Larry Green Chevrolet

Home | Classifieds | Place Ad | Public Notices | Galleries | Kudos | Obits | Real Estate | Subscriber Services | Villager | Amazing Grapes | Yellow Pages | Contact Us
The Verde Independent | Cottonwood, Arizona

home : latest news : latest news September 14, 2014

4/23/2013 7:46:00 AM
Chiropractors lose legal battle with insurance companies

Howard Fischer
Capitol Media Services

PHOENIX -- State judges won't intercede in the fight by chiropractors 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 that, they said means no court can tell her what to do.

Chiropractors have been engaged in a multi-decade 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. That includes the law at issue here.

It says that 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 Thomas Blankenbaker and Shawn Wherry, both chiropractors, said Blue Cross treated chiropractic patient different than 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 what is called a "mandamus' action. It is a court order to compel a public officer to perform an act which 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.

In essence, Gemmill said, courts can step in when a public official refuses to perform a "ministerial' act. That is generally defined as one where, in a given situation, there is really only one thing that the official can legally do, like a clerk accepting a filing that otherwise meets the legal requirements.

In this case, Gemmill acknowledged that state law says the insurance director "shall enforce the provisions' of the state insurance code. But he said that is not the defining factor.

He pointed out that there are laws which make a police chief responsible for enforcing city codes.

But Gemmill said that does not entitle someone to go to court to force the chief to enforce a specific ordinance. He said the chief has discretion and is allowed to consider everything from lack of resources and conflicting priorities to concerns about the legality or wisdom of enforcing that ordinance.

Gemmill said that same discretion exists here.

"The obligation to enforce these statutes necessarily requires the director to interpret the statutes involved, to assess the circumstances and facts surrounding alleged violations, to determine whether a violation warranting action has in fact occurred, and, if so, to determine what form of enforcement, if any, would be appropriate,' he wrote.

Taylor Waste

    Recently Commented     Most Viewed
UPDATE: Court orders Arizona to recognize California-based gay marriage (7 comments)
Editorial: Education's future on shoulders of next governor (2 comments)
Mingus takes case for override to Clarkdale (4 comments)
Obituary: Edward Green 1931 - 2014 (9 comments)
Letters: Why self control should be a part of family planning (11 comments)

Article Comment Submission Form
Comments are not posted immediately. Submissions must adhere to our Use of Service Terms of Use agreement. The email and phone info you provide will not be visible to the public. Rambling or nonsensical comments may not be posted. Comments are limited to 1700 characters or less. In order for us to reasonably manage this feature we may limit your comment entries to five(5) per day.
Submit an Article Comment
First Name:
Last Name:
Anti-SPAM Passcode Click here to see a new mix of characters.
This is an anti-SPAM device. It is not case sensitive.

Advanced Search

HSE - Pulse Research
HSE - We want to hear from you
Find more about Weather in Cottonwood, AZ
Click for weather forecast

Submission Links
 •  Submit your feedback about our site

Find It Features Blogs Celebrate Submit Extras Other Publications Local Listings
Classifieds | Place Ad | Galleries | Kudos | Real Estate | Subscriber Services | e-News | RSS | Site Map | Find Verde Jobs | Contact Us
Yavapai College - Nursing Career

© Copyright 2014 Western News&Info, Inc.® The Verde Independent is the information source for Cottonwood and Verde Valley area communities in Northern Arizona. Original content may not be reprinted or distributed without the written permission of Western News&Info, Inc.® Verde News Online is a service of WNI. By using the Site, ®, you agree to abide and be bound by the Site's terms of use and Privacy Policy, which prohibit commercial use of any information on the Site. Click here to submit your questions, comments or suggestions. Verde News Online is a proud publication of Western News&Info Inc.® All Rights Reserved.

Software © 1998-2014 1up! Software, All Rights Reserved