Chiropractors lose appeal in battle with insurers

2013-04-22T00:00:00Z Chiropractors lose appeal in battle with insurersHoward Fischer Capitol Media Services Arizona Daily Star
April 22, 2013 12:00 am  • 

PHOENIX - State judges won't intercede in chiropractors' fight with insurance companies.

The Court of Appeals has thrown out a request by two chiropractors and one of their patients to force state Insurance Director Germaine Marks to discipline Blue Cross for what they said are violations of anti-discrimination statutes.

In their unanimous ruling, the judges did not address whether the allegations are true.

Instead, they simply ruled that Marks has discretion in how she enforces the law. And they said that means no court can tell her what to do.

Chiropractors have been engaged in a multidecade battle with insurers, contending that they are entitled to be reimbursed for their services just like any other health-care professionals. Insurance companies have fought these mandates, arguing that they drive up costs.

The chiropractors have won some victories over the years. They include the law at issue here. It says insurers can apply deductibles, cost-containment measures and limiting coverage to preferred provider organizations but only "if they are equally applied to all types of physicians referred to in this section."

In their legal complaint, chiropractors Thomas Blankenbaker and Shawn Wherry said Blue Cross treated chiropractic patients differently from other medical professions. This included different copayments, authorizations for treatment, limitations on treatments and exclusions.

But the lawsuit was not against Blue Cross. Instead they said the insurance director had refused to stop the insurer from discriminatory conduct and wanted a court to order her to enforce the law.

When a trial judge dismissed the case, they appealed.

Arizona law does allow for a "mandamus" action. It is a court order to compel a public officer to perform an act that the law specifically imposes as a duty.

But Judge John Gemmill, writing for the appellate court, said this is not absolute.

"Mandamus is not available unless the public officer is specifically required by law to perform the act," he wrote.

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