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Bill on copays may get hearing
Law tainted in Black scandal may rise again
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Published: February 7, 2009
RALEIGH
A state legislator wants to reinstate a law that was repealed two years ago because it was tied to the corruption of Jim Black, the former speaker of the N.C. House now serving five years in prison.
The law, if it's put back on the books, would benefit chiropractors and their patients by preventing insurance companies from charging high copayments for visits to chiropractors.
In 2005, Black slipped the chiropractor provision into the state budget, and it became law without a full hearing in the legislature. Black was later convicted of taking about $30,000 in illegal cash payments from chiropractors.
After his conviction, legislators quickly repealed the tainted law. But this week, Rep. Cullie Tarleton, D-Watauga, introduced a bill that would reinstate it. He said that even though Black's conduct was wrong, the substance of the bill makes for good policy.
"The manner that the idea came about was not appropriate," Tarleton said. "If it's a good idea, it's a good idea, and it ought to be debated on its merits."
Tarleton's bill would require insurers to charge copayments for chiropractic visits no higher than the copayments for visits to primary-care physicians. Typically, insurers might charge patients a $20 copayment for each visit to a primary doctor while charging double that amount for each visit to a specialist, such as a chiropractor. Those copayments can become expensive for chiropractic patients, who often require multiple visits.
"This bill has always been about the patient and their access to chiropractic benefits," said Rod Brown, the president of the N.C. Chiropractic Association and a practicing chiropractor in Summerfield. "It's an access issue."
The state's larger health insurance company, Blue Cross and Blue Shield of North Carolina, opposes the bill.
The company says that in the year after Black inserted the chiropractor provision into the budget, visits to chiropractors increased dramatically and the company's costs for such visits went up by $8 million.
"In these tough economic times, we're trying to hold down the cost of health-care insurance, and it's highly questionable whether this kind of legislation would help," said Lew Borman, a spokesman for Blue Cross.
Tarleton and Brown dispute that, saying that giving people easier access to chiropractors promotes long-term health and decreases the need for surgery and other expensive care.
"I think it saves money because it contributes to this whole idea of wellness," said Tarleton, who has gone to a chiropractor for years.
Borman said that the company prefers that patients first see their primary doctor to get a referral if they need to see a chiropractor or other specialist.
"Blue Cross believes that primary-care doctors are trained to treat a wide range of conditions and coordinate with specialists, and we believe chiropractors are indeed specialists," he said.
A law that mandates lower copayments for chiropractic visits may encourage people to go directly to a chiropractor, rather than visiting their primary doctor for a referral.
Greg Griggs, the executive vice president of the N.C. Academy of Family Physicians, said that it is important for people to visit their primary doctors first. "And the whole idea of the higher copay for specialists is to help do that," Griggs said.
■ James Romoser can be reached at 919-210-6794 or at jromoser@wsjournal.com.
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