What’s In a Name? Not Much, Says Colo. Federal Court

On March 31 a federal court in Colorado threw out a suit by 80 chiropractors against several national health insurers.  The chiropractors alleged that the insurers violated Colorado law by paying them less than physicians and other health care professionals for the same services.

As the judge saw it, the chiropractors’ sole argument rested on the title of the statutory subsection in question.  The subsection, titled “Reimbursement of Providers,” states that insurers can’t deny reimbursement when a covered service is provided by a licensed professional.  But the court ruled that the point of the subsection is to protect patients by assuring coverage if they choose one profession over another.  That doesn’t mean that insurers must pay the same amount to different professions.  In fact, the very next sentence states, “Nothing … in this article precludes a carrier from setting different fee schedules … for different services performed by different professions….”

The court used a footnote to chide the chiropractors for playing fast and loose with names:  “Plaintiffs refer to [the statute] as the ‘Equal Pay Statute,’ apparently a name of their own choosing.”

The case is Abercrombie v. Aetna Health, 2016 BL 102538 (D. Colo. 2016).

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