Chiropractic Ass'n v. State

595 So. 2d 316, 1991 WL 255239
CourtLouisiana Court of Appeal
DecidedNovember 22, 1991
Docket90 CA 1514
StatusPublished
Cited by3 cases

This text of 595 So. 2d 316 (Chiropractic Ass'n v. State) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chiropractic Ass'n v. State, 595 So. 2d 316, 1991 WL 255239 (La. Ct. App. 1991).

Opinion

595 So.2d 316 (1991)

CHIROPRACTIC ASSOCIATION OF LOUISIANA, et al.
v.
STATE of Louisiana, through the BOARD OF TRUSTEES OF the STATE EMPLOYEES GROUP BENEFITS PROGRAM.

No. 90 CA 1514.

Court of Appeal of Louisiana, First Circuit.

November 22, 1991.
Rehearing Denied March 13, 1992.

John R. Martzell, Jane Booth, New Orleans, for plaintiff-appellee Chiropractic Ass'n of La.

Thomas D. Benoit, Baton Rouge, for defendant-appellant Bd. of Trustees, State Employees Group Benefits Program.

Before SHORTESS, SAVOIE, and CRAIN, JJ.

SHORTESS, Judge.

On September 6, 1984, the Chiropractic Association of Louisiana (plaintiff)[1] filed a Petition for Declaratory Judgment and Injunctive Relief and named as defendants the State of Louisiana, through the Board of Trustees of the State Employees Group Benefits Program (Board). The suit focused on the adoption by the Board of Trustees of a state health benefits program (the plan) which allegedly discriminated against persons utilizing the services of chiropractors in Louisiana and against licensed Louisiana chiropractors.

After a trial on the merits, the trial court rendered judgment in favor of plaintiff and issued an injunction permanently enjoining defendant from restricting payment of claims for chiropractic services on the basis of Article 3, Paragraph G, Subsection 24 (Paragraph G) of the plan which provides that:

Outpatient treatment in connection with the detection or correction by manual or mechanical means of structural imbalance, distortion or subluxation in the human body for purposes of removing nerve interference when such interference is a result of or related to distortion, misalignment, or subluxation of or in the vertebral column, with the following limitations: The Program will pay 80 percent of eligible charges incurred, said charges not to exceed $100 for any Covered Person per calendar month.

The trial court found the plan by its terms and in its administration violated LSA-R.S. 22:668, R.S. 42:851.2, and R.S. 40:1299.65. *317 Moreover, the trial court found that certain in-house rules adopted to administer the plan were not promulgated in accordance with LSA-R.S. 49:951(6) of the Louisiana Administrative Procedures Act.

Defendant timely appealed, assigning as error the following:

1. The District Court erred in overruling defendant's objections and allowing plaintiffs to adduce testimony and introduce evidence irrelevant to an[d] beyond the scope of the issues for trial.
2. The District Court erred in finding Article 3, Section I(G)(24) of the State Employees Group Benefits Plan discriminatory by its terms and administered in violation of La.R.S. 22:668, 42:851.2, and 40:1299.65.
3. The District Court erred in finding that the State Employees Group Benefits Program has been administered without its rules being properly promulgated in accordance with the Administrative Procedures Act.

ANALYSIS

Since 1974 when chiropractic became a legitimate health care profession in Louisiana, the legislature has enacted several statutes mandating equal treatment for chiropractors.

In 1975, the legislature passed LSA-R.S. 22:668, which provides as follows:

Notwithstanding any provision of any policy or contract of insurance or health benefits issued after the effective date of this Act, whenever such policy or contract provides for payment or reimbursement for any service, and such service may be legally performed by a chiropractor licensed in this state, such payment or reimbursement under such policy or contract shall not be denied when such service is rendered by a person so licensed. Terminology in such policy or contract deemed discriminatory against any such person or method of practice shall be void. The provisions of this Section shall apply to all new policies issued on or after November 1, 1975. Any insurer who, on August 1, 1975, has health and accident policies in force shall, upon the anniversary date of such policies convert all existing policies to conform to the provisions of this Section; provided, however, that all existing policies shall be converted to conform to the provisions of this Section by August 1, 1976.

The statute was amended in 1984 to add Subsection B, which includes the "State of Louisiana" within its terms. LSA-R.S. 22:668, as amended by Acts 1984, No. 680, § 1, provides:

A. (1) Notwithstanding any provision of any policy or contract of insurance or health benefits issued after the effective date of this Section, whenever such policy or contract provides for payment or reimbursement for any service, and such service may be legally performed by a chiropractor licensed in this state, such payment or reimbursement under such policy or contract shall not be denied when such service is rendered by a person so licensed. Terminology in such policy or contract deemed discriminatory against any such person or method of practice shall be void.
(2) The provisions of this Section shall apply to all new policies issued on or after November 1, 1975. Any insurer who, on August 1, 1975, has health and accident policies in force shall, upon the anniversary date of such policies, convert all existing policies to conform to the provisions of this Section; provided, however, that all existing policies shall be converted to conform to the provisions of this Section by August 1, 1976.
B. Any person, partnership, corporation, or other organization or the state of Louisiana which provides or contracts to provide health and accident benefit coverage as a self-insurer for his or its employees, stockholders, or other persons shall be subject to the provisions of this Section. This Section shall not apply to collectively bargained union welfare plans, other than health and accident plans.
C. The provisions of this Subsection shall apply to all new policies issued on or after December 1, 1984. Any insurer *318 who on December 1, 1984, has health and accident policies in force shall convert upon the anniversary date of such policies all existing policies to conform to the provisions of Subsection B of this Section. All existing policies shall be converted to conform to the provisions of Subsection B of this Section no later than December 1, 1985.

(Footnote deleted.)

In 1977, the Legislature enacted LSA-R.S. 40:1299.65. The purpose of the statute is to ensure "freedom of choice" regarding chiropractic care:

No agency of the state, parish or municipality, under the laws of the state of Louisiana, 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 R.S. 37:2801(3).

On July 2, 1984 (the day after the passage of the disputed portion of the plan), then-Governor Edwin Edwards, approved the passage of LSA-R.S. 42:851.2:

Notwithstanding any provision of law or any rule or regulation to the contrary, the Board of Trustees of the State Employees Group Benefits Program shall provide its eligible benefits as defined by the program for services which are rendered within the lawful scope of practice of a duly licensed chiropractor as defined in R.S. 37:2801.

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595 So. 2d 316, 1991 WL 255239, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chiropractic-assn-v-state-lactapp-1991.