Consumers deserve the fundamental right to choose the type of health care provider that works best for their personal health needs. Millions of Californians rely on a wide range of health care providers, such as chiropractors, naturopaths, optometrists, audiologists, nurse-midwives, psychologists, acupuncturists and others, aside from traditional physicians.
While our state and nation continue to implement the Affordable Care Act, it is especially important that patients have access to a team of health care professionals who work together to achieve the best outcomes for their patients.
Unfortunately, that is not always the case here in the Golden State. While the Affordable Care Act (ACA) bans discrimination against whole classes of health care providers, health plans and insurance companies commonly limit the types of health care providers allowed to provide services.
For example, our state’s 10,000 doctors of chiropractic – who since 1922 have been educated and licensed by the State of California to serve as portal of entry/primary care providers – are licensed to provide many essential health benefits covered by the ACA. Yet often, chiropractors are denied reimbursement.
For example, a patient who purchased her health plan specifically due to its coverage of chiropractic care was referred to me by her medical group for evaluation of a dislocated rib. After her examination, a treatment request was submitted to her insurer — and was subsequently denied — with the insurer stating that “chiropractic care is not covered.”
Similarly, optometrists who can offer routine vision care, are often prohibited from treating medical eye conditions, such as glaucoma, within their scope of practice.
Other providers around the state report similar experiences, including nurse-midwives at birth centers who have been denied reimbursement for performing services that are supposed to be covered.
Practitioners have been excluded altogether from health care networks in certain instances, and insurance companies have imposed limitations on payment, diagnosis or treatment that are not applied to other providers. Such denials, based solely on providers’ licensure, violate the non-discrimination provisions of the Affordable Care Act.
That is why Assembly Bill 41 by Assemblyman Ed Chau – which writes into California law the “non-discrimination” section of the Affordable Care Act – deserves to be passed by the Legislature in 2015.
AB 41 would prohibit a health insurer from preventing any contracted health care professional from participating in the delivery of services within their scope of practice.
As growing demands for services add stress to an already overburdened health care system, efficient use of numerous health care professions is essential to ensuring access and reining in costs.
Eliminating provider discrimination will lower health care costs, improve quality, increase access and lessen the shortage of providers that will be magnified with the millions of newly insured. Anyone who supports those goals should support AB 41.
Ed’s Note: Jay Shery, DC, Esq. is a Culver-City based chiropractor and member of the California Chiropractic Association.