick@peick-usa.com> jpeick@peick-usa.com or Jay Rodne at jrodne@peick-usa.com