State Insurance Regulations
Below you will find specific state regulations pertaining to chiropractic coverage. As the insurance industry changes, more and more insurers do business in multiple states. As penetration of different state markets occurs, state insurance regulations are sometimes overlooked. Be sure that the insurers in your state are operating in accordance with the regulations cited below. This information is also invaluable in adding strength to appeals to insurers and departments of insurance. Please review this information and include any pertinent statutes in your appeal. It is also helpful to review the information available from the Federation of Chiropractic Licensing Boards (FCLB) regarding state scopes of practice. Access FCLB's information here.
Please note: This material is provided for informational purposes only. The ACA does not officially endorse or suggest the enactment of any of the laws or regulations provided below. The ACA cannot provide legal advice or interpretations of state laws. If you need legal advice, please consult a qualified attorney.
To access your state's regulations pertaining to insurer recoupments, please click
here.
Alabama
Alaska
Arizona
Arkansas
California
Colorado
- Retroactive Adjustments of Claims
- Prompt Payment of Claims
- Network Adequacy Requirements
Connecticut
Delaware
Florida
Georgia
Illinois
Indiana
- Employing Assistants (IC 25-10-1-13)
- Delineation of individuals who can perform a manipulation (IC 10-1-14)
- Right to communicate treatment options to patient outside of patient's insurance policy (IC 27-8-11-4.5)
- Certifications for claims reviewers (IC 27-8-16-5.2)
- Requirements for claims reviewers (IC 27-8-16-7)
- Requirements for communications of appeals processes (IC 27-8-16-8)
- Prompt Payment of Claims
Iowa
- Requirement for chiropractic coverage
- Prompt Payment of Claims
Kansas
Kentucky
Louisiana
- Requirement for Medicaid Coverage
- Insurance Commissioner Directive Regarding Copayments, Coinsurance, Deductibles and Benefit Limitations
Maine
Maryland
Massachusetts
Minnesota
Mississippi
- Requirements, guidelines, and qualifications for chiropractor doing insurance claims reviews and/or independent examinations
Missouri
Montana
- Standards for utilization review
Nebraska
Nevada
New Hampshire
New Mexico
New York
North Carolina
Ohio
Oklahoma
Rhode Island
South Carolina
- Requirement of insurers to offer chiropractic care
South Dakota
- Health carrier responsibility for utilization review activities
- Copayment or coinsurance amounts for chiropractic services
- Written utilization review program required
- Utilization review criteria
- Requirements for utilization review agents
- Timeframe for utilization review determinations
- Required information for determinations
- Definition of a clean claim
- Time limits for processing clean claims
- Standards for managed care plans
Texas
- Selection of a chiropractor
- Parity (pages 167-169)
Vermont
- Insurer Recoupments
- Chiropractic Services
Washington
West Virginia
Wisconsin