The Arizona Republic REPORTS HERE that "Chiropractors say that changes in payment policies by two major private health-insurance companies [in Arizona] could slash their income, reduce patient visits and even force some practitioners out of business. One industry group has funded a lawsuit against the director of the Arizona Department of Insurance that seeks to force the agency to halt what chiropractors describe as insurers' unfair payment practices and different standards for chiropractors compared with medical and osteopathic physicians."

"Chiropractors, whose numbers and pay have been declining in Arizona, worry that American Specialty Health's scrutiny will limit insurer-paid visits to a handful per year. Consumers who require as many as 25 visits per year may have to pay for most of those visits with their own money, chiropractors say. They also worry that the company will drastically slash their reimbursement rates. Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona Inc. have outsourced management of chiropractic benefits for some customers to a San Diego-based company, American Specialty Health Inc."

"The insurers and American Specialty Health say that customers' insurance policies won't change and that medically necessary visits still will be covered. The dispute is just one example of the tightening financial picture for many health-care practitioners."

"Insurers are seeking to rein in spiraling medical expenses, from scrutinizing doctors' payments to introducing high-deductible plans that make consumers pay more of their health-care bills. Employers, also seeking to beat back rising health costs, are offering less generous benefit plans to employees that may include higher deductibles and co-payments."

Arizona chiropractors worry that scrutiny from companies such as American Specialty Health will create another economic problem for the industry. Some chiropractors have closed shop, and others are asking more customers to pay cash.

"I have never seen a cash-flow crisis like this in my entire career," said Alan Immerman, president of the Arizona Chiropractic Society, which funded the lawsuit against the Department of Insurance's director. "It is just desperate. I can't see how doctors stay in business."

Chiropractors "are fighting back aggressively against the insurers at a time when the profession is already stressed by recession. The number of licensed Arizona chiropractors has dropped more than 4 percent over the past two years, according to the Arizona Board of Chiropractic Examiners. There are 2,288 chiropractors with active licenses; 357 licenses are suspended due to lack of renewal, are inactive, retired or on probation."

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