March 21, 1983
Subject:
Chiropractors; G.S. 90-157.1; Applicability to exclusion of chiropractic services from a selfinsured employee health insurance plan.
Requested By:
J. Hoyte Stultz, Jr., Attorney for N.C. State Board of Chiropractic Examiners
Question:
Is G.S. 90-157.1 applicable to a self-insured employee health insurance plan operated by a county hospital?
Conclusion:
Yes.
A county hospital provided its employees with insurance coverage through Blue Cross-Blue Shield until it became self insured. Chiropractic services were covered under the former plan but are not covered under the current plan.
G.S. 90-157.1 provides:
"No agency of the State, county or municipality, nor any commission or clinic, nor any board administering relief, social security, health insurance or health service under the laws of the State of North Carolina shall deny to the recipients or beneficiaries of their aid or services the freedom to choose a duly licensed chiropractor as the provider of care or services which are within the scope of practice of the profession of chiropractic as defined in this Chapter."
In order to determine the applicability of this section to the self-insured health insurance plan, the first inquiry is whether the hospital is an agency of the county. Citing the recent Court of Appeals’ opinion in The News and Observer Publishing Company, a Corporation v. Wake County Hospital Inc., 55 N.C. App. 1, 284 S.E.2d 542 (1981), counsel for the hospital acknowledged that the hospital is an agency of the county. The next inquiry is whether the exclusion of chiropractic services from the plan for hospital employees constitutes a denial by the hospital to recipients or beneficiaries of the hospital’s aid or services the freedom to choose a chiropractor. Although there are no judicial opinions construing G.S. 90-157.1, it is the opinion of this Office that the statute encompasses employee health insurance plans. The stated purpose of the statute is to guarantee the freedom to choose qualified chiropractors. The phrase "recipients or beneficiaries of their aid or services" appears broad enough to guarantee that right to persons whose employee benefits include health insurance. Lastly, the statute limits the right to the receipt of "care or services which are within the scope of practice of the profession of chiropractic" as defined in G.S. Chapter 90. Therefore, if the insurance plan covers services which are within the scope of practice of chiropractors as defined by State law, then payment for the services may not be denied because the services are rendered by the chiropractor.
RUFUS L. EDMISTEN Attorney General
Robert R. Reilly Assistant Attorney General