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Governmental Affairs Department Update


In This Issue
SB 863
SB 924
AB 2109 & SB 951/AB 1453
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 September 4, 2012 


The following is a periodic update from the California Chiropractic Association (CCA) Governmental Affairs Department. CCA is committed to providing members with timely information about its legislative, regulatory and political activities, along with inside information not available anywhere else that could impact your practice. As this is a member benefit; please do not forward this e-mail to a non-CCA member.

SB 863 - Workers' Compensation Reform 

The California legislature adjourned just about midnight on Friday night. The final hours saw frantic activity as lawmakers worked to pass a number of bills including a last minute overhaul of the workers' compensation system. The CCA Governmental Affairs department, CCA Governmental Affairs Committee and CCA's lobbying firm  worked diligently to combat this unfair legislation. CCA also issued a full grassroots attack which resulted in hundreds of calls and letters.


SB 863, introduced less than two weeks ago, was a "gut and amend" bill cobbled together by large self insured employer groups and representatives from the California Labor Federation. 


An informational hearing was held August 28th in the Assembly Insurance committee. Four panels were invited to address the committee, representing the Department of Industrial Relations and Employers, Labor-Management, Applicant's Attorneys and Industrial Physicians and Other Physicians followed by a short period of public comment. The day prior to the hearing the Department of Workers' Compensation released a statement saying that SB 863 would add $300 million dollars in costs to the workers' compensation system. The following morning their chief actuary testified that, due to amendments taken the night before, they now believed there to be a $700 million dollar savings to the system with implementation of this bill. It became clear following questions from the Insurance committee members that the actual affect on costs of SB 863 is unknown. Labor and employer groups called the bill a win for both the injured workers with increases in permanent disability payments and faster access to medical treatment and for employers by keeping premiums down. 


CCA, the California Applicants Attorneys Association and other groups argued that it was not at all certain that injured workers would benefit from the changes and that reforming a complex, multi billion dollar system should be done in a thoughtful, transparent manner with all the stakeholders at the table. For a while that message seemed to resonate with lawmakers and the bill appeared to be dead.


However, on Thursday night the Governor got involved and began calling legislators asking them to vote for the reform package. It is unusual for this Governor to take a position on legislation that has not formally gotten to his desk, but on Friday his office issued a statement supporting the passage of SB 863. It has been circulated that he is hoping for support by business and labor for his tax initiative. The bill was heard late on Friday evening in two policy committees and was voted off the Senate and Assembly floors with only a handful of no votes.


SB 863 makes significant changes to the workers' compensation system:

  • For doctors of chiropractic, SB 863 leaves only one pathway for qualifying to sit for the QME examination and it removes doctors of chiropractic as Primary Treating Physicians after the 24-visit cap.
  • SB 863 supposedly increases the amount paid for permanent disability, however it also alters how disability is determined.
  • SB 863 creates Independent Medical Review (IMR) panels to address utilization review. The reviews will be paper reviews and presumed correct.
  • SB 863 creates Independent Bill Review (IBR) panels. The Official Medical Fee Schedule (OMFS) will now be based upon the Resource-Based Relative Value Scale (RBRVS). Fees paid to Ambulatory Surgical Centers will be reduced.
  • Permanent disability ratings will no longer consider "diminished future earning capacity" and "add-ons" such as sleep disorders and sex disorders and to some degree psychological disorders will no longer be considered.
  • SB 863 assigns a new lien filing fee of $150.00 as well as a $100 lien activation fee on liens filed before January 1, 2013.

These are only a handful of the changes to be implemented with the passage of SB 863. CCA will share more information as soon as possible.  


Thank you to everyone who took the time to make our voices heard. We will continue to be as strong as our

grassroots commitment.


SB 924 - Physical Therapist Direct Access
SB 924, the physical therapistdirect access bill died. This is a big win for our profession.
CCA lobbied hard against this bill. CCA representatives met repeatedly with the authors' offices since SB 924's introduction in January. We were told from the outset that the direct access component of the bill was not on the table for discussion, but that other amendments would be considered.
CCA had tentative agreement on those amendments:
that would have limited the extent to which physical therapists had direct access:
  • limited the extent to which physical therapists had direct access;
  • added doctors of chiropractic as part of the provider group that could sign off on a physical therapist's treatment plan after the direct access timeframe had expired;
  • required the informed consent to be clear about the fact that physical therapists do not have the ability to diagnose;
  • and added chiropractic corporations to those that can employ a physical therapists.
It wasn't until just before the bill was set to be heard in its first policy committee hearing (as you may recall, it was sent straight to a floor vote on the Senate side right after it was introduced at the end of January) that CCA was informed that the California Physical Therapy Association (CPTA) was actually the sponsor of this bill. CPTA refused to take ANY amendments to the bill which was voted out of the Assembly Business and Professions committee.
SB 924 moved to Assembly Appropriations where is got put on "suspense" due to an analysis that brought up potential costs to the state due to direct access within the workers' compensation system. Before the bill got voted out of suspense, amendments were made that made it very clear that physical therapists would not be able to provide a diagnosis and that not all insurance would cover directly accessed treatment without a diagnosis. CPTA vehemently opposed that amendment  and tried everything they could think of to go back to the original language, even to adding in chiropractic corporations as being able to employ physical therapists hoping that making that change would convince CCA to help lobby to get rid of the offending diagnosis language. It did NOT influence CCA to support their bill.
In the end, the bill was not moved any further through the process and died without a vote in the Assembly Rules committee.
This is a BIG WIN for our profession!
Thanks again to all who took the time writing letters and making calls to help us defeat SB 924.

AB 2109 - Immunization Exemption and 

SB 951/AB 1453 - Essential Health Benefits


Finally, AB 2109, the immunization exemption bill, and SB 951/AB 1453, the essential health benefits bills, were already  on the Governor's desk.


CCA remains opposed to these bills and will ask everyone to write letters to the Governor asking for his veto. 


Stay Tuned! CCA will be sending out updated Action Alerts to ask Governor Brown to VETO these measure via email and on Facebook.


Your grassroots efforts DO make a difference - so don't stop now!


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You may also contact Michelle Bancroft at 916-648-2727 x136 or at



Please contact Dr. Kassie Donoghue, CCA Governmental Affairs Director at (916) 648-2727, ext 130 or 


Kenneth Winer, D.C.

Governmental Affairs Department Chair

California Chiropractic Association


2012. California Chiropractic Association. All rights reserved. This informational piece is intended to inform CCA member doctors of chiropractic of governmental affairs-related current developments potentially impacting the chiropractic profession. It is not intended to provide legal advice on the subjects addressed, nor establish a standard of any kind or type. Information is gathered from sources deemed reliable, however, CCA is not responsible for its accuracy.