Arizona chiropractors on Tuesday accused state regulators of failing to require a major health insurer to provide promised coverage, resulting in inadequate reimbursements that are driving some out of business.

Blue Cross Blue Shield of Arizona's copay requirements are unreasonably high while the Insurance Department is not enforcing a law against discrimination in coverage for chiropractic care, the Arizona Chiropractic Association alleged.

The association called for Gov. Jan Brewer to either fire Insurance Director Christina Urias or make her go after Blue Cross Blue Shield. She was originally appointed by Gov. Janet Napolitano in 2003 to complete the term of a prior director. Urias' six-year term expires in January.

Association president Alan Immerman said Blue Cross Blue Shield puts a $44 limit on payment for a chiropractor visit and requires the patient to pay $40 of that amount. That causes some patients to skip getting treatment and deprives chiropractors of adequate compensation for treatment they do provide, he said.

A Blue Cross Blue Shield manager didn't dispute the specific cost figures cited by Immerman, but said coverage and payment provisions vary according to policies.

Janis Raynak, the insurer's director of litigation services, said Blue Cross Blue Shield covers medically necessary chiropractic services while trying to hold down rising health care costs.

"We believe chiropractors are an important part of care for people,'' Raynak said. ``We're just trying to ensure it's delivered according to the contract and for every policy that we're not paying for things that aren't included.''

Brewer, whose husband is a retired chiropractor, said she wasn't familiar with the association's concerns and could not comment. Insurance department spokeswoman Erin Klug declined comment, citing pending litigation stemming from a lawsuit filed by chiropractors.

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